Stomach Ulcers and What You Can Do About Them

February 16th, 2018

Stomach ulcers are almost always caused by one of the following:

  • an infection with the bacterium Helicobacter pylori (H. pylori)
  • long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen

Rarely, a condition known as Zollinger-Ellison syndrome can cause stomach and intestinal ulcers by increasing the body’s production of acid. This syndrome is suspected to cause less than 1 percent of all peptic ulcers.

Symptoms of stomach ulcers

A number of symptoms are associated with stomach ulcers. The severity of the symptoms depends on the severity of the ulcer.

The most common symptom is a burning sensation or pain in the middle of your abdomen between your chest and belly button. Typically, the pain will be more intense when your stomach is empty, and it can last for a few minutes to several hours.

Other common signs and symptoms of ulcers include:

  • dull pain in the stomach
  • weight loss
  • not wanting to eat because of pain
  • nausea or vomiting
  • bloating
  • feeling easily full
  • burping or acid reflux
  • heartburn (burning sensation in the chest)
  • pain that may improve when you eat, drink, or take antacids
  • anemia (symptoms can include tiredness, shortness of breath, or paler skin)
  • dark, tarry stools
  • vomit that’s bloody or looks like coffee grounds

Talk to your doctor if you have any symptoms of a stomach ulcer. Even though discomfort may be mild, ulcers can worsen if they aren’t treated. Bleeding ulcers can become life-threatening.

How are stomach ulcers diagnosed?

Diagnosis and treatment will depend on your symptoms and the severity of your ulcer. To diagnose a stomach ulcer, your doctor will review your medical history along with your symptoms and any prescription or over-the-counter medications you’re taking.

To rule out H. pylori infection, a blood, stool, or breath test may be ordered. With a breath test, you’ll be instructed to drink a clear liquid and breathe into a bag, which is then sealed. If H. pylori is present, the breath sample will contain higher-than-normal levels of carbon dioxide.

  • Barium swallow: You drink a thick white liquid (barium) that coats your upper gastrointestinal tract and helps your doctor see your stomach and small intestine on X-rays.
  • Endoscopy (EGD): A thin, lighted tube is inserted through your mouth and into the stomach and the first part of the small intestine. This test is used to look for ulcers, bleeding, and any tissue that looks abnormal.
  • Endoscopic biopsy: A piece of stomach tissue is removed so it can be analyzed in a lab.

Treating stomach ulcers

Treatment will vary depending on the cause of your ulcer. Most ulcers can be treated with a prescription from your doctor, but in rare cases, surgery may be required.

It’s important to promptly treat an ulcer. Talk to your doctor to discuss a treatment plan. If you have an actively bleeding ulcer, you’ll likely be hospitalized for intensive treatment with endoscopy and IV ulcer medications. You may also require a blood transfusion.

Other tests and procedures used to diagnose stomach ulcers include:

Nonsurgical treatment

If your stomach ulcer is the result of H. pylori, you’ll need antibiotics and drugs called proton pump inhibitors (PPI’s). PPI’s block the stomach cells that produce acid.

In addition to these treatments, your doctor may also recommend:

  • H2 receptor blockers (drugs that also block acid production)
  • stopping use of all NSAIDs
  • follow-up endoscopy
  • probiotics (useful bacteria that may have a role in killing off H. pylori)
  • bismuth supplement

Symptoms of an ulcer may subside quickly with treatment. But even if your symptoms disappear, you should continue to take any medication prescribed by your doctor. This is especially important with H. pylori infections, to make sure that all bacteria are eliminated.

Side effects of medications used to treat stomach ulcers can include:

  • nausea
  • dizziness
  • headaches
  • diarrhea
  • abdominal pain

These side effects are typically temporary. If any of these side effects cause extreme discomfort, talk to your doctor about changing your medication.

Surgical treatment

In very rare cases, a complicated stomach ulcer will require surgery. This may be the case for ulcers that:

  • continue to return
  • don’t heal
  • bleed
  • tear through the stomach
  • keep food from flowing out of the stomach into the small intestine

Surgery may include:

  • removal of the entire ulcer
  • taking tissue from another part of the intestines and patching it over the ulcer site
  • tying off a bleeding artery
  • cutting off the nerve supply to the stomach to reduce the production of stomach acid

Healthful diet

In the past, it was thought that diet could cause ulcers. We know now this isn’t true. We also know that while the foods you eat won’t cause or cure a stomach ulcer, eating a healthful diet can benefit your intestinal tract and overall health. In general, it’s a good idea to eat a diet with lots of fruits, vegetables, and fiber.

That said, it’s possible that some foods play a role in eliminating H. pylori. Foods that may help fight off H. pylori or boost the body’s own healthy bacteria include:

  • broccoli, cauliflower, cabbage, and radishes
  • leafy greens, such as spinach and kale
  • probiotic-rich foods, such as sauerkraut, miso, kombucha, yogurt (especially with lactobacillus and Sacharomyces)
  • apples
  • blueberries, raspberries, strawberries, and blackberries
  • olive oil

If you think you have a stomach ulcer, these may be good foods to add to your daily diet.

When should you call or see a doctor?

If you think you have a stomach ulcer, call your doctor. Together you can discuss your symptoms and treatment options. It’s important to get a stomach ulcer taken care of because without treatment, ulcers and H. pylori H. can cause:

  • bleeding from the ulcer site that can become life-threatening
  • penetration, which occurs when the ulcer goes through the wall of the digestive tract and into another organ, such as the pancreas
  • perforation, which occurs when the ulcer creates a hole in the wall of the digestive tract
  • obstruction (blockage) in the digestive tract, which is due to swelling of inflamed tissues
  • stomach cancer, which is up to six time more likely in people who have H. pylori  infections compared to those who don’t

Symptoms of these complications can include those listed below. If you have any of these symptoms, be sure to call you doctor right away:

  • weakness
  • trouble breathing
  • red or black vomit or stools
  • sudden, sharp pain in your abdomen that doesn’t go away

Prevention of stomach ulcers

To prevent the spread of bacteria that might cause a stomach ulcer, wash your hands with soap and water on a regular basis. Also, be sure to properly clean all of your food and to cook it thoroughly as needed.

To prevent ulcers caused by NSAIDs, stop using these medications (if possible) or limit their use. If you need to take NSAIDs, be sure to follow the recommended dosage and avoid alcohol while taking these medications. And always take these medications with food and adequate liquids.

The gastroenterology consultants at Bay Area Gastroenterology are experts in the management of stomach, intestine and colon disorders. For more information, contact Bay Area Gastroenterology online or by phone at 281.480.6264 to schedule an appointment.

 

 

 

 

 

Helicobacter Pylori (H. pylori) infection

February 9th, 2018

Helicobacter pylori (H. pylori) infection occurs when a type of bacteria called Helicobacter pylori (H. pylori) infects your stomach. This usually happens during childhood. A common cause of peptic ulcers, H. pylori infection may be present in more than half the people in the world.

Most people don’t realize they have H. pylori infection, because they never get sick from it. If you develop signs and symptoms of a peptic ulcer, your doctor will probably test you for H. pylori infection. If you have H. pylori infection, it can be treated with antibiotics.

Symptoms

Most people with H. pylori infection will never have any signs or symptoms. It’s not clear why this is, but some people may be born with more resistance to the harmful effects of H. pylori.

When signs or symptoms do occur with H. pylori infection, they may include:

  • An ache or burning pain in your abdomen
  • Abdominal pain that’s worse when your stomach is empty
  • Nausea
  • Loss of appetite
  • Frequent burping
  • Bloating
  • Unintentional weight loss

When to see a doctor

Make an appointment with your doctor if you notice any persistent signs and symptoms that worry you. Seek immediate medical help if you experience:

  • Severe or persistent abdominal pain
  • Difficulty swallowing
  • Bloody or black tarry stools
  • Bloody or black vomit or vomit that looks like coffee grounds

Causes

The exact way H. pylori infects someone is still unknown. H. pylori bacteria may be passed from person to person through direct contact with saliva, vomit or fecal matter. H. pylori may also be spread through contaminated food or water.

Risk factors

H. pylori is often contracted in childhood. Risk factors for H. pylori infection are related to living conditions in your childhood, such as:

  • Living in crowded conditions. You have a greater risk of H. pylori infection if you live in a home with many other people.
  • Living without a reliable supply of clean water. Having a reliable supply of clean, running water helps reduce the risk of H. pylori.
  • Living in a developing country. People living in developing countries, where crowded and unsanitary living conditions may be more common, have a higher risk of H. pylori infection.
  • Living with someone who has an H. pylori infection. If someone you live with has H. pylori, you’re more likely to also have H. pylori.

Complications

Complications associated with H. pylori infection include:

  • Ulcers. H. pylori can damage the protective lining of your stomach and small intestine. This can allow stomach acid to create an open sore (ulcer). About 10 percent of people with H. pylori will develop an ulcer.
  • Inflammation of the stomach lining. H. pylori infection can irritate your stomach, causing inflammation (gastritis).
  • Stomach cancer. H. pylori infection is a strong risk factor for certain types of stomach cancer.

Prevention

In areas of the world where H. pylori infection and its complications are common, doctors sometimes test healthy people for H. pylori. Whether there is a benefit to treating H. pylori when you have no signs or symptoms of infection is controversial among doctors.

If you’re concerned about H. pylori infection or think you may have a high risk of stomach cancer, talk to your doctor. Together you can decide whether you may benefit from H. pylori screening.

For more information, contact Bay Area Gastroenterology online or by phone at 281.480.6264 to schedule an appointment.

 

 

Exocrine Pancreatic Insufficiency…..what are the symptoms of EPI?

February 2nd, 2018

Exocrine pancreatic insufficiency (EPI), sometimes called pancreatic insufficiency for short, is the inability to break down and digest food properly.

Symptoms of EPT can vary, but if you have one or more of these symptoms, you should talk to your doctor. Talking to your doctor is important since only your doctor can tell if your symptoms are due to EPI or another GI condition.

Frequent diarrhea:

EPI can cause problems with undigested food moving too quickly through the digestive tract.

Gas and bloating:

People with EPI cannot properly digest the food they eat, which can result in uncomfortable symptoms like gas and bloating.

Stomach pain:

The gas and bloating caused by maldigestion in people with EPI frequently result in stomach pain.

Foul-smelling, greasy stools (steatorrhea):

Steatorrhea is a type of bowel movement that is oily, floats, smells really bad, and is difficult to flush. People with EPI are not able to absorb all of the fat that they eat, so undigested fat is excreted, resulting in stools that look oily or greasy. Not all people experience this symptom.

Talk to your doctor if you notice oil droplets floating in the toilet bowl or stools that float or stick to the sides of the bowl and are hard to flush; it may be a sign of EPI.

Weight loss:

People with EPI cannot digest fats, proteins, and carbohydrates in the food they eat, which can result in weight loss.

Only your doctor can tell if your symptoms are due to EPI or another digestive condition.

The gastroenterology consultants at Bay Area Gastroenterology are experts in the management of stomach, intestine and colon disorders. For more information, contact Bay Area Gastroenterology online or by phone at 281.480.6264 to schedule an appointment.

 

 

 

 

Barrett’s esophagus

January 26th, 2018

What is Barrett’s Esophagus?

Barrett’s esophagus is a condition in which tissue that is similar to the lining of your intestine replaces the tissue lining your esophagus. Doctors call this process intestinal metaplasia.

Are people with Barrett’s esophagus more likely to develop cancer?

People with Barrett’s esophagus are more likely to develop a rare type of cancer called esophageal adenocarcinoma.

The risk of esophageal adenocarcinoma in people with Barrett’s esophagus is about 0.5 percent per year. Typically, before this cancer develops, precancerous cells appear in the Barrett’s tissue. Doctors call this condition dysplasia and classify the dysplasia as low grade or high grade.

You may have Barrett’s esophagus for many years before cancer develops.

How common is Barrett’s esophagus?

Experts are not sure how common Barrett’s esophagus is. Researchers estimate that it affects 1.6 to 6.8 percent of people.

Who is more likely to develop Barrett’s esophagus?

Men develop Barrett’s esophagus twice as often as women, and Caucasian men develop this condition more often than men of other races. The average age at diagnosis is 55. Barrett’s esophagus is uncommon in children.

What are the symptoms of Barrett’s esophagus?

While Barrett’s esophagus itself doesn’t cause symptoms, many people with Barrett’s esophagus have  gastroesophageal reflux

What causes Barrett’s esophagus?

Experts don’t know the exact cause of Barrett’s esophagus. However, some factors can increase or decrease your chance of developing Barrett’s esophagus.

What factors increase a person’s chances of developing Barrett’s esophagus?

Having GERD increases your chances of developing Barrett’s esophagus. GERD is a more serious, chronic form of gastroesophageal reflux, a condition in which stomach contents flow back up into your esophagus. Refluxed stomach acid that touches the lining of your esophagus can cause heartburn and damage the cells in your esophagus.

Between 10 and 15 percent of people with GERD develop Barrett’s esophagus.

Obesity—specifically high levels of belly fat—and smoking also increase your chances of developing Barrett’s esophagus. Some studies suggest that your genetics, or inherited genes, may play a role in whether or not you develop Barrett’s esophagus.

What factors decrease a person’s chances of developing Barrett’s esophagus?

Having a Helicobacter pylori (H. pylori) infection may decrease your chances of developing Barrett’s esophagus. Doctors are not sure how H. pylori protects against Barrett’s esophagus. While the bacteria damage your stomach and the tissue in your duodenum, some researchers believe the bacteria make your stomach contents less damaging to your esophagus if you have GERD.

Researchers have found that other factors may decrease the chance of developing Barrett’s esophagus, including:

  • frequent use of aspirin or other nonsteroidal anti-inflammatory drugs
  • a diet high in fruits, vegetables, and certain vitamins

How do doctors diagnose Barrett’s esophagus?

Doctors diagnose Barrett’s esophagus with an upper gastrointestinal (GI) endoscopy and a biopsy. Doctors may diagnose Barrett’s esophagus while performing tests to find the cause of a patient’s gastroesophageal reflux disease (GERD) symptoms.

Medical history

Your doctor will ask you to provide your medical history. Your doctor may recommend testing if you have multiple factors that increase your chances of developing Barrett’s esophagus.

Who should be screened for Barrett’s esophagus?

Your doctor may recommend screening for Barrett’s esophagus if you are a man with chronic—lasting more than 5 years—and/or frequent—happening weekly or more—symptoms of GERD and two or more risk factors for Barrett’s esophagus. These risk factors include:

  • being age 50 and older
  • being Caucasian
  • having high levels of belly fat
  • being a smoker or having smoked in the past
  • having a family history of Barrett’s esophagus or esophageal adenocarcinoma

How do doctors treat Barrett’s esophagus?

Your doctor will talk about the best treatment options for you based on your overall health, whether you have dysplasis, and its severity. Treatment options include medicines for GERD, endoscopic ablative therapies, endoscopic mucosal resection, and surgery.

Periodic surveillance endoscopy

Your doctor may use upper gastrointestinal endoscopy with a biopsy periodically to watch for signs of cancer development. Doctors call this approach surveillance.

Experts aren’t sure how often doctors should perform surveillance endoscopies. Talk with your doctor about what level of surveillance is best for you. Your doctor may recommend endoscopies more frequently if you have high-grade dysplasia rather than low-grade or no dysplasia.

Medicines

If you have Barrett’s esophagus and gastroesophageal reflux disease (GERD), your doctor may treat you with acid-suppressing medicines called proton pump inhibitors (PPIs). These medicines can prevent further damage to your esophagus and, in some cases, heal existing damage.

How can your diet help prevent Barrett’s esophagus?

 Researchers have not found that diet and nutrition play an important role in causing or preventing Barrett’s esophagus.​

 If you have gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD), you can prevent or relieve your symptoms by changing your diet. Dietary changes that can help reduce your symptoms include:

  • decreasing fatty foods
  • eating small, frequent meals instead of three large meals

Avoid eating or drinking the following items that may make GER or GERD worse:

  • ​chocolate
  • coffee
  • peppermint
  • greasy or spicy foods​
  • tomatoes and tomato products
  • alcoholic drinks

For more information on Barrett’s esophagus, contact Bay Area Gastroenterology online or by phone at 281.480.6264 to schedule an appointment.

 

 

 

Teen Drinking Ups Risk for Liver Diseases Later

January 23rd, 2018

Men who started drinking in their teens are at increased risk for liver disease, Swedish researchers report.

“Our study showed that how much you drink in your late teens can predict the risk of developing cirrhosis later in life,” said lead investigator Dr. Hannes Hagstrom, with the Center for Digestive Diseases and Karolinska University Hospital in Stockholm.

The finding comes from an analysis of data on more than 49,000 men in Sweden who entered military service in 1969-1970, when they were 18 to 20 years old.

Over the next 39 years, 383 of the men developed cirrhosis and other types of severe liver disease. Some developed liver failure or died from liver disease.

Drinking during the late teen years was associated with an increased risk for liver disease. The association was mostly seen in young men who drank two drinks a day or more, the researchers found.

The study was published Jan. 22 in the Journal of Hepatology. The findings indicate that guidelines for safe levels of alcohol consumption by men may need to be reconsidered, the researchers said.

Current U.S. guidelines recommend no more than two drinks a day for men. The Swedish researchers said some countries recommend no more than three drinks a day for men to avoid alcoholic liver disease.

“However, what can be considered a safe cutoff in men is less clear,” Hagstrom said in a journal news release.

“If these results lead to lowering the cutoff levels for a ‘safe’ consumption of alcohol in men, and if men adhere to recommendations, we may see a reduced incidence of alcoholic liver disease in the future,” he said.

The researchers noted that their findings apply only to men.

Alcohol-related liver cirrhosis causes 493,000 deaths a year worldwide, according to the World Health Organization.

 

C. difficile infection

January 16th, 2018

Clostridium difficile (klos-TRID-e-um dif-uh-SEEL), often called C. difficile or C. diff, is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon.

Illness from C. difficile most commonly affects older adults in hospitals or in long-term care facilities and typically occurs after use of antibiotic medications. However, studies show increasing rates of C. difficile infection among people traditionally not considered high risk, such as younger and healthy individuals without a history of antibiotic use or exposure to health care facilities.

Each year in the United States, about a half million people get sick from C. difficile, and in recent years, C. difficile infections have become more frequent, severe and difficult to treat.

Symptoms:

Some people carry the bacterium C. difficile in their intestines but never become sick, though they may still spread the infection. Signs and symptoms usually develop within five to 10 days after starting a course of antibiotics, but may occur as soon as the first day or up to two months later.

 Mild to moderate infection:

The most common symptoms of mild to moderate C. difficile infection are:

  • Watery diarrhea three or more times a day for two or more days
  • Mild abdominal cramping and tenderness

Severe Infection:

 In severe cases, people tend to become dehydrated and may need hospitalization. C. difficile causes the colon to become inflamed (colitis) and sometimes may form patches of raw tissue that can bleed or produce pus (pseudomembranous colitis). Signs and symptoms of severe infection include:

  • Watery diarrhea 10 to 15 times a day
  • Abdominal cramping and pain, which may be severe
  • Rapid heart rate
  • Fever
  • Blood or pus in the stool
  • Nausea
  • Dehydration
  • Loss of appetite
  • Weight loss
  • Swollen abdomen
  • Kidney failure
  • Increased white blood cell count

When to see a doctor:

 Some people have loose stools during or shortly after antibiotic therapy. This may be due to C. difficile infection. See your doctor if you have three or more watery stools a day and symptoms lasting more than two days or if you have a new fever, severe abdominal pain or cramping, or blood in your stool.

Causes:

C. difficile bacteria are found throughout the environment — in soil, air, water, human and animal feces, and food products, such as processed meats. A small number of healthy people naturally carry the bacteria in their large intestine and don’t have ill effects from the infection.

C. difficile infection is most commonly associated with health care and recent antibiotic use, occurring in hospitals and other health care facilities where a much higher percentage of people carry the bacteria. However, studies show increasing rates of community-associated C. difficile infection, which occurs among populations traditionally not considered high risk, such as children and people without a history of antibiotic use or recent hospitalization.

Spores from C. difficile bacteria are passed in feces and spread to food, surfaces and objects when people who are infected don’t wash their hands thoroughly. These spores can persist in a room for weeks or months. If you touch a surface contaminated with C. difficile spores, you may then unknowingly swallow the bacteria.

Your intestines contain about 100 trillion bacterial cells and up to 2,000 different kinds of bacteria, many of which help protect your body from infection. When you take an antibiotic to treat an infection, these drugs tend to destroy some of the normal, helpful bacteria in addition to the bacteria causing the infection. Without enough healthy bacteria to keep it in check, C. difficile can quickly grow out of control. The antibiotics that most often lead to C. difficile infections include fluoroquinolones, cephalosporins, penicillins and clindamycin.

Once established, C. difficile can produce toxins that attack the lining of the intestine. The toxins destroy cells and produce patches (plaques) of inflammatory cells and decaying cellular debris inside the colon and cause watery diarrhea.

Emergence of a new strain:

 An aggressive strain of C. difficile has emerged that produces far more toxins than other strains do. The new strain may be more resistant to certain medications and has shown up in people who haven’t been in the hospital or taken antibiotics. This strain of C. difficile has caused several outbreaks of illness since 2000.

Risk factors

 Although people — including children — with no known risk factors have gotten sick from C. difficile, certain factors increase your risk.

Taking antibiotics or other medications

Medication-associated risk factors include:

  • Currently taking or having recently taken antibiotics
  • Taking broad-spectrum antibiotics that target a wide range of bacteria
  • Using multiple antibiotics
  • Taking antibiotics for a long time
  • Taking medications to reduce stomach acid, including proton pump inhibitors

Staying in a health care facility

The majority of C. difficile cases occur in, or after exposure to, health care settings — including hospitals, nursing homes and long-term care facilities — where germs spread easily, antibiotic use is common and people are especially vulnerable to infection. In hospitals and nursing homes, C. difficile spreads mainly on hands from person to person, but also on cart handles, bedrails, bedside tables, toilets, sinks, stethoscopes, thermometers — even telephones and remote controls.

Having a serious illness or medical procedure

 If you have a serious illness, such as inflammatory bowel disease or colorectal cancer, or a weakened immune system as a result of a medical condition or treatment (such as chemotherapy), you’re more susceptible to a C. difficile infection. Your risk of C. difficile infection is also greater if you’ve had abdominal surgery or a gastrointestinal procedure.

Older age is also a risk factor for C. difficile infection. In one study, the risk of becoming infected with C. difficile was 10 times greater for people age 65 and older compared with younger people.

After having a previous C. difficile infection, your chances of having a recurring infection can be up to 20 percent, and the risk increases further with every subsequent infection.

Complications

 Complications of C. difficile infections include:

  • Dehydration. Severe diarrhea can lead to a significant loss of fluids and electrolytes. This makes it difficult for your body to function normally and can cause blood pressure to drop to dangerously low levels.
  • Kidney failure. In some cases, dehydration can occur so quickly that kidney function rapidly deteriorates (kidney failure).
  • Toxic megacolon. In this rare condition, your colon is unable to expel gas and stool, causing it to become greatly distended (megacolon). Left untreated, your colon may rupture, causing bacteria from the colon to enter your abdominal cavity. An enlarged or ruptured colon requires emergency surgery and may be fatal.
  • A hole in your large intestine (bowel perforation). This is rare and results from extensive damage to the lining of your large intestine or after toxic megacolon. A perforated bowel can spill bacteria from the intestine into your abdominal cavity, leading to a life-threatening infection (peritonitis).
  • Death. Even mild to moderate C. difficile infections can quickly progress to a fatal disease if not treated promptly.

Prevention

 To help prevent the spread of C. difficile, hospitals and other health care facilities follow strict infection-control guidelines. If you have a friend or family member in a hospital or nursing home, don’t be afraid to remind caregivers to follow the recommended precautions.

Preventive measures include:

  • Hand-washing. Health care workers should practice good hand hygiene before and after treating each person in their care. In the event of a C. difficile outbreak, using soap and warm water is a better choice for hand hygiene, because alcohol-based hand sanitizers do not effectively destroy C. difficile spores. Visitors also should wash their hands with soap and warm water before and after leaving the room or using the bathroom.
  • Contact precautions. People who are hospitalized with C. difficile have a private room or share a room with someone who has the same illness. Hospital staff and visitors wear disposable gloves and isolation gowns while in the room.
  • Thorough cleaning. In any setting, all surfaces should be carefully disinfected with a product that contains chlorine bleach. C. difficile spores can survive routine cleaning products that don’t contain bleach.
  • Avoid unnecessary use of antibiotics. Antibiotics are sometimes prescribed for viral illnesses that aren’t helped by these drugs. Take a wait-and-see attitude with simple ailments. If you do need an antibiotic, ask your doctor to prescribe one that has a narrow range and that you take for the shortest time possible.

Diverticulitis: Symptoms, Causes, Risks, and Complications

January 12th, 2018

Diverticula are small, bulging pouches that can form in the lining of your digestive system. They are found most often in the lower part of the large intestine (colon).

 Diverticula are common, especially after age 40, and seldom cause problems.

Sometimes, however, one or more of the pouches become inflamed or infected. That condition is known as diverticulitis (die-vur-tik-yoo-LIE-tis). Diverticulitis can cause severe abdominal pain, fever, nausea and a marked change in your bowel habits.

Mild diverticulitis can be treated with rest, changes in your diet and antibiotics. Severe or recurring diverticulitis may require surgery.

Symptoms

The signs and symptoms of diverticulitis include:

  • Pain, which may be constant and persist for several days. Pain is usually felt in the lower left side of the abdomen, but may occur on the right, especially in people of Asian descent
  • Nausea and vomiting
  • Fever
  • Abdominal tenderness
  • Constipation or, less commonly, diarrhea

Causes

Diverticula usually develop when naturally weak places in your colon give way under pressure. This causes marble-sized pouches to protrude through the colon wall.

Diverticulitis occurs when diverticula tear, resulting in inflammation or infection or both.

Risk factors

Several factors may increase your risk of developing diverticulitis:

  • Aging. The incidence of diverticulitis increases with age
  • Obesity. Being seriously overweight increases your odds of developing diverticulitis. Morbid obesity may increase your risk of needing more-invasive treatments for diverticulitis
  • Smoking. People who smoke cigarettes are more likely than nonsmokers to experience diverticulitis
  • Lack of exercise. Vigorous exercise appears to lower your risk of diverticulitis
  • Diet high in animal fat and low in fiber, although the role of low fiber alone isn’t clear
  • Certain medications. Several drugs are associated with an increased risk of diverticulitis, including steroids, opiates and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)

Complications

About 25 percent of people with acute diverticulitis develop complications, which may include:

  • An abscess, which occurs when pus collects in the pouch
  • A blockage in your colon or small intestine caused by scarring
  • An abnormal passageway (fistula) between sections of bowel or the bowel and bladder
  • Peritonitis, which can occur if the infected or inflamed pouch ruptures, spilling intestinal contents into your abdominal cavity. Peritonitis is a medical emergency and requires immediate care

Obesity is a major risk factor for diverticulitis!!

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Gastrointestional problems—9 common digestive conditions, from top to bottom.

January 10th, 2018

Many digestive diseases have similar symptoms. Here’s how to recognize them and when to visit your doctor.

 Most people don’t like to talk about it, but having a gastrointestinal problem is common.

There’s no need to suffer in silence. Here’s a top-to-bottom look at nine of the most prevalent digestive conditions, their symptoms, and the most effective treatments available.

 If you suspect you could have one of these issues, don’t delay in speaking with your doctor.

1. Gastroesophageal Reflux Disease (GERD)

When stomach acid backs up into your esophagus — a condition called acid reflux — you may feel a burning pain in the middle of your chest. It often occurs after meals or at night, says Neville Bamji, MD, a clinical instructor of medicine at the Icahn School of Medicine at Mount Sinai and a gastroenterologist with New York Gastroenterology Associates.

While it’s common for people to experience acid reflux and heartburn once in a while, having symptoms that affect your daily life or occur at least twice each week could be a sign of GERD, a chronic digestive disease that affects 20 percent of Americans, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). If you experience persistent heartburn, bad breath, tooth erosion, nausea, pain in your chest or upper part of your abdomen, or have trouble swallowing or breathing, see your doctor.

Most people find relief by avoiding the foods and beverages that trigger their symptoms and/or by taking over-the-counter antacids or other medications that reduce stomach acid production and inflammation of the esophagus. But some cases of GERD require stronger treatment, such as medication or surgery.

2. Gallstones

Gallstones are hard deposits that form in your gallbladder — a small, pear-shaped sack that stores and secretes bile for digestion. More than 25 million people in the United States have gallstones, with nearly one million new cases of gallstone disease diagnosed every year — approximately one-quarter of which require treatment, according to the American Gastroenterological Association. Gallstones can form when there’s too much cholesterol or waste in your bile, or if your gallbladder doesn’t empty properly.

When gallstones block the ducts leading from your gallbladder to your intestines, they can cause sharp pain in your upper-right abdomen. Medications sometimes dissolve gallstones, but if that doesn’t work, the next step is surgery to remove the gallbladder.

3. Celiac Disease

An estimated 1 in 133 Americans has celiac disease, according to Beyond Celiac, formerly the National Foundation for Celiac Awareness. The group also estimates that 83 percent of people who have celiac disease don’t know they have it, or have been misdiagnosed with a different condition.

Celiac disease is a serious sensitivity to gluten, which is a protein found in wheat, rye, and barley. Eat gluten, and your immune system goes on the attack: It damages your villi, the finger-like protrusions in your small intestines that help you absorb nutrients from the foods you eat.

Symptoms of celiac disease in children include abdominal pain and bloating, diarrhea, constipation, vomiting, and weight loss. Symptoms in adults can also include anemia, fatigue, bone loss, depression, and seizures.

Yet some people may not have any symptoms. The only treatment for celiac disease is to completely avoid eating gluten. Common alternatives to gluten include brown rice, quinoa, lentils, soy flour, corn flour, and amaranth.

4. Crohn’s Disease

Crohn’s disease is part of a group of digestive conditions called inflammatory bowel disease (IBD). Crohn’s most commonly affects the terminal ileum, which connects the end of the small bowel and the beginning of the colon, but it can affect any part of the digestive tract. As many as 780,000 Americans may be affected by Crohn’s, according to the Crohn’s & Colitis Foundation (CCFA).

Doctors aren’t sure what causes the disease, but it’s thought that genetics and family history may play a part. The most common Crohn’s symptoms are abdominal pain, diarrhea, rectal bleeding, weight loss, and fever. “Treatment depends on the symptoms and can include topical pain relievers, immunosuppressants, and surgery,” Dr. Bamji says.

5. Ulcerative Colitis

Ulcerative colitis is another inflammatory bowel disease that may affect as many as 907,000 Americans, according to the CCFA. The symptoms of ulcerative colitis are very similar to those of Crohn’s, but the part of the digestive tract affected is solely the large intestine, also known as the colon.

If your immune system mistakes food or other materials for invaders, sores or ulcers develop in the colon’s lining. If you experience frequent and urgent bowel movements, pain with diarrhea, blood in your stool, or abdominal cramps, visit your doctor.

Medication can suppress the inflammation, and eliminating foods that cause discomfort may help as well. In severe cases, treatment for ulcerative colitis may involve surgery to remove the colon.

6. Irritable Bowel Syndrome

Is your digestive tract irritable? Do you have stomach pain or discomfort at least three times a month for several months? It could be irritable bowel syndrome (IBS), another common digestive condition.

An estimated 10 to 15 percent of people worldwide suffer from irritable bowel syndrome, and of that percentage between 25 and 45 million people live in the United States, according to the International Foundation for Functional Gastrointestinal Disorders.

Signs of IBS can vary widely: You can be constipated or have diarrhea, or have hard, dry stools on one day and loose watery stools on another. Bloating is also a symptom of IBS.

What causes IBS isn’t known, but treatment of symptoms centers largely on diet, such as eating low-fat, high-fiber meals or avoiding common trigger foods (dairy products, alcohol, caffeine, artificial sweeteners, and foods that produce gas).

Friendly bacteria, such as the probiotics found in live yogurt, may also help you feel better. Stress can trigger IBS symptoms, so some people find cognitive-behavioral therapy or low-dose antidepressants to be useful treatments, as well.

7. Hemorrhoids

Bright red blood in the toilet bowl when you move your bowels could be a sign of hemorrhoids, which is a very common condition. In fact, 75 percent of Americans over age 45 have hemorrhoids, according to the NIDDK.

Hemorrhoids are an inflammation of the blood vessels at the end of your digestive tract. They can be painful and itchy. Causes include chronic constipation, diarrhea, straining during bowel movements, and a lack of fiber in your diet.

Treat hemorrhoids by eating more fiber, drinking more water, and exercising. Over-the-counter creams and suppositories may provide temporary relief of hemorrhoid symptoms. See your doctor if at-home treatments don’t help; sometimes a hemorrhoidectomy is needed to remove hemorrhoids surgically.

8. Diverticulitis

Small pouches called diverticula can form anywhere there are weak spots in the lining of your digestive system, but they are most commonly found in the colon.

If you have diverticula but no symptoms, the condition is called diverticulosis, which is quite common among older adults and rarely causes problems. But if the pouches become inflamed, it’s called diverticulitis. Symptoms include fever and abdominal pain. Obesity is a major risk factor for diverticulitis.

Mild diverticulitis is treated with antibiotics and a clear liquid diet so your colon can heal. A low-fiber diet could be the cause of diverticulitis, so your doctor may direct you to eat a diet high in fiber — whole grains, legumes, vegetables — as part of your treatment.

If you have severe attacks that recur frequently, you may need surgery to remove the diseased part of your colon.

9. Anal Fissure

Anal fissures are tiny, oval-shaped tears in the lining of the very end of your digestive tract called your anus. The symptoms are similar to those of hemorrhoids, such as bleeding and pain after moving your bowels. Straining and hard bowel movements can cause fissures, but so can soft stools and diarrhea.

high-fiber diet that makes your stool well formed and bulky is often the best treatment for this common digestive condition. Medications to relax the anal sphincter muscles, as well as topical anesthetics and sitz baths, can relieve pain; however, chronic fissures may require surgery of the anal sphincter muscle.

Again, if you suspect you could have one of these issues, call your Gastroenterologist at 281.480.6264 to schedule an appointment.

 

 

 

 

Think before you drink……alcohol can do damage to our cells, costing us more than just a hangover!!

January 5th, 2018

Much previous research looking at the precise ways in which alcohol causes cancer has been done in cell cultures. But in this study, researchers have used mice to show how alcohol exposure leads to permanent genetic damage.

Scientists at the MRC Laboratory of Molecular Biology, Cambridge, gave diluted alcohol, chemically known as ethanol, to mice. They then used chromosome analysis and DNA sequencing to examine the genetic damage caused by acetaldehyde, a harmful chemical produced when the body processes alcohol.

They found that acetaldehyde can break and damage DNA within blood stem cells leading to rearranged chromosomes and permanently altering the DNA sequences within these cells.

It is important to understand how the DNA blueprint within stem cells is damaged because when healthy stem cells become faulty, they can give rise to cancer.

These new findings therefore help us to understand how drinking alcohol increases the risk of developing 7 types of cancer including common types like breast and bowel.

Professor Ketan Patel, lead author of the study and scientist, part funded by Cancer Research UK, at the MRC Laboratory of Molecular Biology, said: “Some cancers develop due to DNA damage in stem cells. While some damage occurs by chance, our findings suggest that drinking alcohol can increase the risk of this damage.”

The study also examined how the body tries to protect itself against damage caused by alcohol. The first line of defense is a family of enzymes called aldehyde dehydrogenases (ALDH). These enzymes break down harmful acetaldehyde into acetate, which our cells can use as a source of energy.

Worldwide, millions of people, particularly those from South East Asia, either lack these enzymes or carry faulty versions of them. So, when they drink, acetaldehyde builds up which causes a flushed complexion, and also leads to them feeling unwell.

In the study, when mice lacking the critical ALDH enzyme — ALDH2 — were given alcohol, it resulted in four times as much DNA damage in their cells compared to mice with the fully functioning ALDH2 enzyme.

The second line of defense used by cells is a variety of DNA repair systems which, most of the time, allow them to fix and reverse different types of DNA damage. But they don’t always work and some people carry mutations which mean their cells aren’t able to carry out these repairs effectively.

Professor Patel added: “Our study highlights that not being able to process alcohol effectively can lead to an even higher risk of alcohol-related DNA damage and therefore certain cancers. But it’s important to remember that alcohol clearance and DNA repair systems are not perfect and alcohol can still cause cancer in different ways, even in people whose defense mechanisms are intact.”

This research was funded by Cancer Research UK, Wellcome and the Medical Research Council (MRC).

Professor Linda Bauld, Cancer Research UK’s expert on cancer prevention, said: “This thought-provoking research highlights the damage alcohol can do to our cells, costing some people more than just a hangover.

“We know that alcohol contributes to over 12,000 cancer cases in the UK each year, so it’s a good idea to think about cutting down on the amount you drink.”

 

Controlling and maintaining your weight after the holidays

January 3rd, 2018

Even though successful dieters work harder than non-dieters at maintaining their weight over the holidays, they often face more weight gain than thinner people. And gaining weight often goes on for another month … into the new year, according to the National Weight Control Registry.

But you can stop the scale from creeping further up and get back on track with renewed dedication starting now.

Diet slips are a normal part of any lifestyle change. Slips don’t really hurt your progress over the long-term, but how you react to a slip can.

Negative thoughts are the most dangerous and can leave you feeling discouraged and down on yourself. Counter them with positive affirmations. Review the diet success you had before the holidays and return to your good eating habits without reprimanding yourself.

Don’t let holiday overeating extend one day longer. That means get back on track with your very next meal — not tomorrow, next Monday or next month. This way, you can limit weight gain and not let it feed on itself.

Zero in on your food triggers so you can avoid them in the future. Sampling grandma’s homemade stuffing at one meal isn’t going to do much damage, but taking home leftovers to eat for days could. This kind of awareness will help you make better food decisions.

Renew your commitment to weight loss and healthy eating by decreasing calories and increasing exercise time for one full week. This can wipe out a typical 1-to-2 pound holiday gain.

Go back to carefully planning out every meal — and snack — in your digital or paper journal, emphasizing vegetables, fruit, lean protein and whole grains.

These steps will keep a lapse from turning into a relapse and a more significant weight gain.

If you are struggling with obesity and would like a healthier lifestyle, let Ideal Protein at Bay Area Gastroenterology help you achieve your goals.

Ideal Protein is a medically developed, scientifically based, supervised weight loss, weight management, and lifestyle counseling program for dieters.

For information about this exclusive program, please contact our wellness coach, Morgan, at 281-258-4280.