Author Archives: Dr Datta

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…

Gastritis Causes and Symptoms

Gastritis is a general term for a group of disorders that have one thing in common: inflammation of the lining of the stomach. The inflammation of gastritis is usually the result of infection with the same bacteria that cause most stomach ulcers or regular use of certain pain relievers. Excessive alcohol consumption can also contribute to gastritis.

Gastritis Causes and Symptoms

Gastritis Symptoms – The signs and symptoms of gastritis include:

• Aching or burning pain (indigestion) in the upper abdomen that gets worse or better with eating
• Nausea
• Vomiting
• Feeling stuffed after eating
• Gastritis might not always show signs and symptoms

Gastritis is an inflammation of the stomach lining. Weaknesses or injuries in the mucosal barrier that protects the stomach lining leading to digestive juices damaging and inflaming the stomach lining. Several diseases and conditions can increase the risk of gastritis, including inflammatory diseases such as Crohn’s disease.

Risk Factors

The factors that increase the risk of gastritis include

Bacterial infection. Although infection with Helicobacter pylori is a very common human infection worldwide, only a few people with the infection develop gastritis or other gastrointestinal disorders.

Doctors believe that susceptibility to the bacteria can be inherited or caused by lifestyle choices such as smoking and diet.

Taking painkillers regularly

Pain relievers commonly known as nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, AnaproxDS), can cause acute gastritis and chronic gastritis. Regular use of these painkillers or taking too many of these medications can deplete an important compound that helps maintain the protective lining of the stomach.

Advancing Age

Older adults are at higher risk of gastritis because the lining of the stomach thins with age and older adults are more likely to have H. pylori infection or autoimmune diseases than younger people.

Excessive consumption of alcohol

Alcohol can irritate and erode the lining of the stomach, making the stomach more susceptible to digestive juices.

Stress

Severe stress from major surgery, injury, burns, or serious infection can cause acute gastritis.

Cancer treatment

Chemotherapy, drugs, or radiation therapy can also increase the risk of gastritis.

When your own body attacks the cells in your stomach

This type of gastritis is called autoimmune gastritis and occurs when your body attacks the cells that make up the lining of your stomach. This reaction can weaken your stomach’s protective barrier. Autoimmune gastritis is more common in people with other autoimmune conditions, such as Hashimoto’s disease and type 1 diabetes. Autoimmune gastritis can also be associated with vitamin B-12 deficiency.

Other diseases and conditions

Gastritis can be associated with other conditions, including HIV/AIDS, Crohn’s disease, celiac disease, sarcoidosis, and parasitic infections.

Complications

Gastritis, if not treated, can lead to stomach ulcers and stomach bleeding. In rare cases, some forms of chronic gastritis may increase your risk of STOMACH CANCER, particularly if you have severe thinning of the lining of the stomach and changes in the cells lining the stomach.

When to see a doctor

Almost everyone has had an episode of indigestion and upset stomach at some point. Most cases of indigestion are short-lived and do not require medical attention. Contact your doctor if you have signs and symptoms of gastritis for a week or more.

See a doctor right away if you experience severe pain, vomiting, loose motions, or feel light-headed or dizzy.

Tell your doctor if your upset stomach occurs after taking any prescription or over-the-counter medicines, especially aspirin or other pain relievers.

If you vomit blood, have blood in your stools, or have stools that are black, see your doctor immediately to determine the cause.

Diarrhea causes and Prevention

Diarrhea is characterized by irregular, watery, or more frequent bowel motions. It could be present by itself or in combination with other symptoms such as nausea, vomiting, stomach discomfort, or weight loss.

The good news is that diarrhea typically only lasts a few days. However, diarrhea that persists for more than a few days or weeks typically points to another issue, such as irritable bowel syndrome (IBS), or a more serious condition, such as a persistent infection, celiac disease, or inflammatory bowel disease (IBD).

The typical signs and symptoms of Diarrhea include loose and watery stools, abdominal cramps, and dehydration.

Adults must visit a physician if signs and symptoms last longer than two days.

If you are an adult, and you have the following symptoms:

• Dehydration
• Severe abdominal or rectal pain
• Red or black colored stool
• Fever above 102 degrees Fahrenheit (39 degrees)

You should see a specialist doctor immediately.

With a fever, diarrhea can quickly lead to dehydration, especially in young children.

Call your doctor if your child’s diarrhea does not improve within 24 hours of onset – and is also associated with the following symptoms:

• Fever above 39°C
• Crying without tears
• Bloody or black stools
• Drowsiness, unresponsiveness or irritability, dimpled appearance of the abdomen, eyes, or cheeks.

Diarrhea Causes and Prevention

Causes of Diarrhea

Diarrhea can be caused by a variety of diseases and conditions, including:

Viruses

Norwalk virus (also known as norovirus), enteric adenoviruses, astrovirus, cytomegalovirus, and viral hepatitis are all viruses that can cause diarrhea. Rotavirus is a common cause of acute diarrhea in children. The virus responsible for coronavirus disease 2019 (COVID-19) has also been linked to gastrointestinal symptoms such as nausea, vomiting, and diarrhea.

Parasites and bacteria

Diarrhea is caused by exposure to pathogenic bacteria such as E. coli or parasites through contaminated food or water. When visiting developing countries, diarrhea caused by bacteria and parasites is commonly referred to as traveler’s diarrhea. Clostridioides difficile (also known as C. diff) is another type of bacterium that can cause diarrhea after taking antibiotics or while hospitalized

Medications

Many medications, including antibiotics, can result in diarrhea. Antibiotics treat infections by killing harmful bacteria, but they also kill beneficial bacteria. This disrupts the natural balance of bacteria in your intestines, resulting in diarrhea or a secondary infection like C. diff. Anti-cancer medications and magnesium-containing antacids are also known to cause diarrhea.

Lactose sensitivity

Lactose is a type of sugar that is found in milk and other dairy products. Lactose-intolerant individuals experience diarrhea after consuming dairy products. Lactose intolerance can worsen with age because levels of the enzyme that aids in lactose digestion decline with age.

Fructose

Fructose is a natural sugar found in fruits and honey. Certain beverages may contain it as a sweetener. People who have problems digesting fructose can get diarrhea.

Artificial sweeteners such as mannitol, erythritol, and sorbitol can also cause diarrhea in otherwise healthy people. People who eat chewing gum and other sugar-free products can develop diarrhea.

Prevention (Prevention of infectious diarrhea)

Washing hands to prevent the spread of infection prevents contagious diarrhea.  To ensure proper hand washing:

Wash your hands: before and after preparing food; after handling raw meat; after using the toilet, after changing nappies; after sneezing or coughing, and blowing your nose.

Lather the soap for 30 seconds. After applying soap to your hands, rub your hands for at least 20 seconds. That’s how long it takes to sing “Happy Birthday” twice.

If hand washing is not possible, use hand sanitizer. If you can’t get to the sink, use an alcohol-based hand sanitizer. Apply a hand sanitizer such as hand lotion and cover the front and back of your hands.

Use products with an alcohol content of 60% or more.

The vaccine is one of two licensed vaccines that can protect children against rotavirus, the most common of diarrhea.

The leading cause of viral diarrhea in children is rotavirus. Enquire with your doctor about your child’s vaccinations.

Traveler’s diarrhea prevention People who travel to countries with poor sanitation and contaminated food are more likely to get diarrhea.

To lower the risk

Take care of what you eat. Consume warm, well-prepared food. Unless you can peel them yourself, avoid eating raw fruits and vegetables. Avoid raw or undercooked meat and dairy products as well. Take care of what you drink. Drink bottled water, soda, beer, or wine in their original containers. Avoid using tap water or ice cubes. You can also brush your teeth with bottled water. When showering, keep your mouth closed.

Coffee and tea, which are made with hot water, are probably safe. Keep in mind that alcohol and caffeine can aggravate diarrhea.

Inquire with your doctor about antibiotics. If you’re going to a developing country for an extended period of time, consult your doctor about antibiotics, especially if you have a weakened immune system.

Check for travel advisories. The Centers for Disease Control and Prevention maintains a website for travelers’ health that includes disease warnings for various countries. If you plan to travel outside of your country of origin, look for warnings and risk-reduction tips there.