A Guide to Gut Disorders
Suffering from stomach troubles? Familiarize yourself with the most common gut-related ailments. Then, walk into your appointment with your gastroenterologist prepared.
For many people, managing gut issues can be challenging. Symptoms are uncomfortable, painful, and often embarrassing, which makes a lot of people hesitant to talk about them. But gut disorders are also extremely common—and with the right plan of attack, they're also extremely treatable. Let's take a look at some of the most common gut disorders, the causes behind them, and, most importantly, how to manage your symptoms.
Gastroesophageal Reflux Disease (GERD)
Do you struggle with acid reflux? You're not alone. "Gastroesophageal Reflux Disease (GERD) is one of the most common gut disorders," says board-certified gastroenterologist Dr. Lawrence Hoberman. "GERD affects 20% of U.S. adults." The most common symptoms of GERD "include a burning sensation in the chest or throat, unpleasant tasting fluid in the mouth, difficulty or pain when swallowing, hoarseness, or chronic cough—all due to a backflow of acid and stomach contents into the esophagus," he explains.
There are a number of factors that increase your risk for developing GERD—including excess weight. "Because excess weight around the midsection creates pressure on the stomach, those who are obese are most susceptible to developing GERD," notes Dr. Hoberman. "And because midsection weight tends to appear later in adult years, those over age 40 are at higher risk." The same goes for smokers: "Smoking can also compromise function of the lower esophageal sphincter (LES) that controls acid backflow," he adds.
Acid reflux can be extremely painful and uncomfortable. But luckily, the foods you eat can directly impact the amount of acid your stomach produces—and making changes to your diet can help get your symptoms better under control. "Generally speaking, I usually make sure people understand that a healthy diet includes eating plenty of vegetables and fruits and avoids processed and packaged foods, especially those with high amounts of sugar," says gastroenterologist Dr. Marvin Singh, founder of the Precisione Clinic in Encinitas, California. Avoiding foods that typically trigger GERD (like spicy food or high-fat foods) is also a must. If your symptoms are severe, your doctor may also recommend additional treatments, like medication.
Irritable Bowel Syndrome (IBS)
"IBS is highly prevalent worldwide, plaguing an estimated 30 to 45 million Americans alone," adds Dr. Hoberman. This ailment can cause a host of uncomfortable symptoms, including pain in the abdomen, diarrhea, and excessive gas. But where does the disorder come from? When it comes to IBS, much of the disorder ties back to the balance—or, in this case, imbalance—of the gut microbiome. "Gut dysbiosis, or impaired gut microbial balance—the underlying root of IBS—can often occur in those who eat a diet high in animal fats and highly processed foods," says Dr. Hoberman. "Bacterial infections, food sensitivities, and psychosocial factors like stress, depression, and anxiety can also increase one's susceptibility to developing IBS. Research suggests that some genetic factors can disrupt bowel function."
Again, eating a healthy, well-balanced diet can help ease IBS symptoms, as can incorporating a probiotic into your daily regimen to restore balance to the gut. But take action if symptoms are extreme: "If you find yourself avoiding social situations or mapping out restroom facilities when you do go out, it's time to seek help from a gastroenterologist who can offer solutions for easing and managing IBS episodes," explains Dr. Hoberman.
Crohn's disease belongs to the family of inflammatory bowel diseases (IBD) "and involves painful ulcerations of the small and large intestines," notes Dr. Hoberman. "Segmental in nature, Crohn's can cause inflammation in certain areas of the bowel while skipping over others." Inflammatory bowel diseases, including Crohn's, are less common than GERD or IBS (according to the Centers for Disease Control, as of 2015, an estimated three million adults in the United States reported being diagnosed with IBD). Though less prevalent, Crohn's is typically more serious—and involves abdominal pain, severe diarrhea, fatigue, weight loss, malnutrition, and bleeding that can lead to anemia.
Currently, there's no cure—but there are a variety of treatments. "Long-term treatment is required and includes medications to control inflammation, relieve symptoms, and prevent malnutrition," says Dr. Hoberman. "Commonly used medications include steroids, antidiarrheals, antibiotics, and also biologics such as Humira and Remicade." In some cases, surgery is necessary; like with IBS, a probiotic can also be beneficial.
Ulcerative Colitis is another form of IBD, and it can have equally challenging symptoms. The ailment causes inflammation of the inner lining of the large intestine and rectum, notes Dr. Hoberman, which often leads to abdominal pain, cramping, frequent diarrhea with blood, and anemia. There's also a long-term consequence to consider: "Because the entire colon becomes inflamed, people with ulcerative colitis are at increased risk for developing colon cancer," he adds.
Depending on the severity, ulcerative colitis may be treated with drug therapy or surgical interventions (like a colostomy). But there are steps people with Ulcerative Colitis can take to better manage their symptoms—steps that can reduce cancer risks and the need for surgical procedures significantly. "Limiting problem foods such as dairy products, spice, and alcohol, and eating small portions can help abate the flaring of symptoms, as can exercising and practicing relaxation techniques for reducing stress," he says.
The gluten-free trend has gained serious traction in recent years, thanks in no small part to an increase in celiac disease (according to the National Institute of Diabetes and Digestive Kidney Diseases, up to one in 141 Americans has celiac disease, and many don't even know it). "Celiac disease is an autoimmune condition triggered by eating foods and using certain products containing gluten—a protein naturally present in wheat, barley, and rye—that causes damage to the villi in the small intestine," says Dr. Hoberman. When people with celiac disease eat gluten, it wreaks havoc on their bodies. "Some common symptoms may include abdominal pain, bloating, change in bowel habits, looser stools, more frequent bowel movements, weight loss, iron deficiency anemia, certain types of skin rashes, malabsorption, and other difficulties with digestion," adds Dr. Singh.
It can also interfere with the body's ability to absorb nutrients from food. "Celiac disease can be serious due to the body's inability to absorb essential nutrients," says Dr. Hoberman. The best way to avoid this is also the best treatment: Cut out gluten altogether. "Total gluten avoidance is the most foolproof way of controlling celiac long term. This includes not only food offenders, but certain medications, cosmetics, skincare products, and even toothpaste," he continues. "For most people, doing so will heal and prevent damage to the small intestine."
Another common gut disorder, particularly among older people? Diverticulitis. "Diverticulitis occurs when diverticula—small sac-like pouches of mucous that form in the digestive lining and bulge outward through the colon, or large intestine—become inflamed or infected," says Dr. Hoberman. "Its prevalence increases with age, and statistics indicate 70 percent of 80-year-olds in the United States live with it. This is likely due to age-related changes in the connective tissue of the colon that may lead to colonic rigidity."
Diverticulitis symptoms can range from mild to severe; on the mild end, think mild cramping, bloating, or constipation. But when it's serious? "It can lead to bleeding and blockages, in which case one might experience fever, nausea, vomiting, and chills." Luckily, there are plenty of at-home remedies for managing diverticulitis symptoms. "Antibiotics, pain relievers, and nonsteroidal anti-inflammatory drugs (NSAIDs), along with a liquid diet, can help reduce symptoms," says Dr. Hoberman. Probiotics can also be extremely helpful. "Studies show that probiotics may help not only with symptoms of diverticulosis but also in preventing the condition," he notes. "A multi-strain probiotic that also contains a natural prebiotic fiber for supporting the probiotic can play a critical role in restoring intestinal flora negatively impacted by diverticular disease."