Digestive Health

Your digestive system breaks down foods and liquids into their chemical components—carbohydrates, fats, proteins, and the like—that the body can absorb as nutrients and use for energy or to build or repair cells.

Food's journey through the digestive system begins in the mouth. It passes down the esophagus and into the stomach, where digestion begins. Next stop: the small intestine, which in the average person is more than 20 feet long. The small intestine further breaks down food, absorbs nutrients, and sends them into the bloodstream.

The remaining watery food residue moves into your large intestine, a muscular tube about 4 feet long. As undigested food passes through it, bacteria feed off the remnants. The wall of the large intestine soaks up most of the remaining water. Any undigested food that remains is expelled by a highly efficient disposal system.

Like all complicated machinery, the digestive tract doesn't always run smoothly. In some people, the problem is genetic. In others, the immune system mistakenly attacks the digestive system, causing various digestive woes. What we eat, and how we eat, can also throw off digestive health.

Common ailments of the digestive system include:

  • heartburn, also known as gastroesophageal reflux disease (GERD)
  • peptic ulcer
  • diverticular disease
  • irritable bowel syndrome (IBS)
  • gallstones
  • celiac disease
  • constipation
  • diarrhea

Keeping your digestive system healthy

There are several ways to keep your digestive system healthy:

  • Don't smoke.
  • Keep your weight in the healthy range.
  • Eat a balanced, healthy diet.
  • Exercise several times a week, if not every day.
  • Learn different ways to reduce stress.

Digestive Health Articles

Comparing the Side Effects of Prostatectomy vs. Radiation Therapy

H. pylori Infection May Aggravate GI Injury in Patients Taking Low-dose AspirinDoctors commonly prescribe low-dose aspirin for the prevention of heart disease, but it may also be responsible for some potentially serious side effects when taken frequently. Among the most common of these are gastrointestinal erosions and ulcers. A recent study in The American Journal of Gastroenterology sought to determine whether certain people taking low-dose aspirin — specifically, people infected with Helicobacter pylori, a common bacterium that can cause ulcers — are more susceptible to gastrointestinal erosions and ulcers than people who are not infected with H. pylori. Researchers from the University of Texas Southwestern Medical School and Baylor College of Medicine recruited 61 healthy volunteers between the ages of 18 and 61. Of these, 29 volunteers were infected with H. pylori. Forty-six of the volunteers were then randomly selected to receive low-dose aspirin (either 81 mg daily or 325 mg every three days), while 15 received a placebo. More »

Diagnosing and treating irritable bowel syndrome

Irritable bowel syndrome (IBS) is a chronic disorder characterized by recurrent bouts of constipation, diarrhea, or both, as well as abdominal pain, bloating, and gas. IBS is a functional disorder, which means that it's not attributable, as far as we know, to any underlying disease process or structural abnormality. It's thought to involve various, often interacting, factors — infection, faulty brain-gut communication, heightened pain sensitivity, hormones, allergies, and emotional stress. The good news is that IBS doesn't increase the risk for more serious conditions, such as ulcerative colitis or colon cancer. On the other hand, a disorder resulting in (at best) annoying and (at worst) debilitating and worrisome symptoms with no known cause can be difficult to diagnose and treat, not to mention live with. Managing IBS typically involves some trial and error, which can be challenging for patients and clinicians alike. Various tests or procedures may be ordered to rule out other conditions. Many diverse therapies, not all of them proven, are used in treating the symptoms, including antibiotics, antispasmodics, antidepressants, dietary changes, relaxation techniques, and psychotherapy, as well as drugs to relieve constipation and diarrhea. In the past doctors often ordered extensive testing (complete blood count, thyroid function test, stool testing for parasites, and abdominal imaging) before diagnosing IBS. This is usually unnecessary for people with typical IBS symptoms who have no family history of colon cancer, inflammatory bowel disease, or celiac sprue — and no "alarm symptoms," including rectal bleeding, weight loss, or iron-deficiency anemia. More »

Health benefits of taking probiotics

What are the benefits of taking probiotics? Bacteria have a reputation for causing disease, so the idea of tossing down a few billion a day for your health might seem — literally and figuratively — hard to swallow. But a growing body of scientific evidence suggests that you can treat and even prevent some illnesses with foods and supplements containing certain kinds of live bacteria. Northern Europeans consume a lot of these beneficial microorganisms, called probiotics (from pro and biota, meaning "for life"), because of their tradition of eating foods fermented with bacteria, such as yogurt. Probiotic-laced beverages are also big business in Japan. Some digestive disease specialists are recommending probiotic supplements for disorders that frustrate conventional medicine, such as irritable bowel syndrome. Since the mid-1990s, clinical studies suggest that probiotic therapy can help treat several gastrointestinal ills, delay the development of allergies in children, and treat and prevent vaginal and urinary infections in women. More »

When You Visit Your Doctor - Gallstones

Do you have pain in the mid- or upper-right portion of your abdomen? Do fatty meals worsen the pain? Does the pain occur after eating? Do you have nausea, vomiting, or bloating? Does the pain ever go through to your back? Is the pain steady or intermittent? Have you had fevers? How long does it take for the pain to go away? Do you take any medications (for example, birth-control pills or hormone therapy)? Have you had any rapid weight loss? Have you noticed darkening of your urine or yellowing of the eyes? Abdominal exam Blood tests of liver function Complete blood count Abdominal ultrasound Cholescintigraphy (HIDA scan)   More »

When You Visit Your Doctor - Gastroesophageal Reflux Disease (GERD)

Do you get a burning sensation in your chest or throat after eating? Do you ever have a bitter or sour taste in your mouth? Do you ever have bloating or nausea after you eat? How often do you get these symptoms? What do you do to relieve the symptoms? Are the symptoms related to physical exertion? Are the symptoms worse when you are lying down or sitting up? Have you noticed any black stools? Do you have a persistent cough? Do you have a history of ulcer disease? Are you taking any medications, especially ones that can irritate the esophagus or stomach, such as aspirin, ibuprofen, naproxen or tetracycline? Do you drink alcohol or smoke? How soon after you eat at night do you go to bed? Have you tried any over-the-counter medications? If so, do they help? Chest and lung exam Abdominal exam Upper endoscopy (internal examination of the esophagus and stomach) pH probe (to assess the acid level in the esophagus and stomach) Manometry (to measure the pressure of the sphincter between the esophagus and the stomach) Stool testing for blood Complete blood cell count   More »

When You Visit Your Doctor - Irritable Bowel Syndrome (IBS)

Do you have pain or cramping in the lower stomach? How often do you get the pain? Is the pain related to meals? Do you suffer from constipation and small bowel movements? Do you have diarrhea that alternates with constipation? Do you have frequent bloating and gas? Do you have a feeling of fullness in the rectum? Is there a family history of inflammatory bowel disease? Do you have a history of mental illness or depression? Are there any things causing unusual stress in your life? Please describe your diet in detail. Careful abdominal exam Rectal exam Stool testing for blood and cultures Conventional abdominal X-rays Endoscopy or sigmoidoscopy Barium enema Complete blood count and other blood tests   More »

When You Visit Your Doctor - Peptic Ulcer Disease

Do you have diffuse or localized abdominal pain? Does the pain ever travel to the back or chest? Do you have nausea associated with the pain? Does eating make the pain better or worse? Do you have black or bloody stools? Do you ever vomit blood or material that looks like coffee grounds? Do you take any medications (for example, pain relievers)? Do you smoke cigarettes or drink alcohol? Do you drink caffeine-containing beverages? Have you ever been tested or treated for a bacteria called H. pylori that can infect the stomach lining? Do you have a family history of peptic ulcer disease? Careful abdominal exam Rectal exam Stool testing for blood Blood or breath test for the presence of H. pylori Upper endoscopy (internal examination of esophagus, stomach, and duodenum) Upper GI series   More »

A New Acute Hepatitis C Treatment

A newly-tested treatment for acute hepatitis C virus (HCV) may prevent the infection from developing into the chronic stage. The virus is the leading cause of liver disease in the United States.Researchers in Germany found acute HCV did not progress in 98 percent of infected study subjects who received interferon alfa-2b treatment, an antiviral protein. Their results also suggest the treatment is more effective, less expensive, and leads to fewer side effects than other known therapies. The study will be appearing in the New England Journal of Medicine's November 15, 2001, issue.During the first four weeks of the study, patients were injected with 5 million U of the drug daily, followed by 5 million U three times a week for the next 20 weeks. It took 3.2 weeks, on average, for levels of HCV to become undetectable in patients, and all 44 patients reached the undetectable mark at some point during therapy. After an additional 24 weeks of follow up, 42 of the 43 patients who completed the study still were still infection free.The researchers suggest 24 weeks of therapy for patients in the early part of the acute stage (fewer in patients whose serum levels of HCV quickly become undetectable), and 48 weeks of therapy for patients with chronic HCV. Though no serious side effects were noted, one person dropped out because of hair loss and flu-like symptoms.There is no standard treatment for acute HCV, and progression from acute to chronic occurs in 50%–84% of cases. Chronic HCV infects almost 4 million people in the United States and about 170 million people worldwide. Cirrhosis of the liver develops in 10–30 percent of those people.November 2001 Update Back to Top An estimated 3.9 million people in the United States are infected with the hepatitis C virus (HCV). Hepatitis C affects the liver. In many — but not all — cases, hepatitis C progresses from mild to moderate inflammation (hepatitis), to scarring (fibrosis), to severe fibrosis with loss of liver function (cirrhosis), and finally liver failure. It is the leading cause of chronic liver disease and liver transplantation. But not all cases of hepatitis C progress to cirrhosis and the rate of progression of the disease is often unpredictable.The standard of care for treating hepatitis C is a combination of the antiviral drugs interferon-alpha and ribavirin. However, these drugs are not completely effective, they cause side effects, and they are expensive. Given the drugs' limitations and the unpredictable nature of disease progression, doctors remain in disagreement about whether treatment should begin at the onset of mild inflammation, or whether it should be delayed until a moderate amount of inflammation or cirrhosis exists.Using information from recent studies about the natural progression of HCV, researchers created a computer model that would help determine the optimal time to start combination antiviral drug therapy with interferon-alpha and ribavirin. The simulation projected that 18 percent of patients who had a liver biopsy every three years and started treatment at the onset of moderate inflammation would progress to cirrhosis after 20 years. This strategy avoided the need for treatment in 50 percent of patients, and increased life expectancy by 1.2 years. In patients who began treatment at the onset of mild inflammation, only 16 percent would progress to cirrhosis after 20 years, increasing life expectancy by another 0.4 years. In comparison, the computer model predicted that 27 percent of patients in the control group, which was left untreated, would have cirrhosis after 20 years.This study illustrated that beginning antiviral treatment at the onset of mild inflammation is the most effective treatment strategy. However, for patients with HCV and mild inflammation of the liver who do not wish to receive drug treatment or hope to delay it, biopsy management is also a reasonably effective option that could avoid treatment altogether. More »

H. Pylori and Gastric Cancer

Studies have linked Helicobacter pylori (H. pylori) infection with the development of gastric (stomach) cancer. H. pylori is a spiral-shaped bacterium that lives in the stomach and duodenum (the section of intestine just below the stomach). It has the ability to adjust to the harsh conditions in the stomach. H. pylori is believed to be transmitted orally. Recently, researchers in Japan sought to clarify this association and explore which, if any, gastrointestinal conditions increase a person's risk of developing gastric cancer. The results of this study appeared in the September 13, 2001, issue of the New England Journal of Medicine. The participants had duodenal (in the duodenum) ulcers, gastric ulcers, gastric hyperplasia (abnormal cell growth), or nonulcer dyspepsia (stomach pain). They underwent endoscopy — for the early detection of cancer — at enrollment and again during the next three years. Of the 1,526 who took part in the study, 1,246 had H. pylori infection and 280 did not. More »

Digestive System

Surgery for GERDIn recent years, people suffering from severe, chronic heartburn that can’t be controlled with medications have turned to surgery with hopes for permanent relief and the prevention of esophageal cancer. But the results of a recent study that assessed the well being of patients a decade after they had surgery question its benefits.Heartburn, also known as gastroesophageal reflux disease (GERD), occurs when the opening between the esophagus and stomach relaxes spontaneously, allowing acidic gastric juices to flow into the esophagus and cause irritation. Medications for GERD include antacids, proton pump inhibitors that decrease the amount of acid produced, and drugs that increase the tightness of the esophageal. Surgery, an option usually reserved for hard-to-treat GERD, involves folding the top of the stomach around the end of the esophagus to create a tighter opening. This procedure has become more popular with the development of minimally invasive techniques.A study from the late 1980s of 247 heartburn patients found surgery was better than medication at controlling symptoms. However, ten years later a follow-up study of 239 of the original patients found many of the patients who underwent surgery still suffered from heartburn. Though their symptoms were less intense than those who received medication in the original study, 62% of the surgical patients still took antireflux medication regularly (compared to 92% of the medical patients).The study also found that surgery failed to significantly decrease the risk for esophageal cancer compared to treatment with medication. Chronic heartburn is a risk factor for this cancer. However, the small size of the study combined with the low incidence of esophageal cancer did not rule out the possibility of a difference. A more surprising result of the study showed surgical patients were more likely to die than patients on medication. These deaths were not related to the surgery, but close to half (48%) were related to heart disease. The researchers were unprepared for this result and therefore have no data to explain this finding.The results of this study suggest that while surgery may do a better job at controlling the symptoms of heartburn, it doesn’t eliminate the need for medication or decrease cancer risk. In general, surgery should be seen as an option of last resort for those patients whose symptoms are hard to treat with medication. June 2001 Update   More »