Common Intestinal Problems

No, Barrett’s is not cancer. In simple terms, Barrett’s Esophagus is a reaction to longstanding esophageal damage that is caused by corrosive stomach acid back splashing upward. After many years of heartburn, the cells in the lower esophagus begin to transform into a different type of cell resembling that of the intestines. In a small percentage of patients, the cells go on to form so-called dysplasia, or early pre-cancerous changes. Some of these cells progress further to high grade dysplasia, which is closer to cancer and thus more serious.

It is true that the risk of esophageal cancer is higher if you have Barrett’s – about 40 times normal. But the usual risk of esophageal cancer in the general population is extremely small. Even when multiplied 40 times, the overall risk in those with Barrett’s is only a few percent. Of course, if you are one of those, numbers make no difference. And the incidence of esophageal cancer is on the rise in the US. Follow-up is important, especially for those with dysplasia.

No. This is a common misconception. For many years, it was believed that peptic ulcers of the stomach and duodenum were caused by what you ate or how you felt. Scientific research over the past decade now has proven spicy foods, emotional stress, and even family history, turn out not to be major causes of ulcer disease. Most ulcers in the stomach or duodenum are caused by one of two things:

• Anti-inflammatory drugs like aspirin, ibuprofen, and other prescription drugs for arthritis
• A bacteria called Helicobacter pylori, commonly called the “ulcer bacteria.”

Ulcers in the esophagus are different because they are usually caused by the backsplash of powerful stomach acids up into the lower esophagus. If you have ulcers or take aspirin-type drugs on a regular basis, switching to a different medication may allow the ulcers to heal and prevent future problems.

We now know that the majority of ulcers are caused by the Helicobacter infection, H. pylori, for short. Antibiotic treatment has a high success rate in eliminating the infection and curing ulcers for a lifetime.

Diverticulosis is a condition, rather than a disease. The majority of adults have some degree of diverticulosis. It affects the large intestine, or colon. A normal colon is strong and relatively smooth. A colon affected by diverticulosis has weak spots in the walls. These defects allow the development of balloon-like sacs or outpouches – much like a bubble forming on a worn inner tube. These hollow pouches, called diverticulae, occur when the inner intestinal lining has pushed through weakened areas of the colon wall. A single pouch is called a diverticulum. The presence of these pouches on the colon is called diverticulosis.

When the pouches are inflamed or infected, it is called diverticulitis, a more serious ailment.

Most individuals with diverticulosis never develop diverticulitis.

It simply means that your stomach organ is slipping upward into your chest. The diaphragm is a tough flat muscular membrane that separates your chest from your abdomen. Your stomach organ is normally below the diaphragm in the abdomen. To connect with your stomach, your esophagus must come down the middle of your chest and pass through a hole in the diaphragm called the hiatus.

In simple terms, some people’s hiatus weakens and opens up. This allows the esophagus to “pull the stomach up” into the chest cavity. Since part of the stomach herniates, or pushes through the opening, this condition has been termed a hiatal hernia.

A hiatal hernia is a common finding in adults and may cause no symptoms at all. Sometimes it is associated with a weakness in the lower esophageal valve and can worsen symptoms of acid reflux, or GERD.

Some slip up into the chest one day and back down into the abdomen another. This is called a sliding hiatal hernia.

When they become large and permanently stuck above the diaphragm, they are called a fixed hiatal hernia.

Many patients ask this question. The answer is sometimes, but usually not.  There are many non-cancerous reasons to have blood in the stool such as hemorrhoids, polyps, or fissures.

However, any adults who see blood in their bowel movements should consult their doctor for an examination. You can’t tell what the cause is without having a look inside.

If the doctor does not suspect a serious problem, a simple exam such as a flexible sigmoidoscopy might be sufficient. If there is any concern about trouble further inside, a full colonoscopy is usually advised.

The point is that all bleeding in adults must be evaluated. In most cases, no serious problem is found.

IBS is a somewhat common disorder in which the nerves and muscles in the bowel are very sensitive and do not function normally. While it is not a disease, it can be a difficult condition to live with. It is characterized by abdominal pain, constipation, or diarrhea. Changes in diet, plus medications and stress reduction can help people deal with the disorder.

IBD or colitis is a chronic disorder of the gastrointestinal tract involving inflammation of the intestine that results in abdominal pain, persistent diarrhea (often with blood and mucus), and fever. Ulcerative colitis is a serious chronic inflammation and ulceration of the lining of the colon and rectum.

Crohn’s disease is another form of colitis that includes thickening of the intestinal wall. The disease typically occurs in the small intestine near the point where it joins the colon, but other parts of the gastrointestinal tract can be affected. Drug treatment is effective for most patients, but others require surgery.

Everyone gets a little “stomach bug” from time to time and develops a bit of diarrhea. The cause is not usually known. Sometimes it’s due to emotional stress, or a virus. Often the cause is unrecognized food poisoning. Some cases are a reaction to the use of antibiotics.  Whatever the cause, most cases are mild and disappear in a few days.  Don’t try to stop diarrhea as soon as it develops.  Diarrhea is the body’s way of getting rid of whatever food, virus, or bug that is causing it.

If the diarrhea is not severe and there is no fever, rectal bleeding, severe abdominal pain, simple measures are usually effective.  This might include going to a BRAT diet for 48 hours and replacing lost fluids. BRATrefers to, Bananas, Rice, Apple Sauce and Tea.

Initially, the main initial concern is dehydration, especially in young children and the elderly. Symptoms of dehydration include fatigue, weakness, dry mouth, dark urine, decreased urine flow. Authorities recommenddrinking at least 8 to 10 glasses of fluid daily while the symptoms are active.  Don’t drink plain water, but instead use a solution such as Gatorade which also contains needed minerals such as sodium and potassium.

If the diarrhea does not respond to fluid and diet changes in a day or two, try one of the over-the-counter anti-diarrheal medicines such as Kaopectate, Pepto-Bismol (will blacken bowel movements), or Imodium AD. Simply follow the label instructions.

Rarely diarrhea is a sign of a more serious infection or ailment.

You should call your doctor for the following reasons:

• Diarrhea after recent antibiotic therapy
• The diarrhea is severe
• Bloody diarrhea
• Fever over 101 degrees
• Severe or persistent abdominal pain
• Symptoms lasting longer than 72 hours
• Decreased urine production or dark urine