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Digestive Tract Problems and Tests: They want to put a tube up where?!

This is the second post of a two part series: Part 1 (What Happens Inside Your Body When You Eat?)

Have you ever wondered if one of your friends actually needs to avoid gluten? In this post we will be discussing common problems that can occur in the digestive tract and the main tests used to diagnose them.

There are two main tests that help your healthcare team to determine if you have a problem in your digestive tract. One is an endoscopy and the other is the lovely colonoscopy.

colonoscopy

Whoa whoa whoa, they put a scope up where? Yes, they do. But it can tell us SO much! The most common reason people receive a colonoscopy is for a preventative screening. Meaning they do not have any reason to be concerned that there is something wrong but have reached the age where their doctor recommends they have a colonoscopy. This is so important to have completed because it can catch colon polyps. These are abnormal cells that grow out from the mucous lining your colon. Some polyps can eventually grow into cancer so by completing a screening colonoscopy these can be removed right away before they have a chance to get that far!

Another reason you may have a colonoscopy done is for a diagnosis. This is when you have been having concerning symptoms in your lower digestive tract such as, diarrhea or constipation, bloody stools or unexplained abdominal pain. During the colonoscopy the doctor is able to look at the inside of your rectum and colon, all the way to your small intestine to see what could be causing the problem.

It is recommended that everyone receive a colonoscopy to screen for colon and rectal cancer around age 45 (earlier of you are at a higher risk).

endoscopy

The counterpart to a colonoscopy is an upper endoscopy. With this test, a scope is inserted down your throat and your healthcare team is able to get a valuable view of what is going on in your esophagus, stomach and the start of your small intestine. Your healthcare team may recommend this test if you are having concerning symptoms affecting the first part of your digestive tract. Concerns might include vomiting blood, heart burn, trouble swallowing or unexplained abdominal pain. With this test they are able to see any abnormal growths, inflammation or deterioration in the lining the upper part of your digestive tract.


Now that we have discussed some of the tests that are used to determine if there is a gastrointestinal (GI) problem lets talk about some of the common problems that can affect the GI tract.

gerd

Gastric Esophageal Reflux Disease (GERD) occurs when a person experiences acid reflux over an extended period of time. When the lower esophageal sphincter that separates the esophagus from the stomach does not close completely, the contents of the stomach can sneak back up into the esophagus. This can be very painful because in order for the stomach to break down our food it creates a very acidic environment and the esophagus was not created to withstand that acid. Over time, this recurrent acidic environment can cause damage to the esophagus, and potentially even your airway, if it travels far enough up your throat.

appendicitis

As every TV show about it portrays, appendicitis is an emergency. Appendicitis happens when a pesky little organ at the start of your colon, called the appendix, becomes inflamed. Amazingly, we still aren’t completely sure what it’s purpose is. There is a theory that it is part of the immune system and acts as a reserve of healthy bacteria. For instance, if you lost the healthy bacteria in your gut, it could be replaced utilizing the bacteria that was safely stored in your appendix. Appendicitis happens when the appendix becomes blocked or infected which causes inflammation. What makes this such an emergency is that the appendix can burst from the swelling. Since your appendix is attached to your colon (where your poop is made) this means that all of the product your digestive tract determined was waste and needed to be removed from your body as poop is now swimming around in your abdominal cavity. This causes your blood stream to absorb the bacteria which can quickly make you very sick. In order to prevent this from happening (especially since we still don’t know what the appendix does and our bodies don’t seem to miss it) the standard treatment is to remove the appendix as soon as it becomes inflamed to prevent it from bursting.

Irritable Bowel Syndrome

Irritable Bowel Syndrome or IBS is an interesting disorder in that it doesn’t actually cause damage to your digestive tract. However, this doesn’t mean that it isn’t very uncomfortable and inconvenient for the person experiencing it. With IBS a person experiences abdominal pain and a change in their bowel movements. They may have diarrhea or constipation, or even a mixture of both. While many people are diagnosed with IBS we don’t know exactly what causes it. The colon contracts more and that is what causes the symptoms. The good news is that it does not damage the digestive tract and it can often be improved by lifestyle changes to include managing stress. This is why it is called a “syndrome” as it is symptomatic but does not cause damage like Inflammatory Bowel Disease does.

Inflammatory Bowel Disease

Inflammatory Bowel Disease refers to a selection of diseases that affect the small intestine and large intestine (colon). These are conditions that will not go away. Two of the most common are Crohn’s Disease and Ulcerative Colitis.

Crohn’s Disease causes a person to have stomach cramps and very bad diarrhea. It can cause inflammation at different parts in the digestive tract in different people. The inflammation can cause nutrient’s from food to not be absorbed leading to feeling tired, losing weight and even being malnourished. It is not clear as to the direct cause, and while it will never go away completely, it does have periods of time when it is severe and periods of time where it has mild or even no symptoms. Lifestyle changes and treatments from your healthcare team can help to increase the periods of time that the disease is symptom free.

Ulcerative Colitis happens in the colon and rectum. The inflammation can lead to open sores called ulcers. We do not know what causes ulcerative colitis to occur but it is believed to be caused by your immune system not responding correctly and being “overactive.” A person might have abdominal pain, diarrhea and blood in their stool. While ulcerative colitis is also a lifetime condition, it can be improved with treatments to reduce the inflammation in the individual’s colon.

Celiac Disease

Yes, your friend with celiac’s disease really needs to avoid gluten. This is a disease that happens in the small intestine (where the nutrients and most water from your food is absorbed). When the grain protein, gluten, enters the small intestine of a person with Celiac’s, their body will attack it and their immune system will mount an inflammatory response. The small intestine uses villi which are fingerlike projections that increase the surface area of your intestines so that more nutrients can be absorbed into the blood stream. When the small intestine becomes inflamed these villi get squished together and significantly decrease the surface area of your small intestine. This means that far less nutrients are able to reach your bloodstream, to the point that it can cause malnutrition. Over time, this damage can lead to more and more health complications. Celiac’s Disease is an autoimmune disorder as it is caused by the body’s immune system causing damage to it’s own tissues.

Hemorrhoids

Well, these are not fun. Hemorrhoids are when the veins around your rectum or anus become inflamed. This can cause pain, itching and bleeding from the location of the inflamed vein. These are caused when increased pressure is placed on these veins. This is why they can commonly occur during pregnancy and after giving birth, by straining to have a bowel movement, or by weight lifters.   

Colostomy

Occasionally a GI disease gets to a state that the person requires surgery. One such procedure is to create what is called a colostomy or iliostomy. These can be either temporary or permanent. During the surgery a hole is made in either the person’s small intestine (iliostomy) or colon (colostomy). This hole creates what is called a stoma and this is where the individual’s poop will now exit their body. The person will be able to attach a bag to the skin around the stoma and this will collect their poop. This can be used as a temporary treatment if a person’s intestines need time to heal from an injury since there is no other way to keep a specific area of their digestive tract from being exposed to the contents to be given time to heal.

The Brain, Our Food, and the Digestive Tract

I think we are still just scratching the surface of understanding just how much our digestive tract can influence our overall health. For instance, the term Gut Brain Connection refers to the connection that research is finding between stress and anxiety levels and the health of our digestive system. Not only do stress and anxiety cause problems for our gut but this connection is so close that it has been shown to work the other way too. Showing that a problem in the digestive tract can cause a person to experience stress and anxiety. This means that some treatments for one may help the other, since your gut and your brain are so closely connected.

More and more studies are finding that the health of our digestive tract (influenced by what we are eating) plays a major role in having a healthy immune system. For instance, if food borne pathogens sneak through the defensive measures of our digestive tract, they get absorbed into our bloodstream and cause problems throughout our body. Research is also showing that nutrition that supports the immune system can help to decrease the chance of a person developing a chronic disease caused by the immune system.

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