By Dr. Amber Khan, MD – Gastroenterologist, Affiliated with Overlook Medical Center
Amber Khan, MD is a Gastroenterologist with offices at 571 Central Avenue, Suite 112 in New Providence. For more information, contact her at (908) 522-1313
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The holidays are over and our "tummies" are talking back. And I don't just mean the extra few pounds that seem to plop up on our mid-guts, but rather, the common symptoms that we experience when we are not watching what we eat or drink. So, with the New Year here, it is once again time to renew our commitment to eating right, shedding those extra pounds, calming down our angry stomachs, and deciding when use an over-the-counter pill and when you need a doctor.
Gastroesophageal Reflux Disease or GERD: Also known as heartburn or reflux, is a very common complaint. It is a burning sensation in the middle area of the upper- abdomen that may travel up the chest. At times, you may even feel food or liquid coming up in the back of your throat. This symptom is worsened by foods containing tomato sauce, garlic, onions, chocolates, peppermint and citrus, as well as alcohol, caffeine, and sodas.
It is very important to avoid these trigger foods and to change how you eat. Eating small and frequent meals every 4 hours or so and not eating or drinking at least 3-4 hours before lying down will help. You may try an over-the counter medication such as an antacid like Tums, an H2Blocker like Zantac, Tagamet, or Pepcid, or a Proton Pump Inhibitor (PPI) like Prilosec, Nexium or Prevacid for 2 weeks.
If your symptoms don’t improve, or if they keep coming back, or if you average 2-3 episodes of reflux a week, you should talk to your doctor and consider having an Upper Endoscopy. It is very important that you not confuse GERD with symptoms of heart disease like angina or heart attack. When in doubt, seek urgent medical help.
Peptic Ulcer Disease: This usually manifests as upper abdominal pain, burning, nausea and a feeling of constant hunger. Risk factors include taking medications like Aspirin, Advil, Aleve, Motrin, Ibuprofen, or Naproxen. Another cause of stomach ulcers is the presence of the bacteria, Helicobacter pylori. Taking medications to decrease acid production, like H2Blockers or PPIs helps these ulcers heal faster. However, removing the offending agent is important. Most ulcers can be diagnosed by an upper endoscopy which allows the gastroenterologist to take biopsies to make sure that the ulcer is benign and to check for Helicobacter pylori. This bacteria can only be eradicated with a combination of antibiotics. Left untreated, it can cause cancers and lymphomas of the stomach and small intestines.
Some ulcers can bleed or cause a hole or perforation. Blood from the upper digestive tract is usually digested and very black in color; this is a medical emergency.
Excessive Gassiness: Occasional gassiness is not uncommon. But when this becomes an ongoing problem, it is embarrassing and socially awkward. The causes are varied and can range from the food we eat, to the medications we take, to the pattern of our bowel movements. Eating a high fiber diet consisting of lots of grains, fresh vegetables, and fruits may actually result in excessive gassiness. Certain diseases, like Celiac disease and lactose intolerance can also predispose you to gassiness.
Gallstones: This is another common cause of abdominal discomfort. You may develop fatty food intolerance resulting in pain after fatty meals, usually occurring below the right rib cage. Other symptoms include gassiness, upper abdominal burning, nausea and even diarrhea. However, it is important to recognize that most people who have gallstones go through life without any symptoms and will not need to have their gallbladders removed.
Changes in Bowel Movements: Any abrupt changes in bowel habits that last beyond 2-3 weeks, need to be investigated, especially if you have not had a recent colonoscopy.
Rectal Bleeding: Rectal bleeding at any age needs to be investigated. Do not assume that it is your hemorrhoids, unless you have had a recent colonoscopy and your doctor tells you that. Make sure to get your baseline colonoscopy at or before the age of 50, and then as recommended, to screen for colon cancer and colon polyps. It will not only help avoid the anxiety associated with seeing any changes in bowel movements or blood in your stool, but it will protect you from the second most common cancer in America.
Eat well, listen to your bodies, and seek medical help when in doubt. And have a Happy 2016!