Digestive Health Archive

Intestinal infection known as C. diff can spread through spores and cause diarrhea

Why would you get an intestinal infection, like C. diff, from treating a different illness with antibiotics?

When you're admitted to a hospital, you expect to receive tests and treatments that will make you feel better. When you get antibiotics in the hospital, you expect that the drugs will treat or prevent infection. But it doesn't always work that way. A distressing number of patients acquire infections while they are in the hospital. And antibiotic therapy can actually increase the odds of coming down with a hospital-acquired infection, particularly when the cause is a bacterium named Clostridium difficile. Although doctors are working hard to control intestinal infections caused by the bug commonly (if not fondly) known as C. diff, the problem is rapidly becoming more common, more serious, and harder to treat.

News briefs

Having gum disease increases your risk for many health problems other than tooth loss, such as heart disease. To add to the list, a study from Harvard summarized in a letter published online July 20, 2020, by the journal Gut suggests that the microbes camping out between your teeth and gums may affect your risk for cancers of the stomach and esophagus. Harvard scientists analyzed health data from two large studies that included almost 150,000 men and women. In up to 28 years of follow-up, people with a history of periodontal (gum) disease were 43% more likely to develop esophageal cancer and 52% more likely to develop gastric (stomach) cancer compared with people whose gums were healthier. The risk was even higher in those with gum disease severe enough to cause tooth loss. The study is observational and doesn't prove that gum disease causes cancer, but it could mean that someday doctors will include a look at your gum health when assessing your overall risk. Fortunately, it's easy to prevent gum disease. The American Dental Association recommends that you brush your teeth twice per day, floss at least once per day, and get a dental exam and cleaning regularly.

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Constant burping can be annoying — and embarrassing! But there are some simple steps that can help you squelch belching. The key is to reduce the amount of air you swallow.

Start by looking at some simple habits. Two of the biggest culprits behind swallowing too much air are chewing gum and smoking. Drop these habits and you'll be gulping less air — and quitting smoking has even more important health benefits! If you wear dentures, make sure they fit snugly. And avoid "high-air" foods and beverages like carbonated beverages and whipped desserts. After eating, consider taking a stroll rather than plunking down in front of the TV. Staying upright and moving helps your stomach empty and relieves bloated feelings. When it's time to go to bed, try sleeping on your stomach or right side to aid in the escape of gas and alleviate fullness.

In the journals

Scientists continue to explore the health benefits versus risks of aspirin therapy. One new analysis suggests that taking aspirin may protect against several types of digestive tract cancers. The results were published online April 1, 2020, by Annals of Oncology.

Researchers examined 113 observational studies of cancer in the general population. They found that individuals who took aspirin regularly — at least one or two tablets a week — had significantly lower rates of cancers of the bowel, stomach, gallbladder, esophagus, pancreas, and liver, compared with people who did not take aspirin.

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.

For many people suffering from heartburn, watching what they eat, over-the-counter medications, and stress reduction can bring relief. But when symptoms don't improve and start to interfere with sleep or daily life, it is time to get your doctor's help.

Your doctor will ask detailed questions about the nature and pattern of your pain.

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).

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.