Author Archives: Dr Datta

Causes of esophageal spasms: Esophagus has muscular walls and is lined with mucus membranes. Esophageal muscles contract abnormally causing esophageal spasms. When this occurs, the food reaches your stomach with great difficulty. Esophageal spasms are rare.

Causes of esophageal spasms

Esophageal muscles flex and relax normally. A wave of coordinated contractions lets the food or liquid move down the stomach. This process is known as peristalsis. If a person has esophageal spasms, contractions don’t work normally. Thus, abnormal contractions make it difficult for food or liquid to move through the esophagus.

The following are the main types of esophageal spasms:

Distal or diffuse esophageal spasm: In this type, abnormal muscle contractions occur in the lower part of the esophagus. Regurgitation occurs, wherein swallowed liquid or food comes back up the esophagus.

Nutcracker esophagus:  Strong or forceful muscle contractions cause jackhammer or nutcracker esophagus. It is associated with pain while swallowing food or liquid. The pain is often severe and it may feel like squeezing chest pain.

Why you should not ignore esophageal spasms?

Esophageal spasms cause pain and swallowing difficulty. Though they are disruptive, esophageal spasms are not considered as a serious health issue.

Swallowing difficulty, heartburn and pain are often the signs of chronic acid reflux or GERD. It is therefore better to evaluate the causes of your symptoms by consulting an experienced gastroenterologist.

Esophageal spasms symptoms mimic the symptoms of a heart attack

Take action immediately and seek emergency medical care if you experience:

• Severe chest pain
• Tightness or heaviness in the chest
• Breathing difficulty
• Irregular heartbeat or heart palpitations
• Cold sweats
• Pain in the shoulder arm or neck
• Weakness
• Dizziness
• Nausea or vomiting

Causes of esophageal spasms

The exact cause of esophageal spasms is not clear. They are however believed to be related to abnormal functioning of the nerves that control esophageal muscles.

Anxiety and depression, very hot or cold foods, certain drinks, gastroesophageal reflux disease (GERD), and certain treatments – such as esophageal surgery, and radiation therapy can also cause esophageal spasms.

Diagnosis of esophageal spasms

Esophageal manometry test measures rhythmic muscle contractions (the force and coordination of esophageal muscles) of the esophagus. It also measures the functioning of the esophageal sphincter (flex and relaxation of the esophageal sphincter during a swallow).

Upper endoscopy: A gastroenterologist uses a flexible thin tube mounted with a light and camera (an endoscope) to see the inside of the esophagus and stomach. The doctor collects a tissue sample (biopsy) during an endoscopy procedure for laboratory analysis to test for other esophageal diseases.

Barium swallow

A doctor orders X-rays after a person drinks or swallows a chalky liquid (barium solution) to look for any narrowing (stricture) in the esophagus. The liquid coats and fills the inner lining of the digestive tract. This helps the gastroenterologist to see the silhouette of the esophagus, stomach, and upper intestine. While barium moves down the esophagus, it slows down or gets stuck in a narrowing or stricture is present in the esophagus.

Bottom Line

Esophageal spasms can sometimes cause symptoms that look very similar to a heart attack. A heart attack can be life-threatening if not treated right away. Therefore, if you experience severe chest pain and breathing difficulty seek emergency medical care straightaway.

Consult an experienced gastroenterologist if you experience the signs and symptoms of esophageal spasms. An underlying cause such as GERD could be the cause of this condition. Therefore, treating the underlying cause is the first line of defense against the symptoms. It is also important to adopt healthy habits and lifestyles – such as managing weight, healthy eating, and proper rest. In most cases, though the cause of esophageal spasms remains unknown they can usually be treated effectively.

If you have any symptoms or issues related to esophageal spasms, meet Dr. Datta Ram U personally for an accurate diagnosis and effective treatment.

Appendicitis causes

The appendix is a finger-shaped pouch. It emerges from the colon and is located on the lower right side of your abdomen. Inflammation of the appendix is known as appendicitis.

If you have appendicitis, you will feel pain in your lower right abdomen.

Pain can also begin around your navel and then moves towards the right. Abdominal pain due to appendicitis can become intense and severe as inflammation worsens. Children and adults develop appendicitis quite often. However, it can develop at any age.

What are the symptoms of appendicitis?

The most common or typical signs and symptoms of appendicitis may include the following:

• Pain on the right side of the lower abdomen
• Sudden pain can also begin around your navel and then radiate to your lower right abdomen
• Pain can become worse when you walk, move and make jarring movements
• Flatulence
• Abdominal bloating
• Constipation or diarrhea
• Loss of appetite
• Nausea and vomiting
• Low-grade fever

What are the causes of appendicitis?

Appendicitis causes: An infection due to a blockage in the lining of the appendix is the potential cause of appendicitis. Rapidly multiplying bacteria cause inflammation in the appendix making it swell and fill up with pus. In the absence of prompt treatment, the appendix can rupture.

What are the complications?

The complications associated with appendicitis include a ruptured appendix. When an appendix ruptures, the infection spreads throughout the abdomen (peritonitis). An experienced surgical gastroenterologist performs emergency surgery to remove the appendix

How is appendicitis diagnosed?

Your surgical gastroenterologist will take into consideration all your signs and symptoms and then examine your abdomen. Your doctor will do a physical examination to assess your pain. He or she will apply gentle pressure on the painful area. After releasing the pressure, the pain will become worse and signals the inflammation of the peritoneum. Your doctor may also examine your rectum – a digital rectal examination. Your doctor may also order a blood test, urine test, and other imaging tests such as an ultrasound or a CT, or MRI.

What is the standard treatment for appendicitis?

The standard treatment for appendicitis is the surgical removal of the appendix.

If an appendix bursts and an abscess form around it, your doctor drains out the abscess by placing a tube through the abdominal wall. The gastro surgeon will also give antibiotics to clear the infection. Appendectomy can be performed several weeks later after controlling the infection.

Crohn’s disease symptoms | Complications | Dr. Datta Ram U

Crohn’s disease causes inflammation (swelling in the tissues of the digestive tract). It is a type of inflammatory bowel disease (IBD).

Crohn’s disease can be debilitating and painful. It affects different areas of the digestive tract in different people. Any part of the large intestine or small intestine is involved. In some people, the disease is only in the colon. The inflammation most commonly affects the small intestine. It can also spread to the deeper layers of the bowel.

Crohn’s disease symptoms

The signs and symptoms can be mild, moderate to severe. Symptoms manifest gradually, but, in some cases, symptoms come on suddenly. There may be periods of no signs and symptoms in between (remission). The typical signs and symptoms include:

• Abdominal cramps
• Malnutrition
• Abdominal pain
• Severe diarrhea
• Fever
• Reduced appetite
• Mouth sores
• Blood in stool
• Weight loss
• Fatigue

Unusual Signs and Symptoms

In some cases, Crohn’s disease symptoms are reported outside the intestinal tract. Some people with severe Crohn’s disease may experience iron deficiency anemia, kidney stones, inflammation of the bile duct or liver; inflammation of skin, eyes, and joints. In children delayed growth and sexual development is seen.

Crohn’s Disease Causes

The exact cause of Crohn’s disease is unknown, but stress, anxiety, and diet can aggravate the condition. Many experts believe that there are several factors that play a role in the development of Crohn’s disease – for instance: the immune system and heredity.

The risk factors for Crohn’s disease may include age, family history, lifestyle, ethnicity, and other habits such as smoking and the use of NSAIDs.

Complications of Crohn’s Disease

Malnutrition: When you have persistent cramping, diarrhea and abdominal pain, you will not eat properly and your intestine doesn’t absorb enough nutrients. Therefore, you may develop anemia, low iron, and vitamin B12 deficiency.

Anal Fissures: If you have constipation and painful bowel movements – a small tear occurs in the tissue that lines the anus. It may lead to infection and painful bowel movements.

Fistulas: These are abnormal connections that can develop near or around the anus (perianal).

Ulcers: Open sores or ulcers can develop anywhere in the digestive tract – mouth, intestine or anus, or in the genital area (perineum).

Other problems:  Gallbladder or liver disease, arthritis, osteoporosis, and anemia (low iron) are some of the other health conditions associated with Crohn’s disease.

Skin disorders:  Hidradenitis suppurativa is a condition seen in some people with Crohn’s disease. It is a skin disorder with deep nodules and abscesses in the armpits, groin, and under the breasts or in the genital or perianal region.

Blood Clots: The risk of the formation of blood clots increases in the arteries if a person has Crohn’s disease.

Diagnosis of Crohn’s disease

The diagnosis of Crohn’s disease is made only after ruling out the other possible causes for the signs and symptoms. Your gastroenterologist may recommend several tests to rule out the cause of other health conditions and diagnose Crohn’s disease.

Blood tests include test to check for anemia and infections, and to check liver function. A stool test may be recommended to look for hidden (occult) blood, infections, or parasites.

Colonoscopy: To have a complete view of the entire colon, your doctor uses a thin, flexible, lighted tube with a camera at the end is used. Your doctor also takes tissue sample (biopsy) for laboratory analysis. Spotting of granulomas (clusters of inflammatory cells) indicates Crohn’s disease.

Crohn’s Disease Treatment

Treatment helps in reducing signs and symptoms. It can provide relief from persistent inflammation and bring long-term remission. However, there is no permanent cure for Crohn’s disease. Furthermore, no single treatment works for everyone. The goal of treatment is to reduce inflammation that prompts the signs and symptoms and to improve long-term prognosis by restricting complications.

Medical treatment involves anti-inflammatory drugs, antibiotics, antidiarrheal drugs, pain relievers, vitamins, and minerals supplements. If drug therapy, diet, lifestyle changes, or other treatments don’t relieve your signs and symptoms, your doctor may recommend surgery.

When should you see a doctor?

If you notice any changes in your bowel habits with any of the typical signs and symptoms of Crohn’s disease such as diarrhea lasting more than two weeks, nausea and vomiting, blood in your stool, abdominal pain, unexplained weight loss, and also fever – then see your doctor.

Older people may develop small bulges or pockets (diverticula) in their intestinal lining. In a majority of people, diverticula do not cause any symptoms. In such cases, people get to know about their condition only when they get scanning done for another reason. When there are no symptoms, the condition is known as diverticulosis. However, when diverticula cause symptoms such as abdominal pain. The condition is known as diverticular disease. When diverticula become infected or inflamed more severe symptoms may manifest. The condition is known as diverticulitis.

Symptoms of Diverticular disease and diverticulitis

Abdominal pain is usually in the left side of the abdomen. The pain looks intermittent. It comes and goes – but may get severe after eating. Farting and bowel movements ease the pain. The other symptoms may include diarrhea, constipation, or both. Infection and inflammation of diverticula (diverticulitis) is associated with more severe abdominal pain, constipation, and severe diarrhea. The other symptoms may include mucus and blood in the stools and rectal bleeding. These symptoms may also be due to other serious health conditions – such as colorectal cancer. Therefore, one must not ignore such symptoms.

Furthermore, having one or more of these symptoms doesn’t always mean that you have diverticulitis. Other gastrointestinal disorders such as stomach ulcers, gallstones, appendicitis, inflammatory bowel disease, celiac disease, and irritable bowel syndrome can also cause similar symptoms.

Who are at risk of developing diverticulosis and diverticulitis?

The risk of developing the diverticular disease is high if you:

• Are obese
• Are Male
• Are above age 40 years
• Eat red meat and diet high in fat
• Eat a diet lacking fiber
• Don’t eat legumes, beans, vegetables, and fruits
• Don’t exercise
• Take NSAIDs
• Smoke

How is diverticulitis diagnosed?

You must see a gastroenterologist if you develop any of the above-mentioned symptoms. Your doctor will also ask you about your symptoms, lifestyle, dietary habits, medical history, bowel habits, and any medicines that you are taking. The doctor may order a few tests after a thorough physical examination. The tests may include blood tests, stool culture, rectal examination, a CT scan, and sigmoidoscopy or colonoscopy. These tests are helpful in the diagnosis of diverticulitis.

Bottom Line

You’re more likely to get diverticular disease and diverticulitis if you do not get enough fiber in your diet. If your diverticulitis is due to an infection or other cause, your gastroenterologist will treat the condition with antibiotics. Mild diverticulitis can be prevented by drinking lots of water, exercising, and taking a high-fiber diet. For severe and chronic cases of diverticulitis, surgery may be required.

Open and painful sores or ulcers develop inside your stomach lining or the first part of the duodenum (the small intestine). The condition is known as peptic ulcers.  This happens when the thick mucus layer that protects the lining of your stomach becomes thin, allowing stomach acid to damage the tissue. The damage could be due to many reasons including infections, excessive use of medicines, and unhealthy lifestyle factors.

Peptic ulcers are of two types:

Gastric ulcers: Ulcers that develop on the inside lining of the stomach are called gastric ulcers.

Duodenal ulcers: They develop on the inside of the duodenal lining – mostly in the upper portion of the duodenum.

What are the symptoms of peptic ulcers?

The common signs and symptoms of peptic ulcer include burning stomach pain, heartburn, intolerance to heavy foods – spicy, hot, and fatty foods, belching or bloating, nausea, and feeling of fullness.

The pain looks like burning. On empty stomach, pain becomes severe and also stomach acid makes the pain worse. Having certain foods and taking antacid medications can help reduce or relieve pain. However, the pain comes back again and becomes worse between meals and at night. Some people may not have any symptoms.

In rare cases, peptic ulcer symptoms can become severe and may include:

Nausea, Vomiting, or vomiting blood

Stools that are black, dark, or tarry

Breathing trouble

Changes in appetite

Weight loss

Feeling faint

What are the causes of peptic ulcers?

Taking pain relievers regularly

If you take pain relievers regularly, then you will be at risk of getting a peptic ulcer. NSAIDs and certain OTCs and prescription pain medications can inflame or irritate the lining of your stomach and small intestine and eventually may lead to peptic ulcer.

Steroids, selective serotonin reuptake inhibitors (SSRIs), low-dose aspirin, and anticoagulants can potentially damage the stomach lining leading to stomach ulcers.

Bacteria – H. Pylori

Usually, Helicobacter pylori don’t cause any damage to the stomach and small intestine. But in some cases, it can become infectious and cause inflammation of the stomach’s inner lining. Though it is unclear how the H. pylori infection spreads. Many people get infected through contaminated food and water.

What are the risk factors for peptic ulcers?

The unprecedented use of NSAIDs, pain relievers, anti-depressants, antacid medications and anticoagulants, and other prescription medicines can increase the risk of ulcers. Similarly, excessive alcohol intake, smoking, excessive stress, and eating spicy and hot foods can also potentially increase the risk of peptic ulcers.

What happens if you don’t treat peptic ulcers?

Peptic ulcers can become severe over a period of time leading to internal bleeding. Slow loss of blood through internal bleeding can make you anemic. Bloody or black or tarry stools are one of the prominent symptoms of internal bleeding.

The risk of perforation of the stomach wall or small intestine increases with peptic ulcers. It will potentially put you at risk of serious infection of your abdominal cavity (peritonitis).

When peptic ulcers become severe, they block the passage of food through the digestive tract. When this happens, you will feel full easily after meals, feel nauseated or vomit. You may start to lose weight if this condition prevails.

The risk of Gastric Cancer

According to some studies, people who are infected with H. Pylori which leads to peptic ulcers, are at increased risk of gastric cancer.

Bottom Line

Many people don’t experience any symptoms. Some people may experience mild to moderate symptoms and therefore, take medicines or OTC drugs. If your symptoms return after taking pain relievers, acid blockers, or antacids, you should see your gastroenterologist. And also, when your symptoms become severe, you must seek immediate medical care.

To be continued…

In the next article, we will discuss the diagnosis, treatment, and prevention of peptic ulcers…