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Facts
and Fallacies About Digestive Diseases
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 illness.
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.
Hiatal
Hernia
Fallacy: Hiatal hernia causes heartburn.
The
fact is, while some people who suffer from heartburn also
have a hiatal hernia, heartburn is not caused by the hernia.
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.
Heartburn
Fact: Chocolate and peppermint cause heartburn in many
people.
The
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 heartburn.
The
fact is that studies have shown that cigarette smoking dramatically
decreases the LES pressure.
Fact:
Nonprescription antacids relieve heartburn.
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 in nonsmokers.
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.
Fallacy:
Peptic 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.
Lactose
Intolerance
Fact: Many people cannot drink milk.
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 percent of African Americans,
Jewish, Mexican Americans, and American Indian adults and
90 percent of Asian American adults have lactose intolerance.
Lactose
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.

Celiac
Sprue
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.
Constipation
Fallacy: Bowel regularity means a bowel movement every
day.
The
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.
The
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.
The
fact 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 percent 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 disorders.
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.
The
fact 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 particular foods.
Gallbladder
Disease
Fallacy: Gallbladder disease always causes severe pain.
The
fact is that about 10 percent 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.
Pancreatitis
Fact: The pancreas is a digestive organ.
The
fact 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.
Cirrhosis
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 environmental toxins.
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.
Hemorrhoids
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.
Ostomy
Surgery
FACT: Ostomy surgery is a common procedure.
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.
The
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 erection).
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.
Additional
Resources
American Liver Foundation. 1425 Pompton Avenue, Cedar Grove,
NJ 07009; (800) 223-1079 or (201) 256-2550. General information
about cirrhosis and other liver diseases.
Crohn's
& Colitis Foundation of America, Inc., 386 Park Avenue
South, 17th Floor, New York, NY 10016-8804; (800) 932-2423
or (212) 685-3440. Information about inflammatory bowel disease.
United
Ostomy Association. 36 Executive Park, Suite 120, Irvine,
CA 92714-6744; (800) 826-0862 or (714) 660-8624. Information
about ostomy care and management.
National
Digestive Diseases Information Clearinghouse
2 INFORMATION WAY
BETHESDA, MD 20892-3570
NIH
Pub. No. 95-2673
October 1991
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