Everyone has experienced the unpleasantness of stomach issues, but when the symptoms are persistent, it could be a sign of something more worrisome. According to the National Institute of Diabetes and Digestive and Kidney Diseases, an estimated 60 million and 70 million Americans suffer from GI issues and people pay the price in more than one way. The National Library of Medicine states, "GI diseases contribute substantially to health care use in the United States. Total expenditures for GI diseases are $135.9 billion annually-greater than for other common diseases. Expenditures are likely to continue increasing." Eat This, Not That! Health spoke with specialists who share what the signs of an intestinal disease are and what to know about your intestines. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.
What to Know About Intestinal Diseases
Dr. George Saffouri, Gastroenterologist with Dignity Health San Bernardino says, "When I hear the term "intestinal diseases," I would say that's an extremely broad term. If I try to break this up further into general categories, I would say that these can involve inflammation, functional impairment, structural impairment, microbial or hormonal imbalance, or malignancy. In the gastroenterology world, these diseases can really present anywhere from mouth to anus so to speak, but the major organs or systems involved include the esophagus, stomach, small intestine, colon, pancreas, liver, and biliary system."
Bhavesh Shah MD Director of Advanced Endoscopy Chief of Endoscopy, the MetroHealth System Case Western Reserve University School of Medicine Cleveland, Ohio adds, "An intestine disease could be any health problem or illness involving the small or large intestine. The small intestine begins just past your stomach and is approximately 20 feet long. This connects to your large intestine (colon) which leads to the end of your intestinal tract."
Who is at Risk?
Dr. Saffouri tells us, "Not to cause panic or alarm, but really anyone is at risk of an intestinal disease. Certain factors may increase risk and these include obesity, smoking, alcohol use, chronic medications such as NSAIDs or opioids, autoimmune conditions, or a family history of an intestinal disease. Again, since we are not talking about specific diseases, it is a bit challenging to think of risk factors that apply broadly, but the above list is a good starting point."
Dr. Shah says, "Depending on the disease, individuals who could be considered to be at risk would be those with someone in their family with an intestinal disease. If you've had some intestinal disease in the past, you could also be at risk for further intestinal disease. There is a large array of intestinal diseases; some are quite simple and uncomplicated to manage and others with serious health consequences which require the assistance of a specialist. Being aware of how your body feels is an important thing to realize about any intestinal disease."
How Can You Help Prevent an Intestinal Disease?
Dr. Saffouri shares, "I think it's important to know that we only have a certain measure of control over our own health. For example, we cannot change our genetics or family history. But what we can do is maintain a healthy lifestyle. Now that's another extremely broad and probably somewhat polarizing term, but when I think about disease prevention, I think of the following:
–Diet: eating a more plant-based or Mediterranean diet, ensuring enough fiber intake (25-34 grams/day for adults), avoiding sugary drinks, and minimizing alcohol (up to 1 drink/day for women and 1-2 drinks/day for men).
–Exercise: staying active and also finding dedicated/protected time for concerted exercise (doesn't always have to be high intensity)
–Substances: cessation or avoidance smoking, IV drugs, and other illicit substances.
–Screening: ensuring you are up to date with age-appropriate cancer screening. In the intestinal diseases world, this really comes down to colon cancer screening starting at age 45 for average risk individuals (remember: 45 is the new 50!)."
Dr. Shah says, "Knowing your family history can help you in terms of preventing intestinal disease- for example if someone in your family has had polyps in their colon or even colon cancer, that means you may need to get your colonoscopy earlier than anyone else. Eating a healthy and balanced diet, exercising regularly and being aware of any changes in your bowel habits can help prevent intestinal disease."
How Can an Intestinal Disease Affect Daily Life and Overall Health?
Dr. Saffouri states, "I suppose this can range from having regular symptoms (for example, abdominal pain, acid reflux, bloating, diarrhea, constipation, bleeding) on a bothersome or even debilitating scale to truly affecting mortality with certain cancers. In that sense, intestinal diseases can drastically affect the quality and quantity of life.I think two good examples of this are:
–Constipation: one of the most common and troubling diagnoses we see in our field is that of chronic constipation. In and of itself it can present as infrequent stools, hard stools, straining, or a sense of incomplete emptying. But it can also contribute to "upstream" symptoms of abdominal pain, nausea and vomiting, and bloating or distention of the abdomen.
–Colon cancer: In the United States, this is the 3rd most common cancer and the 2nd most common cause of cancer death. That's the bad news. The good news is that we have established screening tools to help reduce the risk of cancer and cancer-related death. These can range from a yearly stool test looking for blood to everyone's favorite dinner conversation piece – colonoscopy.
As stated above, if there's one thing to remember it's that 45 is the new 50: national guidelines have recently lowered the age to begin screening for colon cancer since we are seeing it occur increasingly in younger individuals. And remember, this is only for people of average risk for colon cancer. If you have a family history of colon cancer or certain colon polyps, you may need to be screened sooner."
Dr. Shah explains, "Abdominal pain could mean several things- and many diseases start with abdominal pain. Depending on the location, duration and severity of the pain, it could indicate a problem in your large or small intestine. Some intestinal diseases present with abdominal pain include ulcers, intestinal obstruction (or blockage), diverticulitis or inflammatory bowel diseases (such as Crohn's disease or Ulcerative Colitis)."
According to Dr. Saffouri, "Gastrointestinal bleeding: vomiting blood, black/sticky/tarry stool, or frank bright red blood from the bottom could indicate a sign of intestinal disease. Of course bleeding is always concerning when seen, however in the intestinal disease world, this can be an indication of cancer or inflammation/ulcers. Bleeding from the GI tract is always of utmost importance and will frequently warrant investigation with a scope (endoscopy or colonoscopy)."
Dr. Shah explains, "The most common reason for blood in your stool is hemorrhoids. It is always important to ensure that no other reason for blood in your stool exists. Blood in your stool could be related to hemorrhoids, inflammation, inflammatory bowel disease, colon polyps, or even cancer."
A Change in Bowel Habits
Dr. Saffouri explains, "New onset constipation or diarrhea can also be a heralding sign of cancer, inflammation, structural blockage, or functional disorder. Again, these are typically symptoms that will always be considered seriously. Although this is anecdotal, I have caught a lot of colon cancers by asking this bowel habit question when seeing patients in the clinic."
Dr. Shah says, "If you move your bowel regularly and that changes, there could be an underlying reason. It's important to be in touch with your primary care provider and have this discussion to determine whether a referral to a gastroenterologist is recommended."
Unintentional Weight Loss
Dr. Saffouri says, "This may also prompt an investigation for intestinal cancer, but can also be a clue to problems of intestinal absorption, intestinal inflammation, or structural blockage."
Dr. Shah adds, "Weight loss, specifically unexplained weight loss can mean that an intestinal disease exists. This can lead to weight loss even during times when you are eating more than usual. The intestines absorb nutrients play an important role in metabolism- any disturbances in them can lead to weight loss or not absorbing nutrients correctly."