Digestive Health Archive

Peptic Ulcer Disease

Questions to Discuss with Your Doctor:

• Do you have diffuse or localized abdominal pain?
• Does the pain ever travel to the back or chest?
• Do you have nausea associated with the pain?
• Does eating make the pain better or worse?
• Do you have black or bloody stools?
• Do you ever vomit blood or material that looks like coffee grounds?
• Do you take any medications (for example, pain relievers)?
• Do you smoke cigarettes or drink alcohol?
• Do you drink caffeine-containing beverages?
• Have you ever been tested or treated for a bacteria called H. pylori that can infect the stomach lining?
• Do you have a family history of peptic ulcer disease?

Your Doctor Might Examine the Following Body Structures or Functions:

• Careful abdominal exam
• Rectal exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Stool testing for blood
• Blood or breath test for the presence of H. pylori
• Upper endoscopy (internal examination of esophagus, stomach, and duodenum)
• Upper GI series

Irritable Bowel Syndrome (IBS)

Questions to Discuss with Your Doctor:

• Do you have pain or cramping in the lower stomach?
• How often do you get the pain?
• Is the pain related to meals?
• Do you suffer from constipation and small bowel movements?
• Do you have diarrhea that alternates with constipation?
• Do you have frequent bloating and gas?
• Do you have a feeling of fullness in the rectum?
• Is there a family history of inflammatory bowel disease?
• Do you have a history of mental illness or depression?
• Are there any things causing unusual stress in your life?
• Please describe your diet in detail.

Your Doctor Might Examine the Following Body Structures or Functions:

• Careful abdominal exam
• Rectal exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Stool testing for blood and cultures
• Conventional abdominal X-rays
• Endoscopy or sigmoidoscopy
• Barium enema
• Complete blood count and other blood tests

Irritable bowel syndrome (IBS) is a chronic disorder characterized by recurrent bouts of constipation, diarrhea, or both, as well as abdominal pain, bloating, and gas. IBS is a functional disorder, which means that it's not attributable, as far as we know, to any underlying disease process or structural abnormality. It's thought to involve various, often interacting, factors — infection, faulty brain-gut communication, heightened pain sensitivity, hormones, allergies, and emotional stress.

The good news is that IBS doesn't increase the risk for more serious conditions, such as ulcerative colitis or colon cancer. On the other hand, a disorder resulting in (at best) annoying and (at worst) debilitating and worrisome symptoms with no known cause can be difficult to diagnose and treat, not to mention live with. Managing IBS typically involves some trial and error, which can be challenging for patients and clinicians alike. Various tests or procedures may be ordered to rule out other conditions. Many diverse therapies, not all of them proven, are used in treating the symptoms, including antibiotics, antispasmodics, antidepressants, dietary changes, relaxation techniques, and psychotherapy, as well as drugs to relieve constipation and diarrhea.

Here's what to do when certain foods disagree with you.

 Image: ChesiireCat/Thinkstock

You probably remember an occasion when you ate something that did not agree with you. But if your stomach issues have become severe and frequent, you might have a food intolerance.

"Food intolerances puzzle many older men, since foods they long enjoyed suddenly give them problems," says Evagelia Georgakilas, a registered dietitian and nutritionist with Harvard-affiliated Beth Israel Deaconess Medical Center. "They might tough it out and suffer in silence, but by identifying the problem foods, making adjustments in portion sizes, and switching out certain foods as needed, they can avoid painful and recurring digestive issues."

It appears that electroacupuncture may be a treatment option for people with chronic severe functional constipation.

Long-term risks are associated with proton-pump inhibitors, but there are other options for treating acid reflux.

Image: Eranicle/ Thinkstock

Proton-pump inhibitors (PPIs), which reduce the amount of acid produced in the stomach, are so effective at treating heartburn and ulcers that they've been among the world's top-selling drugs for 25 years. Initially available only by prescription, PPIs, which include omeprazole (Prilosec), lansoprazole (Prevacid), and esomeprazole (Nexium), have been sold over the counter for several years. However, now that millions of people are taking PPIs, the drugs have been linked to an increasing number of health risks, such as fractures, kidney problems, vitamin B12 deficiency, low magnesium, and—most recently—dementia and heart attack.

"These studies—especially those suggesting a relationship to dementia and heart attack—are concerning," says Dr. Jacqueline Wolf, a gastroenterologist and associate professor of medicine at Harvard Medical School and author of A Woman's Guide to a Healthy Stomach: Taking Control of Your Digestive Health.

The FDA is warning that over-the-counter antacids with aspirin in them can cause stomach bleeding in rare cases. 

They affect more women, but men still are at risk.

Image: iStock

Most people never think about gallstones—that is until they experience the severe, gut-piercing pain of a gallstone attack. "These often strike after eating, especially a high-fat or high-cholesterol meal, and can last about 30 minutes to two or more hours," says Dr. William Brugge, past director of gastrointestinal endoscopy at Harvard-affiliated Massachusetts General Hospital.

The attacks often begin in the upper-right side of the abdomen and may spread to the back, between the shoulder blades, and under the right shoulder. Nausea or vomiting may also occur.