Digestive diseases (Gastrointestinal diseases)

Digestive disease: Description:All diseases that pertain to the gastrointestinal tract are labelled as digestive diseases. This includes diseases of the esophagus, stomach, first, second and third part of the duodenum, jejunum, ileum, the ileo-cecal complex, large intestine (ascending, transverse and descending colon) sigmoid colon and rectum.The digestive system is made up of the digestive tract—a series of hollow organs joined in a long, twisting tube from the mouth to the anus—and other organs that help the body break down and absorb food (see figure).Organs that make up the digestive tract are the mouth, esophagus, stomach, small intestine, large intestine—also called the colon—rectum, and anus. Inside these hollow organs is a lining called the mucosa. In the mouth, stomach, and small intestine, the mucosa contains tiny glands that produce juices to help digest food. The digestive tract also contains a layer of smooth muscle that helps break down food and move it along the tract.Two “solid” digestive organs, the liver and the pancreas, produce digestive juices that reach the intestine through small tubes called ducts. The gallbladder stores the liver's digestive juices until they are needed in the intestine. Parts of the nervous and circulatory systems also play major roles in the digestive system.When you eat foods—such as bread, meat, and vegetables—they are not in a form that the body can use as nourishment. Food and drink must be changed into smaller molecules of nutrients before they can be absorbed into the blood and carried to cells throughout the body. Digestion is the process by which food and drink are broken down into their smallest parts so the body can use them to build and nourish cells and to provide energy.Digestion involves mixing food with digestive juices, moving it through the digestive tract, and breaking down large molecules of food into smaller molecules. Digestion begins in the mouth, when you chew and swallow, and is completed in the small intestine.The large, hollow organs of the digestive tract contain a layer of muscle that enables their walls to move. The movement of organ walls can propel food and liquid through the system and also can mix the contents within each organ. Food moves from one organ to the next through muscle action called peristalsis. Peristalsis looks like an ocean wave traveling through the muscle. The muscle of the organ contracts to create a narrowing and then propels the narrowed portion slowly down the length of the organ. These waves of narrowing push the food and fluid in front of them through each hollow organ.The first major muscle movement occurs when food or liquid is swallowed. Although you are able to start swallowing by choice, once the swallow begins, it becomes involuntary and proceeds under the control of the nerves.Swallowed food is pushed into the esophagus, which connects the throat above with the stomach below. At the junction of the esophagus and stomach, there is a rianglike muscle, called the lower esophageal sphincter, closing the passage between the two organs. As food approaches the closed sphincter, the sphincter relaxes and allows the food to pass through to the stomach.The stomach has three mechanical tasks. First, it stores the swallowed food and liquid. To do this, the muscle of the upper part of the stomach relaxes to accept large volumes of swallowed material. The second job is to mix up the food, liquid, and digestive juice produced by the stomach. The lower part of the stomach mixes these materials by its muscle action. The third task of the stomach is to empty its contents slowly into the small intestine.Several factors affect emptying of the stomach, including the kind of food and the degree of muscle action of the emptying stomach and the small intestine. Carbohydrates, for example, spend the least amount of time in the stomach, while protein stays in the stomach longer, and fats the longest. As the food dissolves into the juices from the pancreas, liver, and intestine, the contents of the intestine are mixed and pushed forward to allow further digestion.Finally, the digested nutrients are absorbed through the intestinal walls and transported throughout the body. The waste products of this process include undigested parts of the food, known as fiber, and older cells that have been shed from the mucosa. These materials are pushed into the colon, where they remain until the feces are expelled by a bowel movement.The digestive glands that act first are in the mouth—the salivary glands. Saliva produced by these glands contains an enzyme that begins to digest the starch from food into smaller molecules. An enzyme is a substance that speeds up chemical reactions in the body.The next set of digestive glands is in the stomach lining. They produce stomach acid and an enzyme that digests protein. A thick mucus layer coats the mucosa and helps keep the acidic digestive juice from dissolving the tissue of the stomach itself. In most people, the stomach mucosa is able to resist the juice, although food and other tissues of the body cannot.After the stomach empties the food and juice mixture into the small intestine, the juices of two other digestive organs mix with the food. One of these organs, the pancreas, produces a juice that contains a wide array of enzymes to break down the carbohydrate, fat, and protein in food. Other enzymes that are active in the process come from glands in the wall of the intestine.DigestiveThe second organ, the liver, produces yet another digestive juice—bile. Bile is stored between meals in the gallbladder. At mealtime, it is squeezed out of the gallbladder, through the bile ducts, and into the intestine to mix with the fat in food. The bile acids dissolve fat into the watery contents of the intestine, much like detergents that dissolve grease from a frying pan. After fat is dissolved, it is digested by enzymes from the pancreas and the lining of the intestine.Most digested molecules of food, as well as water and minerals, are absorbed through the small intestine. The mucosa of the small intestine contains many folds that are covered with tiny fingerlike projections called villi. In turn, the villi are covered with microscopic projections called microvilli. These structures create a vast surface area through which nutrients can be absorbed. Specialized cells allow absorbed materials to cross the mucosa into the blood, where they are carried off in the bloodstream to other parts of the body for storage or further chemical change. This part of the process varies with different types of nutrients.Digestive Health Tips:Tips on Belching, Bloating, and Flatulence
  • Belching is caused by swallowed air from:
  • Eating or drinking too fast.
  • Poorly fitting dentures; not chewing food completely.
  • Carbonated beverages.
  • Chewing gum or sucking on hard candies.
  • Excessive swallowing due to nervous tension or postnasal drip.
  • Forced belching to relieve abdominal discomfort.
To prevent excessive belching, avoid:
  • Carbonated beverages.
  • Chewing gum
  • Hard candies.
Abdominal bloating and discomfort may be due to intestinal sensitivity or symptoms of irritable bowel syndrome. To relieve symptoms, avoid:
  • Broccoli.
  • Baked beans.
  • Cabbage.
  • Carbonated drinks.
  • Cauliflower.
  • Chewing gum.
  • Hard candy.
Flatulence is gas created through bacterial action in the bowel and passed rectally. Keep in mind that:
  • 10-18 passages per day are normal.
  • Primary gases are harmless and odorless.
  • Noticeable smells are trace gases related to food intake.
Tips on Peptic Ulcer Disease
  • Ulcers are "sores" that frequently affect the stomach and the first part of the small intestine (duodenum).
  • Bacterial infection is the most common cause of duodenal ulcers.
  • Stomach ulcers are often a side effect of pain killers and anti-inflammatory drugs used primarily to treat arthritis.
  • Alcohol ingestion, cigarette smoking, and emotional stress may also influence the development of an ulcer or interfere with its healing.
  • Upper abdominal pain is the most common symptom of ulcers, but many ulcers cause no symptoms at all.
  • Ulcers may hemorrhage (bleeding) into the gastrointestinal tract; this results in the passage of black ("tarry") stool. Very serious ulcer disease may also cause a blockage between the stomach and small intestine and this complication results in persistent vomiting. Severe pain results from the most urgent complication of ulcers - peritonitis caused by a tear through the wall of the stomach or duodenum.
  • Almost all ulcers can be treated successfully, usually without surgery. Many ulcers can be prevented.
  • Ulcer treatments include antibiotics, agents that neutralize gastric acid or reduce its secretion, and drugs that strengthen the resistance of the stomach and duodenum.
Tips on Swallowing and Heartburn:Abnormal swallowing is commonly perceived as food "sticking on the way down." If this complaint persists, it is sometimes due to a serious condition and should always prompt medical attention.Swallowing difficulty may be caused by a number of different problems including:Poor or incomplete chewing (possibly the result of dental problems, poorly fitted dentures, or eating too quickly)
  • Abnormal muscle contraction.
  • Scar tissue from chronic inflammation.
  • Infection.
  • Cancer.
Heartburn is a very common problem caused by regurgitation or reflux of gastric acid into the esophagus, which connects the mouth and the stomach.Heartburn can often be eliminated by avoiding:
  • Smoking.
  • Fatty food in the diet.
  • Caffeine.
  • Chocolate.
  • Peppermint.
  • Overeating.
  • Bed-time snacks.
  • Tight-fitting clothes that constrict the abdomen.
  • Certain medications.
  • Heavy lifting, straining.
Tips on Gallstone Disease:
  • Gallstones typically develop over many years, although they can form in months. Gallstones are present in about 20% of women and 10% of men over the age of 55.
  • There are two basic types of gallstones: cholesterol and pigment. Cholesterol gallstones are the most common type in the United States.
  • About 75% of gallstones do not cause symptoms. The most common symptom caused by gallbladder stones is episodic upper abdominal pain.
  • For healthy patients who have no symptoms, no therapy or change in diet is needed. Patients with uncomplicated symptomatic gallbladder stones should reduce dietary fat and consider surgical removal of the gallbladder (cholecystectomy). An alternate approach is oral bile acid therapy. For complicated disease, gallbladder removal is warranted.
  • Patients who undergo rapid weight loss are at risk for the development of small cholesterol gallstones and may benefit from bile acid therapy. Gallstones can seldom be prevented, although a low-fat diet may provide some protective benefit.
Tips on Hepatitis:
  • Five different hepatitis viruses have been identified: type A; type B; type C; type D, or delta virus; and type E. Type A is probably the most prevalent type of viral hepatitis worldwide, followed by types B, E, C, and D.
  • Hepatitis A and E are transmitted through fecally contaminated food or water. Other modes of transmission include needle sharing among intravenous drug abusers; sexual contact; maternal transmission; and transmission by blood transfusion.
  • A simple blood test is used to determine that a person has one or more of the different types of hepatitis.
  • Acute hepatitis is typically characterized by flu-like symptoms (including fever, headaches, fatigue, nausea and vomiting) and jaundice. Chronic hepatitis is often asymptomatic.
  • Vaccines are available to protect against hepatitis A and B. Additionally, immune globulin for hepatitis A or hepatitis B is recommended when someone has been exposed to an infected person.
  • Among the ways to care for your liver are: limiting alcohol consumption; avoiding liver- damaging drugs; practicing safe sex; avoiding use of illegal drugs; avoiding high doses of vitamins unless prescribed; avoiding tattoos and the sharing of razors; not eating raw shellfish from questionable sources; and carefully following directions for use of toxic substances (e.g., cleaning products).
Tips on Circulatory Disorders of the GI Tract:
  • The small intestine and the colon have a relatively restricted blood supply and are frequently affected by circulatory disorders, whereas the esophagus, stomach, and rectum are well supplied with blood and are only occasionally involved in circulatory disturbances.
  • The colon is commonly affected by ischemia (reduction of blood flow to a level not permitting normal function). In most cases, symptoms subside within days and healing is seen within 2 weeks. Antibiotics and bowel rest usually suffice. In complicated disease, damaged parts of the colon must be removed surgically.
  • Acute mesenteric ischemia results from inadequate circulation of blood to the small intestine. Treatment is aimed at dilating (opening) the blood vessels with drugs and/or surgery to restore intestinal blood flow and to remove any irreversibly damaged bowel.
  • Chronic mesenteric ischemia results when blood flow to the small intestine is reduced to an insufficient level. It causes pain associated with eating. Surgery is often warranted to correct the problem.
Tips on Irritable Bowel Syndrome:Irritable bowel syndrome (IBS) is a digestive problem also known as "spastic colon" or "irritable colon."IBS symptoms include:
  • Abdominal pain (colicky, periodic or continuous dull pain)
  • Erratic bowel activity; frequent constipation or diarrhea
  • Accompanying symptoms of bloating, nausea, headache, fatigue
  • Sensitivity to intestinal gas (cramping, flatulence)
The cause of IBS is unknown:
  • No evidence of specific disease
  • May be triggered by psychological factors or ingestion of food
Treatment of IBS includes:
  • Careful explanation of the syndrome, including what it is not
  • Better management of key triggers: stress and diet
  • Modification of diet to reduce or exclude foods that promote gas
  • Drug therapy to relieve symptoms (bulk fiber products, antispasmodics, antidiarrheals).
  • Occasionally, psychiatric therapy and medication
Tips on Inflammatory Bowel Disease:Inflammatory bowel disease (IBD) is an inflammation of the small or large intestine that may cause these symptoms:
  • Diarrhea.
  • Rectal bleeding.
  • Sharp abdominal pain or cramping.
  • Intestinal obstruction.
  • Fever.
There are two types of IBD:
  • Ulcerative Colitis
  • Crohn's Disease:
  • IBD is not Contagious.
  • IBD is not caused by diet.
  • IBD is not a form of cancer.
  • IBD affects young and old alike.
  • IBD can usually be treated with medicine but sometimes requires surgery.
Treatment of IBD may include:
  • Medications to reduce or eliminate inflammation
  • Special diet or elemental formula diet
  • Surgery
  • Time is critical. If you suspect IBD, call your doctor.
Tips on Constipation and Incontinence of Stool:Despite widespread belief, constipation is not necessarily a part of growing older.Bowel habits are similar in both younger and older healthy people.Constipation is defined as stools that are too hard, too small.Too difficult to passInfrequent (less than 3 per wee.)Constipation is caused by:
  • Not enough dietary fiber or fluids
  • Medication side effects
  • Emotional or physical stress
  • Misconception about normal bowel habits
  • Lack of activity
  • Medical problems
How to manage mild-to-moderate constipation:
  • Gradually add dietary fiber from various sources.
  • Increase fluids (water, soup, broth, juices).
  • Eat meals on a regular schedule.
  • Chew your food well.
  • Gradually increase daily exercise.
  • Respond to urges to move your bowels.
  • Avoid straining.
See your doctor if these measures don't workTips on Diverticular Disease:Diverticulosis is a condition with pouch-like protrusions in the colon:
  • Rare before age 30
  • Common after age 60
  • Usually no symptoms
Complications of diverticulosis include:
  • Bright red rectal bleeding with clots
  • Diverticulitis
Treatment of diverticulitis may include:
  • Antibiotics.
  • Special feeding.
  • Surgery.
Tips on Hemorrhoids:Hemorrhoids are masses of swollen veins in the lower rectum (internal hemorrhoids) or at the anus (external hemorrhoids).Symptoms of internal hemorrhoids include:
  • Bright red rectal bleeding.
  • Staining of undergarments with mucus.
Symptoms of external hemorrhoids include:
  • Pain and itching when irritated by constipation or diarrhea.
  • Difficulty with hygiene.
Hemorrhoids are caused by:
  • Straining.
  • Work strain (lifting, etc.)
  • Straining while defecating.
  • Chronic constipation.
  • Passing hard, dry, small stools.
  • Laxative abuse.
Tips on Use of Medications
  1. Use of medications increases with age: 80% of older Americans who live independently receive 20 or more prescriptions per year Residents of nursing homes receive an average of 8-10 drugs per day
  2. It is important to take medications as prescribed. Reasons for not following directions include:
  • Too many drugs.
  • Error due to visual or mental impairment.
  • Sharing drugs.
  • Changing doctors.
  • Use of over-the-counter drugs.
  • Sparing expense.
  • Drug side effects.
  • Symptoms not improving.
3. See your doctor regularly to check on medications and their effect (bring your medications with you for an office visit or to an emergency room): Drug effect changes with aging There is decreased absorption of drugs through the intestinal tract Decreased kidney function slows drug elimination Metabolism of drugs changes with age4. The effect medications have on your body will change with aging. For example: Drug action may last longer Drugs may produce toxicity at a lower dose in mature adults than in younger adults5. Remember that all changes you experience are not necessarily due to aging. For example, decrease in salivary flow is: Due to disease or medication not due to agingDISCLAIMER: This information should not substitute for seeking responsible, professional medical care. 

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