Common digestive disorders overview

common digestive disorders explained

Welcome to another Gut Be Good article.

Today’s article will provide a common digestive disorders overview, including what they are, their causes and symptoms, and their treatments.

This article is designed and written to provide an overview of the included conditions, but you’ll find links to a more full and in-depth article on each specific condition through-out the article, so look out for those.

Digestive disorders encompass a wide range of conditions affecting the gastrointestinal (GI) tract, leading to various symptoms that can impact your daily life.

Among the numerous digestive disorders there are, some of the most commonly encountered (and which you have most likely heard of) include coeliac disease, non-coeliac gluten sensitivity (the new umbrella term which covers gluten sensitivity, gluten intolerance and similar, older terms), irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and inflammatory bowel disease (IBD).

This article delves into these conditions, exploring their causes, symptoms, and treatment options.

You’ll find links to more in-depth discussion on each specific condition through-out the article, so look out for those.

You can also check out The Gut Be Good Podcast and YouTube episodes by clicking here.

See the content list below for quick links to relevant sections within this article:

Introduction
Coeliac Disease overview
Non-Coeliac Gluten Sensitivity overview
Irritable Bowel Syndrome overview
Gastroesophageal Reflux Disease overview
Inflammatory Bowel Disease overview
Conclusion
Ready to embark on your gut health journey?
Final Message
Disclaimers & Disclosures
Sources

Introduction

Thank you for being here today. Let’s begin and dive into the details of some common digestive disorders and how they work.

By the end of this article your knowledge and understanding of these common conditions should be markedly improved!

You can also listen to my Spotify podcast or YouTube podcast for other interesting topics.

Click the links to head to those platforms directly or find them on this page of my site.

Coeliac Disease Overview

Coeliac disease is a lifelong autoimmune disorder that occurs in genetically predisposed individuals when they consume gluten, which is a protein found in wheat, barley, and rye or derivatives of the 3 grains.

The ingestion of gluten leads to an immune response that damages the intestinal lining, specifically the villi, which are finger-like projections responsible for nutrient absorption, which become flattened in those with coeliac disease if they consume gluten-containing foods.

This damage impairs the body’s ability to absorb essential nutrients, leading to a wide range of symptoms and potentially long-term health complications if left untreated, i.e. by not starting and maintaining of a lifelong gluten free diet (the only treatment for coeliac disease there is).

If you’re looking for an even more full and in-depth article covering all things Coeliac Disease, read this article of mine instead which goes into much greater detail on the condition.

Causes

The exact cause of coeliac disease remains unknown, but it is understood that it results from a combination of genetic and environmental factors.

  1. Genetic Predisposition:


    • The presence of certain genetic markers significantly increases the risk of developing coeliac disease. Almost all individuals with coeliac disease carry one of the variants of the HLA-DQA1 or HLA-DQB1 genes.

      However, having these genes does not guarantee the development of the disease, indicating that other factors play a crucial role.





  2. Environmental Triggers:


    • While genetics lay the groundwork for susceptibility, environmental factors trigger the onset of the disease.


      These potential environmental triggers include things like:


      • Infections: Certain viral or bacterial infections may initiate the autoimmune response.

      • Dietary Factors: The timing and amount of gluten introduction into the diet during infancy might influence the risk.

      • Gut Microbiota: An imbalance in gut bacteria could contribute to disease development.




  3. Immune System Malfunction:


    • In individuals with coeliac disease, the immune system mistakenly identifies gluten as a threat and mounts an inflammatory response.


      This response targets not only the gluten proteins but also the body’s own tissues, specifically the intestinal lining, which leads to damage in the small intestine and the subsequent inability for the body to absorb nutrients effectively.

Symptoms

Coeliac disease presents with a wide spectrum of symptoms, which can vary significantly among affected individuals.

A few of the more common symptoms of coeliac disease are listed below although this is not an extensive list, and you can find more detailed information in my other article written solely about Coeliac Disease, here.

Symptoms can be categorized into gastrointestinal and non-gastrointestinal manifestations:

  1. Gastrointestinal Symptoms:


    • Diarrhoea: Chronic or intermittent diarrhoea is a common symptom due to malabsorption.


    • Abdominal Pain and Bloating: Inflammation and gas build-up can cause significant discomfort.


    • Weight Loss: Inability to absorb nutrients properly can lead to unintended weight loss or poor weight gain, as seen in children commonly with CD.


    • Steatorrhea: Fatty stools that are pale, foul-smelling, and float due to poor fat absorption.
  1. Non-Gastrointestinal Symptoms:


    • Anaemia: Iron deficiency anaemia is common due to poor iron absorption because of the damaged villi in the intestines.


    • Osteoporosis: Malabsorption of calcium and vitamin D can lead to weakened bones. Sometimes a DEXA scan may be required or used to view the bone density and can help in diagnosis.


    • Dermatitis Herpetiformis: This is a chronic, intensely itchy skin rash characterized by blisters and bumps, often appearing on elbows, knees, and buttocks.


    • Neurological Issues: These can include migraines/headaches, peripheral neuropathy (tingling, numbness in hands and feet), a “foggy mind” and sometimes cognitive impairment


    • Fatigue: Persistent tiredness and fatigue can result from chronic nutrient deficiencies.


    • Reproductive Issues: Infertility and recurrent miscarriages have been linked to untreated coeliac disease too.

Introduction
Coeliac Disease overview
Non-Coeliac Gluten Sensitivity overview
Irritable Bowel Syndrome overview
Gastroesophageal Reflux Disease overview
Inflammatory Bowel Disease overview
Conclusion
Ready to embark on your gut health journey?
Final Message
Disclaimers & Disclosures
Sources

Diagnosis and Treatment

Diagnosis:

Diagnosing coeliac disease typically involves a combination of serological (blood) tests and an intestinal biopsy, however, intestinal biopsies are a rarer occurrence these days, because blood tests can indicate coeliac disease in most individuals who have it.

There are some people who may get negative blood tests but still have it, in which case biopsies and different types of serological tests would be considered and most likely carried out by your medical professional.

The most common reason for a negative first-line test result despite having coeliac disease is due to something called IgA deficiency.

  1. Serological Tests:


    • Blood tests are used to detect specific antibodies associated with coeliac disease. The most commonly tested antibodies include:

      • Tissue Transglutaminase Antibodies (tTG-IgA): Elevated levels are highly indicative of coeliac disease.

      • Endomysial Antibodies (EMA-IgA): Another sensitive marker for the disease.

      • Deamidated Gliadin Peptide Antibodies (DGP-IgA and IgG): Useful in certain cases, especially in young children or those with IgA deficiency.



  2. Intestinal Biopsy:


    • If blood tests suggest coeliac disease, an upper gastrointestinal endoscopy is sometimes performed to obtain a biopsy of the small intestine. This biopsy is examined for damage to the villi, a hallmark of coeliac disease.


      That said, intestinal biopsies are done less and less these days due to serological tests being so accurate.


      They are still called for in some cases to confirm a diagnosis, but given their invasive nature, NICE guidelines stipulate that serological tests should be performed in the first instance and outline a structure for further serological tests before even mentioning intestinal biopsies.

Treatment:

The only treatment for coeliac disease is a lifelong gluten free diet. Coeliac disease management is a strict, lifelong gluten-free diet because even the smallest amount of gluten can damage the intestinal lining and make someone with coeliac disease very unwell.


Th gluten free diet approach allows the intestinal lining to heal at first instance, and the continuance of the gluten free diet prevents further damage.

1. Gluten-Free Diet:



Individuals must avoid all foods containing wheat, barley, rye, and their derivatives. This includes many processed foods where gluten may be hidden as an additive.


Oats can be included in the diet for some people with coeliac disease, but not for others.

Oats don’t contain gluten but they are often contaminated with gluten during processing methods, which is why you would need to buy certified gluten free oats if you have coeliac disease, to avoid the risk of cross contamination of gluten.


Also, in some people with coeliac disease it’s possible you won’t be able to eats oats at all.

While oats don’t contain gluten, they do contain a protein very similar to gluten called avenin, and in some people with coeliac disease they react to avenin in the same way they react to gluten, and cannot eat oats.


This is something you should be guided to test in your own gluten free diet by your medical professional though.

2. Nutritional Supplementation:


Initially, individuals may need supplements to address deficiencies in iron, calcium, vitamin D, vitamin B12, and other nutrients.

Once understanding has been reached on following a safe gluten free diet, including which foods to eat instead of gluten foods to ensure you’re reaching your required nutritional intake, supplements can be stopped.



3. Regular Monitoring:


Follow-up care with a healthcare provider is essential to monitor nutritional status, assess for complications, and ensure adherence to the diet.


This typically includes periodic blood tests to check for antibody levels and nutritional deficiencies.

This is especially important in growing children, to ensure they’re meeting their growth and milestones.



4. Support and Education:


Education about reading food labels, avoiding cross-contamination, and maintaining a balanced diet is crucial.

Support groups and resources can provide assistance and be really helpful alongside your medical professional help. Even talking to and educating family and friends as you learn more and more about the gluten free diet, can make you feel more comfortable along the journey.

By adhering to a gluten-free diet and managing your condition with the help of a healthcare professional, anyone and everyone with coeliac disease can lead healthy and symptom-free lives.

Advances in research continue to improve our understanding of the disease, offering hope for even better diagnostic and therapeutic options in the future too.

For the most full exploration of Coeliac Disease, you can read this article of mine.

It covers everything about Coeliac Disease from manifestation, symptoms, signs, diagnosis, treatment and management and more.

So if you’re in need of helpful information regarding Coeliac Disease specifically, this article of mine is the one to read, called: Coeliac Disease: Increase your knowledge and understanding.

Non-Coeliac Gluten Sensitivity (NCGS)

Overview

Non-Coeliac Gluten Sensitivity (NCGS) is a condition characterized by gastrointestinal and extra-intestinal symptoms related to the ingestion of gluten, a protein found in wheat, barley, and rye.

Unlike coeliac disease, NCGS does not involve the autoimmune response that is present in those with coeliac disease, and the lining of the stomach is not damaged in NCGS.



It is also distinct from a wheat allergy, which is an allergic reaction to proteins found in wheat.

If you want to read my article about Non Coeliac Gluten Sensitivity which goes into much greater depth, then click here to be taken to it.

The exact mechanisms underlying NCGS are not well understood, making it a somewhat controversial and challenging condition to diagnose and manage.

What is important to note though about NCGS, is that it is a fairly new medical term which encompasses old phrases for the condition including gluten sensitivity, gluten intolerance and other similar terms.


The idea being that using the term NCGS as an umbrella term for symptoms associated with the ingestion of gluten where no coeliac disease is present and there is no wheat allergy, it will be less confusing for all.

Causes

The precise causes of NCGS remain elusive and unagreed upon within the medical community, but several theories exist regarding its aetiology:

  1. Immune Response:

    • While NCGS does not involve the autoimmunity seen in coeliac disease, it has been suggested that it involves an innate immune response. This non-specific immune reaction might lead to inflammation and the various symptoms experienced by individuals with NCGS.


  2. Non-Gluten Components:

    • Some researchers propose that components other than gluten in wheat, such as amylase-trypsin inhibitors (ATIs) or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), could contribute to the symptoms.

      These components may cause irritation or inflammation in the gut.

  3. Gut-Brain Axis:

    • The interaction between the gut and the nervous system, known as the gut-brain axis, might play a role. Stress and other psychological factors can exacerbate symptoms, suggesting a possible link between mental health and NCGS.

  4. Altered Gut Microbiota:

    • Changes in the composition of gut bacteria might contribute to NCGS. Dysbiosis, or an imbalance in gut microbiota, can affect gut permeability and immune responses, potentially leading to symptoms.



Symptoms

The symptoms of NCGS can overlap with those of coeliac disease and irritable bowel syndrome (IBS), making differential diagnosis often challenging.


Symptoms for NCGS typically appear hours to days after gluten ingestion though, and can affect multiple body systems such as the ones listed below:


  1. Gastrointestinal Symptoms:


    • Abdominal Pain and Bloating:
      Commonly reported, these symptoms can mimic those of IBS.

    • Diarrhoea:
      Frequent, loose stools may occur, though not as severely as in coeliac disease.

    • Constipation:
      Some individuals experience constipation instead of or alternating with diarrhoea.

    • Nausea and Vomiting:
      These symptoms may also be present in some cases.




  2. Non-Gastrointestinal Symptoms:


    • Headache and Migraine:
      Gluten ingestion can trigger headaches or migraines in sensitive individuals.

    • Fatigue:
      Chronic tiredness and a lack of energy are commonly reported.

    • Joint and Muscle Pain:
      Aching joints and muscles can be a feature of NCGS.

    • Mood Disturbances:
      Anxiety, depression, and mood swings are frequently associated with NCGS.

    • Skin Rashes:
      While not as specific as dermatitis herpetiformis in coeliac disease, skin issues can occur.

Introduction
Coeliac Disease overview
Non-Coeliac Gluten Sensitivity overview
Irritable Bowel Syndrome overview
Gastroesophageal Reflux Disease overview
Inflammatory Bowel Disease overview
Conclusion
Ready to embark on your gut health journey?
Final Message
Disclaimers & Disclosures
Sources

Diagnosis and Treatment

Diagnosis:

Diagnosing NCGS is primarily a process of exclusion, as there are no specific biomarkers or serological or physical tests to confirm the presence of the condition, as there is with coeliac disease.


The diagnostic process generally involves:

  1. Excluding Other Conditions:


    • Coeliac Disease:

      Blood tests for coeliac-specific antibodies (tTG-IgA, EMA-IgA) are carried out to rule out the presence of CD, and sometimes an intestinal biopsy is performed too.

    • Wheat Allergy:

      Skin prick tests or serum-specific IgE tests are used to exclude wheat allergy.



  2. Symptom Tracking:

    • A thorough clinical history and symptom diary can help correlate symptoms with gluten ingestion.



  3. Gluten Challenge and Elimination:


    • Elimination Diet:

      Individuals are placed on a strict gluten-free diet for several weeks to observe if symptoms improve.

    • Gluten Challenge:

      After symptom resolution, gluten is reintroduced to see if symptoms recur. This should ideally be done under medical supervision to ensure accurate interpretation.




Treatment:

The primary treatment for NCGS involves dietary management, similar to that of CD treatment but with some notable differences, as discussed below:


  1. Gluten-Free Diet:


    • Similar to the treatment for coeliac disease, individuals with NCGS are advised to follow a gluten-free diet.


      However, the strictness of this diet may vary depending on individual tolerance levels.


      Some people with NCGS can tolerate small amounts of gluten without experiencing significant symptoms.




  2. Dietary Education:


    • Education about identifying and avoiding gluten-containing foods, understanding food labels, and preventing cross-contamination is crucial, much like in coeliac disease.




  3. Nutritional Support:


    • Ensuring a balanced diet is important to avoid potential nutritional deficiencies, especially if the diet becomes too restrictive.

      Learning that there are many gluten free alternatives to foods these days as well as a plethora of natural, whole foods which are naturally gluten free, is crucial to living well whilst living gluten free.




  4. Symptom Management:


    • Medications such as antispasmodics, anti-diarrheal agents, or fibre supplements may be used to manage specific symptoms, particularly if they overlap with IBS.


      However, dietary change and management is really the best and only true way of managing your symptoms in the longer term.




  5. Psychological Support:


    • Given the possible link between NCGS and psychological factors, stress management techniques, cognitive-behavioural therapy (CBT), and other mental health interventions might be beneficial, but this is something your medical professional should and can advise on in your specific case.


      Psychological support can also be as simple as explaining to friends and family why you’re having to change your diet and getting them to understand your new dietary needs.



While research on NCGS is ongoing, the condition remains a diagnosis of exclusion in truth, and management primarily focuses on dietary modifications and symptom relief.

Continued scientific study aims to better understand the underlying mechanisms and develop more specific diagnostic and therapeutic approaches for those affected by NCGS.


If you’re looking for a full and even more in-depth look at NCGS, you can read this article of mine which talks solely about NCGS and how it works.

Irritable Bowel Syndrome (IBS)

Overview

Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal (GI) disorder that affects the large intestine. It is characterized by chronic abdominal pain and altered bowel habits, which may include diarrhoea, constipation, or both.



Unlike structural GI disorders, IBS does not cause visible damage to the digestive tract. Instead, it involves a complex interplay of gut-brain interactions, making it a challenging condition to diagnose and manage.

Causes

The exact cause of IBS remains unknown, but it is believed to result from a combination of several factors:


  1. Abnormal Gut Motility:


    • The muscles of the intestines may contract too strongly or weakly, or for too long or too short a time.


      These irregular contractions can lead to diarrhea or constipation and contribute to the sensation of bloating and gas.



  2. Increased Gut Sensitivity:


    • Individuals with IBS may have a heightened sensitivity to pain or discomfort within the GI tract.


      This increased sensitivity, known as visceral hypersensitivity, means that normal digestive processes can cause significant pain or discomfort.





  3. Psychological Factors:


    • Stress, anxiety, and depression are closely linked with IBS. The gut-brain axis, which connects the central nervous system and the enteric nervous system, plays a key role in this interaction.


      Emotional stress can exacerbate IBS symptoms, and the chronic nature of the symptoms can, in turn, affect mental health.





  4. Changes in the Gut Microbiota:


    • The composition of gut bacteria, or microbiota, may differ in people with IBS compared to those without the condition.


      An imbalance in these bacteria, known as dysbiosis, can contribute to symptoms. For example, certain bacteria produce gas as they digest food, which can lead to bloating and discomfort.




  5. Food Sensitivities and Intolerances:


    • Some individuals with IBS may have sensitivities to certain foods or ingredients, such as lactose, fructose, or gluten.


      These sensitivities can trigger or worsen symptoms.





  6. Post-Infectious IBS:


    • IBS can develop after a severe bout of gastroenteritis caused by bacteria or viruses.


      This form of IBS, known as post-infectious IBS, is thought to result from persistent inflammation or changes in the gut microbiota following the infection.





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    Symptoms

    The symptoms of IBS can vary widely among individuals and may range in severity from mild to debilitating.


    Common symptoms include:

    1. Abdominal Pain and Cramping:


      • Pain is typically located in the lower abdomen and may be relieved by defecation. The intensity and nature of the pain can vary.




    2. Altered Bowel Habits:


      • Diarrhoea-Predominant (IBS-D):
        Frequent, loose, or watery stools.

      • Constipation-Predominant (IBS-C):
        Infrequent, hard, or lumpy stools.

      • Mixed Type (IBS-M):
        Alternating between diarrhoea and constipation.



    3. Bloating and Gas:


      • Many individuals with IBS experience a feeling of fullness, bloating, and excessive gas.




    4. Other Symptoms:


      • Mucus in the stool.

      • A sensation of incomplete bowel evacuation.

      • Nausea.

      • Urgency or the sudden need to have a bowel movement.




    Introduction
    Coeliac Disease overview
    Non-Coeliac Gluten Sensitivity overview
    Irritable Bowel Syndrome overview
    Gastroesophageal Reflux Disease overview
    Inflammatory Bowel Disease overview
    Conclusion
    Ready to embark on your gut health journey?
    Final Message
    Disclaimers & Disclosures
    Sources

    Diagnosis and Treatment

    Diagnosis:

    Diagnosing IBS involves a thorough evaluation to exclude other conditions that might cause similar symptoms.


    The diagnosis is based on clinical criteria, particularly the Rome IV criteria, which include:


    1. Rome IV Criteria:


      • Recurrent abdominal pain, on average, at least one day per week in the last three months, associated with two or more of the following:

        • Related to defecation.

        • Associated with a change in stool frequency.

        • Associated with a change in stool form (appearance).



    2. Exclusion of Other Conditions:


      • Blood tests, stool tests, and sometimes colonoscopy or sigmoidoscopy are conducted to rule out conditions such as coeliac disease, inflammatory bowel disease (IBD), infections, and colorectal cancer.



    Treatment:

    Treatment of IBS focuses on symptom management and improving quality of life.


    A multifaceted approach is often the best way of achieving positive results:

    1. Dietary Changes:



      • Low FODMAP Diet:


        This diet restricts certain carbohydrates that are poorly absorbed in the small intestine and can ferment in the colon, causing symptoms.

        The diet involves eliminating high FODMAP foods and gradually reintroducing them to identify triggers.



      • Increased Fibre Intake:

        Soluble fibre can help with constipation-predominant IBS, but may not be suitable for everyone.



      • Avoidance of Trigger Foods:

        Identifying and avoiding foods that trigger symptoms, such as caffeine, alcohol, spicy foods, and fatty foods.




    2. Medications:


      • Antispasmodics:
        These medications help reduce intestinal spasms and pain.

      • Laxatives:
        Used to relieve constipation.

      • Antidiarrheal:
        Used to control diarrhoea.

      • Probiotics:
        These may help restore a healthy balance of gut bacteria.

      • Antidepressants:
        Low doses of tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs) can help manage pain and other symptoms.




    3. Psychological Therapies:


      • Cognitive-Behavioural Therapy (CBT):
        Helps individuals manage stress and anxiety, which can exacerbate IBS symptoms.

      • Gut-Directed Hypnotherapy:
        Aims to reduce pain and discomfort by addressing the gut-brain interaction.

      • Mindfulness and Relaxation Techniques:
        These can help manage stress and improve symptom control.




    4. Lifestyle Modifications:



      • Regular Exercise:
        Physical activity can help reduce stress and improve bowel function.


      • Adequate Hydration:
        Drinking enough water is important, especially for those with constipation-predominant IBS.


      • Regular Sleep Patterns:
        Maintaining good sleep hygiene can help manage overall health and reduce symptom flare-ups.

    By adopting a comprehensive and personalized treatment plan, many individuals with IBS can effectively manage their symptoms and lead a fulfilling life.



    Ongoing research continues to uncover new insights into the underlying mechanisms of IBS and potential new therapies, offering hope for even better management strategies in the future.

    Gastroesophageal Reflux Disease (GERD)

    Overview

    Gastroesophageal Reflux Disease (GERD) is a chronic digestive disorder characterized by the backflow of stomach acid into the oesophagus, which leads to irritation and inflammation of the oesophageal lining.

    This condition is common but the symptoms and severity of the condition can significantly impact a persons quality of life, especially when left untreated.

    GERD is often associated with a persistent and troublesome form of heartburn, but it can also present with a variety of other symptoms.

    Causes

    GERD is primarily caused by a dysfunction of the lower oesophageal sphincter (LES), a ring of muscle that acts as a valve between the oesophagus and the stomach.

    When the LES is weak or relaxes inappropriately, it allows stomach acid and sometimes food to flow back into the oesophagus. Several factors can contribute to or exacerbate this malfunction such as those listed below:

    1. Obesity:

      • Excess body weight increases abdominal pressure, which can push stomach contents upward into the oesophagus.



    2. Pregnancy:

      • Hormonal changes and increased abdominal pressure during pregnancy can lead to GERD.




    3. Hiatal Hernia:

      • This condition occurs when the upper part of the stomach protrudes through the diaphragm into the chest cavity, disrupting the normal function of the LES.



    4. Dietary Factors:


      • Certain foods and beverages can relax the LES or increase stomach acid production, contributing to GERD. Common culprits include:


        • Spicy foods.
        • Fatty or fried foods.
        • Chocolate.
        • Caffeine.
        • Alcohol.
        • Citrus fruits and juices.
        • Tomato-based products.




    5. Lifestyle Factors:

      • Smoking, lying down soon after eating, and eating large meals can also increase the risk of GERD.



    6. Medications:

      • Certain medications, such as antihistamines, calcium channel blockers, and pain relievers, can relax the LES or irritate the oesophageal lining.




    Symptoms

    The symptoms of GERD can vary in severity and frequency.

    Common symptoms include things like:

    1. Heartburn:

      • A burning sensation in the chest, often after eating, which might be worse at night or when lying down.


    2. Regurgitation:

      • A sensation of acid backing up into the throat or mouth, leading to a sour or bitter taste.


    3. Difficulty Swallowing (Dysphagia):

      • A feeling that food is stuck in the throat or chest, which can be painful.


    4. Chronic Cough:

      • A persistent cough that is not related to respiratory conditions, often worse at night.


    5. Laryngitis:

      • Inflammation of the voice box, leading to hoarseness or a sore throat.


    6. Asthma-Like Symptoms:

      • GERD can exacerbate asthma symptoms or cause new respiratory issues due to the aspiration of stomach acid into the lungs.


    7. Chest Pain:

      • Severe heartburn can mimic the pain of a heart attack, necessitating medical evaluation to rule out cardiac causes.


    Introduction
    Coeliac Disease overview
    Non-Coeliac Gluten Sensitivity overview
    Irritable Bowel Syndrome overview
    Gastroesophageal Reflux Disease overview
    Inflammatory Bowel Disease overview
    Conclusion
    Ready to embark on your gut health journey?
    Final Message
    Disclaimers & Disclosures
    Sources

    Diagnosis and Treatment

    Diagnosis:

    Diagnosing GERD typically begins with a thorough clinical evaluation based on symptoms.

    Additional tests may be used to confirm the diagnosis and assess the severity of the condition, and include such things as:

    1. Endoscopy:

      • A flexible tube with a camera (endoscope) is inserted through the mouth to examine the oesophagus and stomach. This can identify inflammation, ulcers, or other potential complications.


    2. pH Monitoring:

      • A probe is placed in the oesophagus to measure the frequency and duration of acid reflux episodes over a 24-hour period.


    3. Oesophageal Manometry:

      • This test measures the rhythmic muscle contractions (peristalsis) in the oesophagus and the function of the LES.


    4. Barium Swallow:

      • A series of X-rays are taken after swallowing a barium solution to visualize the oesophagus and detect abnormalities.





    Treatment:

    The treatment of GERD involves a combination of lifestyle modifications, medications, and, in more severe cases, surgical interventions:

    1. Lifestyle Modifications:


      • Weight Loss: Reducing body weight can decrease abdominal pressure and lessen symptoms.

      • Dietary Changes: Avoiding trigger foods and beverages, eating smaller meals, and not lying down immediately after eating can help.

      • Elevating the Head of the Bed: Raising the head of the bed by about 6-8 inches can prevent acid reflux during sleep.

      • Smoking Cessation: Quitting smoking can improve LES function and overall digestive health.




    2. Medications:

      • Antacids: Over-the-counter medications that neutralize stomach acid can provide quick relief.

      • H2 Receptor Blockers: Medications such as ranitidine and famotidine reduce acid production.

      • Proton Pump Inhibitors (PPIs): Stronger acid reducers like omeprazole and esomeprazole are used for more severe symptoms and healing of oesophageal inflammation.

      • Prokinetics: These drugs help strengthen the LES and make the stomach empty faster.




    3. Surgery:


      • In cases where lifestyle changes and medications are not effective, surgical options may be considered:

        • Fundoplication: The most common surgery for GERD, where the top of the stomach is wrapped around the LES to strengthen it and prevent reflux.

        • LINX Device: A ring of magnetic beads is placed around the LES to improve its function.

    By adhering to a comprehensive treatment plan, individuals with GERD can effectively manage their symptoms and reduce the risk of complications, such as esophagitis, strictures, or Barrett’s oesophagus, which can increase the risk of oesophageal cancer.

    Ongoing research into GERD continues to enhance understanding and treatment options for this common condition, so it’s likely in the future there will be even more help available than there is today.

    Inflammatory Bowel Disease (IBD)

    Overview

    Inflammatory Bowel Disease (IBD) is a term that encompasses two main disorders: Crohn’s disease and ulcerative colitis. Both are characterized by chronic inflammation of the gastrointestinal (GI) tract, but they differ in terms of the areas they affect and their specific pathological features.



    Below, you’ll find information on both conditions including similarities and the ways in which they differ.

    IBD can significantly impact a person’s quality of life, causing a range of symptoms and requires long-term management strategies in order to achieve a good quality of life for those who have it.

    Causes

    The exact cause of IBD remains unclear, but it is believed to be the result of a complex range of factors, including some of these below:

    1. Abnormal Immune Response:


      • In IBD, the immune system mistakenly attacks the cells of the GI tract, causing chronic inflammation. This response is thought to be triggered by an environmental factor in genetically predisposed individuals.



    2. Genetic Predisposition:


      • A significant number of IBD patients have a family history of the disease, indicating a genetic component. Specific genes, such as NOD2/CARD15 in Crohn’s disease, have been associated with an increased risk of developing IBD.



    3. Environmental Factors:


      • Various environmental factors may contribute to the onset and exacerbation of IBD, including:

        • Diet: High-fat, low-fibre diets may increase risk.
        • Smoking: Particularly associated with Crohn’s disease.
        • Infections: Certain bacterial or viral infections may trigger immune responses.
        • Antibiotics: Use of antibiotics, especially in childhood, has been linked to an increased risk of IBD.



    4. Gut Microbiota:


      • An imbalance in the gut microbiota, or dysbiosis, is often observed in IBD patients. The microbiota plays a crucial role in maintaining gut health and immune function.

    Symptoms

    While both Crohn’s disease and ulcerative colitis share some symptoms, they also have distinct characteristics as you can see below:

    1. Crohn’s Disease:

      • Affected Areas: Can affect any part of the GI tract, from mouth to anus, often with “skip lesions” (areas of diseased tissue separated by healthy tissue).

      • Symptoms:

        • Abdominal Pain and Cramping: Often severe and can occur anywhere in the abdomen.
        • Diarrhoea: Sometimes bloody, more often chronic.
        • Weight Loss and Malnutrition: Due to poor absorption of nutrients.
        • Fatigue: Common due to inflammation and malnutrition.
        • Perianal Disease: Skin tags, fissures, and abscesses around the anus.




    2. Ulcerative Colitis:

      • Affected Areas:


        Only affects the colon and rectum, causing continuous inflammation starting from the rectum and extending proximally.


      • Symptoms:

        • Bloody Diarrhoea: Often severe and frequent.
        • Abdominal Pain: Typically on the left side or in the lower abdomen.
        • Urgency to Defecate: Sudden and intense need to have a bowel movement.
        • Rectal Bleeding: Due to ulceration of the colon lining.
        • Tenesmus: A feeling of incomplete evacuation after a bowel movement.

    Introduction
    Coeliac Disease overview
    Non-Coeliac Gluten Sensitivity overview
    Irritable Bowel Syndrome overview
    Gastroesophageal Reflux Disease overview
    Inflammatory Bowel Disease overview
    Conclusion
    Ready to embark on your gut health journey?
    Final Message
    Disclaimers & Disclosures
    Sources

    Diagnosis and Treatment

    Diagnosis

    Diagnosis of IBD involves a combination of clinical evaluation, laboratory tests, imaging studies, and histopathology to differentiate between Crohn’s disease and ulcerative colitis and to rule out other conditions:


    1. Endoscopy:

      • Colonoscopy: Visualizes the entire colon and ileum to assess the extent and severity of inflammation and obtain biopsies.
      • Upper Endoscopy: May be used if upper GI involvement is suspected, particularly in Crohn’s disease.



    2. Imaging Studies:
      • CT and MRI Enterography: Used to visualize the small intestine and detect complications such as strictures, fistulas, and abscesses.
      • Ultrasound: Sometimes used to assess bowel wall thickness and detect complications.



    3. Laboratory Tests:
      • Blood Tests: Assess for anaemia, infection, inflammation markers (e.g., C-reactive protein), and nutritional deficiencies.
      • Stool Tests: Check for faecal calprotectin, which indicates intestinal inflammation.



    4. Histopathology:
      • Biopsy samples taken during endoscopy are examined under a microscope to identify characteristic features of Crohn’s disease or ulcerative colitis.




    Treatment

    The primary goal of IBD treatment is to reduce inflammation, achieve and maintain remission, and improve a persons quality of life.


    Treatment plans are tailored to the individual but may include things like:

    1. Medications:

      • Amino salicylates (5-ASAs): Used primarily for mild to moderate ulcerative colitis.

      • Corticosteroids: Effective for short-term relief of moderate to severe flare-ups but not for long-term use due to side effects.

      • Immunomodulators: Such as azathioprine and methotrexate, used for maintenance therapy.

      • Biologics: Target specific components of the immune system (e.g., TNF inhibitors like infliximab) and are used for moderate to severe cases.

      • Janus Kinase (JAK) Inhibitors: A newer class of drugs used for moderate to severe ulcerative colitis.




    2. Dietary Changes:

      • Nutritional Support: Addressing malnutrition and ensuring adequate nutrient intake.

      • Specific Diets: Some patients may benefit from diets like the low FODMAP diet, exclusive enteral nutrition, or elimination diets tailored to individual triggers.




    3. Surgery:

      • Crohn’s Disease: Surgery is often required to treat complications such as strictures, fistulas, or abscesses but is not curative.

      • Ulcerative Colitis: Surgical removal of the colon (colectomy) can be curative and may be necessary for severe cases or when there is a risk of cancer.




    4. Lifestyle Modifications:

      • Stress Management: Techniques such as mindfulness, yoga, or counselling can help manage stress, which may exacerbate symptoms.

      • Regular Exercise: Can improve overall health and well-being.

    Conclusion

    Digestive disorders like coeliac disease, non-coeliac gluten sensitivity, IBS, GERD, and IBD significantly impact individuals’ quality of life.


    Understanding these conditions’ causes, symptoms, and treatments is crucial for effective management and improved patient outcomes.


    Advances in research continue to enhance our knowledge and treatment approaches, offering hope for better care and relief for those affected by these disorders.


    By staying informed and adopting comprehensive management strategies, individuals with these conditions can lead healthier, more fulfilling lives.

    Ready to embark on your gut health journey?

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      Introduction
      Coeliac Disease overview
      Non-Coeliac Gluten Sensitivity overview
      Irritable Bowel Syndrome overview
      Gastroesophageal Reflux Disease overview
      Inflammatory Bowel Disease overview
      Conclusion
      Ready to embark on your gut health journey?
      Final Message
      Disclaimers & Disclosures
      Sources

      Final message:

      Remember, empowering yourself with knowledge and seeking professional guidance are paramount in navigating the complexities of diagnosis for these above conditions and for proper management of them, to ensure the appropriate steps are taken towards achieving better health.

      Remember, I’m always here to help!

      Get in contact here if you need me.

      Gemma x

      DISCLAIMERS & DISCLOSURES

      This post may contain affiliate links, which means I may receive a commission, at no extra cost to you, if you make a purchase through a link.
      Please see my full disclosure for further information
      DISCLOSURE
      & my full Disclaimer for further information – DISCLAIMER

      Any advice offered within this article is meant for educational purposes only and should not be used as a sole resource for understanding the medical conditions discussed within. Any changes made to your diet, lifestyle and general well-being should be discussed with your GP or similar healthcare professional who is aware of your unique medical history and not made according to advice provided within this article or anywhere else on this website.


      While the utmost care has been taken in devising the information residing on this website, it is your sole responsibility as the reader to utilise the information as you see fit and by reading the information present on this website you accept personal responsibility over any health outcomes related to you and your condition which occur as a direct or indirect result of using the information on this website in any way.

      Always Check Ingredients Labels for Allergen Information
      before consuming a product.

      This is important in case there are changes in
      manufacturing since the date of publication of this article.

      It’s also a good idea in general, especially if you have allergies rather than intolerances/sensitivities to certain ingredients to check ingredients labels before consuming a product.

      Sources:

      Beyond Celiac, 2023. Non-celiac gluten sensitivity. [online] Available at: https://www.beyondceliac.org/celiac-disease/non-celiac-gluten-sensitivity/ [Accessed 27 June 2024].

      Biesiekierski JR, Iven J. Non-coeliac gluten sensitivity: piecing the puzzle together. United European Gastroenterol J. 2015;3(2):160-165. doi:10.1177/2050640615578388

      Coeliac UK, 2023. About coeliac disease. [online] Available at: https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/ [Accessed 27 June 2024].

      Cleveland Clinic, 2023. Acid reflux (GERD). [online] Available at: https://my.clevelandclinic.org/health/diseases/17019-acid-reflux-gerd [Accessed 27 June 2024].

      Crohn’s & Colitis UK, 2023. Information about Crohn’s and Colitis. [online] Available at: https://crohnsandcolitis.org.uk/info-support/information-about-crohns-and-colitis?utm_term=ibd&utm_source=google&utm_medium=cpc&gad_source=1&gclid=Cj0KCQjw7ZO0BhDYARIsAFttkCj-e3mQhlBFUeQkVBS4o8_UO3pHmbmEbn9eJDlgUMxs-KUysCKWUZ8aAk5REALw_wcB [Accessed 27 June 2024].

      Guts UK, 2023. Irritable bowel syndrome (IBS). [online] Available at: https://gutscharity.org.uk/advice-and-information/conditions/irritable-bowel-syndrome/?gad_source=1&gclid=Cj0KCQjw7ZO0BhDYARIsAFttkCj9rgpFSXcaMz30E_z-5P-T391d0xl8tEOHq86NmCbR2JWQS5X705caAgLQEALw_wcB [Accessed 27 June 2024].

      Johns Hopkins Medicine, 2023. Gastroesophageal reflux disease (GERD). [online] Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/gastroesophageal-reflux-disease-gerd#:~:text=Gastroesophageal%20reflux%20disease%20(GERD)%20is,or%20severe%20symptoms%20or%20injury. [Accessed 27 June 2024].

      National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 2023. Acid reflux (GER & GERD) in adults. [online] Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults [Accessed 27 June 2024].

      NHS, 2023. Coeliac disease. [online] Available at: https://www.nhs.uk/conditions/coeliac-disease/ [Accessed 27 June 2024].

      NHS, 2023. Irritable bowel syndrome (IBS). [online] Available at: https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/ [Accessed 27 June 2024].

      Gemma Hartshorn

      Gemma is a mum to twins with non-coeliac gluten sensitivity and has been living a gut-health focused life for many years herself. She has 5 years adult nursing experience in the UK and achieved a distinction in her Diploma of Higher Education in Healthcare from Oxford Brookes University. She is currently completing a BSc in Health Science and has a keen interest and knowledge of all things gut health. Listen to her Gut Be Good podcast or join her on the Gut Be Good youtube channel for more insights, sharing and helpful information on all things gut health related alongside her website here. Contact Details: glutenfreeshopeasy@gmail.com Unit 80366, PO Box 6945, London, W1A 6US

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