Digestive Health Archive

What Is It?

Gastroenteritis is an inflammation of the intestines that causes diarrhea, abdominal cramps, nausea, loss of appetite, and other symptoms of digestive upset. In adults, the two most common causes of gastroenteritis are viral and bacterial infections:

• Viral gastroenteritis — In otherwise healthy adults, viral infections of the digestive tract are often responsible for mild episodes of gastroenteritis. These viral infections include the Norwalk virus, rotaviruses, adenoviruses and other agents.
  
  The viruses are very contagious, and usually spread from one person to another on unwashed hands, or by close contact with an infected person, such as sharing food or eating utensils. Viral gastroenteritis often spreads very easily in institutions and other situations where people live in close quarters, such as prisons, nursing homes, cruise ships, schools, college dorms and public campgrounds.
  
  The viruses also can be spread when someone either touches an infected person's stool or touches surfaces contaminated with infected stool. For this reason, health care professionals and child care workers have an especially high risk of viral gastroenteritis, particularly if they do not wash their hands thoroughly after dealing with soiled diapers, bedpans or bathroom fixtures.
  
  In some circumstances, the agents that cause viral gastroenteritis also can be carried in water or food, especially in drinking water or commercial shellfish that have been contaminated by sewage runoff. Infected food handlers who don't follow proper sanitary procedures also can spread viral gastroenteritis in meals served in restaurants and cafeterias.
• Bacteria — Salmonella, shigella, Campylobacter jejuni, E. coli and many other types of bacteria can cause gastroenteritis. They can be spread by close contact with an infected person, or by drinking or eating infected food or water. In some cases, the disease is caused by a toxin that is produced by bacteria growing on food that has been prepared or stored improperly. If a person eats this germ-filled food, symptoms of gastroenteritis are triggered either by the bacteria themselves or by their irritating byproducts. Symptoms from a toxin usually begin within a few hours. Symptoms from the bacteria can occur within a few days.

Each year in the United States, millions of people develop gastroenteritis by eating contaminated food, while millions more suffer from mild bouts of viral gastroenteritis. In otherwise healthy adults, both forms of gastroenteritis tend to be mild and brief, and many episodes are never reported to a doctor. However, in the elderly and people with weakened immune defenses, gastroenteritis sometimes can produce dehydration and other dangerous complications. Even in robust adults, certain types of aggressive bacteria occasionally cause more serious forms of food poisoning that can cause high fever and severe gastrointestinal symptoms, such as bloody diarrhea.

What Is It?

A hernia occurs when part of an internal organ or body part protrudes through an opening into an area where it shouldn't. A hiatal hernia is named for the hiatus, an opening in the diaphragm between your chest and your stomach. Normally, the esophagus (the tube that carries food to the stomach) goes through this opening. In a hiatal hernia, part of the stomach and/or the section where the stomach joins the esophagus (called the gastroesophageal junction) slips through the hiatus into the chest.

There are two types of hiatal hernias:

• Sliding — A part of the stomach and the gastroesophageal junction slip into the chest. Sliding hiatal hernias are common, especially in smokers, overweight people and women older than 50. These hernias are related to naturally occurring weaknesses in the tissues that normally anchor the gastroesophageal junction to the diaphragm and to activities or conditions that increase pressure within the abdomen. These activities or conditions include persistent or heavy coughing, vomiting, straining while defecating, sudden physical exertion and pregnancy.
• Paraesophageal — The gastroesophageal junction remains in its proper place, and a fold of the stomach slips into the chest, pinched between the gastroesophageal junction and the diaphragm. Of the two types of hiatal hernias, paraesophageal hernias are more likely to cause severe symptoms.

Symptoms

Sliding hiatal hernias may not cause any symptoms, or they may cause heartburn that is worse when you lean forward, strain or lie down. There may be chronic belching and, sometimes, regurgitation (backflow of stomach contents into the throat).

Over time, everyone's digestive system works less efficiently and people can develop food intolerance or begin taking medications that can affect digestion. These changes can create problems like gas, bloating, cramps, and constipation. By identifying the reasons for the digestive issues, managing them becomes easier and can help keep the entire system running smoothly.

Eating certain foods sometimes triggers indigestion or heartburn symptoms, particularly as people age. For example, consuming foods with certain natural sugars such as lactose may lead to cramping, diarrhea, bloating, and gas. Eating peppers, tomato sauces, and many other foods can worsen heartburn caused by gastroesophageal reflux disease (GERD). When one must remove trigger foods from the diet, there are alternatives that can also be satisfying, such as lactose-free dairy products. When removing a food isn't possible, some tricks—such as adding a dollop of sour cream—can help reduce the heat in spicy dishes.

What Is It?

Cholecystectomy is the surgical removal of the gallbladder, the small saclike organ located near the liver in the upper right side of the abdomen. It is attached to the main duct that carries bile from the liver into the intestine. Bile helps your body to break down and absorb fats. The gallbladder temporarily stores bile from the liver. When you eat, the gallbladder contracts, and squeezes extra bile into the intestine to aid digestion.

There are two ways to remove the gallbladder:

• Traditional surgery - The surgeon cuts open the abdomen and removes the gallbladder through an incision that is about 6 inches long. The abdomen is then stitched closed again.
• Laparoscopic surgery - The surgeon makes four small (less than an inch) incisions for a laparoscope and instruments. A laparoscope is a tube-like instrument with a camera for viewing, and with it the surgeon can to guide the surgical instruments to remove the gallbladder. The gallbladder is cut away from the liver and the bile duct and removed through one of the small incisions.

Over 90% of the time, laparoscopic surgery is used because it requires a shorter hospital stay, is less painful, and has a shorter recovery time compared to traditional surgery. Traditional surgery is usually used because the person has significant abdominal scarring from prior surgery, severe inflammation, unusual anatomy, or other factors that make surgery with a laparoscope very difficult and riskier.

What Is It?

Endoscopy describes many procedures that look inside the body using some type of endoscope, a flexible tube with a small TV camera and a light on one end and an eyepiece on the other. The endoscope allows doctors to examine the inside of certain tube-like structures in the body. Many endoscopes transmit the doctor's view to a video screen. Most endoscopes have attachments that permit doctors to take fluid or tissue samples for laboratory testing.

Upper endoscopy allows a doctor to see inside the esophagus, stomach and top parts of the small intestine. Bronchoscopy examines the large airways inside the lungs (bronchi). Sigmoidoscopy and colonoscopy examine different parts of the lower digestive tract. Each type of endoscopy uses a slightly different endoscope with a different name — an upper endoscope for upper endoscopy, a bronchoscope for bronchoscopy, a sigmoidoscope for sigmoidoscopy and a colonoscope for colonoscopy. Other endoscopes allow doctors to see inside the abdomen and inside joints through small incisions.