Gastrointestinal disease

The gastrointestinal tract is a group of organs in the human body responsible for digesting food. The most vital of these organs include the stomach, esophagus, and intestines. The pancreas, gallbladder, and liver are also part of the gastrointestinal tract (GI). Gastrointestinal diseases affect the gastrointestinal tract.

Definition & Facts

Some of the most common GI tract diseases and conditions are gastroesophageal reflux disease (GERD), diverticulitis, constipation, irritable bowel syndrome (IBS), and colon cancer. Constipation and IBS are two of the most common disorders that involve both the rectum and the colon.

GERD is a digestive problem that impacts the muscle between the stomach and esophagus. Diverticulosis is a condition in which pouches form in the large intestinal wall, and diverticulitis occurs when those pouches become inflamed.

Colon cancer most often begins as benign colorectal polyps in the tissues of the rectum and the colon. When the polyps develop abnormal cells, the cells invade other tissues, which causes cancer to develop. 

Symptoms & Complaints

Symptoms of irritable bowel syndrome include cramps, excessive amounts of gas, pain in the abdomen, bloating, and changes in bowel movements, including hard or loose stool. Sometimes IBS patients alternate between diarrhea and constipation. Constipation symptoms include difficulty passing stool or passing stool less than three times each week.

People with diverticulosis do not often have any symptoms, but complications of the disease can include cramps in the lower abdomen, fever, and chills. Patients might also alternate between diarrhea and constipation.

In its earliest stages, colorectal cancer does not often cause symptoms, but patients may complain of symptoms once the cancer becomes more advanced. Such symptoms include blood in stool, narrow stool, pain in the abdomen, fatigue, and unexplained weight loss.

Causes

Diverticulitis can occur as a result of not eating enough fiber. In Western cultures, about half of all people age 60 or over develop diverticulitis. Lifestyle choices and eating habits are contributing factors for GERD. Consuming chocolate, coffee, alcohol, fried food, and fatty food may cause the heartburn associated with GERD.

The causes of colon cancer are less clear. However, scientists have identified certain risk factors, including old age, obesity, smoking, alcohol, radiation therapy, a sedentary lifestyle, and being African American. Inherited syndromes within a family might also increase a person's risk of colon cancer. Some researchers also believe that eating a diet high in fat and low in fiber contributes to developing the cancer.

Irritable bowel syndrome is among the most common GI disorders, and it can be caused by the following:

• A sedentary lifestyle
• Overuse of laxatives
• Eating a low fiber diet
• Eating too much dairy/lactose intolerance
• Stress
• Resisting the urge to defecate
• Pregnancy

Diagnosis & Tests

Various tests may be ordered to diagnose GI tract diseases and conditions. A physician may diagnose GERD based on a patient's symptoms, or the doctor may order any of three main tests: esophageal PH, esophageal manometry, and endoscopy. PH monitoring is a test in which the acid level in the esophagus is monitored.

Endoscopy involves inserting a tube with a camera attached down the throat and into the esophagus. Manometry can indicate if the esophagus is functioning well. During the esophageal manometry procedure, a tube is pushed through the nose and esophagus and into the stomach. All three tests can help diagnose GERD.

Because the early stages of colon cancer often cause no symptoms, colon cancer is often diagnosed when a patient is being treated for another complaint. Regular colon cancer screenings are recommended for people over age 50 as well as those who have a family history of colon cancer.

To diagnose colon cancer a physician might order a colonoscopy, which involves using a long tube and a camera to examine the rectum and colon. Tissues samples may be collected if unusual areas are found during the colonoscopy. A doctor might also test a patient's blood for chemicals produced by colon cancers.

Diverticulitis is often diagnosed during an attack, which involves a patient complaining of stomach pain. To diagnose the disorder, a physician will examine the abdomen for tenderness. The patient might also undergo blood tests and clinical urine tests, liver function tests, a computed tomography (CT) scan, or even a stool test.

Treatment & Therapy

After a colon cancer diagnosis, the doctor will stage the cancer and proceed with treatment based on how far the cancer has progressed or metastasized. If a patient is still in the early stages of colon cancer, polyps may be removed during a colonoscopy. Laparoscopic surgery can be used to remove polyps that can't be removed via colonoscopy.

When treating invasive cancer, part of the colon may be removed and a hole will be created in the abdominal wall to release waste into a bag (a colostomy). Advanced stage cancers may require chemotherapy or radiation.

Treatment for GERD involves over-the-counter medication in most cases. However, if symptoms are not relieved, a patient may require surgery in rare cases. Treatments for constipation and IBS mostly involve lifestyle changes. To treat IBS, a patient may be instructed to eliminate gassy foods, gluten and certain carbs. Medication may also be required.

To treat constipation, people are often instructed to exercise, drink plenty of fluids, and eat foods high in fiber, such as fruits and vegetables. Stool softeners also help with constipation. A doctor should be consulted if these remedies fail.

Prevention & Prophylaxis

Exercising regularly, eating enough fiber, and avoiding stressful situations reduces the risks of developing some GI tract disorders.