Gastrointestinal disorders such as GERD, diarrhea, and colorectal cancer are illustrations of such conditions. While some disorders may not show any GI tract anomalies during examination, symptoms may still exist. Other disorders may have both symptoms and observable GI tract abnormalities. Most gastrointestinal disorders can be avoided and/or managed.
What are gastrointestinal diseases?
Gastrointestinal disorders impact the GI tract from the mouth to the anus and can be divided into two categories: functional and structural. Instances of such disorders encompass nausea/vomiting, food poisoning, lactose intolerance, and diarrhea.
What are functional gastrointestinal diseases?
Functional gastrointestinal disorders refer to conditions where the GI tract appears normal upon examination, but experiences impaired movement. These disorders are the most frequent issues that affect the GI tract, including the colon and rectum, and examples include constipation, irritable bowel syndrome (IBS), nausea, food poisoning, gas, bloating, GERD, and diarrhea.
Several factors can disrupt the motility of the GI tract, such as consuming a low-fiber diet, insufficient exercise, traveling or any significant changes in routine, consuming high amounts of dairy products, stress, resisting the urge to have a bowel movement due to hemorrhoids, overuse of anti-diarrheal medications leading to weakened bowel muscle movements, taking antacid medicines containing calcium or aluminum, taking certain medicines (particularly antidepressants, iron pills, and strong pain medications such as narcotics), and pregnancy.
What are structural gastrointestinal diseases?
Structural gastrointestinal disorders are characterized by abnormal appearances of the bowel during examination and impaired function. In some instances, surgical removal of the structural abnormality may be necessary. Examples of structural GI diseases include strictures, stenosis, hemorrhoids, diverticular disease, colon polyps, colon cancer, and inflammatory bowel disease.
Constipation
Constipation, a functional gastrointestinal problem, occurs when bowel movements (passing stools) become difficult, infrequent (less than three times per week), or incomplete. A lack of fiber in the diet or disruptions to a regular routine or diet are common causes of constipation. Symptoms include hard, small stools and anal issues like fissures and hemorrhoids, which result from straining during a bowel movement. Constipation is not often indicative of a severe medical condition.
Constipation can be treated by increasing fiber and water intake, exercising regularly, and responding to bowel urges (avoiding constipation). Laxatives may be prescribed if these methods fail. It is important to follow the instructions on the laxative medicine and to remain current on colon cancer screenings.
Irritable bowel syndrome (IBS), a functional gastrointestinal condition, occurs when the colon muscle contracts either more or less often than usual, often triggered by certain foods, medications, or emotional stress. Symptoms include abdominal pain, cramps, excess gas, bloating, changes in bowel habits such as harder, looser, or more urgent stools than normal, and alternating constipation and diarrhea.
Treatment for IBS includes avoiding excessive caffeine, increasing fiber in the diet, identifying and avoiding foods that trigger symptoms, managing stress through relaxation techniques or other coping mechanisms, taking prescribed medications, staying hydrated, and getting enough rest and sleep.
Hemorrhoids
Hemorrhoids are an example of a structural gastrointestinal disease, characterized by dilated veins in the anal canal. They occur when the blood vessels that line the anal opening become swollen. Hemorrhoids are caused by chronic excess pressure from factors such as straining during bowel movements, persistent diarrhea, or pregnancy.
There are two types of hemorrhoids: internal and external.
Internal hemorrhoids
Internal hemorrhoids refer to blood vessels located on the inside of the anal opening. They can become irritated and bleed when they fall down into the anus due to straining, and in severe cases, can prolapse or protrude out of the anus.
Treatment options for internal hemorrhoids include improving bowel habits to avoid constipation and straining during bowel movements, as well as moving bowels when the urge arises. Healthcare providers may also use ligating bands to eliminate the affected vessels or perform surgical removal, although surgery is typically only necessary for individuals with very large, painful, and persistent hemorrhoids.
External hemorrhoids
External hemorrhoids are veins located just under the skin on the outside of the anus. They can burst and form blood clots under the skin, which can be very painful and is called a “pile” or thrombosed external hemorrhoid. Treatment options include removing the clot and vein under local anesthesia or removing the entire hemorrhoid.
Anal fissures
Anal fissures are a type of structural disease that occurs when there are tears or cuts in the lining of the anal opening. The most common cause of anal fissures is passing hard or watery stools. The exposed muscles in the anal area can become irritated and lead to intense pain, burning, bleeding, or spasms after bowel movements. Treatment for anal fissures may include pain medication, adding dietary fiber to reduce the occurrence of large stools, and taking sitz baths. If these treatments are not effective, surgery may be necessary to repair the sphincter muscle.
Perianal abscesses
Perianal abscesses are a type of structural disease that occurs when small anal glands become blocked, leading to a bacterial infection and the formation of pus. This condition requires treatment to drain the abscess, typically done under local anesthesia in a healthcare provider’s office.
Anal fistula
An anal fistula is a structural condition that can occur after an abscess has been drained. It’s an abnormal tube-like passage that connects the anal canal to a hole in the skin near the anus. This tiny channel diverts body waste through the skin, causing itching and irritation. Fistulas also lead to drainage, pain, and bleeding. They rarely heal on their own and usually require surgery to drain the abscess and close off the fistula.
Other perianal infections
In some cases, skin glands close to the anus can become infected and require drainage, as with the pilonidal cyst, which is a structural disease. Other infections that can affect the anus are sexually transmitted infections (STIs) such as anal warts, herpes, AIDS, chlamydia, and gonorrhea.
Diverticular disease
Diverticulosis is a structural disease characterized by small outpouchings or diverticula in the muscular wall of the large intestine, which typically form in weakened areas of the bowel, particularly in the sigmoid colon. This condition is quite prevalent, affecting 10% of people over the age of 40 and 50% of those over 60 in Western cultures, often due to insufficient fiber in the diet. Diverticulosis can progress to diverticulitis, which is marked by infection or inflammation of the outpouchings, bleeding, and obstruction, occurring in around 10% of people with diverticular disease. Treatment of diverticulitis involves addressing constipation and antibiotics in severe cases, while surgery is only considered as a last resort in patients with severe complications to remove the affected segment of the colon.
Colon polyps and cancer
Colorectal cancer is the second most prevalent type of cancer in the United States, and about 130,000 people are diagnosed with it annually. Nevertheless, early detection and treatment advances have made it one of the most treatable cancer forms. A range of screening tests can aid in the early detection, prevention, and treatment of the disease even before symptoms appear.
The importance of screening
Colorectal cancer typically begins as benign growths called polyps in the lining of the colon and rectum. These polyps can become cancerous and invade surrounding tissues. Removing the polyps can prevent the development of colorectal cancer. The most effective method for removing polyps is using a colonoscope. Early forms of colorectal cancer may not show any symptoms, which is why regular screening is crucial. If symptoms do occur, they may include blood in the stool, changes in bowel habits, narrow stools, abdominal pain, weight loss, and fatigue. Advanced cancer requires more complex surgical procedures.
There are four ways in which most cases of colorectal cancer are detected:
- Screening individuals with average risk for colorectal cancer starting at age 45.
- Screening individuals at higher risk for colorectal cancer, such as those with a family history or personal history of colon polyps or cancer.
- Investigating the bowel in patients with symptoms.
- A chance finding during a routine check-up.
It’s important to detect colorectal cancer early, as it offers the best chance for a cure.
Colitis
Colitis is a term used to describe inflammation in the bowel, and there are different types of colitis. These include infectious colitis, ulcerative colitis, Crohn’s disease, ischemic colitis, and radiation colitis. Symptoms of colitis include diarrhea, rectal bleeding, abdominal cramps, and a frequent and immediate need to empty the bowels. Diagnosis is made through colonoscopy and biopsy, and treatment will depend on the type of colitis diagnosed.
Prevention
Can gastrointestinal diseases be prevented?
Maintaining a healthy lifestyle, practicing good bowel habits and undergoing cancer screening are recommended to prevent or reduce the occurrence of colon and rectum diseases.
For average-risk individuals, a colonoscopy should be done at the age of 45, and those with a family history of colorectal cancer or polyps should undergo screening at a younger age, typically 10 years earlier than the affected family member’s age. Early consultation with a healthcare provider is necessary if any symptoms of colorectal cancer are noticed, such as changes in bowel habits, blood in stool, abdominal or gas pains, thin stools, the feeling of incomplete bowel movement, unexplained weight loss, fatigue, or anemia.
Other types of gastrointestinal diseases
There are numerous gastrointestinal diseases, and although a few were mentioned earlier, there are many others that were not discussed. These diseases can be functional or structural, and examples include peptic ulcer disease, gastritis, gastroenteritis, celiac disease, Crohn’s disease, gallstones, fecal incontinence, lactose intolerance, Hirschsprung disease, abdominal adhesions, Barrett’s esophagus, appendicitis, indigestion (dyspepsia), intestinal pseudo-obstruction, pancreatitis, short bowel syndrome, Whipple’s disease, Zollinger-Ellison syndrome, malabsorption syndromes, and hepatitis.
