tag:blogger.com,1999:blog-84114821443838285752024-03-05T01:13:13.060-08:00GastroenterologyAn evidence-based blog by Professor Barbara ErfurtProf. E. GCChttp://www.blogger.com/profile/01259451081865074245noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-8411482144383828575.post-81963972321978194612020-05-12T14:14:00.002-07:002020-06-10T15:01:18.398-07:00Celiac Disease<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
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<span style="font-family: "verdana" , sans-serif;"><br /><br />Celiac disease is an auto-immune condition that impacts the digestive system. This disease causes a pathological reaction of the immune system to something called gluten, a protein found in commonly consumed grains, such as wheat, barley, and rye. For an unknown reason, celiac disease causes the immune system to attack the inner lining of the small intestine, damaging nutrient absorption sites and reducing nutrient absorption. <br /><br />Celiac disease shares symptoms </span><span style="font-family: "verdana" , sans-serif;">like diarrhea and bowel pain which are also common to </span><span style="font-family: "verdana" , sans-serif;">other gastrointestinal conditions such as irritable bowel syndrome and inflammatory bowel disease, making it difficult to diagnose. People with celiac disease may also manifest other non-digestive symptoms like headaches, muscle and joint pain, moodiness, fatigue, and skin rashes with blisters. In people showing such symptoms, the appearance of certain antibodies in blood work and/or a biopsy of the small intestine can help confirm a diagnosis.<br /><br />While this disease can do significant damage to the intestinal tract if untreated, it is fairly easy to treat for many people through dietary reduction of foods containing gluten. It is important to note that gluten lies hidden in <a href="https://celiac.org/gluten-free-living/what-is-gluten/sources-of-gluten/">food products</a> and supplements where many people would not know to expect it, so people with this disease need to carefully read food ingredient lists and labels. If dietary change is not sufficient to cause improvement in the condition, anti-inflammatory drugs and drugs that suppress the immune system's activity may need to be added to the treatment regimen.</span><br />
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<span style="color: #666666; font-family: "verdana" , sans-serif; font-size: xx-small;"><br /><span style="color: #444444;"><i>What is Celiac Disease? | Celiac Disease Foundation</i>. (2017, December 31). Celiac Disease Foundation; Celiac. https://celiac.org/about-celiac-disease/what-is-celiac-disease/</span></span><br />
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Prof. E. GCChttp://www.blogger.com/profile/01259451081865074245noreply@blogger.comtag:blogger.com,1999:blog-8411482144383828575.post-47668072074264665752020-05-05T10:43:00.001-07:002020-06-10T15:01:36.821-07:00Gastric Ulcers<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
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<span style="font-family: "verdana" , sans-serif;"><br /><br />A gastric ulcer is a digestive condition in which a painful sore develops in the lining of the stomach or small intestine. It was once believed that stress was a cause of ulcers, due to an excess quantity of hydrochloric acid released into the stomach during stressful times. Turns out, however, that gastric ulcers are actually caused by infectious bacteria called helicobacter pylori, which usually live quietly within the stomach walls, but for reasons that are not well-understood, periodically cause infection. <br /><br />Ordinarily, the lining of the stomach is protected against the hydrochloric acid that contacts it during the digestive process and within the small intestine a buffering agent is added to the digestive mixture to minimize the risk of damage from stomach acid to the small intestinal wall. However, if H. pylori bacteria infects the stomach or intestinal wall and a sore develops, hydrochloric acid irritates the open wound, causing inflammation, burning pain, and other symptoms commonly associated with ulcers. Adding stressful lifestyle, the use of over-the-counter non-steroidal anti-inflammatory pain relievers like ibuprofen and aspirin, and substances like caffeine and spicy foods may exacerbate the pain caused by the infection. <br /><br /> A helicobacter pylori infection can be managed with antibiotics. Reducing stomach acid production may be a concurrent treatment, as well as reducing, modifying, or eliminating other medications or dietary items and stressors that may be exacerbating the condition.</span><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span>
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Peptic ulcer - Symptoms and causes. (n.d.). Mayo Clinic. Retrieved June 10, 2020, from https://www.mayoclinic.org/diseases-conditions/peptic-ulcer/symptoms-causes/syc-20354223#:~:text=Ulcers</span><br />
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Prof. E. GCChttp://www.blogger.com/profile/01259451081865074245noreply@blogger.comtag:blogger.com,1999:blog-8411482144383828575.post-57575463114777945142020-05-04T17:04:00.003-07:002020-06-10T15:01:51.491-07:00Irritable Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS): A comparison<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
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<tr><td class="tr-caption" style="text-align: center;"><span style="color: #444444; font-family: "verdana" , sans-serif; font-size: xx-small;">Image Credit: http://www.scientificanimations.com / CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0)</span></td></tr>
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<span style="font-family: "verdana" , sans-serif;"><br /> <a href="https://www.crohnscolitisfoundation.org/sites/default/files/2019-02/Updated%20IBD%20Factbook.pdf">Inflammatory bowel disease</a> describes several chronic inflammatory conditions of the bowel, with the two most common being Crohn's disease and ulcerative colitis. In IBD, for reasons that are poorly understood, a pathological inflammatory effect causes significant damage and narrowing to the inner walls of the digestive tract. IBD is an auto-immune condition which results from the body's immune system over-reacting to ordinary gastric bacteria or something else in the digestive tract. This condition is not to be confused with <a href="https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016">irritable bowel syndrome</a> (IBS), which is NOT an auto-immune condition, but a gastrointestinal syndrome sharing similar symptoms. <br /><br /><br /> Both IBD and IBS sufferers may have symptoms that include chronic bloating, abdominal pain, gas, and diarrhea and/or constipation. More serious symptoms may be seen in patients with IBD, including bloody stool, blocked bowels, fever, and extreme weight loss. Additionally, IBD can put a patient at risk for colon cancer. Both conditions may also respond to treatments using anti-inflammatory drugs, antibiotics and modifications to diet, with special attention paid to <a href="https://www.healthline.com/nutrition/low-fodmap-diet" target="_blank">FODMAPS</a> (certain foods that are thought to provoke both conditions), and any other lifestyle-related triggers of an episode. </span><br />
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<span style="font-family: "verdana" , sans-serif;">IBD is a much more serious condition than IBS in the long run, which will continue to cause pathogenic damage to the gastrointestinal tract over time and may require surgery to manage. </span>
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<span style="color: #444444; font-family: "verdana" , sans-serif; font-size: xx-small;">Michael Kerr and Kristeen Cherney. (2020). <i>IBS vs. IBD: What’s the Difference?</i> Healthline. https://www.healthline.com/health/crohns-disease/ibs-vs-ibd#q&a</span><br />
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Prof. E. GCChttp://www.blogger.com/profile/01259451081865074245noreply@blogger.comtag:blogger.com,1999:blog-8411482144383828575.post-19741952878462461732020-05-04T16:35:00.001-07:002020-06-10T09:20:27.121-07:00Gallstones<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
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<span style="font-family: "verdana" , sans-serif;"><br /><br />The gallbladder is an accessory organ belonging to the digestive system. It is called an accessory because it contributes something essential to digestion, but is not actually an organ of the digestive tract. The gallbladder stores something called bile, a substance made by the liver of calcium, cholesterol, and several other minerals. Bile's purpose in the body is to emulsify fat in the small intestine, meaning spread it out and separate it into small droplets, enabling the body to completely digest it using enzymes. <br /><br /> The gallbladder operates as a result of nerves that cause it to contract in similar fashion to a turkey baster, pushing bile into the small intestine by way of a duct, or tube. Residual bile that is left in the duct reverses course and returns to the gallbladder. <br /><br /> Sometimes in the face of high cholesterol content in the gallbladder, or in the event of liver disease, people develop <a href="https://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214">gallstones</a>, which are clumps of bile. Stones may get squeezed into the duct, causing a blockage, resulting in significant lower abdominal pain and as well as upper back and shoulder pain. Smaller gallstones will commonly pass on their own. However, if stone development becomes a persistent problem, the gallbladder may need to be surgically removed. Living without a gallbladder is possible, since the organ's function is to store, but not produce bile. </span>
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Gallstones - Symptoms and causes. (n.d.). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214#:~:text=Gallstones%20are%20hardened%20deposits%20of</span><div style="box-sizing: border-box; font-family: "Times New Roman"; font-size: 16px; text-align: start;">
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Prof. E. GCChttp://www.blogger.com/profile/01259451081865074245noreply@blogger.comtag:blogger.com,1999:blog-8411482144383828575.post-30277100540226653362020-05-04T12:05:00.000-07:002020-06-10T09:22:23.987-07:00Food Allergies<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
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<span style="font-family: "verdana" , sans-serif;">An allergy is a reaction of a body's immune system to something contacted or consumed that the body thinks is foreign or pathogenic. Food allergies usually result from eating a food (or food additive) that the body believes is dangerous. Food allergies can also develop in people who are allergic to tree pollens by way of </span><a href="https://www.thermofisher.com/diagnostic-education/patient/us/en/understanding-allergies/cross-reactivity.html" style="font-family: Verdana, sans-serif;">cross-reactivity</a><span style="font-family: "verdana" , sans-serif;">. Cross-reactivity related to foods happens when the proteins in one food are similar to the proteins in another and the body's immune system misperceives them as the same. Similarly, a protein found in trees that is similar to one in foods may trigger an allergic response to either trees and/or that food. In an allergic reaction, the body mounts a major immune response, as though it were handling a flu virus or strep infection. Symptoms of food allergies might include digestive discomfort, shortness of breath, skin rashes, hives, lip or mouth swelling, or in extreme cases anaphylaxis (throat closure), which can be life-threatening.</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /> Common foods that people are allergic to include nuts, eggs, dairy foods and fish. An allergist can diagnose the more common food allergies using skin and blood tests. Treatments involve avoiding contact with the foods to which people are allergic, making sure to read labels carefully, as foods like eggs commonly hide in the ingredients list. Additionally, the use of antihistimines may be implemented to manage the immune system's overreaction. In people with risk of anaphylaxis, prescription epinephrine, found in epi-pen, is carried on their person. Epinephrine dilates the respiratory airway to allow oxygen to be inhaled.</span><br />
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Why Do We Have Allergies?</i> (n.d.). Allergy Insider. Retrieved June 10, 2020, from https://www.thermofisher.com/diagnostic-education/patient/us/en/understanding-allergies.html</span><div style="box-sizing: border-box; font-family: "Times New Roman"; font-size: 16px; text-align: start;">
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Prof. E. GCChttp://www.blogger.com/profile/01259451081865074245noreply@blogger.comtag:blogger.com,1999:blog-8411482144383828575.post-85626552466090119612020-05-04T11:49:00.002-07:002020-06-10T09:24:03.811-07:00Dumping Syndrome<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
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<a href="https://www.mayoclinic.org/diseases-conditions/dumping-syndrome/symptoms-causes/syc-20371915" style="font-family: Verdana, sans-serif;" target="_blank">Dumping Syndrome</a><span style="font-family: "verdana" , sans-serif;"> is a condition that occurs when the contents of the stomach empty into the small intestine and/or bloodstream faster than they should. There are two stages of dumping syndrome.</span><br />
<span style="font-family: Verdana, sans-serif;"><br />Early dumping syndrome describes a situation in which food passes too quickly through the digestive tract. Ordinarily, the process of digestion takes a number of hours. This time is required for chemicals and enzymes to dismantle the food into its simplest components, then absorb it from the digestive tube into the bloodstream slowly. The faster passage of food minimizes digestion time, reducing nutrient absorption and resulting in symptoms including nausea, cramping, flushing, and diarrhea. Early dumping syndrome happens within about 30 minutes of eating, especially if the foods consumed are predominantly sugars. <br /><br /> Late dumping syndrome happens several hours after eating a meal when blood glucose level rises quickly due to rapid sugar absorption. This glucose rise tricks the pancreas into releasing more insulin than is necessary to return blood glucose concentration to normal (homeostasis). The excess insulin drives too much glucose out of the bloodstream, causing hypoglycemia. Symptoms of hypoglycemia include rapid heart rate (tachycardia), elevated blood pressure, shaking, sweating, lightheadedness, and fainting. <br /><br /> Dumping syndrome is common in people who undergo gastric surgeries, including gastric bypass surgery, and particularly the roux-en-y gastric bypass, because the digestive tract is cut and reassembled in such a way that food transit time is naturally shorter and absorption of nutrients is limited. <br /><br /> People suffering from dumping syndrome need to modify the manner in which they eat, how much they eat, and their nutrient choices in a way that helps avoid dumping. Tactics might include eating small, high-protein, high-fiber meals, not drinking liquids during eating (but rather, in between meals), and chewing food thoroughly. Avoiding alcohol, highly acidic foods and all simple sugars are also strongly suggested. </span><br />
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<span style="color: #444444; font-family: Verdana, sans-serif; font-size: xx-small;"><i>Dumping syndrome - Symptoms and causes.</i> (n.d.). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/dumping-syndrome/symptoms-causes/syc-20371915</span><div style="box-sizing: border-box;">
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<span style="color: #444444; font-family: "verdana" , sans-serif; font-size: xx-small;">*Certain images and/or photos at this site are the copyrighted property of 123RF Limited, their Contributors or Licensed Partners and are being used with permission under license. These images and/or photos may not be copied or downloaded without permission from 123RF Limited.</span></div>
Prof. E. GCChttp://www.blogger.com/profile/01259451081865074245noreply@blogger.comtag:blogger.com,1999:blog-8411482144383828575.post-37381547753854886162020-05-04T11:39:00.001-07:002020-06-10T15:02:28.856-07:00Diverticulosis<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
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<tr><td class="tr-caption" style="text-align: center;"><span style="color: #444444; font-family: "verdana" , sans-serif; font-size: xx-small;">Blausen.com staff (2014). Medical gallery of Blausen Medical 2014. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. / CC BY (https://creativecommons.org/licenses/by/3.0)</span></td></tr>
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<span style="font-family: "verdana" , sans-serif;">Diverticulosis is a gastrointestinal condition in which small pouches develop and bulge from the wall of the large intestine. Risk of bulges increases with age, although much of the time they occur asymptomatically. Researchers believe that the condition is caused by lack of fiber in the diet. Sometimes, these pouches can become infected, in which case they become inflamed and noticeably painful, in a condition called diverticulitis. If the infections persists, symptoms can advance and become systemic and might include fever, vomiting, and cramping. Diverticulitis is commonly treated with antibiotics and possibly with modifications to diet. The best way to prevent diverticulosis and diverticulitis is to eat a diet high in plant foods containing plenty of fiber, drink plenty of water, and exercise regularly, as all three of these behaviors promote gastric motility.</span><br />
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<span style="color: #444444; font-family: "verdana" , sans-serif; font-size: xx-small;"><i>Diverticulosis and Diverticulitis</i>. (n.d.). Medlineplus.Gov. https://medlineplus.gov/diverticulosisanddiverticulitis.html#:~:text=Diverticula%20are%20small%20pouches%20that</span><br />
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Prof. E. GCChttp://www.blogger.com/profile/01259451081865074245noreply@blogger.comtag:blogger.com,1999:blog-8411482144383828575.post-90498675876079463882020-05-04T09:11:00.000-07:002020-06-10T15:02:38.295-07:00Constipation<span style="font-family: "verdana" , sans-serif;">Constipation is a gastrointestinal condition in which defecation becomes challenging due to slowed passage of food waste through the large intestine and episodes of defecation become infrequent, rather than daily. This is due to the consistency of the stool becoming hard or dry. Constipation can be caused by bowel disorders, medication, or simply due to poor diet.</span><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span>
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<span style="font-family: "verdana" , sans-serif;"><br />If constipation is related to a bowel disorder or due to prescription medications that are necessary to manage other health conditions, laxative drugs may be prescribed to soften the stool or to cause the nerves of the digestive tract to actively push food waste through the large intestine. However, consuming high fiber foods along with being physically active may be a more than adequate lifestyle remedy that avoids laxative medications and their side effects. <br /><br /> Fibers are located in plant foods including vegetables, fruits, and whole (unprocessed) grains. The general guideline for fiber intake is about 30 grams daily, but many people barely consume half of that amount with regularity. Additionally, water is required to move the feces through the intestinal pathway, so dehydration, another common problem, can contribute to the development of hard stools that become difficult to release. Prunes (dried plums) along with plenty of water can jump start digestive movement. Besides that, leafy green veggies (<a href="https://en.wikipedia.org/wiki/Cruciferous_vegetables">cruciferous veggies</a>) and beans are two other foods that help add bulk to the stool, making it easy to pass. If leafy greens have little appeal, consider making a green smoothie, mixing in some fruits like banana to make them more attractive! </span><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span>
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<span style="color: #444444; font-family: "verdana" , sans-serif; font-size: xx-small;"><i>Constipation - Symptoms and causes.</i> (n.d.). Mayo Clinic. Retrieved June 10, 2020, from https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253#:~:text=Overview</span><br />
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Prof. E. GCChttp://www.blogger.com/profile/01259451081865074245noreply@blogger.comtag:blogger.com,1999:blog-8411482144383828575.post-22793454993924307312020-05-02T08:49:00.003-07:002020-06-10T15:02:49.579-07:00Gastro-esophageal Reflux Disease (GERD)<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
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<span style="font-family: "verdana" , sans-serif;"><br />Gastro-esophageal reflux disease (commonly known as acid-reflux) describes a digestive condition in which food backwashes from the stomach into the esophagus, potentially as high as the throat. This condition happens due to a failure of a structure called the lower esophageal sphincter. Under normal circumstances, this sphincter opens to allow food and beverages to pass, then closes behind the food, keeping it in the stomach to be digested. <br /><br /> This sphincter can be influenced by food choices. Certain foods like mint, chocolate, caffeinated products, spicy foods and high-acid content foods can cause the sphincter to become lazy and not close fully. If the sphincter fails to close properly with enough regularity, the acid produced by the stomach will damage or erode the esophagus. Contact of the stomach acid on the esophageal walls produces the burning sensation commonly associated with acid reflux. Continued exposure of the esophagus to acid can lead to complications including esophageal ulcerations and esophageal or laryngeal cancers.<br /><br /> Over-the-counter antacid medications like TUMS or pepcid may help manage mild GERD by neutralizing stomach acid. However, these medications are not designed for long-term management of this condition. Rather, medications called proton-pump inhibitors like Prilosec or Prevacid, which diminish the production of stomach acid are used to tackle GERD that remains problematic over time. Of course, this does not solve the problem of a lazy sphincter. In extreme cases of GERD, <a href="https://www.youtube.com/watch?v=X840-6PyO4c">surgery</a> may be needed to correct the behavior of the lower esophageal sphincter.</span><br />
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<span style="color: #444444; font-family: "verdana" , sans-serif; font-size: xx-small;"><i>GERD</i>. (2019). Medlineplus.Gov; National Library of Medicine. https://medlineplus.gov/gerd.html</span><br />
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Prof. E. GCChttp://www.blogger.com/profile/01259451081865074245noreply@blogger.com