Acid Reflux (GER)
Gastroesophageal reflux (GER) occurs when stomach contents flow back up into the esophagus—the muscular tube that carries food and liquids from the mouth to the stomach.
GER is also called acid reflux or acid regurgitation because the stomach’s digestive juices contain acid and bile. Sometimes people with GER can taste food or acidic fluid in the back of the mouth. Refluxed stomach acid that touches the lining of the esophagus can cause symptoms such as heartburn. Also called acid indigestion, heartburn is an uncomfortable, burning feeling in the midchest, behind the breastbone, or in the upper part of the abdomen—the area between the chest and the hips.
Occasional GER is common. People may be able to control GER by
•avoiding foods and beverages that contribute to heartburn, such as chocolate, coffee, peppermint, greasy or spicy foods, tomato products, and alcoholic beverages
•losing weight if they are overweight
•not eating 2 to 3 hours before sleep
•taking certain over-the-counter medications
Lifestyle changes and medications are often the first lines of treatment for suspected GERD. If symptoms improve with these treatment methods, a GERD diagnosis often does not require testing. However, a person may need testing if symptoms do not improve or if other concerning symptoms are present such as worsening of long standing symptoms, symptoms starting over the age of 50, weight loss, or trouble swallowing.
For more info on GER visit National Digestive Diseases Information Clearinghouse (NDDIC)
Gastroesophageal reflux disease (GERD) is a more serious, chronic––or long lasting––form of GER. GER that occurs more than twice a week for a few weeks could be GERD, which over time can lead to more serious health problems. People with suspected GERD should see a health care provider.
Gastroesophageal reflux disease results when the lower esophageal sphincter—the muscle that acts as a valve between the esophagus and stomach—becomes weak or relaxes when it should not, causing stomach contents to rise up into the esophagus.
Abnormalities in the body such as hiatal hernias may also cause GERD. Hiatal hernias occur when the upper part of the stomach moves up into the chest. The stomach can slip through an opening found in the diaphragm. The diaphragm is the muscle wall that separates the stomach from the chest. Hiatal hernias may cause GERD because of stomach acid flowing back up through the opening; however, most produce no symptoms.
Other factors that can contribute to GERD include
•certain medications, such as asthma medications, calcium channel blockers, and many antihistamines, pain killers, sedatives, and antidepressants
•smoking, or inhaling secondhand smoke
People of all ages can develop GERD, some for unknown reasons.
The main symptom of GERD is frequent heartburn, though some adults with GERD do not have heartburn. Other common GERD symptoms include
•a dry, chronic cough
•asthma and recurrent pneumonia
•a sore throat, hoarseness, or laryngitis—swelling and irritation of the voice box
•difficulty swallowing or painful swallowing
•pain in the chest or the upper part of the abdomen
•dental erosion and bad breath
Lifestyle changes and medications are often the first lines of treatment for suspected GERD. If symptoms improve with these treatment methods, a GERD diagnosis may not require additional testing. However, to confirm a diagnosis, a person may need testing if symptoms do not improve or if other concerning symptoms are present such as recent worsening of long standing symptoms, symptoms starting over the age of 50, weight loss, bleeding, or trouble swallowing.
Treatment for GERD may involve one or more of the following, depending on the severity of symptoms: lifestyle changes, medications, or surgery.
For more info on GERD visit National Digestive Diseases Information Clearinghouse (NDDIC)
Barrett’s esophagus is a condition in which the tissue lining the esophagus—the muscular tube that carries food and liquids from the mouth to the stomach—is replaced by tissue that is similar to the intestinal lining. This process is called intestinal metaplasia. People with Barrett’s esophagus are at increased risk for a type of cancer called esophageal adenocarcinoma.
The exact cause of Barrett’s esophagus is unknown, but gastroesophageal reflux disease (GERD) is a risk factor for the condition. GERD is a more serious, chronic—or long lasting—form of gastroesophageal reflux, a condition in which stomach contents flow back up into the esophagus. Refluxed stomach acid that touches the lining of the esophagus can cause heartburn and damage the cells in the esophagus. Heartburn, also called acid indigestion, is an uncomfortable, burning feeling in the midchest, behind the breastbone, or in the upper part of the abdomen—the area between the chest and hips. Between 5 and 10 percent of people with GERD develop Barrett’s esophagus.3 Other risk factors include obesity—specifically high levels of belly fat—and smoking. Some studies suggest that genetics, or inherited genes, may play a role.
Barrett’s esophagus can only be diagnosed with an upper GI endoscopy and biopsy.
The risk of esophageal adenocarcinoma in people with Barrett’s esophagus is about 0.5 percent per year. Typically, before esophageal adenocarcinoma develops, precancerous cells appear in the Barrett’s tissue can be treated before cancer develops.
For more information on Barrett’s Esophagus visit National Digestive Diseases Information Clearinghouse (NDDIC)
Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. Gluten is found mainly in foods but may also be found in everyday products such as medicines, vitamins, and lip balms.When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging or destroying villi—the tiny, fingerlike protrusions lining the small intestine. Villi normally allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. Without healthy villi, a person becomes malnourished, no matter how much food one eats.Celiac disease is both a disease of malabsorption—meaning nutrients are not absorbed properly—and an abnormal immune reaction to gluten. Celiac disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy. Celiac disease is genetic, meaning it runs in families. Sometimes the disease is triggered—or becomes active for the first time—after surgery, pregnancy, childbirth, viral infection, or severe emotional stress.
Symptoms of celiac disease vary from person to person. Symptoms may occur in the digestive system or in other parts of the body. Digestive symptoms are more common in infants and young children and may include
•abdominal bloating and pain
•pale, foul-smelling, or fatty stool
Irritability is another common symptom in children. Malabsorption of nutrients during the years when nutrition is critical to a child’s normal growth and development can result in other problems such as failure to thrive in infants, delayed growth and short stature, delayed puberty, and dental enamel defects of the permanent teeth.
Adults are less likely to have digestive symptoms and may instead have one or more of the following:
•unexplained iron-deficiency anemia
•bone or joint pain
•bone loss or osteoporosis
•depression or anxiety
•tingling numbness in the hands and feet
•missed menstrual periods
•infertility or recurrent miscarriage
•canker sores inside the mouth
•an itchy skin rash called dermatitis herpetiformis
People with celiac disease may have no symptoms but can still develop complications of the disease over time. Long-term complications include malnutrition—which can lead to anemia, osteoporosis, and miscarriage, among other problems—liver diseases, and cancers of the intestine.
Recognizing celiac disease can be difficult because some of its symptoms are similar to those of other diseases. Celiac disease can be confused with irritable bowel syndrome, iron-deficiency anemia caused by menstrual blood loss, inflammatory bowel disease, diverticulitis, intestinal infections, and chronic fatigue syndrome. As a result, celiac disease has long been underdiagnosed or misdiagnosed. As doctors become more aware of the many varied symptoms of the disease and reliable blood tests become more available, diagnosis rates are increasing.
The only treatment for celiac disease is a gluten-free diet. Doctors may ask a newly diagnosed person to work with a dietitian on a gluten-free diet plan. A dietitian is a health care professional who specializes in food and nutrition. Someone with celiac disease can learn from a dietitian how to read ingredient lists and identify foods that contain gluten in order to make informed decisions at the grocery store and when eating out.
For more information on Celiac Disease visit National Digestive Diseases Information Clearinghouse (NDDIC)
Cirrhosis is a condition in which the liver is unable to function properly due to chronic injury. Scar tissue replaces healthy liver tissue, partially blocking the flow of blood through the liver.
Scarring also impairs the liver’s ability to
•remove bacteria and toxins from the blood
•process nutrients, hormones, and drugs
•make proteins that regulate blood clotting
•produce bile to help absorb fats—including cholesterol—and fat-soluble vitamins
A healthy liver is able to regenerate most of its own cells when they become damaged. With end-stage cirrhosis, the liver can no longer effectively replace damaged cells. A healthy liver is necessary for survival.
Cirrhosis has various causes. In the United States, heavy alcohol consumption and chronic hepatitis C have been the most common causes of cirrhosis. Obesity is becoming a more common cause of cirrhosis, either as the sole cause or in combination with other factors. Many people with cirrhosis have more than one cause of liver damage.
Many people with cirrhosis have no symptoms in the early stages of the disease. However, as the disease progresses, a person may experience the following symptoms:
•loss of appetite
•abdominal pain and bloating when fluid accumulates in the abdomen
•Jaundice or yellowing of the skin
•spiderlike blood vessels on the skin
The diagnosis of cirrhosis is usually confirmed by physical examination, blood tests, and imaging. The doctor will ask about the person’s medical history and symptoms and perform a thorough physical examination to observe for clinical signs of the disease. For example, on abdominal examination, the liver may feel hard or enlarged with signs of ascites, fluid in the abdomen. The doctor will order blood tests that may be helpful in evaluating the liver and increasing the suspicion of cirrhosis.
Treatment for cirrhosis depends on the cause of the disease and whether complications are present. The goals of treatment are to slow the progression of scar tissue in the liver and prevent or treat the complications of the disease.
For more information on Liver Cirrhosis visit National Digestive Diseases Information Clearinghouse (NDDIC)
Colorectal cancer, or colon cancer, occurs in the colon or rectum. The rectum is the passageway that connects the colon to the anus.
Colon cancer, when discovered early, is highly treatable. Even if it spreads into nearby lymph nodes, surgical treatment followed by chemotherapy is highly successful. In the most difficult cases — when the cancer has metastasized to the liver, lungs or other sites — treatment can prolong and add to one’s quality of life. Most colon cancers develop first as colorectal polyps, which are abnormal growths inside the colon or rectum that may later become cancerous.
Colon cancer affects men and women of all racial and ethnic groups, and is most often found in people 50 years or older. It is the third most common cancer in the United States, behind only lung and prostate cancers in men and lung and breast cancers in women. Colon cancer is the second leading cause of cancer death in the United States.
Studies have found the following risk factors for colon cancer:
Age over 50, colon polyps, Family history of colon cancer, genetic alterations, Ulcerative colitis or Crohn’s disease, and tobacco use.
Colon cancer first develops with few, if any, symptoms. It is important not to wait for symptoms before talking to your doctor about getting screened. However, if symptoms are present, they may include:
•A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool
•Feeling that your bowel does not empty completely, rectal bleeding, or finding blood (either bright red or very dark) in your stool
•Finding your stools are narrower than usual
•Persistent abdominal discomfort, such as cramps, gas, pain, or feeling full or bloated
•Losing weight with no known reason
•Weakness or fatigue
•Having nausea or vomiting
These symptoms can also be associated with many other health conditions. Only your doctor can determine why you’re having these symptoms. Usually, early cancer does not cause pain. It is important not to wait to feel pain before seeing a doctor.
There are a few different ways your doctor can screen you for colon cancer. The best ways is thought to be a colonoscopy. If your physical exam and test results do not suggest cancer, your doctor may decide that no further tests are needed and no treatment is necessary. However, your doctor may recommend a schedule for checkups.
If tests show an abnormal area (such as a polyp), then a biopsy to check for cancer cells may be necessary. Often, the abnormal tissue can be removed during a colonoscopy or sigmoidoscopy. A pathologist checks the tissue for cancer cells using a microscope.
The process used to find out if cancer has spread within the colon/rectum or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.
Treatment depends mainly on the location of the tumor in the colon or rectum and the stage of the disease. Treatment for colorectal cancer may involve surgery, chemotherapy, biological therapy or radiation therapy. Some people have a combination of treatments. Treatment for colon cancer is sometimes different than treatment for rectal cancer. Cancer treatment can be local therapy or systemic therapy.
For more information on Colon cancer visit Colon Cancer Alliance,
Constipation is a condition in which a person has fewer than three bowel movements a week or has bowel movements with stools that are hard, dry, and small, making them painful or difficult to pass. People may feel bloated or have pain in their abdomen—the area between the chest and hips. Some people think they are constipated if they do not have a bowel movement every day. Bowel movements may occur three times a day or three times a week, depending on the person.
Most people get constipated at some point in their lives. Constipation can be acute, which means sudden and lasting a short time, or chronic, which means lasting a long time, even years. Most constipation is acute and not dangerous. Understanding the causes, prevention, and treatment of constipation can help many people take steps to find relief.
Constipation is caused by stool spending too much time in the colon. The colon absorbs too much water from the stool, making it hard and dry. Hard, dry stool is more difficult for the muscles of the rectum to push out of the body.
Common factors or disorders that lead to constipation are
•diets low in fiber
•lack of physical activity
•life changes or daily routine changes
•ignoring the urge to have a bowel movement
•neurological and metabolic disorders
•GI tract problems
•functional GI disorders
To diagnose the cause of constipation, the health care provider will take a medical history, perform a physical exam, and order specific tests. The tests ordered depend on how long the person has been constipated; how severe the constipation is; the person’s age; and whether the person has had blood in stools, recent changes in bowel habits, or weight loss. Most people with constipation do not need extensive testing and can be treated with changes in diet and exercise.
Treatment for constipation depends on the cause, severity, and duration of the constipation and may include one or more of the following:
•changes in eating, diet, and nutrition
•exercise and lifestyle changes
First-line treatments for constipation include changes in eating, diet, and nutrition; exercise and lifestyle changes; and laxatives. People who do not respond to these first-line treatments should talk with their health care provider about other treatments.
For more information on Constipation visit National Digestive Diseases Information Clearinghouse (NDDIC)
Crohn’s disease is a disease that causes inflammation, or swelling, and irritation of any part of the digestive tract—also called the gastrointestinal (GI) tract. The part most commonly affected is the end part of the small intestine, called the ileum.
In Crohn’s disease, inflammation extends deep into the lining of the affected part of the GI tract. Swelling can cause pain and can make the intestine—also called the bowel—empty frequently, resulting in diarrhea. Chronic—or long-lasting—inflammation may produce scar tissue that builds up inside the intestine to create a stricture. A stricture is a narrowed passageway that can slow the movement of food through the intestine, causing pain or cramps.
Crohn’s disease is an inflammatory bowel disease (IBD), the general name for diseases that cause inflammation and irritation in the intestines. Crohn’s disease can be difficult to diagnose because its symptoms are similar to other intestinal disorders, such as ulcerative colitis, infections, and irritable bowel syndrome. For example, ulcerative colitis and Crohn’s disease both cause abdominal pain and diarrhea.
The cause of Crohn’s disease is unknown, but researchers believe it is the result of an abnormal reaction by the body’s immune system. Normally, the immune system protects people from infection by identifying and destroying bacteria, viruses, or other potentially harmful foreign substances. Researchers believe that in Crohn’s disease the immune system attacks bacteria, foods, and other substances that are actually harmless or beneficial. During this process, white blood cells accumulate in the lining of the intestines, producing chronic inflammation, which leads to ulcers, or sores, and injury to the intestines.
The most common symptoms of Crohn’s disease are abdominal pain and diarrhea. Rectal bleeding, weight loss, and fever may also occur. Bleeding may be serious and persistent, leading to anemia—a condition in which red blood cells are fewer or smaller than normal, which means less oxygen is carried to the body’s cells.
Treatment may include medications, surgery, nutrition supplementation, or a combination of these options. The goals of treatment are to control inflammation, correct nutritional deficiencies, and relieve symptoms such as abdominal pain, diarrhea, and rectal bleeding. Treatment for Crohn’s disease depends on its location, severity, and complications.
Be sure to check out this great resource: Crohnology.com
Crohnology is a network that allow patients to collaborate, share health and treatment information with each other, and track and share their health. This is a great way to connect and learn from other’s experiences.
For more information on Crohn’s Disease visit National Digestive Diseases Information Clearinghouse (NDDIC)
Diarrhea is loose, watery stools. Acute diarrhea is a common problem that usually lasts 1 or 2 days and goes away on its own.
Diarrhea lasting more than 2 days may be a sign of a more serious problem. Chronic diarrhea—diarrhea that lasts at least 4 weeks—may be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual or they may come and go. Diarrhea of any duration may cause dehydration, which means the body lacks enough fluid and electrolytes—chemicals in salts, including sodium, potassium, and chloride—to function properly. Loose stools contain more fluid and electrolytes and weigh more than solid stools.
Acute diarrhea is usually caused by a bacterial, viral, or parasitic infection. Chronic diarrhea is usually related to a functional disorder such as irritable bowel syndrome or other intestinal diseases. Some people develop diarrhea after stomach or gallbladder surgery, which may cause food to move through the digestive system more quickly. People who visit certain foreign countries are at risk for traveler’s diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites. Traveler’s diarrhea can be a problem for people traveling to developing countries in Africa, Asia, Latin America, and the Caribbean. Visitors to Canada, most European countries, Japan, Australia, and New Zealand do not face a high risk for traveler’s diarrhea. In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own within 1 to 2 days, finding the cause is not usually necessary.
Adults with any of the following symptoms should see a health care provider:
•signs of dehydration
•diarrhea for more than 2 days
•severe pain in the abdomen or rectum
•a fever of 102 degrees or higher
•stools containing blood or pus
•stools that are black and tarry
Diarrhea is not usually harmful, but it can become dangerous or signal a more serious problem. If acute diarrhea lasts 2 days or less, diagnostic tests are usually not necessary. If diarrhea lasts longer or is accompanied by symptoms such as fever or bloody stools, a doctor may perform tests to determine the cause.
In most cases of diarrhea, the only treatment necessary is replacing lost fluids and electrolytes to prevent dehydration. Over-the-counter medicines such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol and Kaopectate) may help stop diarrhea in adults. However, people with recent antibiotic use, recent hoapitlaizations, bloody diarrhea, or fever—signs of bacterial or parasitic infection—should not use these medicines. If diarrhea is caused by bacteria or parasites, over-the-counter medicines may prolong the problem. Medications to treat diarrhea in adults can be dangerous for infants and children and should only be given with a doctor’s guidance.
Until diarrhea subsides, avoiding caffeine and foods that are greasy, high in fiber, or sweet may lessen symptoms. These foods can aggravate diarrhea. Some people also have problems digesting lactose during or after a bout of diarrhea. Yogurt, which has less lactose than milk, is often better tolerated. In some cases, yogurt with active, live bacterial cultures may even help people recover from diarrhea more quickly.
As symptoms improve, soft, bland foods can be added to the diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. For children, the health care provider may also recommend a bland diet. Once the diarrhea stops, the health care provider will likely encourage children to return to a normal and healthy diet if it can be tolerated. Infants with diarrhea should be given breast milk or full-strength formula as usual, along with oral rehydration solutions. Some children recovering from viral diarrheas have problems digesting lactose for up to a month or more.
For more information on Diarrhea visit National Digestive Diseases Information Clearinghouse (NDDIC)
Irritable Bowel (IBS)
Irritable bowel syndrome is a functional gastrointestinal (GI) disorder, meaning symptoms are caused by changes in how the GI tract works. People with a functional GI disorder may have frequent symptoms; however, the GI tract does not become damaged. IBS is a group of symptoms that occur together, not a disease. In the past, IBS was called colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel. The name was changed to reflect the understanding that the disorder has physical causes and is not a product of a person’s imagination.
IBS is diagnosed when a person has had abdominal pain or discomfort at least three times a month for the last 3 months without other disease or injury that could explain the pain. The pain or discomfort of IBS may occur with a change in stool frequency or consistency or can be relieved by a bowel movement.
IBS is often classified into four subtypes based on a person’s usual stool consistency. These subtypes are important because they affect the types of treatment that are most likely to improve the person’s symptoms.
The four subtypes of IBS are
•IBS with constipation (IBS-C) ◦hard or lumpy stools at least 25 percent of the time
◦loose or watery stools less than 25 percent of the time
•IBS with diarrhea (IBS-D) ◦loose or watery stools at least 25 percent of the time
◦hard or lumpy stools less than 25 percent of the time
•Mixed IBS (IBS-M) ◦hard or lumpy stools at least 25 percent of the time
◦loose or watery stools at least 25 percent of the time
•Unsubtyped IBS (IBS-U) ◦hard or lumpy stools less than 25 percent of the time
◦loose or watery stools less than 25 percent of the time
The most common symptoms of IBS are abdominal pain or discomfort, often reported as cramping, along with changes in bowel habits. To meet the definition of IBS, the pain or discomfort will be associated with at least two of the following three symptoms:
•bowel movements that occur more or less often than usual
•stool that appears less solid and more watery, or harder and more lumpy, than usual
•bowel movements that improve the discomfort
Other symptoms of IBS may include
•diarrhea—having loose, watery stools three or more times a day and feeling urgency to have a bowel movement.
•constipation—having fewer than three bowel movements a week. During a bowel movement, stools can be hard, dry, and small, making them difficult to pass. Some people find it painful and often have to strain to have a bowel movement.
•feeling that a bowel movement is incomplete.
•passing mucus—a clear liquid made by the intestines that coats and protects tissues in the GI tract.
Symptoms may often occur soon after eating a meal. To meet the definition of IBS, symptoms must occur at least three times a month.
The causes of IBS are not well understood. Researchers believe a combination of physical, dietary, and mental stress can lead to and exacerbate IBS.
To diagnose IBS, a health care provider will conduct a physical exam and take a complete medical history. The medical history will include questions about symptoms, family history of GI disorders, recent infections, medications, and stressful events related to the onset of symptoms. An IBS diagnosis requires that symptoms started at least 6 months prior and occurred at least three times a month for the previous 3 months. Further testing is not usually needed, though the health care provider may perform a blood test to screen for other problems. Additional diagnostic tests may be needed based on the results of the screening blood test and for people who also have signs such as
•anemia—too few red blood cells in the body, which prevents the body from getting enough oxygen
•family history of colon cancer
•family history of inflammatory bowel disease—long-lasting disorders that cause irritation and ulcers, or sores, in the GI tract
•family history of celiac disease—an abnormal immune reaction to gluten, a protein found in wheat, rye, and barley, that damages the lining of the small intestine and prevents absorption of nutrients
Though IBS does not have a cure, the symptoms can be treated with a combination of
•changes in diet and nutrition
•medications for pain, constipation, or diarrhea
•therapies for mental stress
For more information on IBS visit the National Digestive Diseases Information Clearinghouse (NDDIC)
Hepatitis is inflammation of the liver, the most common disease of the liver. Inflammation disrupts your liver’s ability to filter harmful substances from your body as well as make the proteins and substances that help the body to function properly.
If the liver can not function appropriately, waste products can build up in your bloodstream. If the inflammation continues unchecked, your liver my be permanently damaged from scaring and fibrosis, a condition called cirrhosis There are several forms of Hepatitis each having a different prognosis and treatment. It is important to determine the cause of the inflammation so it can be treated correctly.
For more information on Hepatitis visit the National Digestive Diseases Information Clearinghouse (NDDIC)
Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes long-lasting inflammation in the colon.
Like Crohn’s disease, another common type of IBD, ulcerative colitis can be debilitating and sometimes can lead to life-threatening complications. Because ulcerative colitis is a chronic condition, symptoms usually develop over time, rather than suddenly.
Ulcerative colitis usually affects only the innermost lining of your large intestine (colon) and rectum but can also effect other parts of the body including the joints, skin, and eyes. It is usually seen in continuous stretches of your colon starting in the rectum, unlike Crohn’s disease, which occurs anywhere in the digestive tract and often spreads deeply into the affected tissues.
Therapies are available that may dramatically reduce the signs and symptoms of ulcerative colitis and even bring about a long-term remission. It is important for patients with this condition to have regular follow up and care from a gastroenterologist.
For more information on Ulcerative Colitis visit the National Digestive Diseases Information Clearinghouse (NDDIC)
Information from the National Digestive Diseases Information Clearinghouse (NDDIC), the Colon Cancer Alliance and