Symptoms of Impacted Bowel

The most common (and obvious) symptom of an impacted bowel: Being unable to have a bowel movement no matter how hard you try, with accompanying pain in the abdomen or back. Other symptoms include:

• Leaking of watery stool, especially when you cough
• Nausea
• Vomiting
• Headache
• Unexplained weight loss
• Poor appetite

More serious symptoms that could require immediate medical attention include:

• Breathing problems
• Rapid heart rate
• Fever
• Incontinence (uncontrollable urination)
• Confusion
• Agitation
• Dizziness

Impacted Bowel Causes

One of the most common causes of an impacted bowel is an overuse of laxatives. Higher doses and repeated use can make the colon less able to naturally respond to the body’s need to have a bowel movement.

When taking laxatives on a regular basis, your body may adjust itself and begin to depend on these laxatives in order to make a bowel movement. Instead of using laxatives regularly, be sure to eat a diet high in fiber. How much fiber? Between 20 and 30 grams of fiber per day is required to encourage proper bowel function. Unfortunately, most American diets contain only half of that amount, which can result in bowel impaction.

In certain cases, an impacted bowel or constipation may result from a more serious condition, such as irritable bowel syndrome, diverticulitis, and even colon cancer. It’s important to check with your doctor if you are suffering from what you believe to be an impacted bowel.

Other causes include:

• Constipation that goes untreated.
• Little or no physical activity over a long period.
• Diet changes that may include less fiber.
• Opioid pain medicines.
• Inadequate fluid intake.
• Travel and schedule changes.
• Pain or discomfort around the anus.
• Ignoring the initial urge to defecate.

Diagnosis

If you have symptoms of chronic constipation or an impacted bowel, see your doctor. He or she may perform one or more tests to determine the severity of your fecal obstruction symptoms. For example:

• X-rays of the abdomen.
• Digital rectal exam (DRE). The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for a fecal impaction, lumps, or anything else that seems unusual.
• Sigmoidoscopy. A thin, lighted tube is inserted through the anus and rectum and into the lower part of the colon to look for fecal impaction and abnormal areas.

How to Treat an Impacted Bowel and Constipation

The first treatment for bowel impaction may be to soften the stool with an enema so it can be removed or passed out of the body. In most cases, your physician may be able to manually disimpact the stool. This process, according to an article in Clinics in Colon and Rectal Surgery, involves inserting a lubricated, gloved index finger in the rectum to gently soften and break up the stool. The physician’s finger, bent slightly, can then remove and extract the stool. This process is repeated until the rectum is cleared of any stool impaction.

An impacted bowel also can be removed through enemas and suppositories prescribed by your doctor. Enema solutions usually contain water and some sort of osmotic agent that act to soften the impacted stool. The additional volume of liquid also promotes the stool to evacuate the body.

When receiving an enema, patients are placed in the Sims’ position and the enema is passed through a rubber catheter into the patient’s anus. The pressure and volume of enema administration is determined by the size of the patient and how impacted the stool is in the body. After the enema is administered, patients usually wait a few minutes for the solution to mix and soften the stool. A massage of the lower abdomen can help the process until the patient voluntarily releases the impacted stool and solution. The process can be repeated until the symptoms are clear. Too many enemas, however, can damage your intestine.

Preventing Impacted Stool

The best way to avoid impacted bowel issues is to make sure you don’t become constipated, taking these steps:

• Drink plenty of liquids daily to reduce your risk of dehydration.
• Consume more high-fiber foods (such as whole-wheat bread, oats, and vegetables) to promote regular bowel movements.
• Lower your intake of high-sugar foods.
• Exercise; a regular routine can help your digestive system run smoothly.

RECOMMENDED FOR YOU

• Bristol Stool Chart: What It Can Tell You About Your Health
• What Helps Constipation? Know the Causes—and Find Relief
• Should You Use an Enema for Constipation?

Originally posted in 2016, this post is regularly updated.

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Your body makes about one to two quarts of mucus every day to help trap and destroy foreign particles like dust, bacteria, and viruses before they can cause infection. Often, this mucus mixes with your salvia and drips normally down the back of your throat and is then swallowed.

However, your body sometimes may produce excess mucus, which makes the drip more noticeable—hence the need for post-nasal drip relief.

Causes and Symptoms of Post-Nasal Drip

Common causes of post-nasal drip include colds and flus, allergies, sinus infections, and deviated septum. Other causes are medications, such as blood pressure medications and birth control pills, along with spicy foods and fumes from chemicals, smoke, and other similar irritants.

Post-nasal drip symptoms can include a stuffy nose, the persistent need to cough up phlegm, and a hard-to-shake sore throat. Postnasal drip can cause hoarseness and the constant feeling you have something in your throat.

Post-Nasal Drip Treatment and Remedies

Post-nasal drip treatment depend on what’s causing the problem. For instance, bacterial infections are treated with antibiotics. Antihistamines and decongestants can help with postnasal drip caused by viral infections. They are also used with steroid medications for drips caused by allergies.

Be mindful that some older antihistamines brands may dry and thicken post-nasal secretions even more. Check with your doctor about recommendations for post-nasal drip relief.

Increasing your intake of fluids, especially for older people, can dilute secretions so they pass more easily. Avoiding caffeine and, with your doctor’s approval, diuretics (fluid-eliminating drugs) also can help.

Keeping your environment free of dust and irritants can reduce your risk of post-nasal drip. For instance:

• Wash all sheets, pillowcases, and mattress covers often, and in hot water.
• Use special HEPA (high-efficiency particulate air) air filters in your home.
• Dust and vacuum on a regular basis.

Originally published in May 2016 and updated.

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As with many cancers, people over age 55 are at increased risk. Men are almost twice as likely as women to get stomach cancer, and it is more common in African-Americans than in whites. Having the bacteria H. pylori in the stomach may raise the risk, but prompt treatment to eradicate the bacteria can reduce the risk. A diet high in preserved meats (such as bacon and deli meats) and low in fruits and vegetables may contribute to stomach cancer. Conversely, a healthy diet loaded with fruits, vegetables and whole grains, and low in saturated fat may help decrease the risk of developing stomach cancer, and is particularly important for people infected with H. pylori.

Stomach Cancer Symptoms

Stomach cancer often causes no symptoms at all. When symptoms are present, they are likely to include:

• Pain or discomfort in the abdomen
• Loss of appetite
• Nausea or vomiting
• Vomiting blood or bloody stools
• Weakness or fatigue
• Weight loss.

If you experience any of these symptoms, see your doctor.

Diagnosing Stomach Cancer

One or more diagnostic tests may be needed, such as a fecal occult blood test, an upper GI series, and/or an endoscopy. New research has suggested that looking for changes in certain chemicals in the breath could be used to identify both stomach and esophageal cancers.

If cancer is suspected, the doctor will take a small sample of tissue (biopsy) from the wall of the stomach during an endoscopy. The tissue will be examined under a microscope to look for changes in the cells that would indicate cancer. If stomach cancer is diagnosed, the next step is to determine the stage of the cancer, which indicates how far it has spread, if at all (stomach cancer can spread to nearby organs, such as the liver or pancreas). Staging of stomach cancer may be done with a computed tomography (CT) scan or ultrasound. Endoscopic ultrasound is also very good for this purpose.

Treating Stomach Cancer

Treatment for stomach cancer depends on a number of factors, including the size, location, and extent of the tumor, whether it has spread, and the patient’s general health. Options include surgery, chemotherapy, radiation therapy, and the newest weapon, targeted therapy. According to the ACS, using two or more approaches produces the best outcomes. Surgery is the most common treatment. If the cancer is in its early stages, the surgery may be performed endoscopically, using instruments that are inserted into the stomach via the throat. If only part of the stomach needs to be removed, the remaining portion will be connected to the esophagus or small intestine, but if the cancer has spread throughout the stomach, the entire stomach may need to be removed (total gastrectomy), along with lymph nodes and other organs. The esophagus is then attached to the small intestine. After this surgery, patients must eat small amounts of food often, and some need a feeding tube for liquid nutrition in order to receive sufficient calories.

With targeted therapy, certain drugs identify unique aspects of stomach cancer cells and target them for destruction. This treatment may be effective in patients who do not respond to chemotherapy.

Two types of targeted therapy are now used in stomach cancer. Many people are familiar with the monoclonal antibody trastuzumab (Herceptin) from its use in HER2-positive breast cancer. It also is effective in HER2-positive stomach cancer. HER2 is a growth-promoting hormone, and one in five stomach cancer patients have too much of it. Trastuzumab finds this protein on the surface of cancer cells and destroys the cells. It is usually given intravenously every two to three weeks, along with chemotherapy.

Ramucirumab (Cyramza) is a monoclonal antibody that targets specific proteins that allow cancers to grow and spread by creating new blood vessels. It is given intravenously every two weeks, and is generally reserved for patients with advanced stomach cancer that no longer responds to other drugs.

For more information about stomach cancer, purchase Digestive Disease & Disorders at www.UniversityHealthNews.com.

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In the past, it was thought that ulcers were caused by stress, spicy foods, or an overabundance of stomach acid. It is now known that one of the main causes is infection with H. pylori. Infection with H. pylori, which usually occurs in childhood, doesn’t always cause ulcers—in fact, most people who carry H. pylori in their gastrointestinal tracts do not develop ulcers. Older adults are more likely to have ulcers, which may be due to a higher infection rates with H. pylori, or because they use more NSAIDs.

H. pylori bacteria have the ability to survive in the acidic environment of the stomach because they secrete enzymes that neutralize the acid. The bacteria also can burrow deep into the thick layer of mucus that coats the lining of the stomach. This mucus is essential for protecting the layers of tissue underneath from being damaged by stomach acid. If the mucus layer is damaged, acid can irritate the sensitive tissue underneath, causing inflammation. Once inflammation occurs, continued irritation from acid and bacteria can lead to the formation of an ulcer.

Long-term use of NSAIDs also can cause ulcers. People of any age can develop an ulcer from long-term use of NSAIDs, but it is more common in people aged 60 and older. A warning sign that NSAID use may lead to an ulcer is upset stomach or heartburn after taking an NSAID. People with a history of ulcers, and those taking NSAIDs for long periods of time, are particularly at risk.

Peptic Ulcer Symptoms

The first sign of an ulcer is usually a burning sensation in the upper-to-middle abdomen that occurs within one to two hours after a meal. Other symptoms may include:

• Pain that feels like a dull, gnawing ache
• Pain that is intermittent or constant, lasting for days to weeks at a time before subsiding
• Pain that strikes in the middle of the night, or any other time that the stomach is empty
• Pain that decreases after you eat a meal
• Nausea and vomiting
• Weight loss
• Poor appetite
• Bloating
• Burping

Some symptoms warrant emergency medical attention, because they indicate that the ulcer has caused a hole (perforation) in the stomach or duodenal wall, broken a blood vessel, or blocked the path of food leaving the stomach and entering the intestine. If you experience any of the following symptoms, seek medical help immediately:

• Sharp, sudden, persistent stomach pain
• Bloody or black stools
• Bloody vomit or vomit that looks like coffee grounds

Diagnosing a Peptic Ulcer

If you have any of the non-emergency symptoms of an ulcer, see a doctor to get diagnosed. Either an upper gastrointestinal (GI) series or an endoscopy will likely be ordered. If an ulcer is spotted, you will be tested for the presence of H. pylori. The bacteria can be detected non-invasively, with breath or stool tests. If you have undergone an endoscopy, biopsy tissue will be tested for H. pylori.

Treating a Peptic Ulcer

If the ulcer is caused by bacteria, medications are given to reduce stomach acid and kill the bacteria. This allows the ulcer to heal, and lowers the chance it will recur. The treatment regimen will most likely involve two weeks of triple therapy: antibiotics to destroy the bacteria, a PPI to reduce the production of stomach acid, and medications to protect the lining of the stomach from acid, such as sucralfate (Carafate) and bismuth, which also kills H. pylori. This regimen is effective for 70 to 85 percent of patients, and it is important that it be taken each day as prescribed. An alternative is sequential therapy, which involves taking one or two drugs for a few days, followed by one or more different drugs.

If you have ulcers or ulcer complications and take NSAIDs, you may also need to take a PPI. You can get both with esomeprazole/naproxen (Vimovo), or you may try to substitute acetaminophen (Tylenol) for the NSAID. If acetaminophen does not relieve your pain, your doctor may suggest trying a different over-the-counter NSAID from the one causing the problem. You also can try to reduce the dose or the frequency with which you take the NSAID.

For more information about ulcers, purchase Digestive Disease & Disorders at www.UniversityHealthNews.com.

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GERD occurs when the acidic contents of the stomach flow backwards (reflux) into the esophagus. This happens when the lower esophageal sphincter separating the lower end of the esophagus from the stomach becomes weak or doesn’t close properly. The lining of the esophagus is not meant to withstand stomach acid, which leads to inflammation and pain.

There are several possible causes that can underpin reflux:

• An overly full stomach, which may push some of the acidic contents back up into the esophagus
• A hiatal hernia
• Pregnancy, as the growing uterus presses on the stomach and pregnancy hormones cause digestion to slow
• Drugs that may cause the valve to remain relaxed—these include beta-agonists (used for treating asthma), calcium channel blockers (for treating high blood pressure), some antihistamines (such as Benadryl), and sedatives
• Being obese or overweight

GERD should be taken seriously, especially if you experience symptoms often, since it can lead to other conditions. Too much acid in the esophagus can cause esophagitis (inflammation of the lining of the esophagus), a condition that may lead to esophageal bleeding or ulcers. Also, acid can scar the esophagus, causing it to narrow and make swallowing difficult.

A small percentage of people with long term exposure to GERD develop a condition called Barrett’s esophagus, which can lead to esophageal cancer.

GERD Symptoms

Persistent recurring heartburn is the main symptom of GERD—if heartburn occurs more than twice a week, GERD is the most likely reason. However, older adults may not experience as many symptomatic episodes.

Other symptoms of GERD include chest pain, trouble swallowing, and difficulty keeping food down after meals. Some people taste the stomach acid in the back of their mouth: It has a metallic taste and may cause bad breath. GERD also can cause a sore throat, dry cough, hoarseness, or a repeated need to clear the throat. Some experts believe that GERD may be a cause of sinusitis (inflamed or infected sinuses) and dental erosions.

Because GERD can cause chest pain that may be similar to the chest pain caused by heart problems, it’s important for anyone at risk for heart disease to be checked to rule out a heart-related cause for the discomfort before attributing it to GERD. Risks for heart disease include a personal or family history of heart disease, high total cholesterol, high LDL (“bad” cholesterol), low HDL (“good” cholesterol”), high blood pressure, being overweight or obese, diabetes, smoking, physical inactivity, and being age 65 or older.

Lifestyle Measures for GERD

Certain foods can weaken the lower esophageal sphincter, triggering GERD symptoms. These include chocolate, peppermint, fatty foods, caffeine, and alcohol. If you experience GERD after eating these foods, eliminating them from your diet should relieve the symptoms.

In addition to modifying your diet, there are other strategies you can try to alleviate your symptoms. For example, eat small meals frequently, rather than large ones less often. Don’t eat or drink anything after 7 p.m., and don’t lie down for at least an hour after eating any meal. Also, stop smoking, and lose weight, if you are overweight. Do not wear tight-fitting clothing or belts, and avoid strenuous exercises that increase abdominal pressure, such as sit-ups. To help alleviate heartburn during the night, elevate the head of your bed on six- to eight-inch blocks, or put a foam-rubber wedge below the mattress under your shoulders and upper back. This may help the acid remain in your stomach.

For additional GERD treatments and information on other digestive problems, purchase Digestive Diseases & Disorders from www.UniversityHealthNews.com.

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Fiber is found in plant foods, such as grains, vegetables, and fruits. There are two types: insoluble and soluble.

Insoluble fiber is not digested—instead, it adds bulk to the stool, enabling it to pass more rapidly through the digestive system. Sources of insoluble fiber include wheat bran, whole grains and wholegrain products, and the tough parts of fruits and vegetables that take longer to chew, like the skins of apples, cucumbers, and grapes.

Soluble fiber attracts water as it passes through the digestive system, resulting in soft stool that is easier to pass. Soluble fiber is found in beans, fruit, oats/oat bran, nuts, seeds, and many vegetables, including Brussels sprouts, sweet potatoes, and asparagus, among others. It also can be taken in capsule form as psyllium.

Introduce Dietary Fiber Slowly

If you’re planning to increase the amount of dietary fiber in your diet, it’s best to do so slowly. Soluble fiber has the potential to produce gas, so you may notice more gas or bloating when you suddenly increase your fiber intake. However, if you add fiber slowly over time, your gastrointestinal tract will adjust. In addition, as you increase fiber, it’s important to drink more fluids (water, soup, broth, juices). Try to drink eight glasses of liquid a day.

While the average American takes in only 15 grams (g) of fiber a day, the recommended intake is 25 g per day for women, and 38 g per day for men. If you consume less fiber than recommended, you’ll want to increase your daily fiber intake. You can do this by eating:

• Two to three cups of vegetables per day
• Two cups of fruit every day
• Three servings of beans, lentils or peas every week
• Whole-grain bread instead of white bread
• Whole-grain cereals and bran cereal
• Brown rice instead of white rice.

To learn more about ways to improve your digestion, purchase Digestive Diseases & Disorders from www.UniversityHealthNews.com.

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The first section of the small intestine that receives food is called the duodenum. Enzymes secreted by the pancreas, plus bile from the gallbladder and liver, mix with food in the duodenum, where they break down carbohydrates, fats, and proteins. Bile— which is produced in the liver and stored in the gallbladder—dissolves fat, allowing the intestinal lining to absorb it. In addition, microorganisms called gut microbiota— which are present in the intestinal tract—help in the digestive process.

The parts of the small intestine below the duodenum are called the jejunum and the ileum. Most absorption of the digested molecules of food takes place in these sections. The small intestine is an exceptionally long organ—about 22 feet in length—that is coiled up inside the abdomen. This length is necessary to accomplish the task of absorbing all the nutrients. The lining of the small intestine contains many folds and small projections (called villi and microvilli), which enhance contact with food, and provide more opportunities for absorption.

The now-small molecules of sugars, amino acids, and fatty acids are then absorbed through the walls of the intestine and into blood vessels and lacteals (thin-walled vessels that transport fat and white blood cells away from the intestine), which carry them to other parts of the body, where they help build, repair, and maintain body tissues and provide energy.

To learn more about how your digestive system works and ways to keep it healthy, purchase Digestive Diseases & Disorders from www.UniversityHealthNews.com.

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What GERD Symptoms Feel Like

Persistent heartburn is the main symptom of GERD. If heartburn occurs more than twice a week, GERD is the most likely reason. Other GERD symptoms include chest pain, trouble swallowing, or difficulty keeping food down after meals.

Some people can taste the acidic fluid in the back of the mouth, which has a metallic taste or causes bad breath. GERD can also cause a sore throat, a dry cough, or hoarseness. Some experts believe that GERD may be a cause of sinusitis (inflamed or infected sinuses) and dental erosions.

Food Triggers

It has long been believed that certain foods can weaken the lower esophageal sphincter and trigger GERD symptoms. These include chocolate, peppermint, fatty foods, caffeine, and alcohol. Some research has found that these foods lower the pressure in the esophageal sphincter. However, they do not appear to have a direct effect on curbing GERD symptoms.

A trial-and-error approach can often identify problems foods. Notice when symptoms arise and what types of food you have just eaten. Reducing or eliminating those foods or drinks can help keep your GERD away or reduced the severity of symptoms. Also, small, frequent meals often are better for your GERD than larger, less-frequent ones.

In addition to modifying your diet certain medications taken before or after meals can reduce flare-ups. These include:

• Antacids: They contain calcium carbonate, aluminum hydroxide, and magnesium hydroxide, all of which neutralize acid. They start working rapidly but last only about two hours or less. You can take them after a meal while you have symptoms.
• H2 Blockers: These over-the-counter drugs decrease the production of stomach acid and can prevent heartburn for up to eight hours. These drugs need to be taken before symptoms begin because they take 30 minutes to two hours to take effect.
• Proton Pump Inhibitors: PPIs block an enzyme that is necessary for acid secretion. However, PPIs may decrease the absorption of calcium in some people, and can affect bone density in older adults who use high doses for long periods of time.

For further reading on GERD and related topics, visit these University Health News posts:

• “Melatonin for GERD: How to Help Acid Reflux With This Natural Supplement“
• “What Does Heartburn Really Feel Like?“
• “4 Causes of Gastritis That You Can Treat on Your Own“

Originally published May 2016 and updated.

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If you have regular bouts of GERD symptoms, also known as “heartburn“—that sharp, burning sensation in the chest—do not necessarily dismiss them as something you ate. You may have developed gastroesophageal reflux disease. This is a condition where stomach acid flows back (reflux) up into the esophagus, burning the esophageal lining. Left untreated, the condition can worsen and lead to bleeding, scarring, and narrowing of the esophagus.

GERD occurs when stomach acid backs up into the esophagus.

What Is GERD? Causes to Consider

GERD occurs when the lower esophageal sphincter (LES) becomes weak or defective and doesn’t close properly. An overly full stomach, a hiatal hernia, or even pregnancy can cause this. Certain drugs may cause the valve to leak, such as beta-agonists, calcium channel blockers, some antihistamines, and sedatives.

GERD Risk Factors

Risk factors for GERD include foods that can weaken the lower esophageal sphincter. These include chocolate, peppermint, fatty foods, caffeine, and alcohol. Being overweight or obese also put you at risk for GERD.

Other than persistent heartburn, GERD symptoms include chest pain, trouble swallowing, or difficulty keeping food down.

Some people can detect the acid in their mouths, which has a metallic taste and can cause bad breath. GERD can also cause a sore throat, a dry cough, or a hoarse voice.

What Is GERD? Diagnosis and Treatment

Your doctor will need to perform tests to confirm a GERD diagnosis. Common screening methods include endoscopic exams of the esophagus and stomach or a biopsy of tissue, or your doctor may perform tests to check the function of the LES or the volume of acid your stomach produces.

To treat GERD symptoms, your diet will come into play. Small, frequent meals are preferred over larger, less-frequent ones. Over-the-counter drugs can help and come in three categories: antacids, H2 blockers, and proton pump inhibitors (PPIs). Antacids contain components that neutralize acid, H2 blockers decrease production of stomach acid, and PPIs block enzymes necessary for acid secretion. Stronger drugs are available by prescription.

A few preventative measures can discourage GERD, such as avoiding troublesome food and drink, maintaining a healthy weight, and sleeping with the head of the bed slightly elevated.

Originally published in 2016, this post is regularly updated.

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How does constipation occur? As undigested food passes through the colon, water is absorbed to form the solid waste (stool). If not enough water is removed, diarrhea symptoms will result. If too much water is removed, the stool becomes hard, dry, and difficult to pass out of the body—constipation.

Many people believe they are constipated if they don’t have a bowel movement every day. In fact, the frequency of bowel movements considered “normal” can range from three times a day to three times a week.

What Helps Constipation? Start with Diet

Constipation means passing small amounts of hard, dry stool, usually less than three times a week, and straining to have a bowel movement. Other symptoms are bloating, general discomfort, and sluggishness. Like diarrhea, constipation is common and usually lasts only short time. Even so, constipation accounts for about 2 million doctor visits each year in the United States.

A low-fiber diet, not drinking enough fluids, and lack of exercise are common causes of constipation. Plus, many medications can cause constipation; among them are pain medications (opioids), antacids that contain aluminum and calcium, calcium channel blockers (for lowering blood pressure), anti-Parkinson’s drugs, antispasmodics, antidepressants, iron supplements, diuretics, and anticonvulsants.

Constipation Treatment Options

So what helps constipation? In most cases, it’s treated with lifestyle modifications, including increasing activity, daily fluid intake, and the amount of fiber (from beans, fruits, vegetables, or grains) in the diet. Laxatives are usually not necessary for mild cases of constipation. However, if lifestyle changes don’t help, the doctor may recommend laxative or enema use for a short time.

Most treatments for occasional constipation fall into one of four groups:

• Bulk or fiber laxatives (Metamucil, Citrucel, Fibercon, and Benefiber) serve to hold water in the intestines and soften stool. Patients using these must drink at least eight glasses of fluid (water, juice, milk, coffee, or tea) per day to avoid side effects.
• Osmotic laxatives (Milk of Magnesia and MiraLax) cause the intestines to secrete water into the colon to soften stool. These also require adequate fluid intake.
• Stool softeners (Colace and Surfak) provide moisture to the stool
• Stimulants (Correctol, Dulcolax, and Senokot) cause intestinal muscle contractions to help move the stool more quickly. Long-term use is not recommended.

Originally published in 2016, this post is regularly updated.

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