Dr. Amey Sonavane, MBBS, DNB (General Medicine), DNB (Gastroenterology), MRCP (SCE-Gastroenterology), Fellow in Clinical and Transplant Hepatology, is an consultant in the department of Gastroenterology, Hepatology and Liver transplantation at Apollo Hospitals, Navi Mumbai.
Your stomach is an organ between your esophagus and small intestine. It is where digestion of protein begins. The stomach has three tasks. It stores swallowed food. It mixes the food with stomach acids. Then it sends the mixture on to the small intestine.
Most people have a problem with their stomach at one time or another. Indigestion and heartburn are common problems. You can relieve some stomach problems with over-the-counter medicines and lifestyle changes, such as avoiding fatty foods or eating more slowly. Other problems like peptic ulcers or GERD require medical attention.
Into everyone’s life a little digestive distress will occur. Whether it’s a meal that doesn’t agree with us or a lingering gastrointestinal ailment requiring lifestyle changes and treatment, digestive problems are extremely common, afflicting as many as one in five Americans.
Here are six of the most common gastrointestinal problems — and what can be done about them.
Heartburn happens, but if it occurs regularly, you may need to be evaluated for GERD. A medical provider can often diagnose GERD based on a description of symptoms alone, but if the problem has been ongoing for some time, additional diagnostic testing may be necessary to evaluate if the disease has caused damage to the esophagus.
GERD most often presents as heartburn, but uncontrolled GERD can erode the lining of the esophagus and lead to bleeding. The condition can also cause pain in the chest so extreme that it is sometimes mistaken for a heart attack.
Controlling GERD usually begins with simple lifestyle changes, including avoiding food for at least two hours before bedtime. Over-the-counter remedies can also provide some short-term relief for occasional heartburn, but for chronic or serious GERD, a prescription medication or even surgery may be necessary.
Diarrhea: it’s never the topic of polite conversation, but when it happens, it’s impossible to ignore. Occasional urgency to go is normal, but loose stool — often three or more times a day — that lasts for at least four weeks could be cause for concern.
Diarrhea is tricky to treat because it can have so many possible causes. It could be a result of the body’s inability to absorb foods — as with celiac disease and foods containing gluten — or a disease or disorder, like irritable bowel syndrome (IBS), Crohn’s disease or ulcerative colitis. Infections — often viral — and even parasites can also be to blame.
Besides making it difficult to carry on daily living, chronic diarrhea can be an indication of a more serious problem that may need medical intervention and should be evaluated by a medical professional.
At the other end of the spectrum, sometimes it’s the inability to go that troubles us.
Chronic constipation is typically defined as having fewer than three bowel movements a week for three weeks or longer. It may also be the case that stools are hard and difficult to pass.
And like diarrhea, the cause of chronic constipation can be difficult to diagnose. Treating the condition can begin with over-the-counter remedies, such as stool softeners and fiber supplements. Adding more fluids to your diet — namely, water — may help. If those fail to bring relief, a physician may recommend some exercise to strengthen the muscles that move the stool through the bowels.
With symptoms like a fever, vomiting, diarrhea and headaches, it’s no wonder most people call this the stomach flu.
Gastroenteritis is caused by an infection — either viral or bacterial — in the gut. Bacterial infections can be caused by E. coli or salmonella, while viral infections can include rotavirus or that infamous scourge of cruise ships, norovirus. Parasites, too, can cause gastroenteritis.
If the symptoms last for a few days, the best advice is to drink plenty of fluid to avoid dehydration and try to make the best of it. Use good hand hygiene to prevent spreading the infection and, if at all possible, ask others not to use the same bathroom facilities until your symptoms stop and you have a chance to sanitize the facilities. Symptoms lasting more than a few days require further observation, which may include testing for antibodies that could indicate an allergy or signs of infection in the stool that can help a physician prescribe the most effective treatment.
We used to attribute peptic ulcers to lifestyle factors, like stress or diet, but research in recent years indicates that peptic ulcers are most likely caused by either bacteria in the stomach or heavy use of over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen.
The bacteria or NSAIDs can damage the mucus that lines the inside of the stomach, exposing the interior of the stomach to acid which irritates the tissue and causes the peptic ulcer. Essentially a sore on the inside of the stomach, these can be very difficult to resolve because of the constant exposure to stomach acid.
A physician can run tests to determine if the peptic ulcer is caused by an infection (usually H. pylori) and prescribe antibiotics for treatment. A proton pump inhibitor to reduce the acid in the stomach is also often prescribed. Untreated, ulcers can not only cause pain, but may bleed, leading to anemia.
Are you sitting down?
Some three-quarters of individuals age 45 and older experience hemorrhoids. There are several causes for these small, swollen rectal veins, from straining during bowel movements (see chronic constipation, above) to family history to just plain spending too much time sitting on the toilet. They’re also very common during pregnancy.
Hemorrhoids tend to cause pain or itching around the anus. You may notice a hard knot near the anus or even bright red blood in the toilet bowl.
You can try treating hemorrhoids at home. Over-the-counter ointments and cold packs can shrink the inflamed tissue. Soaking in plain, warm water can help make the tissue softer, enabling it to heal.
If these don’t work, consult a physician. He or she can recommend additional treatment, including rubber band ligation, which uses rubber bands to prohibit blood flow to the hemorrhoid, and sclerotherapy, in which a small needle is used to inject medication into the vessels and cause them to shrink.