Digestive Health Archive

New information may affect your approach to treatment.

Millions of people turn to prescription and over-the-counter medications to cope with heartburn from gastroesophageal reflux disease or other stomach conditions. But navigating the risks of heartburn remedies can leave a sour taste in your mouth, since some have been tied to health concerns. Here's what you need to know about two mainstays of treatment, and how the latest developments may affect you.

H2 blockers

Histamine₂-receptor antagonists, better known as H2 blockers — such as famotidine (Pepcid) and cimetidine (Tagamet) — are available over the counter or by prescription. They block a chemical that signals the stomach to produce acid, and are the go-to drugs when an antacid like calcium carbonate (Tums) or aluminum hydroxide (Maalox) isn't strong enough.

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.