What Is Diverticulitis And How Do You Know If You Have It Is It Preventable How Is It Treated
A diverticulum is a circumscribed pouch or sac that either occurs naturally or is created by herniation of the first mucosal lining of the GI tract through a defect in the muscle wall layer of the intestine. Multiple diverticulum are called diverticulosis. When these diverticula get infected itâs called diverticulitis,â an acute, painful disease.
Although the specific cause of diverticulitis is unknown, the development likely involves mechanical, environmental and lifestyle factors. Contributing factors include age older than 50, obesity, sedentary lifestyle, corticosteroids, use of NSAIDs, smoking, constipation and excessive alcohol consumption. Therefore, this condition is partially preventable by modifying these factors . In western societies, 95 percent of diverticula are located on left side of the colon.
Mild diverticulitis is treated on an outpatient basis with clear liquids or a low-residue diet for a few weeks, as prescribed by your doctor. After complete resolution of the acute event, the colon should be evaluated by a colonoscopy, barium enema, or CT colography to ensure absence of other diseases of the colon, including cancer.
Certified by the American Board of Internal Medicine and Gastroenterology, Dr. Razas professional interests and experience include:
How Can My Doctor Help
If changes to your lifestyle and natural remedies have not helped you, seek further advice from your doctor. Medication for indigestion such as antacids, H2 blockers or proton pump inhibitors such as omeprazole may be prescribed.
In some cases, these drugs can be prone to side effects and long-term use has to be considered carefully. Read our blog article: Hard to stomach to find out more.
How Is Functional Dyspepsia Diagnosed
When you explain your symptoms to your healthcare provider, they will test you for common causes. Tests may include:
- Blood tests to check for common infections and diseases that might explain your symptoms.
- Upper endoscopy, an imaging test to look inside your organs for any structural problems.
- Breath tests to screen for abnormal bacteria in your gut. The urea breath test can detect H. pylori infection, while the hydrogen breath test can detect SIBO.
- Gastric emptying studies to see how fast your stomach empties into your small intestine.
If theres no evidence of a structural or biochemical disease, and your symptoms have been persistent for three months or more, youll be diagnosed with FD.
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Getting Accredited Representation For Ibs Or Gerd Benefits
If you need assistance filing a claim or appealing a denial of benefits, the accredited representatives at Chisholm Chisholm & Kilpatrick may be able to help. Our veterans advocates have helped veterans with their appeals for both IBS and GERD benefits. Contact our office today for a free case evaluation.
Signs You Need To See A Gastroenterologist
Archbold Medical Center: 419-446-3019
Do you experience frequent abdominal pain, heartburn, nausea or vomiting? If so, you may have a digestive health disorder. Your family doctor may recommend dietary adjustments, lifestyle changes or prescription drugs to prevent your symptoms from worsening. In some cases, they may run tests to determine your condition and recommend treatment. Some gastrointestinal conditions require more specific care than your family doctor can provide in this case, you will be referred to a Gastroenterologist.
Common symptoms of digestive health disorders:
- Abdominal pain and discomfort
- Bleeding in the GI tract
- Constipation and diarrhea
Severe symptoms could indicate one of these GI disorders:
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The Differences Between Silent Reflux Acid Reflux Gerd And Lpr
Lets start with defining reflux by itself. Reflux occurs when the contents of the stomach come back up into your esophagus, and sometimes all the way up to your throat. For many people , this causes heartburn. From there we get two different types of reflux:
- Silent reflux: This affects the voice box/larynx and the throat/pharynx. You might feel this as a sore throat, burping, hoarse voice, etc. The reflux is silent because it doesnt cause the burning pain of heartburn and so may go unnoticed for some time.
- Acid reflux: This affects the esophagus, which connects the throat and the stomach. The primary symptom is heartburn or burning pain.
Then, we have LPR and GERD, two conditions involving chronic reflux:
- LPR : You can think of LPR as the chronic presentation of silent reflux. The two terms are often used interchangeably. Laryngo means something that affects the larynx or voice box, and pharyngeal means something that affects the area at the back of the throat, called the pharynx. So together, this is reflux affecting the larynx and the pharynx.
- GERD : GERD is a condition involving chronic acid reflux. This condition often overlaps with LPR.
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Prevalence And Symptoms Of Ibs
Statistics show that approximately 2 in 10 people in the UK have IBS. Many more people are thought to have IBS who have either not been diagnosed correctly or havent consulted a GP for a diagnosis. Many people think that IBS symptoms such as constipation, loose stools, going to the toilet less than once a day, wind or bloating is normal.
In terms of a healthy bowel movement, the gold standard is 2 to 3 times a day and doesnt leave any marks on the toilet bowel or even on the toilet paper! Can you honestly say your stools are like that?
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How Gut Health Affects Silent Reflux
Research shows that your gut health, specifically your microbiome health, may relate to reflux symptoms. One systematic review showed that probiotics seemed to improve the symptoms of GERD, including heartburn, regurgitation, abdominal pain, and gas .
A meta-analysis also found that H. pylori, a bacterium that can infect the stomach and cause ulcers, is present in about half of LPR patients . However, some research shows that H. pylori can actually protect against developing acid reflux or esophageal cancer .
We can tentatively suggest that working to reduce H. pylori and any other gut pathogens as well as supporting the beneficial bacteria in the microbiome with probiotic therapy may help improve LPR or silent reflux symptoms.
Gerd/fh And Ibs Overlap
To date, several studies have reported a certain degree of overlap between GERD and IBS that cannot be explained solely by chance. By contrast, epidemiological data regarding the possible concomitance of FH and IBS in the same patient are lacking.
In the last two decades, the assessment of the epidemiological and clinical features of IBS has gained considerable attention. At present, the overall prevalence of IBS ranges from 10% to 20% of adults and adolescents, and it predominantly affects young females. Population-based studies suggest that GERD, defined by at least weekly heartburn and/or regurgitation, is a common condition, with a prevalence of 10%-20% in Western populations. Several studies have shown that up to 70% of patients complaining of heartburn have NERD 30%-50% of NERD patients display normal 24-h esophageal pH monitoring, and approximately 60% of these patients show a negative relationship between symptoms and acid reflux events. More recent studies conducted with MII-pH in NERD patients suggest an FH prevalence ranging from 19% to 26%. Very little is currently known about gender prevalence among patients with FH, although the condition seems to be more common in women.
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Jaw Pain Is Strongly Associated With Two Conditions:
Cardiac Problem: Heart Disease or Heart Attack
Coronary artery disease over time.Source: vecteezy.com
TMJ Disorder
Jose Larena/CreativeCommons
A lesser-known cause of jaw pain is GERD or acid reflux.
Chest pain that radiates to the left arm or jaw should be seriously investigated by a heart doctor to rule out angina or a heart attack, says Hugh Mai, MD, Director of Endoscopic Ultrasonography and Bariatric Endoscopy, Gastroenterology Division, Sinai Hospital of Baltimore and LifeBridge Health.
Once a cardiac cause is eliminated, acid suppression should be tried.
This can involve taking antacids or taking a medication that suppresses gastric acid.
If either of these is successful in relieving the jaw pain, then the jaw pain may be associated with acid reflux as a referred pain pathway in atypical GERD.
Dr. Maiis well-versed in the endoscopic treatment of GERD. LifeBridge Health provides the Baltimore community and beyond with a wide array of choices in health care services.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.
Tdiu With Ibs And Gerd
Any VA rating can contribute to a veterans eligibility for TDIU. TDIU, or Total disability based on individual unemployability , is a disability benefit available to veterans who are unable to obtain or maintain work on account of their disabilities. TDIU compensates veterans at the 100 percent pay rate, even if their combined disability rating may be less than that.
There are generally two pathways to TDIU:
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Va Disability Ratings For Ibs
VA rates Irritable Bowel Syndrome under 38 C.F.R. 4.114, Diagnostic Code 7319 for Irritable Colon Syndrome . VA characterizes IBS as mild, moderate, or severe under the rating criteria and includes symptoms to help figure out which rating a veterans IBS falls under.
Below are the criteria for each rating given for IBS:
- 30%Severe: Diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress
- 10%Moderate: Frequent episodes of bowel disturbance with abdominal distress
- 0%Mild: Disturbances of bowel function with occasional episodes of abdominal distress
Does Yogurt Increase Stomach Acid
Yogurt by itself doesnt create excess stomach acid that leads to heartburn. But too much sugar in any food can lead to weight gain and high cholesterol, which both cause acid reflux symptoms.
Too much harmful bacteria can lead to heartburn, not too little.
If you find that yogurt helps your acid reflux, then it might be worth it to you to buy some at the store. But always remember not to go overboard with how much you eat or drink.
If you cant find a low-fat yogurt with less than 5 grams of sugar per serving , then have half a cup or less and eat it with food.
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Causes Of Comorbid Ibs And Gerd
There are no definitive answers that explain why these two disorders often co-exist.
Sometimes IBS and GERD are triggered by the same underlying digestive dysfunction. For example, visceral hypersensitivity can trigger motility dysfunction of the upper and/or lower GI tract.
And sometimes IBS is one aspect of the full spectrum of GERD.
Treatments For Acid Reflux With Ibs
While medications may provide relief in many cases, the preferred treatment for most people suffering from both acid reflux and IBS is lifestyle and dietary modification.
In addition to avoiding certain foods, people with IBS or GERD may find relief by losing weight, quitting smoking, and learning stress-reduction techniques such as deep breathing, exercise, or yoga.
Although lifestyle and dietary changes can benefit many people with IBS, if you have GERD symptoms as well, certain medications may help:
- Proton pump inhibitors, such as omeprazole, are the drugs of choice for GERD sufferers.
- Antacids may be enough to relieve symptoms for people with occasional mild acid reflux.
- Anti-gas medications like simethicone can work for occasional gas, bloating, and indigestion.
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Pathophysiological Similarities In Gerd Fh And Ibs
Previous studies dealing with the overlap between GERD and IBS have proposed that visceral hypersensitivity, motility dysfunctions, and central neural mechanisms can be the main common pathophysiological mechanisms. However, following the release of Rome III criteria, an increasing number of studies have indicated the importance of a careful categorization of GERD patients via pathophysiological investigations to better appreciate the degrees of overlap between IBS and reflux symptoms in various subgroups of patients. Accordingly, this section intends to appraise and critically discuss the available evidence supporting a pathophysiological relationship among GERD, FH and IBS. When attempting such a difficult task, two important points must be carefully considered: In previous studies, GERD and IBS patients have been investigated to determine their pathophysiological and clinical features, while FH patients constitute a new entity for which pathophysiological studies are urgently required and Most of the available literature on the pathophysiology of FH addresses patients who were identified using old criteria that also identified NERD patients with normal esophageal AET. Even when these issues are kept in mind, IBS and FH, as well as IBS and GERD, appear to share some pathophysiological features that need to be carefully considered.
The Link Between Ibs Acid Reflux And Antacids
When you think of irritable bowel syndrome , which part of your body comes to mind? If youre like most people, its the intestines. But an IBS diagnosis isnt quite so straightforward. And the quick-fix many women turn to could, in fact, be doing more damage than good.
Many women who have been diagnosed with IBS also complain of symptoms in their upper GI tract: heartburn/acid reflux, nausea, and stomach pain. These upper GI symptoms are often related to the rate at which the stomach empties. If the gastric environment is out of balance, the stomach tries to squeeze its partially digested contents out from both ends as quickly as possible. This leads to a burning sensation, and when that happens, many of us self-medicate with antacids.
Unfortunately, using antacids will not get at the root cause of your upper GI symptoms, and might even make the problem worse. In my experience, acid reflux and chronic heartburn can actually be the result of too little acid in the stomach not too much. Overuse of antacids will initially lend some relief only to end up aggravating the underlying condition. In addition, antacid use can lower the acidity of the stomach to such a degree that it loses its ability to protect us from bacterial infection. It is now widely recognized that bacterial infection can cause ulcers.
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How Do I Know If I Have Sibo
Lab tests such as a 3 hour lactulose breath test, possibly followed by a glucose test as well if necessary, can be carried out by a SIBO practitioner such as myself. It is important that the test is a 3 hour test and that it tests for both methane and hydrogen.
Methane & hydrogen are emitted by bacteria in the small intestine, before you have had chance to absorb your food which can cause the symptoms of wind, bloating, stomach cramps, iron deficiency, B vitamin deficiency, fatigue, etc! But a word of warning There is a third gas, called hydrogen sulphide, that doesnt show up on a standard test.
Hydrogen Sulphide
Leading expert in the field, Dr Mark Pimental, has recently developed a test for Hydrogen Sulphide SIBO. Unfortunately, at the time of writing this article, it is not yet available in the UK.
However, if you have a flat line across the whole of your 3 hour breath test, it is possible that this is not a negative breath test for SIBO, but in fact a positive indicator that you have hydrogen sulphide SIBO. So, if you have previously been tested, as I was, and told that the test is negative because you had a flat line but you are still symptomatic, you may in fact need treating for Hydrogen Sulphide SIBO. A trained SIBO practitioner should be able to help you interpret the test and give you some indication of how long treatment might take.
The Low Fodmap Diet And Gerd
We know that the low FODMAP diet is an effective treatment for IBS,10,11 but it has not yet been conclusively shown to effectively treat GERD on its own. However, dietary and lifestyle recommendations for GERD often overlap with those for IBS, indicating that there may be some benefit to the LFD for individuals who struggle with both gut disorders.
For example, it is known that gut-irritating foods such as onions, garlic and spicy foods or beverages such as coffee or alcohol can exacerbate symptoms of both GERD and IBS. Lifestyle habits such as exercise, smoking and stress will also affect both disorders in positive or negative ways.
Additionally, some preliminary evidence has shown a connection between certain FODMAPS and inappropriate LES relaxation , indicating the possibility that reducing the intake of these FODMAPs may help alleviate GERD symptoms.12
There is also a theory that proposes a connection between the treatment of GERD with PPIs and the development of SIBO due to decreased stomach acid, which could initiate a cycle of increased gut pressure and gas production, further aggravating GERD symptoms.13, 14, 15
From a clinical perspective, these theories seem to accurately reflect real world scenarios. I, and many of the gut health dietitians Ive spoken to around the world, have seen substantial success by combining the LFD, GERD dietary recommendations and/or first-line IBS guidance as dietary strategies for patients with coexisting IBS and GERD.
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Prevalence Of Ibs In Patients With Gerd/fh
Thirty-two articles investigated the prevalence of IBS in subjects with a previous diagnosis of GERD/FH. The details are shown in Table Table2.2. In GERD patients, the overall mean prevalence of IBS was 36%, although there was considerable variability, as shown by values ranging from 8% to 71%. In 3 studies, IBS was diagnosed according to the Manning criteria in 8 studies, it was diagnosed according to the RomeIcriteria in 10 studies, it was diagnosed according to the Rome II criteria in 8 studies, it was diagnosed according to the Rome III criteria in 3 studies according to the ReQuest criteria . In all studies, IBS was diagnosed via a symptom questionnaire. However, in one study, hematological and stool examinations were also performed to exclude organic diseases. In comparison, GERD was diagnosed via a symptom questionnaire in 18 studies and via a symptom questionnaire combined with upper endoscopy in 7 studies. In 7 studies, esophageal pathophysiological studies were performed in addition to the symptom questionnaire and upper endoscopy. Overall, IBS was more prevalent in patients with NERD than in those with ERD . Two studies, which evaluated FH in accordance with the Rome III criteria, estimated prevalences of 39% and 61.4% for IBS. In the first study, heartburn was investigated via pH-metry, while the latter used MII-pH testing.