Gastrointestinal Diseases

Gastrointestinal diseases affect the gastrointestinal (GI) tract from the mouth to the anus. There are two types:
functional and structural. Some examples include nausea/vomiting, food poisoning, lactose intolerance and
diarrhea.

Constipation
Constipation occurs when bowel movements become
less frequent and stools become difficult to pass. It
happens most often due to changes in diet or routine, or
due to inadequate intake of fiber. You should call your
doctor if you have severe pain, blood in your stools, or
constipation that lasts longer than three weeks.
Having fewer than three bowel movements a week is,
technically, the definition of constipation. However,
how often you “go” varies widely from person to
person. Some people have bowel movements several
times a day while others have them only one to two
times a week. Whatever your bowel movement pattern
is, it’s unique and normal for you – as long as you don’t
stray too far from your pattern.

Regardless of your bowel pattern, one fact is certain: the longer you go before you “go,” the more difficult it
becomes for stool/poop to pass. Other key features that usually define constipation include:

 Your stools are dry and hard.

 Your bowel movement is painful and stools are difficult to pass.
 You have a feeling that you have not fully emptied your bowels.

People of all ages can have an occasional bout of constipation. There are also certain people and situations that
are more likely to lead to becoming more consistently constipated (“chronic constipation”).

These include:

 Older age. Older people tend to be less active, have a slower metabolism and less muscle contraction
strength along their digestive tract than when they were younger.
 Being a woman, especially while you are pregnant and after childbirth. Changes in a woman’s
hormones make them more prone to constipation. The baby inside the womb squishes the intestines,
slowing down the passage of stool.
 Not eating enough high-fiber foods. High-fiber foods keep food moving through the digestive system.
 Taking certain medications
 Having certain neurological (diseases of the brain and spinal cord) and digestive disorders (see
causes).

Constipation happens because your colon absorbs too much water from waste (stool/poop), which dries out the
stool making it hard in consistency and difficult to push out of the body.

To back up a bit, as food normally moves through the digestive tract, nutrients are absorbed. The partially
digested food (waste) that remains moves from the small intestine to the large intestine, also called the colon.
The colon absorbs water from this waste, which creates a solid matter called stool. If you have constipation,
food may move too slowly through the digestive tract. This gives the colon more time – too much time – to
absorb water from the waste. The stool becomes dry, hard, and difficult to push out.

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common
disorder that affects the large intestine. Signs and
symptoms include cramping, abdominal pain,
bloating, gas, and diarrhea or constipation, or
both. IBS is a chronic condition that you'll need
to manage long term.

Only a small number of people with IBS have

severe signs and symptoms. Some people can
control their symptoms by managing diet,
lifestyle and stress. More-severe symptoms can
be treated with medication and counseling.

IBS doesn't cause changes in bowel tissue or

increase your risk of colorectal cancer.
The signs and symptoms of IBS vary but are
usually present for a long time. The most
common include:

 Abdominal pain, cramping or bloating

that is related to passing a bowel
movement
 Changes in appearance of bowel movement
 Changes in how often you are having a bowel movement

Other symptoms that are often related include bloating, increased gas or mucus in the stool.
See your doctor if you have a persistent change in bowel habits or other signs or symptoms of IBS. They may
indicate a more serious condition, such as colon cancer. More-serious signs and symptoms include:

 Weight loss
 Diarrhea at night
 Rectal bleeding
 Iron deficiency anemia
 Unexplained vomiting
 Difficulty swallowing
 Persistent pain that isn't relieved by passing gas or a bowel movement

The precise cause of IBS isn't known. Factors that appear to play a role include:

 Muscle contractions in the intestine. The walls of the intestines are lined with layers of muscle that
contract as they move food through your digestive tract. Contractions that are stronger and last longer
than normal can cause gas, bloating and diarrhea. Weak intestinal contractions can slow food passage
and lead to hard, dry stools.
  Nervous system. Abnormalities in the nerves in your digestive system may cause you to experience
greater than normal discomfort when your abdomen stretches from gas or stool. Poorly coordinated
signals between the brain and the intestines can cause your body to overreact to changes that normally
occur in the digestive process, resulting in pain, diarrhea or constipation.

 Severe infection. IBS can develop after a severe bout of diarrhea (gastroenteritis) caused by bacteria or
a virus. IBS might also be associated with a surplus of bacteria in the intestines (bacterial overgrowth).

 Early life stress. People exposed to stressful events, especially in childhood, tend to have more
symptoms of IBS.

 Changes in gut microbes. Examples include changes in bacteria, fungi and viruses, which normally
reside in the intestines and play a key role in health. Research indicates that the microbes in people
with IBS might differ from those in healthy people.

Anal Fissures
An anal fissure is a small tear in the thin, moist tissue
(mucosa) that lines the anus. An anal fissure may occur
when you pass hard or large stools during a bowel
movement. Anal fissures typically cause pain and
bleeding with bowel movements. You also may
experience spasms in the ring of muscle at the end of
your anus (anal sphincter).

Anal fissures are very common in young infants but can

affect people of any age. Most anal fissures get better
with simple treatments, such as increased fiber intake or
sitz baths.

Some people with anal fissures may need medication or, occasionally, surgery.
Signs and symptoms of an anal fissure include:

 Pain, sometimes severe, during bowel movements

 Pain after bowel movements that can last up to several hours
 Bright red blood on the stool or toilet paper after a bowel movement
 A visible crack in the skin around the anus
 A small lump or skin tag on the skin near the anal fissure

Common causes of anal fissure include:

 Passing large or hard stools

 Constipation and straining during bowel movements
 Chronic diarrhea
 Anal intercourse
 Childbirth

Less common causes of anal fissures include:

 Crohn's disease or another inflammatory bowel disease

 Anal cancer
 HIV
 Tuberculosis
  Syphilis

You may be able to prevent an anal fissure by taking measures to prevent constipation or diarrhea. Eat high-
fiber foods, drink fluids and exercise regularly to keep from having to strain during bowel movements.

Hemorrhoids
Hemorrhoids, also called piles, are swollen
veins in your anus and lower rectum, similar to
varicose veins. Hemorrhoids can develop inside
the rectum (internal hemorrhoids) or under the
skin around the anus (external hemorrhoids).

Nearly three out of four adults will have

hemorrhoids from time to time. Hemorrhoids
have a number of causes, but often the cause is
unknown.
Fortunately, effective options are available to
treat hemorrhoids. Many people get relief with
home treatments and lifestyle changes.

Signs and symptoms of hemorrhoids usually

depend on the type of hemorrhoid.

External hemorrhoids

These are under the skin around your anus.

Signs and symptoms might include:
 Itching or irritation in your anal region
 Pain or discomfort
 Swelling around your anus
 Bleeding

Internal hemorrhoids

Internal hemorrhoids lie inside the rectum. You usually can't see or feel them, and they rarely cause
discomfort. But straining or irritation when passing stool can cause:

 Painless bleeding during bowel movements. You might notice small amounts of bright red blood on your
toilet tissue or in the toilet.
 A hemorrhoid to push through the anal opening (prolapsed or protruding hemorrhoid), resulting in pain
and irritation.

Thrombosed hemorrhoids

If blood pools in an external hemorrhoid and forms a clot (thrombus), it can result in:
 Severe pain
 Swelling
 Inflammation
 A hard lump near your anus

The veins around your anus tend to stretch under pressure and may bulge or swell.
Hemorrhoids can develop from increased pressure in the lower rectum due to:
 Straining during bowel movements
 Sitting for long periods of time on the toilet
 Having chronic diarrhea or constipation
 Being obese
 Being pregnant
 Having anal intercourse
 Eating a low-fiber diet
 Regular heavy lifting

Complications of hemorrhoids are rare but include:

 Anemia. Rarely, chronic blood loss from hemorrhoids may cause anemia, in which you don't have
enough healthy red blood cells to carry oxygen to your cells.
 Strangulated hemorrhoid. If the blood supply to an internal hemorrhoid is cut off, the hemorrhoid may
be "strangulated," which can cause extreme pain.
 Blood clot. Occasionally, a clot can form in a hemorrhoid (thrombosed hemorrhoid). Although not
dangerous, it can be extremely painful and sometimes needs to be lanced and drained.

Anal Fistula
An anal fistula is a tunnel that runs
from inside the anus -- the hole your
body uses to get rid of solid waste -- to
somewhere in the skin around it. It
usually follows an infection that didn’t
heal the right way. Your doctor can
repair the fistula, but you'll need
surgery for that.

Just inside your anus are several

glands that make fluid. Sometimes,
they get blocked or clogged. When
that happens, a bacteria buildup can
create a swollen pocket of infected
tissue and liquid. Doctors call this
an abscess.
If you don’t treat the abscess, it’ll
grow. Eventually, it’ll make its way
to the outside and punch a hole in the skin somewhere near your anus so the gunk inside it can drain. The
fistula is the tunnel that connects the gland to that opening.
Most of the time, an abscess causes a fistula. It’s rare, but they can also come from conditions
like tuberculosis, sexually transmitted diseases, or an ongoing illness that affects your bowels, such as Cohn’s
disease or ulcerative colitis.

What Are the Symptoms?

The most common symptoms are:

  Pain
 Redness
 Swelling around your anus

You might also notice:

 Bleeding
 Painful bowel movements or urination
 Fever
 A foul-smelling liquid oozing from a hole near your anus

If you have any of these symptoms, call a doctor.

If the doctor thinks you have an anal fistula, they'll ask about your medical history and give you a physical exam.

Some fistulas are easy to spot. Others aren’t. Sometimes they close on their own, then open back up. Your doctor
will look for signs of oozing fluid or bleeding. The doctor might stick a finger into your anus during the exam.

The doctor will probably send you to a specialist in colon and rectal problems for more exams or imaging tests like
X-rays or a CT scan. You might even need a colonoscopy. For this test, the doctor will put a tube with a camera on
the end into your anus to look at the inside of your bowels. You’ll be asleep when this happens.