Digestive Health Archive

They're the biggest contributors to improved digestion.

If you struggle with bloating, diarrhea, and constipation, your diet may be partly to blame. Certain foods and medications can cause these digestion problems. Likewise, eating too few fibrous foods can cause constipation. "Most people are not eating the right foods, and they're not drinking enough water," says gastroenterologist Dr. Jacqueline Wolf, associate professor of medicine at Harvard Medical School.

The offenders

Dr. Wolf recommends taking an in-depth look at what you're eating to see if you're consuming potential offenders. "Too many carbohydrates may make you constipated. Artificial sweeteners such as sorbitol, mannitol, and xylitol are big offenders for diarrhea and bloating," she explains. Dietary supplements such as calcium and iron can also make you constipated.

After removal of precancerous growths (polyps) in the colon, return for a follow-up colon exam in three, five, or 10 years, depending on the number and types of growths that the doctor found and removed. A healthy diet can help prevent cancer.

Surgery for chronic heartburn relieves symptoms better than medication even after five years, according to a study in BMJ. Acid-reducing medications curb the symptoms of gastroesophageal reflux disease (GERD), in which caustic stomach contents back up (reflux) into the throat. Some men who don't want to take medication indefinitely could have a procedure, called fundoplication, to tighten up the base of the esophagus and reduce reflux. Surgery relieves GERD symptoms quickly, but does it last?

To find out, researchers compared two groups of people treated for GERD. One group was offered fundoplication and the others were kept on medication. After five years, those who had surgery reported fewer symptoms, and only a low percentage had complications. Surgery for GERD comes with a small risk of complications, so it should be considered carefully as a medication alternative. But for those who do choose fundoplication, this study suggests, surgery works better over the long term than medication.

Being tested for the bacteria that cause many ulcers and having the infection quashed with antibiotics can prevent ulcers in many people who take daily aspirin for heart protection, suggests a study in Gastroenterology.

Daily low-dose aspirin can prevent a heart attack, but it may also put you at risk for peptic ulcers—sores in the stomach and upper intestine. Two factors that predispose aspirin users to this kind of trouble are a history of ulcers and infection with Helicobacter pylori, the bacterium that causes most peptic ulcers.

Dietary changes, medications, and a lack of exercise often contribute to constipation in older women. Getting plenty of fiber and drinking four to six glasses of fluid each day are the best ways to prevent-and treat-constipation.

People with celiac disease must avoid all foods that contain the protein gluten, found in wheat, barley, rye, and other grains. Those with nonceliac gluten sensitivity can also benefit from a gluten-free diet.

Q. I have chronic diarrhea because of irritable bowel syndrome (IBS). Should I take probiotics?

A. Probiotics are live microbes that are taken in capsule or powder form. They're also available in some yogurt products. Probiotics are thought to help with intestinal problems by restoring bacterial balance in the gut and possibly by affecting the immune system. Many strains of bacteria and a strain of yeast are used as probiotics, but they don't all have the same effectiveness.

If you suffer from chronic heartburn or another digestive disorder, you may have been prescribed a proton-pump inhibitor (PPI), which helps reduce the production of stomach acid. There are several different types of PPIs. Prescription-only PPIs include esomeprazole (Nexium) and pantoprazole (Protonix). Some PPIs are also available over the counter, including lansoprazole (Prevacid) and omeprazole (Prilosec).

How they work

PPIs work by inhibiting certain stomach cells from "pumping" acid into the stomach. When taken 30 to 60 minutes before a meal, PPIs can prevent or reduce heartburn. However, they do not work as well when taken on demand as they do when taken over a period of time. And while PPIs are generally safe when used in the short term, they do carry some risks in the long term. Unfortunately, the medications tend to be overused. "I think a lot of people get heartburn from taking medications or ingesting certain food and drinks. To treat their symptoms they get PPIs over the counter or from their physicians," says Dr. Jacqueline Wolf, associate professor of medicine at Harvard Medical School.

Proton pump inhibitors (PPIs) are safe for most people, but also have potential risks you should know about.

Have you heard in the news about infections and other dangerous side effects from heartburn medications? Should you stop taking yours? If you take a drug to ease heartburn, you may have already discussed these concerns with your doctor. There are several kinds of heartburn medications, but the type under fire are the proton-pump inhibitors (PPIs). Six of these are available in the United States (see table, right).