Digestive Disorders: Treatment, Procedure, Cost and Side Effects

The digestive process is complex and takes place in the digestive tract and involves a number of organs. It begins with the esophagus that helps to carry food to the stomach. A number of different organs like the pancreas and the gall bladder produce digestive juices that help to break down the food for digestion.

Digestion is the breakdown and transformation of food into micronutrients that pass through the intestinal walls to the bloodstream from where it circulated throughout the body. Distress in the digestive system causes great discomfort to the body and mind.

Digestive disorders are any distress or discomfort in the digestive system. Once occurred in one part of the digestive system, they may malfunction in the other parts of the digestive system. The conditions range from minor to serious. For example perianal abscesses, colitis, anal fissures, constipation, colon polyps, hemorrhoids, and cancer.

• Functional Digestive Disorders:

  These are also called Dyspepsia, functional digestive disorders are usually the result of the malfunctioning of the digestive system. This may cause loss of appetite, nausea, bloating, rashes, heartburn.

  The cause of dyspepsia could be a large meal that is not easy to digest, eating without chewing, alcohol abuse, stress, lack of exercise, resisting bowel movement.

  Functional Digestive disorders are of two types:

  • Irritable Bowel Syndrome: It is intestinal pain that doesn’t go away with bowel movement. It involves constipation, diarrhea, and bloating. It is caused by the rate at which food processes in the colon and the type of food.
  • Functional Dyspepsia: it is recurring indigestion that has no underlying cause. It is also called non-ulcer stomach pain or non-ulcer dyspepsia. The symptoms are similar to ulcers i.e pain in the upper abdomen, bloating, belching, and nausea.
• Structural gastrointestinal disorders:

  This is the structural dysfunction of the bowel. In extreme cases, the bowel has to be removed surgically. It usually causes colon cancer, diverticular disease, inflammatory bowel disease.

Some of the common digestive system disorders include:

• Chronic Diarrhea: It is usually induced by the body’s incapability to digest food. Chronic diarrhea usually lasts 2-4 weeks, the cause of which could be infection and non-infection. Infectious diarrhea is usually caused by parasites, bacteria, viruses. Non-infectious diarrhea is caused by pancreatic or intestinal disorders, medications, certain foods, immunological disorders, and hereditary factors.
• Chronic Constipation: It is the difficulty of passing stool and infrequency in bowel movement. Occasional constipation is normal, however, some experience chronic constipation which can interfere with daily activities. It is generally caused by the slowed movement of stool through the digestive system and the inability to pass through the rectum. Other causes include anal fissure, bowel obstruction, colon cancer, rectal cancer.
• Gastroenteritis: The infection of bacteria and viruses, also called infectious diarrhea. Symptoms include diarrhea and vomiting, fever, stomach pain, headache. It is caused by contaminated water or unsanitary hands.
• Ulcers: It is also known as peptic ulcers and are usually caused by stress, bacteria, long-term use of non-steroidal medications, and diet. Symptoms are typically heartburn, painful and burning sensation in the stomach, intolerance to food rich in fat, and nausea, and vomiting.

Symptoms of digestive disorders are:

• Heartburn
• Nausea
• Constipation
• Diarrhea
• Swallowing problems
• Bleeding
• Vomiting
• Abdomen pain
• Bloating

The digestive disorders are usually caused by:

• Unhygienic food
• Stress
• Certain medications and their overuse
• Infections caused by bacteria, viruses, fungus, parasites
• Low fibrous diet
• Resisting bowel movement
• Physical inactivity
• Consuming large amounts of dairy products
• Frequent changes in body schedule

Some patients need to undergo a more extensive diagnostic evaluation. This may include lab tests, imaging tests, and/or endoscopic procedures. These tests may include any, or a combination of, the following:

• Lab test:
  • Stool culture. A stool culture checks for the presence of abnormal bacteria in the digestive tract that may cause diarrhea and other problems. A small sample of stool is collected and sent to a lab by your healthcare provider's office. In 2 or 3 days, the test will show whether abnormal bacteria are present.
  • Fecal occult blood test. A fecal occult blood test checks for hidden (occult) blood in the stool. It involves placing a very small amount of stool on a special card. The stool is then tested in the healthcare provider's office or sent to a lab.
• Imaging test:
  • Colorectal transit study: This test shows how well food moves through the colon. The patient swallows capsules containing small markers which are visible on X-ray. The patient follows a high-fiber diet during the course of the test.

    The movement of the markers through the colon is monitored with abdominal X-rays taken several times 3 to 7 days after the capsule is swallowed.

  • Computed tomography scan (CT or CAT scan): This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
  • Defecography: Defecography is an X-ray of the anorectal area that evaluates completeness of stool elimination, identifies anorectal abnormalities, and evaluates rectal muscle contractions and relaxation. During the exam, the patient's rectum is filled with a soft paste that is the same consistency as stool.

    The patient then sits on a toilet positioned inside an X-ray machine and squeezes and relaxes the anus to expel the solution. The radiologist studies the X-rays to determine if anorectal problems happened while the patient was emptying the paste from the rectum.

  • Ultrasound: Ultrasound is a diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs.

    Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.

Common digestive problems such as constipation, diarrhea, heartburn, bloating can be treated with some lifestyle changes. Some of the treatments that will help with digestive disorders are:

• Heartburn:

  Heartburn is caused due to indigestion and can make you feel really uncomfortable. You can avoid fatty and oily foods and aerated drinks if you are suffering from this condition. You can take lactase supplements, alpha-galactosidase, simethicone and probiotics.

• Peptic ulcers:

  Peptic ulcers cause stomach pain and can cause internal bleeding and may also cause a hole to be formed in the stomach wall.

  Normally, 10-14 days of antibiotic treatment together with acid reduction therapy works to alleviate this condition.

  Gallstones are made of cholesterol and bile salts and may require treatment in some cases. Removal of gallbladder can be done through laparoscopy and also via mouth or vagina without any external incision.

• Other disorders include constipation, diarrhea, hemorrhoids and others.

However for acute digestive disorders, the key treatments are gastric electrical stimulation and islet auto-transplantation for chronic pancreatitis.

• Gastric electric stimulation or GES:

  GES is performed in patients who suffer from gastroparesis due to diabetes or any other cause. This method uses a device implanted in the abdomen to send mini electrical impulses to the smooth muscles and nerves of the lower stomach.

  Gastroparesis is the condition where the nerves and muscles of the stomach are affected and this delays the emptying of food from the stomach to the small intestine. It can happen in people with diabetes or nervous disorder and sometimes, the cause is not detected.

• Islet auto-transplantation:

  Chronic pancreatitis requires auto-islet transplantation after a total pancreatectomy which is the removal of the entire pancreas. Chronic pancreatitis is a serious condition which causes inflammation of the pancreas that worsens over time and leads to permanent damage.

  It gradually impairs a patient’s ability to digest food and make pancreatic hormones. During islet autotransplant, the patient’s own cells are kept separate from the pancreas. They are put back when the patient starts receiving insulin.

Food that is gentle to the digestive system are:

• Ginger: it is excellent to reduce bloating and other digestive problems.
• Unsaturated fats: These help the body easily absorb vitamins, and conjugates with fibers for an easier bowel movement. Olive oil is recognized as unsaturated fats in plant oils.
• Vegetables: Vegetables are rich in fibers, which is important for digestion. Vegetable skin is richer in fibers, it is best to consume it whole like potatoes, carrots, legumes, and beans.
• Fruits: These are also a rich source of fibers, along with that they are rich in vitamins and minerals such as Vitamin C and potassium.
• Whole grains: Whole grain foods have high fiber content. The body breaks it down slowly which helps in controlling blood sugar levels. Whole grain food includes brown rice and quinoa.

While the above lists will help to keep the digestive system healthy, there is also some food that should be avoided for the sake of intestinal health. For example high saturated fats like cheese, white and milk chocolate, carbonated beverages, alcohol, refined carbohydrates.

Heartburn patients are generally prescribed H2 blockers which reduces the amount of acid that a stomach intakes. However, there are a number of side-effects of consuming H2 blockers: they can cause constipation, diarrhea, headache or nausea and vomiting. Islet autotransplantation involves the complete removal of the pancreas.

This exposes the patient to the risk of developing permanent diabetes. A patient will then have to take insulin shots or to use an insulin pump for the rest of their lives. Gastric electrical stimulation may cause pain at the implant site, infection, stomach wall perforation, lead obstruction of intestines, lead/device problems and lead penetration, irritation, inflammation, uncomfortable stimulation, tissue damage and others.

Gastric electric stimulation helps to reduce symptoms of chronic intractable vomiting and nausea related to gastroparesis. But it is not a complete cure in itself for gastroparesis.

It helps to reduce symptoms but patients generally need to take medication and follow a special diet to control the symptoms even after undergoing this surgery.

Islet autotransplantation may induce permanent diabetes in some people. Those people will have to take insulin shots or will have to use an insulin pump for the rest of their lives.

Most patients are discharged within 1-5 days of gastric electrical stimulation procedure. However, as this surgery is not an end in itself, a person will have to go to the doctor for regular check-ups.

Other digestive disorders like gas, heartburn, constipation and diarrhea may be treated within a time span of a few hours to a few days with the help of proper medication and a proper diet.

The islet autotransplantation procedure is complex and a person may require quite some time to recover.

Common digestive disorders like heartburns, gas, constipation or diarrhea can be effectively treated with the help of some medicines which do not cost much. Medicines for indigestion and heart burn are available within a price range of Rs 50-100.

However, islet transplantation for treating acute pancreatitis is expensive and may cost about 10,00,000 – 12,00,000 rupees. Gastric electric stimulation may cost around 6 lakh rupees in India.

Common gastric disorders like gas, constipation, diarrhea and heartburms are more often than not the result of lifestyle irregularities. Thus there is seldom a permanent solution to such problems.

Gastric electric stimulation is not an end in itself and patients will require medication and routine check-ups to keep the symptoms of gastroparesis at bay.

Islet transplantation procedure may cause to reduce chronic pancreatitis but it tends to have a lot of side-effects.

There are simple lifestyle choices that can have a huge positive impact on your body such as:

• Eat frequent small meals: This rule will not only help with the weight loss but it will also keep the digestive system in check. Eating a big meal once or just eating big meals in general overloads the digestive system which can cause heartburn, acidity, gas, nausea, vomiting.
• Consuming more fibers: Eating enough fiber helps prevent digestion problems. It’s naturally available in fruits, vegetables, beans, legumes, and whole grains.
• Water: Water purges the body of wastes. And aids in the smooth flow of stool that also assists in the prevention of constipation.
• Avoiding dairy, greasy and spicy food that can exacerbate the digestive system

There is no such alternative to islet autotransplantation as these method is adopted only when all other options fail. Chronic gastric stimulation is used to treat gastroparesis. Alternative methods to treat gastroparesis may include changes in the diet of the patient and medications.

Such medications like metoclopramide and erythromycin can be used to stimulate the stomach muscles. Other drugs that help to contain nausea and vomiting may include prochlor perazine and diphenhydramine.

• Lactase supplements: If dairy is causing your problems, taking these tablets or drops just before you eat will help you digest lactose (the main sugar in dairy foods) and reduce gas.
• Alpha-galactosidase: This digestive aid comes as liquid or tablets. You take it before you eat to help your body break down the complex carbs or sugars that cause gas, such as those found in beans, broccoli, and cabbage.

  Caution: People with the genetic condition galactosemia should avoid it. It may also interfere with some diabetes drugs like acarbose (Precose) or miglitol (Glyset).

• Probiotics: These supplements contain ""friendly"" bacteria that can help digestion. In addition to tablets and powders you sprinkle on your food, foods like yogurt, kefir, and sauerkraut contain probiotics.

The ingredients that help prevent and treat home remedies present at home are:

• Turmeric: It helps in treating normal digestive problems. It is because of Curcumin, a component of turmeric that gives it yellow color and aids in digestion and liver function. Turmeric also has anti-inflammatory properties that help in the prevention of ulcers.
• Probiotics: There is a natural inoculum existing in the body that is essential for digestion. Probiotics are also naturally present in yogurt and are important for the treatment of diarrhea.
• Mint: It helps prevent vomiting, nausea, muscle spasms, intestinal pain caused by digestive distress.
• Heating pad and warm bath: Heat relaxes the muscles, ease pain, and helps in indigestion.
• Taking the BRAT diet: A diet that is rich in starch that helps make the stool firm by binding the food together. It basically includes banana, rice, applesauce, and toast
• Avoid alcohol consumption: It is obviously smart to avoid alcohol consumption and smoking so as to not further the digestive problem.
• Lemon water: Having lemon water with a pinch of baking soda has been found to relieve digestive strains. It is because the carbonic acid present in the liquid is known to reduce gas and indigestion.