Gut Disorders

Bowel movement patterns vary greatly from person to person. Some individuals have regular daily movements, others have them multiple times a day, while some may only go a few times a week. Most people typically pass stools between three times a day and three times a week, with normal stools being solid. Diarrhoea is characterised by passing stools more than three times a day, with the stools being loose or watery. Acute diarrhoea is when these symptoms appear suddenly but generally resolve within 5-10 days.

The most common cause of acute diarrhoea is an intestinal infection, known as gastroenteritis. Food poisoning is another common cause, frequently due to bacteria such as Salmonella and Campylobacter, which can be transmitted through contaminated food (like poultry and eggs) or water, and sometimes by asymptomatic food handlers.

Travellers are also at higher risk of intestinal infections, commonly due to the bacterium Escherichia coli, which produces enterotoxins in the gut, leading to increased intestinal secretion. Acute diarrhoea can also result from a variety of other factors, including antibiotic use, certain medications, alcohol consumption, and acute anxiety. In most cases, acute diarrhoea subsides after a few days without the need for medical treatment.

Is caused by a sensitivity to the protein gluten (found in wheat, barley and rye), to the extent that gluten, if ingested, causes harm to the lining of the small intestine. The disease is thought to affect around 1% of people, but many will not experience symptoms – and so in a large proportion of people, the condition will remain undiagnosed.

Symptoms of the condition can vary widely, but include: diarrhoea, vomiting, weight loss or a failure to gain weight, abdominal pain and mouth ulcers.

The best treatment for coeliac disease is simply to abstain from consuming any product containing gluten. Gluten is not an essential protein, and so, with a little planning, can simply be replaced in the diet. If you believe you may have coeliac disease, it is important to visit your doctor for a diagnosis. For further information, contact Coeliac UK – www.coeliac.co.uk

Constipation is often considered more of a symptom than a condition itself, typically characterised by difficulty in opening the bowels or passing stools.

Those diagnosed with constipation usually have fewer than three bowel movements per week, may need to strain during bowel movements and/or produce hard or pellet-like stools.

Several factors can contribute to the likelihood of developing constipation, including a diet low in fibre, fruits, and vegetables; insufficient exercise; lifestyle changes and ignoring the urge to pass stools. Additionally, being underweight, overweight, or experiencing increased stress levels may also contribute to constipation. Addressing these underlying factors can often resolve the issue.

Although a very common complaint, constipation rarely leads to long-term complications and is generally treatable quickly and effectively.

This condition causes inflammation in the gut and is one of two conditions referred to as Inflammatory Bowel Disease (or IBD) the other one being Ulcerative Colitis. Crohn’s disease can lead to symptoms such as pain, diarrhoea, fatigue, loss of appetite and ulcers.

Although any part of the gut can be affected, the condition most often manifests itself in the lower part of the gut (bottom of small intestine or top of large intestine).

The disease is thought to affect 1 in 650 people, and usually starts between the ages of 15 and 40. The exact cause is unknown, although it is thought that there may be a genetic link, with one in five sufferers also having another family member with the disease. Men and women are affected equally and incidence has also been found to be higher in smokers. No specific link to diet has been discovered.

Treatment and management of the condition focuses largely on reducing the inflammation in the intestine. This can sometimes be achieved through dietary or drug therapy, but in as many as 80% of cases, surgery is required to remove sections of the intestine. For more information, see www.crohnsandcolitis.org.uk and www.crohnscolitis.ie

Diarrhoea is the passing of frequent, loose or watery stools. This may be accompanied by stomach cramps, which will generally be reduced after a stool is passed. There are two types of diarrhoea – acute (short-term) and chronic (long-term).

Chronic diarrhoea is most commonly caused by Irritable Bowel Syndrome but can also be linked to Inflammatory Bowel Diseases, hormonal changes or certain medications. It is vital to visit the doctor for a full diagnosis and treatment options.

Gallstones are crystals that form in bile within the body (usually in the gall bladder or bile duct). Bile is made in the liver, but is stored in a small ‘bag’ called the gall bladder. Bile is made of a number of different chemicals, and when it can no longer hold these chemicals as a liquid, gallstones begin to form. Gallstones can be as small as a grain of sand – or as large as a golf ball, but they most frequently contain cholesterol, a substance found in large amounts within bile.

Gallstones are more common in females and older people – but in many cases, they will go unnoticed and will cause no symptoms. They generally only tend to cause symptoms when they move from the gall bladder into the bile duct, at which point acute stomach pains will be felt. If gallstones are causing no problems, then they are best left alone; if however they cause repeated pain, they will generally be removed via keyhole surgery.

Haemorrhoids occur when blood vessels in the rectum and anus become inflamed. This condition is extremely common, affecting about 50% of people at some point in their lives.

There are two types: internal haemorrhoids, which develop inside the rectum, and external haemorrhoids, which form outside the anus. Common symptoms include itching and bleeding around the anus, as well as discomfort during bowel movements. Haemorrhoids are typically caused by excessive pressure on the blood vessels around the rectum, often due to straining during bowel movements. Pregnant women are particularly prone to haemorrhoids because increased abdominal pressure pushes down on the pelvic blood vessels. Similarly, obesity can increase the risk due to added pressure in the area.

Treatment generally involves dietary changes to increase fibre intake and reduce straining, self-care measures such as sitting in a warm bath to alleviate itching and medications. A procedure called “banding,” where a band is placed around the haemorrhoid to reduce its blood supply, is commonly used. In severe cases, surgery may be required to remove the haemorrhoids.

When we eat or drink, food travels down the oesophagus to the stomach in a ‘one-way’ motion. However, reflux can occur when food or drink flows back up from the stomach into the oesophagus. Unlike vomiting, which is a forceful reaction, reflux can happen without a person even noticing. At the lower end of the oesophagus, there is a ring of muscle designed to prevent reflux. This muscle usually functions efficiently – relaxing when we eat or drink, then tightening afterwards. However, if this muscle becomes too loose, reflux can occur.

The most common symptom of reflux is heartburn, a burning sensation in the chest. If reflux happens repeatedly, it can lead to esophagitis, which is inflammation and damage to the lining of the oesophagus. Often, there are no clear factors that cause the weakening of this muscle, though consuming rich, fatty foods can increase the likelihood of reflux.

Treatment typically involves medication, though lifestyle changes can also be beneficial.

Indigestion can be surprisingly difficult to define, despite being something we all experience occasionally—often after eating or drinking too much or consuming food too quickly. It is best described as an unpleasant or even painful sensation in the upper abdomen or lower chest, typically occurring after meals. Indigestion is more of a symptom than a disease itself.

Although it can be irritating, unpleasant, and a nuisance, it is rarely serious. Even after medical tests, most people with indigestion do not have ulcers or more serious issues.

However, if indigestion occurs for the first time in midlife or later, it is advisable to consult your GP. Those who take anti-inflammatory drugs for arthritis or similar conditions are at a higher risk of developing both indigestion and peptic ulcers. Additionally, an increasing number of people experience indigestion due to stomach acid refluxing into the oesophagus. Less commonly, indigestion can be related to gallstones, pancreatic disease, or, in rare cases, cancer of the stomach or oesophagus. Fortunately, most people with indigestion do not have these conditions and are diagnosed with what is known as ‘non-ulcer dyspepsia’.

Irritable Bowel Syndrome (IBS) is a medical term given to a collection of otherwise unexplained symptoms relating to a disturbance of the large bowel. At some point in their lives, about a third of the population will be affected and one in ten people seek advice from a GP.

It can be both a painful and distressing condition and should be properly diagnosed by a medical professional. Symptoms of IBS can include:

• Abdominal pain and spasms, often relieved by going to the toilet.
• Diarrhoea, Constipation or an alternation between the two.
• Bloating or swelling of the abdomen.
• Rumbling noises and excessive passage of wind.
• Urgency (An urgent need to visit the toilet).
• Incontinence (If a toilet is not nearby).
• Sharp pain felt low down inside the rectum.
• Sensation of incomplete bowel movement.

IBS is more frequently diagnosed in women compared with men, in young compared with old and in western countries compared with the developing world. It is commonly associated with emotional tension, is frequently triggered by life changes, difficult life situations or stressful life events.

There is no cure for IBS and as symptoms can be different for people so too can the treatment to help alleviate symptoms. For some changes to diet can help while others take anti-spasmodic drugs. Some people have found benefit from complementary medicine such as acupuncture or homeopathy or taking probiotics. More information, advice and support available from www.theibsnetwork.org

Ulcerative colitis (UC) is a long-term condition that causes inflammation in the colon and, along with Crohn’s disease, is classified as an Inflammatory Bowel Disease (IBD).

In severe cases, the inflammation can lead to the development of ulcers in the colon, although this does not occur in every instance. UC always affects the rectum (the part of the colon just inside the anus) and in some cases, the inflammation is limited to this area. However, in other individuals, the entire colon (large intestine) can be affected.

The most common symptoms include abdominal pain, diarrhoea and bleeding from the back passage. UC affects men and women equally, with symptoms typically appearing between the ages of 15 and 30. Despite extensive research, the exact cause of UC remains unknown, though it is believed to be related to the body’s immune response to the bacteria present in the intestines.

Treatment primarily involves medication, but in severe cases, surgery may be necessary. For more information, visit www.crohnsandcolitis.org.uk and www.crohnscolitis.ie