There's something about digestive difficulties that makes them hard to discuss in polite company—which leaves many of us suffering one problem or another in silence. What's more, digestive disorders are placing a "growing burden" on Americans, causing an unprecedented number of clinic visits and hospitalizations, says Stephen Bickston, an American Gastroenterological Association fellow and professor of internal medicine at Virginia Commonwealth University. Yet fixes can be as simple as making informed lifestyle changes or taking over-the-counter remedies. Peppermint oil and soluble fiber, for example, can help people with irritable bowel syndrome; a 2008 British Medical Journal study suggests that both should be first-line therapies for IBS.
Here's a rundown of the latest medical wisdom on eight common gastrointestinal problems.
Symptoms of reflux, such as heartburn, are among the most common digestive ills. In a Swedish study, 6 percent of people reported experiencing reflux symptoms daily and 14 percent had them at least weekly. Such frequent symptoms may indicate a person has GERD, or gastroesophageal reflux disease. Aside from being painful, GERD can harm the esophagus over time or even lead to esophageal cancer.
Heartburn typically involves a "hot or burning feeling rising up from the center of the abdomen area and into the chest under the breastbone or sternum," says Michael Gold, a gastroenterologist at MedStar Washington Hospital Center in Washington, D.C. "It may be accompanied by a sour taste in the mouth, or hypersalivation, or even finding food or fluid in your mouth," particularly at night. Pregnancy, some medications, and consuming alcohol or certain foods can cause heartburn. Kids under age 12 and some adults may have GERD without heartburn, instead experiencing asthma-like symptoms, trouble swallowing, or a dry cough.
Treatment options include drugs that reduce acid levels, such as the proton pump inhibitors Aciphex, Nexium, Prevacid, Prilosec, and Protonix and the H2 blockers Axid, Pepcid, Tagamet, and Zantac. But taking medication is not without risk. In 2008, a study found that a proton pump inhibitor may weaken the heart-protective effect of the blood thinner Plavix in patients taking both medications.
In severe cases of GERD, surgeons can tighten a loose muscle between the stomach and esophagus to inhibit the upward flow of acid. Laparoscopic surgery, which involves small incisions, has been found to lessen scarring and shorten recovery time compared with open procedures.
If you have unexplained stomach pain, consider this before reaching for a painkiller: "The worst thing to do if ulcers are suspected is to take aspirin or other NSAID [nonsteroidal anti-inflammatory drug] pain reducers," Gold says. "They worsen it and don't help."
Instead, if you think you have a peptic ulcer—and 25 million living Americans will get one at some point—consider getting tested for Helicobacter pylori, experts advise. By disrupting a protective layer of mucus, that bacterium causes ulcers, which are sores in the lining of the stomach or first stretch of the small intestine. Other causes include smoking, which can elevate stomach acidity, and excessive NSAID use. Alcohol use may also be a factor, but it's unclear whether that alone can cause ulcers. (The old theory blaming factors like stress isn't totally wrong: Stress can aggravate symptoms of peptic ulcers and delay healing.)
Left untreated, ulcers can cause internal bleeding and may eat a hole in the small intestine or stomach wall, which can lead to serious infection. Ulcer scar tissue can also block the digestive tract. And long-term H. pylori infection has been linked to an increased risk of gastric cancer.
Ten to 14 days of antibiotic treatment, often combined with acid reduction therapy, can rid someone of H. pylori. Surgery is an option for more severe cases. A 2008 study published in the World Journal of Surgery concluded that laparoscopic repair should be considered for all patients with so-called perforated ulcers.