Qban Health Care – Dominica

Ulcerative colitis (UC) is a chronic condition that happens when you have inflammation in your colon. Most people with UC experience periods of symptom flare-ups followed by periods of remission without symptoms. Signs and symptoms include diarrhea, bloody stools, abdominal cramping and weight loss Treatments include medication and surgery.

What is ulcerative colitis (UC)?

Ulcerative colitis (UC) is a lifelong condition that causes inflammation and ulcers inside your colon (large intestine). UC is one of the most common types of inflammatory bowel disease (IBD), alongside Crohn’s disease. UC often causes bloody diarrhea and abdominal cramping. It may make you have to poop more.

Most people with UC experience periods when they experience symptoms (flare-ups), followed by longer periods of no symptoms (remission).

Types of ulcerative colitis

Healthcare providers classify UC based on where the inflammation is in your colon. The inflammation usually starts in your rectum, which is close to your anus (butthole). The inflammation can spread and affect all or part of your colon. Types include:

• Ulcerative proctitis: Inflammation affects your rectum.
• Inflammation affects your rectum and sigmoid colon (the lower, S-shaped part of your colon).
• Left-sided colitis: Inflammation affects the left side of your colon.
• Pancolitis: Inflammation affects your entire colon.

UC may be mild, moderate or severe, depending on your symptoms. The most severe form, fulminant ulcerative colitis, is rare. It can cause life-threatening complications that require urgent medical treatment.

How common is ulcerative colitis?

Together with Crohn’s disease, another type of inflammatory bowel disease, UC affects up to 1 in 250 people in North America and Europe. According to the National Institute of Diabetes and Digestive and Kidney Diseases (U.S.), up to 900,000 people in the U.S. are living with UC.

What are the symptoms of ulcerative colitis?

Ulcerative colitis symptoms often get worse over time. In the beginning, you may notice signs of mild UC, including:

• Diarrhea (may or may not be bloody).
• Increased bowel movements or episodes of diarrhea (four or fewer episodes daily).
• Urgent bowel movements (sudden need to poop).
• Tenesmus (feeling like you have to poop but being unable to).
• Mild abdominal (belly) cramping or tenderness.

Later, you may also have symptoms of moderate to severe UC, including:

• Frequent bowel movements or episodes of diarrhea (four or more episodes daily).
• Blood, mucus or pus in your stool.
• Severe belly cramping.
• Fatigue (extreme tiredness).
• Sudden weight loss.
• Nausea.
• Fever.

About half of people have mild symptoms during flare-ups. Others experience frequent fevers, bloody diarrhea, nausea and severe abdominal cramps.

Other UC symptoms

About 25% of people with UC eventually develop conditions and associated symptoms that affect body parts other than their colon. The inflammation can spread to your bones, joints, eyes, skin and liver.

Symptoms include:

• Joint pain and swelling.
• Red, burning or itchy eyes.
• Painful bumps, rashes or ulcers on your skin.

What causes ulcerative colitis?

Researchers think the cause of ulcerative colitis is complex and involves many risk factors. Most agree that it’s related to an overactive immune response. Your immune system’s job is to protect your body from germs and other dangerous substances. But sometimes, your immune system mistakenly attacks your body, which causes inflammation and tissue damage.

Risk factors

Anyone can get ulcerative colitis, but your risk is greater based on your:

• Age: Most people get diagnosed between 15 and 30 years old or when they’re older than 60.
• Race and ethnicity: You’re at greater risk of UC if you’re white, especially if you’re of Ashkenazi Jewish descent.
• Genetics: You’re more likely to develop UC if a first-degree relative (parent, sibling or child) has it. Up to 20% of people with UC have a family member with UC or Crohn’s disease.
• Gut microbiome. Your gut microbiome consists of bacteria, viruses and fungi in your digestive system. Think of it as your gut’s ecosystem. People with UC have differences in their microbiomes when compared to people without. Researchers aren’t sure why.

Other factors, like stress and your diet, don’t increase your risk of developing UC, but they can trigger a symptom flare-up. One of the best things you can do if you’re diagnosed with UC is to note your triggers so you can avoid them.

What are the complications of ulcerative colitis?

Having ulcerative colitis raises your risk of developing other conditions that may require additional monitoring and treatment, including:

• Anemia: Severe bleeding from your colon can cause anemia, or a reduced number of red blood cells.
• Colon cancer: UC increases your risk of developing colon cancer. Your risk depends on where in your colon the inflammation is (with proctitis posing the least risk) and how long you’ve had UC. Discuss your risk factors with your provider.
• Osteoporosis: The inflammation can spread to your bones and joints, causing bone weakening or osteoporosis.
• Primary sclerosing cholangitis: Inflammation that spreads to your liver can cause primary sclerosing cholangitis, a condition that causes liver scarring. The damaged tissue can prevent your liver from working as it should.
• Growth and development issues in children: UC can limit a child’s colon function, so they can’t absorb key nutrients needed for growth and development. In addition to taking medicine to treat UC, your child may need vitamins to get the nutrients their bodies need.

Emergency complications of UC that require immediate treatment in the ER include:

• Dehydration: Frequent trips to the bathroom can deplete your body of the fluids it needs (dehydration). You may need IV fluids in the hospital if your dehydration is severe.
• Perforation: A hole in your colon (perforation) is a medical emergency, requiring immediate treatment.
• Severe bleeding: Depending on your blood loss, you may need a blood transfusion.
• Toxic megacolon: Severe inflammation can cause your colon to stop working. When this happens, the materials inside your colon build up, expanding your colon walls while toxins seep into your bloodstream. This rare complication is called toxic megacolon. It most commonly occurs alongside fulminant ulcerative colitis.
• Blood clots: UC increases the risk of clotting in your blood vessels (veins, arteries and capillaries). These clots can be life-threatening, depending on where they are.

How is ulcerative colitis diagnosed?

To diagnose UC, your healthcare provider will perform a physical exam and ask about your symptoms and family history of IBD. They’ll order tests and perform procedures to rule out conditions similar to UC.

Tests and procedures include:

• Blood tests: Your blood can show signs of anemia, which may mean you have bleeding in your colon or rectum. Blood tests can also help providers rule out other causes of your symptoms, like an infection.
• Stool samples: Signs of infection, parasites (tiny organisms that can live in a person’s body) and inflammation can show up in your poop.
• Imaging tests: Your healthcare provider may need a picture of your colon and rectum. You may need a specialized type of X-ray called a barium enema to reveal signs of inflammation in your colon. A CT scan (computed tomography scan) and MRI (magnetic resonance imaging) can show signs of inflammation in your colon, especially with moderate and severe UC. An X-ray can show complications like megacolon or perforation.
• Endoscopic tests: An endoscope is a thin, flexible tube with a tiny camera. Your provider can insert the endoscope through your rectum to see inside your colon and take tissue samples for testing (biopsy). Common endoscopic tests to diagnose UC include colonoscopy and sigmoidoscopy.

How is ulcerative colitis treated?

The goal of treatment is to put you into remission if you’re experiencing a flare-up or help you maintain remission if you’re not currently experiencing symptoms. Treatment options include medications and surgery.

Medications

Healthcare providers use several medications (alone or in combination) to calm inflammation in your large intestine. Reducing the swelling and irritation lets the tissue heal. It can also relieve your symptoms so you have less pain and diarrhea.

Medications for UC include:

• Aminosalicylates: Your healthcare provider may prescribe sulfasalazine (Azulfidine®) for mild to moderate ulcerative colitis. Let your provider know if you’re allergic to sulfa. They can prescribe a sulfa-free aminosalicylate instead, such as mesalamine (Canasa®, Delzicol®, Asacol® HD, Pentasa®, Lialda®, Apriso®).
• Corticosteroids: If you have a severe form of ulcerative colitis, you may need a corticosteroid such as prednisone (Deltasone®) or budesonide (Entocort® EC, Uceris®). Because corticosteroids have serious side effects, healthcare providers only recommend them for short-term use.
• Immunosuppressants: Your healthcare provider may recommend an immunosuppressant to calm your immune system. These medicines include 6-mercaptopurine (Purixan®, Purinethol®), azathioprine (Azasan® and Imuran®) or methotrexate (Trexall®).
• Biologics: Biologics treat moderate to severe ulcerative colitis by calming parts of your immune response. Medications like infliximab (Remicade®), adalimumab (Humira®), golimumab (Simponi®), certolizumab pegol (Cimzia ®), vedolizumab (Entyvio®) and ustekinumab (Stelara®) are biologics.
• Janus kinase (JAK) inhibitors (small molecule drugs): Drugs like tofacitinib (Xeljanz®) stop one of your body’s enzymes (chemicals) from triggering inflammation. Upadacitinib (RinvoQ®) is another JAK inhibitor.

Surgery

Surgery is an option if medications aren’t working or if you’re experiencing serious complications. About 30% of people with ulcerative colitis need surgery at some point. About 20% of children with ulcerative colitis will need surgery.

There are two kinds of surgery for ulcerative colitis. Both involve a proctocolectomy, surgery to remove all or part of your colon and rectum.

• Proctocolectomy and ileal pouch: The proctocolectomy and ileal pouch is the most common procedure for ulcerative colitis. This procedure removes your colon and rectum but leaves your anus intact. Then, the surgeon forms an ileal pouch, a section of small intestine that attaches to your anus. Once you’ve healed, this section of your small intestine acts as a new rectum that allows you to poop as you typically would.
• Proctocolectomy and ileostomy: If an ileal pouch isn’t an option, your healthcare team might recommend a permanent ileostomy (without an ileal pouch). Your surgeon removes your colon, rectum and anus. They make an opening in your belly that attaches to a pouch outside your body (ileal stoma) that collects poop. You’ll empty the bag regularly.

What can I expect if I have ulcerative colitis?

A few people have one flare-up and never have another. Others have chronic symptoms that are difficult to manage. Most people have symptoms that come and go, with periods of flare-ups and longer periods of remission. In up to 30% of people, ulcerative symptoms worsen and happen more often. Eventually, they’ll need surgery.

Most people manage UC by avoiding triggers and taking medicines regularly to prevent inflammation. You’ll also need frequent provider visits to monitor your health. For example, depending on your risk, you may need regular colonoscopies to screen for colon cancer. Your provider can advise you.

Does ulcerative colitis ever go away?

The only “cure” for UC is surgery to remove your colon and rectum. Still, most people can manage UC with medications or surgery. With UC treatment, the goal is achieving and maintaining remission. Your healthcare provider can help you get there.

How can I prevent ulcerative colitis flare-ups?

You can reduce your likelihood of a flare-up by identifying and avoiding your triggers. Tips for avoiding common triggers include:

• Managing stress: Get at least seven hours of sleep a night, exercise regularly and find healthy ways to relieve stress, such as meditation.
• Avoid NSAIDs: For pain relief or a fever, use acetaminophen (Tylenol®) instead of NSAIDs like Motrin® and Advil®. NSAIDs can worsen ulcerative colitis symptoms.
• Avoid foods that trigger flare-ups: No single meal plan prevents flare-ups. Your food triggers may be different from someone else’s. Still, many people find it helpful to avoid dairy and high-fiber foods. Work with your provider to develop a personalized meal plan to avoid trigger foods without depriving yourself of essential nutrients.

It’s a good idea to note your triggers in a diary you can share with your provider. Together, you can work on strategies to avoid things that may cause a flare-up.

When should I call my doctor about my ulcerative colitis?

Call your healthcare provider immediately if you have:

• Heavy, persistent diarrhea.
• Blood leaking from your anus with clots of blood in your stool.
• Constant pain and a high fever.

What should I ask my healthcare provider?

Questions to ask include:

• How does the type of UC I have affect my prognosis (outcome)?
• What’s my risk of experiencing complications from UC?
• What treatments do you recommend?
• What risks or side effects can I expect from treatment?
• How can I change my lifestyle to prevent flare-ups?
• What can I do at home to manage symptoms of a flare-up?

A note from QBan Health Care Services

It’s essential to work closely with your healthcare team if you have ulcerative colitis. Take your medicines as prescribed, even when you don’t have symptoms. Skipping your medicine can lead to flare-ups and make your condition harder to manage. Make sure you understand how your risk of complications impacts your care. For example, you may need more frequent blood tests or colonoscopies than someone without UC. Ask how your care plan will increase your likelihood of staying in remission while promoting your overall health.

Crohn’s disease is a lifelong condition that causes inflammation in your digestive tract. It can lead to symptoms like ongoing diarrhea, belly pain and weight loss. These symptoms often come and go in cycles, called flares and remission. There’s no cure, but treatment can reduce inflammation, manage symptoms and help improve your quality of life.

What Is Crohn’s Disease?

Crohn’s disease is a long-term condition that causes swelling and irritation in your digestive tract. It’s one of the main types of inflammatory bowel disease (IBD).

Crohn’s happens when your immune system overreacts and attacks your digestive tract, causing inflammation. Symptoms can range from mild to severe.

For some people, Crohn’s disease can be debilitating. Ongoing inflammation may lead to frequent bathroom trips, pain, fatigue and time away from work or school.

Crohn’s is a lifelong condition. But treatment can help you manage symptoms, reduce inflammation and live an active life.

Types of Crohn’s disease

Crohn’s can affect any part of your digestive tract, from your mouth to your anus. Some people have Crohn’s in more than one area of their digestive tract. Healthcare providers often describe the disease based on where swelling and irritation occur.

Types include:

• Ileocolitis: Affects the end of your small intestine (ileum) and your large intestine (colon) — this is the most common type
• Crohn’s colitis: Limited to your large intestine
• Ileitis: Affects only the last part of your small intestine (ileum)
• Gastroduodenal Crohn’s disease: Affects your stomach and the start of your small intestine (duodenum)
• Jejunoileitis: Patchy areas of swelling in the upper part of your small intestine (jejunum)

These types describe where Crohn’s affects your body. But your symptoms and treatment may be similar.

Crohn’s disease symptoms

Symptoms of Crohn’s disease may develop slowly over time or come on suddenly. They may be mild to severe.

Some people have long-term (chronic) symptoms until treatment helps manage them. Other people have symptoms that come and go. You may have periods when the disease is active (flares) and times when you feel better (remission).

In more severe cases, symptoms can interfere with your daily life. They can make it difficult to work, go to school or keep up with normal routines.

Signs of Crohn’s disease include:

• Belly pain or cramps
• Ongoing diarrhea
• Feeling very tired
• Loss of appetite
• Unexpected weight loss
• Fever
• Blood in your poop
• Mouth sores

Crohn’s can also affect other parts of your body. You may notice signs and symptoms like:

• Joint pain
• Skin rashes
• Eye irritation
• Liver or bile duct swelling
• Kidney stones
• Bone loss

In children and teens, Crohn’s may delay growth or puberty.

What causes Crohn’s disease?

Researchers don’t know the exact cause of Crohn’s disease. But they believe it may be due to a combination of your immune system and your genes.

In Crohn’s disease, your immune system overreacts. Normally, your immune system protects you from harmful germs. But with Crohn’s, it attacks harmless bacteria in your gut. This causes swelling and irritation.

Genetics may also play a role. Crohn’s sometimes runs in biological families. Certain genes may increase your risk. But many people with Crohn’s have no family history of the condition.

Risk factors

Anyone can develop Crohn’s disease. But some factors raise your risk, including:

• Age: Healthcare providers most often diagnose Crohn’s in teens and young adults ages 15 to 35.
• Biological family history: If a parent, sibling or child has Crohn’s, your risk may be higher.
• Smoking: Smoking increases your risk and can make symptoms worse.
• Ethnicity: Crohn’s is more common in people of Northern European descent.
• Certain medications: NSAIDs like ibuprofen (Advil®) and naproxen (Aleve®) don’t cause Crohn’s, but they can worsen symptoms.

Complications of Crohn’s disease

Crohn’s can sometimes lead to serious complications that may need extra treatment or surgery. Without treatment, these complications can affect your quality of life.

One example is a fistula. Fistulas are abnormal tunnels that form between parts of your body that don’t usually connect. In Crohn’s, they often develop around your anus and may cause pain, swelling, or leakage of pus or poop.

Other complications may include:

Abscesses: Infected pus-filled pockets in your belly or near your anus

Anal fissures: Small tears in the lining of your anus

Strictures and blockages: Scarring that narrows your intestines, leading to blockages

Malnutrition: Vitamin or mineral deficiencies because your body can’t absorb nutrients

Anemia: Low red blood cell level from bleeding or poor nutrient absorption

Colorectal cancer: Cancer in your colon or rectum

Not everyone with Crohn’s disease develops these complications.

How doctors diagnose Crohn’s disease

There isn’t one test to diagnose Crohn’s disease. A healthcare provider will use a combination of tests to look for inflammation and rule out other conditions.

Your provider will start by asking about your symptoms, medical history and biological family history. They’ll also do a physical exam. They may refer you to a gastroenterologist (a doctor who specializes in digestive diseases).

Tests used to make a Crohn’s disease diagnosis may include:

• Blood tests: These tests check for signs of irritation, infection or anemia.
• Stool tests: A sample of your poop can help find inflammation or infection in your intestines.
• Colonoscopy: Your provider uses a thin tube with a camera to look inside your colon and the end of your small intestine. They may also take small samples (biopsies) of your intestines to confirm the diagnosis.
• Imaging tests: CT or MRI scans show detailed images of your digestive tract.

Your provider will review the results to confirm Crohn’s disease or rule out other conditions.

Crohn’s disease treatments

There’s no cure for Crohn’s. But treatment can reduce inflammation, relieve symptoms and help you stay in remission. Without treatment, the condition can worsen over time and lead to more serious symptoms or complications.

Your healthcare provider will make a plan based on:

• How severe your disease is
• Which parts of your digestive tract it affects
• How you respond to treatment

Your provider may recommend medications, nutrition therapy and/or surgery.

Crohn’s disease medication

Most people take medicine to reduce inflammation or calm their immune system. These medications reduce your risk of flares and complications.

Types of medications to treat Crohn’s disease include:

• Corticosteroids: Corticosteroids quickly reduce inflammation during a flare. They work more as a bandage to get you on the right long-term medication and treatment.
• Immunomodulators: This type of medicine calms your immune system.
• Biologics: Biologics target specific parts of your immune system that cause inflammation.
• JAK inhibitors: JAK inhibitors reduce immune system activity.
• Antibiotics and other medications: Other medications kill harmful bacteria, treat diarrhea or manage pain.

Your provider will monitor your response and change your medications as needed.

Nutrition therapy

Crohn’s can make it harder for your body to absorb nutrients. To help prevent malnutrition, your provider may recommend:

• Making changes to what you eat
• Taking supplements
• Starting a specialized meal plan
• Using a feeding tube in severe cases

Surgery

Medications work for many people. But you may need surgery if complications develop or symptoms don’t improve with treatment. Surgery for Crohn’s disease can treat problems like:

• Bowel blockages
• Fistulas
• Abscesses
• Severely damaged parts of your intestine

Surgery can improve symptoms and treat complications, but it doesn’t cure Crohn’s disease. You may still need medication after.

When should I call my healthcare provider?

Contact a healthcare provider if you notice symptoms of Crohn’s. They’ll run tests to find out what’s going on.

If you’ve been diagnosed with Crohn’s, reach out to your provider if you:

• Have new or worsening symptoms
• Think you’re having a flare
• Feel like treatment isn’t working
• Notice blood in your poop
• Have continued diarrhea or belly pain
• Have fevers or concern for infection
• Lose weight without trying

Seek immediate care if you have severe belly pain, signs of a blockage (like vomiting or not passing gas or poop) or heavy bleeding.

What’s the outlook for people with Crohn’s disease?

There’s currently no cure for Crohn’s disease, and outlooks vary. Some people have mild symptoms. But for others, the disease is severe. They may require ongoing treatment or surgery.

Crohn’s disease isn’t usually life-threatening. Life expectancy is generally normal. But ongoing inflammation can increase your risk of colon cancer and cause other complications.

Regular check-ups and screening tests, like colonoscopies, can monitor your health and catch problems early. Treatment can help manage irritation and reduce symptoms. Most people with Crohn’s disease can live full, active lives.

Can Crohn’s disease be prevented?

You can’t prevent Crohn’s disease. But you may be able to reduce flare-ups and manage symptoms. These self-care tips may help:

• Quit smoking: Quitting can reduce flare-ups and your chance of complications.
• Avoid medicines that bother your gut: Some medicines, especially NSAIDs, can trigger symptoms.
• Pay attention to foods that trigger symptoms: Some foods may worsen your symptoms, so you may want to keep a food diary.
• Eat smaller, balanced meals: Eating easy-to-digest foods more often may help reduce symptoms during flares.
• Manage stress: Getting regular physical activity, enough sleep and mental healthcare can help.

Work with your provider or a dietitian to create a plan that fits your needs.

A note from QBan Health Care Services

Crohn’s disease is a lifelong condition, but it doesn’t have to define your life. Symptoms can sometimes be challenging, but you can successfully manage them with the right treatment plan and support. Working closely with your healthcare provider, you can find a plan that keeps inflammation under control. That, along with regular check-ups and healthy habits, can help you reduce flares and spend long periods in remission.

Barrett’s esophagus is a change in the cellular structure of your esophagus lining. It’s a risk factor for cancer, but the risk is low. It usually occurs in people with chronic, untreated acid reflux (GERD). Treating the underlying condition can help prevent Barrett’s esophagus from progressing to cancer.

What is Barrett’s esophagus?

Barrett’s esophagus is a change in the cellular structure of your esophagus lining. Your esophagus is the swallowing tube that carries food from your mouth to your stomach. Like all of your gastrointestinal (GI) tract, your esophagus has a protective mucous lining on the inside. But if something irritates this lining for a long time, it can damage the tissues. Sometimes, this damage actually reprograms the cells.

These changes affect the structure and appearance of your esophagus lining. To scientists, it now looks more like the lining of your intestines. They call this intestinal metaplasia. Metaplasia is when tissues in your body replace themselves with a different type of tissue that isn’t normally found there. This is a risk factor for cancer. Although the risk is small, metaplasia makes cancerous changes more likely.

How serious is Barrett’s esophagus?

Because of the small chance it might progress to esophageal cancer, healthcare providers like to keep an eye on Barrett’s esophagus. But the risk is only about half a percent per year. Cellular changes happen slowly, and metaplasia passes through another precancerous stage (dysplasia) before progressing to cancer. If your provider notices any dysplasia, they’ll remove it to stop it from progressing further.

What are the symptoms of Barrett’s esophagus?

On its own, Barrett’s esophagus doesn’t produce any symptoms. But if something is irritating your esophagus lining for a long time, you’re likely to have symptoms from that. Chronic esophagitis — inflammation in your esophagus — may feel like heartburn or chest pain on the lower end, or like a sore throat if it’s higher. It may make your esophagus feel swollen or cause difficulties swallowing.

It takes years of chronic esophagitis to damage your esophagus tissues enough to trigger metaplasia. If you have any chronic symptoms, even if they’re mild or they come and go, check in with a healthcare provider. Chronic acid reflux is the most common cause of esophagitis leading to Barrett’s esophagus. If you ever feel or taste stomach juices backwashing into your esophagus after you eat, take notice.

What causes Barrett’s esophagus?

Scientists don’t completely understand why Barrett’s esophagus occurs, but it seems to relate to chronic irritation or injury inside your esophagus. It may be a result of constant cellular repair. Most people who develop Barrett’s esophagus have had gastroesophageal reflux disease (GERD) for at least 10 years. But not everyone fits this profile, and other irritants may also lead to Barrett’s esophagus.

The ways that Barrett’s esophagus changes your esophagus lining suggest that it’s trying to protect itself. Your esophagus lining normally has some protection from acids and other irritants, but not as much as your intestinal lining. Since acids and digestive enzymes do most of their work inside your small intestine, it needs extra protection. Intestinal metaplasia in your esophagus suggests that it does, too.

What are the risk factors for getting Barrett’s esophagus?

You may be more likely to develop Barrett’s esophagus if you:

• Are male. Males get it two to three times more often than females.
• Are older than 55. This condition takes time to develop.
• Have GERD. Between 10% and 15% of people with GERD get Barrett’s esophagus.
• Smoke. Smoking may be a contributing factor.

How is Barrett’s esophagus diagnosed?

A gastroenterologist, a specialist in gastrointestinal diseases, usually diagnoses Barrett’s esophagus. They’ll look inside your esophagus for evidence of the tissue changes and take small tissue samples to confirm them (biopsies). They’ll do this in a procedure called an endoscopy. This means putting a tiny camera on a long tube down your throat to examine your esophagus, while you’re under sedation.

What are the signs of Barrett’s esophagus on examination?

In general, normal esophageal lining is pale pink and smooth, while intestinal metaplasia is salmon-colored and coarse. But inflammation in your esophagus could obscure these features. Your provider might need to take multiple biopsy samples from different places to study under a microscope. This is how they’ll confirm the structural changes in the cells of your esophagus lining (epithelium).

Normal esophageal epithelium consists of stratified squamous cells. These are flat, square cells arranged in layers (“squamous” means flat, and “stratified” means in layers). The lower part of your GI tract (your intestine) is lined with columnar epithelium. Columnar cells are rectangular and lay side-by-side in a single layer. If these appear in your esophagus, your provider will diagnose Barrett’s esophagus.

Classifying Barrett’s esophagus

Your provider might describe your condition as:

• Short-segment Barrett’s esophagus. This means the affected area is less than 3 cm long.
• Long-segment Barrett’s esophagus. This means the affected tissue is longer than 3 cm.

They might define the stage as:

• Non-dysplastic metaplasia. This means there’s no dysplasia yet and a low cancer risk.
• Metaplasia with low-grade dysplasia. This means there’s some dysplasia and cancer risk.
• Metaplasia with high-grade dysplasia. This means there’s significant dysplasia and cancer risk.
• Carcinoma. This means dysplasia has progressed to cancer.

Other findings

People with Barrett’s esophagus may also have:

• Esophageal stricture. This means your esophagus has become narrower, often due to scarring.
• Peptic ulcers. These are open sores caused by stomach acid or enzymes.

What is the treatment for Barrett’s esophagus?

Treatment for Barrett’s esophagus includes:

• Treating the cause to stop it from progressing.
• Regular surveillance to check for precancerous changes.
• Removing precancerous tissue if necessary.

Treating the cause

Chronic acid reflux, the most common condition leading to Barrett’s esophagus, is treatable. Healthcare providers usually recommend a combination of diet and lifestyle changes and acid-blocking medications. Medications called proton pump inhibitors (PPIs) are very effective in protecting your esophagus from acid reflux and helping the tissues heal. A minor procedure can also fix the underlying defect that causes it.

Medications

Prescription medications to treat acid reflux include:

• Omeprazole.
• Lansoprazole.
• Pantoprazole.
• Rabeprazole.
• Esomeprazole.
• Dexlansoprazole.

Surveillance

You’ll need to have periodic endoscopy exams to check on your metaplasia and see if it’s progressing. Your provider will tell you how often you should have them, depending on whether you have any dysplasia yet (precancerous changes). Barrett’s esophagus without dysplasia only needs to be examined every few years. Barrett’s esophagus after dysplasia should be examined yearly.

Treatments for dysplasia

Dysplasia is the next stage of cellular changes in your tissues between metaplasia and cancer. If a pathologist confirms you have dysplasia, they’ll characterize it as either low-grade or high-grade (mild or severe). Your provider may recommend treatment or more frequent surveillance for low-grade dysplasia. For high-grade dysplasia, they’ll recommend treatment to remove the affected tissue.

Procedures

Procedures to treat dysplasia include:

• Ablation therapy. Ablation means using very high or low temperatures to eliminate the affected tissue. Your provider can freeze or burn off the layer of intestinal metaplasia with cold gas (cryotherapy), a thermal balloon, a laser or radiofrequency. These are endoscopic procedures, meaning your provider treats you through an endoscope during an endoscopy exam.
• Endoscopic mucosal resection. Endoscopic surgery is a minimally invasive surgery technique that allows an endoscopist to perform minor surgery through an endoscope. Mucosal resection simply means that surgeons cut out the affected tissue from your esophageal lining (the mucosa). This might be a second-line treatment if ablation therapy fails to prevent further dysplasia.
• Surgery (esophagectomy). Surgery might be necessary if you have extensive, high-grade dysplasia, carcinoma or other complications, like a severe esophageal stricture. A surgeon removes the affected portion of your esophagus, then rebuilds it using pieces from your GI tract.

Does Barrett’s esophagus ever go away?

Metaplasia won’t go away by itself, though medical procedures can remove the affected tissue. Healthcare providers don’t recommend these procedures unless you have dysplasia. Barrett’s esophagus without dysplasia won’t affect you much. It just means you have to have periodic endoscopy exams. But it’s important to address what’s injuring your esophagus. You can make GERD go away.

Can treatment fix Barrett’s esophagus?

If you remove the affected tissue and stop whatever was injuring your esophagus, Barrett’s esophagus may be cured. But it can return. Sometimes, a layer of metaplasia hides underneath a layer of new, normal tissue. Sometimes, the injury continues, and so the process of metaplasia continues. Because of this risk, your healthcare provider will probably recommend continued surveillance, just to be safe.

How long can you live with Barrett’s esophagus?

You can live a normal life with Barrett’s esophagus, as long as it doesn’t continue to progress. Precancerous or cancerous changes will affect your life expectancy. But most people with Barrett’s esophagus will never develop these changes. In general, your prognosis (outlook) is better the sooner you seek treatment. You can prevent and even remove cancerous changes if you catch them early enough.

Can Barrett’s esophagus be prevented?

The known causes of chronic esophagitis leading to Barrett’s esophagus are treatable. Most people have these conditions for a long time before they progress to Barrett’s esophagus. You can help prevent this from happening by paying attention to your symptoms and seeking treatment for these conditions. You can also reduce your risk by avoiding or quitting smoking. A healthcare provider can help you quit.

A note from QBan Health Care Services

Barrett’s esophagus by itself won’t harm you. But it’s an important sign of prior injury. It’s also a mild warning of possible future harm. What it means is that you need to address the underlying cause of injury to your esophagus. The common causes of esophagitis are usually treatable, and treating them can greatly improve your quality of life. Consider it a bonus if you can also reduce your risk of cancer.

Occasional indigestion (dyspepsia) is common and not serious. If you get a stomachache after a large meal, you can usually relieve it with an antacid. But if you have indigestion often, there might be more going on. Sometimes, it means you have a treatable condition, like acid reflux or peptic ulcer disease. Other times, it’s more complex.

What Is Indigestion (Dyspepsia)?

Indigestion is pain or discomfort that happens while your stomach digests food. It’s also called dyspepsia, which means impaired digestion. If you often get a stomachache after eating, something in your digestion may not be working as it should.

Indigestion isn’t usually serious — small changes in your eating habits can help. But how often it happens and how severe it feels matter.

Most people have occasional indigestion. For others, it happens often enough to affect daily life. If that’s the case, you may want to see a healthcare provider. Sometimes, indigestion is a sign of an underlying digestive condition. Other times, there’s no clear cause.

What are indigestion symptoms?

Healthcare providers define indigestion (dyspepsia) by the following three symptoms:

1. Pain in your upper belly: This area, called the epigastric region, holds important digestive organs like your stomach, liver, pancreas and the first part of your small intestine.
2. A burning feeling: This can come from stomach acid, digestive enzymes or inflammation. You might feel it in your upper belly or chest.
3. Uncomfortable fullness: You may feel full sooner than expected, or long after eating. This can make it hard to eat even small amounts.

Symptoms often show up within minutes to a few hours after a meal. It normally takes three to five hours for your stomach to digest food before passing it to your small intestine. During this time, your pancreas and gallbladder release enzymes and bile to help break food down — right in the same area where indigestion pain tends to show up.

Many people who experience indigestion also report additional symptoms, including:

• Belching
• Bloating
• Gas
• Nausea

These symptoms can overlap with dyspepsia, or they may occur on their own.

Sometimes, a heart attack can feel like indigestion — called a silent heart attack.

Seek emergency care if you have indigestion along with:

• A tight, clenching feeling in your diaphragm
• Pain in your jaw, arms or upper back
• Fatigue
• Shortness of breath
• Chest heaviness or soreness
• Sweating

What causes indigestion (dyspepsia)?

The most common cause of indigestion is stomach acid — especially when there’s too much of it or when it gets where it doesn’t belong. Acid can irritate the lining of your stomach, esophagus or small intestine, causing that familiar burning or painful sensation.

This extra acid often results from underlying conditions like GERD (acid reflux) or peptic ulcer disease, which are among the most common causes of chronic indigestion.

But indigestion can also stem from what and how you eat, how well your digestive system functions and how your nerves interpret discomfort in your gut.

Occasional indigestion

Sometimes, indigestion is simply due to overeating or eating rich, fatty foods. These meals require more digestive effort, which means more acid and stronger contractions from your stomach, gallbladder and pancreas. This extra activity can irritate your digestive tract and cause temporary discomfort.

Chronic indigestion

When indigestion happens regularly, it may be linked to a digestive condition — or it may have no identifiable cause.

• GERD allows acid to escape from your stomach into your esophagus, which isn’t built to handle it.
• Peptic ulcers can form in your stomach or the first part of your small intestine (duodenum) when acid damages the protective lining.
• Gastritis occurs when acid irritates or inflames the stomach lining.

These acid-related conditions are among the few clear “organic” causes of indigestion. When symptoms like heartburn, regurgitation or belching appear alongside dyspepsia, GERD is often the reason. If nausea, early fullness or bloating are present, peptic ulcer disease may be the cause.

When testing rules out acid-related disease, the diagnosis is often functional dyspepsia — a condition where overly sensitive gut nerves misinterpret normal digestion as pain or discomfort.

Risk factors

You’re more likely to experience indigestion if you have certain conditions or lifestyle factors that affect your digestive system or increase acid production:

Health conditions linked to dyspepsia include:

• Eating disorders
• Food intolerances
• Gallstones
• Gastroparesis
• Hiatal hernia
• H. pylori infection
• IBS
• SIBO
• Stomach cancer
• Visceral hypersensitivity

Lifestyle factors that may raise your risk include:

• Chronic stress
• Smoking
• Frequent alcohol use
• Regular use of NSAIDs (like ibuprofen)
• An eating pattern high in fried, spicy or acidic foods

Specific food triggers include:

• Carbonated drinks
• Coffee
• Chocolate
• Greasy or fried foods (like fried chicken)
• Shellfish (like shrimp and lobster)
• Spicy foods

How is dyspepsia diagnosed?

If your indigestion is mild or only happens once in a while, you probably don’t need a formal diagnosis. But if it’s frequent, severe or interfering with your daily life, your provider will start by asking about your symptoms.

They’ll likely begin with:

• A physical exam
• A review of your health history
• Questions about your eating habits and lifestyle

In some cases, your provider may prescribe acid-blocking medication first to see if it helps. If it does, your symptoms are likely related to stomach acid. If it doesn’t — or if you have other concerning symptoms — your provider may recommend further testing to check for an underlying condition.

Tests might include:

• Imaging tests
• Blood tests
• Breath tests (to check for H. pylori)
• Stool tests
• Upper endoscopy (to view your esophagus, stomach and small intestine)

If tests don’t show any clear cause and acid-reducing medications don’t help, your provider may diagnose functional dyspepsia.

How can I treat indigestion at home?

If your symptoms are mild or occasional, you can often manage them with simple changes:

• Adjust your eating habits: Eat smaller meals and avoid rich or fatty foods, which require more stomach acid to digest. Try to finish eating a few hours before bedtime.
• Review your medications: If you regularly take NSAIDs (like ibuprofen), they may irritate your stomach. Talk to your provider about other options for pain relief.
• Sip water: Small sips may help wash acid out of your esophagus or help your stomach empty more quickly. But too much water can sometimes make symptoms worse.
• Use antacids: Over-the-counter antacids can neutralize stomach acid and relieve occasional indigestion. But if you need them often — or they don’t work — see your provider.

How do healthcare providers treat chronic indigestion?

If you have traditional acid-related indigestion, your provider may prescribe medications to reduce or manage stomach acid. These can include:

• Antibiotics: Used to treat bacterial infections like H. pylori or SIBO, which can contribute to indigestion.
• H2 blockers: These reduce stomach acid by blocking histamine signals. They’re effective in the short term but may lose effectiveness with long-term use.
• Prokinetic agents: These help your digestive system move food along more quickly, reducing how long acid and enzymes sit in your stomach.
• Proton pump inhibitors (PPIs): These are strong acid blockers that also help heal tissue damage, such as ulcers or inflammation.

If you have functional dyspepsia, treatment may involve a combination of:

• Medications
• Eating habit changes
• Lifestyle changes
• Complementary therapies (like stress management or probiotics)

It may take some trial and error to find what works best for you.

When should I seek healthcare for indigestion?

See a healthcare provider if your symptoms are frequent, if antacids don’t help or if you’re relying on antacids too often and need a longer-term plan. You should also seek care if your current treatment stops working or if you develop new or concerning symptoms.

Red-flag symptoms include:

• Blood in your poop
• Difficulty swallowing
• Nausea and vomiting
• Unexplained weight loss

Is dyspepsia curable?

Not all causes of indigestion are curable, but most are treatable. Depending on the underlying issue, you may need occasional or daily treatment — sometimes long-term.

Medications that reduce stomach acid are often effective, but they can have side effects. You may need to work with your provider to find the right balance.

Functional dyspepsia can be harder to treat, and not everyone finds lasting relief.

A note from QBan Health Care Services

Indigestion is common and usually not serious. But when it happens often, it can interfere with your eating, sleeping and overall quality of life. It may be a sign of an underlying condition — and in rare cases, a serious one.

Your digestive system is complex. An experienced healthcare provider can help you figure out what’s going on and guide you toward relief.

Acid reflux is when acid from your stomach moves up into your esophagus and even your throat. It can cause unpleasant symptoms like heartburn and nausea. This is a normal but temporary inconvenience. When it’s chronic, it’s called GERD. GERD can damage your GI system over time. Treatment includes at-home adjustments, medication and surgery.

What Are Acid Reflux and GERD?

Acid reflux is when stomach acid flows upward into your esophagus and, sometimes, your throat. Normally, these acids flow one way: down. So, your esophagus and throat aren’t built to withstand them. Stomach acid can irritate the tissues there. This can lead to uncomfortable sensations, like heartburn. But most people have occasional reflux. It’s nothing to worry about.

GERD (gastroesophageal reflux disease) is when acid reflux becomes chronic. This means you have reflux episodes twice a week for several weeks straight.

While acid reflux can be annoying but temporary, GERD (also spelled GORD for gastro-oesophageal reflux disease) is a constant, mechanical problem. The systems in place to keep acid moving down aren’t working right.

Acid reflux and GERD are common. GERD affects 1 in 5 people in the United States.

Acid reflux in babies is also normal, especially in their first year of life. They can have GERD, too. But it looks a little different for them.

Symptoms of acid reflux and GERD

Symptoms of acid reflux and GERD can include:

• A burning feeling: Stomach acid burns the lining in your esophagus and throat. When the pain is in your chest, it’s heartburn. When it’s closer to your stomach, it’s indigestion.
• Chronic coughing, wheezing and shortness of breath: If particles of stomach acid enter your airways, it can make them contract. This causes symptoms like those of asthma.
• Noncardiac chest pain: This is when the pain in your chest feels like a heavy pressure or tightness. Pain in your esophagus triggers the same nerves as pain related to your heart.
• Nausea: Acid overflow and regurgitation can make you feel sick to your stomach or lose your appetite. You may also feel like there’s still food in your stomach even if you haven’t eaten in a while.
• Regurgitation: You might notice acid, food or liquids coming back up into your throat. There may also be a sour taste along with the backwash.
• Sore throat: Your throat may get sore after acid rises into it and inflames the tissues. It may feel like there’s a lump in your throat, or like swallowing is hard. Reflux in your throat often happens at night.

GERD symptoms can be worse at night or while lying down. They can also worsen after you:

• Have a large or fatty meal
• Bend over
• Drink alcohol or smoke

What causes acid reflux and GERD?

A weakened or relaxed lower esophageal sphincter (LES) causes acid reflux and GERD. For acid to get into your esophagus and throat, it needs to get past the LES, a special valve at the bottom of your esophagus. Its job is to prevent stomach contents from moving upward.

Some things can temporarily relax your LES, like lying down after a large meal. But if you have GERD, your LES is doing this more often than it should.

Sometimes, occasional acid reflux turns into GERD when its triggers persist or overlap.

Risk factors

Common risk factors for acid reflux and GERD include:

• Hiatal hernia: A hiatal hernia can squeeze your esophagus, trapping stomach acid. It can also move your LES and weaken the muscles that support it.
• Pregnancy: Increased abdominal pressure and volume during pregnancy can strain the muscles that prop up your LES. Hormones can also relax the LES.
• Obesity: Like in pregnancy, obesity increases the pressure and volume inside your abdomen and can weaken your LES. Fat tissue also makes hormones that relax the valve.
• Smoking: Tobacco smoke — even secondhand exposure — relaxes your LES. Smoking also triggers coughing, which opens your LES. Together, smoking and coughing can weaken muscles in your diaphragm and slow your digestion (this can produce more stomach acid).

Less common risk factors are:

• Certain conditions: Disorders you have from birth that affect your digestive system can affect your LES. Connective tissue diseases can impact your esophagus muscles.
• Medications: Some medications may relax your LES. These include NSAIDs, calcium channel blockers, antidepressants and theophylline.
• Surgery in your chest and abdomen: Procedures in these parts of your body can injure your esophagus.

How to lower your risk

Many risk factors of acid reflux and GERD are beyond your control. But certain changes to your daily habits can help lower your risk, like not smoking or removing yourself from smoky environments. So can maintaining a weight that’s healthy for you.

Can foods cause acid reflux?

Not on their own. But they can contribute to it. In higher doses, chocolate, coffee, alcohol, mint, garlic and onions can relax your LES.

Heavy meals and fatty foods need more stomach acid to break down, and they take longer. They might not have enough time to digest before you go to bed.

Complications of GERD

Having acid reflux here and there won’t affect your long-term health. But GERD can damage digestive organs above your stomach. This is because your stomach has built-in protection against acid. But your esophagus and throat don’t. Over time, stomach acid can burn and hurt them.

Possible complications include:

• Asthma and breathing problems: Stomach acid in your airways can irritate asthma that already exists. But it can also cause symptoms similar to asthma if you don’t have the condition.
• Barrett’s esophagus: This is when the cells in your esophagus’s lining change to look like those in your intestines. It happens after long-term exposure to acid and inflammation. Barrett’s esophagus is a risk factor for esophageal cancer.
• Esophageal stricture: To protect itself from damage, your esophagus may form scar tissue. This can narrow your esophagus and make it hard to swallow.
• Esophagitis: The lining of your esophagus becomes irritated and inflamed. Chronic esophagitis can cause pain and lead to ulcers, scarring and a precancerous condition called intestinal metaplasia.
• Laryngopharyngeal reflux (LPR): Reflux that travels all the way to your throat can cause swelling, hoarseness and growths on your vocal cords. Acid can also get into your breathing tubes. LPR may happen while you sleep.

How doctors diagnose GERD

A specialist called a gastroenterologist will take a closer look at your situation. They’ll ask about your symptoms and go over your medical history. If that isn’t enough to diagnose GERD, or they want to check for complications, your provider may use:

• Esophagram: This test takes moving X-rays (fluoroscopy) of your esophagus while you swallow a chalky liquid called barium.
• Upper endoscopy: A thin tube with a light and camera at the end lets your provider look inside your esophagus while you’re sedated.
• Esophageal pH test: A small, wireless receiver measures how much stomach acid is inside your esophagus.
• Esophageal manometry: Pressure sensors in a tube that goes through your nose and into your stomach measure muscle activity in your esophagus.

How is acid reflux treated?

If you have acid reflux, you may be able to ease your symptoms by adopting some new habits. These can include:

• Quitting smoking
• Drinking less alcohol or none at all
• Maintaining a weight that’s healthy for you
• Elevating your head at night by 6 to 8 inches using extra pillows or a foam wedge
• Avoiding foods and drinks that make acid reflux worse
• Eating smaller meals
• Eating two to three hours before you lie down
• Avoiding tight clothing (this puts pressure on your abdomen)

Medications

If you need a little extra help in the short term, over-the-counter (OTC) medications for acid reflux include:

• Antacids: These medicines (like Tums® and Rolaids®) weaken stomach acid.
• Alginates: These are sugars that seaweed naturally produces. They create a physical barrier between stomach acid and the esophagus.

Some medications have both antacids and alginates.

How is GERD treated?

Incorporating these habits can help if you have GERD. But your provider may also prescribe medications to reduce your stomach acid. They’re safer to take long term than OTC medications.

Medications

Medications for GERD include:

• H2 blockers: They’re also called histamine receptor antagonists. They reduce stomach acid by preventing your body from making histamine. But sometimes, your body gets used to them and they don’t work as well.
• Proton pump inhibitors (PPIs): If your GERD is severe or your esophagus is damaged, a provider will probably recommend PPIs first. They’re very effective at lowering reflux.
• Baclofen: This medication helps keep your LES from relaxing too much and letting acid flow upward. It’s not a first-line treatment, but it can be helpful in some cases.

Surgery

While daily habits and medication can ease the symptoms and effects of GERD, they can’t stop it from happening entirely. A severe case of GERD can still cause problems on medication, even if you can’t feel it.

When this happens, surgery may be the best option. Procedures to treat GERD are minor and have excellent outcomes. You can typically go home the same day. They include:

• Nissen fundoplication: This is the most common surgery for GERD. A surgeon wraps the top of your stomach around your lower esophagus and secures it with stitches to tighten your LES. It only needs small incisions, and recovery is relatively quick.
• LINX device: A ring of tiny magnets helps keep your LES closed. A surgeon implants a LINX device using small cuts in your abdomen.

When should I seek care?

Reach out to a provider if symptoms are still bothering you after treatment, or if they get worse. If you have acid reflux, this may mean that it’s become chronic. If you have GERD, it could mean that your treatment plan needs an update.

What can I expect if I have acid reflux or GERD?

So many things contribute to acid reflux that it can be hard to tell what’s triggering yours. Sometimes, simple tactics like new habits and over-the-counter medications can make symptoms disappear. Other times, acid reflux can get worse.

Talk with a healthcare provider if acid reflux is getting in the way of life. They can see whether it’s causing problems you aren’t aware of.

You may need surgery if you have severe GERD or complications that medications can’t help. Surgery is usually minimally invasive and effective. It might be worth doing to prevent complications or keep them from making things worse.

How can I stop an acid reflux attack?

If it’s happening right now, try:

• Standing up
• Taking small sips of water
• Loosening your waistband or belt
• Taking an antacid

A note from QBan Health Care Services

It’s normal to have acid reflux from time to time. It may be unpleasant, but over-the-counter medication and changes to your normal routine may just do the trick.

If you have reflux more often or your symptoms are disruptive, it may be GERD. Talking with a healthcare provider can shed some light on your situation. They can help find a treatment that works for you.

Lactose intolerance occurs in people who lack the enzyme they need to break down lactose, the sugar in milk. It causes digestive distress when you eat dairy products. A food intolerance is different from a food allergy.

What is lactose intolerance?

Lactose intolerance is a reaction in your digestive system to lactose, the sugar in milk. It causes uncomfortable symptoms after you eat dairy products. Many people have difficulty digesting lactose, but not everyone experiences noticeable symptoms from it. If you do, it’s called lactose intolerance.

What is lactose malabsorption?

Lactose malabsorption is the inability to break down and absorb lactose molecules in your digestive system. It’s common — in fact, about 65% of adults worldwide can’t break down and absorb lactose. Unabsorbed lactose passes undigested through your gastrointestinal tract, causing symptoms for some people.

What’s the difference between lactose malabsorption vs. lactose intolerance?

Everyone with lactose intolerance has lactose malabsorption, but not everyone with lactose malabsorption has lactose intolerance. One way of thinking about it is that malabsorption happens in your small intestine, while symptoms of food intolerance happen later in your large intestine.

Your small intestine is where most of the nutrients from your food are absorbed. Your small intestine breaks nutrients down into smaller molecules that can pass through the intestinal wall into your bloodstream. Everything that isn’t absorbed in your small intestine passes to your large intestine.

Undigested sugar molecules in your large intestine produce more water and more gas. They trigger your large intestine (colon) to secrete extra fluid to help pass them through. They produce gas when the bacteria in your colon ferment them. This can lead to digestive symptoms such as diarrhea and gas pain.

How noticeable your symptoms are will depend on other variables. Can you break down lactose a little bit, or not at all? How much lactose do you eat at a time? What other conditions might affect the water and gas content in your colon? These are some of the factors your healthcare provider will explore.

What are the signs and symptoms of lactose intolerance?

Signs and symptoms of lactose intolerance may include:

• Bloated stomach.
• Intestinal gas.
• Nausea and vomiting.
• Stomach pain and cramping.
• Stomach gurgling or rumbling.
• Diarrhea.

These symptoms come from undigested lactose in your large intestine. It takes between six to 10 hours for food to reach your large intestine after you eat it, and another 24-36 hours after that to travel through your large intestine. So your symptoms might occur up to a day or two after you eat lactose.

What foods trigger lactose intolerance symptoms?

Lactose is in most dairy products unless it’s been removed. That includes cow’s milk and goat’s milk products. There’s more in some types than others. For example, fresh milk and cream are higher in lactose, while hard cheeses have less. You might be OK with a sprinkling of parmesan on your salad.

On the other hand, if you’re very sensitive to lactose, you might react to even small amounts. Check nutrition labels and ingredient lists on food. Lactose is often added to processed foods, including soups, salad dressings and snack foods. It may even be added to your prescription medications.

What causes lactose intolerance?

Two factors contribute to lactose intolerance: lactose malabsorption and gut sensitivity. Lactose malabsorption is the most important factor. It’s the inability to break down and absorb lactose in your small intestine that leads to lactose later entering your large intestine and triggering symptoms.

Lactase deficiency

Your small intestine needs a specific enzyme, called lactase, to break down lactose into smaller molecules that it can absorb. Most people naturally produce lactase in their small intestines during infancy to help digest breast milk. Most people begin to make less of it as they grow up.

If you don’t have enough lactase, you won’t be able to digest lactose. Some people produce more or less lactase than others. But technically, the majority of people worldwide have lactose malabsorption due to lactase deficiency. Only certain populations continue to produce lactase into adulthood.

You and your gut

This is where your gut sensitivity factors in. We all consume things from time to time that we can’t fully digest. Certain dietary fibers and sugars go straight through our digestive systems to feed the bacteria living in our guts. Most of us tolerate a little of this to some extent, without overwhelming symptoms.

But everyone is a little different. Our genes, intestinal health, sensitivities and diet all factor in. Your unique gut microbiome — the different types of bacteria living in your colon — may process lactose differently from someone else’s. Your symptoms will tell you how much lactose you can tolerate.

What are the four types of lactose intolerance?

The four types, and their causes, are:

• Primary (caused by diminishing lactase production in your small intestine).
• Secondary (caused by injury or disease that damages your small intestine).
• Congenital (caused by lactase deficiency present at birth).
• Developmental (caused by premature birth, when the small intestine is underdeveloped).

Is lactose intolerance genetic?

Genes determine how likely you are to continue to produce lactase, the enzyme that helps you digest lactose. Genes may also partly affect your gut sensitivity and the types of bacteria you have in your gut. Some bacteria convert lactose into gas, but others convert it into lactic acid, which may not cause symptoms.

You’re more likely to have lactose malabsorption and lactose intolerance if your genetic profile is:

• Asian.
• Native American.
• Hispanic.

You may be more likely to have lactase persistence and lactose tolerance if your genetic profile is:

• Northern European.
• African.
• Middle Eastern.

Rarely, some people are born with congenital lactase deficiency. This is a genetic disorder that causes lactose intolerance from birth.

Can you develop lactose intolerance over time?

Most people develop lactose intolerance as they grow from childhood into adulthood. The most common type of lactose intolerance, primary lactose intolerance, happens because you gradually stop producing lactase, the enzyme that digests lactose. Your gut sensitivity can also change over time.

Separately from lactose malabsorption, you may be more likely to experience symptoms if you have:

• Irritable bowel syndrome.
• Visceral hypersensitivity.
• Small intestinal bacterial overgrowth.

These are conditions that tend to develop gradually over your lifetime.

Can you suddenly become lactose intolerant if you weren’t before?

You can develop secondary lactose intolerance suddenly as a result of damage to your small intestine. Injury, surgery, infections or chronic diseases may damage the cells that produce lactase. This can cause sudden lactose malabsorption and intolerance, even if you could previously digest lactose.

Secondary causes of lactose intolerance include:

• Radiation therapy.
• Small bowel resection.
• Cystic fibrosis.
• Inflammatory bowel disease.
• Celiac disease.
• Enterocolitis.

Secondary lactose intolerance may not be permanent. If your small intestine recovers its usual function, you may regain the ability to digest lactose.

How do you know if you’re lactose intolerant?

You might suspect you’re lactose intolerant if you notice a pattern of gastrointestinal symptoms after you eat dairy products. However, many people with lactase deficiency can tolerate some lactose, sometimes. If you’re not sure whether lactose is affecting you, visit a healthcare provider.

How do you test for lactose intolerance?

Healthcare providers have several ways of testing for lactose intolerance. Common tests include:

• Hydrogen breath test. A breath test measures the amount of hydrogen and methane gases in your breath when you exhale. Bacteria in your colon produce these gases. If you have higher levels of these gases after ingesting lactose, it’s because your gut bacteria are fermenting the lactose, producing gas in your colon that can later be measured in your breath.
• Blood sugar test. If a breath test is inconclusive, a healthcare provider might suggest a blood glucose (blood sugar) test. This test measures the sugar content in your blood before and after you ingest lactose. If your blood sugar doesn’t rise, it shows you’re not absorbing the lactose.
• Stool acidity test. Healthcare providers use this test for small children and infants. After feeding a child lactose, they’ll take a poop (stool) sample and analyze the content. Levels of lactic acid and other byproducts in the sample can show whether or not the body is absorbing the lactose.

How do you fix lactose intolerance?

If you want to be able to digest lactose, you need lactase in your gut. Most people with lactose intolerance can’t produce lactase naturally. Lactase supplements can give your body the lactase it needs to break down lactose. You can take these as tablets or drops before consuming lactose.

Researchers are also experimenting with lactic acid bacteria as a possible fix for lactose intolerance symptoms. These are bacteria that convert lactose into lactic acid instead of gas. Ingesting these bacteria as probiotics, together with prebiotics that feed them, may improve lactose tolerance.

How can I manage lactose intolerance with diet?

Experiment with your diet to find out what your personal lactose threshold is. Some people find they can tolerate certain dairy foods in certain amounts, or when combined with other foods. Begin with a lactose-free diet, then gradually reintroduce lactose-containing foods to see how your system responds.

Some people with lactose intolerance can tolerate up to 12 grams (g) of lactose at one time, which is a cup of milk or a scoop of ice cream. You can also find lactose-reduced and lactose-free versions of most dairy products at the supermarket. Experiment with these and other dairy alternatives in your diet.

Can lactose intolerance go away?

Secondary lactose intolerance caused by damage to your small intestine might be reversible after your small intestine recovers. This will depend on how permanent the damage is. It may also take some time. Babies born prematurely who have developmental lactose intolerance usually grow out of it.

If you have primary or congenital lactose intolerance, you won’t ever start naturally producing more lactase. But it’s possible your symptoms could change if your intestinal health or microbiome changes. In theory, your tolerance might improve a little, or you might notice your symptoms a little less.

What happens if you ignore lactose intolerance?

Lactose intolerance won’t seriously harm you. If you can cope with the symptoms while the lactose passes through your digestive system, they’ll eventually end. However, you can easily avoid lactose intolerance symptoms with lactase supplements and lactose-free dairy products.

Are there any long-term consequences of lactose intolerance?

Lactose intolerance will affect your diet, which means you’ll have to pay attention to the nutrients you’re getting. If you avoid all dairy products, you could end up low in calcium and vitamin D. You can get these nutrients from other food sources, but dairy products are some of the most common ones.

Calcium deficiency or vitamin D deficiency can affect your bones, muscles and nervous system. Deficiencies can particularly affect growing children. Your healthcare provider might recommend taking calcium or vitamin D supplements — or giving them to your child — if you can’t get enough from your diet.

Is lactose intolerance an allergy?

No. A food allergy is a reaction from your immune system, usually to a protein in your food. Your immune system registers the protein as a threat and reacts to remove it. Even a small amount of the protein can cause a big reaction if you’re allergic, and it usually occurs very soon after ingesting it.

An allergic reaction can cause symptoms throughout your body, not just in your digestive system. It may include swelling, hives and shortness of breath. You may also have stomach pain, nausea and vomiting, but this would usually occur early in the digestive process when the protein is still in your stomach.

What is the difference between lactose intolerance vs. milk allergy?

The main difference is that a milk allergy is a reaction from your immune system to a milk protein. Lactose intolerance is a reaction in your digestive system to a milk sugar. An allergic reaction has an emergency quality. It can be immediate, severe and, in some cases, life-threatening (anaphylaxis).

When your digestive system reacts to a sugar that it can’t digest, it can mean uncomfortable symptoms during digestion, but it isn’t dangerous. Undigested lactose will produce extra water and gas in your colon. It might give you diarrhea and gas while it’s processing through, but it won’t harm you.

What is the difference between lactose intolerance vs. milk protein intolerance?

Like lactose intolerance, milk protein intolerance begins with malabsorption in your small intestine. When your small intestine can’t break down and absorb one of the proteins in milk (usually casein or whey), the undigested protein passes on through your intestines, just like undigested sugars do.

The difference is that undigested proteins in your digestive system can raise a red flag in your immune system. Your immune system may register the protein as an allergen sometime later in the digestive process, producing a delayed immune response. You may later develop an allergy to the protein.

A note from QBan Health Care Services

Lactose intolerance isn’t a disorder. It’s just a natural variation in how our digestive systems work. Actually, the ability to digest lactose past infancy is a relatively recent genetic adaptation in humans. Not all of us have that adaptation, and that’s OK. You can live a healthy life with lactose intolerance.

If you have digestive symptoms and think they might be related to dairy products, a healthcare provider can help. They can test you for lactose intolerance and other possible causes of your symptoms. If you do have lactose intolerance, a provider can help you adjust your lifestyle to avoid those symptoms.

Gastroenteritis is inflammation that spreads from your stomach into your intestines, causing pain, vomiting and diarrhea. When it feels like it’s “coming out both ends,” you’ve usually ingested a virus, bacteria or chemical by mistake. Most of the time, it goes away by itself.

What is gastroenteritis?

Gastroenteritis means inflammation in your stomach and intestine. Inflammation makes these organs feel swollen and sore. It causes symptoms of illness, like nausea, vomiting, abdominal pain and diarrhea.

Gastroenteritis often happens when you get an infection in your gastrointestinal (GI) tract. Bacteria and viruses can cause food poisoning and stomach flu infections. Chemicals can also cause gastroenteritis.

Types of gastroenteritis

Infectious gastroenteritis is the most common type. It’s caused by an infection in your gastrointestinal tract (your stomach and/or intestines). Viruses, bacteria, fungi or parasites may cause the infection.

Chemical gastroenteritis can happen if you ingest toxic chemicals, which can contaminate food and water sources. You can also get it from heavy doses of alcohol or drugs, including some medications.

How common is this condition?

Just about everyone gets gastroenteritis, likely more than once. Most of the time, it’s not serious. But in more vulnerable populations, it can be. Around the world, gastroenteritis is a leading cause of death.

What are the signs and symptoms of gastroenteritis?

Symptoms involving your intestines (diarrhea, cramps), together with symptoms involving your stomach (nausea, vomiting) are the hallmarks of gastroenteritis. You’ll know it if it’s “coming out both ends.”

Gastroenteritis symptoms may include:

• Diarrhea.
• Nausea and vomiting.
• Loss of appetite.
• Abdominal pain and cramping.
• Fever.
• Chills.
• Fatigue.
• Body aches.

What are the first signs of gastroenteritis?

Gastroenteritis symptoms often come on suddenly. Gastrointestinal symptoms appear first. You might have diarrhea, stomach pain or cramps, nausea and/or vomiting many times in a short period.

As the day goes on, you may or may not begin to experience what are called “systemic symptoms” — symptoms that affect the rest of your body. These may include fever, chills and body aches.

How long does gastroenteritis last?

The most common types of gastroenteritis only last a day or two. Your body can overcome most bacterial and viral infections on its own. Some types may last longer or need treatment to go away.

What is the main cause of gastroenteritis?

Gastroenteritis happens when your immune system activates to defend your stomach and intestines from harm. It sends inflammatory cells to help fight infections and repair injured tissues.

This is usually a temporary (acute) response to a temporary threat or injury. It takes a short time to work, and then, the inflammation goes away. Longer-lasting (persistent) gastroenteritis is unusual.

What are the specific causes of acute gastroenteritis?

Infectious diseases or toxic chemicals can trigger acute gastroenteritis.

Infectious diseases

Infectious gastroenteritis is caused by an infection in your gastrointestinal tract, like a:

• Viral infection.
• Bacterial infection.
• Parasitic infection.
• Fungal infection.

Infections are the most common cause of acute gastroenteritis.

Viral gastroenteritis

Viral infections cause viral gastroenteritis, which is the most common type overall. Viruses cause 60% of all gastroenteritis cases. Norovirus alone accounts for 50% of all viral gastroenteritis cases.

Viral gastroenteritis sometimes goes by the nickname, “stomach flu,” although this isn’t a medical term. Influenza (flu) viruses don’t cause viral gastroenteritis. Viruses that can cause “stomach flu” include:

• Norovirus.
• Rotavirus.
• Astrovirus.
• Adenovirus.
• Calicivirus.
• Sapovirus.

Bacterial gastroenteritis

Bacterial infections cause bacterial gastroenteritis. Common bacterial gastrointestinal infections include:

• Campylobacter.
• Clostridioides difficile (C. diff).
• Escherichia coli (E. coli).
• Salmonella.
• Shigella.
• Staphylococci (Staph).

Parasitic gastroenteritis

Parasite infections cause parasitic gastroenteritis. Common parasite infections include:

• Giardiasis.
• Cryptosporidiosis.
• Cyclosporiasis.
• Amebiasis (amoebic dysentery).

Fungal gastroenteritis

Fungal infections can cause fungal gastroenteritis. The most common fungal infections are:

• Candidiasis.
• Aspergillosis.

Chemical gastroenteritis

Chemicals can injure and inflame the lining of your stomach and intestines. Some chemicals do this even in small amounts. Others, like alcohol and certain medications, can cause gastroenteritis in larger doses.

Causes of chemical gastroenteritis include:

• Heavy metal poisoning.
• Plant toxins, like poisonous mushrooms.
• Cocaine.
• Chemotherapy drugs.
• Alcohol overuse.
• NSAIDs overuse.
• Colchicine overuse.
• Digoxin overuse.

Is gastroenteritis contagious?

Infectious gastroenteritis is contagious. When you have an infection in your gastrointestinal system, it infects your poop. Infections can spread from your poop to anyone who comes into contact with it.

Microscopic traces of poop can linger on bathroom surfaces, diaper changing areas and people’s hands if they don’t wash well. These traces can transfer to others who touch them, or to their food or water.

Chemical gastroenteritis isn’t contagious. But it can affect many people in one place at one time. If you get toxic poisoning from food, water or your environment, others sharing those things may also get it.

How do you catch gastroenteritis infections?

The most common way to get a gastrointestinal infection is from contaminated food or water. You can also catch it by touching an infected person, or by touching a surface that an infected person touched.

How long is gastroenteritis contagious?

Gastrointestinal infections are most contagious during the period when you have symptoms, and for two days after. These last two days are when your body is shedding the infection through your poop.

What are the risk factors for getting gastroenteritis?

Just about everyone gets gastroenteritis. But you’re more likely to get it more frequently if you:

• Are older than 65 or younger than 6.
• Live or work in a childcare or nursing home.
• Eat raw fish or meat.
• Travel abroad, especially in less developed regions.
• Have a chronic condition that weakens your immune system.
• Use certain drugs or alcohol frequently.

What are the possible complications of acute gastroenteritis?

Most of the time, gastroenteritis is brief and ends by itself. When this is the case, the primary complication to look out for is dehydration. This is more of a risk for children and senior citizens.

When you’re having frequent diarrhea or vomiting, you’re losing a lot of fluids and electrolytes. If you can’t replace them fast enough, you could become dehydrated and develop electrolyte imbalances.

If gastroenteritis lasts a long time, it could begin to damage your stomach and intestines. For example, you might develop ulcers in your organs that bleed. Only a few types of gastroenteritis can last longer.

Some specific causes of gastroenteritis can have their own side effects. These are separate from the effects of gastroenteritis itself. Certain infections or toxins can do more lasting damage to your body.

People with weakened immune systems and people with less access to clean water, nutrition, sanitation and healthcare are more vulnerable to gastroenteritis. They might get it more often, and for longer.

Children in less developed countries and senior citizens in long-term care facilities are more at risk of serious complications from gastroenteritis. This is because their health status is lower to begin with.

How is gastroenteritis diagnosed?

Healthcare providers can usually recognize gastroenteritis by your symptoms. They’ll ask you when your symptoms started and what was going on at the time that could have triggered them.

If you have unusual symptoms, or if they want to investigate your symptoms further, they may order some tests. A poop test or blood test can help prove gastroenteritis and rule out other conditions.

What is the best way to get rid of gastroenteritis?

In most cases, gastroenteritis goes away by itself. The best way to help your body recover is to give it lots of rest and fluids. You might want to stick with bland, easy-to-digest foods for a few days.

But certain, less common causes of gastroenteritis do need treatment. If your symptoms don’t seem to be going away, or you believe you have a type of toxic poisoning, tell a healthcare provider.

What is the medical treatment for gastroenteritis?

Most of the time, medical treatment for gastroenteritis is supportive. That means the treatment supports your body’s natural healing process rather than curing gastroenteritis. It might include:

• IV fluids to prevent or correct dehydration and electrolyte imbalances.
• Parenteral nutrition to give your body energy without using your stressed digestive system.
• Medications to treat symptoms like nausea and diarrhea, in certain cases.

But some causes of acute gastroenteritis may need medication to go away. For example, you may need a specific antibiotic or antiparasitic medication to treat a specific type of bacterial or parasite infection.

If you have chemical gastroenteritis due to toxic poisoning, you may need additional treatment to help clear the toxin out of your body. The treatment will depend on the toxin and on your condition.

How soon will I feel better?

You should feel better within two to three days after your symptoms first started, or after you started medication if you needed it. If you aren’t feeling better yet, let your healthcare provider know.

How serious is gastroenteritis?

For most people, gastroenteritis isn’t serious. But for people with weaker immune systems, it can be. This includes children under 5, adults over 65 and anyone with a lower health status in general.

If you know that you or someone in your care has a weaker immune system, take special care to avoid dehydration and exhaustion from gastroenteritis. Seek healthcare if symptoms don’t improve soon.

Can gastroenteritis be prevented?

Not every case of gastroenteritis is preventable. But there’s a lot we can do to reduce our personal risk and prevent common gastrointestinal infections from spreading in our communities. For example:

• Good handwashing. Good handwashing is one of the most important and easiest ways to protect yourself and others from infections. Lathering with soap for at least 20 seconds removes germs and toxins from your hands that might transfer to your mouth or to other people.
• Good cleaning. Diligent cleaning is especially important in community places like schools, daycares, nursing homes and hospitals, where many people use the same facilities every day. Cleaning with disinfectants can help remove germs that may linger on common surfaces.
• Safe food handling. Food can become contaminated at any stage of production, from harvesting and storage to cooking and preparation. Remember to wash your hands before and after handling food. Wash, refrigerate, freeze, cook and serve food according to food safety guidelines.
• Safe travels. It’s especially easy to get food poisoning while traveling abroad. (This is called traveler’s diarrhea.) You may be exposed to microorganisms there that you wouldn’t meet at home. When traveling, it’s best to stick to cooked, peeled or packaged foods and bottled water.
• Safe substance use. Only use drugs as directed. If you feel like your medications aren’t doing enough as directed, or you’re self-medicating with substances, see a healthcare provider for a better long-term treatment plan. If you have a substance use disorder, treatment can help.

What foods should I eat or avoid while living with gastroenteritis?

You may not have much appetite with gastroenteritis, and that’s natural. Your irritated stomach and intestines won’t be able to digest or absorb many of the foods that you would normally eat anyway.

It’s OK to eat a very limited diet for a few days until the inflammation goes down. Just focus on bland foods that are easy to digest and avoid foods that might make your gastrointestinal symptoms worse.

What to eat (and drink):

• Crackers.
• Soup broths.
• Bananas.
• Toast.
• Rice or porridge.
• Applesauce.
• Watermelon.
• Popsicles.
• Ice chips.
• Sports drinks or hydration formulas.

Foods (and drinks) to avoid:

• Caffeinated beverages.
• Artificial sweeteners.
• Dairy products.
• Alcohol.
• Red meat.
• Spicy foods.
• Sharp foods, like chips.
• Seeds and nuts.
• Rich or fatty foods.
• Sweets.

When should I seek medical care for gastroenteritis?

Contact a healthcare provider if you notice any unusual or red flag symptoms, such as:

• Inability to keep fluids down, signs of dehydration.
• Symptoms last longer than five days.
• Fever lasts more than three days or is higher than 104 degrees Fahrenheit (40 degrees Celsius).
• Severe abdominal pain or a rigid, distended abdomen.
• Abnormal heartbeat or abnormal breathing.
• Blood in your poop.
• Green vomit.
• Altered mental status.

What’s the difference between gastritis vs. gastroenteritis?

Gastritis is inflammation in your stomach.

Gastroenteritis is inflammation in your stomach and intestine. (Enteritis means inflammation in your small intestine, but it may spread to your large intestine, too.)

Gastritis causes stomach symptoms, like stomach pain, nausea and vomiting. Inflammation in your intestines affects your poop, causing diarrhea.

Gastroenteritis means that you have both.

A note from QBan Health Care Services

Gastroenteritis is a universal experience, but that doesn’t make it easy to go through. If your time has come to weather the storm, take care, and know that it will most likely be over in a day or two.

It can be alarming to have sudden and frequent symptoms like diarrhea and vomiting. It can feel like something is really wrong. But those symptoms mean that your body is already taking care of it.

Most people won’t need or benefit from medications. Many infections have no antidote. But a few do, and a few might need meds to go away. If your gastroenteritis isn’t going away, tell a healthcare provider.

If you’re immunocompromised or caring for someone with a weaker immune system, don’t hesitate to stay in touch with a healthcare provider during gastroenteritis, and let them know how it’s going.

Colitis means inflammation in your colon, where digested food becomes poop. Inflammation in your colon can make your poop more urgent, painful, runny or bloody. You can get temporary colitis from an infection. Some people have chronic colitis.

What Is Colitis?

Colitis is inflammation in your colon, which is the main part of your large intestine. Your colon is the last leg of the journey your food takes through your digestive system. Inflammation makes the tissues in your colon swell and cause discomfort. This can affect the way the journey ends, causing pain, diarrhea and, sometimes, blood in your poop. Colitis can also affect your quality of life and make it difficult to do your normal activities.

There are different types of colitis. Some are short-lived and easy to treat, like when you have food poisoning. Other types — like inflammatory bowel diseases — are longer-lasting and difficult to treat. Colitis is more serious when it doesn’t go away. A severe case can damage your colon over time.

Symptoms of colitis

Common symptoms include:

• Abdominal pain
• Bloating
• Feeling like you need to poop
• Watery diarrhea
• Mucus or blood in your poop
• Loss of appetite
• Fever
• Fatigue

Colitis causes

The causes can vary depending on the type of colitis you have:

• Infectious colitis is caused by a viral, parasitic or bacterial infection. Salmonella and E. coli are common causes. Most people get it from eating or drinking contaminated food or water.
• Pseudomembranous colitis is the result of a specific bacterium known as C. diff (clostridioides difficile). C. diff already lives in your intestines, but certain antibiotics can cause C. diff to overgrow.
• Allergic colitis primarily affects babies who drink breastmilk. An allergy to the protein in cow’s milk (lactose intolerance) causes it.
• Ischemic colitis is when your intestines aren’t getting enough blood. A blockage in your blood vessels, like a blood clot or atherosclerosis, causes it.
• Inflammatory bowel diseases (IBD) are a group of conditions that cause chronic inflammation in your colon. They include ulcerative colitis, microscopic colitis and Crohn’s disease. Experts believe they’re a type of autoimmune disease, which means they cause your immune system to malfunction and attack its own tissue.
• Radiation colitis is a side effect of radiation therapy, which is a treatment for certain types of cancer.
• Diversion colitis is a side effect that can occur in people who’ve had a colostomy. Experts believe it happens when the part of your colon that’s not being used is deprived of certain nutrients.

Complications of colitis

Complications usually result from severe, long-term colitis. They can include:

• Perforation: Chronic inflammation weakens your colon walls, making them more likely to rupture. An ulcer in your colon may wear a hole all the way through the lining of the colon. This can cause bacteria from your colon to infect your abdominal cavity or bloodstream.
• Toxic megacolon: Severe inflammation causes the muscles in your colon to stop working. Food and gas build up in your colon and make it widen or stretch.
• Increased risk of colon cancer: Long-term inflammation in your colon can sometimes lead to changes in your colon wall that become cancerous.

How doctors diagnose colitis

Your healthcare provider will begin by asking you about your symptoms, when they began and what you were eating and drinking at the time. They’ll ask you about your current medications and any health conditions that you have. After a physical examination, they may recommend medical tests. These are likely to include blood tests, stool tests and imaging tests to look at your colon.

Tests for colitis

Endoscopic tests that check the inside of your colon with a lighted camera can be helpful in diagnosing the type of colitis you have. Colonoscopy and flexible sigmoidoscopy also allow your provider to take tissue samples from the inside of your colon (biopsy). Analyzing the tissue sample can help them figure out the cause of your symptoms.

CT scans can also help diagnose colitis and determine if the condition affects more than just the colon.

What is the treatment for colitis?

Treatment for colitis depends on the type and the cause. It may include:

• Medications: Your provider may prescribe antibiotics to treat infections, corticosteroids to treat inflammation, immunomodulators to help your immune system, biologic (intravenous or subcutaneous) medications and mucosal agents like mesalamine to treat IBD.
• Food changes: If you have temporary colitis, you may benefit from foods that are low in fiber and easy to digest. If you have chronic colitis, you may need a personalized eating plan that avoids trigger foods and ensures you’re getting the right nutrients.
• Surgery: People with certain types of colitis may require surgery to treat complications. Surgery doesn’t always cure these conditions, but it may be necessary to stop bleeding, repair a perforation or remove a blockage.

What kind of diet is helpful for colitis?

Your healthcare provider may suggest following a:

• Soft diet: A soft food diet refers to food that’s soft in texture, low in fiber and easy to digest. This way of eating is sometimes called a gastrointestinal (GI) soft diet.
• Anti-inflammatory diet: To keep chronic inflammation low, your healthcare provider might recommend you avoid highly inflammatory foods, especially fast and processed foods high in sugar and fat.
• Elimination diet: If you have an inflammatory bowel disease, your healthcare provider will likely recommend an elimination diet to figure out which foods cause your symptoms to flare up. An elimination diet eliminates certain types of foods and then adds them back in a systematic way so that you can observe how your gut responds to them.

When should I see my healthcare provider?

Contact your provider if you have symptoms of colitis, like:

• Abdominal pain that doesn’t get better
• Blood in your poop
• Diarrhea that doesn’t go away

What’s the outlook for people with colitis?

Colitis can be challenging, but it’s manageable with help from a healthcare provider. Your exact outlook also depends on what type of colitis you have.

Sometimes, colitis is acute and temporary. There are fixes that are easier to incorporate. For example, avoiding specific foods or taking antibiotics is all you need for certain types of colitis.

But people with chronic, long-term colitis work closely with their provider on a treatment that gives them the most relief. This could include medication or changes to your eating habits. It can be a lifelong condition that comes and goes. You may try several treatments or have to adjust your treatment every so often. This can make managing the condition challenging, but your provider can help find a way to ease your symptoms.

A note from QBan Health Care Services

Having colitis can mean not knowing when the urge to poop will strike. It can mean your day becomes unpredictable. If symptoms of colitis impact your life, talk to a healthcare provider. Luckily, some forms are temporary and go away within a few days. On the other hand, others last weeks, months or years. These types can affect your quality of life and harm your colon in the long run.

Celiac disease is an autoimmune disease that triggers an abnormal reaction from your immune system when you eat gluten. This reaction causes inflammation in your small intestine, which can damage it over time. Fortunately, eating a gluten-free diet can often stop and reverse the damage.

What Is Celiac Disease?

Celiac disease is an autoimmune disease that causes your body to react to a protein called gluten. When you eat gluten, it triggers an abnormal response from your immune system. Your immune system attacks the gluten in your digestive system, causing inflammation. This inflammation damages the inside of your small intestine.

Your small intestine is where most of the nutrition from food gets absorbed. So, damage to this organ can prevent it from doing its job and lead to serious complications.

Without treatment, celiac disease can lead to malabsorption and malnutrition. Malnutrition has many serious side effects, especially in children. Children with celiac disease may have growth and development delays.

Gluten is found in grains like wheat, barley and rye. These grains make up many of the staple foods of the standard Western diet. These include bread, cereals, pasta and beer. Gluten is also added to many food products that you may not expect. These include sauces, soups and packaged foods.

If you have celiac disease, it’s important to eat gluten-free.

Celiac disease symptoms

Signs and symptoms of celiac disease can appear at any age. Healthcare providers most often see it develop during two clear age windows:

• Early childhood, between 8 and 12 months old (when children may begin eating solid foods with gluten in them, like crackers or cereals)
• Midlife, between the ages of 40 and 60

Celiac disease symptoms vary widely. Some people don’t notice any symptoms at all. Some experience indigestion or other GI symptoms after eating gluten. Others only begin to see signs of nutrient deficiencies later, when significant damage has been done.

Gastrointestinal (digestive) symptoms of celiac disease may include:

• Stomach pain
• Bloating
• Gas
• Diarrhea

Nondigestive symptoms may include:

• Paleness
• Extreme tiredness
• Cold hands
• Indented (concave) nails
• Dental enamel defects
• Abnormal periods
• Trouble getting pregnant
• Irritability or depression
• Unexplained weight loss
• Growth faltering in children

Some people with celiac disease develop a condition called dermatitis herpetiformis. This is an itchy rash that looks like clusters of bumps or blisters. It affects your elbows, knees, butt and scalp.

What causes celiac disease?

Almost everyone with celiac disease has a genetic change (variant) in the HLA-DQ2 gene or HLA-DQ8 gene. You get these changes from your biological parents. But not everyone with these genes develops celiac disease.

Celiac disease is partly genetic, but other factors are also involved in triggering it. Some experts think the balance of microorganisms living in your gut might play a part. Others think a major physical event, like an illness or surgery, might trigger it.

Risk factors

You’re more likely to develop celiac disease if you’re female. Your chances also increase if you have:

• Another autoimmune disease
• A chromosomal disorder, like Turner syndrome, Williams syndrome or Down syndrome
• A first-degree relative (biological parent, sibling or child) who has it

Complications of this condition

Without treatment, celiac disease can lead to long-term complications. These include:

• Malnutrition, which leads to changes in your nervous system and skeletal system that can be hard to reverse
• Food intolerances, like lactose intolerance, due to damage to your intestinal lining
• Collagenous sprue, which causes collagen deposits in the lining of your small intestine that prevent it from absorbing nutrients
• Weakened immunity, which makes you more vulnerable to illness, including other autoimmune diseases

Celiac disease may also affect your liver. Over time, you can develop chronic liver disease. Untreated celiac disease also increases your risk of developing small intestine cancer.

How is celiac disease diagnosed?

If you have celiac disease symptoms after eating gluten, you may have the condition.

Keep in mind that food intolerances can cause discomfort that mimics celiac disease. Many people have a sensitivity to gluten or wheat products.

But these conditions don’t damage your small intestine the way celiac disease does. To make a celiac disease diagnosis, your healthcare provider will look for signs of this damage.

How to test for celiac disease

Healthcare providers use two celiac disease tests. They like to use them together to confirm the diagnosis:

1. Blood test: Your provider checks your blood for antibodies to gluten.
2. Biopsy: Your provider looks for damage to the lining of your small intestine. They do an endoscopy to take a small tissue sample (biopsy).

Your provider may also want to test your blood for nutrient deficiencies. Severe deficiencies can have wide-ranging effects on your body. You may need nutrition therapy to treat them. Common findings include:

• Iron-deficiency anemia
• Vitamin-deficiency anemia
• Vitamin D deficiency

How is celiac disease treated?

The most crucial step in celiac disease treatment is to stop eating gluten. You can’t change the way your body reacts to gluten. But you can prevent gluten from triggering that reaction.

When you stop eating gluten, it allows your small intestine to begin to heal. It will soon be able to absorb nutrients again. But you need to be strict about following a gluten-free diet for life. Otherwise, gluten could hurt your small intestine again.

Other celiac disease treatments may include:

• Nutritional supplements to replace any serious deficiencies
• Medications to treat dermatitis herpetiformis, like dapsone
• Corticosteroids for severe inflammation

You’ll also need regular follow-up care, including frequent testing.

How long does the treatment take to work?

Most people say their symptoms improve almost immediately after starting to eat gluten-free. It may take several weeks to reverse your nutrient deficiencies. It may take several months for your gut lining to fully heal. It can take longer, in some cases. It depends on how damaged your gut is and how long the damage has been going on. Eating any amount of gluten (however small) can also delay healing.

What is the outlook for people with celiac disease?

Most people who stop eating gluten have an excellent prognosis. Most of the damage done by celiac disease can be undone. If you continue to have symptoms, it may be that you’re consuming small amounts of gluten without realizing it. It’s also possible you have another condition. A small percentage of people have a type of celiac disease that doesn’t respond to standard treatments.

A note from QBan Health Care Services

A celiac disease diagnosis will change your life in many ways and make you think twice before ordering anything off a menu. It might seem overwhelming at first. But the change that comes from getting this diagnosis is for the better. Before diagnosis, you didn’t know you needed to avoid gluten. You didn’t know what it was doing to your small intestine. You may have had strange and uncomfortable symptoms for years without understanding why. Now that you know, the power is in your hands to restore your health.

Diverticulitis is a complication that can affect people with diverticulosis, small pockets on the inside of their colon. If one of the pockets becomes injured or infected, it can cause inflammation inside. If you have a sharp pain in your lower left abdominal quadrant, it might be diverticulitis.

What is diverticulitis?

Diverticulitis is inflammation in your diverticula, which are small pockets that can develop on the inside of your colon. Having diverticula is called diverticulosis. It’s common as you get older, and most people never have any problems with it. But if one of your diverticula becomes inflamed, it can cause acute pain and other symptoms. It might mean that it has an infection, which needs medical attention.

How common is diverticulitis?

Although diverticulosis is common, diverticulitis is an uncommon complication. It affects about 4% of people with diverticulosis. Once you’ve had it, you have a 20% chance of getting it again.

Are there different types of diverticulitis?

Healthcare providers classify diverticulitis as acute or chronic and as complicated or uncomplicated.

Acute/chronic

Diverticulitis begins as an acute problem, which means that it comes on suddenly and goes away shortly with treatment. But some people have recurring (repeat) episodes of diverticulitis, and some people develop chronic inflammation. There are different theories about why this happens. It may be because an acute episode didn’t heal completely, or it may be related to another chronic condition in your colon.

Complicated/uncomplicated

Most of the time, diverticulitis is uncomplicated, which means that inflammation and possible infection are the extents of the problem. It heals easily with the right treatment. Diverticulitis becomes complicated when the inflammation begins to cause secondary problems. For example, severe acute inflammation may cause a diverticulum (singular of diverticula) to rupture. Chronic inflammation may cause scarring.

What are the symptoms of diverticulitis?

Symptoms may include:

• Abdominal pain, often severe.
• Distended abdomen or palpable colon (you can feel it with your hand).
• Fever.
• Nausea and vomiting.
• Rectal bleeding.
• Constipation or, less commonly, diarrhea.

What does a diverticulitis attack or flare-up feel like?

Whether you’re having an acute diverticulitis attack or a flare-up of chronic diverticulitis, the pain will be similar. An acute attack may come on more suddenly, while a chronic flare-up may build up over a few days. You should be able to locate it in the precise spot where your diverticulum has become inflamed. It may feel sharp and penetrating or have a burning quality. The pain is usually moderate to severe.

Where is diverticulitis pain located?

In people of European descent, diverticula most often occur in the last part of the colon, called the sigmoid colon. This segment begins on your lower left side and tilts slightly to the right to meet your rectum. For this reason, most people feel diverticulitis pain in the lower left quadrant of their abdomen. Occasionally, lower abdominal pain may also spread to your pelvis or radiate to your back.

However, in people of Asian descent, it’s more common to have diverticulosis in the first part of the colon, which is in your upper right quadrant. Diverticulitis here might cause upper abdominal pain.

What causes diverticulitis?

Inflammation in your diverticula often involves a tear in the lining and infection, though it’s not always clear which came first. On one hand, diverticula make great hiding places for bacteria to set up camp and multiply. This might happen if, for example, some poop gets stuck in one of them. A bacterial infection might trigger inflammation, and inflammation might cause a diverticulum to swell and tear.

On the other hand, if a diverticulum tears for another reason, it can easily become infected by normal levels of bacteria living in your colon. It might tear if hard poop stretches it while passing through, or if it’s been affected by general colitis (inflammation in your colon). Some studies have suggested that cytomegalovirus (CMV) infection in your colon might be a significant factor in triggering diverticulitis.

Is diverticulitis hereditary?

Diverticulitis seems to occur incidentally (by chance). But genetics might be partly involved in getting diverticulosis. Although you aren’t born with diverticulosis, you’re more likely to develop it in a certain part of your colon if you’re of European or Asian descent. It’s also possible that genetics could influence your likelihood of developing chronic inflammation. More research is needed on this subject.

What are the possible complications of diverticulitis?

Diverticulitis is uncomplicated 80% of the time. But severe or persistent diverticulitis can lead to complications such as:

• Gastrointestinal bleeding: Bleeding from diverticula can be severe and lead to anemia.
• Intestinal obstruction: Severe swelling might cause your colon to temporarily narrow. Chronic swelling might cause scarring (stricture), which can cause more permanent narrowing.
• Fistulas. An inflamed and eroded colon wall might fuse to another body canal (such as your small intestine, bladder or vagina), creating an inappropriate tunnel between the two.
• Bladder inflammation: Diverticulitis that’s close to your bladder may irritate it. A fistula to your bladder may also spread an infection there.
• Abscess: An abscess is a pocket of infected pus that may need to be drained. If it ruptures, it can infect your peritoneal cavity (peritonitis). This is an emergency.
• Gastrointestinal perforation: If a diverticulum becomes swollen enough to rupture (tear), it could allow intestinal bacteria to leak into your peritoneal cavity. Peritonitis can lead to sepsis.

What are the signs of complicated diverticulitis?

You might’ve developed complications if you notice:

• Fresh blood in your poop.
• Paleness in your face or you feel weak.
• You feel like you need to pee often or irritation when you pee.
• Your abdomen is rigid and sensitive to touch.

How is diverticulitis diagnosed?

If you and your healthcare provider already know that you have diverticulosis, they might recognize your symptoms as possible diverticulitis. But people often don’t know, and the symptoms of diverticulitis can resemble many other conditions. Your healthcare provider may begin with some routine tests to rule out other causes, such as a blood test (comprehensive metabolic panel), stool test or urine test.

When your provider suspects diverticulitis, they’ll look for it on imaging tests. A CT scan works well: it’s quick and can show the extent of the inflammation as well as any related complications. In some cases, your provider might need to look inside your colon with a lighted scope to investigate further. This is called a colonoscopy. They might be able to treat some complications during the colonoscopy.

Can diverticulitis go away on its own?

If it’s mild and uncomplicated, it can go away on its own. But you should still go to a healthcare provider to have it evaluated. They might need to give you antibiotics for an infection, and some people might need prescription pain medications. Your provider will also tell you how to care for yourself at home while you’re recovering. It takes about a week. They’ll want you to keep in touch during this time.

How do you treat diverticulitis at home?

If your healthcare provider has given you the go-ahead, you can treat diverticulitis at home with:

• A liquid diet. Avoiding solid foods gives your bowels a chance to rest and recover from the disease. Your provider can give you more specific instructions on what to eat and when.
• Prescription antibiotics. You may not need them, but if you do, your provider will give you some to take home with you. The type will depend on the kind of infection you have.
• Acetaminophen. For over-the-counter (OTC) pain relief, it’s best to stick to acetaminophen (Tylenol®). Other common pain relievers could increase your risk of gastrointestinal (GI) bleeding.

Drugs to avoid with diverticulitis

Healthcare providers suggest that you avoid NSAIDs when you have diverticulitis, as they can increase your risk of bleeding. NSAID stands for “nonsteroidal anti-inflammatory drugs.” These include:

• Aspirin (Bayer® or St. Joseph®).
• Ibuprofen (Motrin® or Advil®).
• Naproxen sodium (Aleve®).

What happens if diverticulitis goes untreated?

You may not need treatment if you have a mild and uncomplicated case. But it’s important to see a healthcare provider about diverticulitis. If you don’t, you may end up with a more severe and complicated case. Certain infections may need to be treated with antibiotics or antivirals to go away. Inflammation that doesn’t go away may begin to cause secondary problems. Pain may also worsen.

How do you get diverticulitis to go away?

If conservative at-home treatment hasn’t worked, or if you have severe, chronic or complicated diverticulitis, you may need to stay in the hospital for treatment. Treatment may include:

• IV medication. Your provider may give you antibiotics or antivirals through an IV line so that the medicine goes directly to your bloodstream. They may also give you pain relief this way. Some people may need strong analgesics, such as opioids.
• Blood transfusion. If you’ve lost a lot of blood from a bleeding diverticulum, you may need an emergency blood transfusion to replace it.
• Endoscopic procedures. Your provider might use a colonoscope or sigmoidoscope — different types of endoscopes that examine your colon — to treat minor complications. For example, they can often stop active bleeding, drain an abscess or open up a narrowed section of your bowel using tools passed through the endoscope.
• Surgery. Some people may need surgery to treat an abscess, persistent bleed, perforation (tear) or fistula. In rare cases of chronic diverticulitis, some people may need to have the problematic section of their bowel removed (colectomy). This might involve a temporary colostomy.

What can I expect if I have this condition?

Only a small percentage of people will have complicated diverticulitis, and only a small percentage of those will need surgery. In most cases, even complicated diverticulitis resolves quickly and completely with treatment. Diverticulitis shouldn’t affect your overall life expectancy. Only in the unlikely event of a bowel perforation or a ruptured abscess would you be at risk of life-threatening complications.

Can I prevent diverticulitis from occurring or returning?

Healthcare providers don’t know enough about why diverticulitis happens or why it returns to know definitively how to prevent it. But they suspect that general bowel wellness can help. Eating more plants and fewer animal fats, drinking enough water and getting some regular exercise can help keep your bowel movements healthy. For some people, they might recommend fiber supplements or probiotics.

Are there any dietary restrictions with diverticulosis or diverticulitis?

In the past, people with diverticulosis were told to avoid seeds and nuts, in case one might get stuck in a diverticulum and cause diverticulitis. This risk is considered mostly a myth today. Seeds and nuts are great sources of fiber and plant-based protein, and they tend to appear in healthy meals. It’s much better for your bowels to maintain a healthy diet overall than to worry about the rare chance of a seed going awry.

What should I do if diverticulitis keeps coming back?

If diet and lifestyle improvements haven’t prevented diverticulitis from recurring, there might be other factors involved that put you more at risk. People with weakened immune systems are more prone to frequent infections and slower to recover. People with autoimmune diseases are more likely to have chronic inflammation. Even the balance of different bacteria living in your gut may affect your gut immunity.

Healthcare providers don’t always know why diverticulitis continues to return in some people. But if it’s returned more than once, and if it’s brought complications at least once, they might suggest an elective bowel resection to resolve it. That means removing the small section of your colon that’s causing the trouble. If it’s not an emergency, you can probably do this as a one-step surgery without a colostomy.

A note from QBan Health Care Services

Diverticulitis is an uncommon complication of diverticulosis. Diverticulitis that causes its own complications is even less common. But if it happens to you, you might need urgent care. See a healthcare provider right away for symptoms of diverticulitis. They’ll figure out what kind of treatment you need and whether you can treat it safely at home, or if you need to stay in the hospital for treatment.