Johns Hopkins Medical Center estimates that 70 million people in the United States suffer from digestive disorders. These disorders cause a variety of symptoms, some of which can be disabling. Diagnosis can be difficult because of the wide range of underlying causes. Careful analysis of the symptoms and location of the problem helps physicians to pinpoint the problem for proper diagnosis. Dr. Graham Gibb, an accomplished surgeon, sheds light on digestive disorders and understanding the differences.
Gastroesophogeal Reflux (GERD)
GERD is characterized by coughing, hoarseness, difficulty breathing, a feeling of a lump in the throat, earaches, chest pain, heartburn, nausea, and sudden regurgitation. Reflux occurs when stomach acids move up into the esophagus. The pain can be sharp, burning or feel like a heart condition like angina. It can become a chronic problem that makes eating difficult. A variety of tests on the upper gastrointestinal system are generally done to determine if the muscles of the stomach and esophagus are at fault. These include upper GI endoscopy, x-rays, and esophageal tests. A number of medications are available to help this condition. Dietary changes can also help to reduce symptoms. If other treatments are not sufficient to provide relief, surgery may be necessary to tighten the upper part of the stomach.
Sometimes, small pouches develop in the lining of the digestive system. Often, these pouches cause no symptoms. The pockets can become infected, causing diverticulitis, and may even lead to diverticular bleeding. Cramping, abdominal pain, constipation, and diarrhea are common. A barium enema x-ray or colonoscopy is used to diagnose the presence of these pouches. Avoiding constipation can help to reduce diverticulosis symptoms. The use of fiber supplements and a careful diet is recommended.
Irritable Bowel Syndrome (IBS)
Another of the irritable bowel disorders is generally known as IBS or irritable syndrome. Up to 55 million Americans are affected by this disorder that causes chronic symptoms of abdominal pain, diarrhea, constipation, bloating and abdominal distension. Pain is often located in the lower left quadrant. It affects many more women than men and is believed to have a hormonal component. IBS can also be caused by food allergies, medications, enzyme deficiencies, and intestinal infections. Colonoscopy and signoidoscopy tests are done to view the condition of the intestines. Blood and stool tests are also useful to diagnose the condition. Avoiding substances such as caffeine, nicotine, and alcohol can help to reduce the symptoms of IBS. Laxatives, bulking agents and anti-diarrheal medications can help to manage symptoms. Sometimes, antidepressant or anti-spasmodic medications are prescribed.
Another inflammatory condition, called ulcerative colitis, can also cause pain and cramping of the digestive system. Chronic inflammation of the intestines causes ulcers to form in the innermost lining. These ulcers can occur along extended lengths of the intestines, in the left colon, closer to the anus or all along the intestine. Symptoms include pain, profuse diarrhea, and weight loss. Severe cases can lead to shock. Heredity and immune system dysfunction may cause this condition. Ulcerative colitis is treated with anti-inflammatory medications, immunosuppressant medications, antibiotics, and anti-diarrheal drugs. Surgery may be necessary to remove damaged parts of the colon. Colonscopy, barium enema x-rays and sigmoidoscopy tests help to diagnose this disorder.
Crohn’s disease also causes ulcers in the intestines, but these are generally in specific spots of the colon rather than in extended lengths. Abdominal pain and diarrhea, sometimes with bleeding, are common symptoms. Weight loss, fistulas, and fissures can also occur in the intestines. Crohn’s disease can increase in severity, leading to chills, vomiting, weak pulse and severe pain. They physician may require colonscopy, a stool analysis, and biopsy to diagnose this condition. Antibiotics, anti-diarrheal medications, steroids, and immune system drugs can help to manage Crohn’s disease. Severe attacks may require hospitalization.
Celiac disease is caused by an immune system response to eating gluten, a protein in wheat, rye, and barley. People with celiac disease develop chronic inflammation that damages the lining of the intestines. Symptoms vary from person to person, but generally include diarrhea, abdominal cramping and bloating. Some people experience constipation from this condition. As many as twenty percent of those with celiac disease may develop additional symptoms of anemia, joint pain, skin rashes, damage to dental enamel, acid reflux and bone density problems. Blood tests and endoscopy can help physicians diagnose celiac disease. Treatment includes avoiding gluten products as much as possible, steroids to control inflammation and vitamin supplements to aid in healing. A mild gluten sensitivity may produce less severe symptoms. Removing gluten from the diet can often help minor gluten intolerance.
Colorectal cancer includes all forms of cancer that affect the colon or the rectum. Medical researchers have found that 95 percent of cancers that affect the colon or rectum are adenocarcinomas found in the lining of the intestines. Colonoscopy can help to detect abnormalities in the cells of the intestines. Surgery, chemotherapy, and radiation are used to treat colorectal cancer. Early treatment of polyps and other precancerous conditions can help to prevent the development of colorectal cancer.
About Dr. Graham Gibb:
Dr. Graham Gibb has been a practicing surgeon for 18 years. He received specialized training in colorectal surgery from the University of Texas and completed his postgraduate work in general surgery in Calgary, Alberta. When he can get away from the hospital, Dr. Gibb loves taking advantage of his new pilot’s license and take in the beautiful scenery in Peterborough, Ontario.
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