In addition to IBS, there are a number of other gastrointestinal problems that originate in other diseases of the gastrointestinal tract. In many cases, these must be ruled out before IBS can be diagnosed. Here is a brief summary of some common gastrointestinal problems.
Heartburn / Reflux disease
Reflux disease or “heartburn / acid regurgitation” is a common gastrointestinal problem that affects almost every fifth Swede.
The symptoms are a burning sensation from the chest / throat when gastric juice comes up from the stomach. You can also have swallowing problems and some also experience a feeling of pressure over the chest. Heartburn can therefore be confused with heart problems. The acid reflux also causes some people to have a dry cough.
Changes in lifestyle and different types of medications that suppress the acid can provide relief.
In gastric ulcers, ulcers form in the duodenum (the small part of the intestine that comes after the stomach) or in the stomach. The wounds are caused by stomach acid damaging parts of the mucous membranes. The reason for this can be, for example, drugs (for example Ipren and Treo) or infection by the stomach ulcer bacterium Helicobacter pylori (Hp).
Common in stomach ulcers is that you experience gastrointestinal problems with a gnawing pain and tenderness in the upper part of the stomach. You often feel unwell and are quickly measured. The problems come and go with discomfort for several weeks followed by periods without discomfort at all. Often, the discomfort when eating (although in some people it can also be aggravated with food) decreases and can be extra difficult at night. For stomach ulcers, you should avoid tobacco, coffee, alcohol, tea and certain medicines.
A ruptured or bleeding stomach ulcer must be treated urgently in hospital. Today, there are effective drugs that, together with antibiotics, cure the disease by reducing acid production and giving the wounds a chance to heal at the same time as any disease-causing bacteria are eliminated.
Unfortunately, gallstone attacks are quite common. As many as 30% of women and 20% of men over 40 have a gallstone attack at some point and the risk increases if, for example, you are overweight or eat a high-fat diet. A gallstone attack often comes in attacks, i.e. you have periods of more severe pain under the ribs on the right side of the body while it hurts. The pain is often quite high in the abdomen and can radiate to the back and shoulder.
Why then do you get gallstone attacks? Bile is formed in the liver and then stored in the gallbladder. The body then uses bile to be able to atomize fats from food. In connection with eating, bile passes into the intestines from the gallbladder. Gallstone attacks occur when bile from the liver forms such large crystals that the bile finds it difficult to pass out of the gallbladder into the intestines. The pressure in the gallbladder causes the pain.
Painkillers and antispasmodics can provide relief and if you have long-term problems, the gallbladder can be removed. Gallstones can, if you are unlucky, cause inflammation in the gastrointestinal tract (gallbladder, bile ducts, pancreas) that requires urgent care.
Bile acid Diarrhea
Bile is formed as mentioned earlier in the liver and contains bile salts. These bile salts are important for us to be able to absorb fats from food. Most of the bile salts are reused by being taken up from the intestine and transported back to the liver. However, a small part of the bile salts (approx. 5%) is not taken up again but passes on to the colon where they have a certain laxative effect that can cause gastrointestinal problems.
If the levels of bile salts are high in the colon, you can suffer from diarrhoea. When the salt concentration increases in the colon, more fluid is drawn out into the intestine and several other intestinal functions are affected, which leads to loose stools.
It has been estimated that about one percent suffer from the so-called bile acid diarrhoea, also called bile acid malabsorption or BAD (Bile Acid Diarrhoea). Among those who suffer from chronic diarrhoea, however, almost every third person suffers from bile acid diarrhoea.
Common symptoms of gallbladder diarrhea are watery and recurrent diarrhoea with foul-smelling stools with a yellow tone, often with a “fluffy” appearance, even at night, pain,
gases / bloating and stool leakage (stool incontinence) also occur.
Bile salt diarrhoea may be secondary to other diseases or surgery, for example in Crohn’s disease, microscopic colitis, chronic pancreatitis or amyloidosis, but it can also occur without associated disease or previous surgery. This form that is not linked to any other disease or surgery is called idiopathic bile acid diarrhea (type 2) and this can sometimes be misinterpreted as IBS-D (IBS / irritable bowel syndrome with diarrhea).
The diagnosis of bile salt diarrhea can be made with a so-called “75Se HCAT test”. In this test, the patient takes a capsule with a test substance and then follows how the substance is metabolized in the body. Since the method involves a low radiation dose, for example, the examination is not performed on pregnant women. There are also some other examination methods that may be relevant to establish the diagnosis of bile salt diarrhoea.
Bile acid diarrhoea is primarily treated with bile acid binding agents (Questran or Lestid) which are considered to have a good effect. Patients are also advised to reduce the amount of fat in their diet.
Gastrointestinal problems due to food intolerance ( food allergy )
It is relatively common for various foods to cause gastrointestinal problems.
Suffering from lactose intolerance means that you are sensitive to the sugar in milk – lactose. However, it is not an allergy because you do not get an allergic reaction. In lactose intolerance, you lack the enzyme that normally breaks down lactose in the intestines – lactase, which makes you hypersensitive to milk sugar. Lactose intolerance in itself is harmless.
If you look at the sales of expensive lactose-free products, you could believe that every second person suffers from lactose intolerance, which is not the case – at least not in Sweden where only 3-5% suffer from primary lactase deficiency. Many people also confuse lactose intolerance with other gastrointestinal problems and begin to exclude lactose from the diet.
Congenital lactose intolerance (primary congenital lactase deficiency) is extremely rare and is usually detected during infancy because the infant then needs special breast milk replacement. These patients then need to live their entire lives with lactose-reduced or lactose-free dairy products.
Other cases of lactose intolerance (secondary lactase deficiency) may be temporary and occur after other intestinal disease that damaged the intestinal mucosa in some way (intestinal infection, gluten intolerance, Mb Crohn). Often a diet reduced on lactose can help reduce the symptoms of diarrhoea and the extra gases that are formed when the intestinal bacteria break down the lactose. However, the disease that causes the temporary problems must be treated first. Then you can possibly eat lactose again.
Lactose intolerance can be diagnosed by a healthcare professional by simply testing what happens when you remove or add lactose to the food (reduction / provocation) or you carry out a so-called lactose load and measure hydrogen levels in the exhaled air. If you start excluding dairy products from your diet, you may need other supplements to get enough, for example, calcium and Vitamin D. Something that can otherwise cause, for example, osteoporosis and fractures.
Read more about lactose intolerance here at alltomibs.se
Gluten Intolerance (Celiac Disease)
Gluten is a protein found in flour products. Gluten intolerance is a more serious problem than, for example, lactose intolerance because the function of the intestine can be damaged. Celiac disease patients often suffer from impaired nutrient uptake and various gastrointestinal problems such as flatulence, stomach pain and diarrhoea. By excluding gluten from the diet, you can get rid of the problems.
Inflammatory bowel disease (IBD)
Ulcerative colitis is an incurable chronic inflammation that usually begins in the 20s and 30s and affects the intestines (colon and / or rectum). The inflammation impairs the function of the intestine. Common symptoms of ulcerative colitis are blood in the stool, abdominal pain that decreases after going to the toilet and other gastrointestinal problems such as diarrhea. It is common for the disease to last a lifetime and for it to come and go in periods.
It is not known today why some people suffer from Ulcerative Colitis, but there are treatments (surgery and medication) that often reduce the symptoms considerably. Reduced stress, more sleep and adjusting the diet also usually have an effect on the symptoms. If you have had widespread ulcerative colitis for a long time, there is an increased risk of developing bowel cancer.
Crohn’s is a disease that can affect the entire gastrointestinal tract from mouth to anus, although the lower part of the small intestine and the large intestine are the ones most often affected. Crohn’s often causes gastrointestinal problems such as stomach pain, diarrhea, bloody stools while losing weight and feeling tired. Crohn’s disease is an incurable chronic inflammatory disease that causes damage to the intestinal mucosa due to the activation of the body’s immune system.
Crohn’s usually appears at the age of 18-30 years and affects men and women equally. The victims should avoid smoking as smoking can aggravate the course of the disease. Smoking also increases the risk of getting the disease. Today, there are drugs that reduce the problems of Crohn’s, which means that many can live normally. Sometimes, however, medication does not help and fistulas or blockages can occur, which means that you may need surgery.
Diverticulitis (infected intestinal pockets)
When feces get stuck in bulges of the intestinal mucosa (so-called intestinal pockets), an infection can occur when the intestinal mucosa is simultaneously weakened / damaged. Inflamed intestinal pockets are also called diverticulitis and are often located in the lower part of the colon. Intestinal pockets are common, especially the older you get and usually give no problems, but if an inflammation occurs in one or more of them, you can get stomach pain, fever and feel nauseous and vomit.
It usually hurts in the lower abdomen, often on the left side. It can also happen that you get other gastrointestinal problems such as a sluggish or loose stomach and feel bloated. Intestinal pockets are not usually treated, but in some cases antibiotics or surgery may be necessary.
The most common reasons why the stool becomes hard and that it is difficult to empty the bowel is that you ingest too little fluid and possibly also eat too little fiber.
Other causes of constipation can be various medications, certain diseases and certain foods. Women can also experience temporary constipation during pregnancy and at the end of the menstrual cycle. Constipation can lead to other ailments such as nausea, stomach pain and hemorrhoids.
Common advice for easing constipation is to drink more, eat high-fiber food, exercise more and create daily routines for toilet visits. More long-lasting and more severe symptoms should always be investigated by a doctor.
Everyone has gas in the stomach and intestines. The gas comes from air we swallow / drink (carbon dioxide) or from bacteria that live in our intestines. It is the gases that make us belch and fart. However, the gases can cause the stomach to make noise and hurt.
Some foods can increase gas production (for example fiber) and if you want to reduce any problems with gases, you can learn which foods give the most gases. Many times, regular toilet visits and increased exercise can reduce the problems and it is important that you let out the gases when you can. Here you can read more about gases in the stomach.
Vid blindtarmsinflammation gör det ofta ont och ömmar runt naveln och i magens nedre högra del. Från början kan smärtan vara lindrig men tilltar efter hand. Ofta får man feber, dålig aptit och blir illamående.
Blindtarmsinflammation uppstår när det då kallade blindtarmsbihanget (del av tjocktarmen precis efter tunntarmen) blir inflammerat.
En blindtarmsinflammation som inte behandlas kan ge komplikationer såsom bukhinneinflammation eller brusten blindtarm. Vanligaste åldern att drabbas av blindtarmsinflammation är i tonåren (mellan 10 och 20 årsåldern). Blindtarmsinflammation behandlas vanligen genom operation, idag ofta genom titthål.
Tumörsjukdomar – tjocktarmscancer
En av de vanligaste cancerformerna drabbar just mag-tarmkanalen nämligen tjocktarmscancer. Tjocktarmscancer utvecklas i tarmens slemhinna ofta där det redan finns en skada eller annan missbildning (polyp). Symtom som är vanliga vid tjocktarmscancer är mag-tarmproblem i form av tätare toalettbesök, svårigheter att tömma tarmen – att man aldrig blir klar på toaletten, att man blöder från tarmen och att avföringen är blodig och slemmig. Ofta gör det också ont i magen och man kan känna sig trött och lätt få hjärtklappning.
De flesta som drabbas av tjocktarmscancer är äldre och tjocktarmscancer drabbar relativt sällan personer under 30 år. Tjocktarmscancer kan också till viss del vara ärftlig och riskerna att drabbas ökar av vissa mag-tarmsjukdomar som till exempel ulcerös colit.
Behandling av tjocktarmscancer består vanligen i operation där man försöker ta bort tumören ofta kombinerat med cellgiftsbehandling. Som med många andra cancersjukdomar så gäller att ju tidigare man upptäcker sjukdomen desto lättare brukar det vara att behandla den.
Om man har blod blandat med avföringen och märker av nya mag-tarmproblem och att avföringsvanorna förändras ska man söka vård direkt på en vårdcentral eller akutmottagning. Det ska man också göra om man har svåra magsmärtor.
När skall man direkt kontakta vården?
Några tecken från mag-tarmkanalen som generellt indikerar att man direkt bör kontakta vården för sina mag-tarmproblem är…
In appendicitis, it often hurts around the navel and in the lower right part of the stomach. From the beginning, the pain may be mild but gradually increases. You often get a fever, poor appetite and nausea.
Appendicitis occurs when the so-called appendix (part of the large intestine just after the small intestine) becomes inflamed.
An untreated appendicitis can cause complications such as peritonitis or ruptured appendix. The most common age to suffer from appendicitis is in adolescence (between 10 and 20 years of age). Appendicitis is usually treated by surgery, today often by a laparoscopic appendectomy surgery
Tumor Diseases – Colon Cancer
One of the most common cancers is the gastrointestinal tract, namely colon cancer. Colon cancer often develops in the intestinal mucosa where there is already an injury or other malformation (polyp). Symptoms that are common in colon cancer are gastrointestinal problems in the form of more frequent visits to the toilet, difficulties in emptying the bowel – that you never get done in the toilet, that you bleed from the bowel and that the stool is bloody and contains mucous. It often also hurts in the stomach and you can feel tired and easily get palpitations.
Most people who suffer from colon cancer are older and colon cancer relatively rarely affects people under 30 years of age. Colon cancer can also be inherited to some extent and the risks of developing it increase with certain gastrointestinal diseases such as ulcerative colitis.
Treatment of colon cancer usually consists of surgery where an attempt is made to remove the tumor, often combined with chemotherapy. As with many other cancers, the earlier you discover the disease, the easier it is to treat it.
If you have blood mixed with the stool and notice new gastrointestinal problems and that the stool habits change, you should seek care directly at a health center or emergency room. You should also seek help if you have severe stomach pain.
When should you contact healthcare directly?
Some signs from the gastrointestinal tract that generally indicate that you should contact healthcare directly for your gastrointestinal problems are …
- lose weight fast and / or have no appetite
- suddenly get a lot of pain in the upper abdomen
- severe abdominal pain that does not subside
- vomit and stomach contents look like ground coffee or contain blood
- have black / bloody stools
- have a stomach ache and at the same time, for example, fever or nausea
- clear change in toilet habits
- are older than 50 years and have stomach problems that you have not had before.
For all thoughts and concerns about gastrointestinal problems and other diseases, you can always call the health care counseling service ( 1177 – www.1177 .se ) for advice.
The information on this page can never replace a visit to a doctor or other healthcare professional who can provide customized advice, diagnosis, treatment.