Medical Questions & Answers » Intestines

Causes of Stomach Ulcers

medicalquestions — Thu, 07 May 2009 06:00:37 +0000

For two months I have had bad stomach aches on and off. The pain seems to run up into my chest sometimes. I am getting worried. Please help.
There are several dozen possible causes for your stomach pains, but the most likely are a peptic ulcer, regurgitation of acid from the stomach into the gullet, and a hiatus hernia.
Peptic ulcers cause severe pains at the top of the belly, that are often worse at night, and eased for a short time by food.
The stomach is full of acid, but the cells lining the stomach are covered with an acid-resistant mucus. If the mucus breaks down, a peptic ulcer results. If excess acid is produced, it may be regurgitated from the stomach, and run up into the gullet, which has no acid-protecting mucus. This results in a severe burning pain just below and behind the breast bone.
A hiatus hernia occurs when a small piece of the stomach slips up out of the belly and into the chest. The hernia itself causes little discomfort, but the stomach acid is allowed to flow freely up into the gullet to cause pain.
You will need to see a doctor to have your problem more thoroughly investigated, possibly by gastroscopy. This procedure involves swallowing a thin tube while under sedation. Through this, a doctor can examine the inside of your stomach and gullet to detect any abnormalities.

What sort of acid causes stomach ulcers? Why do we have acid in our stomachs?
Hydrochloric acid is known to most high-school students as a potent acid that can eat through many substances and cause nasty burns on your skin. This acid is also naturally produced in the body, and in its correct place in the stomach does no harm to the body but aids food digestion.
Specialised cells lining the stomach make the acid and release it in response to the sight or smell of food. We also start to produce more saliva when food is nearby, and if the food is not forthcoming, we are left drooling and with an ache in the gut, because no food has been eaten to soak up the saliva and acid. We normally end up eating the food we expect, and the acid works in the stomach to break it down to its basic components. Further digestive enzymes are added to the food when it passes out of the stomach into the small intestine.
The cells lining the stomach protect themselves from attack by the acid with a thin layer of mucus. If there is excess acid or insufficient mucus present, the acid may be able to attack the stomach wall. Many factors can produce either or both of these stomach problems. The most common triggers are smoking, stress, alcohol, and aspirin-type medications that are used in treating arthritis (eg. nonsteroidal anti-inflammatory drugs—NSAID). Anxiety can cause excess acid to be produced, which can then eat into the stomach. Smoking can reduce the mucus secretions that protect the stomach, while aspirin and some anti-arthritis drugs can directly damage the mucus layer. In recent years, a bacteria {Helicobacter pylori) has been identified in association with many ulcers, and it is believed that this bacteria may damage the mucus lining of the stomach.

Nourish Your Liver

medicalquestions — Mon, 05 Jan 2009 05:52:15 +0000

I am a 73-year-old CAD, post renal artery angioplasty patient. The specialist have prescribed the following medicines for liver protection which I have been taking for more than a year now: 1. Ursocol SR-450 and 2. Livesil B-1 BD. Despite this, LFTs done quarterly show abnormally high readings, particularly SGOT (220 to 380) and SGPT(220 to 350). The specialist treating me feels that in view of the toxic side-effects, this line of treatment is not advisable for someone of my age.
I am in complete agreement with your medical specialist and suggest that you should not take Peg Interferon + ribavirin treatment. You are asymptomatic as far Hep C infection is considered. Ultrasonography does not reveal advanced liver disease. Progression of Hep C infection is very slow. Peg Interferon can produce significant depression and side effects like bone marrow suppression. It may not be tolerated by you at this age and in Genotype I, the success rate is not beyond 50%. Hence risk/benefit assessment in your case does not favor taking treatment.

Constipation Problem

medicalquestions — Sun, 23 Nov 2008 04:58:00 +0000

I am a 22-year-old female suffering from constipation since 4 years. Lately, I keep hearing bubbling sounds in the abdomen and a dull pain is also there. Blood studies and occult blood testing were done. All were normal. I consulted a gastroentrologist who offered little advice and insisted there’s no need to do a colonoscopy. What are the remedies for IBS? And will IBS lead to colon cancer?

You are probably suffering from habitual constipation, but perhaps you need to go in for a thyroid function test, serum calcium levels exam, a double contrast barium enema and, if required, anorectal manometry to exclude any other cause. There are many pharmacological remedies for constipation but the selection of these remedies need to be done on an individual basis. Constipation does not lead to colon cancer. It’s a common enough condition in women of your age, and certainly not life threatening.

Inflatable Penile Prosthesis

medicalquestions — Sat, 09 Aug 2008 06:00:41 +0000

Question: My testicle bag keeps contracting. There is no pain, but it will not stop contracting day or night. I have seen 12 doctors and had one operation, but nothing helps. Could you give me some advice?
The scrotum in males is the sac that holds the testicles. The testicles must be kept at exactly the right temperature in order to produce sperm and hormones properly. This temperature is slightly lower than normal body temperature, and this is why the testicles are slung outside the body in the scrotum.
A muscle in the scrotum, called the detrusser, contracts to make the scrotum smaller, or relaxes to make it larger. In cold weather, the detrusser contracts, brings the testicles closer to the body, and thus keeps them warm. In hot weather, the reverse occurs, with the detrusser relaxing to allow the scrotum to sag, and the testicles to move away from the body and keep cool. I suspect that you are having spasms of the detrusser muscle, which are causing your scrotal contractions. These may be very difficult to stop, but a low dose of a muscle relaxant such as Valium may be tried.

Question: How effective are the operations to insert an inflatable prosthesis in the penis to overcome impotence in a 64 year old man?
This operation is the absolute last resort in the treatment of erectile failure in a man. It is necessary to start with investigations to find any cause of his impotence. These causes can be as diverse as diabetes, psychological problems, pituitary tumors, thyroid disease and alcoholism, as well as a host of less common problems.
Once a cause of impotence has been found, that should be dealt with, or if no specific cause can be found, other forms of treatment can be tried. Other treatments include using a simple vacuum tube that ’sucks up’ the penis, and a rubber ring around the base of the penis then keeps it erect. Medications such as Viagra, and the injection into the penis known as Caverject, can also give a very effective erection in many impotent men. If all else fails and the man is keen to proceed, an operation to replace the internal organs of the penis with an inflatable balloon can be used. The overall results of this operation (which is quite expensive) are good, but as with all operations, there is always a small chance of failure or complications.
It is essential that all the pros and cons of such a procedure are discussed in detail with both a doctor who is not directly involved in the procedure (eg. your general practitioner) and the surgeon.

Colitis Inflammatory Condition

medicalquestions — Sun, 15 Jun 2008 06:00:46 +0000

Question: After examination and tests, doctors have diagnosed the cause of my intestinal discomfort and bloody motions as colitis. Cortisone enemas have been prescribed, but results have not been encouraging. I would appreciate your comments.
Ulcerative colitis is an inflammatory condition of the last part of the bowel that causes multiple deep bleeding ulcers to form. Its cause is unknown.
Patients experience bloody diarrhea, cramping pains in the lower belly, fevers, weight loss and sometimes anemia.
When the diagnosis is suspected by a doctor, it is confirmed by performing a colonoscopy. In this procedure a flexible tube is passed through the anus up into the colon, and through this the examining doctor can easily see the ulcers and inflammation that are characretistic of the disease.
Unfortunately there is no cure for this condition. In acute attacks, hospitalization may be necessary with many medications being given in high doses to bring the condition under control. Long-term treatment with steroid enemas, oral steroid tablets and special antibiotics (sulphasalazine) is then given to control the condition.
Patients with ulcerative colitis should be on a specific diet that is high in protein and low in dairy products. Each patient will learn to identify specific foods that aggravate the condition and avoid them. As a last resort, it is sometimes necessary for the affected piece of bowel to be surgically removed. If your condition is not adequately controlled, you should be discussing the matter further with your doctor, as good control of ulcerative colitis is essential for your long-term wellbeing.

Chronic diarrhea

medicalquestions — Sun, 15 Jun 2008 06:00:32 +0000

Question: What can I do to stop chronic diarrhea?
The most important thing is to determine the cause of the diarrhea. The first step is a thorough examination by a doctor, and then appropriate investigations. These would certainly include examination of your faeces in a laboratory for any infecting agents, abnormal cells or blood. Another probable investigation would be blood tests to find any diseases that may have diarrhea as a component.
Diarrhoea has scores of different causes including infections, diseases of food absorption, allergies, cancer, gut inflammations, liver disease, tuberculosis, stress, diabetes, psychiatric diseases, kidney failure and a host of others. Once the cause of the diarrhea is found, the appropriate treatment can be given. Treating any chronic condition without determining its cause is foolish and dangerous.

Question: I am a 54 year old female, and for some years my bowels have caused pain. I have to use an enema to qo to the toilet, but afterwards I have pain at the bottom of my stomach. Should I go to a doctor?
A Anyone who has persistent constipation should not use laxatives or enemas regularly, but should be investigated by a doctor to find out why they are constipated. If laxatives are used regularly, the bowels become dependent upon them to work, and a long-term habit that is very difficult to break may develop.
Over-stimulation of the bowel by enemas may cause spasm and pain in the bowel. Your symptoms may be caused by the treatments you are using. The best treatment for constipation is prevention, and that means a diet high in fiber and fluids, and passing a motion every day. The best time to do this is immediately after the main meal of the day.
You should certainly see a doctor to have your chronic bowel condition sorted out.

Passing Tool Problems

medicalquestions — Sun, 15 Jun 2008 06:00:29 +0000

Question: After I have anything more than a snack to eat, I have to rush to the toilet to pass a motion. It’s getting embarrassing! How can I stop this?
In all animals there is a reflex known as the gastro-colic reflex. This acts so that when the stomach becomes distended by food, the rectum (last part of the gut) contracts to move out faeces. This reflex is easily seen in animals such as cattle and horses. In humans, the reflex is better controlled, for obvious social reasons, but it is still easier and better to go to the toilet after the main meal of the day than at other times.
Some unlucky people have an overactive gastro-colic reflex. This may be due to some disease or chronic irritation of the lower part of the gut, and it would be essential for you to see a doctor for a large bowel examination to exclude any problems in this area.
Colonoscopy involves passing a flexible tube into your back passage. Through this, the inside of your gut can be easily seen and any diseases identified. If nothing is found, exercises to improve your bowel control may be tried, dietary modification may be useful, and as a last resort medications can be prescribed to help your problem.

Question: Whenever we go away I suffer constipation and dreadful wind pains. I don’t like to use public toilets and can’t go away for more than a few days because I can’t go to the toilet until I get home.
Your self-diagnosis of a psychological problem is obviously correct, but these problems are not silly, and can seriously affect the lives of some people. The solution is to be taught to use public toilets and other facilities away from home. It is worth keeping in mind that even the Queen has to go to the toilet— a point many royalists who worship the Queen would never even consider! Arrange through your general pracritioner to see a good behavioural psychologist or a psychiatrist who has an interest in behavioural problems. Over a period of several weeks you will be taught how to cope with your fear, and in due course you will be able to enjoy long holidays away from home.
Fear of almost anything can be overcome by using appropriate techniques, and your fear of strange toilets is no worse than another person’s fear of heights, fear of spiders, or a fear of confined spaces. Don’t delay seeking help—a wide world away from home is waiting to be explored. A light-hearted paperback called ‘London’s Distinguished Dunnies’ (or something similar) is available for your perusal should you venture that far afield!

Appendix Problem

medicalquestions — Sat, 14 Jun 2008 06:00:32 +0000

Question: What is appendicitis, and how do people get this problem? My sister has just had hers removed at age 38.
Appendicitis is an infection of the appendix, which is a narrow dead end tube about 12 cm long that attaches to the caecum (first part of the large intestine). It is an almost unknown condition in poorer countries for dietary reasons, and the lack of fiber in Western diets is often blamed, although its incidence is steadily falling due to better dietary education. In other mammals, particularly those that eat grass, the appendix is an important structure which aids in the digestion of cellulose, but in humans it serves no useful purpose.
If the narrow tube of the appendix becomes blocked by faeces, food, mucus or some foreign body, bacteria start breeding in the closed-off area behind the blockage. When a patient develops appendicitis, pain develops around the navel and soon moves to the lower right side of the abdomen just above the pelvic bone and steadily worsens. It is often associated with loss of appetite, slight diarrhea and a mild fever. There is no specific diagnostic test, but blood and urine rests are done to exclude other causes of pain. Once removed, the appendix will be sent to a pathologist to confirm the diagnosis.
The only effective treatment is surgical removal of the appendix in a simple operation (appendectomy) which takes about 20 minutes. The usual hospital stay is only two days, and patients return to work in seven to ten days. The operation is sometimes done through laparoscopes (1 cm diameter tubes). The surgeon looks through one and operates through two others, leaving only three tiny scars scattered across the belly. This speeds recovery so that sometimes only a single night is required in hospital. If left untreated, the appendix becomes steadily more infected, full of pus, and eventually bursts to cause peritonitis. Most patients get very good results from treatment.

Stomach Pain

medicalquestions — Sat, 14 Jun 2008 06:00:20 +0000

Question: I have had pain in the right lower part of my belly for three months. The pain often goes to the back, but I have no loss of weight or appetite. What could cause such a pain?
There are a wide range of conditions that can cause such a pain, and you will need a wide range of investigations to discover its cause.
The first step is a detailed physical examination and history by your general practitioner. This will be followed by one or more of the following tests:
— Blood tests to check liver, kidney, pancreas, to find any infection, and assess your general health.
— Urine test to check bladder and kidney.
— Ultrasound scan of ovaries, uterus and other pelvic organs. —X-ray of back, bowel and/or kidney.
— CT scan of abdomen.
— Colonoscopy (a flexible tube passed up your back passage) to check the bowel.
— Laparoscopy (tube put through your belly button) to directly look around inside your belly.
A few of the many possible causes could include an ovarian cyst, an abscess from appendicitis, endometriosis, back arthritis, kidney stone, aneurysm (swelling) of the aorta, arterial thrombosis (clot), irritable bowel syndrome, tube infection, hernia, Crohn’s disease, cancer and many more.
I can only guess at a diagnosis. Your GP and the specialists s/he may refer you to, should be able to come to a definite diagnosis that can then be treated appropriately.

Bowel syndrome

medicalquestions — Fri, 13 Jun 2008 06:00:32 +0000

Question: Doctors have diagnosed my wife’s condition as a bowel syndrome, and she has to watch her diet as eggs and meat cause diarrhea. Her bowel X-ray shows diverticulae. Can you help us please?
It appears that you may be confused by two different bowel conditions, although it is possible that your wife has both of them.
The irritable bowel syndrome (IBS) causes painful spasms of the gut that result in irregular bowel activity, and is caused by anxiety, stress or depression. The treatment involves a high-fiber diet, bulking agents (eg. Normacol, Meta-mucil) and drugs to stop the gut spasm.
Diverticulitis is the inflammation or infection of multiple small out-pocketing (diverticulae) of the large gut wall. When inflamed, these diverticulae cause diarrhea and abdominal pain. The diverticulae are the result of a low-fiber diet over many years, and the condition is also treated with bulking agents, a high-fiber diet and antispasmodics. Antibiotics are also used sometimes to remove any infection in the diverticulae. The symptoms of the two conditions are very similar, and only by performing an X-ray of the bowel (a barium enema) or examining the bowel with a flexible microscope tube (colonoscopy) can the diagnosis be made. It is certainly possible for the two conditions to be present in the one patient, and one may worsen the other, but as the treatments are almost identical, the differentiation between them is not of critical importance.
Both conditions can be well controlled in most patients. The irritable bowel syndrome often comes and goes depending on stress levels, while diverticulitis will persist for the rest of the patient’s life, causing occasional periods of diarrhea and discomfort.

Question: I have had terrible belly pains on and off for years. My doctor now tells me it is diverticulitis so can you tell me what causes diverticulitis?
Diverticulitis is the inflammation of small bubbles that develop on the large gut. They are out-pocketing of the gut that form between the muscular bands that run along and around the gut. They are caused by excess pressure inside the intestine when there is inadequate bulk in the diet for the constantly contracting gut to move along towards the anus.
If you squeeze a half-inflated balloon between your fingers, it will bulge out between your fingers. This is what happens in the gut, but after a while the bulges become permanent, and these are the diverticulae. When food waste becomes trapped in a diverticulum, it may become infected and painful and cause diarrhea. A high-fiber diet will prevent formation of the problem.