DOCSLIB.ORG

Gastrointestinal Disturbances

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Gastrointestinal Disturbances Gastrointestinal disturbances This Infosheet explains what gastrointestinal disturbances are, what causes nausea, vomiting, constipation and diarrhoea in myeloma patients, how they are treated and some tips for self-management. What are gastrointestinal a few days) or chronic (persisting for disturbances? longer periods of time, usually more Gastrointestinal (GI) disturbances than two weeks). are issues involving your stomach Severe or long-term vomiting, and intestines. This can include constipation or diarrhoea can lead nausea, vomiting, constipation and to more serious conditions, so any diarrhoea. These are very common vomiting or change in your normal side effects in myeloma patients, bowel habits should be reported and can upset normal day-to-day life to your doctor or nurse. If you feel and be distressing to live with. awkward or embarrassed discussing GI disturbances can be acute your bowel habits, try to remember (lasting for a short time only, such as that your doctor and nurse will be Myeloma Symptoms and Infosheet complications Series Infoline: 0800 980 3332 1 used to talking about it and that If you find blood (either bright red they are there to help prevent and or dark and like coffee grounds) in manage any side effects of myeloma your vomit you should seek medical and its treatment. advice immediately. What are the causes of nausea and Nausea and vomiting in myeloma patients? vomiting Nausea and vomiting are very common in myeloma patients. They What are nausea and vomiting? can be due to a number of reasons. Nausea is a feeling of queasiness, Myeloma treatment and unease and discomfort in the upper supportive treatment stomach, with an urge to throw up or be sick (vomit). Treatment for myeloma is the most common cause of nausea You may not necessarily vomit if you and vomiting in myeloma patients. have nausea. They are common side effects of chemotherapy drugs, such as What are the symptoms of nausea cyclophosphamide and melphalan, and vomiting? and other anti-myeloma drugs, such The symptoms of nausea and as bortezomib. vomiting include: Some supportive treatments can Feeling like you need to vomit or also cause nausea and vomiting. actually vomiting For example, some people can feel Queasiness sick during or after radiotherapy. Antibiotics and some painkillers can Dizziness cause nausea and vomiting too. Excessive sweating and If you have previously been affected clamminess by nausea and vomiting during Dry mouth treatment, you may anticipate Severe or persistent vomiting can that you will experience the same lead to: symptoms again. This can induce a type of nausea called anticipatory Dehydration nausea. Stomach pain Damage to the throat 2 www.myeloma.org.uk Infection Treatment for other illnesses or Certain bacterial and viral infections conditions may also cause nausea cause nausea and vomiting. These and vomiting. You can check infections are often contagious, so whether any other treatment you if you have been around others who are having can cause nausea and have had stomach bugs it is not vomiting by consulting the patient uncommon to pick up an infection information leaflet (PIL) included too, especially because myeloma in the drug pack. You should make patients have a higher risk of your doctor or nurse aware of any developing infections. other treatments you are taking for other illnesses or conditions. Other symptoms of an infection include diarrhoea, abdominal How are nausea and vomiting cramps and pain, a high temperature treated? and loss of appetite. Anti-emetics For more information see the Infection and Nausea and vomiting are usually myeloma Infosheet from Myeloma UK treated with anti-emetics, for example metoclopramide, Stress, anxiety and nervousness granisetron and ondansetron. They Strong emotions, in particular stress, will be prescribed along with your anxiety and nervousness, can make myeloma treatment to prevent or you feel sick or vomit. minimise these side effects. You should take your anti-emetic For more information see the Infopack for medications regularly as prescribed. living well with myeloma from Myeloma UK Do not wait until you feel sick, as the drugs won’t be as effective this way. Pain If you find the anti-emetics you have Severe pain can cause nausea and/ been prescribed are not effective or vomiting. when taking them as prescribed, ask to try a different one as there are Other illnesses and conditions several types available. Other illnesses and conditions can Other treatments be responsible for causing nausea and vomiting, for example, diabetes If your nausea and/or vomiting or travel sickness. are not directly caused by your myeloma treatment, you may be Infoline: 0800 980 3332 3 given treatments other than anti- sick, try putting light perfume emetics to help. This could include onto a handkerchief that you can painkillers, antibiotics or relaxation use to help mask the smell aids like complementary therapies. Certain scents may help, for example lavender. Speak to a Tips for self-management complementary therapist who It is important to keep drinking should be able to recommend as vomiting can dehydrate you. some aromatherapy scents to Allow your stomach to rest after help with your nausea vomiting then sip drinks such as Try to take your mind off how still or sparkling water or fizzy you feel – talk to people, watch a drinks film or listen to soothing music to Ginger may help settle your distract yourself stomach. Try ginger tea, non- Relaxing breathing exercises or alcoholic ginger beer/ale or ginger lying down in a darkened room biscuits may help to reduce feelings of Mint can also help with nausea. nausea Try mint tea, mints or chewing Fresh air may help – try sitting gum outside or near an open window Eat little and often. Snacking on Calm your anxiety or stress with plain, cold or room-temperature relaxation techniques food may be more palatable than hot meals. If you can’t face eating If vomiting is severe, fluid can be solid food, high calorie drinks may replaced by special preparations be more tolerable available through your GP or from a chemist Avoid spicy, fatty or acidic foods Avoid your favourite foods to prevent you associating them with nausea and vomiting Avoid strong smells if they exacerbate your nausea, for example avoid cooking or keep the window open during food preparation If hospital smells make you feel 4 www.myeloma.org.uk A feeling that you have not Constipation completely emptied your bowels What is constipation? If constipation is not treated it can cause more severe symptoms, Constipation is defined as having including: difficulty emptying your bowels. When you are constipated, bowel Swollen, painful stomach, often movements occur less often than accompanied by stomach cramps they would normally and they may Loss of appetite be dry, hard and painful. Nausea It is important to know what your Vomiting normal bowel pattern is because constipation is relative to your usual Excessively runny diarrhoea – this habits and this varies between may occur if you bowel is blocked patients. Some people have two with hard faeces or three bowel movements a day Headache and thirst whereas for others three or four movements per week might be What are the causes of more normal. constipation in myeloma patients? It is worth remembering that in the There are several reason why majority of people, the digestive you may have constipation as a system slows down with age, so as myeloma patient. It is important you get older, you may need to move to know what has caused your your bowels less often. constipation, as this will help both you and your doctor or nurse treat it What are the symptoms of effectively. constipation? Myeloma treatment and The symptoms of constipation supportive treatment include: Some treatments for myeloma can Fewer than three bowel cause constipation as they slow movements a week the moving of faeces through the Pain or discomfort when opening bowel. This causes more water to be your bowels removed from the faeces, resulting Passing small hard stools in dry, hard stools. Feeling bloated and tired Treatments and supportive Infoline: 0800 980 3332 5 treatments that may cause Dehydration constipation include: Your body needs a lot of fluid to help Thalidomide, lenalidomide move food through your intestines (Revlimid®) and bortezomib and also to keep your faeces soft. (Velcade®) If you are not drinking enough fluid Anti-sickness drugs (e.g. and you become dehydrated, your granisetron, ondansetron) faeces will become hard and you may have difficulty opening your Some chemotherapy drugs (e.g. bowels. vincristine) Most strong painkillers (e.g. Lack of exercise/poor mobility codeine, tramadol, oramorph®) If you are unable to exercise or it is hard for you to get around then Hypercalcaemia you may lose muscle tone in your Myeloma bone disease can increase stomach area and in your intestine. the amount of calcium in your blood As these muscles are needed which can cause hypercalcaemia. to help move food through the Symptoms of hypercalcaemia digestive tract, the decrease in include constipation and muscle tone can cause constipation. dehydration, as well as increased Prolonged sitting can also lead thirst and confusion. to constipation, as the effects of gravity can help to move food For more information see the Myeloma bone through your intestines. disease and bisphosphonates Infoguide from Myeloma UK Stress, anxiety and depression Periods of prolonged stress, Poor diet/loss of appetite anxiety or depression may cause If your diet is lacking in essential constipation. nutrients, particularly fibre, then you are more likely to become For more information see the Infopack for constipated. Fibre helps keep your living well with myeloma from Myeloma UK bowels healthy and active. It also helps keep your faeces soft and Change in routine increases the speed with which your food is digested.
Load more

Recommended publications
  • Acid Reflux and Oesophagitis Gastro-Oesophageal Reflux Disease (GORD)
    Acid reflux and oesophagitis Gastro-oesophageal reflux disease (GORD) Acid reflux is when acid from the stomach leaks up into the gullet (oesophagus). This may cause heartburn and other symptoms. A medicine which prevents your stomach from making acid is a common treatment and usually works well. Some people take short courses of treatment when symptoms flare up. Some people need long term daily treatment to keep symptoms away. Understanding the oesophagus and stomach When we eat, food passes down the oesophagus (gullet) into the stomach. Cells in the lining of the stomach make acid and other chemicals that help to digest food. Stomach cells also make mucus that protects them from damage from the acid. The cells lining the oesophagus are different and have little protection from acid. There is a circular bank of muscle (a ‘sphincter’) at the junction between the oesophagus and stomach. This relaxes to allow food down but then normally tightens up and stops food and acid leaking back up (refluxing) into the oesophagus. In effect the sphincter acts like a valve. What are reflux and oesophagitis? Acid reflux is when some acid leaks up (refluxes) into the oesophagus. Oesophagitis means inflammation of the lining of the oesophagus. Most cases of oesophagatis are due to reflux of stomach acid which irritates the inside lining of the oesophagus. The lining of the oesophagus can cope with a certain amount of acid. However, it is more sensitive to acid in some people. Therefore, some people develop symptoms Source: Endoscopy Reference No: 6556-1 Issue date: 11/9/19 Review date: 11/9/22 Page 1 of 6 with only a small amount of reflux.
    [Show full text]
  • Medicine Hx- Gastrointestinal System History of “Heartburn”
    Medicine Hx- Gastrointestinal System History of “Heartburn” A. Overview: GORD is common, and is said to exist when reflux of stomach contents (acid ± bile) causes troublesome symptoms (≥2 heartburn episodes/wk) and/or complications. If reflux is prolonged, it may cause oesophagitis, benign oesophageal stricture or Barrett’s oesophagus. Causes: lower oesophageal sphincter hypotension, hiatus hernia, loss of oesophageal peristaltic function, abdominal obesity, gastric acid hypersecretion, slow gastric emptying, overeating, smoking, alcohol, pregnancy, surgery in achalasia, drugs (tricyclics, anticholinergics, nitrates), systemic sclerosis. Symptoms: 1. Heartburn (burning, retrosternal discomfort after meals, lying, stooping or straining, relieved by antacids) 2. Belching; acid brash (acid or bile regurgitation) 3. Waterbrash (Increased salivation: “My mouth fills with saliva”) 4. Odynophagia (painful swallowing, eg from oesophagitis or ulceration). 5. Extra-oesophageal: Nocturnal asthma, chronic cough, laryngitis (hoarseness, throat clearing), sinusitis. (From Oxford Handbook Of Clinical Medicine p244) Don’t confuse between acid regurgitation and waterbrash: -Acid regurgitation: the patient experiences a sour or bitter tasting fluid coming up into the mouth. This symptom strongly suggests that the reflux is occurring. -Waterbrash: excessive secretion of saliva into the mouth may occur, uncommonly, in patients with peptic ulcer disease or oesophagitis. The patient experience tasteless or salty fluid his mouth. B. Differential diagnosis:
    [Show full text]
  • General Signs and Symptoms of Abdominal Diseases
    General signs and symptoms of abdominal diseases Dr. Förhécz Zsolt Semmelweis University 3rd Department of Internal Medicine Faculty of Medicine, 3rd Year 2018/2019 1st Semester • For descriptive purposes, the abdomen is divided by imaginary lines crossing at the umbilicus, forming the right upper, right lower, left upper, and left lower quadrants. • Another system divides the abdomen into nine sections. Terms for three of them are commonly used: epigastric, umbilical, and hypogastric, or suprapubic Common or Concerning Symptoms • Indigestion or anorexia • Nausea, vomiting, or hematemesis • Abdominal pain • Dysphagia and/or odynophagia • Change in bowel function • Constipation or diarrhea • Jaundice “How is your appetite?” • Anorexia, nausea, vomiting in many gastrointestinal disorders; and – also in pregnancy, – diabetic ketoacidosis, – adrenal insufficiency, – hypercalcemia, – uremia, – liver disease, – emotional states, – adverse drug reactions – Induced but without nausea in anorexia/ bulimia. • Anorexia is a loss or lack of appetite. • Some patients may not actually vomit but raise esophageal or gastric contents in the absence of nausea or retching, called regurgitation. – in esophageal narrowing from stricture or cancer; also with incompetent gastroesophageal sphincter • Ask about any vomitus or regurgitated material and inspect it yourself if possible!!!! – What color is it? – What does the vomitus smell like? – How much has there been? – Ask specifically if it contains any blood and try to determine how much? • Fecal odor – in small bowel obstruction – or gastrocolic fistula • Gastric juice is clear or mucoid. Small amounts of yellowish or greenish bile are common and have no special significance. • Brownish or blackish vomitus with a “coffee- grounds” appearance suggests blood altered by gastric acid.
    [Show full text]
  • Diagnostic Approach to Chronic Constipation in Adults NAMIRAH JAMSHED, MD; ZONE-EN LEE, MD; and KEVIN W
    Diagnostic Approach to Chronic Constipation in Adults NAMIRAH JAMSHED, MD; ZONE-EN LEE, MD; and KEVIN W. OLDEN, MD Washington Hospital Center, Washington, District of Columbia Constipation is traditionally defined as three or fewer bowel movements per week. Risk factors for constipation include female sex, older age, inactivity, low caloric intake, low-fiber diet, low income, low educational level, and taking a large number of medications. Chronic constipa- tion is classified as functional (primary) or secondary. Functional constipation can be divided into normal transit, slow transit, or outlet constipation. Possible causes of secondary chronic constipation include medication use, as well as medical conditions, such as hypothyroidism or irritable bowel syndrome. Frail older patients may present with nonspecific symptoms of constipation, such as delirium, anorexia, and functional decline. The evaluation of constipa- tion includes a history and physical examination to rule out alarm signs and symptoms. These include evidence of bleeding, unintended weight loss, iron deficiency anemia, acute onset constipation in older patients, and rectal prolapse. Patients with one or more alarm signs or symptoms require prompt evaluation. Referral to a subspecialist for additional evaluation and diagnostic testing may be warranted. (Am Fam Physician. 2011;84(3):299-306. Copyright © 2011 American Academy of Family Physicians.) ▲ Patient information: onstipation is one of the most of 1,028 young adults, 52 percent defined A patient education common chronic gastrointes- constipation as straining, 44 percent as hard handout on constipation is 1,2 available at http://family tinal disorders in adults. In a stools, 32 percent as infrequent stools, and doctor.org/037.xml.
    [Show full text]
  • Abdominal Pain - Gastroesophageal Reflux Disease
    ACS/ASE Medical Student Core Curriculum Abdominal Pain - Gastroesophageal Reflux Disease ABDOMINAL PAIN - GASTROESOPHAGEAL REFLUX DISEASE Epidemiology and Pathophysiology Gastroesophageal reflux disease (GERD) is one of the most commonly encountered benign foregut disorders. Approximately 20-40% of adults in the United States experience chronic GERD symptoms, and these rates are rising rapidly. GERD is the most common gastrointestinal-related disorder that is managed in outpatient primary care clinics. GERD is defined as a condition which develops when stomach contents reflux into the esophagus causing bothersome symptoms and/or complications. Mechanical failure of the antireflux mechanism is considered the cause of GERD. Mechanical failure can be secondary to functional defects of the lower esophageal sphincter or anatomic defects that result from a hiatal or paraesophageal hernia. These defects can include widening of the diaphragmatic hiatus, disturbance of the angle of His, loss of the gastroesophageal flap valve, displacement of lower esophageal sphincter into the chest, and/or failure of the phrenoesophageal membrane. Symptoms, however, can be accentuated by a variety of factors including dietary habits, eating behaviors, obesity, pregnancy, medications, delayed gastric emptying, altered esophageal mucosal resistance, and/or impaired esophageal clearance. Signs and Symptoms Typical GERD symptoms include heartburn, regurgitation, dysphagia, excessive eructation, and epigastric pain. Patients can also present with extra-esophageal symptoms including cough, hoarse voice, sore throat, and/or globus. GERD can present with a wide spectrum of disease severity ranging from mild, intermittent symptoms to severe, daily symptoms with associated esophageal and/or airway damage. For example, severe GERD can contribute to shortness of breath, worsening asthma, and/or recurrent aspiration pneumonia.
    [Show full text]
  • Acute Abdomen
    Acute abdomen: Shaking down the Acute abdominal pain can be difficult to diagnose, requiring astute assessment skills and knowledge of abdominal anatomy 2.3 ANCC to discover its cause. We show you how to quickly and accurately CONTACT HOURS uncover the clues so your patient can get the help he needs. By Amy Wisniewski, BSN, RN, CCM Lehigh Valley Home Care • Allentown, Pa. The author has disclosed that she has no significant relationships with or financial interest in any commercial companies that pertain to this educational activity. NIE0110_124_CEAbdomen.qxd:Deepak 26/11/09 9:38 AM Page 43 suspects Determining the cause of acute abdominal rapidly, indicating a life-threatening process, pain is often complex due to the many or- so fast and accurate assessment is essential. gans in the abdomen and the fact that pain In this article, I’ll describe how to assess a may be nonspecific. Acute abdomen is a patient with acute abdominal pain and inter- general diagnosis, typically referring to se- vene appropriately. vere abdominal pain that occurs suddenly over a short period (usually no longer than What a pain! 7 days) and often requires surgical interven- Acute abdominal pain is one of the top tion. Symptoms may be severe and progress three symptoms of patients presenting in www.NursingMadeIncrediblyEasy.com January/February 2010 Nursing made Incredibly Easy! 43 NIE0110_124_CEAbdomen.qxd:Deepak 26/11/09 9:38 AM Page 44 the ED. Reasons for acute abdominal pain Visceral pain can be divided into three Your patient’s fall into six broad categories: subtypes: age may give • inflammatory—may be a bacterial cause, • tension pain.
    [Show full text]
  • Student Health Center NURSE Abdominal and Urinary Problems Upper Abdomen • Heartburn • Stomach Ulcers • Stomach Ache
    Student Health Center NURSE Abdominal and Urinary Problems Upper Abdomen • Heartburn • Stomach ulcers • Stomach ache • Viral stomach illness Lower Abdomen • Appendicitis • Constipation • Menstrual cramps • Urinary tract infection • Viral stomach illness • Sexual transmitted infection (STI) • Vaginal or uterine infections • Ectopic pregnancy • Testicular torsion If your need is urgent, and the Student Health Center is closed, go to the nearest hospital emergency department or call 911 for an ambulance. Seek Immediate Medical Care through Emergency Room If: • The pain becomes worse, sudden, sharp, severe, or changes location • You are pregnant or have a risk of pregnancy • You have an increase in fever or develop shaking chills • You vomit many times or your vomiting persists • You see blood in your urine, vomit or bowel movements • You see coffee grounds-appearing vomit; or maroon or tarry-black bowel movements • You move your bowels many times; or your bowel movements stop (become blocked), or you cannot pass gas, especially if you are also vomiting • Your skin or the whites of your eyes turn yellow • Your abdomen becomes swollen or seems larger • Your abdomen becomes stiff, hard and tender to touch. • The pain does not improve in 1-2 days • You develop any dizziness or bleeding • Have pain in, or between, your shoulder blades with/without nausea • You develop chest, neck or shoulder pain • You have difficulty breathing • Symptoms do not improve in 2 days after starting antibiotic treatment • Fever develops or persists after 2 days of starting antibiotic treatment • You have abdominal pain with vaginal bleeding • You have scrotal pain Self-Care Treatment Heartburn • Avoid ibuprofen, naproxen and aspirin types of pain relievers which can irritate the lining of the stomach.
    [Show full text]
  • DEXCEL HEARTBURN RELIEF 10Mg TABLETS
    PACKAGE LEAFLET: INFORMATION FOR THE USER Acid Reflux 20mg Gastro-Resistant Tablets (Omeprazole) Referred to as Acid Reflux Tablets throughout this leaflet Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. This medicine is available without prescription. However, you still need to take Acid Reflux Tablets carefully to get the best results from them. Always take this medicine exactly as described in this leaflet or as your doctor or pharmacist has told you. - Keep this leaflet. You may need to read it again. - Ask your pharmacist or doctor if you need more information or advice. - If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. (See section 4). - You must talk to a doctor if you do not feel better or if you feel worse after 14 days. - If any of the side effects gets serious, or if you notice any side effect not listed in this leaflet, please tell your doctor or pharmacist. What is in this leaflet: 1. What Acid Reflux Tablets are and what they are used for 2. What you need to know before you take Acid Reflux Tablets 3. How to take Acid Reflux Tablets 4. Possible side effects 5. How to store Acid Reflux Tablets 6. Contents of the pack and other information Further helpful information 1. WHAT ACID REFLUX TABLETS ARE AND WHAT THEY ARE USED FOR This medicine contains the active substance omeprazole. It belongs to a group of medicines called ‘proton pump inhibitors’.
    [Show full text]
  • Does Your Patient Have Bile Acid Malabsorption?
    NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #198 NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #198 Carol Rees Parrish, MS, RDN, Series Editor Does Your Patient Have Bile Acid Malabsorption? John K. DiBaise Bile acid malabsorption is a common but underrecognized cause of chronic watery diarrhea, resulting in an incorrect diagnosis in many patients and interfering and delaying proper treatment. In this review, the synthesis, enterohepatic circulation, and function of bile acids are briefly reviewed followed by a discussion of bile acid malabsorption. Diagnostic and treatment options are also provided. INTRODUCTION n 1967, diarrhea caused by bile acids was We will first describe bile acid synthesis and first recognized and described as cholerhetic enterohepatic circulation, followed by a discussion (‘promoting bile secretion by the liver’) of disorders causing bile acid malabsorption I 1 enteropathy. Despite more than 50 years since (BAM) including their diagnosis and treatment. the initial report, bile acid diarrhea remains an underrecognized and underappreciated cause of Bile Acid Synthesis chronic diarrhea. One report found that only 6% Bile acids are produced in the liver as end products of of British gastroenterologists investigate for bile cholesterol metabolism. Bile acid synthesis occurs acid malabsorption (BAM) as part of the first-line by two pathways: the classical (neutral) pathway testing in patients with chronic diarrhea, while 61% via microsomal cholesterol 7α-hydroxylase consider the diagnosis only in selected patients (CYP7A1), or the alternative (acidic) pathway via or not at all.2 As a consequence, many patients mitochondrial sterol 27-hydroxylase (CYP27A1). are diagnosed with other causes of diarrhea or The classical pathway, which is responsible for are considered to have irritable bowel syndrome 90-95% of bile acid synthesis in humans, begins (IBS) or functional diarrhea by exclusion, thereby with 7α-hydroxylation of cholesterol catalyzed interfering with and delaying proper treatment.
    [Show full text]
  • Today's Topic: Bloating
    Issue 1; August 2017 Dr. Rajiv Sharma attended medical school at Daya- nand Medical College, Punjab, India. He received his Undernourished, intelligence Internal Medicine training from Loma Linda Univer- sity, Loma Linda, California and received his Gastro- becomes like the bloated belly enterology Fellowship training from University of Rochester, Rochester, New York. Dr. Sharma trained of a starving child: swollen, under the mentorship of Dr. Richard G. Farmer, who is world renowned for his work on Inflammatory Bowel Disease. filled with nothing the body Rajiv Sharma, MD Dr. Sharma’s special interests include GERD, NERD, can use.” Inflammatory Bowel Disease (Crohn’s & Ulcerative Colitis), IBS, Acute and Chronic Pancreatitis, Gastro- intestinal Malignancies and Familial Cancer Syn- - Andrea Dworkin dromes. In an effort to share his extensive knowledge with the public, Dr. Sharma re- leased his first book, Pursuit of Gut Happiness: A Guide for Using Probiotics to Inside this issue Achieve Optimal Health, in 2014. In Dr. Sharma’s free time, he enjoys medical writing, watching movies, exercis- Differential Diagnosis 2 ing and spending time with his family. He believes in “whole person care” and the effect of mind, body and spirit on “wellness”. He has a special interest in nu- trition, exercise and healthy eating. He prides himself on being a “fact doctor” as Signs of a More Serious 2 he backs his opinions and works with solid scientific research while aiming to deliver a simple and clear message. Problem Lab Workup 2 Non-Pathological Bloating 2 Today’s Topic: Bloating Bloating may seem an odd topic to choose for our first newsletter.
    [Show full text]
  • Travelers' Diarrhea
    Travelers’ Diarrhea What is it and who gets it? Travelers’ diarrhea (TD) is the most common illness affecting travelers. Each year between 20%-50% of international travelers, an estimated 10 million persons, develop diarrhea. The onset of TD usually occurs within the first week of travel but may occur at any time while traveling and even after returning home. The primary source of infection is ingestion of fecally contaminated food or water. You can get TD whenever you travel from countries with a high level of hygiene to countries that have a low level of hygiene. Poor sanitation, the presence of stool in the environment, and the absence of safe restaurant practices lead to widespread risk of diarrhea from eating a wide variety of foods in restaurants, and elsewhere. Your destination is the most important determinant of risk. Developing countries in Latin America, Africa, the Middle East, and Asia are considered high risk. Most countries in Southern Europe and a few Caribbean islands are deemed intermediate risk. Low risk areas include the United States, Canada, Northern Europe, Australia, New Zealand, and several of the Caribbean islands. Anyone can get TD, but persons at particular high-risk include young adults , immunosuppressed persons, persons with inflammatory-bowel disease or diabetes, and persons taking H-2 blockers or antacids. Attack rates are similar for men and women. TD is caused by bacteria, protozoa or viruses that are ingested by eating contaminated food or beverages. For short-term travelers in most areas, bacteria are the cause of the majority of diarrhea episodes. What are common symptoms of travelers’ diarrhea? Most TD cases begin abruptly.
    [Show full text]
  • Symptomatic Approach to Gas, Belching and Bloating 21
    20 Osteopathic Family Physician (2019) 20 - 25 Osteopathic Family Physician | Volume 11, No. 2 | March/April, 2019 Gennaro, Larsen Symptomatic Approach to Gas, Belching and Bloating 21 Review ARTICLE to escape. This mechanism prevents the stomach from becoming IRRITABLE BOWEL SYNDROME (IBS) Symptomatic Approach to Gas, Belching and Bloating damaged by excessive dilation.2 IBS is abdominal pain or discomfort associated with altered with OMT Treatment Options Many patients with GERD report increased belching. Transient bowel habits. It is the most commonly diagnosed GI disorder lower esophageal sphincter (LES) relaxation is the major and accounts for about 30% of all GI referrals.7 Criteria for IBS is recurrent abdominal pain at least one day per week in the Carly Gennaro, DO1; Helaine Larsen, DO1 mechanism for both belching and GERD. Recent studies have shown that the number of belches is related to the number of last three months associated with at least two of the following: times someone swallows air. These studies have concluded that 1) association with defecation, 2) change in stool frequency, 1 Good Samaritan Hospital Medical Center, West Islip, NY patients with GERD swallow more air in response to heartburn and 3) change in stool form. Diagnosis should be made using these therefore belch more frequently.3 There is no specific treatment clinical criteria and limited testing. Common symptoms are for belching in GERD patients, so for now, physicians continue to abdominal pain, bloating, alternating diarrhea and constipation, treat GERD with proton pump inhibitors (PPIs) and histamine-2 and pain relief after defecation. Pain can be present anywhere receptor antagonists with the goal of suppressing heartburn and in the abdomen, but the lower abdomen is the most common KEYWORDS: ABSTRACT: Intestinal gas production is a normal physiologic progress.
    [Show full text]