Digestive Health Archive

Q. A friend has a condition called gastroparesis. Please explain what it is and how it can be treated.

A. Gastroparesis is the term used for sluggish emptying of food from the stomach into the small intestine. Normally, your stomach moves about half of an average meal into the small intestine within two hours after you eat, and about 90% within four hours. If you have gastroparesis, food stays in the stomach much longer. Nausea and upper abdominal pain are common symptoms. It may become difficult to keep a full meal down. People with serious cases may eat so little they become dangerously thin and malnourished.

The average human gut harbors between 500 and 1,000 bacterial species, the majority of which reside in the large intestine. Most of these inhabitants are helpful — indeed, essential — serving functions like producing vitamin K or stimulating the immune system. When this "intestinal microbiome" is disrupted by infection, illness, or treatment with antibiotics, a person's ability to digest food can be impaired and overall health affected.

In this country, recurrent infections with Clostridium difficile bacteria are one of the main causes of this kind of intestinal distress. C. difficile (pronounced see dif-uh-SEAL) infects as many as 7,000 hospitalized Americans a day, and treatment of those infections is a major cause of antibiotic-associated diarrhea. C. difficile competes for survival with other bacteria in the gut. Antibiotics are capable of killing many of its bacterial competitors, but often not C. difficile, which allows C. difficile to run wild.

Q. I often feel like I have a lump of mucus in my throat. In the morning I spit some of it up, but the sensation doesn't go away. What can I do about it?

A. Doctors sometimes use the term "globus sensation" for the feeling of a lump in the throat. It's one of those minor maladies about which we know only a little, since medical research focuses mainly on the diseases that are disabling or fatal rather than the symptoms that constantly aggravate us.

Both are on the rise — and it's important to know the difference.

It's no fun to live in fear of food. If you can't tolerate certain foods, you probably dread the gastrointestinal distress they can cause. If you have a food allergy, the stakes are higher: a meal could end in a trip to the emergency room. Or, like many people, you could be uncertain whether your symptoms are due to an allergy (which requires eliminating all traces of the food from your diet) or an intolerance (which can be managed with less drastic measures). An analysis revealed that while 13% of adults described themselves as allergic to peanuts, milk, eggs, fish, or shellfish, only 3% truly were. Other studies have shown that undetected food allergies may play a role in several medical conditions.

Proton-pump inhibitors are the strongest type of medicine available for treating stomach acid. There is some concern about their potential side effects and interactions with other medications.

Women under 40 are at much greater risk of developing gallstones than men, due to the actions of the hormones estrogen and progesterone.

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.

Q. I belch a lot and get a feeling of fullness in the upper abdomen. Is excessive belching  a common condition? What are the causes and cures? I would prefer natural remedies.

A. Belching and feeling full are normal, everyday experiences. So, what makes them "excessive"? There's no precise definition. But if you start belching or feeling full more often than you have in the past, or if belching and fullness are causing you distress and discomfort, then I'd consider that excessive belching and a problem that you should try to solve.

Q. I have read that people who have had their gallbladders removed should take bile salts. My gallbladder was removed many years ago, and no doctor has said I should take bile salts. Should I?

A. Bile salts are produced in the liver, secreted into the bile ducts and gallbladder, and sent from there to the small intestine by way of the common bile duct. In the intestine, bile salts make it easier for your body to absorb and digest the fats and fat-soluble vitamins that you've eaten. Remember, not all fats are bad: there are "good" fats, and they are crucial to our health.

Many overdoses are accidental, so the FDA may require new warnings on the popular pain reliever and lower the daily limit.

For a long time, acetaminophen, the active ingredient in Tylenol, has seemed to be the safe bet among the commonly available pain relievers.