DIGESTIVE SYSTEM MODULE FOR STUDENTS

PREPARED BY

PROF. FERNANDO P. FLORENDO

M.S. Human Movement Science (Exercise Science)
College of Human Kinetics, U.P. Diliman

Effects of Exercise on the Digestive System

Exercise has little effect or influence on the ultimate digestive task of the stomach. Exercise
closely associated with meal time does not seem detrimental as far as digestion is concerned.
Repetition of the exercise may result in a gradual decrease in the effect on the ease and
efficiency of athletic performance. Distention of the stomach by raising the pressure in the
abdominal cavity may interfere with the descent of the diaphragm in inspiration or inhalation,
thus diminishing the efficiency of the respiratory response to exercise. Light exercise such as
moderate walking does not divert any blood and therefore digestion and the rate of emptying of
the stomach are not affected. However, more strenuous exercise such as running may retard
digestion and emptying of the stomach.

Immediate Effects of Exercise

1. Mild exercise such as walking – generally without influence or effect on the stomach
contraction.
2. Severe and exhausting exercise – usually depresses the stomach activity and reduces
stomach secretions.
3. During violent exercise following a meal – an individual may have distress referable to
the abdomen that may culminate in nausea and vomiting.
4. In general, light or moderate exercise before or after a meal laves the secretion function
unchanged.
5. Very little effect on the pancreas and on the lining of the small and large intestines.
6. Eating too much before exercising causes sluggish feeling, upset stomach, cramping
and diarrhea since the muscles of the digestive system are competing with each other
for energy resources.

** Not eating before exercising can result can blood sugar levels to drop causing feeling
of weakness, faintness or tiring. It

- also affects mental alertness thus it slows reaction time.

Common Digestive Disorders

Many ailments or maladies can afflict the digestive system. Although it is remarkably resistant to
abuse, it is still vulnerable and can break down. Some ailments are relatively minor, such as
cancer sores in the mouth. Others are severe and life-threatening, such as cancers that can
target almost every part of the digestive system.

1. Appendicitis

An inflammation of the appendix. It is the most common abdominal emergency found in children
and young adults. Because of the appendix’s position at the bottom of the cecum, scientists
believe one of the main causes of appendicitis is an invasion of bacteria. When infected with
bacteria, the appendix may become swollen and filled with pus. It may then eventually rupture.
Symptoms of the condition include pain that begins above or around the navel. The pain which
may be severe or only achy, then moves into the right corner of the abdomen. In this position,
the pain often becomes more steady and severe. If left untreated, appendicitis is f atal.

Appendix - a small finger- like, 9cm tube organ in the lower right side of the abdomen

Symptoms:

a) loss of appetite
b) nausea
c) vomiting
d) constipation or diarrhea
e) inability to pass gas
f) a low-grade fever that follows other symptoms
g) abdominal swelling
h) the feeling that passing stool will relieve discomfort

Prevention/Treatment:

Appendectomy is the removal of the appendix which usually takes the patient to stay in the
hospital for about 2-3. It involves incision of the abdomen
 2. Heartburn (Gastro Esophageal Reflux Disease or GERD)

Heartburn is a burning sensation in the chest that can extend to the neck, throat, and face. It is
caused by a backflow of the stomach's acids through the lower esophageal sphincter into the
esophagus, leading to inflammation. More than one third of the population suffers from this
disorder, commonly known as acid reflux.

Normally, the lower esophageal sphincter is tightly closed and opens only to allow food to pass
from the esophagus into the stomach. However, many different factors may cause the sphincter
to open inappropriately or fail to close completely. Fatty or greasy foods, cigarettes, alcohol,
chocolate, caffeine, and certain medications can relax the sphincter, increasing reflux. A large
meal, obesity, and pregnancy increase pressures with the abdomen, pushing the contents of the
stomach into the esophagus.

Heartburn can be prevented by avoiding those foods, drugs, or conditions that cause the
disorder. Mild cases of heartburn can be treated with over-the-counter antacids, which decrease
the acidity in the stomach. Surgery to correct a defective or damaged sphincter may be
necessary in severe cases.
 3. Hepatitis

Hepatitis is an often fatal disease that causes inflammation of the liver. There are various types
of hepatitis, most of which are caused by a virus. The viral forms include hepatitis A, B, C, D, E,
and G. The assorted symptoms marking hepatitis include jaundice (yellowing of the skin),
nausea, vomiting, fever, weakness, loss of appetite, abdominal and joint pain, and cirrhosis
(scarring of the liver).

Alcoholic hepatitis is a noninfectious type of hepatitis. Alcohol, a poison if taken in more than
modest amounts, is detoxified in the liver. Too much alcohol causes the liver to become
inflamed. The liver cannot function properly and eventually turns to useless fat. If the poisoning
continues, cirrhosis develops.

Two viral forms of hepatitis are most common: A and B. Hepatitis A (commonly known as
infectious hepatitis) is spread through direct contact with contaminated feces, food, or water.
Once infected, an individual usually recovers within two months. Hepatitis B (commonly called
serum hepatitis) is much more severe. It is transmitted by sexual activity, blood transfusions,
and the use of shared syringes by drug uses. Hepatitis B may destroy the liver through cirrhosis
or it may lead to cancer of the liver.

Hepatitis C causes acute (rapidly developing) and chronic (long-term) disease. It is spread
mainly through blood transfusions. Medical researchers believe hepatitis C may be caused by
several viruses. As with hepatitis B, hepatitis C may lead to cirrhosis of the liver and eventually,
liver cancer. Vaccines have been developed for both hepatitis A and B, but no vaccine has yet
been developed to prevent hepatitis C.

Hepatitis Virus
 Hepatitis A is manifested here as icterus, or jaundice of the conjunctivae and facial skin

What are the symptoms of hepatitis?

Acute hepatitis

The symptoms of acute hepatitis vary considerably from person to person. Some patients have
no symptoms at all, and in most cases, children only show mild symptoms.

In the early stages:

a) tiredness, general malaise, slight fever

b) nausea, poor appetite, changes in taste perception
c) pressure or pain below the right ribs caused by an enlarged liver
d) aching muscles and joints, headache, skin rash.

The jaundice phase:

a) yellowing of sclerae (the white portions of the eyes), skin and mucous membranes
b) dark urine
c) light-colored stools
d) around this time, the other symptoms subside.

The recovery phase:

 Tiredness that can last for weeks.

Chronic hepatitis

a) Many patients have no symptoms.

b) Tiredness, an increased need for sleep, aching muscles and joints.
c) Periodic light pressure or pain below the right ribs - enlarged liver.
d) Jaundice is a very late symptom of chronic hepatitis. It is a sign that the disease has
become serious.
Who is at risk of hepatitis?

a) Patients with jaundice or other symptoms of hepatitis.

b) People who are very likely to have contracted the hepatitis B or the hepatitis C virus.
c) People who are at increased risk due to a hereditary type of hepatitis in their families.

How can hepatitis be prevented?

a) By avoiding exposure to the infectious hepatitis viruses.

b) By being vaccinated against hepatitis A and hepatitis B, if you run a high risk of being
infected.
c) By refraining from drinking large amounts of alcohol.

What can be done at home?

a) Avoid drinking alcohol if you have symptoms of hepatitis or if a blood sample has shown
that the disease is active.
b) If alcoholism is the cause, you must stop drinking completely and see your doctor. Eat a
well-balanced diet.
c) If you have symptoms of acute hepatitis, you may need to slow down. However, if you
feel fine, there is no reason why you should not go to work and keep up your other
activities.
d) If you have chronic hepatitis, try to lead a normal life as far as possible.
e) People with hepatitis B must inform their family and their sexual partners about it. They
will need to protect themselves by being vaccinated against it. Condoms should be used
until the vaccine has begun to work.
f) If you have hepatitis A, you must inform your family, so that they can protect themselves
against it by practicing good hygiene and having injections of gamma globulin (normal
immunoglobulin).
g) If you have chronic hepatitis, you should have regular examinations by your doctor.

Why a healthy liver is important

When your body attempts to fight the hepatitis B virus, it sends white blood cells (called
"leukocytes") to the liver. This results in inflammation. Over time, the effects of this inflammation
can damage the liver. If your liver fails to function, your body will fail too. In fact, we can only
survive a few days if our liver shuts down. The liver has many important functions, which is why
we need it working properly to live.

a. Your liver is the body's chemical factory: Your liver produces several different
substances that your body needs. It produces bile, which is used to help digest your
food. It also produces substances that clot your blood to help prevent excessive
bleeding when you have a cut or injury. Lastly, it produces substances that help your
body's defense, or "immune," system.
b. Your liver is a storage unit: Your liver also stores vitamins, sugar and iron to help
give your body energy and nutrients. Any time your body is low on energy from food,
the liver releases its reserves to help keep you going.
c. Your liver is the body's filter for harmful substances: Your liver acts as a filter to
draw out harmful substances from your bloodstream, including waste products,
 alcohol, drugs and other toxins. Without its filtering capability, these materials build up
in your bloodstream, making you very sick.

What happens when the liver is damaged?

If untreated, chronic hepatitis B can lead to the following serious liver diseases:

a. Cirrhosis (cir-oh-sis): When the cells in your liver are damaged, they cannot
function and may die. Scar tissue can develop, which can prevent blood from flowing
freely through the liver. This slows down the liver’s ability to circulate blood and
remove toxins. Cirrhosis often sets the stage for liver cancer.

b. Liver cancer: Chronic hepatitis B is the leading cause of liver cancer worldwide.
According to the American Liver Foundation, an estimated 5,000 people die each
year of chronic liver disease associated with hepatitis B infection. Cancer is when
abnormal cells grow out of control, often forming tumors. Liver cancer may require
surgery to remove the tumor or a liver transplant. The overall relative 5-year survival
rate for liver cancer is about 7% according to the American Cancer Society.

Because of the serious threats that hepatitis B poses to your liver, it is extremely important that
you work with your doctor to monitor your health. Doing this will give you the best chance to stay
healthy and avoid serious damage to your liver.

Protecting Others from the Hepatitis B Virus

While there may not be a cure for hepatitis B, there is a vaccine available that can prevent
others from being infected. You may spread the infection to your loved ones if you do not take
the proper steps to protect those around you. These steps include:

a) Make sure that all household members and sex partners get tested for and vaccinated
against hepatitis B.
b) Practice safe sex (if used correctly, condoms can reduce the risk of infection.
 c) Do not share needles or personal items, such as shaving razors, toothbrushes, nail
clippers or washcloths, with others.
d) Do not donate blood, body organs, tissue or sperm.
e) If you are pregnant, make sure your baby gets the hepatitis B vaccine. Without the
vaccine, there is a high risk of passing the virus on to your baby during childbirth.

 Remember, hepatitis B is NOT transmitted casually and cannot be spread through

sneezing, coughing, hugging, food or water. Consider talking to your loved ones to make
sure this is understood and help prevent any misunderstanding that may arise.

The Importance of a Healthy Lifestyle

One of the best things you can do — whether you are taking medication or not — is to take care
of yourself. If you are diagnosed with chronic hepatitis B, here are a few things you can do to
live healthy:

a) Eat a healthy diet — while there is no special diet for people with chronic hepatitis B,
you should focus on a balanced diet that is low in fat and high in fruits and vegetables.
b) Get enough sleep — rest helps your body regain energy and strength to fight the
infection.
c) Avoid things that may harm your liver — such as alcohol, drugs, some herbal
medicines and raw shellfish (they may contain bacteria harmful to your liver).
d) Stop smoking — this can also improve your overall health, reducing your risk for other
conditions, such as heart disease and high blood pressure.
e) Talk to your doctor about all medications — before you start taking any medication,
whether it's a medication prescribed by a doctor or a supplement you decide to take on
your own, you should consult your doctor. The medication or supplement may have an
effect on your liver or affect how your treatment works.
f) Focus on you — to stay healthy, you need to make your health a priority. You need to
make time to sleep, exercise and relax to get away from daily stress. This effort may
help not only your health, but also your well-being.

Seeing your doctor at least every six to 12 months is also an important part of taking care of
yourself. The hepatitis B virus can silently attack your liver, so blood tests and/or a liver
biopsy are sometimes the only way to know what's really going on inside your body.

4. Ulcer

A digestive ulcer is any sore that develops in the lining of the stomach or duodenum (sores in
the lower esophagus occur less frequently). Because these sores form in areas where gastric
juice is present, they are generally referred to as peptic ulcers (pepsin is an enzyme in gastric
juice). Peptic ulcers found in the stomach are more specifically called gastric ulcers. Those in
the duodenum are called duodenal ulcers. Of the two, duodenal ulcers are the most common
type, accounting for about 80 percent of all digestive ulcers. They tend to be smaller than gastric
ulcers and heal more quickly. Any ulcer that heals leaves a scar.
The symptoms for gastric ulcers include feelings of heartburn, nausea, weight loss, and
stomach pain. That pain is described as gnawing, dull, aching, or resembling hunger pangs.
About one-third of those individuals suffering from gastric ulcers are awakened by pain at night.

The symptoms for duodenal ulcers differ slightly. They include heart-burn, stomach pain that is
relieved by eating or antacids, and a burning sensation at the back of the throat. Pain is most
often felt two to four hours after a meal. Citrus juices, coffee, and aspirin bring on pain more
quickly. About 50 percent of individuals suffering from duodenal ulcers are awakened by pain at
night.

Before the 1980s, physicians believed ulcers were caused by several factors—including stress
and a poor diet—that resulted in excess stomach acid. Medical research has since shown that a
certain bacterium that can live undetected in the mucous membrane of the digestive tract is the
culprit. This bacterium irritates and weakens the lining, making it more susceptible to damage by
gastric juice. About 95 percent of duodenal ulcers and 70 percent of gastric ulcers are caused
by this bacterium.

Treatment for peptic ulcers includes antibiotics to eliminate the bacterium and other drugs to
reduce the amount of gastric juice secreted in the stomach. Very few ulcers fail to respond to
the medications that are currently used to treat them.
 5. Mumps (SALIVARY GLANDS)

Mumps is a disease caused by a virus that usually spreads through saliva and can infect many
parts of the body, especially the parotid salivary glands. These glands, which produce saliva for
the mouth, are found toward the back of each cheek, in the area between the ear and jaw. In
cases of mumps, these glands typically swell and become painful.

What are the symptoms of mumps?

The most common symptoms are followed by onset of swollen and tender salivary glands
under the ears—on one or both sides.

Are there complications of mumps?

The most common complication is the inflammation of the testicles in males who have reached,
but rarely does this lead to fertility problems.
Other rare complications include:
a) Inflammation of the brain and/or tissue covering the brain and spinal cord)
b) Inflammation of the ovaries and/or breast in females who have reached puberty
c) Spontaneous abortion particularly in early years
d) , usually permanent
 How soon do symptoms appear?
Symptoms typically appear 16-18 days after infection, but this period can range from 12-25 after
infection.

How is mumps spread?

Mumps is spread by mucus or droplets from the nose or throat of an infected person, usually
when a person coughs or sneezes. Surfaces of items (e.g. toys) can also spread the virus if
someone who is sick touches them without washing their hands, and someone else then
touches the same surface and then rubs their eyes, mouth, nose etc. (this is called fomite
transmission).

How long is an infected person able to spread the disease?

Mumps virus has been found in respiratory secretions 3 days before the start of symptoms until
9 days after onset. Although mumps virus has been detected on rare occasions for up to 9 days

after symptom onset, the patient is most infectious within the first 5 days. Therefore, CDC now
recommends isolating mumps patients for 5 days following onset of symptoms (parotitis).

What is the treatment for mumps?

There is no specific treatment. Supportive care should be given as needed. If someone
becomes very ill, they should seek medical attention. If someone seeks medical attention, they
should call their doctor in advance so that they don't have to sit in the waiting room for a long
time and possibly infect other patients.

Prevention:

Two doses of mumps-containing, given as combination, mumps, vaccine, separated by at least

28 days, are routinely recommended for all children. The first dose is given on or after the first
birthday; the second is given at 4 - 6 years of age. MMR is a live, weakened (attenuated)
vaccine. Most adults who have not been vaccinated should also receive 1 dose of MMR
vaccine, but adults who work in healthcare, a school/university setting, and persons at high risk
of exposure to mumps should get 2 doses. women and persons with an impaired immune
system should not receive live attenuated vaccines (MMR vaccine).
 6. Diarrhea

Diarrhea is loose, watery, and frequent stool. Diarrhea is considered chronic (long-term) when
you have had loose or frequent stools for more than 4 weeks.

Considerations

Diarrhea in adults is usually mild and goes away quickly without complications. In infants and
children (especially under age 3), diarrhea can cause dangerous dehydration fairly quickly.

Causes

The most common cause of diarrhea is a mild viral infection that goes away on its own within a
few days. This condition is often called the stomach flu. Viral gastroenteritis often occurs in mini-
epidemics in schools, neighborhoods, or families.

and traveler's diarrhea are two other common causes of diarrhea. They occur as a result of
eating food or drinking water contaminated with bacteria or parasites.
Medications, especially antibiotics, laxatives containing magnesium, and chemotherapy for
cancer treatment, can also cause diarrhea.

Prevention

a) Wash your hands often, especially after going to the bathroom and before eating.
b) Teach children to not put objects in their mouth.
c) When taking antibiotics, try eating food with Lactobacillus acidophilus, a healthy
bacteria. This helps replenish the good bacteria that antibiotics can kill. Yogurt with
active or live cultures is a good source of this healthy bacteria.
d) Use alcohol-based hand gel frequently.

When traveling to underdeveloped areas, follow the steps below to avoid diarrhea:

a) Drink only bottled water and do NOT use ice.

b) Do NOT eat uncooked vegetables or fruits that do not have peels.
c) Do NOT eat raw shellfish or undercooked meat.
d) Do NOT consume dairy products.

Alternative Names

Stools - watery; Frequent bowel movements; Loose bowel movement

7. Constipation

Constipation is a slow movement of feces through the large intestine. The feces become dry &
hard because of the increased fluid absorption during the extended time they are retained in the
large intestine. It is also the condition in the digestive system in which someone experiences
hard feces that are hard to expel.

Constipation refers to infrequent or hard stools, or difficulty passing stools. Constipation may
involve pain during the passage of a bowel movement, inability to pass a bowel movement after
straining or pushing for more than 10 minutes, or no bowel movements after more than 3 days.
Infants who are still exclusively breastfed may go 7 days without a stool.

Alternative Names

Irregularity of bowels; Lack of regular bowel movements

Causes

Constipation is most often caused by a low-fiber diet, lack of physical activity, not drinking
enough water, or delay in going to the bathroom when you have the urge to defecate. Stress
and travel can also contribute to constipation or other changes in bowel habits.

Other times, diseases of the bowel (such as pregnancy, certain medical conditions (like an
underactive thyroid or, mental health problems, neurological diseases, or medications may be
the reason for your constipation. More serious causes, like, are much less common.

Constipation in children often occurs if they hold back bowel movements when they aren't ready
for toilet training or are afraid of it.

Home Care

Children and adults should get enough fiber in their diet. Vegetables, fresh fruits, dried fruits,
and whole wheat, bran, or oatmeal cereals are excellent sources of fiber. To reap the benefits of
fiber, drink plenty of fluids to help pass the stool.

For infants with constipation:

a) Over 2 months old -- try 2-4 ounces of fruit juice (grape, pear, apple, cherry, or prune)
twice a day.
b) Over 4 months old -- if the baby has begun solid foods, try baby foods with high-fiber
content (peas, beans, apricots, prunes, peaches, pears, plums, spinach) twice a day.

Regular exercise is also important in establishing regular bowel movements. If you are confined
to a wheelchair or bed, change position frequently and perform abdominal contraction exercises
and leg raises. A physical therapist can recommend exercises appropriate for your physical
abilities.

Stool softeners (such as those containing docusate sodium) may help. Additionally, bulk
laxatives such as psyllium may help add fluid and bulk to the stool. Suppositories or gentle
laxatives, such as milk of magnesia liquid, may establish regular bowel movements. Enemas or
laxatives should be reserved for severe cases only. These methods should be used only if fiber,
fluids, and stool softeners do not provide enough relief.
DO NOT give laxatives or enemas to children without first asking your doctor.

When to Contact a Medical Professional

Call your doctor if you have:

a) Sudden constipation and an inability to pass gas or stool (DO NOT take any laxatives --
call immediately!)
b) Sharp or severe abdominal pain, especially if you're also bloated
c) Constipation alternating with diarrhea
d) Thin, pencil-like stools
e) Rectal pain
f) Been using laxatives for several weeks or self care is not working

Call if:

a. An infant younger than 2 months is constipated

b. An infant (except those exclusively breastfed) goes 3 days without a stool -- call
immediately if the child is vomiting or irritable
c. A child is holding back bowel movements in order to resist toilet training

Prevention
Avoiding constipation altogether is easier than treating it, but involves the same lifestyle
measures:

a. Eat lots of fiber.

b. Drink plenty of fluids each day (at least 8 glasses of water per day).
c. Exercise regularly.
d. Go to the bathroom when you have the urge. Don't wait.

7. Indigestion/Dyspepsia
Indigestion, also known as dyspepsia, is a term used to describe one or more symptoms
including a feeling of fullness during a meal, uncomfortable fullness after a meal and burning or
pain in the upper abdomen.

Causes

Sometimes a person has indigestion for which a cause cannot be found. This type of
indigestion, called functional dyspepsia, is thought to occur in the area where the stomach
meets the small intestine. The indigestion may be related to abnormal motility, the squeezing or
relaxing action of the stomach muscle as it receives, digests, and moves food into the small
intestine.

Symptoms

a) Fullness during a meal. The person feels overly full soon after the meal starts and
cannot finish the meal.

b) Bothersome fullness after a meal. The person feels overly full after a [Link] may
feel like the food is staying in the stomach too long.

c) Epigastric pain. The epigastric area is between the lower end of the chest bone and
the navel. The person may experience epigastric pain ranging from mild to severe.

d) Epigastric burning. The person feels an unpleasant sensation

Sometimes the term indigestion is used to describe the symptom of heartburn, but these

are two different conditions. Heartburn is a painful, burning feeling in the chest that

radiates toward the neck or back. Heartburn is caused by stomach acid rising into the

esophagus. A person can have symptoms of both indigestion and heartburn.

Prevention.

a) eating several small, low-fat meals throughout the day at a slow pace
b) refraining from smoking
c) abstaining from consuming coffee, carbonated beverages, and alcohol
d) stopping use of medications that may irritate the stomach lining—such as aspirin or
e) anti-inflammatory drugs
f) getting enough rest
g) finding ways to decrease emotional and physical stress, such as relaxation therapy or
yoga
 8. Gastritis

Gastritis is not a single disease, but several different conditions that all have inflammation of the
stomach lining.

Causes

Drinking too much alcohol, prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs)
such as aspirin or ibuprofen, or infection with bacteria such as Helicobacter pylori (H. pylori).
Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections.
Certain diseases, such as pernicious anemia, autoimmune disorders, and chronic bile reflux,
can cause gastritis as well.

Gastritis is associated with various medications, medical and surgical conditions, physical
stresses, social habits, chemicals, and infections. Some of the more common causes of gastritis
are listed here.

Symptoms

Symptoms of gastritis do not always correspond to the extent of physical changes in the lining
of the stomach.

a) The stomach lining can be examined with an endoscope, a thin probe with a tiny camera
on the end that can be inserted into the stomach.
b) Severe gastritis may be present when the stomach is viewed without symptoms being
present.
c) Severe gastritis symptoms may be present despite only minor changes in the stomach
lining.
d) Elderly people in particular have a much higher likelihood of developing painless
stomach damage. They may have no symptoms at all,(vomiting, pain) until they are
suddenly taken ill with internal bleeding.

In people who have gastritis symptoms, pain or discomfort in the upper abdomen is the most
common.

a) The pain is usually in the upper central portion of the abdomen (the "pit" of the stomach).
b) Gastritis pain occurs in the left upper portion of the abdomen and in the back. The pain
seems to "go right straight through" a person as it travels from the belly to the back.
c) People often use the terms burning, aching, gnawing, or sore to describe the pain.
Usually, a vague sense of discomfort is present, but the pain may be sharp, stabbing, or
cutting.

Other symptoms of gastritis include the following:

a) Belching usually either does not relieve the pain or relieves it only briefly.
b) Nausea and vomiting: The may be clear, green or yellow, blood-streaked, or completely
bloody, depending on the severity of the stomach inflammation.
 c) Bloating
d) Feeling of fullness or burning in the upper part of the belly

In more severe gastritis, bleeding may occur inside the stomach. Any of the following symptoms
can be seen as well as those already mentioned.

a) Pallor and rapid (or "racing") heart beat.

b) Feeling faint or short of breath
c) or severe stomach pain
d) Vomiting large amounts of blood
e) Bloody bowel movements or dark, sticky, very foul-smelling bowel movements

Any or all of these symptoms can occur suddenly. This is particularly true in adults older than 65
years.

a. Parasites and worms

When to Seek Medical Care

See your health care provider if your symptoms are new, long-lasting, or worsening despite self-
care.

There is little need to see a medical professional in the following cases:

a) If there is an obvious cause for your gastritis symptoms such as taking aspirin on an
empty stomach

b) If your symptoms are mild

c) If you are able to take medications to relieve your symptoms

Seek immediate medical attention if you have any of the following symptoms.

Vomiting that does not allow you to take food, fluids, and medications

a) with abdominal pain

b) or feeling faint

c) Rapid heartbeat

d) Unexplained sweating

e) Pallor

f) Repeated vomiting of green or yellow material

g) Vomiting any amount of blood

h) Shortness of breath
Exams and Tests

Whether you see your own health care provider in his or her office or go to an emergency
department, the evaluation is the same.

The health care provider first interviews you about your symptoms, habits and lifestyle, and the
medications you take.

 This information is enough to make the diagnosis in many people.

 Be sure to tell him or her about all the medications you take, including nonprescription
drugs, and botanical preparations.

 Also report any measures you have taken to relieve the symptoms and how well those
measures worked.

Laboratory testing: No laboratory tests can pinpoint a diagnosis of gastritis.

 Often, no tests are necessary.

 If your health care provider orders tests, it is probably to certain medical conditions.

 If all other possibilities are ruled out, that leaves gastritis as the most likely cause of your
symptoms.

The following tests are most likely to be ordered:

a) Blood cell counts (looking mostly low)

b) test

c) H pylori tests for blood

films or other diagnostic images may be ordered, although they are usually not necessary.

An (a heart wave tracing) is usually performed if your heartbeat is rapid or you are having chest
pain.

You may be referred to a doctor who specializes in diseases of the

The gastroenterologist may in turn recommend an endoscopy.

a) During the endoscopy, a thin, flexible probe with a tiny camera on the end is sent into
your stomach for a direct look.

b) At the same time, samples of your stomach lining can be taken to test for a wide variety
of conditions.
Gastritis Treatment

Once the diagnosis of gastritis has been confirmed by a medical professional, treatment can
begin. The choice of treatment depends to some extent on the cause of the gastritis. Some
treatments target the exact cause of a particular type of gastritis. Most treatments aim at
reducing symptoms. Your stomach often will heal over time if it is protected.

Medical Treatment

The safest treatment is to avoid substances that enhances gastritis symptoms.

a) Almost all health care providers would recommend this as the first step in preventing
gastritis.

b) First, you have to identify what these triggers are for you.

c) Most people are fairly aware of their triggers before seeking medical care.

d) If you do not know your triggers, your health care provider can help you figure them out.

Common avoidable triggers of gastritis symptoms include the following. See Causes for a more
complete list.

a) Certain medications and poisons

b) Alcohol

c) Coffee and other beverages that contain, such as cola and tea

9. Gallstones

Gallstones are hard, pebble-like deposits that form inside the gallbladder.
Gallstones may be as small as a grain of sand or as large as a golf ball

Alternative Names: Cholelithiasis; Gallbladder attack; Biliary colic; Gallstone attack;

Bile duct stone; Bile calculus; Biliary calculus

Causes

The cause of gallstones varies. There are two main types of gallstones:

a) Stones made out of cholesterol. Gallstones made out of cholesterol are by far the most
common type. Cholesterol gallstones have nothing to do with the cholesterol levels in
the blood.
 b) Stones made from too much bilirubin in the bile. Bile is a liquid made in the liver that
helps the body digest fats. Bile is made up of water, cholesterol, bile salts, and other
chemicals, such as bilirubin. Such stones are called pigment stones.

Gallstones are more common in women, Native Americans and other ethnic groups, and people
over age 40. Gallstones may also run in families.

The following are conditions most likely to develop gallstones:

a) Failure of the gallbladder to empty bile properly (this is more likely to happen during
pregnancy)
b) Medical conditions that cause the liver to make too much bilirubin, such as chronic
hemolytic anemia, including sickle cell anemia
c) Liver cirrhosis and biliary tract infections (pigmented stones)
d) Diabetes
e) Bone marrow or solid organ transplant
f) Rapid weight loss, particularly eating a very low-calorie diet
g) Receiving nutrition through a vein for a long period of time (intravenous feedings)

Symptoms

Many people with gallstones have never had any symptoms. The gallstones are often
discovered when having a routine x-ray, abdominal surgery, or other medical procedure.

However, if a large stone blocks either the cystic duct or common bile duct (called
choledocholithiasis), you may have a cramping pain in the middle to right upper abdomen. This
is known as biliary colic. The pain goes away if the stone passes into the first part of the small
intestine (the duodenum).

Symptoms that may occur include:

a) Pain in the right upper or middle upper abdomen:

- May go away and come back
- May be sharp, cramping, or dull
- May spread to the back or below the right shoulder blade
- Occurs within minutes of a meal
b) Fever
c) Yellowing of skin and whites of the eyes (jaundice)

Additional symptoms that may occur with this disease include:

a) Abdominal fullness
b) Clay-colored stools
c) Nausea and vomiting

It is important to see a doctor if you have symptoms of gallstones. Gallstones are found in many
people with gallbladder cancer.
 Hemorrhoids

Also called: Piles

Hemorrhoids are swollen, inflamed veins around the anus or lower rectum. They are either
inside the anus or under the skin around the anus. They often result from straining to have a
bowel movement. Other factors include pregnancy, aging and chronic constipation or diarrhea.

Hemorrhoids are very common in both men and women. About half of all people have
hemorrhoids by age 50. The most common symptom of hemorrhoids inside the anus is bright
red blood covering the stool, on toilet paper or in the toilet bowl. Symptoms usually go away
within a few days.

If you have rectal bleeding you should see a doctor. You need to make sure bleeding is not from
a more serious condition such as colorectal or anal cancer.

Treatment

Treatment may include warm baths and a cream or other medicine. If you have large
hemorrhoids, you may need surgery and other treatments.
 10. Colon Cancer

Cancer of the colon or rectum is also called colorectal cancer. It is a disease in which
malignant (cancer) cells form in the tissues of the colon.

It is more common in people over 50, and the risk increases with age. You are also more likely
to get it if you have

a) Polyps - growths inside the colon and rectum that may become cancerous
b) A diet that is high in fat
c) A family history or personal history of colorectal cancer
d) Ulcerative colitis or Crohn's disease

Symptoms can include blood in the stool, narrower stools, a change in bowel habits and general
stomach discomfort. However, you may not have symptoms at first, so screening is important.
Everyone who is 50 or older should be screened for colorectal cancer. Colonoscopy is one
method that your doctor can use to screen for colorectal cancer.

Treatment

Treatments for colorectal cancer include surgery, chemotherapy, radiation or a combination.

a) Colorectal cancer is a malignant tumor arising from the inner wall of the large intestine.
b) Colorectal cancer is a malignant tumor arising from the inner wall of the large intestine.
c) Colorectal cancer is the third leading cause of cancer in males and fourth in females in
the U.S.
d) Risk factors for colorectal cancer include heredity, colon polyps, and long-standing
ulcerative colitis.
 e) Most colorectal cancers develop from polyps. Removal of colon polyps can prevent
colorectal cancer.
f) Colon polyps and early cancer can have no symptoms. Therefore regular screening is
important.
g) Diagnosis of colorectal cancer can be made by barium enema or by colonoscopy with
biopsy confirmation of cancer tissue.
h) Treatment of colorectal cancer depends on the location, size, and extent of cancer
spread, as well as the age and health of the patient.

Surgery is the most common treatment for colorectal cancer

Colorectal Cancer: What Is It?

Colorectal cancer is the third most frequently diagnosed cancer in men and women and the
second highest cause of cancer deaths in the U.S. Yet, when found early, it is highly curable.
This type of cancer occurs when abnormal cells grow in the lining of the large intestine (colon)
or rectum. Learn more about who gets colorectal cancer, how it is detected, and what the latest
treatments can accomplish.

Colorectal Cancer: How It Starts

Colorectal cancers often begin as polyps – benign growths on the surface of the colon. The two
most common types of intestinal polyps are adenomas and hyperplastic polyps. They develop
when there are errors in the way cells grow and repair the lining of the colon. Most polyps
remain benign, but some have the potential to turn cancerous. Removing them early prevents
colorectal cancer

Risk Factors You Can't Control

Your risk of colorectal cancer depends on genetics and lifestyle. Factors you can't control
include:

a) Age – most patients are older than 50

b) Polyps or inflammatory bowel disease
c) Family history of colorectal cancer
d) History of ovarian or breast cancer
e) Diet high in red, processed, or heavily cooked meats
f) Being overweight (excess fat around the waist)
g) Exercising too little
h) Smoking or drinking alcohol
Colorectal Cancer Warning Signs

There are usually no early warning signs for colorectal cancer. For this reason it's important to
get screened. Detecting cancer early means it's more curable. As the disease progresses,
patients may notice blood in the stool, abdominal pain, a change in bowel habits (such as
constipation or diarrhea), unexplained weight loss, or fatigue. By the time these symptoms
appear, tumors tend to be larger and more difficult to treat.
Colorectal Cancer Screening

Because colorectal cancer is stealthy, screenings are the key to early detection. Beginning at
age 50, most people should have a colonoscopy every 10 years. This procedure uses a tiny
camera to examine the entire colon and rectum. These tests not only find tumors early, but can
actually prevent colorectal cancer by removing polyps (shown here).

Virtual Colonoscopy

There is now an alternative to colonoscopy that uses CT scan images to construct a 3-D model
of your colon. Called virtual colonoscopy, the procedure can reveal polyps or other
abnormalities without actually inserting a camera inside your body. The main disadvantage is
that if polyps are found, a real colonoscopy will still be needed to remove and evaluate them .
X-Rays of the Colon (Lower GI)

X-Rays of the colon -- using a chalky liquid known as barium as a contrast agent -- allow your
doctor a glimpse at the interior of the colon and rectum, offering another way to detect polyps,
tumors, and changes in the intestinal tissue. Shown here is an "apple core" tumor constricting
the colon. Like the virtual colonoscopy, any abnormalities that appear on the X-rays will need to
be followed up with a conventional colonoscopy.

Diagnosing Colorectal Cancer

If testing reveals a possible tumor, the next step is a biopsy. During a colonoscopy, your doctor
will remove polyps and take tissue samples from any parts of the colon that look unusual. This
tissue is examined under a microscope to determine whether or not it is cancerous. Shown here
is a color-enhanced, magnified view of colon cancer cells.
Staging Colorectal Cancer

If cancer is detected, it will be "staged," a process of finding out how far the cancer has spread.
Tumor size may not correlate with the stage of cancer. Staging also enables your doctor to
determine what type of treatment you will receive.

1. Stage I – Cancer has not spread beyond the inside of the colon or rectum
2. Stage II – Cancer has spread into the muscle layer of the colon or rectum
3. Stage III - Cancer has spread to one or more lymph nodes in the area
4. Stage IV – Cancer has spread to other parts of the body, such as the liver, lung, or
bones. This stage does NOT depend on how deep the tumor has penetrated or if the
disease has spread to the lymph nodes near the tumor.
Colorectal Cancer Survival Rates

The outlook for your recovery depends on the stage of your cancer, with higher stages meaning
more serious cancer. The five-year survival rate refers to the percentage of patients who live at
least five years after being diagnosed. Stage I has a 93% five-year survival rate while stage IV
has a five-year survival rate of only 8%.

Preventing Colorectal Cancer: Diet

There are steps you can take to dramatically reduce your odds of developing colorectal cancer.
Researchers estimate that eating a nutritious diet, getting enough exercise, and controlling body
fat could prevent 45% of colorectal cancers. The National Cancer Institute recommends a low-
fat diet that includes plenty of fiber and at least five servings of fruits and vegetables per day
Preventing Cancer with Exercise

Physical activity appears to be a powerful weapon in the defense against colorectal cancer. In
one study, the most active participants were 24% less likely to have the cancer than the least
active people. It didn't matter whether the activity was linked to work or play. The American
Cancer Society recommends exercising for at least 30 minutes most days of the week.

11. Gastroenteritis

Gastroenteritis is a condition that causes irritation and inflammation of the stomach and
intestines

Symptoms

crampy abdominal pain, , and vomiting are the most common symptoms.

, parasites, and food-borne illness (such as shellfish) can be the offending agent.

Many people who experience the vomiting and diarrhea that develop from these types of
infections or irritations think they have gastritis," and they may indeed have a food-borne
illness. Many people also refer to gastroenteritis as "stomach flu," although influenza has
nothing to do with the condition.

Causes

Gastroenteritis has many causes. Viruses and bacteria are the most common.

Viruses and bacteria are very contagious and can spread through contaminated food or water.
In up to 50% of diarrheal outbreaks, no specific agent is found. Improper hand washing
following a bowel movement or handling a diaper can spread the disease from person to
person.

Gastroenteritis caused by viruses may last one to two days. On the other hand, bacterial cases
can last for a longer period of time.

Viruses

Fifty to seventy percent of cases of gastroenteritis in adults are caused by the.

is the leading cause of infection in children.

Other viruses that cause gastrointestinal symptoms include:

a) Astroviruses

Bacteria

Bacteria may cause gastroenteritis directly by infecting the walls of the stomach and intestine.
As well, some bacteria like aureus can form a toxin that is the cause of symptoms. Staph is a
common type of food poisoning.

a. can cause significant problems, and one type of the bacteria, can also affect kidney
function.
b. Salmonella, Shigella and Campylobacter

, Shigella and Campylobacter are also common causes of illness.

 The bacteriaf is contracted from handling poultry or reptiles such as turtles that
carry the germs

 From the consumption of undercooked meat, unpasteurized milk

 - typically spread from person to person

 c. Clostridium difficile

bacteria may overgrow in the large intestine after a patient has been on for an infection.

Parasites and protozoans

These tiny organisms are less frequently responsible for intestinal irritation. You may become
infected by one of these by drinking contaminated water. Swimming pools are common places
to come in contact with these parasites. Common parasites include these:

a) Giardia - The most frequent cause of waterborne diarrhea, causing giardiasis

b) - Affects mostly people with weakened immune systems and causes watery diarrhea

Other common causes

Gastroenteritis that is not contagious to others can be caused by chemical toxins, most often
found in seafood, food allergies, heavy metals, antibiotics, and other medications.

Gastroenteritis Symptoms

By definition, gastroenteritis affects both the stomach and the intestines, resulting in both
vomiting and diarrhea.

Common symptoms may include:

a) Low grade fever to 100°F (37.7°C)

b) Nausea with or without vomiting

c) Mild-to-moderate diarrhea:

d) Crampy painful abdominal bloating

More serious symptoms

a) Blood in vomit or

b) Vomiting more than 48 hours

c) Fever higher than 101°F (40°C)

d) Swollen abdomen or Dehydration - weakness, decreased urination, and lack of When to

Seek Medical Care

Most often gastroenteritis is self-limiting, but it can cause significant problems with dehydration.
Should that be a concern, contacting your is reasonable.
Vomiting blood or having bloody or black bowel movements are not normal, and emergency
care should be accessed. Some medications, for example, (Pepto-Bismol), turns stool black
because of the bismuth in the medication.

Fever, increasing severity of abdominal pain, and persistent symptoms should not be ignored
and contacting your primary care provider should be considered if these symptoms are present.

Gastroenteritis Treatment

Self-Care at Home

The mainstay of home treatment of gastroenteritis is hydration. Dehydration will make the
symptoms of nausea and vomiting worse and compound symptoms.

Clear fluids should be consumed for the first 24 hours, then gradually progress the diet as
tolerated. Clear fluids are anything you can see through. Popsicles and jell-o work well, since
they are ingested slowly. Drinking too much fluid too quickly will distend the stomach and
worsen the nausea.