Gastrointestinal Disorders

Washington Hospital is dedicated to informing residents about healthcare topics through community forums and free health classes. The goal is to empower community members with information for informed health decisions. The hospital has served the Washington Township healthcare district for 60 years. Today's presenter, Dr. Arun Srivatsa, a gastroenterologist, will discuss digestive system symptoms and common conditions to improve digestive health.

The most common symptom of a sick digestive system is abdominal pain, which can indicate specific conditions based on the area of pain. Epigastric pain, right in the center of the abdomen, is often due to peptic ulcer disease or gastritis. Right upper quadrant pain can indicate gallbladder disease, while left upper quadrant pain may be due to splenic enlargement or pancreatitis. Right lower quadrant pain is commonly due to appendicitis, and left lower quadrant pain often results from diverticulitis. Diffuse pain can be benign or serious, such as generalized peritonitis or mesenteric thrombosis.

Pain practitioners describe pain using technical terms. Visceral pain originates in the digestive organs and is often confused with referred pain, where pain is felt in a different area due to nerve supply. Colicky pain is wave-like and often digestive in nature, while parietal pain is more constant and comes from the abdominal lining. Organic pain is specific to a digestive organ and is usually serious, while functional pain is not limited to one organ and is often less severe.

When examining a patient with abdominal pain, physicians start with inspection, listening for bowel sounds with a stethoscope, and palpating the abdomen to identify the most painful areas. They look for guarding and rebound tenderness. Initial tests include urine and blood tests, including hemoglobin, white blood count, and liver, kidney, and pancreas numbers. Imaging with x-rays, ultrasound, CT scans, MRIs, endoscopy, or colonoscopy follows, depending on the suspected condition.

Appendicitis is the leading cause of acute abdominal pain and requires immediate attention. Pain typically starts in the right lower quadrant and is accompanied by nausea, vomiting, and fever. Diverticulitis involves inflammation of the colon pockets and presents with left lower quadrant pain, fever, and changes in bowel habits. Treatment for mild cases includes oral antibiotics and bowel rest, while severe cases may require IV antibiotics and hospitalization.

Cholecystitis, or gallbladder attacks, are caused by gallstones and present with pain in the right upper quadrant, fever, and possibly jaundice. Pancreatitis, often due to gallstones or alcohol, causes severe pain radiating to the back. Peptic ulcer perforation is a life-threatening condition causing severe pain and may lead to bleeding. Small bowel obstruction presents with crampy pain, vomiting, and bloating, often due to adhesions or hernias. Aortic rupture is a dangerous condition causing sudden, severe pain and requires immediate surgery.

Irritable bowel syndrome (IBS) is a functional disorder causing abdominal spasms and pain, often relieved after bowel movements. Celiac disease is an autoimmune reaction to gluten leading to small intestine damage and nutrient malabsorption. Constipation is a common complaint with various underlying causes, including neurological disorders and medications. Diverticulosis involves colon pockets and can cause irregular bowel habits and pain. Gastroesophageal reflux disease (GERD) occurs when stomach contents move into the esophagus, causing heartburn and potential damage.

Management of digestive disorders involves dietary modifications, medications, and sometimes surgery. For IBS, a FODMAPs diet and anti-spasmodics may help. Celiac disease requires a gluten-free diet and vitamin supplementation. Constipation can be managed with fiber supplements, stool softeners, and laxatives. Diverticulosis is treated with increased fiber intake. GERD management includes antacids, H2 blockers, and proton pump inhibitors, with lifestyle changes to reduce symptoms.

Digestive health is crucial and should not be ignored. While some complaints are minor, others can be serious or life-threatening. It's important to discuss any digestive issues with a primary physician or see a gastroenterologist for proper diagnosis and treatment.