Digestive Disorders

Julie Corliss

Probiotics may ease constipation

Probiotics, the beneficial bacteria found in yogurt and other cultured foods, have long been touted for their ability to ease digestive woes. The strongest evidence for probiotics is in treating diarrhea caused by a viral infection or from taking antibiotics. Do probiotics also work for the opposite problem — constipation? A report from King’s College in London showed that taking probiotics can help soften stools, making them easier to pass, and can increase the number of weekly bowel movements. What we don’t know is which probiotic species and strains are most effective, how much to take, and for how long.

Heidi Godman

Study says aggressive treatment for diverticulitis is often overused

Diverticulitis, an unpleasant condition that occurs when tiny pouches inside the large intestine become inflamed, can cause intense lower abdominal pain, diarrhea, constipation, a fever, and sometimes a good deal of rectal bleeding. Following a liquid diet for a while can help treat it, but antibiotics, and sometimes even surgery, may be needed. A new study in JAMA suggests that these treatments may be overused.
University of Michigan researchers reviewed the results of 80 studies of diverticulitis and its treatment. While the team agreed that antibiotic use and surgery are sometimes necessary, it concluded that there should be a lesser role for aggressive antibiotic or surgical intervention for chronic or recurrent diverticulitis than was previously thought necessary. Some studies suggest that exercising, controlling weight, and eating a high-fiber diet can prevent diverticular disease. It can also bring relief from constipation, better cholesterol control, and make for more filling meals. Adults should get 25 to 30 grams of dietary fiber every day. It’s best to get it from high-fiber foods, such as beans, whole grains, vegetables, and fruits. Some people need a fiber supplement.

Daniel Pendick

6 self-help tips for hemorrhoid flare-ups

Hemorrhoids are swollen blood vessels on the outer rectum and anus. They can turn bowel movements into intensely painful experiences. Classic symptoms include rectal pain, itching, bleeding, and possibly prolapse (protrusion of hemorrhoids into the anal canal). Although hemorrhoids are rarely dangerous, they can be a painful recurrent bother. Simple self-help measures can ease the ordeal of most hemorrhoids and allow healing. These include: Step up the fiber. Lubricate the process. Don’t delay having bowel movements. Try over-the-counter remedies. And sit in a sitz.

Patrick J. Skerrett

Simple blood test helps bring celiac disease out of the shadows

What happens when the body rejects a protein found in many foods? Ask anyone with celiac disease. This increasingly common condition—it’s grown four-fold since the 1950s—causes a host of aggravating and potentially disabling symptoms such as gas, bloating, diarrhea, cramps, fatigue, weight loss, and more. But it’s also a trickster, causing subtle changes that may not be identified as stemming from celiac disease, like iron-deficiency anemia, low vitamin D, or a suspicious broken bone in an otherwise healthy person. People with celiac disease can’t tolerate gluten, a protein found in wheat, barley, and rye, even in small amounts. It once took an average of 10 years to diagnose celiac disease. Today it can happen faster, thanks to a simple blood test that detects anti-gluten antibodies.

Patrick J. Skerrett

CDC wants all Baby Boomers to be tested for hepatitis C

In an effort to stem the smoldering epidemic of hepatitis C, the Centers for Disease Control and Prevention is proposing today that all Baby Boomers—anyone born between 1945 and 1965—have a one-time test for hepatitis C. This widespread but often silent disease can lead to liver damage, and even death.

Howard LeWine, M.D.

Probiotics may help prevent diarrhea due to antibiotic use

Eating yogurt or taking a so-called probiotic when you have to take antibiotics may help prevent the diarrhea that often accompanies antibiotic treatment. That’s the conclusion of a study just published in the Journal of the American Medical Association. A team of California-based researchers combined the results of 63 randomized trials pitting probiotics versus placebo among almost 12,000 men and women taking antibiotics. Those who took antibiotics plus probiotics were 42% less likely to develop diarrhea as those who got the placebo. About one in three people who take antibiotics develop diarrhea. Antibiotics kill these “good” microbes along with bacteria that are causing an infection. This upsets the balance of the normal flora in the intestines. The result is often loose, watery stools known as antibiotic-associated diarrhea.

Howard LeWine, M.D.

$2 drug treatment helps prevent exam-caused pancreas problem

A test used to give doctors a close-up view of the pancreas, called endoscopic retrograde cholangiopancreatography (ERCP), often cause a painful inflammation of the pancreas (pancreatitis). According to report in the New England Journal of Medicine, a single dose of indomethacin, a powerful nonsteroidal anti-inflammatory drug, can help prevent this post-procedure problem. About half a million Americans have ERCP each year. As many as one in six develop pancreatitis afterward. In a randomized controlled trial that included men and women who had just undergone ERCP, administration of an indomethacin suppository right after the procedure cut the rate of post-ERCP pancreatitis almost in half. Once a person has pancreatitis, the chances he or she will have it again go up. That’s why the New England Journal report is good news for anyone who needs to undergo ERCP.

Kay Cahill Allison

Itching rash or tingling toes: Is gluten the cause?

Gluten, an umbrella term for proteins found in wheat, rye, and barley, makes dough resilient and stretchy. Some people can’t eat foods made with these grains because gluten triggers an immune reaction and causes inflammation of the lining of the small intestine. This can eventually interfere with the absorption of nutrients from food. This condition, called celiac disease, can cause symptoms like gas, bloating, and abdominal cramps. A growing number of people who don’t have celiac disease suffer many of its symptoms. They are classified as “gluten sensitive” or “gluten intolerant.” A new Special Health Report from Harvard Health Publications called “Food Allergy, Intolerance, and Sensitivity” covers how to cope with gluten sensitivity, lactose intolerance, and other food allergies and sensitivities.