Irritable Bowel Syndrome (IBS) affects the large intestine and can cause bloating, abdominal cramping and a change in bowel habits. Some patients with IBS have constipation while others have diarrhea. Some people go back and forth between the two. Though IBS is uncomfortable, it does not harm the intestines.
IBS is common and more frequently affects women than men. No one knows the exact cause of IBS, but most people can control symptoms with a change in diet, medicine and stress management.
Acid Reflux, also known as gastroesophageal reflux (GERD) or acid regurgitation, occurs when the lower esophageal sphincter (LES) opens spontaneously or does not close properly, and the contents of the stomach, including digestive juices or acid, rise up into the esophagus. When acid reflux occurs, people may experience indigestion and they may be able to taste food or fluid in the back of the mouth. If acid touches the lining of the esophagus, heartburn can result.
Occasional acid reflux is a very common problem, but those who suffer from reflux more than twice a week may have gastroesophageal reflux disease (GERD), a more serious form of GERD that can lead to serious health problems. GERD symptoms also include dry cough, wheezing or trouble swallowing.
If you think you may have GERD and have used over-the-counter reflux medications for more than two consecutive weeks, consult your physician. GERD treatment may include the following lifestyle changes and medications:
• Lifestyle modifications, such as a healthy diet; exercise; eating small, frequent meals; avoiding foods that worsen symptoms; and raising the head of your bed six to eight inches may help remedy the symptoms of GERD.
• Your physician may also prescribe certain medications to treat GERD, including antacids, foam agents, H2 blockers, proton pump inhibitors and Prokinetics which all work to reduce regurgitation and strengthen the LES to prevent acid reflux.
If lifestyle changes and medications do not help treat your symptoms, your health care provider may suggest an Upper Endoscopy or other procedure to examine your esophagus for abnormalities and surgery may be warranted.
Esophagitis is a general term for any inflammation, irritation or swelling of the esophagus, which is the tube that leads from the back of the mouth to the stomach. It is frequently caused by a backflow of stomach acid to the esophagus. This is commonly called heartburn or GERD (gastroesophageal reflux disease). Irritation may cause the tissues to become inflamed and occasionally form ulcers, and patients may have difficulty swallowing and have a burning sensation in the esophagus. Other symptoms include painful swallowing, heartburn or oral lesions. A stricture occurs when the inflamed area heals with a scar that narrows the esophagus, resulting in trouble swallowing. People who have frequent heartburn, vomit excessively, have had surgery or radiation to the chest or take medications like aspirin, ibuprofen and potassium are at a higher risk of developing strictures.
Benign esophageal stricture is a narrowing of the esophagus that can cause swallowing difficulties. It can be caused by gastroesophageal reflux disease (GERD), certain medications, long-term use of a nasogastric tube that runs from the nose to the stomach, swallowing corrosive substances, or a bacterial or viral infection. Symptoms can include difficult or painful swallowing, unintentional weight loss or food regurgitation.
Barrett’s Esophagus is a condition in which the esophagus, the tube that carries food and saliva from the mouth to the stomach, changes so that some of its lining is replaced by a tissue type similar to that normally found in the intestine. This is called intestinal metaplasia.
This condition may be associated with having heartburn, but it may cause no symptoms on its own. A small percentage of people with the condition develop cancer of the esophagus. Therefore, it is important to be diagnosed with Barrett’s Esophagus so appropriate care can be started. Barrett’s Esophagus is relatively common, particularly in people with frequent heartburn and gastroesophageal reflux disease (GERD).
Helicobacter Pylori (H. pylori) is a type of bacterium that causes inflammation of the stomach, chronic gastritis, and ulcers in the stomach or small intestine. People with H. pylori infections may be more likely to develop cancer in the stomach, including mucosa-associated lymphoid tissue (MALT) lymphoma. The bacteria weakens the protective coating of the stomach and first part of the small intestine, allowing digestive juices to irritate the sensitive lining.
If someone is a carrier of H. pylori, they may have no symptoms. However, if a patient has an ulcer or gastritis, they may experience abdominal pain, indigestion, bloating, mild nausea, belching and regurgitation or feel very hungry one to three hours after eating.
H. pylori is treatable with antibiotics, proton pump inhibitors and histamine H2 blockers. Once the bacteria are completely gone from the body, the chance of its return is low.
Peptic ulcer disease refers to painful sores or ulcers in the lining of the stomach or first part of the small intestine, called the duodenum.
What Causes Ulcers?
No single cause has been found for ulcers. However, it is now clear that an ulcer is the end result of an imbalance between digestive fluids in the stomach and duodenum. Ulcers can be caused by:
Infection with a type of bacteria called Helicobacter pylori (H. pylori)
Use of painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen (Aleve, Anaprox, Naprosyn, and others), ibuprofen (Motrin, Advil, Midol, and others), and many others available by prescription. Even safety-coated aspirin and aspirin in powered form can frequently cause ulcers.
Excess acid production from gastrinomas, tumors of the acid producing cells of the stomach that increases acid output (seen in Zollinger-Ellison syndrome).
Colon cancer forms in the tissues of the colon which is the largest part of the intestine. Rectal cancer forms in the tissues of the rectum which is the last several inches of the large intestine before the anus. Either of these cancers is called colorectal cancer.
In the United States, colon cancer is the second deadliest form of cancer.
Each year about 150,000 people will be diagnosed with colon cancer, and approximately one third of the (50,000) will die from the disease, according to the American Cancer Society.
• Risk Factors
• Warning Signs and Symptoms
• Colon Polyps
• Treatments and Procedures
• Preventing Colon Cancer
• Risk Factors
Though scientists are unsure of exactly what causes colon and colorectal cancer, some risk factors have been identified, including:
• Being over age 50
• Polyps, growths inside the colon and rectum that may become cancerous
• A high-fat diet
• Family or personal history of colon cancer or polyps
• Inflammatory bowel disease (Ulcerative colitis, Crohn’s disease)
• Sedentary lifestyle
• Diabetes
• Obesity
• Smoking
• Alcohol
• Growth hormone disorder
• Radiation therapy for cancer
• Warning signs and symptoms
Many cases of colon or colorectal cancer have no symptoms or warning signs until the cancer has advanced. That being said, the following symptoms may indicate colon cancer. Of course, other conditions can cause the same symptoms, so patients should consult their doctor if they experience any of the following:
• Abdominal pain or tenderness in the lower abdomen
• Bloody stool, either bright red or very dark
• Diarrhea, constipation or other changes in bowel functions
• Intestinal obstruction
• Narrower than normal stools
• Unexplained anemia
• Unexplained weight loss
• Bloating, fullness or cramps
• Vomiting
• Colon Polyps
A colon polyp is a growth of extra tissue in the lining of the bowel, colon or large intestine. While some can be cancerous, most are not. However, almost all colon cancer does begin as a polyp. Therefore, by removing polyps early the chances of it growing into colon cancer are eliminated. People with a higher risk for developing polyps are anyone over age 50, those who have had polyps previously or those who have a family history of polyps or colon cancer.
Polyps generally do not cause symptoms. If a patient does have symptoms, they can include: blood in their underwear or on toilet paper after a bowel movement, blood in stool, or constipation or diarrhea that has lasted more than a week.
It is critical to remember that not having a family history or symptoms does not protect you. In fact, 80 percent of those who are diagnosed with colon cancer have no family history or symptoms.
If polyps are removed through a colonoscopy and performed on the schedule recommended by your physician, the chances of getting colon cancer are dramatically reduced. If precancerous colon polyps are removed, the chance of the polyp turning into cancer is eliminated. If colon cancer is detected early (well before symptoms occur) it is more than 90% curable. Depending on an individual’s medical and family history, colonoscopies are typically recommended every 1, 3, 5 or 10 years.
Treatments and Procedures
Treatment options for colon cancer depend on the following:
• The stage of the cancer
• Whether the cancer has recurred
• The patient’s general health
The three primary treatment options available for colon cancer are surgery, chemotherapy and radiation. The surgical option, a partial colectomy, is the main treatment and includes removing the affected portion of the colon. How much of the colon is removed and whether it is done in conjunction with other treatments will depend on the location of the cancer, how deep it has penetrated the wall of the bowel and if it has spread to the lymph nodes or other parts of the body.
In surgical treatment, the part of the colon that contains the cancer, as well as portions of healthy colon on either side, will be removed to ensure no cancer is left behind. Nearby lymph nodes will be removed and tested at the same time. Usually the doctor is able to reconnect the healthy portions of the colon, but if that is not possible the patient will have a temporary or permanent colostomy bag. A colostomy bag is a device that is worn on the skin discreetly under the clothing and is attached to the remaining bowel end. Solid waste material travels into this bag which is then disposed of and replaced as needed. Sometimes, a colostomy is done temporarily to give the bowel time to heal; sometimes it becomes permanent if too much of the colon has to be removed.
If the cancer is small, early-stage and localized in a polyp, it is possible it may all be removed during a colonoscopy.
If the cancer is very advanced or the patient’s health is extremely poor, surgery may be done simply to enhance comfort. This is an operation that will relieve a blockage of the colon to improve symptoms. This will not cure cancer but will relieve pain and bleeding.
Chemotherapy can be used after surgery to destroy any remaining cancer cells and may be recommended by the doctor if the cancer has spread beyond the colon. Chemotherapy can be used in conjunction with radiation.
Radiation therapy uses powerful energy sources to kill any cancer cells that may remain after surgery or to shrink large tumors before an operation. This option is rarely used in early stages of colon cancer.
Preventing Colon Cancer
Getting screened is the first step in preventing colon cancer. Regular colonoscopies should begin at age 50 for people with an average risk for developing colon cancer. For those with a family history of polyps or colon cancer, many physicians may recommend starting at age 40. Some recent studies indicate that African-Americans may need to start screening at age 45. Consult your physician if you are African-American.
Several screening options are available, including colonoscopy and flexible sigmoidoscopy. More frequent and earlier screening is recommended if you are at a high risk for colon cancer.
Those with a high risk include:
• Over age 50
• Polyps, growths inside the colon and rectum that may become cancerous
• A high-fat diet
• Family or personal history of colon cancer
• Ulcerative colitis, Crohn’s disease or other inflammatory bowel diseases
• Sedentary lifestyle
• Diabetes
• Smoking
• Alcohol
• Growth hormone disorder
• Radiation therapy for cancer
• Lifestyle changes can also be made to reduce the risk of colon cancer
Take the following steps:
• Add fruits, whole grains and vegetables to your diet
• Limit saturated fat
• Limit alcohol
• Eat a varied diet
• Stop smoking
• Stay active and maintain a healthy body weight
• Add a regular colonoscopy, as prescribed by your physician, to your health-care practices
Inflammatory Bowel Disease (IBD) is an ongoing problem that causes inflammation and swelling in the digestive tract. The irritation causes bleeding sores, known as ulcers, to form along the digestive tract. Symptoms include abdominal pain and cramping as well as bloody diarrhea. The two main types of IBD are ulcerative colitis and Crohn’s disease.
Ulcerative colitis is an inflammatory bowel disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. Ulcers form where inflammation has injured the cells that usually line the colon, which then may bleed and create pus. This inflammation also causes the colon to empty frequently, causing diarrhea.
Colitis can be difficult to diagnose because symptoms such as abdominal pain and diarrhea are so similar to other intestinal disorders. About half the people diagnosed with ulcerative colitis have mild symptoms. Others may suffer frequent fevers, bloody diarrhea, nausea and severe abdominal cramps. It may also cause problems such as arthritis, inflammation of the eye, liver disease and osteoporosis. It is not known why these problems occur outside the colon, but scientists think it may be the result of inflammation triggered by the immune system. Some of these problems go away when the colitis is treated.
Crohn’s disease is a chronic disorder that creates inflammation in the digestive tract (also known as the GI tract). It can affect any area from the mouth to the rectum but most commonly affects the lower part of the small intestine. The disease causes inflammation and swelling deep into the affected area, resulting in pain that can make the intestines empty frequently, causing diarrhea.
Crohn’s disease may be difficult to diagnose because the symptoms, including abdominal pain and diarrhea, are so similar to other intestinal disorders. Bleeding from the rectum, joint pain, weight loss and skin problems are other symptoms.
Also called diverticular disease, diverticulosis happens when small pouches, called diverticula, bulge outward through the colon. This becomes more common as people get older, and about half of all people over age 60 have it. Physicians believe the main cause of this condition is a low-fiber diet. Most people with diverticulosis don’t have symptoms, but the condition can cause mild cramps, bloating or constipation. A high-fiber diet and medications to reduce colon spasm will often relieve these symptoms.
If the pouches become inflamed or infected, the condition is then called diverticulitis. The most common symptom is abdominal pain, usually on the left side. If the diverticula are infected, patients can also have fever, nausea, vomiting, chills, cramping or constipation. In serious cases, diverticulitis can lead to bleeding or blockages or even perforation (puncture) through the bowel wall. Treatment focuses on clearing up the infection with antibiotics, resting the colon and preventing future problems.
Liver disease, also called hepatic disease, refers to any number of diseases that may affect the liver and its function. The liver plays a role in the production of bile, blood-clotting and amino acids, and it aids in the processing and storage of iron for red blood cell production.
Symptoms of liver disease include nausea and vomiting, abdominal pain in the upper right quadrant and jaundice (yellowing of the skin due to high concentrations of the bile pigment bilirubin). Unexplained fatigue, weakness and weight loss may also be associated with liver disease and should prompt a visit to the doctor.
Some of the diseases that affect the liver include infectious hepatitis, cirrhosis (scarring of the liver), cancers, bile flow abnormalities, blood flow abnormalities and alcohol abuse. Some medications may also cause liver damage, including acetaminophen (Tylenol). Treatments for these conditions vary depending on the disease and its causes.