Common Gastroenterologic Conditions Part II

Hepatitis | Heartburn | Peptic Ulcer Disease | Gallstones | IBS | Pancreatitis

Hepatitis
Hepatitis is an inflammation of the liver that usually produces swelling and tenderness. Hepatitis has a variety of causes, including alcohol, drugs or chemical abuse, as well as viral infections. At onset, such liver inflammation is known as acute hepatitis, and inflammation that continues longer than six months is called chronic hepatitis. The inflammation, if untreated, may become permanent.

Five different viruses are known to cause hepatitis. Hepatitis A, also known as Infectious Hepatitis, is spread by eating food or drinking water contaminated with human feces. It is not normally life threatening. Hepatitis B, also called Serum Hepatitis, spreads from mother to child at birth, through sexual contact, or through contaminated blood transfusions and needles. This form of hepatitis may lead to a scarring of the liver. Hepatitis C, the most common form, is spread through blood transfusions and contaminated needles. This form of hepatitis also may lead to scarring of the liver. Hepatitis D is found most often in IV drug users who are carriers of the hepatitis B virus. It spreads only in the presence of the Hepatitis B virus and is transmitted through sexual contact, contaminated blood transfusions and needles. Hepatitis E, which is rarely life threatening, is found most often in countries with poor sanitation.

Treatment for Hepatitis varies from bed rest to prescription medications to liver transplantation in the most severe instances of Hepatitis D.

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Gastroesophageal Reflux Disease (Heartburn)
Gastroesophageal Reflux Disease (GERD), also known as heartburn, is the painful burning feeling in the chest or throat that occurs when stomach acid backs up into the esophagus, the tube that carries food from the mouth to the stomach. GERD occurs when muscles at the end of the esophagus do not close tightly enough, allowing the contents of the stomach to back up, or reflux, into the esophagus and irritate it. Pregnancy; foods such as chocolate, coffee and tomato sauce; alcohol and some medications can trigger heartburn.

Over time, reflux can cause damage to the esophagus. Medication advancements have allowed for the purchase of over-the-counter remedies that often help cure the symptoms. Experts warn, however, that chronic use may simply mask the symptoms of what can be evolving into a more serious condition. As such, continued episodes require physician intervention with prescription strength medicines or, in some cases, surgery.

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Peptic Ulcer Disease
Peptic ulcer disease refers to painful sores or ulcers in the lining of the stomach or first part of the small intestine. Ulcers result from the imbalance between digestive fluids in the stomach and small intestine, and are caused by bacteria, the use of painkillers and nonsteroidal anti-inflammatory medications, and excessive acid production.

Treatments for peptic ulcers include dietary and lifestyle changes, including smoking cessation and elimination of alcohol; the use of anti-acid medications; and antibiotics. Bleeding ulcers may be repaired with a minimally invasive surgery using an endoscope and in severe cases, a hole in the wall of the stomach may need repair to deter serious bleeding.

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Gallstones
Gallstones are pieces of hard solid matter in the gallbladder, the pear-sized organ connected to the liver and intestine that stores bile, which aids in digestion. Gallstones form when cholesterol crystallizes into stones as small as grains of sand or as large as golf balls. Often, more than one gallstone is present in the gallbladder.

Gallstones may be asymptomatic or they may produce severe pain, the result of inflammation developed from a prolonged blockage. This prolonged blockage, called acute cholecystitis, is treated with antibiotics, pain medications and often surgery during an inpatient hospital stay. More serious complications may result if the stone passes into the main bile duct, causing inflammation in the main bile duct or the pancreas, which also necessitates surgery.

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Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a common disorder of the intestines that leads to cramps, gassiness, bloating, and changes in bowel habits ranging from constipation to frequent diarrhea or both.

IBS symptoms often are diminished with a healthy diet. It is recommended that IBS sufferers keep track of the foods they eat and remove from their diets to determine those that actually contribute to IBS. A dietician may assist with this process. Because there are no treatments for IBS, physicians may suggest over-the-counter fiber supplements and/or occasional laxatives for constipation or over-the-counter anti-diarrheal medicine for diarrhea.

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Pancreatitis
Pancreatitis is an inflammation of the pancreas, a large gland behind the stomach that secretes digestive enzymes into the small intestine to help digest fats, proteins, and carbohydrates in food. The pancreas also releases hormones into the bloodstream to help the body convert glucose into energy. If the digestive enzymes become active before they reach the small intestine, they can start digesting the pancreas itself, causing inflammation.

Acute pancreatitis, caused by gallstones or heavy alcohol consumption, is brief and usually resolves itself. Chronic pancreatitis does not resolve itself, resulting in a slow destruction of the pancreas. Severe cases may cause bleeding, tissue damage, infection, accumulations of fluid and tissue debris. Additionally, enzymes and toxins may enter the bloodstream, injuring the heart, lungs, and kidneys or other organs.

Treatment depends on the severity of the attack. If the pancreatitis is unresolved, a hospital stay with intravenous fluids may be necessary to restore vital functioning. Severe cases may require total intravenous nutrition for up to six weeks. If cysts develop that interfere with the healing process, they may need to be surgically removed.

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