Tummy Troubles
This
month I want to discuss what can happen when we do not pay sufficient
attention to what we are putting into our bodies, by looking at
some common gastro-intestinal complaints.
Unless
you never watch television, read a magazine or listen to commercial
radio, you will have heard an awful lot about GERD, or gastro
esophageal reflux disease, and the many drugs used to treat it.
It is better known as serious 'heart-burn' or as 'acid reflux',
and most of us are familiar with the main symptoms: a sour taste
in the mouth and burning in the chest following a meal, or certain
other everyday comestibles, such as coffee. But, there are other
indicators of GERD that you may not connect with the disease,
such as hoarseness, repeatedly feeling as if you have to clear
your throat, and wheezing or coughing as soon as you lay down
to sleep, or after eating.
Certain drug companies would have you think that GERD is automatically
dangerous, and you should speak with your doctor IMMEDIATELY about
getting a prescription for their particular medicine. However,
while it is not good to have stomach acid constantly backing up
your esophagus (the tube that runs from your throat to your stomach),
unless it has been happening over a very long period of time,
or is causing you extreme discomfort, you do not need to demand
any toxic pharmaceuticals to stop it. What you need instead is
a relatively simple lifestyle change, mostly centered on altering
your diet, losing weight if you are carrying extra pounds, not
eating within three hours of going to bed, avoid bending over
after eating, and elevating the head of your bed, using blocks,
books or whatever, about six or so inches. And if you smoke, quit!
The foods you should avoid, especially at night, are citrus fruits
and juices, tomatoes and tomato-based sauces, coffee and other
caffeine-containing drinks, chocolate, alcohol (especially wine),
milk and mint-flavored products (uh-huh, the same ones that are
supposed to cure heartburn), and heavily-spiced foods. If you
follow these suggestions your GERD should subside by itself, if
not you should discuss with your doctor what other steps you can
take that hopefully fall short of resorting to medication.
Another
common ailment, affecting one in five Americans, involves the
large intestine (colon), and is known as Irritable Bowel Syndrome
(IBS). It can be decidedly uncomfortable, not to mention inconvenient,
but is not considered to be life-threatening. At its worst, IBS
causes abdominal pain, cramping, gas, diarrhea, interspersed with
bouts of constipation. At its best, IBS is a minor gastric disturbance
that may not have many, if any, symptoms for long periods at a
time. Your doctor can make the diagnosis, usually by taking a
thorough history of your digestive health.
There
is no definitive root cause to IBS, but it is thought that perhaps
the colon is more sensitive in affected individuals, and thus
more susceptible to allergic reactions, poor diet, or strong emotions
and stress. Women, around the time of their period, can be affected,
leading us to conclude that hormones can also play a part in IBS.
Or, maybe it is some kind of auto-immune response; whereby the
body's disease-fighting system goes awry and turns on the very
body it is trying to protect. What IS know is that those with
IBS have a colon that does not seem to function adequately to
pass food waste through at an efficient rate; instead it moves
either too slowly (leading to constipation) or too fast (leading
to diarrhea).
Although there is no 'cure' for IBS, there are some steps that
can be taken to ameliorate (improve) and control symptoms; not
least of which is diet. Part of this would be ensuring a proper
intake of natural fiber - no less than 30mg per day to normalize
bowel function - but if you think it could be wheat or other grains
contributing to the IBS try using soluble fiber, such that found
in rice, inulin (a derivative of chicory root, which can be found
in Stonyfield organic yogurt, for example) or apple pectin (applesauce
is a good source), instead. Getting at least 8-10 glasses of water
per day is also vital, and not just to your digestive health.
If your IBS is emotion or stress-related, you will need to examine
ways to diffuse the effects on you, or preferably distance yourself
from the cause altogether: If it is a bad work or personal relationship
address it, and if the situation cannot be resolved, leave. Your
health is too important, and IBS will be one of only several other,
possibly far more hazardous, ill effects letting you know that
you need to take action. You may need to discuss the possibility
of counseling or stress-reduction techniques with your health
care professional, even the use of a natural anti-anxiety remedy.
Getting plenty of exercise and adequate sleep will go a long way
towards improvement too.
A gastric ailment found in roughly one in ten of us, but which
can be potentially fatal, is the ulcer. Peptic ulcers are located
either in the stomach lining (usually found more often in women),
or at the start of the small intestine (duodenum ) - found more
often in men), and may be caused by several different factors.
Of these, the helicobacter pylorus (H pylori) bacterium is probably
the best know, and most common. H pylori infection, if left untreated,
can eventually weaken the protective coating of the stomach wall
(and/or duodenum), allowing the acid environment that exists there
to break through and irritate the lining beneath, and where the
bacteria eventually burrow in. The resultant sore, which can even
progress into an actual hole, causes an array of symptoms; from
gnawing pain to nausea, vomiting, weight loss and bloating. These
symptoms may intensify at night, when the stomach is empty, and
only be relieved by eating something or the use of antacids.
Other causes of ulcers range from the overuse of NSAIDs (non-steroidal
anti-inflammatory drugs, such as aspirin, naproxen, or ibuprofen),
to physical stress, especially following major surgery. Smoking,
caffeine and alcohol use have also been implicated. Approximately
ten percent of those diagnosed with an ulcer will require surgery,
and there is a small group who will develop complications, or
cancer, either of which can prove fatal. A bleeding ulcer will
often go unnoticed until the person begins to feel weak, becomes
anemic or loses weight. It is thus important to remember that
if you begin to experience any of the earlier symptoms, such as
gnawing pain, you see your doctor first and foremost, and also
keep an eye on your stool for any signs of blood (the stool will
look 'tarry'). N.B. If you feel dizzy, begin to vomit blood
or faint, go to the ER, immediately!
Treatment for an ulcer includes dietary changes, i.e. avoiding
those foods which can trigger or exacerbate symptoms, the use
of medications - particularly antibiotics for H. Pylori infection,
quitting smoking, caffeine and alcohol, and if warranted, surgery.
Colorectal cancer is the second leading
cause of death in the United States; therefore it would be seriously
remiss of me not to mention the importance of colorectal screening
for everyone over the age of 50, or earlier for those with a family
history of gastrointestinal disease.
In
an ideal world, and according to the American College of Gastroenterology,
the best form of screening is a colonoscopy,
every 10 years after the age of 50 - a procedure that requires
sedation and several hours of recovery, but with an enormous success
rate in catching potentially cancerous growths. A less extensive
and expensive alternative to this is the sigmoidoscopy,
which is an outpatient procedure that only examines the first
part of the rectum and colon. If you do not have the option to
have either of these procedures, at least insist that your doctor
give you a 'Fecal Occult Test' -
which checks for any traces of blood in your stool. Whatever you
do, please make sure that you discuss the subject with you physician
now, rather than later.
There
are many more 'tummy troubles' that could be included here, but
it would take a series of articles to cover them allÉbut hopefully
you will not be affected by any of them!
Now
all that remains for me to do is to wish you and yours a healthy,
happy and prosperous New year, and please send your thoughts and/or
prayers to all those who are suffering so terribly in the world.
Tina
Steele, MA
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As
always, here are some useful sites, which can provide you with
further information regarding this month's column:
This
is a user-friendly site about many different gastrointestinal
diseases:
http://www.gicare.com/pated/ecd0001.htm
The
NIH's National Digestive Diseases Information Clearinghouse Info
site:
http://digestive.niddk.nih.gov/ddiseases/a-z.asp
Help
for IBS website, with info on diet, etc:
http://www.helpforibs.com/diet/
The
BBC's informative site on Ulcers:
http://news.bbc.co.uk/1/hi/health/medical_notes/259038.stm
The American College of Gastroenterology site - has patient info
too:
http://www.acg.gi.org/