Symptoms Peptic Ulcer Disease
Peptic ulcers are essentially sores that have developed within the esophagus, stomach, or even the upper section of the small intestine. These areas are very acidic due to the part they play in the digestive system, which frequently causes the ulcers to be very painful to the sufferer. Symptoms of mild cases of this disorder include pain in the abdominal region, bloating, nausea/vomiting, and the loss of one’s appetite which can lead to weight loss. Patients with more severe cases may experience severe pain, as well as darker colored vomit or stools due to the passing of blood. In the most severe of cases, patients can even suffer from a perforation, or hole, in their stomach or intestinal lining which requires immediate surgical repair.
Peptic ulcers are named specifically by referring to the location in the digestive system in which they occur. Gastric ulcers are those that occur within the stomach itself, while duodenal ulcers occur in the first section of the small intestine (the duodenum.) Additionally, ulcers can also appear along the inside of the esophagus where they are known as esophageal ulcers.
It was once believed that stress or a poor diet lead to the development of these ulcers, but researchers have determined that this is not the case. Other, more likely, causes have been realized in more recent medical history.
1. In the early 1980s, it was discovered that a common bacteria known as Helicobacter pylori was too blame for a majority of instances of peptic ulcer disease. Although many people suffer from H. pylori infections, in only a few of them does the bacteria reproduce to the point that it disrupts the chemical balance in their digestive tracts and causes an ulcer.
2. Another cause of these ulcers that is becoming more common is the use of non-steroidal anti-inflammatory drugs (NSAIDs.) These drugs are prescribed primarily for pain, although many are available over the counter, but they also prevent the production of a chemical necessary to protect the lining of the stomach and small intestine. When the body is prevented from producing this enzyme, the stomach lining is exposed to the same acids used to digest food and often develops ulcers.
3. Other possible, but yet unproven, causes of peptic ulcers also include smoking cigarettes and drinking alcohol in excess.
1. The probability of H. pylori infection is less common in well developed nations the food quality is greater and drinking water is kept clean. However, the chance of these infections increases in increments of about 10% every ten years, thus the elderly population is more common to experience these ulcer causing infections.
2. Due to the increased use of NSAIDs to treat chronic pain in many patients, the chances of developing a peptic ulcer has risen dramatically across all ages and social orders. For this reason, it is very important for anyone with any other risk factors for ulcers to notify their physician or pharmacist before taking any NSAID.
Methods of Diagnosis
There are currently several methods of diagnosing a patient with peptic ulcer disease. The simplest method can be conducted on your first visit to the physician’s office. It involves discussing what medications you take as well as their dosages. If the physical symptoms of an ulcer are present and the patient is not currently taking any NSAIDs or similar medications, then H. pylori bacteria is more than likely to blame.
The physician can then take a blood or stool sample to test for the bacteria, or he may use a breath test which can also detect its presence. If the symptoms are severe or if the doctor wishes to visually inspect the ulcerated area, he may elect to perform an endoscopy. During this procedure, a long tube with a camera and light is inserted through the mouth and down the throat all the way to the stomach where it can relay images to a monitor.
Treatment for peptic ulcers depends primarily on the cause of each particular case. If the patient is diagnosed with an ulcer caused by the H. pylori bacteria, a combination of two antibiotics along with a proton pump inhibitor (PPI) can be used. The antibiotics can be chosen from a list of multiple prescriptions, and the PPI may be prescribed or picked up over the counter. Ulcers caused by the taking of NSAIDs can usually be treated by simply stopping those medications and supplementing with an over the counter antacid or PPI. Occasionally, doctors may prescribe additional medication if this method fails to allow the ulcer to heal. If your doctor believes alcohol or tobacco use is the root of your problem, once again, healing can come from halting consumption of these products.
Some patients may also want to treat their ulcers at home, saving prescription options as a last resort. Potential natural remedies include bananas, and the juices from fresh carrots and cabbage. It has also been suggested that a tea made from the leaves of the wood apple plant is an affective option. In years past it was suggested that drinking milk would soothe an ulcer and allow it to heal, although this has been proven to actually aggravate the symptoms of an ulcer due to the high acid content of dairy products.
Surgical procedures may also be suggested by your doctor as treatment for an ulcer that has begun to bleed into the stomach or intestine. The surgeon will perform the operation to cauterize the ulcer or remove pieces of tissue to stop the bleeding. If an ulcer causes a perforation, or hole, in the wall of the stomach, there is a need for emergency surgery to repair the damage. After the performance of any surgery, doctors may choose one of the above methods to treat the ulcers and prevent any future problems.
Lactose intolerance is a disorder in which sufferers cannot produce the necessary enzymes to digest lactose, a form of sugar found in milk and other dairy products. When the ingested lactose passes into the colon unmolested by digestive enzymes, bacteria residing in the lower bowel begin to break it down. The occurrence of this process in the colon produces several symptoms including cramping, bloating, diarrhea, and large amounts of gas.
Lactose intolerance is sometimes referred to as lactase deficiency, named for the lack of the digestive enzyme lactase. Lactase is the enzyme specifically produced to aid in the digestion of the sugar lactose.
1. A certain degree of lactase deficiency can be expected with advanced age. As people grow older, their bodies tend to produce less lactase and therefore they may experience some level of lactose intolerance.
2. There is also a proven genetic component in the causation of lactose intolerance. This can be seen not only in its prevalence within individual families, but also in the fact that it tends to affect some entire races of people more than others. Lactose intolerance is more common in individuals of African, Asian, and Hispanic descent, as well as those descended from the Native American populations. People of the Jewish race also tend to see a higher incidence of this disorder.
3. Illness or disease of the small intestine is also known to cause a reduction in the amount of lactase in the bowel. Some patients experience a short period of lactose intolerance after a bout of stomach flu, while others suffering from chronic disorders such as cystic fibrosis or celiac disease are intolerant of the sugar throughout the term of their illness. Surgical removal or radioactive treatment of the small intestine can also prevent the release of lactase allowing undigested lactose to pass into the colon.
The risk factors for lactose intolerance tend to correlate with common causes of the disorder.
1. As a person’s age increases, so does the likelihood of suffering from this condition.
2. Individuals with a known family history of lactose intolerance can expect a higher than average chance of experiencing it themselves.
3. Patients being treated for inflammatory diseases of the small intestine, or who have had surgery or cancer treatments in the area around the lower digestive organs may expect a degree of lactose intolerance as an after effect of these procedures.
4. Also, babies born prematurely are sometimes unable to produce lactase due to their undeveloped digestive systems, but time usually resolves these problems.
Methods of Diagnosis
Currently, there are several tests that doctors use in diagnosing a patient with lactose intolerance. Before any of these tests are ordered, your doctor may suggest that you remove dairy from your diet and monitor your symptoms to see if they improve. If there is no improvement a breath test may be ordered, during which you will drink a lactose solution and your breath will be inspected for certain gases after your body has tried to digest the lactose.
If this test points toward a case of lactose intolerance, a follow up blood test can be done to confirm the lack of broken down sugars in the bloodstream. For babies and small children who cannot be exposed to the high level of lactose required for testing, a stool sample can be analyzed for excess amounts of lactic acid that has passed through the colon.
There is no cure for lactose intolerance, or a prescription that can force the body to produce lactase, so a large part of treatment is diet modification. However, a solution containing the necessary lactase enzyme is available over the counter and may help some sufferers. The drop can be taken before meals where lactose is present, or even added to milk before consumption.
The severity of this condition varies considerably among its sufferers, from those who cannot consume any dairy at all to those who are only affected after consuming large amounts. Therefore, it is the responsibility of each patient to find what modifications work for them. Milk, cheese, and butter created from plant based ingredients can be substituted for dairy products. Additionally, several companies now specialize in production of lactose free dairy foods specifically for those suffering from lactose intolerance. Patients may also experiment with products containing lactose to note the degree to which their symptoms occur. Some may be able to tolerate small amounts of dairy at certain times of the day, or when consumed with a large meal containing no other lactose. Eating live culture yogurt may also assist in the breakdown of lactose.
Lack of Calcium
One major concern for individuals who are unable to consume dairy products is the inability to ingest enough calcium to maintain their health. This problem can be remedied by substituting other calcium rich foods, which range from meats and vegetables to breakfast cereals. Green leafy vegetables such as turnip and collard greens, kale, and broccoli all contain healthy amounts of calcium. A diet including sardines, salmon, and tuna would be well supplemented as well. Almonds can make a calcium rich snack, while many breakfast cereals now come fortified with calcium. Due to the wide variety of naturally calcium rich foods, as well as those that now have calcium added, a person suffering from lactose intolerance should have little concern as to whether they are able to live a healthy, happy life.
Diverticulitis is an infection that develops within the small intestine. One of the initial symptoms would be sudden, severe pain in the lower left portion of the abdomen. Rarely, this pain would alternately be felt on the right side of the abdomen. These pains would be followed by fever, bloating and gas, and a noticeable change in bowel activity, either constipation or diarrhea. In extreme cases, the patient may even experience bleeding from the rectum.
1. Diverticulitis is caused when small pouches called diverticula form in the walls of the small intestine, then become infected. These pouches are usually formed when the bowel exerts extra pressure to propel waste through the intestine and are found in naturally weak spots along the intestinal walls.
Doctors are at odds over what exactly causes the diverticula to become inflamed or infected.
a. One theory is that the narrow openings of the diverticula are prime locations for fecal matter to become trapped and harbor infection.
b. Another states that these same narrow openings result in a reduction of blood supplied to the area, causing inflammation.
1. Diverticulitis is most common in the elderly, with the chances of infection increasing after the age of forty. This is perhaps due to the reduced strength and resilience of the muscles found in the intestinal walls. For unknown reasons, a lack of physical activity which is common in those of advanced age also contributes to higher incidences of diverticulitis.
2. A lack of fiber in the diet has been proven to create harder, more dense stools which cause the bowel to exert the extra pressure needed to form diverticula, thus increasing the likelihood of infection.
3. In younger patients, obesity is almost always cited as a contributing factor in the development of diverticulitis.
Methods of Diagnosis
The most common method of diagnosing a patient with diverticulitis is to perform a blood test which screens for infection, as well as ruling out other diseases, followed by a CT scan of the abdomen. The CT scan allows the doctor to see if diverticula are present and, if they are, if there are areas of inflammation or infection. Your doctor may also order a colonoscopy to be sure there is no cancer or other structural problems in the lower bowel.
The methods of treating diverticulitis depend heavily upon the severity of the patient’s symptoms, as well as how frequently these infections occur. In mild cases of the disorder, doctors may prescribe any of a variety of antibiotics that will rid the body of the infectious bacteria. The prescription is complemented by a liquid or soft food diet that will allow the bowel to rest and the infected area to heal. After the course of medication is completed, the patient should be advised to dramatically increase the amount of fiber in their diet to prevent any recurrence of problems. Over the counter pain relievers may also be suggested to ease the pain associated with this disorder.
Home treatment of diverticulitis relies primarily on diet modification. Sufferers should replace any white bread in their diets with whole wheat bread, and should also add oats and bran to their diets. Water is an extremely important component of the diet as it will help soften the stool and relieve the pressure exerted in the intestine. The diet should be full of fruits, especially apples, and these should be consumed whole as juices are usually strained of any beneficial fiber. This method of treatment should not be expected to heal the body as quickly as other means, and usually takes anywhere from two to six weeks before results are noticed.
Treatment for Severe Cases
In severe or repetitive cases of diverticulitis, surgery may be required. It will be up to the patient and their doctor to decide if the risks of surgical intervention outweigh the problems caused by frequent infections. Surgery may be the only option, however, if there is an obstruction in the bowel or if a hole develops in the wall of the intestine.
A fistula, or abnormal passageway, may develop which allows for fecal matter to leave the intestine and travel back into the stomach or other area where it can cause even more infections. These are also correctable by surgery. In some cases, the surgeon will remove the affected area of the intestine and be able to reattach the upper portion to a section farther down. However if too much of the intestine must be removed to prevent reoccurrence, a tube will be attached to the end of the remaining intestine allowing fecal material to flow outside of the body to be collected in a colostomy bag carried on the patient’s person.