Like so many aspects of our busy lives, we tend to ignore our digestive system until we end up in a doctor’s office, queasy, bloated or doubled over in pain.
“Digestion is the breakdown of food into basic biochemical components that nourish and repair the body,” explains Dr. Fred Williams of Gateway Gastroenterology. Sounds simple, but a lot can go wrong as food travels down the 25- to 30-foot digestive tract. “I see a lot of people with heartburn, indigestion, gas and ongoing irritable bowel syndrome (IBS), a combination of symptoms that can include abdominal discomfort and cramping, diarrhea, constipation, or alternating diarrhea and constipation,” Williams says. “These are known as functional complaints, they’re uncomfortable and a nuisance, but not life-threatening.”
More serious problems include inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease, in which the immune system attacks the digestive tract, causing inflammation and ulceration. Celiac disease, or intolerance to gluten that causes symptoms similar to those of IBS, is increasingly common. “It used to be rare, but in the last 10 years it’s been on the rise,” Williams says. “About one in every 130 American adults now has it, I diagnose a new case every month or so. Untreated, it can lead to vitamin and mineral deficiencies, systemic problems such as joint pain, and even several different types of cancer.”
What is causing our national tummy ache? “Inflammatory bowel diseases generally have a strong genetic component,” Williams says. “Patients with ulcerative colitis or Crohn’s often have a relative with an inflammatory disease such as rheumatoid arthritis. The disease is often dormant until a triggering event maybe a virus, maybe a reaction to a certain food, sets it off.”
Stress, too, can contribute to digestive problems, according to Dr. Jennifer McCleary of Triad Sports & Family Chiropractic. “IBS, which is more common in women, is definitely aggravated by long-term stress,” she says. “There’s a close mind-body connection, and the nervous system affects body function.”
Williams agrees. “Stress can create a lot of symptoms, abdominal pain, indigestion, nausea, diarrhea. I see it often in patients who’ve lost their jobs or have family problems. But I can’t emphasize enough that serious diseases such as Crohn’s and ulcerative colitis are not caused by stress, although stress can make them worse.”
In Williams’ opinion, the major cause of most functional digestive complaints is the American diet. “It’s absolutely atrocious,” he says. “Overindulgence in processed junk foods causes most minor problems and exacerbates more serious illnesses.”
The first step in treating digestive complaints, say Williams and McCleary, is a good physical exam, which includes a comprehensive medical history. “You want to determine if it’s a potentially life-threatening problem such as cancer, bowel obstruction or inflammatory bowel diseases, or a functional complaint like IBS,” McCleary says. Diagnostic tests can include endoscopic evaluation and blood work. Some conditions, adds Williams, can be diagnosed by simple breath tests, which are noninvasive and relatively inexpensive. “Breath tests can determine if a patient has a lactose or fructose intolerance or small intestinal bacterial overgrowth, a condition in which too much bacteria moves from the colon to the small intestine,” he says.
Once a diagnosis is made, Williams believes in solving problems with a combination of dietary changes, patient education and medication. “There are all sorts of medications that can help with heartburn, cramping, colon spasms and other issues,” he notes. “But I’ll be the first to tell you that meds don’t cure, they just treat the symptoms, and they have all sorts of side effects. They are at most a helpful adjunct to a healthy diet and lifestyle.”
McCleary has had good results treating digestive problems with a combination of acupuncture and chiropractic. “The nerves in the mid-back go directly to the gut, you want to make sure those nerves aren’t aggravating the stomach.” But she, like Williams, believes that a healthy lifestyle and stress reduction are keys to digestive health. “Try adding yogurt and kefir, a tart, fermented beverage, to your diet,” she suggests. “They contain probiotics, healthy bacteria that protect the digestive system against microbial and parasitic attack. They’re a strong source of calcium, too.”
Supplements can be helpful. McCleary recommends fish oil to ease inflammation. “Try about one gram a day, but check with your doctor first, especially if you’re on blood thinners.” Williams sometimes recommends a short-term course of probiotics or pancreatic enzymes.
Although open to alternative approaches, Williams cautions against ‘colon cleansing’ with fasting and herbal supplements. “I get a lot of questions about it from patients, so I guess it’s a trend,” he says. “But there’s no scientific evidence that it works, and herbal supplements, an unregulated industry, are potentially dangerous. If you want a healthy gut, it’s pretty simple: stop dumping junk into your intestines! Eat colorful, healthy foods like vegetables, fruits, whole grains. Cut down on red meat. Exercise. Relax with yoga, meditation or a sport or hobby you really enjoy. The body’s an amazing thing. If you nourish it with good food most of the time, then an occasional hot dog or piece of cheesecake won’t kill you.”