Danger level: Low

What is it?

Irritable bowel syndrome (IBS) is a chronic condition of the digestive system causing pain and a change in bowel habits.

Who gets it?

It’s estimated that as much as 10-20% of the population in the US suffer from IBS.

Women are 2-3 times more likely to develop IBS than men in Western countries. In the Indian subcontinent, on the other hand, 70-80% of sufferers are men.

The condition starts before age 35 in about 50% of people.

If you have someone in your close family (parents, siblings) with IBS, you may have a higher chance of developing it yourself.

What causes it?

The reason behind IBS isn’t known yet, although there are many theories.

The symptoms of IBS (which we will discuss next) are caused by changes in our bowel habits. Our intestines move the food we eat along the gastrointestinal tract by contraction and relaxation of muscles in the intestines’ walls.

In IBS, these contractions may be stronger and longer, leading to food passing more quickly than normal in the intestines. This can cause gas, bloating and diarrhea. In other people, contractions may be weaker, causing the stools to stay longer in the intestines, making them hard and dry. This may lead to constipation.

The intestines. For some people, they just don’t work the way they’re supposed to. Photo by Curious Expeditions. 

People with IBS have a sensitivity to certain triggers which other people don’t respond to. For example -

1. Foods: Some foods worsen the symptoms in some IBS patients. Examples of such foods include chocolate, milk and alcohol. Also carbonated beverages and some fruits and vegetables may cause discomfort.
2. Stress: Stressful events may aggravate the symptoms.

How does it feel?

1. Abdominal pain – The pain is usually crampy and located in the lower left abdomen. Sometimes, as mentioned above, stress and eating may worsen the pain. Going to the toilet may relieve the pain.

   
   Abdominal pain is the most common symptom of IBS. Photo by Peter Gerdes.

2. Changes in bowel habits – This can include diarrhea, constipation, or an alternation between the two. The diarrhea usually happens during the daytime, most often in the mornings or after meals. People often feel they just have to run to the toilet, and after emptying they often feel not completely emptied. The constipation can last from days to months.
3. Other symptoms – These can include bloating, gas, belching, heartburn, difficulty swallowing, an early feeling of fullness with eating, and nausea.

How is it discovered?

There are no specific tests which can be done to determine if you have IBS. Instead, there are some criteria, called the Rome 3 diagnostic criteria for IBS, which may help the doctor (and you) determine if you have IBS.

The criteria say that if you have abdominal pain or discomfort that lasts for at least 3 days per month in the last 3 months which are associated with either:

- Improvement with defecation

- It started with a change in bowel frequency

- It started with  a change in the appearance of stools

Then you may have IBS.

IBS isn’t a life threatening disorder, but other diseases that may be life threatening may show up with the same symptoms. This is why the doctor may perform tests to rule out other conditions before deciding you have IBS.

How is it treated?

There is really no cure for IBS, so treatment is usually a long term process. Treatment includes:

1. Monitoring symptoms – This helps to identify which things cause you to feel worse so that you may avoid them. It can be done with a daily diary.
2. Diet changes – Eliminating foods that may worsen your symptoms is part of the treatment. It shouldn’t be done without a doctor’s consultation, though. This may include lowering your daily intake of dairy products, eating less foods that may cause gas, eating foods which may be easier to digest, and increasing your dietary fiber.
3. Psychosocial therapy – Since stress and anxiety may worsen the disease for some people, learning to deal with them may ease the disease.
4. Medications – None of those cure the disease, but may help with the symptoms. Consult your doctor for info about those.

What happens after treatment?

Although IBS can cause substantial physical discomfort and emotional distress, the condition isn’t life threatening. Most people with the condition learn to control their symptoms with time.

The bottom line – How do I avoid it?

There is no known way to prevent IBS, since no one really knows what causes it. If you do have the condition, dealing with stress and eating a proper diet may help to avoid its symptoms.

This video showcases a personal story of IBS, as seen on the Discovery Channel:

Do you suffer from IBS or know someone who does? Share your story in the comments below.

Related posts:

1. Crohn’s Disease – Inflammation in The Intestines Which Can Influence Your Whole Life
2. Peptic Ulcer Disease – Wounds in your stomach and intestines
3. Asperger Syndrome – A Life of Misunderstandings

Danger: Medium

What is it?

Peptic ulcer disease (PUD) is a condition in which wounds form in the digestive tract, mainly in the stomach or the duodenum (a part of the intestine).

Who gets it?

You have about a 10% chance of having PUD during your lifetime. In the United States, about 4 million people get it each year.

The two main groups of people who get it are people who are treated with nonsteroidal anti-inflammatory medications (such as ibuprofen) and those who are infected with a specific germ called helicobacter pylori (see ahead).

What causes it?

Our stomach releases acid, which helps in the process of food breakdown in the body. Under normal conditions, the body can protect itself from that acid since it has a protective lining on the stomach and the duodenum. There’s usually a balance between the secretion of acid and the protective lining. When that balance is disrupted, a peptic ulcer can occur.

The following things are known to change that balance and bring about ulcers:

1. Infection with a germ called Helicobacter pylori (H. pylori) – There are estimates that about half of the world’s population are infected with it. The relationship between ulcers and H. pylori wasn’t known until 1982, when a researcher decided to prove his theory of a connection between the two by swallowing these bacteria. Not long after, he had ulcers.
   H. pylori is responsible for 90% of ulcers in the duodenum and 70% in the stomach.
2. Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin: These are drugs used to treat pain, inflammation and fever. Everyone uses them from time to time. You might know them by their names: aspirin, ibuprofen (Advil, Motrin, Midol), naproxen (Aleve, Anaprox, Naprosyn), and others.
3. Zollinger-ellison syndrome: This is a rare tumor which we will cover here in the future. It causes extra secretion of acid.
4. Others: Other reasons include smoking, radiation therapy (such as for cancer), chemotherapy for cancer and others.

  
Aspirin. It and other NSAIDs can cause peptic ulcers. Photo by ragesoss.

This video shows how an ulcer develops:

How does it feel?

The main thing you feel when you have a peptic ulcer is abdominal pain (although you may also not feel it at all). The pain is usually located in the upper abdomen. If the ulcer is located in the duodenum, the pain is usually relieved by eating food. If it’s located in the stomach, it usually gets worse by eating.

If an ulcer isn’t treated properly, it can develop complications. These include:

1. Bleeding
2. Perforation – A hole through the wall of the stomach or duodenum
3. Gastric outlet obstruction – If the ulcer causes a swelling which blocks the passageway leading from the stomach to the small intestine. This can bring about early satiety when eating, a feeling of fullness, nausea and vomiting.

Since these complications may be life threatening, it’s important to seek treatment if you have a peptic ulcer.

How is it discovered?

There are a few things which can be done to discover a peptic ulcer:

1. H. pylori testing – There are several tests which can detect if you are infected with this germ. These tests include blood tests, tests for your breath and tests for your stool. If you are positive, you will be treated for infection and then get re-checked to see if the germ is gone.
2. Upper endoscopy – This is a tube with a camera inserted through your mouth to your intestines or stomach to see the appearance there. This is done more in older people or people with other symptoms such as weight loss, to rule out the possibility that the symptoms are caused by cancer and not by a peptic ulcer. A biopsy of the intestine or stomach can be taken during that test.

How is it treated?

There are a few ways to treat peptic ulcers:

1. Stopping taking NSAIDs – If they are the cause of the ulcer.
2. Treating H. pylori – This involves taking several medications together for about 7-14 days.
3. Acid suppression drugs – If there is no known infection with H. pylori, these drugs can also be used. They suppress the release of acid from the stomach.
4. Surgery – If complications develop, a surgery may be needed.

What happens after treatment?

Most patients are treated successfully with the cure of H pylori infection, avoidance of NSAIDs, and the use of acid suppression drugs.

In the past, more people had to be treated with surgery. Since the discovery of H. pylori and the above treatments, surgeries are rarely needed today.

The bottom line – How do I prevent it?

You can avoid having peptic ulcers or having them recurring if you follow these tips:

1. Quit smoking
2. Avoid heavy alcohol use
3. Don’t overuse NSAIDs
4. Contact your doctor if you have the symptoms mentioned above

Know of any tips of your own? Share them in the comments.

Related posts:

1. Crohn’s Disease – Inflammation in The Intestines Which Can Influence Your Whole Life
2. Gastroesophageal Reflux Disease – Very Common But Not So Innocent
3. Irritable Bowel Syndrome (IBS) – How the Intestines Can Affect Your Whole Life

Danger level: Medium

What is it?

Crohn’s disease is a condition in which there is a chronic inflammation in the intestines (you might also hear the name inflammatory bowel disease (IBD) when Crohn’s is mentioned).

Who gets it?

About 7 people out of 100,000 in the US (and about 1-10 out of 100,000 in Europe) get Crohn’s disease. More and more people have been getting the disease in the last 5 decades, especially in northern areas. It’s less common in other areas of the world, like Asia, South Africa and Latin America.

The disease can begin at two time periods in life – most commonly in the ages 15-30, but also at 60-80.

There are a few things known to increase the risk as well -

• Crohn’s is more common in Ashkenazi Jews.
• If you have a close family member with Crohn’s (parent, sibling, children) – your chances of getting it are also higher.
• Smokers have a higher chance of developing Crohn’s.

What causes it?

No one knows exactly why it is caused. It might be related to an over-reaction of the immune system to normal bacteria in the intestines, although other theories exist as well.

Whatever the cause may be, it causes an inflammation in the intestines (the small intestine as well as the large intestine). This inflammation causes damage to the intestines, which brings about the symptoms of the disease.

How does it feel?

Usually Crohn’s has a pattern of flares (when the disease worsens) and remissions (when it gets better).

The main symptoms of Crohn’s are abdominal pain and diarrhea (sometimes with blood). The diarrhea can appear many times a day (even 10-20), and even at night. This can cause weight loss, as well.

Other things which are related to our digestive system and that happen here can include mouth sores, bowel blockages, anal fissures (tears), and openings between organs (called fistulas).

Unfortunately, Crohn’s isn’t limited to our digestive system. Other things can happen here as well -

1. Growth failure – If the disease starts at an early age, there may be a problem with the growth of the child.
2. Fever
3. Inflammation in the eyes
4. Inflammation in the joints (which can also involve the spine)
5. Skin flares

And others…

This photo shows what happens on the inside of a Crohn patient’s intestines – You can see wounds (ulcers) all over the place. Photo by Samir.

How is it discovered?

There are several tests which can be done to discover Crohn’s. They include -

1. X-Rays or CT scans of the intestines
2. Colonoscopy – Which is a tube with a camera which is inserted into the intestines and can show what’s going on inside them (like in the picture above).
3. Biopsy – A sample of the intestines can be taken to see the disease under the microscope.

How is it treated?

There are two types of treatments for Crohn’s:

1. Medications – There are many drugs out there used to treat Crohn’s. They include drugs that take down the inflammation in the body (such as steroids and others), as well as antibiotics and other drugs.
2. Surgery – Sometimes the drugs won’t do the trick, and a surgery may be the only way to improve the symptoms. Surgery doesn’t cure the disease, though – it only takes down the diseased part of the intestines, but other parts can continue to develop the disease.

What happens after treatment?

Crohn’s is a chronic disease, meaning it can’t be cured. Flares of the disease can continue in spite of the treatment, although less severely.

People with Crohn’s are also more likely to develop colon cancer over time.

The bottom line – How do I avoid it?

Since the cause for Crohn’s isn’t known, there is currently no known way to prevent it.

This video tells the story of pro quarterback David Garrard and the effect Crohn’s disease had on his life:

For another personal story, you can read the living with Crohn’s disease blog, written by Scottie Roy.

If you had a brush with the disease or know of anyone who did you’re welcome to share it in the comments below.

Related posts:

1. Irritable Bowel Syndrome (IBS) – How the Intestines Can Affect Your Whole Life
2. Peptic Ulcer Disease – Wounds in your stomach and intestines
3. Familial Mediterranean fever – Fever and Inflammation Inside The Body