Health News
Health News
March 2, 2020
All About Digestive Health

IBS, IBD, GER, GERD – what does this alphabet soup of digestive ailments mean?  And if you’re experiencing some issues with your gut, how do you know if it’s a normal annoyance that will soon pass or something more serious that requires you to seek medical attention?  Privia Medical Group North Texas physicians are here to tell you about some common gastrointestinal (GI) issues and what you need to know. 

Irritable Bowel Syndrome (IBS)

April is Irritable Bowel Syndrome (IBS) Awareness Month, a good time to look at this common condition.  IBS affects 10 -15% of American adults, according to the American College of Gastroenterology.  It is the most common condition treated by gastroenterologists and one of the more common illnesses that primary care physicians see.  However, it is thought that half the people who suffer from IBS do not seek medical attention and have never been diagnosed or treated for the condition. 

IBS is defined as a “functional gastrointestinal disorder,” which essentially means the digestive system is not working correctly.  When someone has IBS, the muscles in the colon are either contracting too frequently or not often enough.  IBS is not a result or a symptom of a structural problem with the GI tract, such as cancer or any other GI disorders. 

IBS symptoms are not present all the time, but they are recurring.  The most common symptoms of IBS include excessive pain in the gut, gas, bloating and mucus in the stool. Constipation, diarrhea or a combination of both are also symptomatic of IBS.  These symptoms can be severe and frequent enough to disrupt someone’s work schedule, limit activity and impact social interactions. 

The exact causes of IBS are difficult to pinpoint, but the disorder is generally believed to be caused by a GI tract that has unusual sensitivities and/or a digestive system that is working faster than it should (causing diarrhea) or slower than it should (causing constipation). 

“Everyone experiences many or all of the symptoms of IBS at various times in our lives,” explains Dr.  Pavani Muddasani, a gastroenterologist.  “Occasional symptoms are likely not a cause for concern, but if you experience these symptoms on a regular basis, you should see your health care provider for an evaluation.”

Diagnosing IBS often involves ruling out other conditions first, which may be done through blood and other lab tests, as well as imaging.  Occasionally, a colonoscopy may be ordered to rule out cancer, especially in patients over the age of 50.  For the physician to make a diagnosis, it is especially important that the patient fully describe all of their symptoms in detail to the doctor. 

Different people have different triggers. IBS can be triggered by stress, hormones and certain types of foods.  Treatments for IBS vary widely and can include medication, as well as individualized food restrictions.  A physician will often work with the patient to make modifications to diet to identify and avoid foods that trigger an onset of IBS symptoms. 

While there are no foods that are known to universally cause IBS, some of the most commonly identified food triggers include:

  • Fruits, vegetables and legumes that cause gas, such as cauliflower and cabbage, beans and broccoli
  • Chocolate
  • Sorbitol (a sugar substitute)
  • Carbonated beverages
  • Alcoholic beverages
  • Dairy products – many people with IBS are also found to be lactose intolerant

Keeping a food journal and correlating it to when symptoms occur will help narrow down and identify potential triggers. 

“For IBS patients who suffer from frequent constipation, we will sometimes recommend increasing dietary fiber in an effort to aid the digestive process,” explains Dr. Muddasani.  “It’s important that increased fiber consumption be implemented gradually to minimize additional gas and bloating.” 

In addition to dietary changes, your physician may prescribe medication to treat IBS.  It’s important that a person with IBS not habitually rely on over-the-counter laxatives to relieve constipation or on anti-diarrheal medications.  While it is OK to use these on a limited basis for occasional symptoms, they should not be used regularly and are not an effective treatment for IBS. 

Heartburn: GER & GERD         

Most people experience Gastroesophageal Reflux (GER) occasionally.  GER is more commonly known as heartburn or acid reflux.  The condition occurs when stomach contents, including acid, travel back up the esophagus, creating an unpleasant burning sensation.  This is a common condition and can usually be managed with dietary adjustments and a variety of over-the-counter medicines, provided the symptoms are not occurring on a regular basis.  People have different GER triggers, but the most common culprits include foods that are fried, greasy or spicy.

If someone experiences acid reflux on a frequent and regular basis, that could indicate a more serious condition, known as Gastroesophageal Reflux Disease (GERD). GERD is a chronic condition characterized by frequent and severe episodes of acid reflux.  GERD is a serious disease, as it can damage the lining of the esophagus and even cancer, if left untreated.  In addition to dietary changes, your doctor may prescribe medication to treat GERD and, in some cases, surgery is an option. 

Smoking is a significant risk factor for GERD.  One of the many ways smoking damages the body is by weakening the lower esophageal sphincter, the muscle in between the stomach and esophagus.  This muscle is responsible for keeping the contents of the stomach in the stomach – when it is weakened, it allows stomach acid to flow back up into the esophagus, causing heartburn. 

Inflammatory Bowel Disease (IBD)

Despite their similar initials, Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS) should not be confused with one another.  While IBS does not result in structural damage to the digestive system, IBD refers to serious conditions that result in the inflammation of the digestive tract.  In some cases, IBD can be life-threatening.   

There are two main types of Inflammatory Bowel Disease (IBD): Chron’s disease and ulcerative colitis.  With ulcerative colitis, the inner lining of the large intestine becomes inflamed, while Chron’s disease is characterized by inflammation that extends deep into the intestine wall and possibly into the small intestine and other parts of the digestive system.  Both types of IBD cause severe symptoms, including rectal bleeding, fever, fatigue, loss of appetite, diarrhea, weight loss and cramping pain in the gut. 

There is no identified cause of IBD, but research suggests that the introduction of certain bacteria or viruses into the digestive system may play a role, as could food allergies or genetics.  The immune system mistakes food or other substances, such as bacteria, for a threat and begins to attack, causing fever and white blood cell counts to rise. 

IBD can be treated with a variety of medications, including anti-inflammatories, immune system suppressors and antibiotics.  While there is no cure for IBD, medications can sometimes prevent symptoms from recurring and push the disease into remission.  In some cases, surgery is also required to treat both Chron’s disease and ulcerative colitis. 

Diverticulitis

A common GI issue in adults over the age of 50 is diverticular disease, which occurs when a weakening of the wall of the colon allows small pouches to push through these weak areas.  For many people, this never causes any symptoms, but sometimes the pouches can become infected or inflamed, bringing about an onset of diverticulitis. 

Diverticulitis can come on suddenly and causes nausea, fever, pain and changes in bowel movements.  You should see a physician immediately if these symptoms occur.  In milder cases, diverticulitis can be treated with antibiotics, rest and a temporary restricted diet.  In more severe cases, hospitalization may be required.  Surgery may be necessary if the diverticulitis symptoms recur frequently or a complication, such as a bowel obstruction, develops. 

Gallstones

A gallstone is a hard object that develops in the gallbladder.  It can range from a small speck to the size of a golf ball.  Most gallstones are made up of hardened cholesterol and usually produce no symptoms or problems.  However, if a gallstone obstructs the ducts in the gallbladder, this interferes with the normal digestive process and can cause intense pain in the upper right abdomen, nausea and vomiting.

A gastroenterologist can diagnose the presence of gallstones through a CT scan or ultrasound.  The most common treatment is surgery to remove the gallbladder, which is a non-essential organ. 

“While the gallbladder serves a purpose, it is not an essential organ,” says Dr. David Rutledge, a general surgeon who specializes in minimally invasive surgery.  “When the gallbladder causes problems, such as painful gallstones, the best solution is usually to simply remove the gallbladder – and the best way to conduct this surgery is usually laparoscopically.”

Keep Your Gut Healthy

Pay attention to the foods you eat and how they make you feel.  If eating certain foods causes you to have heartburn or other unpleasant symptoms, avoid or cut back on those foods.

Everyone experiences an upset stomach occasionally, but if you have recurring and frequent bouts of diarrhea, constipation, gas or other issues that cause you discomfort, it’s time to make an appointment to see your doctor about it.  And while over-the-counter medications can work to relieve occasional symptoms such as heartburn, gas, cramping, and upset stomach, never use them for more than a few days at a time. 

Finally, if you experience these symptoms combined with a high fever, blood in stool or vomit, severe cramping or dehydration, it may well be a medical emergency, so get to a health care provider immediately. 

This article contains information sourced from:

American College of Gastroenterology

The U.S. Centers for Disease Control and Prevention

National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health

The Mayo Clinic