A: Cellulose gum is a common ingredient in both food products, such as salad dressings, sauces, yogurts, and ice cream, and in pharmaceuticals, such as tablets and liquid medications. It’s an effective thickening agent, stabilizer, and an emulsifier. It has no calories or nutritional value and is used in very small quantities in processed foods. The gum comes from plant cell walls, often from wood pulp or cotton. The Food and Drug Administration and the Environmental Working Group, a nonprofit, nonpartisan organization that evaluates the safety of foods, among other things, have recognized cellulose gum as a safe ingredient in foods, pharmaceuticals, and even cosmetics. While cellulose gum is generally considered safe, some research has suggested that a diet that contains a lot of processed foods, with cellulose gum as an ingredient, could upset the balance of good to bad bacteria in the intestinal tract and cause bloating, gas, and diarrhea. Also, people with irritable bowel syndrome (IBS) may be more sensitive to the additive. 

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Eating nutritious, whole, and minimally processed foods that are prepared in ways you enjoy has inherent value. So does moving your body regularly in ways that work your muscles, heart, and lungs. Here are six small-but-significant wins you may experience as you work towards your overall goals:

Better health markers. Positive changes in blood pressure, blood sugar, and cholesterol levels can be a sign that your new nutrition and exercise habits are “working.” However, genetics also plays a role, so some people will see more significant changes from diet and lifestyle than others.

More energy. Nourishing yourself with healthy meals and snacks spaced throughout the day will give your body the fuel it needs to run optimally, which can reward you with steady energy levels. Similarly, “spending” energy each day on physical activity will yield you even more energy.

Better digestion. Changes to eating patterns such as reducing meal skipping, eating more fiber-rich plant foods, putting down your fork when you are satisfied but not stuffed, and reducing late-night eating can all improve digestion.

Improved sleep. Shifting more of your food intake to earlier in the day—starting with eating breakfast, then making lunch a bigger meal than dinner if you can—can also promote more restful sleep and may have other health benefits. Regular exercise can also help you sleep better.

Increased fitness. Regular exercise doesn’t always lead to weight loss, but it does improve your strength, endurance, and flexibility. Not only is maintaining and building muscle and cardiovascular fitness important for health, especially as we age, but you’ll find that many routine daily activities become easier as you become stronger.

Greater resilience. Supporting your body with nutrition and the movement it needs supports physical and mental health, which can help you recover from stressful events big and small.

Another benefit of looking beyond the scale—even if you do hope to see the number on the scale shift—is that when you pay attention to how the results of your new habits make you feel every day, this can be more motivating than simply focusing on a far-off goal.

You may also notice a synergy to the changes you’re making. For example, eating better and staying active may improve your energy and help you sleep better, and feeling refreshed and energetic can make it easier to plan and prepare nutritious meals and decide to go for a walk instead of lounging on the couch…which continues to support energy and good sleep.

When you feel better and know you’re feeling better, this can strengthen your new nutrition and exercise habits. It becomes easier to do the work to maintain those habits long term, and to return to them if you find yourself off-track along the way because life threw you a curveball.

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What Causes Acid Reflux at Night?

Stomach digestive juices are very acidic, which helps your stomach break down food. The lining of your stomach can tolerate these acids. When you swallow foods or liquids, a valve between your swallowing tube (esophagus) and stomach opens. It should close tightly after swallowing to prevent stomach acids from flowing back into your esophagus.

The valve is called the lower esophageal sphincter (LES). For many reasons, lots of people have a leaky LES, that does not close tightly enough to prevent reflux. Although your stomach can tolerate acid, your esophagus can’t. Acid reflux causes burning pain in your esophagus, commonly called heartburn. But it’s your esophagus that’s burning, not your heart. This pain can also feel like chest pain.

Acid reflux is often worse at night mainly due to gravity. When you are standing up, stomach juices naturally flow downhill into your intestines. When you are lying down, stomach juices are more likely to build up in your stomach and push through your LES into your esophagus. Sometimes these juices can flow all the way up into the back of your throat or your mouth. Reflux juices can even “go down the wrong pipe” into your breathing tube (trachea) and cause choking and coughing.

GERD Symptoms At Night and Risk Factors

Some risk factors for GERD are being overweight, having a family history of GERD, smoking, and having a hiatal hernia. A hiatal hernia is a weakening of the muscle separating your belly from your chest. The top of your stomach pushes through the weak area and bulges into your chest. Symptoms of GERD include:

• Heartburn, which may be worse at night or after eating
• Tasting stomach acid in your throat, which may make you gag or choke
• Chest pain
• Nausea
• Difficulty swallowing or feeling like there is a lump in your throat
• Cough or hoarse voice

How to Prevent Acid Reflux at Night

There are over-the-counter (OTC) medications that can reduce acid reflux and there are some simple steps you can take on your own. The first medication option could be an antacid at bedtime like a Tums or Rolaids that neutralize the acid. If that does not help, you can take an OTC medication that blocks acid production. These medications include proton pump inhibitors like Prevacid or Prilosec and H2 receptor blockers like Pepcid or Tagamet. Proton pump inhibitors may cause side effects, learn more in our article on surprising PPI side effects.

These lifestyle modifications also help:

• Avoid foods or liquids that trigger your heartburn. These triggers may be different for different people, but common triggers include fatty foods, spicy foods, alcohol, coffee or tea, citrus juices, and caffeinated beverages.
• Lose weight if you are overweight.
• Avoid eating for at least three hours before bed.
• Raise the head of your bed, or sleep with your upper body propped up on pillows or a wedge.
• Try to sleep on your left side, which takes the pressure off your LES.

What Else Causes Choking at Night?

Choking on saliva is much less common than acid reflux, but it could happen if you have a condition that weakens or blocks your esophagus, called dysphagia. Dysphagia usually occurs in elderly people with neurologic disease or a growth in the esophagus that blocks the swallowing of solids and liquids. Long-term acid reflux can cause dysphagia due to swelling and narrowing of the esophagus.

Another condition that may feel like choking at night is obstructive sleep apnea. Like acid reflux, this condition is very common. It causes more of a gasping for air than a choking sensation. People with sleep apnea have loud snoring and periods when they briefly stop breathing called apnea. Apnea can wake you up suddenly gasping for breath.

If you experience choking at night that does not respond to OTC medications or lifestyle modifications, let your doctor know. It is important to rule out other causes like or sleep apnea or dysphagia. There may be a prescription strength medicine that will help reduce acid. When all else fails. There is a very effective surgical procedure that can tighten the LES and stop acid reflux.

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Home Treatment | Surgical Treatment | Prevention

What Are Anal Fissures?

Anal fissures are tears in the inner lining of your anal canal. Your anal canal is the short tube at the end of your rectum. The opening of the anal canal for a bowel movement is controlled by a circular muscle called the anal sphincter. A tear in the inner lining (mucosa) of your anal canal is usually caused by passing a hard and large stool. People with tighter anal sphincters and people with frequent constipation are at higher risk for an anal fissure.

Chronic Anal Fissure

Pain from an anal fissure can be severe and it can continue after a bowel movement. Your anal sphincter may go into a spasm and cause pain for minutes or even hours. Not Surprisingly, this can make someone want to avoid having a bowel movement. Avoiding bowel movements leads to harder and larger stools. Tears take several weeks to heal and a hard and large bowel movement can reopen a healing sphincter. This type of cycle can delay healing for six to eight weeks. When this happens, it is called a chronic anal fissure.

How to Treat Anal Fissures

Although anal fissures are not dangerous, you should always see your doctor if you have any blood in your stool or rectal bleeding. Your doctor can usually diagnose an anal fissure from your history and a rectal examination. The other common cause of rectal bleeding is hemorrhoids. Hemorrhoids also cause bright red bleeding during a bowel movement, but the bleeding is usually not painful. Bleeding from a rectal or anal cancer can cause bright red blood, but not the severe pain of a fissure.

Home Treatment for Anal Fissures

In most cases, treatment of an anal fissure starts with home treatment. Because constipation and large hard stools are the usual cause of a fissure, softening your stool and preventing constipation are the first steps in-home treatment. Home treatment instructions may include:

• Add fiber to your diet by eating more fruit, vegetables and whole grains. Try to get about 30 grams of fiber each day.
• Increase the amount of water you drink every day.
• Use a fiber supplement like Metamucil as directed.
• Use an over-the-counter stool softener as directed.
• Sit in a warm tub for 10 to 20 minutes a few times during the day, especially after a bowel movement. This may relieve pain and increase healing.

If these home care treatments are not helping, your doctor may prescribe medications to take at home. These include medications to increase blood flow to your anal area and topical creams or ointments to relieve pain.

Surgical Treatment for Anal Fissures

If you have a chronic anal fissure, you may need to see a rectal surgeon. The first option may be to inject your anal sphincter with a medication called Botox to relax the muscle and prevent spasms. This treatment is 50 to 80 percent successful. If all else fails, a surgical procedure may be needed to cut the anal sphincter muscle, called a sphincterotomy. Although this procedure is rarely needed, it is successful over 90 percent of the time.

How to Prevent Anal Fissures

Preventing constipation and hard stools is the best way to prevent an anal fissure. Constipation prevention includes getting plenty of fluid, exercise, and fiber in your diet. Let your doctor know any time you have rectal bleeding. Ask your doctor for help if you have frequent constipation.

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PPIs reduce the amount of stomach acid made by the acid glands of your stomach. Many brands of PPI are over-the-counter (OTC). Your doctor may also prescribe a higher and longer dose PPI for severe stomach acid problems like gastroesophageal reflux disease (GERD), stomach or duodenal ulcer disease, and inflammation of the esophagus. OTC PPIs include:

• Omeprazole (Prilosec)
• Esomeprazole (Nexium)
• Lansoprazole (Prevacid)

Other types of OTC antacids work more quickly than PPIs, but they are not as powerful. These include antacids like Tums or Rolaids and drugs called histamine-2 (H2) blockers, like cimetidine (Tagamet) and famotidine (Pepcid).

OTC PPIs are approved to treat heartburn that occurs frequently, on two or more days per week. They are taken as pills or capsules, once per day, before your morning meal. PPI directions for use say you should only take a PPI for up to two weeks and not for more than three times per year unless you check with your doctor first.

While your stomach lining is strong enough to handle a normal amount of stomach acid, your esophagus is not. This is what causes heartburn.

Short-Term Side Effects of PPIs

If you take a PPI for frequent heartburn as directed – not longer than two weeks – side effects are rare and usually mild. Common side effects include:

• Headache
• Stomachache
• Nausea
• Constipation or diarrhea

Other side effects may include itching or dizziness. Side effects stop when you stop taking the PPI and do not lead to serious complications.

Long-Term Effects of PPIs

Because PPIs are so effective, they have become one of the most commonly used OTC medications. Many people take a PPI on their own for many weeks or even many years. Doctors may also prescribe long-term PPI treatment for some people. Because the long-term effects of PPIs were not known, many studies have been done to look for them.

In 2010, the U.S. Food and Drug Administration (FDA) cautioned people and their doctors that long-term use of PPIs may increase the risk of hip, wrist, and bone fractures. This side effect is more likely in patients ages 50 and older taking a prescription strength PPI for one year or longer.

In 2012, the FDA put out another warning that PPIs may increase the risk of a bacterial gastrointestinal infection called C. difficile associated diarrhea. This watery and painful diarrhea does not go away without treatment. This side effect often occurred in people who were elderly, had a long-term health condition, or were taking antibiotics.

What Does the Research Say About Long-Term Effects of PPI?

Since the FDA warnings, a recent review of long-term PPI side effects has been published in the journal Basic & Clinical Pharmacology & Toxicology. Sixty-seven studies, case reports, and reviews were included. Side effects that were studied and reviewed include:

• PPIs and difficile and other bacterial infections. Because acid in your stomach is a natural defense against bacteria that you swallow, lower levels of acid due to PPI treatment may allow more bacteria to enter your digestive system. Studies show that taking a long-term PPI may increase the risk of C. difficile and other gastrointestinal infections. For C. difficile infection, the risk may increase by 2 to 3 percent.
• PPIs and rebound hypersecretion. When you stop taking a PPI, your gastric cells will produce more acid than normal for a while and cause worsening of your heartburn. This may cause heartburn when you try to get off a PPI. Studies show that about 30 percent of long-term PPI users will have this side effect.
• PPIs and bone fractures. The acid in your stomach is needed to absorb calcium, which you need for bone strength. Some studies have found this risk and others have not.
• PPIs and liver infection and lung infection. Lower stomach acid may allow bacteria to spread from your stomach to your liver or your lungs. Studies on this side effect have not shown a consistently increased risk.
• PPIs and vitamin B 12, magnesium, and iron deficiency. These side effects have been studied because lower levels of acid may reduce the ability to absorb these important nutrients. Studies do not show that PPIs cause any decrease significant enough to cause symptoms or require additional supplements.
• PPIs and stomach cancer. This has been a concern because PPIs may increase the levels of a hormone called gastrin. Gastrin has been linked to increased cell growth, which may increase cancer risk. Some studies have found an increased risk and others have not.
• PPIs and kidney failure or injury. This side effect has been found in some studies but not others. It is not known why PPIs might cause kidney damage. Evidence for this risk is low or insufficient.
• PPIs and memory loss, dementia, or Alzheimer’s disease. A protein that builds up in the brains of people with dementia, especially Alzheimer’s disease, may be increased in people on long-term PPIs because stomach acids help break down this protein. A few studies have found an increased risk of dementia with PPI use, but one of the largest studies found that PPIs decreased the risk of developing dementia.

The authors of the review conclude that the most likely side effects from long-term PPIs are gastrointestinal infection and rebound hypersecretion heartburn. Other long-term dangers of PPIs have not been supported by enough research to limit their use in people who need them. PPIs should be used in the lowest effective dose and stopped if they are no longer needed.

Getting Off Proton Pump Inhibitors and Alternative Solutions

If you have been taking a PPI for a long time, you may have a lot of heartburn if you stop taking the PPI suddenly. Talk to your doctor about getting off a long-term PPI. You may need to taper the dose of your PPI slowly and use an H2-blocker to manage symptoms until your stomach acid secretion returns to normal.

You can try some alternative solutions for getting rid of heartburn without medication. The Mayo Clinic suggests these lifestyle changes:

• Avoid gaining too much weight. Losing weight and maintaining a healthy weight help keep stomach acid in your stomach.
• Avoid tight clothing that puts pressure on your belly. This can force stomach acid up into your esophagus.
• Avoid foods that trigger your heartburn. Different people have different food triggers, so keep a heartburn food diary to find yours.
• Do not lie flat for at least three hours after eating. Raise the head of your bed or sleep on a wedge pillow to keep stomach acid from seeping up into your esophagus.
• Eat smaller and more frequent meals instead of large meals, especially in the evening.
• Don’t smoke and limit or avoid alcohol; both can increase stomach acid.

And finally, you can try some natural herbal antacids. Harvard Medical School’s Harvard Health suggests these natural alternatives: Chamomile tea, ginger, and licorice.

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Gut Healthy Foods
Gut Healthy Diet Recommendations

What About Probiotics?

According to the National Institutes of Health (NIH), only vitamins and minerals are more popular as dietary supplements than probiotics. People use probiotics to add healthy bacteria to their gut. Everyone has bacteria living in their gut, but healthy bacteria are important for digestion and for the health of your immune system. People often use a probiotic supplement to maintain gut health or to restore healthy gut flora and bacteria after a bout of diarrhea.

Although using probiotics to kill bad bacteria or to restore gut health naturally seems like a good idea, NIH says no health claims for probiotics have been approved by the U.S. Food and Drug Administration, at least not yet.

Probiotics are actively being researched, and researchers are learning that probiotics are complicated. In order for them to be effective, we still need to learn which probiotics work best,  and that may vary from person to person. You also need to know how much to use and for how long. On all those questions, the jury is still out. NIH says, if you want to try a probiotic supplement for gut health talk to your health care provider.

Gut Healthy Foods

There is much more agreement on gut-friendly foods than on probiotics. NIH says the basic strategy should be to eat more fruits, vegetables, and add foods high in fiber. As for food to avoid for a healthy gut, avoid red meat, processed meats, and fatty foods. _[5]

John Hopkins Medicine suggests these food tips for gut health:

• Eat lots of whole grains for fiber.
  Good gut health requires at least 25 grams of fiber every day. Gut bacteria break down fiber into nutrients that improve immune system health. Avoid refined carbohydrates, which are stripped of their outer shell where all the nutrients are. Look for brown bread and rice as opposed to processed white rice and white bread.

• Eat lots of leafy green
  

  Leafy green vegetables are rich in vitamins B, C, K, and A. © Olivier Tabary | Dreamstime.com

  vegetables like spinach and kale.
  These vegetables promote healthy gut flora and they also provide vitamins B, C, K, and A.

• Eat lean proteins like fish and poultry and avoid red meats and fatty meats.
  Foods that are high in fat, especially fried foods, can make your bowel more sensitive and trigger contractions of your colon.

• If you are prone to gas or bloating, avoid high-sugar fruits like apples, pears, or mango.
  Try eating more berries, citrus fruits, and bananas. These fruits stimulate the good bacteria in your gut.

• Learn to love avocado.
  Avocado is a gut-friendly vegetable packed with fiber and potassium. Adding some avocado to your diet promotes healthy digestion and gut health.

Gut Healthy Diet Recommendations

Rush University Medical Center says to follow these diet recommendations to reduce your risk of colon cancer and improve colon health:

• Make at least half your diet plant-based.
  Fill at least half your plate with foods like vegetables, fruits, nuts, seeds, beans, lentils, or whole grains.

• Limit red meat and processed meats.
  Processed meats include hot dogs, sausage, and lunch meats. According to the American Cancer Society (ACS) your risk of colon cancer goes up by 15 to 20 percent if you eat a hamburger or a hot dog every day. If you eat red meat, limit your serving to the size of a deck of cards and no more than three times per week.

• Avoid adding sugar or buying foods with added sugar.
  The natural sugar in dairy products and fruit is fine for colon health, but added sugar leads to added pounds, and obesity has been linked to colon cancer.

• Intake at least 30 grams of fiber a day.
  The ACS recommends at least 30 grams from sources like whole grains, fruits, vegetables, nuts, seeds, and beans. If you have trouble eating enough fiber, consider a fiber supplement like Metamucil. Fiber will prevent constipation and lower your risk of hemorrhoids and diverticulosis.

• At least half of your grains should be whole, and you should get 3 to 5 servings daily.
  Whole grains can include barley, whole wheat, wild and brown rice, oatmeal, or quinoa. You won’t get the same gut-friendly benefits of vitamins, minerals, and antioxidants from refined grains like white bread, rice, and pasta.

A final tip is to maintain a healthy weight. If you are overweight, get down to a healthy weight. Get at least 30 minutes of exercise every day. Lack of activity and obesity are bad for gut health and may increase your risk for colon cancer.

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Small intestinal bacterial overgrowth (SIBO) is a medical condition caused by abnormal types and amounts of bacteria growing in your small intestine. Your small intestine is the part of your digestive system between your stomach and your colon. It is about  20 feet long. Food moves quickly through your small intestine, and unlike your colon, there is very little bacteria. [1-2]

If you have SIBO, the passage of food through your small intestine slows down. This allows bacteria to grow in your small intestine. The growth of bacteria causes the symptoms of SIBO. There are many reasons why digestion in the small intestine may slow down. Possible causes include: [1,2]

• Cancer
• Surgery or scar tissue from surgery for obesity, cancer, or ulcer disease
• Diabetes
• Twisting of the small intestine
• Opioid drugs
• Diseases of the liver or pancreas
• Inflammatory small bowel disease (Crohn’s disease)

SIBO Symptoms

According to the American College of Gastroenterology (ACG), the most common symptoms of SIBO are: [2]

• Abdominal pain
• Bloating
• Gas
• Distention
• Flatulence

Other symptoms may include nausea, loss of appetite, and weight loss. Because long-term SIBO can interfere with the absorption of vitamins and minerals, you may have symptoms of vitamin B-12 deficiency including fatigue, tingling, numbness, and confusion. You may also develop weak bones or kidney stones from a lack of calcium. [1]

SIBO Diagnosis and Treatment

Because SIBO can be caused by a serious condition and can have serious complications, you should see your doctor if you have SIBO symptoms. The best test for SIBO is a small intestine fluid culture. A small tube is placed down through your stomach into your small intestine to sample intestinal fluid. This test can find abnormal bacteria caused by SIBO. [1,2]

Another important diagnostic test is a SIBO breath test. For this test, you eat some sugary food. The bacteria caused by SIBO will digest the food and give off gasses that can be detected in your breath. [1,2]

Treatment for SIBO is antibiotics along with correction or treatment of the cause when possible. Sometimes surgery is needed to remove scar tissue or correct a twisted intestine. [1] SIBO may return and require another treatment with a different type of antibiotic. [2]

SIBO Diet

A diet that reduces the foods that create gas when broken down by bacteria in the small intestine may be helpful along with another treatment. ACG says that the only diet supported by research so far is the low FODMAP diet. Probiotics are not helpful and may make SIBO worse. [2]

If your doctor diagnoses malnutrition from SIBO, you may need to take nutritional supplements like vitamin B-12, other vitamins, calcium, or iron supplements. In some cases, damage to your small intestine may cause you to lose the ability to digest the milk protein lactose. Therefore, you may need to avoid food products with lactose. [1]

According to Johns Hopkins University, the FODMAP diet is used to treat SIBO, but it is not a diet that you can pick up from a book or the internet and try on your own. Low FODMAP is a temporary diet that eliminates certain types of sugars that are not well absorbed in the small intestine. After the elimination phase, sugars are reintroduced gradually to find out which ones trigger your symptoms. This is a restrictive and complicated diet, so it is important to work with a dietician or a doctor familiar with the FODMAP diet for SIBO. [3]

Bottom Line on SIBO and a SIBO Diet

Symptoms of SIBO are common and be caused by many intestinal problems. If you have intestinal symptoms that last or keep coming back, let your doctor know. If you are diagnosed with SIBO, a SIBO diet such as FODMAP may help as part of a doctor managed treatment plan. [1-3]

Sources:

[1] Mayo Clinic, Small intestinal bacterial overgrowth (SIBO) – Diagnosis and treatment – Mayo Clinic

[2] American Journal of Gastroenterology, ACG Clinical Guideline: Small Intestinal Bacterial Overgrowt… : Official journal of the American College of Gastroenterology | ACG (lww.com)

[3] Johns Hopkins, FODMAP Diet: What You Need to Know | Johns Hopkins Medicine

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How Do You Get H. pylori?

The exact way you become infected with H. pylori is still unknown, but it can be passed from person to person. [2] The most common way H. pylori pass from person to person is through contact with the stomach contents or the stool of an infected person. This is called oral-to-oral or fecal-to-oral contact. [3] A common fecal to oral spread occurs if an infected person does not wash their hands after a bowel movement and then touches food that you eat. [1]

H. pylori can also be found in saliva, so it may be spread through kissing. This infection most often spreads between people in close contact, such as families or people who live together in nursing homes. H. pylori infections are more common in African, Hispanic, and Asian Americans. [1]

According to the American College of Gastroenterology, most H. pylori infections start in childhood and never cause any symptoms. [4] The exact way H. pylori infect children is not known, but the infection probably spreads from close contact with an infected family member. Children who live in a home with many people are at higher risk. Why some people develop symptoms and others don’t is not known, but may be due to differences in people’s immune systems. [2]

What Are the Symptoms of H. Pylori?

Most people with H. pylori never have symptoms. If you do have symptoms they could include: [2]

• Aching or burning pain in your stomach area
• Pain that gets worse on an empty stomach
• Nausea or loss of appetite
• Burping and bloating
• Weight loss

How Is H. pylori Diagnosed and Treated?

Because H. pylori is one of the most common, long-term infections in humans, and most people do not have symptoms or problems, doctors do not routinely test for it. You may be tested if you have symptoms. [4] There are several ways to diagnose H. pylori: [1-3]

• Blood testing may tell if you have been infected, but can’t tell if you have an active infection.
• Breath testing involves swallowing a substance that is broken down by H. pylori bacteria. Exhaling into a bag can detect molecules from the substance released by H. pylori.
• Stool testing can detect a protein released by H. pylori.
• Endoscopy is a test using a flexible scope placed down your mouth into your stomach. Samples taken from your stomach can be studied for the presence of H. pylori.

Antibiotic treatment for H. pylori is the recommended treatment protocol

If you test positive for H. pylori, you should be treated. The type of treatment depends on where you live, your exposure to antibiotics, and any history of resistance or allergies to antibiotics. There are three recommended treatments for initial therapy: [4]

• Triple drug therapy is an acid lowering medication called a proton pump inhibitor (PPI) and two antibiotics (Clarithromycin and Amoxicillin).
• Quadruple drug therapy is a PPI, two antibiotics (Tetracycline and Metronidazole) and the antacid in Pepto Bismol, called bismuth.
• Concomitant drug therapy is a PPI and three antibiotics (Clarithromycin, Amoxicillin, and Nitroimidazole).

Treatment lasts for 10 to 14 days. During that time symptoms should improve. Four weeks after treatment ends, you will be tested again with a breath test, stool test, or endoscopy test to make sure all the H. pylori is gone. Once all the bacteria are gone, you cannot spread the infection after successful antibiotic treatment. [4]

Treatment is usually successful, but in a small percentage of people H. pylori does not respond to treatment or comes back after treatment. In these cases, a different antibiotic treatment combination will be used. [3]

Can You Prevent H. pylori Infection?

Because this infection is so common and most people have no H. pylori symptoms, it is hard to avoid it. There may be ways that H. pylori passes from person to person that are not yet known. There are no special diets, foods, or supplements that are recommended. You may reduce your risk by washing your hands after changing a diaper or coming into contact with another person’s stool or vomit. Making sure the food you eat and the water your drink is tested and safe is another way to lower your risk of contracting H. pylori. [1-3]

Sources:

[1] Merck Manual, Helicobacter pylori Infection – Digestive Disorders – Merck Manuals Consumer Version

[2] Mayo Clinic, Helicobacter pylori (H. pylori) infection – Symptoms and causes – Mayo Clinic

[3] Medscape, Helicobacter Pylori Infection: Practice Essentials, Background, Pathophysiology (medscape.com)

[4] American Journal of Gastroenterology, ACG-H.-pylori-Guideline-Summary.pdf (gi.org)

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What Causes C diff?

About 10 to 20 percent of people have diarrhea as a side effect of taking an antibiotic. That’s because antibiotics can kill the healthy bacteria in your colon, allowing “bad” bacteria to grow. Bad bacteria can cause inflammation and diarrhea. C diff is a particularly bad bacteria that takes over when healthy bacteria decrease. C diff produces a poison (toxin) that is very damaging to your colon. [1,2]

C diff infection is more common if you have taken a type of antibiotic that kills lots of different types of bacteria, called a broad-spectrum antibiotic like clindamycin, cephalosporins, and quinolones. You could be at higher risk if you are elderly or sickly or in a hospital or long-term care facility. [1,2]

What Are the Symptoms of C diff Infection?

The main symptom is crampy and watery diarrhea. You may also have fever, nausea, and vomiting. Dangerous infection may cause fever, bloody diarrhea, and a distended, tender belly. If you have any of these symptoms let your doctor know. C diff is diagnosed with stool testing to look for C diff toxins. [1,2]

How Is C diff Treated?

Your doctor may stop or change an antibiotic that you are still taking if possible, but you will need to start another antibiotic that kills C diff bacteria. The first choice is an antibiotic called metronidazole. Other options are vancomycin and fidaxomicin. [1]

An emerging alternative treatment is a stool transplant from a healthy stool donor, called a fecal microbiota transplant (FMT). Studies show that FMT can replace harmful bacteria, like C diff, with healthy bacteria and restore a healthy bacterial balance in your colon. About 20 percent of people get a recurrence of C diff after treatment. FMT may be most valuable in these cases. [2]

What Should You Eat to Help a C diff Infection?

Look for probiotic-rich yogurts and kefir in the dairy aisle.

Diet changes will not get rid of a C diff infection, but they may help you manage the diarrhea. [2] One possible change is to add probiotics, which are common in foods like yogurt, kefir, sauerkraut, tempeh, or miso. According to the Academy of Nutrition and Dietetics, live cultures of “friendly bacteria” may be helpful for C diff diarrhea. [3]

The Academy of Nutrition and Dietetics also says that although there is not much research on the best diet for C diff diarrhea, some studies suggest a diet that includes soluble fiber and reduces insoluble fiber.

Soluble fiber foods include:

• Oats
• Beans
• Peas
• Carrots
• Barley
• Citrus fruits
• Strawberries
• Bananas
• The pulp of apples

Insoluble fiber foods include:

• Whole wheat in breads and cereals
• Rye
• Brown rice and other whole grains
• Cabbage
• Beets
• Brussel sprouts
• Turnips
• Cauliflower
• Apple skin [3]

Mayo Clinic suggests drinking plenty of fluids and starting with a liquid diet until you get your appetite back. Mayo also warns that some people develop a temporary lactose intolerance, so you might want avoid milk-based foods for a while.

Good foods for managing diarrhea include:

• Starchy foods (potatoes, noodles, rice, and oatmeal)
• Saltine crackers
• Bananas
• Soups
• Boiled vegetables [2]

The bottom line is that symptoms of C diff should not be ignored. They do require a diagnosis and medical treatment. Diet changes may help you manage diarrhea until treatment takes effect. [1,2]

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• Probiotic Benefits for Chronic Fatigue Symptoms and Digestive Issues
• SIBO Diet: What to Eat If You Have Small Intestinal Bacterial Overgrowth
• Alternative Sources of Calcium: 7 Reliable Food Types
• How to Stop Diarrhea: Here’s What You Can Do to Treat and Prevent Outbreaks

SOURCES

1. American College of Gastroenterology, C. Difficile Infection, https://gi.org/topics/c-difficile-infection/
2. Mayo Clinic, C. difficile infection, https://www.mayoclinic.org/diseases-conditions/c-difficile/diagnosis-treatment/drc-20351697
3. Academy of Nutrition and Dietetics, Diet and C. Difficile, https://www.oncologynutrition.org/erfc/eating-well-when-unwell/surgery/diet-and-c-difficile

The post C Diff Diet: Clostridium Difficile Symptoms, Treatment and Recommended Foods appeared first on University Health News.

Kidney Stones: Mineral Concentration

Kidney stones develop when minerals and salts in the urine become concentrated in the kidney and form pebble-like lumps, usually made of calcium and oxalate or phosphorus, A stone  may eventually move out of your kidney and travel through your  ureter, bladder, and urethra.

The ureter is the tube that drains urine from the kidney to the bladder; the urethra is the tube through which urine travels on its way out of the body. Eighty percent of stones include  calcium, but the body can also produce other types of stones, including  , uric acid, struvite, and cysteine (an amino acid that helps build protein) stones.

The most common contributing factor to kidney stones is dehydration, according to Washington University School of Medicine in St. Louis. Urine is a solution, but with dehydration, there may not be enough fluid in the urine to dilute  the minerals and salts that develop into stones.

The Cause of Kidney Stone Pain

It’s not the stone itself that causes pain. In fact, if a stone can stay in the kidney or pass through the ureter without causing a blockage, there may be little or no pain. But when a stone moves around in the kidney or gets stuck in the ureter and blocks the passage of urine, the blockage can cause the following symptoms:

• Sharp stabbing pain in the back or side
• Pain that comes and goes
• Nausea, vomiting
• Frequent urination
• Painful urination
• Blood in the urine
• Fever, but only if an infection is present

The smaller the stone, the more likely it will pass on its own. Eighty percent of kidney stones fall into that category (less than 4mm), but it takes an average of 31 days to happen. If the stone is 4-6mm, it will pass about 60 percent of the time. If greater than 6mm, the stone will pass about 20 percent of the time. In most cases where the stone is greater than 4mm, a medical procedure is necessary.

Managing the Pain

Medications include aspirin, acetaminophen, prescription pain medications, diuretics, and antibiotics. Drink plenty of fluids to increase urinary volume that may help pass the stone. Stay as active as possible. Walking helps. Your doctor may prescribe a drug that relaxes the ureter, which allows the stone to pass. Taking a hot shower or sitting in a tub of warm water offers temporary relief.

When to See a Doctor for Kidney Stones

Notify your doctor if you think you have a kidney stone. If you have severe pain and other signs and symptoms of a stone, get help right away. Your healthcare provider may recommend some of the measures above, and may ask you to capture a stone if it passes so it can be analyzed.

Blood tests can show calcium levels, glandular problems, and kidney dysfunction. A CT scan can identify a kidney stone, and ultrasound scans detect swelling of the kidney and/or the ureter—an indication that the stone is blocking the flow of urine.

Under the supervision of a doctor, you might be able to treat a kidney stone at home. If the stone is too large, the pain too severe, infection is present, or there is significant bleeding, the kidney stone will have to be removed surgically or broken into fragments that can move through the urinary tract.

Prevention

About half the people who have a kidney stone will never have another incident. For those who have recurring stones, the prognosis depends on the cause and on how well the patient responds to prevention guidelines. They include drinking more fluids, eating less protein, reducing the intake of salt, and increasing the intake of citrate (lemons, oranges, grapefruit), a chemical that inhibits the production of kidney stones.

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• Natural Remedies for Kidney Stones
  
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• Kidney Stone Treatment: It Can Range from Home Remedies to Hospital Stays
  
• Kidney Stone Diet: Can Foods You Eat—and Avoid—Help Prevent Kidney Stones?
  
• Kidney Pain: What’s Behind It?

This article was originally published in 2018. It is regularly updated.

The post Kidney Stones: Causes, Symptoms, Management and Prevention appeared first on University Health News.