One thing I’ve noticed in my practice over the years is that in many cases, patients are typically disinclined to talk to their doctor about digestive disorders. Maybe they’re embarrassed to discuss things like reflux or constipation, but they shouldn’t be. Often, treatments can be as simple as making lifestyle changes or taking over-the-counter remedies. Please don’t suffer in silence…if your digestive tract is bothering you or causing you pain, please go see your physician or a gastroenterologist.
So that patients can be more informed about these conditions and recognize if they’re suffering from them, I’ve compiled a list of the five most common digestive problems and what to do about them.
5 most common digestive problems
Afflicting millions of people many times a day, reflux, or heartburn, may indicate that a person has GERD, or gastroesophageal reflux disease. As well as being painful and causing difficulty swallowing, over time GERD can cause damage to esophageal tissues from stomach acid backing up into your esophagus. This can lead to spasm or scarring and narrowing of your lower esophagus, and possibly even esophageal cancer.
Reflux typically involves a hot or burning feeling rising up from the center of the abdomen into the chest, breastbone or sternum. It may be accompanied by a sour taste in the mouth or even the presence of food or fluid in your mouth, particularly at night. Pregnancy, some medications, alcohol and certain foods can cause heartburn.
Treatment options include drugs that reduce acid levels, such as proton pump inhibitors (Aciphex, Nexium, Prevacid, Prilosec and Protonix) and H2 blockers (Axid, Pepcid, Tagamet and Zantac).
In severe cases of GERD, surgeons can use laparoscopic surgery to tighten a loose muscle between the stomach and esophagus to inhibit the upward flow of acid. However, with proper medical therapy and lifestyle modification, this is rarely necessary.
If you have unexplained stomach pain, think twice before reaching for a painkiller. The worst thing to do if ulcers are suspected is to take aspirin or other NSAID [nonsteroidal anti-inflammatory drug] pain reducers—not only will they not help the problem, they’ll make it worse.
Instead, if you think you have a peptic ulcer (25 million living Americans will get one at some point), consider getting tested for Helicobacter pylori, a bacterium that disrupts a protective layer of mucus and causes ulcers, which are sores in the lining of the stomach or small intestine. Other causes include smoking and excessive NSAID use.
Left untreated, ulcers can cause internal bleeding and may eat a hole in the small intestine or stomach wall, which can lead to serious infection. Ulcer scar tissue can also block the digestive tract. And long-term H. pylori infection has been linked to an increased risk of gastric cancer.
To treat an ulcer, 10-14 days of antibiotics, often combined with acid reduction therapy, can rid someone of H. pylori. For more severe cases, surgery may be necessary.
Inflammatory Bowel Disease
People with Crohn’s disease or ulcerative colitis, the two most common inflammatory bowel diseases, most often complain of abdominal pain and diarrhea. They also may experience anemia, rectal bleeding or weight loss. There are both invasive and non-invasive testing that can reveal these diseases such as lab tests with specific markers, imaging studies, colonoscopy with biopsies, and endoscopies. With Crohn’s disease, appendicitis, irritable bowel syndrome, an ulcer or an infection is often wrongly suspected.
Both disorders may arise from an out-of-whack immune system that directs the body to attack the gastrointestinal tract. Crohn’s involves ulcers that may burrow into the tissue lining of the GI tract, leading to infection, thickening of the intestinal wall and blockages that need surgery. Ulcerative colitis afflicts only the colon and rectum, where it also causes ulcers.
Treating either disease requires correcting and then continuously holding in check the inappropriate inflammatory response. This involves a combination of prescription anti-inflammatories, steroids and immunosuppressants. Crohn’s patients may also be given antibiotics or other specialized drugs. Surgery can “cure” ulcerative colitis by removing the colon but this (rather drastic) measure requires patients to wear a pouch—internally or externally—for waste. Medicines in recent years are much more effective for Colitis and Crohn’s then in the past.
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a disorder of the intestines. It causes belly pain, cramping or bloating, and diarrhea or constipation. IBS is a long-term problem, but there are things you can do to reduce your symptoms.
Americans spend $725 million a year on laxatives. However, overuse of stimulant laxatives, which cause the intestines to contract rhythmically, can make the gut dependent on them, requiring more of the drug and eventually rendering it ineffective.
If you are experiencing discomfort and can’t make your bowels move (anywhere between 3 times a day and 3 times a week is normal), try a typical over-the-counter remedy. If you have gone a week without a bowel movement, this is good reason to visit your physician. Constipation, hard stools and straining could lead to hemorrhoids or an anal fissure.
Constipation is best avoided through regular exercise, drinking plenty of water and eating a diet high in fiber, including whole grains, fruits and vegetables. Also, be aware of any medications that might be causing the slowdown.
About 1 percent of the U.S. population has celiac disease, an autoimmune and digestive disorder. Sufferers are unable to eat gluten—a protein found in rye, barley, wheat and other grains. When they do, it triggers an attack on their small intestine. Symptoms include: abdominal pain and bloating, chronic diarrhea, vomiting, constipation and pale, foul-smelling or fatty stool. Celiac disease can be diagnosed with blood tests and stool samples.
There is no cure for celiac disease but people can successfully manage it by sticking to a gluten-free diet. However, accidently eating a product with gluten could cause a flare-up at any time.
Colorectal cancer screening
Where feasible, six states in CDC’s Colorectal Cancer Control Program provide colorectal cancer screening to low-income men and women aged 50–64 years who are underinsured or uninsured for screening, when resources are available and there is no other payment option. Colorectal cancer screening tests may be covered by your health insurance policy without a deductible or co-pay.
If you are experiencing digestive problems, come see us
If your digestive tract is bothering you or causing you pain, please call (914) 232-1919 to make an appointment with one of our Westchester Health gastroenterologist specialists. Whenever, wherever you need us, we’re here for you.