What is your gut telling you?
It is normal for everyone’s stomach to feel unsettled from time to time, but if your gut is giving you problems frequently – gas, bloating, cramping, nausea – it’s time to head to your doctor’s office to get checked out.
You don’t have to live with frequent discomfort in your stomach, and Privia Medical Group North Texas (PMGNTX) primary care providers can diagnose and treat what’s ailing you. For complex gastrointestinal (GI) issues, PMGNTX gastroenterologists provide advanced, expert care for a wide range of issues.
Here’s an overview of some of the more common GI ailments:
Irritable Bowel Syndrome
Irritable Bowel Syndrome (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).
“We all experience many of the symptoms of IBS at various times,” explains Dr. Pavani Muddasani, a gastroenterologist in Fort Worth. “Occasional symptoms are probably not cause for concern, but if you experience this type of discomfort often, you should see your doctor 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. A colonoscopy may be ordered to rule out cancer, especially in patients over the age of 45. 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.
IBS Triggers
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.
Some of the most common IBS 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 may recommend increasing dietary fiber to aid the digestive process,” explains Dr. Muddasani. “Increased fiber consumption should be implemented gradually to minimize gas and bloating.”
In addition to dietary changes, your physician may prescribe medication to treat IBS. Someone with IBS should not regularly take over-the-counter laxatives to relieve constipation or 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.
GER & GERD
Most people experience Gastroesophageal Reflux (GER) occasionally. GER is 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 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 required to treat both Chron’s disease and ulcerative colitis.
Diverticulitis
A common GI issue in adults over the age of 50, diverticular disease occurs when a weakening of the colon wall allows small pouches to push through the weak area. 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. Gallbladder removal is almost always done through minimally invasive surgery.
Appendicitis
While technically not a GI condition, appendicitis can easily be confused with one since it causes intense pain in the abdomen. The appendix is a finger-shaped pouch located on the lower right side of the abdomen. If the appendix becomes infected, surgery is usually necessary to remove it before it bursts. People of any age can be impacted but the condition is most common between the ages of 10 and 30.
Appendicitis can be very dangerous. It is characterized by sudden sharp, intense pain in the lower part of the abdomen and may be accompanied by a low-grade fever and nausea. Anyone who experiences these symptoms or has unexplained and severe stomach pain should get to the emergency room immediately.
Appendicitis can be quickly diagnosed – or ruled out – through a blood test, physical exam and/or imaging. If untreated, appendicitis can cause the appendix to rupture, which results in the release of toxins into the abdomen, a dangerous and potentially lethal condition.
“Prior to the advent of laparoscopic surgery, an appendectomy required a four-inch incision to open the patient up and remove the appendix,” explains Dr. Annette Marie Elbert, a general surgeon in Fort Worth. “In most cases today, we can remove the appendix laparoscopically, through three small incisions. This results in a shorter and less painful recovery period for the patient and prevents a long scar on the patient’s abdomen.”
Keep Your Gut Healthy
If you have occasional stomach discomfort, 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 relieve occasional symptoms, don’t use them for more than a few days at a time.
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
This article contains information sourced from:
American College of Gastroenterology
