By Elizabeth Colsen, MD, General Surgeon
On the annual Ladies on the Lake excursions, our topic of discussion this year was digestive health. Everyone has a digestive system, so everyone deals with at least one of these issues at some point. Here are the 8 most common gastrointestinal issues, and what you can do to deal with them. When it starts to affect your quality of life, seek help from your provider.
Belching, burping – whatever you want to call it – is caused by swallowing air when eating, chewing gum, swallowing due to postnasal drip or nervous tension. Poorly fitting dentures and not chewing food completely can lead to swallowing more air when we eat and drink. To prevent excessive belching, avoid carbonated beverages, chewing gum, hard candy, eating too fast, and swallowing air.
- Abdominal Bloating
Bloating may be due to intestinal sensitivity or symptoms of irritable bowel syndrome. It can also be due to ingestion of gas-producing foods in your diet or swallowing air. To relieve or prevent bloating avoid foods that cause gas including broccoli, cauliflower, baked beans, and cabbage. Avoid chewing gum or sucking on hard candy, which promotes air swallowing. Carbonated drinks can also contribute to bloating.
- Abdominal Distention
When this results from weak abdominal muscles, abdominal distention is better in the morning and progresses as the day goes on. This is common for people that do not exercise and have weak core muscles. To prevent distention, tighten abdominal muscles by exercising them, do core strengthening and balance activities using a workout ball.
Flatulence (farting) is gas created by the bacteria breaking down food in the colon. It is also from swallowed air that is not expelled by burping. Note that 10-18 passages of gas per day are normal and the smell of your flatulence is from the foods you eat. Foods that are likely to form gas include milk and other dairy products, baked beans, cauliflower, broccoli, cabbage, wheat, oats, corn, and fiber-containing foods. Avoid these foods if flatulence is a problem for you.
- Reflux and Heartburn
This is caused by acid refluxing into the esophagus from the stomach and causes pain (heartburn) and indigestion. Factors that make heartburn worse include smoking, alcohol, fatty foods, caffeine, chocolate, peppermint, overeating, eating at night, tight-fitting clothes on the abdomen, medications, and straining. If your reflux continues after eliminating the trigger foods and modifying your lifestyle, please talk to a doctor.
Hemorrhoids are swollen veins in the lower rectum (internal) or near the anus (external). Symptoms of hemorrhoids include bright red rectal bleeding, difficulty with hygiene, pain and itching when irritated by diarrhea or constipation. Hemorrhoids are caused by straining while having a bowel movement, chronic constipation, laxative abuse, and physically straining. To prevent and manage hemorrhoids – increase fiber and fluid intake, avoid sitting on the toilet for longer than two minutes, clean the rectal area using cloths or soap and water after bowel movements, and use topical creams or baths to help reduce inflammation. If you have new rectal bleeding that is not already diagnosed as a hemorrhoid, please see your doctor.
Constipation is defined as stools that are too small, too hard, difficult to pass, and infrequent (less than 3 times per week). It is caused by not getting enough fiber and fluids, medication side effects, stress, lack of activity, and medical problems. Managing constipation includes adding fiber and water to your diet. Eat meals on a regular schedule and chew your food well. Exercising daily to help with healthy bowel function will help constipation. Your doctor may recommend Miralax or other stool softeners to help with constipation. Keep in mind that the use of stimulant laxatives (Senna) may actually make constipation worse if used for prolonged periods of times.
- Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is also known as spastic colon or irritable colon syndrome. Symptoms include abdominal pain that is periodic or dull and continuous, erratic bowel habits with frequent constipation or diarrhea/bloating/nausea/headache/fatigue, and sensitivity to intestinal gas with cramping and flatulence. It is more common in women than men and usually starts in the 20-30s. The hormones your body makes during times of stress directly affect the digestion tract so treatment of IBS includes management of triggers including stress and your diet. Start by modifying your diet to decrease gas-producing foods. In addition to managing your intake of fiber, fluids, and using stool softeners for constipation, a prescription medication may help treat the symptoms. Antispasmodics and antidiarrheals for diarrhea prone patients can be used if necessary. Sometimes psychiatric therapy and medication can also help IBS symptoms because it is strongly related to stress and anxiety.
These recommendations are for commonly occurring digestive issues. Remember, everything on this list is common, but it does not have to be endured. If you have any questions or concerns, please consult your medical provider for assistance.