Good gut health is key to a happy, active life. Dr Prasanna Shah simplifies the symptoms, causes and treatments of stomach problems.
When we talk about abdominal discomfort, we usually mean the stomach – just one of the organs of the digestive tract which the abdomen contains.
The stomach is a small organ, situated below the lungs, aligning with the heart, and is part of the upper body. The stomach is responsible for producing acid and churning the food in puree form to pass through the intestines where the nutrients are absorbed. Often abdominal discomfort such as indigestion, gastric problems are treated with home remedies or OTC self-medication. However, sometimes the most common discomfort could be an early onset of a health condition.
Symptoms of Acidic Stomach
Acidity – Acidity is acid that is produced in the stomach, sometimes the production of acid gets too much and can cause acidity. This then leads to inflammation in the lining of the stomach.
Belching – It is an involuntary reflex where one emits air from the stomach, from where it goes beyond our cricopharynx – our voice box. From there it goes in between the vocal cords, thus reverberating the voice box and producing a sound – burpp. Belching can be of two types:
Passive belching
Forceful belching
GERD or Gastro-Esophageal Reflux Disease – It is a very common gastric disorder, in which the acid in the stomach or the bile comes out in the food pipe and irritates the lining of the oesophagus.
One of the most common extraintestinal manifestations of GERD includes blockage of the nasal passages post meals. The acid comes up, hits the throat and causes sinusitis. And this phenomenon is called Laryngopharyngeal reflux (LPR). It is a severe form of GERD.
Gastroparesis – A condition which by affecting the stomach muscles also affects the process of stomach emptying – nausea.
It is caused by several factors that include – heartburns, eating disorders, chronic fatigue symptoms, side-effects of medication, nervous system disorder, and metabolic disorder – thyroid.
5 Habits to Ease Acidity
Bingeing food that causes acidity – Fried food, cheese, coffee, garlic, onion, mint, alcohol, smoking are common refluxers. If one is experiencing prolonged reflux, cut back on these refluxers for six to eight weeks and then gradually consume them in moderation.
Regularly indulging post-dinner chocolate – Cocoa is a refluxer and the sweetener produces a lot of weight. This will cause acid reflux and worsen diabetes, or if you are prediabetic you will become diabetic. But to satiate your mind you can have a small piece once or twice a week.
Not eating enough fibre – Lack of fibre in your diet can lead to diverticular disease – they are small pouches formed in the colonic wall, which develops over sometime if there is a lack of fibre. There are be one too many diverticula varying in different sizes.
Erratic food habits – Late night binge-watching and snacking changes the circadian rhythm aka sleep pattern. This can lead to acid reflux, leading to indigestion and other stomach-related problems – constipation, irritable stomach, affected concentration while working.
Overdoing Antacids – Over the counter, an antacid is helpful when you consume it in balance. If you consume more of it then it can lead to an antacid failure which can be serious.
Stomach ulcers
Stomach ulcer is a type of peptic ulcer disease that affect the stomach and the small intestines, also knowns as Gastric Ulcer. However, there are three types of peptic ulcers –
Gastric ulcer – Ulcer that develops inside the stomach
Esophageal ulcer – Ulcer that develops inside the oesophagus
Duodenal ulcer – Ulcer that develops in the upper half of the small intestines known as duodenal
The good news is that ulcers are treatable and can be easily cured, however, neglecting the preventive measures and leaving the ulcer untreated can cause a severe case of ulcer. Certain ulcers of cancer cannot be treated if presented late
What causes stomach ulcers? Before we jump to any conclusions let’s debunk the myth that ulcers are solely caused by the consumption of spicy foods or stress. It is not common to develop an ulcer just by these factors, certainly, it makes the ulcer worse.
There are two main causes of stomach ulcers –
Nonsteroidal painkillers – A class of anti-inflammatory drugs that causes ulcers. If you regularly pop over-the-counter non-steroidal painkillers such as diclofenac sodium, naproxen, brufen or ibuprofen, one could develop an ulcer. These medications inflame the digestive tract leading to ulcers and complications of ulcer-like bleeding and perforation.
Helicobacter pylori – H. pylori is a form of bacteria found in the gut that inflames the insides of the lining of the stomach until the formation of severe inflammation and ultimately ulcer. The bacteria slowly feed off the protective layer leading to painful ulcer sores. There is no clarity on how the bug gets into the system, but it may spread through contaminated food and water. One can test if one has the infection by doing an endoscopy {rut} or then a urea breath test {ubt}.
Endoscopy
A small tube will be inserted through the mouth into the stomach to look for any signs of ulcer, bleeding or abnormalities. Endoscopy is also called the OGDscopy which is the oesophago-gastro-duodenoscopy. It is an upper GI endoscopy.
The upper GI endoscopy is divided into 2 types:
Diagnostic – This is done to diagnose and identify the problem. We also look for the pathology of the food pipe, stomach or duodenum. This can be inflammation, ulcer, infection, cancer, Barrett’s oesophagus, any hernia or strictures.
It also reveals if the patient has celiac disease, inflammatory bowel disease, malabsorption disorders. The test can also be performed by taking biopsies. These have next to nil complication rates.
Therapeutic – Depending on the procedure being performed, you can have procedure-related complications or side effects that are 0.001-0.1% of all the endoscopies done worldwide.
Rectal Bleeding
Rectal bleeding is caused by several factors – some are benign while others can be serious. Hence getting it medically examined at first sight is a good idea. Because if you are suffering from a serious condition, an early diagnosis could save you from the pain it may cause later.
What causes rectal bleeding?
Medication side effects – Sometimes it’s the medicines that you use to treat other conditions that may result in rectal bleeding. This is a side effect that can cause blood to appear when you fart. Medicines that cause gastrointestinal bleeding include –
Serotonin reuptake inhibitors
Antiplatelets and anticoagulants
Nonsteroidal anti-inflammatory drugs
Buttock chafing – Chafing is caused by the friction between the skin rubbing against each other. Sometimes a severe case of buttock chafing can lead to bleeding.
Chafing can be treated at home by applying some aloe vera gel, or shea butter, or petroleum jelly, or coconut oil.
Anal fissures – When you pass hard or a large stool during the bowel movement it may cause anal fissure. This means that while you were straining to pass the stool there was a small tear in the skin that lines the anus. This can be painful and you may bleed during, in some cases, one may also fart blood.
Anal fissures are temporary and usually heal on their own within a few weeks.
Haemorrhoids – Also known as piles. When one has haemorrhoids or piles, blood may appear when you pass gas. This is caused by swollen inflamed veins on the inside or outside the anus.
Haemorrhoids, like anus fissures, are temporary and can happen after a long period of strained bowel movement. However, some cases can be more severe than others.
Diverticulitis – An infection or inflammation of pouches formed in the intestines. Often cases of this condition are minor however, it can be severe with a massive infection that could lead to rupturing of the bowel that leads to blood in the stool.
Colon polyps – A small clump of cells that forms on the lining of the colon are called colon polyps. Colon polyps often are asymptomatic and hence it is important to have regular screening such as colonoscopy.
Colonoscopy will help remove colon polyps at an early stage and avoid the risk of colon cancer. Seniors are at a higher risk especially adults with weight issues, smokers or family history of this condition.
Colonoscopy is also a form of investigative procedure where a slender tube with a camera and source of light is introduced. The tube used in colonoscopy is much longer than the one used in endoscopy.
A colonoscopy helps us visualise the whole of the colon which includes the rectum, sigmoid colon, splenic flexure, transverse colon, hepatic flexure, ascending colon and the caecum which is the start of the colon and the IC valve where the start of the small intestine ends and joins the large intestine and it also shows the last 10-20 cms of the small intestine.
Healthy lifestyle is key
All we want is our gut to be happy. To make that happen it is important to live a healthy, clean and active lifestyle.
Eating right – A well-balanced meal that includes protein, carbohydrate, good fat, nutrient-rich vegetables and superfoods.
Regular exercise – Walking at least 6000 steps a day will not only keep you active but will also improve digestion.
Quality sleep – Sleeping is essential when it comes to overall health. Our body repairs and recovers during the sleep cycle.
Why is a healthy lifestyle important?
Looking after your lifestyle with age helps maintain the body’s metabolic rate. There are several benefits of following an active, clean and healthy lifestyle that includes –
Improved heart and gut health.
Strengthens bone and dental health.
Promotes a positive mindset.
Boosts memory and brain health.
Healthy weight management.
Regulated hormonal levels, resulting in a maintained metabolic rate.
Nutrition is the key to metabolism
A chemical reaction that processes nutrients from food and converts it into energy. That is a combination of rich protein, carbohydrates and good fat. When one consumes unhealthy food it disrupts the process of energy conversion – especially foods that are high in unhealthy fats.
When the process of energy conversion is disrupted it begins to store fat. However, following an active lifestyle where you exercise regularly, eat healthy then the energy conversion begins to rebuild muscles.
Muscles burn more calories resulting in a fit body with less fat content. If there is more fat than muscle then your body will burn fewer calories resulting in a slower metabolism. Slower metabolism occurs when you are less active, you burn fewer calories resulting in fat storage. The metabolic rate depends on the current condition of the body.
Why does metabolism slow down with ageing?
With age one naturally begins to lose muscle mass and this results in fat accumulation, especially around the waistline. When there is muscle loss the body begins to store the fat, this means with age you begin to lose fewer calories resulting in a slower metabolism. Throughout life, the body changes its metabolic rate due to various shifts in the body. A sedentary lifestyle affects this chemical reaction and slows down the metabolism. However, if you choose to exercise regularly and eat healthily then you can rebuild muscle mass. Your body needs to be conditioned to maintain a good metabolic rate.
Signs of slow metabolism
Weary and bored – A feeling of perpetual tiredness even after getting plenty of sleep.
Weight gain – As your metabolism slows down, one becomes less active resulting in weight gain.
Increase flatulence – Slower metabolism leads to an increased amount of gas accumulation.
Difficult to lose weight – If your body has all fat and no muscle then losing weight becomes difficult.
High blood sugar – Slow metabolism also affects blood sugar levels.
Myths about metabolism
Myth – Being overweight is a result of slow metabolism.
Fact – Being less active results in slow metabolism.
Myth – Consuming certain foods boost metabolism.
Fact – Consuming certain foods may boost metabolism temporarily.
Myth – Late night bingeing slows down metabolism.
Fact – Late night bingeing results in increased calorie intake.
Myth – High-intensity interval training (HIIT) improves metabolism.
Fact – High-intensity interval training (HIIT) burns calories and does not affect the metabolic rate.
Myth – Consuming small meals throughout the day reverses metabolism.
Fact – Consuming small meals throughout the day can result in weight gain if you are less active.
How to improve body metabolism?
To improve your metabolism you must be able to burn calories easily. This happens when your bodies muscle cells are more than fat cells.
Body strengthening exercise regime – This regime will help you build muscles and result in an improved metabolic rate.
Protein-rich diet – Protein burns more calories while digesting than carbohydrates and fat.
Avoid crash diets – Crash diet is a category of diet where one suddenly changes their diet to achieve rapid weight loss.
Your Bowel Movement is a Health Indicator
A bowel movement is the body’s way of ridding the undigested food, protein, salts, bacteria and other substances that are produced. It is passed by the intestines. However, every individual has a distinct bowel movement in terms of consistency, shape, size, colour and smell.
Type 1 – Broken hard pieces
This type of stool is an indicator of severe constipation. You may find yourself struggling in the bathroom trying to pass stool. Even if your bowel movement is regular and your stool breaks into several small hard lumps, it is a sign that your body needs more fibre in your diet.
Type 2 – Sausage-shaped but lumpy
This type of stool is an indicator of mild constipation. You may find yourself in pain trying to pass stool. This could happen if you are stressed, or travelling, or haven’t had enough water to drink or dietary fibre. Exercising, hydration and a diet with more fibre content should relieve you from this problem.
Type 3 – Sausage-shaped but with cracks on the surface
This type of stool is an indicator of a healthy bowel moment. You may find it easy and quick to pass.
Type 4 – Snake-like smooth and soft
This type of stool is also an indicator of a healthy bowel moment. It’s soft, smooth and easy to pass. According to health experts passing this type of stool every two days is normal.
Type 5 – Soft blobs with cut edges
This type of stool is an indicator of not eating enough fibre. The stool is soft and easy to pass, however, there are small irregular pieces. You should add some vegetables and fruits to your diet to improve your stool appearance.
Type 6 – Mushy and fluffy blobs
This type of stool is an indicator of loose motion. If you pass this type more than three times in a day, that is a sign of mild diarrhoea. Drink plenty of water with electrolytes, soups or fruit juices to replace the loss of minerals. Keep yourself hydrated and you should be fine.
Type 7 – Watery, no pieces at all
This type of stool is an indicator of stool moving through your bowel very quickly that it didn’t form a poo. If this persists three to four times a day you need to see a doctor immediately. This kind of bowel movement can cause dehydration, stomach ache, dizziness and a high fever.
Once you have understood the appearance of your bowel movement, the other factors such as colour, consistency and smell will give you an overall view of what’s happening in your body.
Colour, Consistency and Smell
Green stool with a liquid consistency – This isn’t normal and is an indicator of an infection that generally occurs when you have antibiotics. These kinds of medicine kill the good bacteria in your stomach which causes colour and consistency. It could also lead to dehydration and you may want to seek the advice of your doctor.
Yellowish loose stool but with some solidity – This kind of bowel movement is an indicator of not eating right. The bowel movement shows that what you eat isn’t being processed correctly. You may want to consider a gluten-free diet. It could also mean you could have Celiac disease, so you should get your doctor to run a test.
Bloody or black colour stool – This kind of bowel movement indicates internal bleeding and it could indicate haemorrhoids or stomach ulcers. You should consult your doctor immediately if you notice blood in your stool.
Floating stool – If your stool floats it means you have too much gas in your digestive system. This can happen when you overload on gassy food such as brussels sprouts, beans, cabbage, broccoli and others. Or it could be an indicator of a health condition related to the pancreas. If your stool is persistently floating you should consult your doctor.
Sulphur-smelling stool – If you are suffering from diarrhoea and running a fever with an eggy smelling stool, you should get it checked by your doctor. This kind of stool is an indicator of a parasite in your gut that requires medical attention.
Pale-looking stool – If your stool looks white or flushed out it means you are lacking bile. Bile is a digestive fluid that is part of the liver and gallbladder. If your bile duct is blocked your stool will appear chalky in colour. This could happen due to the side effects of certain anti-diarrhoea medicines. If your stool appears pale you should consult your doctor for treatment.
Signs of Good Bowel Function
Apart from your stool appearing normal in term of consistency, smell and colour, here are the signs of good bowel movement –
- Able to hold on to the pressure for a short time till you reach the bathroom. If you are unable to hold on to the pressure and pass the stool it is a sign of poor bowel function.
- Passing stool within a minute after sitting down. A sign of good poop is when everything comes out without pushing or waiting for it.
- No sign of struggle while pooing, everything comes out soft, smooth and easy without any struggle of passing hard and dry stool.
- When you empty your bowel all in one go – no need to return to the bathroom soon after.
Dr Prasanna Shah advises all senior citizens above the age of 60 to get an endoscopy done every 18 months as a preventive step to ensure gut health and safety. Dr Shah can be reached Monday through Friday, 3-6pm at Tel: 022-23676598/83. Email: drpssshah@yahoo.co.in
