Dr. MJ Bazos MD,
Diseases: Facts and Fallacies
The digestive tract is a complex system of
organs responsible for converting the food we eat into the nutrients we need to
live. We would expect a system as well used as the digestive tract to be the
source of many problems—and it is. Diseases of the digestive tract are
responsible for the hospitalization of more people in the United States than any
other group of disorders. Yet, until recently, little was known about the
causes, treatment, or prevention of these illnesses.
In recent years, researchers have
begun to shed light on some of the more baffling aspects of digestive diseases.
Some studies have indicated that those diseases once thought to have been caused
by emotional problems may, in fact, be the result of viruses interacting with
the body's immune system or disturbances in the motility patterns of the organs.
And doctors now know that an ulcer has more to do with the presence of the
bacterium Helicobacter pylori than with the level of stress in one's life.
Listed below are facts about common digestive diseases.
Fallacy: Hiatal hernia causes
The fact is,
while some people who suffer from heartburn also have a hiatal hernia, heartburn
is not caused by the hernia. A hiatal hernia is the protrusion of a portion of
the stomach through a teardrop-shaped hole in the diaphragm where the esophagus
and the stomach join. The most frequent cause of hiatal hernia is an increased
pressure in the abdominal cavity produced by coughing, vomiting, straining at
stool, or sudden physical exertion. A majority of people over 60 years have
hiatal hernias and, in most cases, the hiatal hernia does not cause problems.
Fact: Chocolate and peppermint
cause heartburn in many people.
fact is heartburn occurs when the lower esophageal sphincter (called the LES),
located at the junction of the esophagus and the stomach, either relaxes
inappropriately or is very weak . This allows the highly acidic contents of the
stomach to back up into the esophagus. Both chocolate and peppermint are thought
to cause the LES to relax and allow the contents of the stomach to back up into
the esophagus. Other foods associated with heartburn include tomato products,
citrus fruits and juices, coffee, and fried or fatty foods.
Fact: Cigarette smoking causes
The fact is that studies
have shown that cigarette smoking dramatically decreases the LES pressure.
Fact: Nonprescription antacids relieve
The fact is that many
people have discovered that nonprescription antacids provide temporary or
partial relief from heartburn. Long-term use of antacids can, however, result in
side effects like diarrhea, altered calcium metabolism, and magnesium retention.
(Magnesium retention can be serious for patients with kidney disease.) As with
other nonprescription drugs, if prolonged use (longer than 3 weeks) becomes
necessary, consult your doctor.
Peptic Ulcer Disease:
Fallacy: Peptic ulcer disease is
most prevalent among persons under stress.
The facts are that peptic
ulcers are sores in the lining of the stomach or duodenum and occur in many
people. According to some studies, ulcers have been found to be more common
among people in lower socioeconomic groups.
Fact: Cigarette smokers are about twice
as likely to have ulcers as nonsmokers.
The fact is that current research
indicates an association between smoking cigarettes and peptic ulcer disease.
This applies to both gastric (stomach) and duodenal ulcers and to both men and
women. Also, ulcers heal slower and recur more often in cigarette smokers than
Fact: People who take
aspirin regularly increase their risk of getting a gastric ulcer.
The fact is that people who take
aspirin 4 or more days a week for 3 or more months increase their risk of
getting a gastric ulcer. Also, aspirin increases the likelihood of bleeding
from an ulcer.
ulcers should be treated with a bland diet.
The fact is that there is little
agreement about what the term "bland" means. Also, there is little indication
that any particular diet is helpful for all peptic ulcer patients. Although some
patients find that coffee or extremely spicy foods are bothersome, each person
has to find out for him/herself which foods, if any, cause distress.
Fact: Many people cannot drink
The fact is that an estimated 50
million Americans have lactose intolerance. Certain racial and ethnic
populations are more affected than others. As many as 75% of African Americans,
Jewish, Mexican Americans, and American Indian adults and 90% of Asian American
adults have lactose intolerance.
intolerance is caused by a deficiency of lactase, the intestinal enzyme that
digests milk sugar (lactose). Persons with lactose intolerance cannot properly
digest milk and milk products when taken in the usual amounts. Some people are
even sensitive to extremely small quantities of dairy products. Symptoms of
lactose intolerance include cramps, gas, bloating, or diarrhea within 15 minutes
to 3 hours after consuming milk or milk products.
Fallacy: A person with celiac
sprue (an inherited disorder affecting the lining of the small intestine) may
eat small amounts of food containing gluten (a substance found in wheat, rye,
barley, and oats) as long as symptoms do not develop.
The fact is that a person with
celiac sprue should avoid all foods containing wheat, rye, barley, and oats
(foods containing gluten). Severe damage to the intestines can occur even when
there are no symptoms. Some experts think that small amounts of gluten can cause
damage to the intestines.
Fallacy: Bowel regularity means
a bowel movement every day.
facts are that the frequency of bowel movements among normal, healthy people
varies from three movements a day to three a week, and perfectly healthy people
may fall outside both ends of this range.
Fallacy: Nonprescription laxatives
are always safe and always cure constipation.
The fact is that, although
short-term use of laxatives is usually effective in relieving temporary
constipation, long-term use of laxatives impairs the natural muscle actions
required to have a bowel movement. Also, overuse of mineral oil, a popular
laxative, may reduce the absorption of certain vitamins (A, D, E, and K).
Mineral oil also may interact with some drugs, causing undesirable side effects.
Consult your doctor if you need to use a laxative for longer than 3 weeks. And,
if you are on medication, check with your doctor before taking any laxative.
Fact: Habitual use of enemas eventually
leads to loss of normal bowel function.
The fact is that habitual use of
enemas usually is not necessary and will eventually lead to an inability of the
bowels to function normally. As with laxatives, overuse of enemas can impair the
natural muscle actions of the bowel.
Irritable Bowel Syndrome:
Fallacy: Irritable bowel
syndrome (spastic colon, mucous colitis) is a serious disease that often leads
to ulcerative colitis.
fact is that irritable bowel syndrome (IBS) is a common functional disorder
characterized by gas, abdominal pain, and diarrhea or constipation or the
cyclical occurrence of both. IBS, although often causing considerable
discomfort, generally does not lead to other gastrointestinal disorders.
Fallacy: IBS frequently leads to
cancer of the colon.
is that there is no evidence that IBS is a precursor of cancer.
Diverticulosis and Diverticulitis:
Fallacy: Diverticulosis always
causes a serious problem.
The fact is that
diverticulosis is a condition in which little sacs (diverticula) develop in the
wall of the colon. In the United States, the majority of people over the age of
60 years have diverticulosis. Most people do not have symptoms and would not
know that they had diverticula unless an x-ray or intestinal examination were
done. Only about 20% of patients with diverticulosis develop complications such
as diverticulitis, bleeding, or perforation.
Inflammatory Bowel Disease:
Fallacy: Inflammatory bowel
disease (Crohn's disease and ulcerative colitis) is caused by personality
The fact is that the
cause of inflammatory bowel disease (IBD) is not known. IBD is a name for a
group of disorders in which various parts of the intestinal tract become
inflamed. Currently, researchers speculate that IBD may be caused by a viral or
bacterial agent interacting with the body's immune system. There is no evidence
to support the theory that IBD is caused by tension, anxiety, or other
psychological factors or disorders.
Fallacy: Patients with IBD
require a special diet.
is that there is no evidence that the inflammation of the intestines is affected
by specific foods. Many patients tolerate all varieties of food and require no
dietary restrictions. Others, particularly when their disease is active, find a
diet low in fiber and spicy foods easier to tolerate. Maintaining good general
nutrition, however, is more important than emphasizing or avoiding any
disease always causes severe pain.
The fact is that about 10%
of the American population has gallstones, but many do not have symptoms.
However, when gallbladder pain occurs, it is usually sudden, severe, and steady
and is felt in the upper abdomen.
Fact: The pancreas is a
is that the pancreas, a gland that is located next to the duodenum, produces
enzymes and hormones that aid in digestion.
Fallacy: Pancreatitis (inflammation
of the pancreas) is always caused by alcoholism.
The facts are that
approximately one-third of all cases of pancreatitis are due to unknown causes,
and many attacks of acute pancreatitis are associated with gallstones.
Fallacy: Chronic alcoholism is
the only cause of cirrhosis of the liver.
The fact is that
cirrhosis has many causes. In the United States, three-fourths of the cases are
due to chronic alcoholism. In those parts of the world where viral hepatitis is
common, hepatitis is the leading cause of cirrhosis. In children, cirrhosis may
be caused by a host of inherited disorders including cystic fibrosis, alpha-l
antitrypsin deficiency, biliary atresia, glycogen storage disease, and other
rare diseases. In adults, cirrhosis may be caused by hepatitis B or a host of
rare diseases, such as primary biliary cirrhosis, abnormal storage of metals by
the body, severe reactions to prescribed drugs, and prolonged exposure to
Fact: You may
have cirrhosis of the liver and not know it.
The fact is that onset of cirrhosis is
often "silent," having few specific symptoms. In fact, cirrhosis may not cause
symptoms until the disease is far advanced.
Fallacy: Hemorrhoids are the
only cause of bright red bleeding from the rectum.
The fact is that,
although most cases of bright red bleeding from the rectum are due to
hemorrhoids, polyps and cancer of the rectum also can cause a similar type of
bleeding. Any bleeding from the rectum should be evaluated by a doctor.
Fact: Ostomy surgery is a common
The fact is that about
100,000 ostomy surgeries are performed each year and about 1 million persons
have ostomies. Although ostomies create great changes for the patient, they are
rather simple procedures. Ostomy surgery is a procedure in which the affected
part of the small or large intestine is removed, an opening (stoma) is created
on the body's surface, and a portion of the intestine is brought out through the
opening. A pouch is worn to collect the body's waste.
Fallacy: Men become impotent
following ostomy surgery.
fact is that men who have ostomy surgery may have full potency (the ability
to have an erection and orgasm) or complete impotence (the inability to have an
Fallacy: After ostomy
surgery, women experience impaired sexual function and cannot become pregnant.
The fact is that, in
general, having an ostomy does not lessen a woman's sexual or reproductive
capabilities. In a few cases, the condition that necessitates ostomy surgery
also may necessitate additional surgery such as hysterectomy. Hysterectomies
make it impossible to conceive but have no effect on sexual desire or the
ability to have sexual relations.