GI Disorders
Gastrointestinal (GI) Functional and Motility Disorders
Abdominal Adhesions
|
Achalasia
|
Acute Hepatic
Porphyria (AHP)
|
Anal Fistulas
|
Bowel Incontinence
|
Celiac Disease
|
Centrally Mediated
Abdominal Pain Syndrome (CAPS)
|
Chronic
Constipation
|
Clostridioides
Difficile Infection (CDI)
|
Congenital
Sucrase-Isomaltase Deficiency (CSID)
|
Cyclic Vomiting
Syndrome (CVS)
|
Difficult to
Interpret Intestinal Symptoms
|
Dyspepsia
|
Diverticulosis and
Diverticulitis
|
Gastroparesis
|
Dyssynergic
Defecation: About a Common Cause of Chronic Constipation
|
Eosinophilic
Gastroenteritis
|
Hirschsprung’s
Disease
|
GERD
|
Globus
|
Irritable Bowel
Syndrome
|
Inflammatory Bowel
Disease
|
Intestinal
Pseudo-obstruction
|
Opioid Induced
Constipation
|
Long Term Use of
Loperamide
|
Malabsorption
|
Sphincter of Oddi
Dysfunction
|
Radiation Induced
Injury to the Colon and Rectum
|
Scleroderma
|
Volvulus
|
Understanding
Chronic or Functional Diarrhea
|
Superior Mesenteric
Artery Syndrome
|
Gastrointestinal Diseases
GERD, diarrhea and colorectal cancer
are examples of gastrointestinal diseases. When examined, some diseases show
nothing wrong with the GI tract, but there are still symptoms. Other diseases
have symptoms, and there are also visible irregularities in the GI tract. Most
gastrointestinal diseases can be prevented and/or treated.
What are gastrointestinal diseases?
Gastrointestinal diseases affect the
gastrointestinal (GI) tract from the mouth to the anus. There are two types:
functional and structural. Some examples include nausea/vomiting, food
poisoning, lactose intolerance and diarrhea.
What are functional
gastrointestinal diseases?
Functional diseases are those in
which the GI tract looks normal when examined, but doesn't move properly. They
are the most common problems affecting the GI tract (including the colon and
rectum). Constipation, irritable bowel syndrome (IBS), nausea, food
poisoning, gas, bloating, GERD and diarrhea are common examples.
Many factors may upset
your GI tract and its motility (ability to keep moving), including:
- Eating a diet low in fiber.
- Not getting enough exercise.
- Traveling or other changes in routine.
- Eating large amounts of dairy products.
- Stress.
- Resisting the urge to have a bowel movement, possibly
because of hemorrhoids.
- Overusing anti-diarrheal medications that, over time, weaken
the bowel muscle movements called motility.
- Taking antacid medicines containing calcium or
aluminum.
- Taking certain medicines (especially antidepressants,
iron pills and strong pain medicines such as narcotics).
- Pregnancy.
What are structural
gastrointestinal diseases?
Structural gastrointestinal diseases
are those where your bowel looks abnormal upon examination and also doesn't
work properly. Sometimes, the structural abnormality needs to be removed
surgically. Common examples of structural GI diseases include strictures,
stenosis, hemorrhoids, diverticular disease, colon polyps, colon cancer and
inflammatory bowel disease.
Constipation
Constipation, which is a functional problem, makes it hard for you to
have a bowel movement (or pass stools), the stools are infrequent (less than
three times a week), or incomplete. Constipation is usually caused by
inadequate "roughage" or fiber in your diet, or a disruption of your
regular routine or diet.
Constipation causes you to strain
during a bowel movement. It may cause small, hard stools and sometimes anal
problems such as fissures and hemorrhoids. Constipation is rarely the sign that
you have a more serious medical condition.
You can treat your constipation by:
- Increasing the amount of fiber and water to your diet.
- Exercising regularly and increasing the intensity of
your exercises as tolerated.
- Moving your bowels when you have the urge (resisting
the urge causes constipation).
If these treatment methods don't
work, laxatives can be added. Note that you should make sure you are up to date
with your colon cancer screening. Always follow the instructions on the
laxative medicine, as well as the advice of your healthcare provider.
Learn more about: Constipation
Irritable bowel syndrome (IBS)
Irritable bowel syndrome (also called
spastic colon, irritable colon, IBS, or nervous stomach) is a functional
condition where your colon muscle contracts more or less often than “normal.”
Certain foods, medicines and emotional stress are some factors that can trigger
IBS.
Symptoms of IBS
include:
- Abdominal pain and cramps.
- Excess gas.
- Bloating.
- Change in bowel habits such as harder, looser, or more
urgent stools than normal.
- Alternating constipation and diarrhea.
Treatment includes:
- Avoiding excessive caffeine.
- Increasing fiber in your diet.
- Monitoring which foods trigger your IBS (and avoiding
these foods).
- Minimizing stress or learning different ways to cope
with stress.
- Taking medicines as prescribed by your healthcare
provider.
- Avoiding dehydration, and hydrating well throughout the
day.
- Getting high quality rest/sleep.
Hemorrhoids
Hemorrhoids are dilated veins in the
anal canal, structural disease. They’re swollen blood vessels that line your
anal opening. They are caused by chronic excess pressure from straining during
a bowel movement, persistent diarrhea, or pregnancy. There are two types of
hemorrhoids: internal and external.
Learn more about: Hemorrhoids
Internal hemorrhoids
Internal hemorrhoids are blood
vessels on the inside of your anal opening. When they fall down into the anus
as a result of straining, they become irritated and start to bleed. Ultimately,
internal hemorrhoids can fall down enough to prolapse (sink or stick) out of
the anus.
Treatment includes:
- Improving bowel habits (such as avoiding constipation,
not straining during bowel movements and moving your bowels when you have
the urge).
- Your healthcare provider using ligating bands to
eliminate the vessels.
- Your healthcare provider removing them surgically.
Surgery is needed only for a small number of people with very large,
painful and persistent hemorrhoids.
External hemorrhoids
External hemorrhoids are veins that
lie just under the skin on the outside of the anus. Sometimes, after straining,
the external hemorrhoidal veins burst and a blood clots form under the skin.
This very painful condition is called a “pile.”
Treatment includes removing the clot
and vein under local anesthesia and/or removing the hemorrhoid itself.
Learn more about: Hemorrhoids
Anal fissures
Anal fissures are also a structural
disease. They are splits or cracks in the lining of your anal opening. The most
common cause of an anal fissure is the passage of very hard or watery stools.
The crack in the anal lining exposes the underlying muscles that control the
passage of stool through the anus and out of the body. An anal fissure is one
of the most painful problems because the exposed muscles become irritated from
exposure to stool or air, and leads to intense burning pain, bleeding, or spasm
after bowel movements.
Learn more about: Anal fissures
Initial treatment for anal fissures
includes pain medicine, dietary fiber to reduce the occurrence of large, bulky
stools and sitz baths (sitting in a few inches of warm water). If these
treatments don't relieve your pain, surgery might be needed to repair the
sphincter muscle.
Perianal abscesses
Perianal abscesses, also a
structural disease, can occur when the tiny anal glands that open on the inside
of your anus become blocked, and the bacteria always present in these glands
causes an infection. When pus develops, an abscess forms. Treatment includes
draining the abscess, usually under local anesthesia in the healthcare
provider’s office.
Learn more about: Perianal abscesses
Anal fistula
An anal fistula – again, a
structural disease – often follows drainage of an abscess and is an abnormal
tube-like passageway from the anal canal to a hole in the skin near the opening
of your anus. Body wastes traveling through your anal canal are diverted
through this tiny channel and out through the skin, causing itching and
irritation. Fistulas also cause drainage, pain and bleeding. They rarely heal
by themselves and usually need surgery to drain the abscess and "close
off" the fistula.
Learn more about: Anal fistula
Other perianal infections
Sometimes the skin
glands near your anus become infected and need to be drained, like in this
structural disease. Just behind the anus, abscesses can form that contain a
small tuft of hair at the back of the pelvis (called a pilonidal cyst).
Sexually transmitted
infections (STIs) that can affect
the anus include anal warts, herpes, AIDS, chlamydia and gonorrhea.
Learn more about: Anal Warts
Learn more about: Herpes
Learn more about: AIDS
Learn more about: Chlamydia
Learn more about: Gonorrhea
Diverticular disease
The structural disease
diverticulosis is the presence of small outpouchings (diverticula) in the
muscular wall of your large intestine that form in weakened areas of the bowel.
They usually occur in the sigmoid colon, the high-pressure area of the lower large
intestine.
Diverticular disease
is very common and occurs in 10% of people over age 40 and in 50% of people
over age 60 in Western cultures. It is often caused by too little roughage
(fiber) in the diet. Diverticulosis can sometimes develop/progress into
diverticulitis
Complications of
diverticular disease happen in about 10% of people with outpouchings. They
include infection or inflammation (diverticulitis), bleeding and obstruction.
Treatment of diverticulitis includes treating the constipation and sometimes
antibiotics if really severe. Surgery is needed as last resort in those who
have significant complications to remove the involved diseased segment of the
colon.
Colon polyps and cancer
Fortunately, with
advances in early detection and treatment, colorectal cancer is one of the most
curable forms of the disease. By using a variety of screening tests, it is
possible to prevent, detect and treat the disease long before symptoms appear.
Learn more about: Colon polyps and Cancer
The importance of screening
Almost all colorectal
cancers begin as polyps, benign (non-cancerous) growths in the tissues lining
your colon and rectum. Cancer develops when these polyps grow and abnormal
cells develop and start to invade surrounding tissue. Removal of polyps can
prevent the development of colorectal cancer. Almost all precancerous polyps
can be removed painlessly using a flexible lighted tube called a colonoscope.
If not caught in the early stages, colorectal cancer can spread throughout the
body. More advanced cancer requires more complicated surgical techniques.
Most early forms of
colorectal cancer do not cause symptoms, which makes screening especially
important. When symptoms do occur, the cancer might already be quite advanced.
Symptoms include blood on or mixed in with the stool, a change in normal bowel
habits, narrowing of the stool, abdominal pain, weight loss, or constant
tiredness.
Most cases of
colorectal cancer are detected in one of four ways:
- By screening people at average risk for colorectal
cancer beginning at age 45.
- By screening people at higher risk for colorectal
cancer (for example, those with a family history or a personal history of
colon polyps or cancer).
- By investigating the bowel in patients with symptoms.
- A chance finding at a routine check-up.
Early detection is the
best chance for a cure.
Colitis
There are several
types of colitis, which are conditions that cause an inflammation of the bowel.
These include:
- Infectious colitis.
- Ulcerative colitis (cause unknown).
- Crohn's disease (cause unknown).
- Ischemic colitis (caused by not enough blood going to the colon).
- Radiation colitis (after radiotherapy).
Colitis causes
diarrhea, rectal bleeding, abdominal cramps and urgency (frequent and immediate
need to empty the bowels). Treatment depends on the diagnosis, which is made by
colonoscopy and biopsy.
Learn more about: Colitis
Prevention
Can gastrointestinal
diseases be prevented?
Many diseases of the
colon and rectum can be prevented or minimized by maintaining a healthy
lifestyle, practicing good bowel habits and getting screened for cancer.
A colonoscopy is
recommended for average-risk patients at age 45. If you have a family history
of colorectal cancer or polyps, a colonoscopy may be recommended at a younger
age. Typically, a colonoscopy is recommended 10 years younger than the affected
family member. (For example, if your brother was diagnosed with colorectal
cancer or polyps at age 45, you should begin screening at age 35.)
If you have symptoms
of colorectal cancer you should consult your healthcare provider right away.
Common symptoms include:
- A change in normal bowel habits.
- Blood on or in the stool that is either bright or dark.
- Unusual abdominal or gas pains.
- Very narrow stool.
- A feeling that the bowel has not emptied completely
after passing stool.
- Unexplained weight loss.
- Fatigue.
- Anemia (low blood count).
Other types of gastrointestinal diseases
There are many other
gastrointestinal diseases. Some are discussed, but others are not covered here.
Other functional and structural diseases include peptic ulcer disease,
gastritis, gastroenteritis, celiac disease, Crohn's disease, gallstones, fecal incontinence, lactose
intolerance, Hirschsprung disease, abdominal adhesions, Barrett's esophagus,
appendicitis, indigestion (dyspepsia), intestinal pseudo-obstruction,
pancreatitis, short bowel syndrome, Whipple’s disease, Zollinger-Ellison
syndrome, malabsorption syndromes and hepatitis.
References
- International Foundation for Functional
Gastrointestinal Disorders. About
GI Motility. (http://aboutgimotility.org/learn-about-gi-motility.html) Accessed
12/26/2020.
- American College of Gastroenterology. Digestive Health Tips. (http://patients.gi.org/topics/digestive-health-tips/) Accessed
12/26/2020.
- National Institute of Diabetes and
Digestive and Kidney Diseases. Digestive
Disease Topics. (http://www.niddk.nih.gov/health-information/digestive-diseases) Accessed
12/26/2020.
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