Tummy Troubles

Article Six

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Tina Steele, MA

Tina Steele is a Science and Medical correspondent who will help you to understand the roles of conventional and alternative, or complimentary, medicine in creating and maintaining health and wellness.
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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


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:

The NIH's National Digestive Diseases Information Clearinghouse Info site:

Help for IBS website, with info on diet, etc:

The BBC's informative site on Ulcers:

The American College of Gastroenterology site - has patient info too:

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Editors note:

We are honored to have Tina Steele's participation and contributions to Pathfinders and look forward to learning of the ways our readers have benefited from her articles and guidance on healthcare.
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