Mayo Clinic on Digestive Health

How to Prevent and Treat Common Stomach and Gut Problems

Sahil Khanna

• Publisher: Mayo Clinic Press
• Year: 2020
• ISBN:
  9780795352898
• Topic: Medicina
• Subtopic: Gastroenterologia ed epatologia

Digestive problems are among the most common reasons people see their doctors. They’re also a leading reason why people take medication. Mayo Clinic on Digestive Health, fourth edition, is an authoritative, yet practical reference manual that includes information on everything from healthy digestion to cancer treatment. The book is packed with helpful advice about how to maintain a healthy gut; manage heartburn, gas, constipation and diarrhea; treat several common digestive conditions; and prevent serious disease. The book provides guidance and helpful tips on a variety of digestive conditions, including: Belching, bloating and gas Celiac disease Colorectal cancer Constipation and diarrhea Crohn’s disease and ulcerative colitis Diverticular disease Gallbladder disease Heartburn and GERD Irritable bowel syndrome Liver disease Pancreatic disease Swallowing difficulties Ulcers and stomach pain

Part 1 Digestive health basics

Chapter 1 Why your gut matters

Good health and a healthy gut go hand in hand. Digestion is one of the critical functions your body must perform in order to survive and thrive. The food you eat provides necessary nutrients that supply your cells with sustenance and energy so your body can develop, repair and maintain itself.

When you take a bite of food, what enters your mouth must be transformed before it can nourish your body. That’s the primary function of digestion — to break down food into smaller components and change it chemically so nutrients can be extracted and absorbed into your bloodstream (while the remainder is eliminated as waste). The breakdown of food occurs primarily through the action of digestive juices in your mouth, stomach and intestines, with assistance from the tearing, grinding action of your teeth.

When things go according to plan, the organs of your digestive tract perform a variety of specialized functions in an efficient and timely manner. But like any complex system that contains integrated parts, sometimes the process gets disrupted, and even a slight malfunction can cause problems.

When this happens, you begin to experience signs and symptoms. That’s your body’s way of letting you know something isn’t quite right. Often, the problems are minor and infrequent, but sometimes they can be complex and chronic.

Warning signs

Heartburn, pain, cramps, bloating, nausea, vomiting, diarrhea, constipation, bleeding — these are some of the ways your digestive system alerts you to a problem. And try as you may to ignore what’s happening (or isn’t happening) in your stomach or gut, doing so is virtually impossible.

For some people, the pain, bloating or nausea comes and goes. It may come on sporadically, and sometimes suddenly, and then gradually diminish after a few hours. For others, digestive distress persists and becomes a constant, unwanted companion.

Digestive issues have many possible causes, including infection, inflammation, digestive tract blockages, and lifestyle issues including diet and stress. For many individuals, no matter what they may try to relieve their signs and symptoms, it doesn’t work and the problem persists.

It’s estimated that 60 million to 70 million Americans — perhaps even more — experience some type of digestive issue. Evidence of this is on display in drugstore and grocery store aisles lined with an impressive array of digestive-related medicines and supplements, including antacids, acid blockers, laxatives and fiber supplements.

Over-the-counter medications often help relieve bothersome signs and symptoms, but they aren’t always the answer. If you’re regularly affected by periods of indigestion, pain, nausea or cramps, it’s important that you see your doctor.

Knowing the root cause of what’s ailing you can help reduce your anxiety, put you more at ease in social situations and allow you and your doctor to work together on a plan to manage the condition and possibly even cure it. Early action on your part may also prevent a serious digestive condition from becoming life-threatening.

• • • • •

Problems by the numbers

Are digestive problems more common today than they were years ago? The answer appears to be yes.

Why are digestive issues on the rise? There could be many reasons, and it’s difficult to point to one or two factors. However, there seems to be a legitimate association between digestion and lifestyle. Some of the increase in digestive-related issues could be linked to increasingly fast-paced lifestyles, unhealthy diets and reduced exercise.

The prevalence of digestive problems is reflected in these general statistics:

• More than 60 million Americans experience heartburn at least once a month, and more than 15 million may have heartburn daily.
• About 36 percent of Americans have trouble digesting dairy products, a condition called lactose intolerance.
• An estimated 15 million Americans experience abdominal pain, gas, and diarrhea or constipation associated with irritable bowel syndrome.
• More than 3 million clinic and hospital visits each year are for constipation.
• Just under 6 percent of U.S. adults have ulcers.
• About 3.5 million Americans are living with hepatitis C, a viral liver infection.
• An estimated 135,000 Americans are diagnosed each year with colorectal cancer.

• • • • •

Digestion at work

Your digestive tract is a series of hollow, connected organs including the esophagus, stomach, small intestine and colon. Together they form a long, convoluted passageway extending from the mouth to the anus, where solid waste exits the body. Organs such as the salivary glands, pancreas, liver and gallbladder also serve essential functions in the digestive process.

Along this tract, muscular contractions move food along through successive stages of the digestive process. Valves at critical junctures control the amount of food that can be moved forward and prevent food from moving backward. A network of nerves and glandular cells regulates much of this activity, including the release of enzymes and digestive juices. When food is broken down, nutrients are absorbed into your blood via tiny pores in the intestinal wall. The nutrients are transported in the bloodstream to nourish your body’s cells.

When problems occur, certain signs and symptoms may point to any number of possible causes, making a diagnosis difficult (and your life miserable). The tasks at hand for you and your doctor during a medical visit are to identify all the possibilities and — often through a process of elimination — focus on the most likely cause.

In the sections that follow, we describe the different digestive organs and their relationships to one another. This knowledge may help you better understand the complexities of the digestive process and why problems develop.

Salivary glands

Digestion actually starts even before you take your first bite. The aroma of the food you’re about to eat — or are thinking about eating — is enough to get saliva in your mouth flowing. You have three pairs of large salivary glands, in addition to smaller glands in the lining of your mouth.

When you take a bite of food, your glands pump out saliva containing the enzyme amylase that begins to chemically break down the food. Your teeth crunch and grind the food, while your tongue mixes it with the saliva. These actions transform a bite of food into a bolus — a soft, moist, rounded mixture suitable for swallowing.

You control many aspects of the digestive process at the beginning — what you put into your mouth, how long you chew it and when you swallow. But once you swallow, the rest of the digestive process is controlled by your nervous system.

The digestive tract begins at the mouth and ends at the rectum and includes several internal organs. Food moves through your body along the digestive tract.

Esophagus

When you swallow, muscles in your mouth and throat propel food through a relaxed ring of muscle (upper esophageal sphincter) that connects the back of your throat (pharynx) to your upper esophagus. The esophagus, commonly referred to as the food pipe, is a tube about 10 inches long that connects your throat and stomach.

Gravity alone isn’t sufficient to move food through the esophagus. Help comes from muscles in the wall of the esophagus that move in synchronized waves — one after another — propelling the food toward your stomach. Muscles above the swallowed food contract, squeezing it downward, while muscles below the food relax to allow it to advance without resistance. This pattern of progressive contraction and relaxation is called peristalsis. Peristalsis is a coordinated muscular action that continues through your entire digestive tract.

As food reaches the lower portion of your esophagus, it approaches the lower esophageal sphincter (LES). When you’re not eating, this muscle valve remains tightly closed to keep stomach acid from flowing backward (regurgitating) into your esophagus and causing heartburn. The act of swallowing signals the valve to relax and open in order to let food pass through on its way to your stomach.

In some people, food doesn’t move down the tract ...