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Digestive disorders
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Suffering from heartburn, constipation, diarrhoea or gas? Most of these conditions can be controlled with lifestyle changes and medication
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Sarguna is feeling out of sorts. Her abdomen feels bloated. She feels gassy and full. She has constipation. At the same time, there are days when she has a loose bowel movement after every meal. Sarguna has irritable bowel syndrome.
Women can suffer from common digestive disorders such as heartburn, constipation, diarrhoea, irritable bowel syndrome, or gas. Most of these conditions are not serious and are easy to control with lifestyle changes and medication. In some cases, however, these problems can be a sign of more serious medical problems.
Common digestive problems
Some digestive problems occur more often in women than in men. Sometimes, digestive problems are linked to gynaecologic problems. Hormone changes during pregnancy or menstruation also can cause digestive problems.
Functional digestive disorders are those where there is no physical abnormality but still the organs do not work properly. Structural disorders are those where there are actual abnormalities in the digestive system.
Functional disorders
Heartburn: Heartburn is an irritation of the oesophagus that is caused by stomach acid. A muscular valve called the lower oesophageal sphincter, normally keeps stomach acid in the stomach. This opens to allow food into the stomach or to permit belching, and then closes again. But if the sphincter loosens up, stomach acid can reflux (leak up) into the oesophagus and cause a burning sensation.
At least one third of the population will have heartburn occasionally and 10 per cent will have it daily. Most pregnant women will have some symptoms of heartburn. Overeating or too much pressure on the stomach (from obesity or pregnancy) is the most common cause. Certain foods commonly causing sphincteric relaxation leading to heartburn include tomatoes, citrus fruits, garlic, onions, chocolate, coffee, tea, alcohol, and peppermint. Spicy and oily foods often lead to heartburn. Anti-inflammatory drugs, and smoking increase acid production and can cause heartburn.
You can control or even prevent heartburn by taking these steps:
Giving a gap of at least 90-120 minutes between eating and lying down.
Elevating the head of the bed
Eating small meals at shorter intervals
Avoiding smoking and alcohol
Avoiding oily foods
Antacids and drugs that inhibit acid production may be prescribed to treat heartburn. If heartburn does not respond to medications, you might be asked to undergo an endoscopy (a procedure where a lighted scope is inserted into the stomach to inspect it) to rule out peptic ulcer disease or a more serious condition such as malignancy.
Constipation: Constipation involves having infrequent bowel movements that also may be painful. Signs of constipation include fewer than three bowel movements a week, stools that are hard to pass, bloating of the abdomen, straining during bowel movements and a feeling of incomplete emptying. Although constipation is uncomfortable, in most cases it is not a sign of a serious problem. You can prevent constipation by drinking at least eight glasses of water a day, eating a high-fibre diet, exercising regularly and not postponing going to the bathroom. You might also take bulk-forming agents, stool softeners or laxatives. However, the overuse of laxatives can worsen the condition.
Diarrhoea: Having three or more loose stools a day is called diarrhoea. It may be accompanied by mild to severe abdominal cramping. Usually diarrhoea is caused by eating spoiled or infected food. Occasionally, some people have diarrhoea due to lactose intolerance which is an inability to handle dairy products.
Diarrhoea can lead to dehydration if not treated. Drink plenty of fluids containing salt and sugar. Buttermilk, lime juice, tender coconut water and water are good ways of preventing dehydration.
Seek medical treatment if the diarrhoea persists for more than 24 hours. Diarrhoea with bloody stools, fever, or severe abdominal pain needs immediate medical attention.
Irritable bowel syndrome (IBS)
Irritable bowel syndrome mainly affects women between the ages 30–50 years. The symptoms may vary from mild to extremely annoying. The commonest symptom of IBS is an urge to pass motion soon after eating. Other symptoms include gas, cramping, bloating, constipation or diarrhoea or both, a repeated urge to pass motion but not passing motion.
The cause for IBS is not always clear. Women may have more symptoms during their menstrual periods. Keeping a record of foods you eat and the symptoms you have may help you avoid foods which trigger IBS.
(Part 2 will follow.)
GITA ARJUN
(The author is a Chennai-based obstetrician and gynaecologist with a special interest in women’s health issues.)
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