Diseases of the stomach


9 Common Digestive Conditions From Top to Bottom

While it’s common for people to experience acid reflux and heartburn once in a while, having symptoms that affect your daily life or occur at least twice each week could be a sign of GERD, a chronic digestive disease that affects 20 percent of Americans, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). If you experience persistent heartburn, bad breath, tooth erosion, nausea, pain in your chest or upper part of your abdomen, or have trouble swallowing or breathing, see your doctor.

Most people find relief by avoiding the foods and beverages that trigger their symptoms and/or by taking over-the-counter antacids or other medications that reduce stomach acid production and inflammation of the esophagus. But some cases of GERD require stronger treatment, such as medication or surgery.

2. Gallstones

Gallstones are hard deposits that form in your gallbladder — a small, pear-shaped sack that stores and secretes bile for digestion. More than 25 million people in the United States have gallstones, with nearly one million new cases of gallstone disease diagnosed every year — approximately one-quarter of which require treatment, according to the American Gastroenterological Association. Gallstones can form when there’s too much cholesterol or waste in your bile, or if your gallbladder doesn’t empty properly.

When gallstones block the ducts leading from your gallbladder to your intestines, they can cause sharp pain in your upper-right abdomen. Medications sometimes dissolve gallstones, but if that doesn’t work, the next step is surgery to remove the gallbladder.

3. Celiac Disease

An estimated 1 in 133 Americans has celiac disease, according to Beyond Celiac, formerly the National Foundation for Celiac Awareness. The group also estimates that 83 percent of people who have celiac disease don’t know they have it, or have been misdiagnosed with a different condition.

Celiac disease is a serious sensitivity to gluten, which is a protein found in wheat, rye, and barley. Eat gluten, and your immune system goes on the attack: It damages your villi, the finger-like protrusions in your small intestines that help you absorb nutrients from the foods you eat. Symptoms of celiac disease in children include abdominal pain and bloating, diarrhea, constipation, vomiting, and weight loss. Symptoms in adults can also include anemia, fatigue, bone loss, depression, and seizures.

Yet some people may not have any symptoms. The only treatment for celiac disease is to completely avoid eating gluten. Common alternatives to gluten include brown rice, quinoa, lentils, soy flour, corn flour, and amaranth.

4. Crohn’s Disease

Crohn’s disease is part of a group of digestive conditions called inflammatory bowel disease (IBD). Crohn’s most commonly affects the terminal ileum, which connects the end of the small bowel and the beginning of the colon, but it can affect any part of the digestive tract. As many as 780,000 Americans may be affected by Crohn’s, according to the Crohn’s & Colitis Foundation (CCFA).

Doctors aren’t sure what causes the disease, but it’s thought that genetics and family history may play a part. The most common Crohn’s symptoms are abdominal pain, diarrhea, rectal bleeding, weight loss, and fever. “Treatment depends on the symptoms and can include topical pain relievers, immunosuppressants, and surgery,” Dr. Bamji says.

5. Ulcerative Colitis

Ulcerative colitis is another inflammatory bowel disease that may affect as many as 907,000 Americans, according to the CCFA. The symptoms of ulcerative colitis are very similar to those of Crohn’s, but the part of the digestive tract affected is solely the large intestine, also known as the colon.

If your immune system mistakes food or other materials for invaders, sores or ulcers develop in the colon’s lining. If you experience frequent and urgent bowel movements, pain with diarrhea, blood in your stool, or abdominal cramps, visit your doctor.

Medication can suppress the inflammation, and eliminating foods that cause discomfort may help as well. In severe cases, treatment for ulcerative colitis may involve surgery to remove the colon.

6. Irritable Bowel Syndrome

Is your digestive tract irritable? Do you have stomach pain or discomfort at least three times a month for several months? It could be irritable bowel syndrome (IBS), another common digestive condition.

An estimated 10 to 15 percent of people worldwide suffer from irritable bowel syndrome, and of that percentage between 25 and 45 million people live in the United States, according to the International Foundation for Functional Gastrointestinal Disorders. Signs of IBS can vary widely: You can be constipated or have diarrhea, or have hard, dry stools on one day and loose watery stools on another. Bloating is also a symptom of IBS.

What causes IBS isn’t known, but treatment of symptoms centers largely on diet, such as eating low-fat, high-fiber meals or avoiding common trigger foods (dairy products, alcohol, caffeine, artificial sweeteners, and foods that produce gas).

Friendly bacteria, such as the probiotics found in live yogurt, may also help you feel better. Stress can trigger IBS symptoms, so some people find cognitive-behavioral therapy or low-dose antidepressants to be useful treatments, as well.

7. Hemorrhoids

Bright red blood in the toilet bowl when you move your bowels could be a sign of hemorrhoids, which is a very common condition. In fact, 75 percent of Americans over age 45 have hemorrhoids, according to the NIDDK.

Hemorrhoids are an inflammation of the blood vessels at the end of your digestive tract. They can be painful and itchy. Causes include chronic constipation, diarrhea, straining during bowel movements, and a lack of fiber in your diet.

Treat hemorrhoids by eating more fiber, drinking more water, and exercising. Over-the-counter creams and suppositories may provide temporary relief of hemorrhoid symptoms. See your doctor if at-home treatments don’t help; sometimes a hemorrhoidectomy is needed to remove hemorrhoids surgically.

8. Diverticulitis

Small pouches called diverticula can form anywhere there are weak spots in the lining of your digestive system, but they are most commonly found in the colon.

If you have diverticula but no symptoms, the condition is called diverticulosis, which is quite common among older adults and rarely causes problems. But if the pouches become inflamed, it’s called diverticulitis. Symptoms include fever and abdominal pain. Obesity is a major risk factor for diverticulitis.

Mild diverticulitis is treated with antibiotics and a clear liquid diet so your colon can heal. A low-fiber diet could be the cause of diverticulitis, so your doctor may direct you to eat a diet high in fiber — whole grains, legumes, vegetables — as part of your treatment.

If you have severe attacks that recur frequently, you may need surgery to remove the diseased part of your colon.

9. Anal Fissure

Anal fissures are tiny, oval-shaped tears in the lining of the very end of your digestive tract called your anus. The symptoms are similar to those of hemorrhoids, such as bleeding and pain after moving your bowels. Straining and hard bowel movements can cause fissures, but so can soft stools and diarrhea.

A high-fiber diet that makes your stool well formed and bulky is often the best treatment for this common digestive condition. Medications to relax the anal sphincter muscles, as well as topical anesthetics and sitz baths, can relieve pain; however, chronic fissures may require surgery of the anal sphincter muscle.

Is poor digestion cramping your style? Don’t let it go on another day. We’ve got 5 ways to improve your digestion naturally.

If gas, bloating, heartburn, nausea, constipation or diarrhea are part of your everyday life, you’re not alone.

In our modern day society digestive problems have become a part of our daily routine. Albeit often an inconvenient, painful or embarrassing one.

We don’t talk about digestive disorders and we rarely seek advice to help such a common problem. The most common problems associated with the digestive tract are diarrhea, constipation, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and heartburn. These can be caused by many things, such as an unhealthy lifestyle, poor nutrition, a food sensitivity or even an infection. And just as there are many causes, there are many ways to help your digestive system work smoothly.

As dietitians we believe that real food (and a healthy lifestyle) is powerful medicine and that with just a few adjustments to what you eat, when you eat and how you eat you can noticeably improve your digestion.

Here are our top 5 ways to improve your digestion naturally:

1. Add probiotics to your life: Probiotics are strains of beneficial bacteria that live in your digestive system. These bacteria are microorganisms called “probiotics” which means ‘for life’. These microscopic ‘bugs’ live in your intestines where they produce vitamins and short-chain fatty acids that feed and nurture other beneficial bacteria , are nonpathogenic (non-disease causing) and directly contribute to a healthy gut flora (the community of bacteria in your gut). These bacteria aid in digestion (breaking down the foods you eat), help prevent infection and reduce chronic inflammation. You can get more probiotics by taking a supplement (here’s one of our favorites – use coupon code: realfoodrds10) or eating raw fermented foods like kefir, yogurt, sauerkraut, kimchi and kombucha.

2. Change your eating habits: The way you eat has a large impact on how your digestive system works. By changing a few of your eating habits you may be able to improve your digestion dramatically. These are some of our favorite non-food digestion hacks:

  • Eat in a relaxed environment and focus on eating. Just eating.
  • Turn off the television and phone so you can fully focus on the food you are eating and the act of eating. Notice how your food looks, tastes, smells and feels in your mouth. This is called being mindful..
  • Try not to eat when you are upset or in a bad mood. Your brain and your digestive tract are interconnected so these feelings can impact the effectiveness of your digestive system.
  • Be sure to chew each mouthful of food thoroughly before swallowing it to lessen the impact on your digestive system. Chewing your food into smaller particles is an essential, but often overlooked, step in digestion. The more you chew your food, the better it will be broken down which will help with the digestive process. This is because breaking down your food mechanically is actually considered to be the first phase of digestion. The smaller the particles the easier the food travels down the esophagus. As you chew your food, saliva is released from glands in your mouth and which then begins the chemical digestion of the food before it even reaches your stomach. Additionally, the presence of saliva triggers the stomach to produce acid and its own digestive enzymes in preparation for the arrival of your meal.
  • The act of chewing is often the most overlooked step in the digestive process but not one to be taken lightly.

3. Stay hydrated: Water is important for digestion! We need water to digest solid food and absorb nutrients properly. Without water, the entire body’s performance decreases which can lead to dehydration and decrease blood pressure which can cause constipation.

  • Drink enough water each day. The average person should aim to consume approximately 80 ounces of water (or other non-caffeinated fluids) each day.
  • But…..you need to drink this water between meals rather than with meals to avoid diluting stomach acid which is vital for optimal digestion.

4. Rejuvenate with a REAL Food Reboot: Excess toxins can be a cause of digestive problems for many people, causing either diarrhea, constipation or in the case of many with IBS – both! Eliminating the foods that create inflammation in your body while replacing them with whole, nourishing and nutrient-dense foods is one of the best ways to reset your digestive and help you troubleshoot what’s really going on in there.

  • Ditch the artificial sweeteners. These have been shown to drastically alter gut bacteria which we already know is a very important part of healthy digestion and overall health.
  • Eat fewer processed foods. These foods tend to be empty calories with little to no nutrient value and are often full of refined sugars, artificial flavors, colors and preservatives that cause harm to your kidneys and liver and are addictive.
  • Eliminate gluten from your diet. Gluten is a common allergen and gut irritant (even for those without gluten allergies like celiac disease).
  • Avoid processed soy. Soy interferes with the absorption of nutrients and causes a hormone imbalance in the body when consumed in large quantities (i.e. as soy protein isolates in processed foods and beverages).

5. Boost your stomach acid. That’s right. Boost it. The truth is that high levels of hydrochloric acid, or ‘stomach acid’, are often not the cause of heartburn as we’ve been lead to believe. In fact, it’s often too little stomach acid that’s to blame. In order for food to be released from the stomach into the small intestine where most of the digestion and absorption of nutrients occurs, food needs to be in a liquid state. So if you don’t chew each mouthful thoroughly and you have low stomach acid that means your stomach needs to do more ‘mechanical’ digesting – or more churning and squeezing, to break the food down. This mechanical digestion takes more time which means food is left in the stomach longer where it can start to ferment, causing pressure to build (read: gas and bloating). What you now have is the perfect storm with regards to heartburn because the increased pressure exerts force on the esophageal sphincter (the muscle that closes the esophagus off from the stomach) making the acid you do have more likely to splash back up into the esophagus. Here are three simple ways to boost stomach acid naturally:

  • Add freshly squeezed lemon juice to the water you drink between meals.
  • Drink 1-2 teaspoons of raw, unfiltered apple cider vinegar in a small amount of water before each meal.
  • Chew your food. Chew each mouthful until it is nearly impossible to discern what was in the bite you took. This may mean upwards of 15-20 chews per bite.

The ‘Take Away”

You are not alone. We’ve all experienced digestive problems at one time or another. Some digestive issues are harder than others to troubleshoot and fix, but many of them can be fixed with some simple adjustments to how you eat, when you eat and of course, what you eat.

We can all use better digestion – tell us in the comments what small change you’re going to make right away to improve your digestion and start feeling amazing.

What are the best foods to aid digestion?

Share on PinterestAdding ginger to food may reduce digestive problems.

As soon as food enters the body through the mouth, the process of digestion begins.

The body gradually moves it through the digestive system, which breaks the food down into smaller, more useable parts.

Various foods can help at different stages of this process. For example, some aid digestion in the stomach, while others support the intestines.

Fiber is essential to digestive health in general. If a person is not used to eating fiber often, it is best to increase fiber intake slowly, starting with soluble fiber such as from oatmeal, apples, and bananas.

Add around one serving of fiber to the diet every 4–5 days. Increasing fiber intake too quickly can be bad for digestion.

Drinking plenty of water is also important, as it combines with fiber and adds bulk to stool.

Specific foods that are good for digestion include:

Foods containing ginger

Ginger is a plant that can reduce bloating and other digestive problems.

Dried ginger powder is an excellent spice for flavoring meals, and a person can also use slices of ginger root to make tea.

Choose a quality ginger root powder for flavoring meals. For tea, choose fresh ginger root for the best results.

Unsaturated fats

This type of fat helps the body absorb vitamins. It also combines with fiber to help encourage bowel movements.

Plant oils such as olive oil are a good source of unsaturated fats.

Always consume fats in moderation. For an adult following a 2,000-calorie-per-day diet, for example, fat intake should not exceed 77 grams daily.

Vegetables with skin

Vegetables are rich in fiber, which is an important nutrient for digestion. Fiber stimulates the bowels to move stool out of the body.

The skins of vegetables are often rich in fiber, and it is best to consume them whole. Some vegetables with skin rich in fiber include potatoes, beans, and legumes.


Many fruits are also rich in fiber. They also contain vitamins and minerals that are good for digestion, such as vitamin C and potassium.

For example, apples, oranges, and bananas are nutritious fruits that could help with digestion.

Whole-grain foods

Whole-grain foods also have a high fiber content that aids digestion. The body breaks down whole grains slowly, which helps control blood sugar levels.

Many whole grain foods are available, including brown rice and quinoa.


Many yogurt products contain probiotics. These are live bacteria and yeasts that may have benefits for the digestive system.


Kefir is a fermented milk drink that is filling and contains probiotics. As mentioned above, these may promote better digestion and gut health.

Leafy green vegetables

Leafy green vegetables are packed with nutrients that are helpful for digestion.

According to an article in the journal Nature Chemical Biology, these vegetables also contain sulfoquinovose. This is a sugar that may feed healthful bacteria in the stomach, thereby promoting digestion.


It is important to understand how the GI tract works normally and to identify differences in men and women which may be associated with possible worsening of GI problems. These differences may present with unique symptoms in women for shared diseases or even unique diagnoses for women.


A woman’s unique experience of symptoms starts with the tongue and goes through the entire digestive tract. More women can be classified as “supertasters” – they are able to taste both bitter and sweet foods more strongly than men. They don’t need as much of the food to determine if the food is bitter or sweet. This increased sensitivity of the gut to different types of stimulation is seen throughout a woman’s GI tract. Normal women have been shown to be more sensitive to pressure from an inflated balloon placed in the esophagus (swallowing tube between the mouth and the stomach), small intestine, colon or large intestine, and rectum than men. Through each area of the digestive tract, we will talk about symptoms unique to women, their causes, risk factors, testing and treatment.


The GI tract muscles in women may function differently compared with men. Between the end of the esophagus and the beginning of the stomach, there is a muscle which acts like a door. When one eats, the door opens allowing the food to slide into the stomach and then quickly closes again, preventing the food from flowing back up into the esophagus. The muscle in women, especially premenopausal women, squeezes shut with more force than that found in men, making certain that the food and stomach juices stay in the stomach. There is a similar muscle protecting the windpipe from esophageal backflow. In women, tests have shown that after drinking fluids, this muscle tightens more than in men. In part due to this finding, women may have more occurrences of “globus” (the feeling of a “lump in the throat”) that is not necessarily associated with swallowing food. However, overall these strong muscles suggest that women may have some extra protection in the esophagus, normally.

Although women may experience heartburn, they generally have less damage in their esophagus than men. Women secrete less stomach acid than men, throughout their lives and they tend to have fewer ulcers related to acid. The stronger muscles at the end of the esophagus and the lesser amount of stomach acid present in women may help to explain the milder damage to the esophagus. However, because women are more sensitive to irritants, they may experience heartburn more strongly than men. Several things can precipitate heartburn symptoms, including spicy or acidic foods, caffeine, large meals, obesity, or eating prior to lying down. The treatment for heartburn includes modification of any precipitating factors followed by a trial of an acid-suppression medication if symptoms persist. There is data suggesting that prolonged duration of higher-dosed acid-suppressive medication may increase the risk of osteoporosis. This risk can be discussed with your doctor before starting the medication. For refractory cases of heartburn, an endoscopy (a procedure that involves looking into the esophagus and stomach with a small camera) is often indicated to exclude other diagnoses.


Women also seem to have slower emptying of food from the stomach than men. This may be important in explaining why women tend to experience nausea and bloating more frequently than men. Certain conditions including diabetes, prior stomach surgeries, infections, medications, and low thyroid levels can cause damage to nerves that are responsible for gastric emptying, leading to a condition called gastroparesis (delayed gastric emptying). Common symptoms include abdominal bloating, nausea, fullness and weight loss. The diagnosis requires testing by your doctor. The treatment involves eating smaller, more frequent meals that are lower in fat. Although medications may be prescribed by your doctor, options are limited due to drug side effects.

Another stomach problem that may affect women includes inflammation of the stomach (known as gastritis). Many women use aspirin and aspirin-like compounds, known as non-steroidal anti-inflammatory drugs (NSAIDs); ibuprofen is included in this class of medications. Some NSAIDs are available in over-the-counter form while others require a prescription. Women, especially older women, use these medications more often than men for a variety of reasons. These drugs, if used persistently, are known to cause irritation to the stomach lining and may lead to bleeding from ulcers. In recent years, new types of prescription NSAIDs have become available, such as COX-2 inhibitors, which reportedly have less adverse effects on the GI tract, but have been linked to an increase in heart attacks. All patients should discuss with their doctors if the COX-2 inhibitors are right for them. Women should tell their doctors if they are using NSAIDs, whether prescribed or purchased in a drugstore, in order to develop a regimen to help protect their stomach.


Women also have slower emptying from the large intestine when compared with men but this difference disappears in old age. This may be important in explaining why women tend to be more constipated than men. Additionally, at the end of the rectum, the anal sphincter is the muscle that allows us to delay moving our bowels until we find an appropriate place, such as a bathroom. When physicians evaluate the function of the anal sphincter, they measure squeeze pressure – how firmly the patient can squeeze the muscle shut. Most investigators agree that women have less squeeze pressure than men. The anal canal (the passage from the opening to the rectum) is shorter in women and the length of both the sphincter and area of highest pressure is also shorter in women. Men tolerate more volume in the rectal area. Overall, men anatomically should be better able to handle an episode of diarrhea than women.

Chronic constipation is common in women and tends to worsen with age. Treatment includes at least 20-35 grams of dietary fiber per day, adequate fluid intake, and regular exercise. Non-prescription medications may include stool softeners and laxatives. If you don’t respond to these therapies, your doctor may order additional testing or medications.

Irritable Bowel Syndrome (IBS) occurs 2 to 6 times more often in women than in men. In patients with IBS, there is super-sensitivity to irritants (such as intestinal gas) that would not be bothersome to other people. The etiology is believed to be due to the way intestinal nerves send messages to the brain, the interpretation that the brain makes, and its response back to the gut. If a person has emotional stress, the IBS response appears to be worse. The good news is that there is no damage to the intestinal lining. This is a “functional” problem – that is, the bowel is not functioning at a normal level, but at a super- or suboptimal level. Symptoms often include diarrhea, constipation or combination of both. Bloating and abdominal pain are part of the syndrome, and often improve after bowel movements. The diagnosis is made based upon specific criteria and lack of other objective findings. Currently, there is no one treatment to cure this disorder, but many effective management strategies exist. Lifestyle changes are recommended, which include the development of coping strategies for life stressors. This is a chronic condition and many patients have reached satisfactory results working with their physicians as a team.

Inflammatory bowel disease (IBD) includes both Crohn’s and Ulcerative Colitis. IBD is more frequent in women with a ratio of about 2:1. Women may have a milder course of Crohn’s, especially if they have given birth to several children. Hormones during pregnancy could improve or worsen the disease; this is not similar for all subsequent pregnancies in the same patient. Symptoms may include diarrhea, blood in the stool, weight loss, and anemia. Diagnosis is generally made after colonoscopy and review of biopsy specimens by pathology. Treatment can vary but often requires long-term medications, many of which are safe in pregnancy.

Colon cancer is the number 3 cancer for women in the United States. Women should be advised to follow current guidelines to be screened at age 50, and talk to their doctors if they have a family history of the disease, in which case they should be screened at an earlier age and at more frequent intervals. Patients should discuss screening options with the doctor to determine the best individual screening option. There are familial colon cancer syndromes that are also associated with uterine, ovarian and breast cancers, so if several of these cancers are found within a family, genetic counseling should be offered.


Women have slower gallbladder emptying than men normally and are twice as likely to develop gallstones as men. This effect is exaggerated during pregnancy due to unique female hormones, and may be one reason why many women develop gallstones after having a baby. Symptoms of gallbladder disease may include right upper abdominal pain after eating, nausea or vomiting. Gallbladder disease can often be diagnosed by your doctor based upon history and ultrasound results.

Liver and Small Intestine

There are two areas where women have different enzyme systems from men where the effect can be important. There are enzymes in the small intestine as well as in the liver that help break down medications. The enzymes function slightly differently in men and women. Because of this, women may handle various medications differently, resulting in either little effect of the drug or too much effect of the drug. Therefore, it is important that patients ask their doctors if medications that they prescribe may behave differently in women.

Some Common Problems During Pregnancy

Pregnancy is associated with nausea, which occurs early in the pregnancy. This effect may result from a slowing of stomach emptying, beyond what is seen normally in women. One of the pregnancy hormones, progesterone, is associated with delaying muscle contraction, and it is believed that this is a major cause of the nausea seen with pregnancy. Women also experience heartburn during pregnancy. This seems to be caused by the increasing levels of progesterone during pregnancy as well as the increasing size of the baby. It is most prominent during the second half of the pregnancy. Constipation is common for similar reasons.

The muscle coordinating moving one’s bowels can be damaged by a tear during childbirth, leading to possible long-term problems. Therefore, it is important for pregnant women to perform the Kegel exercises, which help to strengthen this area, and to discuss any concerns with their obstetrician.

Author(s) and Publication Date(s)

Rebecca Ensley, DO, and Alissa Speziale, MD, FACG, FACP, Naval Medical Center San Diego, San Diego, CA – Updated July 2013.

Robyn G. Karlstadt, MD, MACG, Shire Pharmaceuticals, Wayne, PA – Published October 2002. Updated April 2007.

The views expressed in this presentation are that of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.

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Gastrointestinal disorders are among some of the most commonly diagnosed medical conditions, yet some people hesitate to discuss them with a doctor, especially those ones that affect bathroom habits. However, GI conditions aren’t limited to the bowel. They comprise a variety of issues, from heartburn to hepatitis C. These disorders can range in severity from acute, mildly annoying, to chronic, debilitating and potentially life-threatening. In other words, they’re well worth talking with your doctor about.

People with GI symptoms who are reluctant to speak to a doctor should remember that most people experience GI issues at some point in their lives and it’s not smart or necessary to suffer in silence. There are effective treatments, and with the help of your doctor, it’s possible to eliminate or effectively manage the symptoms caused by most common GI disorders. And if you think that GI problems are a personal or private issue, understand that a GI doctor is an expert in this sensitive subject.

When it comes to gastrointestinal (GI) conditions, symptoms can be as mild as a nagging stomach ache, or as serious as a sharp pain that lasts all day. But how do you know if your symptoms are serious?

Any symptom that lasts more than a few weeks or causes interruptions in sleep or your daily schedule should not be ignored, as they could be the sign of a more serious problem. Here are the following symptoms to look out for:

Blood in Stool or Vomit

Bleeding in the GI tract is not normal and needs to be evaluated by your gastroenterologist immediately. This goes for anyone experiencing blood in the stool or blood in vomit. We perform procedures like endoscopy and colonoscopy in order to evaluate and diagnose GI bleeding, which could be due to an ulcer, hemorrhoids, cancer, or other conditions.

Difficulty Swallowing

If you have problems coordinating your swallowing, difficulty getting food from your mouth down your esophagus, or you feel like food keeps getting stuck in your chest, it’s important to consult with a physician. Difficulty swallowing or getting food through the esophagus into the stomach can mean there is an inflammation or some sort of narrowing or blockage within the esophagus.


Anemia is defined as having low iron in the blood. While having a balanced diet rich in iron can help raise low iron levels in the blood, there may be other causes of iron deficiency, so be sure to consult with your physician, as anemia can also be a symptom of bleeding, which means the body is losing blood or isn’t absorbing the necessary nutrients for your body to properly function. Symptoms of anemia include feeling tired, dizzy, having heart palpitations, or being short of breath. A blood test can determine if someone is anemic, however, only GI testing can determine if there is a cause within the GI tract.

For more information about common signs and symptoms of gastrointestinal disorders, schedule an appointment with one of our physicians by calling Carlisle Digestive Disease Associates at (717) 245-2228. Our board-certified physicians will help to diagnose your possible condition and offer the best treatment options available.

All of us get a little gassy or stopped up from time to time or feel the burn after a giant Mexican dinner. But there’s a point when these symptoms aren’t normal and could even be a sign of something more serious. “An off day here or there, especially if your schedule, diet, or lifestyle has changed, is fine. But if there is a sudden change or one that persists without clear explanation, it’s a good idea to get a gastroenterologist involved,” says James F. Marion, M.D., Professor of Medicine and Gastroenterology at the Icahn School of Medicine at Mount Sinai. Here’s what to look out for with some of the most common stomach problems, what it could mean, and when to see a doc.

Christine Frapech

If you’ve never had heartburn before (other than after a spicy or super-sized meal) and you’re suddenly experiencing burning on the regular without a specific trigger, it’s time to call your doctor—especially if you have other symptoms like weight loss, the feeling that food is getting stuck in your throat, or blood in your stool. You could be one of the estimated 20 percent of people, according to the National Institutes of Health (NIH), with gastroesophageal reflux disease (GERD), a condition where stomach acid causes inflammation and narrowing of the esophagus, says Marion. Since heartburn can lead to serious complications including ulcers and asthma, you shouldn’t suffer in silence—the right medications usually nix symptoms.

Some people also confuse heartburn with chest pain, since the burn often hits between your chest and abdomen. “Once people hit their forties, they take it more seriously. Severe heartburn can feel like angina, and it can be hard to distinguish the two,” says Marion. That’s why it’s all the more important to see your doc and get checked if you’re experiencing what feels like an unusual new bout of heartburn.

Related: ​5 Signs You Might Have A Scary Vitamin B12 Deficiency

Christine Frapech

Abdominal pain can be tough to pinpoint. “Even though your appendix is in your lower right abdomen, a lot of people have pain in their belly button when they have appendicitis,” says Marion. Problems with your gallbladder, located just below your liver in the middle of your abdomen, can give you pain in your upper abdomen or even your back. Recurring abdominal pain could also be a sign of irritable bowel syndrome (IBS), which, according to the American College of Gastroenterology, is thought to affect 10 to 15 percent of Americans, although only 5 to 7 percent get diagnosed. Symptoms, which often include gas, diarrhea, and/or constipation, happen at least three times a month for three months or have been ongoing for at least six months.

When to talk to your doc depends on how long you’ve been feeling discomfort and how sharp the pain is. “If it’s relatively new and not something you can associate with any change in your diet or lifestyle, if it’s keeping you from doing your daily activities and especially if associated with red-flag symptoms (more on that below), you should see your doctor after a couple of days,” says Marion. Also check in if you have regular, ongoing pain, even if it passes—there’s often something your doc can do about it.

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Christine Frapech

“Being constipated is not alarming, and there’s no amount of bowel movements that’s ‘normal,’” says Jennifer Katz, M.D., Attending Physician at the Montefiore Medical Center Department of Gastroenterology in New York, NY. In fact, getting stopped up is one of the most common gastrointestinal problems, affecting an estimated 42 million Americans, according to the National Institutes of Health. Usually, constipation—taking a poop less than three times per week or having incomplete bowel movements—is caused by not getting enough fiber or a change in your routine or diet.

That said, constipation can sometimes be a sign of something more ominous, says Katz, which might include a thyroid problem, scarring or structuring from injury to the lining of the colon, IBS, or side effects from medications. If your BMs are interfering with the things you like to do, you’re constantly running to the toilet to take a BM in installments, your stool is harder and requires straining, or you’re using laxatives all the time to try and get things going, make an appointment, says Marion.

“There are an amazing number of people who suffer in silence because they’re reluctant to bring it up with their doc,” says Marion. “There are many things we can do, like dietary changes or medications.”

Watch a hot doc explain how you can help a thyroid disorder:

​ Christine Frapech

Acute diarrhea, which lasts less than four weeks, is super common, with about 179 million cases happening every year, according to the NIH; it can be caused by viral or bacterial infections, a parasite, or even eating too many sorbitol-containing foods (commonly found in sugar-free gum, sorbitol is also a common cause of gas). Since diarrhea can lead to severe dehydration fast, it’s important to see a doc if you have the runs with any of the following symptoms: loose stools for more than two days; a fever over 102 degrees F; frequent vomiting; six or more stools in 24 hours; severe pain in the abdomen or rectum; black, tarry, or blood/pus-containing stools; or symptoms of dehydration (thirst, sunken eyes, dark pee, peeing less than usual).

Chronic diarrhea, which happens on-and-off for at least one month, is less common. It could be caused by a thyroid issue, injury to the colon, medication side effects, a long-standing infection, Crohn’s disease, ulcerative colitis, IBS, celiac disease, or (rarely, and usually in older people) even cancer—although these tend to go hand-in-hand with red-flag symptoms. Or it might be a food allergy or intolerance to cow’s milk, soy, cereal grains, eggs, or seafood. The only way to know for sure is to talk to a doc. “We want to find out exactly what’s happening so we can treat problem from the source,” says Marion.

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Christine Frapech

Literally everyone gets gas—but some toot more than others. Maybe you’ve always been a little gassy for as long as you can remember, or maybe you rarely let one loose but have been super bloated for a week. If that discomfort keeps you from your normal routines, a good nutritionist and/or a gastroenterologist can help. It could be an anatomic problem like a stricture; inflammation related to IBS, Chrohn’s, or colitis; or a functional issue with what Marion calls the “choreography or mobility of your bowel.” You could even have recently developed a food allergy like lactose intolerance, which tends to crop up after the age of 30, celiac disease, or a bacterial overgrowth, adds Katz.

No matter the cause, it’s time to see your doctor—especially if gas is accompanied by signs like bleeding, weight loss, or recurrent vomiting—to get tests to pinpoint the cause and medication to treat it if necessary. A dietitian may also want to check your diet to help you figure out if you should cut certain foods that might be making you balloon.

Related: 7 Sneaky Signs Your Blood Sugar Is Too High

Christine Frapech

If any of your stomach problems are accompanied by the following symptoms, be sure to check in with your doctor right away:

Unexplained weight loss can be a sign of lots of conditions that need attention (like Crohn’s disease, ulcerative colitis, celiac disease, ulcers, depression, or, rarely, cancer). Other things to keep an eye on: fever, vomiting, no appetite or a change in appetite, blood in your stool or the feeling that food is getting stuck in your throat. “These are all cases where you’ll want to get an explanation. Your doctor will give you a more invasive workup to get at the source of the problem,” says Marion.

Colleen de Bellefonds Colleen de Bellefonds is an American freelance journalist living in Paris, France, with her husband and dog, Mochi.

Something about your day doesn’t feel quite right. Having stomach pains but not quite sure what might be the cause?

“An upset stomach is very common and may be related to any number of health issues,” explained Dr. John Boger, Geisinger gastroenterologist. “Often it goes away on its own; other times it might be a symptom of something more serious.”

Here are some different causes for an upset stomach and when you may need to see a doctor.


It’s a common feeling when you have a big event or presentation coming up—you start to feel nauseous or like your stomach is full of butterflies.

Whether you’re stressed, nervous or even overexcited, any emotion can cause a physical response. These changes can impact every major system, including your digestive system.

Stress not only heightens your emotions but your physical body functions as well. Stress can send your digestive system into overdrive, which can cause a stomachache or nausea. An upset stomach due to stress isn’t typically a cause for concern and will go away on its own.

Food poisoning

It is always important to keep track of what you eat, especially when dining out for a meal. Symptoms of food poisoning can often kick in within hours of eating contaminated food. These often include nausea, vomiting, diarrhea and abdominal pain.

“Most often food poisoning is mild and will clear up within a few days and without treatment. Monitor your status and seek medical attention if symptoms persist or become more severe,” said Dr. Boger.


Indigestion is also very common and can stem from certain lifestyle habits or eating choices. If you eat certain foods, eat too fast, smoke, drink alcohol or are often fatigued, you may experience indigestion.

“You may experience a burning sensation, bloating, gas, belching or pain,” said Dr. Boger. “It’s important to eat and drink in moderation and be aware of what you’re ingesting and how fast.”

Irritable bowel syndrome

If you experience stomach pains on a regular basis, you may have irritable bowel syndrome (IBS). IBS is a common condition and can cause symptoms like cramping, bloating, gas and constipation.

IBS is a chronic condition that needs management long term. Managing certain things in your life such as diet and stress can help keep your symptoms under control.


Nausea, heartburn, vomiting or feeling full fast are symptoms of a rare but serious condition called gastroparesis. The exact cause of gastroparesis is often unknown but can sometimes be caused by uncontrolled type 1 and 2 diabetes, narcotics or antidepressants, multiple sclerosis or an injury to a major nerve called the vagus nerve. When you have gastroparesis, the muscles in your stomach slow or stop emptying food properly into the intestine.

“Gastroparesis is a chronic condition, but it’s important to get a proper diagnosis so you and your doctor can help manage it—especially if you suffer from diabetes too,” said Dr. Boger.

When to see your doctor

Stomach problems that stick around for a few days or more may signal something more serious. And diagnosing gastrointestinal conditions is not always easy.

Talk to your doctor about any irregular stomach pains or frequent pain, diarrhea, nausea or constipation.

“It’s important to keep track of what you consume or if there’s anything about your lifestyle that may cause stomach pain and uncomfortable side effects,” stressed Dr. Boger. “Being aware of all noticeable symptoms you experience with abdominal pain can help you find out what may be the cause.”

Gastroenterologist Dr. John Boger, MD, sees patients at Geisinger Wyoming Valley Medical Center in Wilkes-Barre. To make an appointment with Dr. Boger or another Geisinger gastroenterologist, please call 800-275-6401 or visit Geisinger.org.

Gastrointestinal Disorders

What are functional gastrointestinal disorders?

Functional disorders are those in which the gastrointestinal (GI) tract looks normal but doesn’t work properly. They are the most common problems affecting the GI tract (including the colon and rectum). Constipation and irritable bowel syndrome (IBS) are two common examples.

Many factors may upset the GI tract and its motility (or ability to keep moving), including:

  • Eating a diet low in fiber
  • Not enough exercise
  • Traveling or other changes in routine
  • Eating large amounts of dairy products
  • Stress
  • Resisting the urge to have a bowel movement
  • Resisting the urge to have bowel movements due to pain from hemorrhoids
  • Overusing laxatives (stool softeners) that, over time, weaken the bowel muscles
  • Taking antacid medicines containing calcium or aluminum
  • Taking certain medicines (especially antidepressants, iron pills, and strong pain medicines such as narcotics)
  • Pregnancy


Constipation means it is hard to have a bowel movement (or pass stools), they are infrequent (less than three times a week), or incomplete. Constipation is usually caused by inadequate “roughage” or fiber in the diet, or a disruption of the regular routine or diet.

Constipation causes a person to strain during a bowel movement. It may cause small, hard stools and sometimes anal problems such as fissures and hemorrhoids. Constipation is rarely the sign of a more serious medical condition.

You can treat your constipation by:

  • Increasing the amount of fiber you eat
  • Exercising regularly
  • Moving your bowels when you have the urge (resisting the urge causes constipation)

If these treatment methods don’t work, laxatives are a temporary solution. Note that the overuse of laxatives can actually make symptoms of constipation worse. Always follow the instructions on the laxative medicine, as well as the advice of your doctor.

Irritable bowel syndrome (IBS)

Irritable bowel syndrome (also called spastic colon, irritable colon, or nervous stomach) is a condition in which the colon muscle contracts more often than in people without IBS. Certain foods, medicines, and emotional stress are some factors that can trigger IBS.

Symptoms of IBS include:

  • Abdominal pain and cramps
  • Excess gas
  • Bloating
  • Change in bowel habits such as harder, looser, or more urgent stools than normal
  • Alternating constipation and diarrhea

Treatment includes:

  • Avoiding caffeine
  • Increasing fiber in the diet
  • Monitoring which foods trigger IBS (and avoiding these foods)
  • Minimizing stress or learning different ways to cope with stress
  • Sometimes taking medicines as prescribed by your healthcare provider

What are structural gastrointestinal disorders?

Structural disorders are those in which the bowel looks abnormal and doesn’t work properly. Sometimes, the structural abnormality needs to be removed surgically. Common examples of structural GI disorders include hemorrhoids, diverticular disease, colon polyps, colon cancer, and inflammatory bowel disease.

Anal disorders


Hemorrhoids are swollen blood vessels that line the anal opening. They are caused by chronic excess pressure from straining during a bowel movement, persistent diarrhea, or pregnancy.

There are two types of hemorrhoids: internal and external.

Internal hemorrhoids

Internal hemorrhoids are blood vessels on the inside of the anal opening. When they fall down into the anus as a result of straining, they become irritated and start to bleed. Ultimately, internal hemorrhoids can fall down enough to prolapse (sink or stick) out of the anus.

Treatment includes:

  • Improving bowel habits (such as avoiding constipation, not straining during bowel movements, and moving your bowels when you have the urge).
  • Your doctor using elastic bands to eliminate the vessels.
  • Your doctor removing them surgically. Surgery is needed only for a small number of patients with very large, painful, and persistent hemorrhoids.

External hemorrhoids

External hemorrhoids are veins that lie just under the skin on the outside of the anus. Sometimes, after straining, the external hemorrhoidal veins burst and a blood clot forms under the skin. This very painful condition is called a pile.

Treatment includes removing the clot and vein under local anesthesia and /or removing the hemorrhoid itself.

Anal fissures

Anal fissures are splits or cracks in the lining of the anal opening. The most common cause of an anal fissure is the passage of very hard or watery stools. The crack in the anal lining exposes the underlying muscles that control the passage of stool through the anus and out of the body. An anal fissure is one of the most painful problems because the exposed muscles become irritated from exposure to stool or air, and leads to intense burning pain, bleeding, or spasm after bowel movements.

Initial treatment for anal fissures includes pain medicine, dietary fiber to reduce the occurrence of large, bulky stools, and sitz baths (sitting in a few inches of warm water). If these treatments don’t relieve pain, surgery might be needed to repair the sphincter muscle.

Perianal abscesses

Perianal abscesses can occur when the tiny anal glands that open on the inside of the anus become blocked, and the bacteria always present in these glands cause an infection. When pus develops, an abscess forms. Treatment includes draining the abscess, usually under local anesthesia in the doctor’s office.

Anal fistula

An anal fistula often follows drainage of an abscess and is an abnormal tube-like passageway from the anal canal to a hole in the skin near the opening of the anus. Body wastes traveling through the anal canal are diverted through this tiny channel and out through the skin, causing itching and irritation. Fistulas also cause drainage, pain, and bleeding. They rarely heal by themselves and usually need surgery to drain the abscess and “close off” the fistula.

Other perianal infections

Sometimes the skin glands near the anus become infected and need to be drained. Just behind the anus, abscesses can form that contain a small tuft of hair at the back of the pelvis (called a pilonidal cyst).

Sexually transmitted diseases that can affect the anus include anal warts, herpes, AIDS, chlamydia, and gonorrhea.

Diverticular disease

Diverticulosis is the presence of small outpouchings (diverticula) in the muscular wall of the large intestine that form in weakened areas of the bowel. They usually occur in the sigmoid colon, the high-pressure area of the lower large intestine.

Diverticular disease is very common and occurs in 10% of people over age 40 and in 50% of people over age 60 in Western cultures. It is often caused by too little roughage (fiber) in the diet. Diverticulosis rarely causes symptoms.

Complications of diverticular disease happen in about 10% of people with outpouchings. They include infection or inflammation (diverticulitis), bleeding, and obstruction. Treatment of diverticulitis includes antibiotics, increased fluids, and a special diet. Surgery is needed in about half the patients who have complications to remove the involved segment of the colon.

Colon polyps and cancer

Each year 130,000 Americans are diagnosed with colorectal cancer, the second most common form of cancer in the United States. Fortunately, with advances in early detection and treatment, colorectal cancer is one of the most curable forms of the disease. By using a variety of screening tests, it is possible to prevent, detect, and treat the disease long before symptoms appear.

The importance of screening

Almost all colorectal cancers begin as polyps, benign (non-cancerous) growths in the tissues lining the colon and rectum. Cancer develops when these polyps grow and abnormal cells develop and start to invade surrounding tissue. Removal of polyps can prevent the development of colorectal cancer. Almost all precancerous polyps can be removed painlessly using a flexible lighted tube called a colonoscope. If not caught in the early stages, colorectal cancer can spread throughout the body. More advanced cancer requires more complicated surgical techniques.

Most early forms of colorectal cancer do not cause symptoms, which makes screening especially important. When symptoms do occur, the cancer might already be quite advanced. Symptoms include blood on or mixed in with the stool, a change in normal bowel habits, narrowing of the stool, abdominal pain, weight loss, or constant tiredness.

Most cases of colorectal cancer are detected in one of four ways:

  • By screening people at average risk for colorectal cancer beginning at age 50
  • By screening people at higher risk for colorectal cancer (for example, those with a family history or a personal history of colon polyps or cancer)
  • By investigating the bowel in patients with symptoms
  • A chance finding at a routine check-up

Early detection is the best chance for a cure.


There are several types of colitis, conditions that cause an inflammation of the bowel. These include:

  • Infectious colitis
  • Ulcerative colitis (cause not known)
  • Crohn’s disease (cause not known)
  • Ischemic colitis (caused by not enough blood going to the colon)
  • Radiation colitis (after radiotherapy)

Colitis causes diarrhea, rectal bleeding, abdominal cramps, and urgency (frequent and immediate need to empty the bowels). Treatment depends on the diagnosis, which is made by colonoscopy and biopsy.

Can gastrointestinal disease be prevented?

Many diseases of the colon and rectum can be prevented or minimized by maintaining a healthy lifestyle, practicing good bowel habits, and submitting to cancer screening.

Colonoscopy is recommended for average risk patients at age 50. If you have a family history of colorectal cancer or polyps, colonoscopy may be recommended at a younger age. Typically, colonoscopy is recommended 10 years younger than the affected family member. (For example, if your brother was diagnosed with colorectal cancer or polyps at age 45, you should begin screening at age 35).

If you have symptoms of colorectal cancer you should consult your doctor right away. Common symptoms include:

  • A change in normal bowel habits
  • Blood on or in the stool that is either bright or dark
  • Unusual abdominal or gas pains
  • Very narrow stool
  • A feeling that the bowel has not emptied completely after passing stool
  • Unexplained weight loss
  • Fatigue

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What to know about bowel disorders

There are several types of bowel disorder, including:

Irritable bowel syndrome

Irritable bowel syndrome (IBS) refers to a number of symptoms that affect the digestive system. These symptoms include:

  • intermittent abdominal discomfort or pain
  • diarrhea
  • constipation

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), IBS is a type of functional GI disorder that increases gut sensitivity and changes how the muscles in the bowels react to stimuli.

Increased gut sensitivity can cause stomach pain and bloating, while changes in intestinal contractions can lead to diarrhea or constipation.

Learn about how to cope with the symptoms of IBS here.

Inflammatory bowel disease

Inflammatory bowel disease (IBD) is an umbrella term that describes several conditions that can cause inflammation in the digestive system.

Inflammation in the digestive tract causes severe abdominal pain, cramps, and diarrhea. It also impairs the body’s ability to absorb nutrients. If a person does not seek treatment for it, over time, IBD can lead to further complications, such as malnutrition and anemia.

The two types of IBD are Crohn’s disease and ulcerative colitis. Crohn’s disease can affect any part of the GI tract but usually involves the small intestine. Ulcerative colitis affects the large intestine and rectum.

Celiac disease

Celiac disease is an autoimmune condition that damages the small intestine. Autoimmune conditions cause the immune system to attack the body.

In celiac disease, the body launches this attack when a person ingests gluten, which is a protein present in wheat, rye, and barley. Ingesting gluten triggers an immune response that attacks the villi in the small intestine.

The villi help transport nutrients from food into the bloodstream. Continual damage to the villi can lead to malnutrition, a variety of digestive symptoms, skin rashes, and many other nondigestive symptoms, including irritability and bone loss.

Over time, celiac disease can even start to affect organ systems outside of the GI tract, such as the reproductive and nervous systems.

According to the National Institutes of Health (NIH), the inflammation caused by celiac disease may increase the risk of small intestine or esophageal cancer.


Diverticulosis causes inflammation in the colon, which results in the formation of small sacs in the walls of the colon.

Although diverticulosis can cause symptoms similar to those of other bowel disorders, most people with diverticulosis do not experience symptoms.

However, people may notice blood in their stools if one of the sacs becomes inflamed and swollen. If one of these bursts, it can cause severe pain and may lead to sepsis.

People with diverticulosis may develop an infection or inflammation in one or more sacs, resulting in a condition called diverticulitis.

Intestinal obstruction

Intestinal obstructions occur when a blockage forms in the intestines, preventing the normal passage of stools.

Learn more about intestinal obstruction here.

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