Digestive Health Archive


Ask the doctor: Health benefits of probiotics

Q. Would you suggest I try taking a probiotic supplement for general colon health? I have a sensitive stomach and sometimes suffer from constipation.

A. Probiotics, the beneficial bacteria that live in our intestines and assist in digestion, have gained a lot of support lately. Each week, a new study appears describing health benefits or diseases associated with changes in the so-called microbiome—the diverse community of microorganisms each of us carries inside our body. Still, the benefits of adding probiotics to the intestinal tract are uncertain.

Probiotics have proved helpful in situations where the body's normal, healthy bacteria have been destroyed, such as after taking a powerful antibiotic. Small studies in people with irritable bowel syndrome have suggested that taking probiotics improves pain and diarrhea. The benefit in constipation is less certain, but it's reasonable for you to try taking a probiotic if you are interested.

Acupressure relieves constipation in small clinical trial

For anyone who has been constipated, the promise of relief through medication is clouded by the possibility of developing a "laxative habit." However, a study published online Nov. 18, 2014, by the Journal of General Internal Medicine offers a drug-free approach to the problem: applying pressure to the perineum (the area between the genitals and the anus).

Researchers from the University of California, Los Angeles, studied 100 women and men with chronic constipation. Half were randomly assigned to receive handouts describing conventional approaches to relieving constipation, such as increasing fluid and fiber intake, getting regular exercise, and using laxatives and other medications. The other half got the same handouts, and were also instructed to use their index and middle fingers to press on the perineum at the first urge to defecate and continue until the stool passed easily.

Upset stomach? Don't write it off

Dyspepsia is a frequent or persistent upset stomach. Sometimes no underlying cause is found. It can help to avoid foods that trigger the dyspepsia, such as fatty foods, and to eat smaller but more frequent meals.

Are you stuck on heartburn medications?

Taper off heartburn medications if you are willing to make lifestyle changes to prevent the problem from coming back.

To any man once tormented by frequent heartburn from stomach acid backing up, not taking your daily tablet of omeprazole (Prilosec) or lansoprazole (Prevacid) might seem like a bad idea. These and similar drugs, known as proton pump inhibitors (PPIs), are the foundation of treatment for chronic acidic heartburn, also known as gastroesophageal reflux disease (GERD).

Laxatives: What to know about choosing the right one

Eating a fiber-rich diet helps to prevent constipation. There are a variety of laxatives for occasional irregularity.

Ask the doctor: Using PPIs to fight cancer risk.

Q. Do PPI drugs for stomach acid reduce the risk of cancer in people (like me) with Barrett's esophagus?

A. Probably so. But before explaining why, I'll define some terms.
Proton-pump inhibitor (PPI) drugs—such as omeprazole (Prilosec), pantoprazole (Protonix), and lansoprazole (Prevacid)—powerfully suppress stomach acid. These drugs have been a boon for many people with heartburn caused by acid reflux (also called gastroesophageal reflux disease, or GERD).

When to seek a doctor's help for heartburn

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.

News briefs: Heartburn medicine users: Watch vitamin B12 levels

Photo: Thinkstock

If you're a long-term user of medications for heartburn, you might want to check your vitamin B12 levels. A study in the Dec. 11, 2013, issue of The Journal of the American Medical Association found that using either proton-pump inhibitors (PPIs) or H2 blockers was associated with a new diagnosis of vitamin B12 deficiency. Prescription-only PPIs include esomeprazole (Nexium) and pantoprazole (Protonix). Some PPIs are also available over the counter, including lansoprazole (Prevacid) and omeprazole (Prilosec). H2 blockers include famotidine (Pepcid) and ranitidine (Zantac). PPIs and H2 blockers can interfere with absorption of vitamin B12 from food: stomach acid shakes loose the vitamin B12 in food, making it easier to absorb into the blood. Too little vitamin B12 can lead to anemia, neurological diseases, and even dementia. "If you're a longtime user of PPIs or H2 blockers, ask your doctor to check the level of vitamin B12 n your blood. If your level is low, a vitamin B12 supplement will increase it," says gastroenterologist Dr. Jacqueline Wolf, associate professor of medicine at Harvard Medical School.

Ask the doctor: What should I do about bloating and gas?

Q. Every once in a while I get bloating and gas. It's uncomfortable and embarrassing. What can I do to get rid of it?

A. Gas and bloating are tough to talk about, but we've all have had to deal with these afflictions at one time or another. Although they're not pleasant, there are things you can do to prevent and treat them.

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