Health is always a popular topic of conversation at get-togethers, but you don’t often hear anyone talk about their gas and diarrhea. When these kinds of symptoms are chronic, however, it is important to talk to your doctor or pharmacist as they may be signaling more serious digestive disorders, which are far more common than you think.
“Probably half to two-thirds of the population will develop either gastroesophageal reflux disease (GERD) or irritable bowel syndrome (IBS) in their lifetime,” says Dr. Richard Fedorak, president of Canadian Digestive Health Foundation (CDHF) and director of the Center of Excellence for Gastrointestinal Inflammation and Immunity Research at Edmonton’s University of Alberta. What links these and other digestive disorders are the gastrointestinal tract and their symptoms.
Experts are not always sure why these conditions occur, but there seem to be genetic and environmental components. If you are born with the genetic defect for Crohn’s disease, says Fedorak, you will develop the disorder. However, if you’re obese, make unhealthy food choices, and often eat late at night, you have a higher-than-average risk of developing GERD. Stress is also part of the equation, says Fedorak, because it often leads to drinking, eating and working late, and eating incorrectly.
We offer a quick review of digestive disorders below.
GASTROESOPHAGEAL REFLUX DISEASE GERD occurs when stomach acid flows backward because the sphincter separating the esophagus and stomach fails to seal tightly. Certain foods, smoking, alcohol, pregnancy, and some medications may weaken or loosen the esophageal sphincter. Alternatively, abdominal pressure caused by obesity or a hiatal hernia can push against the sphincter, forcing it open.
Symptoms include:
Heartburn
Recurring sour or bitter taste
Chest pain that worsens when eating, bending, or reclining
Difficulty swallowing
Coughing, wheezing, asthma, hoarseness or constantly needing to clear your throat
Treatment GERD can be reduced by lifestyle changes that reduce the pressure on the abdomen: e.g., lose weight, eat smaller meals, and avoid trigger foods. If symptoms are mild, OTC products such as antacids may help, but if symptoms are frequent and persistent, drugs such as high-dose H2-receptor blockers, proton pump inhibitors, and motility drugs may be prescribed. Untreated, GERD can lead to Barrett’s esophagus, which increases the risk of esophageal cancer.
DYSPEPSIA As its name implies, non-ulcer dyspepsia involves temporary upper abdominal pain that is not caused by an ulcer. The exact cause is unknown but it can be connected to problem with the muscular squeezing action of the stomach. Symptoms are often linked to unhealthy lifestyle and some medication.
Symptoms include:
Rising burning or discomfort in the upper abdomen
Bloating, belching, and gas
Early feeling of fullness with meals
Nausea
A feeling of abnormal or slow digestion
Treatment Avoiding food and situations that trigger dyspepsia is usually the best approach. That can include losing weight, smoking cessation, exercising, calmly eating smaller, more frequent meals, and limiting drinks during meals. Your doctor may treat dyspepsia with antacids, acid blockers, proton pump inhibitors, prokinetic agents, antispasmodics, acid suppressors, low-dose antidepressants, or antibiotics.
CELIAC DISEASE This condition is a lifelong digestive disorder in which the body cannot tolerate gluten—a protein found in many grains—which triggers an immune reaction occurs causing inflammation and damage to the surface of the small intestine. Because celiac disease has no typical symptoms, doctors test for it with a blood test or intestinal biopsy.
Symptoms to watch for, however, include:
Chronic diarrhea and/or constipation
Bloating, gas
Abdominal pain
Foul-smelling, greasy pale stool
Treatment There is no cure but adhering to a strict gluten-free diet should help. There are many new gluten-free products on the market along with gluten-free cookbooks. As the disorder can lead to severe nutritional deficiencies, your doctor or dietitian may recommend dietary supplements.
IRRITABLE BOWEL SYNDROME IBS occurs when the intestines squeeze too hard or not hard enough, causing food to move too fast or too slowly through the digestive system. Affecting up to 20% of the population, the causes IBS are unknown, but may involve a hereditary factor and many patients blame dietary allergy or intolerance.
Symptoms include:
Abdominal pain (bloating, gas)
Irregular bowel movement (diarrhea and constipation)
Mucus in stool
A feeling of incomplete bowel movement
Treatment Most people with mild IBS find relief by altering their diet and lifestyle. Leisurely eating regular smaller meals can also help, as can regular exercise and finding ways to reduce stress. If lifestyle changes aren’t effective, there may be medication that helps.
CROHN’S DISEASE This lifelong condition that usually starts in young adulthood involves chronic inflammation in the intestinal tract. Although Crohn’s is not continuously active, it can be aggravated by stress and diet, and because it is associated with a higher risk of colon cancer, patients should be checked regularly.
Symptoms include:
Abdominal pain and cramping (usually worse after meals)
Nausea and vomiting
Diarrhea
Pain with bowel movement and blood in stool
Reduced appetite and weight loss
Fever
Fatigue
Treatment The best approach is to work with a dietician or doctor to find out what dietary habits will work best, such as limiting dairy products, avoiding high fat foods, and eating small meals. Taking multivitamins and managing stress may also help. If medication is recommended, the first line of attack is often an anti-inflammatory, although antibiotics and anti-diarrhea medication may be prescribed.
COLITIS This condition causes chronic inflammation of the inner lining of the large intestine (colon). The cause is unknown but one theory suggests that the digestive system becomes inflamed when the immune system tries to fight off a virus or bacterium. There may also be a hereditary component.
Symptoms include:
Bloody diarrhea
Cramps
Sudden bowel movement urges
Inability to move the bowels despite the urge
Tiredness
Mild fever, nausea, and vomiting
Loss of appetite and weight loss
Treatment It’s best to consult a doctor or dietician but some people are able to decrease the frequency and severity of flare-ups by altering their diet and avoiding foods such as dairy products, raw or crunchy foods, and gassy foods that make their symptoms worse. It may also help to eat small meals, drink plenty of liquids, and reduce stress. To control inflammation, Prednisone and 5-ASA compounds may be prescribed. Other medications may include antibiotics, immunosuppressive drugs, and pain killers, and fish oil supplements may be recommended.
