Heartburn, Diarrhea & Constipation
(Reflux, GERD, Irritable Bowel Syndrome, Celiac Disease)
If you are living with one or more of these issues, you are probably taking something to treat the symptoms and reduce the discomfort. BUT, if there was a way to identify the cause and actually correct the problem, wouldn’t you want to know about it?
GI Disease vs. GI Dysfunction
Patients that seek our care usually have already seen at least one other doctor prior to getting to us. This generally means that certain diagnostic testing (lab tests, endoscopy, colonoscopy, etc.) has been performed. These tests are done to rule out disease processes like ulcers, infections and tumors. If we are the first to see a patient, we want to rule these out as well and we will make appropriate referrals when necessary.
Most of the time, we work with patients who have seemingly tried everything and nothing has worked. This usually points to a dysfunction in the gut that does not show up on standard testing. In addition to a careful case history and clinical examination, we will order specific tests that will help us define exactly what is happening.
Why Do So Many People Suffer With These Problems?
- Prevalence: 60 to 70 million people affected by all digestive diseases
- Ambulatory care visits: 104.7 million (2004)
- Hospitalizations: 13.5 million (2004)
- Mortality: 236,164 deaths (2004)
- Diagnostic and therapeutic inpatient procedures: 5.5 million — 12 % of all inpatient procedures (2006)
- Ambulatory surgical procedures: 20 million – 31% of all ambulatory procedures (2006)
- Costs: $141.8 billion (2004)
- $97.8 billion direct medical costs (2004)
- $44 billion indirect costs (e.g., disability and mortality) (2004)
Gastrointestinal disorders are a prominent component in the overall disease burden of the world’s most developed economies, and a lack of effective long – term treatments and limited etiological understanding is continuing to exacerbate the impact of such conditions.
Many times we find that a person’s diet causes their issues. But commonly our patients feel that their diet is ‘good’ and they still have stomach problems.
GERD – Gastroesophageal Reflux Disease Causes, incidence, and risk factors
When you eat, food passes from the throat to the stomach through the esophagus . Once food is in the stomach, a ring of muscle fibers prevents food from moving backward into the esophagus. These muscle fibers are called the lower esophageal sphincter, or LES.
If this sphincter muscle doesn’t close well, food, liquid, and stomach acid can leak back into the esophagus. This is called reflux or gastroesophageal reflux. This reflux may cause symptoms, or can even damage the esophagus.
The risk factors for reflux include hiatal hernia (a condition in which part of the stomach moves above the diaphragm), pregnancy, obesity and H. Pylori infection. Studies have found that people who are overweight or obese may be up to six times more likely to have gastroesophageal reflux disease (GERD) than people who are of normal body weight.
Both obesity and GERD raise the risk of developing esophageal cancer, the incidence of which has also been rising in the last few years.
“A staggering 113.4 million prescriptions for proton pump inhibitors (prescription antacids) are filled each year, making this class of drugs, at $13.9 billion in sales, the 3rd highest seller in the US.”
Antacids can be hurting you!
Antacids neutralize stomach acid, raising the pH level from very acidic (2.0) to between 3 and 4, which destroys about 99% of the stomach acid.
When this happens, you completely throw off the balance of bacteria in your intestinal tract and give the bad bacteria the upper hand. To sum it up, antacids are literally killers of probiotics (good bacteria) in your gut. And it doesn’t stop there. The hydrochloric acid in your stomach not only digests food — it also acts as a protective barrier for your body. Every day you ingest food and other organisms that have the potential to make you sick or even kill you. Your stomach acids typically destroys these dangerous invaders before they can cause you harm. But when your stomach acid is neutralized, the protective barrier isn’t there and the invaders can get into your intestinal tract.
If your gut has mainly bad bacteria to begin with, you’ve got a great chance of getting REALLY sick.
* The idea that ‘too much stomach acid causes these problems is very flawed and simple testing can determine if you actually have too much or too little. The treatment is VERY different.
IBS – Irritable Bowel Syndrome
What Is Irritable Bowel Syndrome?
While most people experience digestive troubles once in a while, what sets IBS apart is belly pain and diarrhea or constipation that comes back again and again. IBS affects 10% to 15% of people in North America.
Symptoms of IBS
The main symptoms of IBS are abdominal pain accompanied by constipation, diarrhea, or both. Gas and a visibly bloated belly are also common. The condition does not damage the digestive system, but persistent pain and frequent trips to the bathroom can interfere with everyday life.
IBS: Who’s at Risk?
IBS is twice as common in women as in men and it is also more likely to affect people who have a family history of IBS. Symptoms usually begin when people are in their late 20s and can sometimes co-exists with depression or anxiety.
IBS and Stress
Stress can be particularly problematic for people with IBS. IBS symptoms can cause stress, and stress can make the symptoms worse, leading to a vicious cycle.
IBD – Inflammatory Bowel Disease
What Is Inflammatory Bowel Disease?
Inflammatory bowel disease (IBD) refers to chronic conditions that cause inflammation in some part of the intestines. The
intestinal walls become swollen, inflamed, and develop ulcers, which can cause discomfort and serious digestive problems. The exact symptoms depend on which part of the digestive tract is involved.
Types of IBD: Crohn’s Disease Crohn’s disease is a form of IBD that can occur anywhere along the digestive tract – from the mouth to the anus. It affects the deeper layers of the digestive lining and can occur as “skip lesions” between healthy areas. Crohn’s often involves the small intestine, the colon, or both.
Types of IBD: Ulcerative Colitis Unlike Crohn’s disease, ulcerative colitis only involves the colon and rectum. Inflammation and ulcers typically affect only the innermost lining in these areas, compared with the deeper lesions seen in Crohn’s disease.
Symptoms of IBD
- Abdominal pain or cramping
- Diarrhea multiple times per day
- Bloody stools
- Weight loss
Celiac Disease (CD) is a lifelong inherited autoimmune condition affecting children and adults. When people with CD eat foods that
contain gluten, it creates an immune – mediated toxic reaction that causes damage to the small intestine and does not allow food to be properly absorbed. Even small amounts of gluten in foods can affect those with CD and cause health problems.
Even if you do NOT have Celiac, you may still have a problem with gluten called gluten related enteritis. Many people incorrectly think that once Celiac is ruled out, that gluten is not a problem.
Increased prevalence and mortality in undiagnosed celiac disease.
We investigated the long-term outcome of undiagnosed CD and whether the prevalence of undiagnosed CD has changed during the past 50 years. This study included 9,133 healthy young adults at Warren Air Force Base (sera were collected between 1948 and 1954) and 12,768 gender – matched subjects. The prevalence of undiagnosed CD between the Air Force cohort and recent cohorts was compared. The prevalence of undiagnosed CD seems to have increased dramatically in the United States during the past 50 years. During 45 years of follow-up, undiagnosed CD was associated with a nearly 4 – fold increased risk of death.
In the past 50 years, Celiac disease went from 1 in 700 people to 1 in 100!