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My father recently suffered from a severe bout of ulcerative colitis; he developed painful ulcers in his colon or large intestine, and began bleeding profusely through the stools. Despite his gastroenterologist's best efforts to heal him using medicine, he finally had to undergo surgery. Now, he is recovering slowly but steadily and as they say, all's well that ends well; the New Year began on an optimistic note for this family.
Ulcerative colitis is a common occurance in the West. However, the number of cases of gastro-intestinal disorders like UC in India, is gradually rising. A local newspaper in Goa, reported that the state is witnessing an alarming increase in the number of people with gastrointestinal disorders. According to consultant gastroenterologist Dr Jose Filipe Alvares at Apollo-Victor Hospitals, Goa, many of his patients are in their 20's, 30's and 40's as opposed to their 60's and 70's as was the case earlier.
"This is due to the diet/lifestyle habits of today's generation," he says. This trend also applies to people in other metros too, where fast food, take-out and dining out, are burgeoning trends. Much has been written about eating habits and heart disease.
In this article Dr Alvares, who has 19 indexed publications in Indian and International journals to his credit and was an associate professor of gastroenterology for 31/2 years at Manipal Hospital, shares valuable insights on gastrointestinal disorders and their symptoms and his advice for a healthier digestive system.
Symptoms of digestive disorders
If you experience any of the following symptoms it is preferable to visit a gastroenterologist (a doctor who specialises in health problems related to your digestive system) as opposed to your GP.
Once you experience any of these symtoms, you may have to undergo a procedure known as a colonoscopy, which is used to determine whether you have any disorders in the colon and the terminal part of the small intestine. It takes about five to 10 minutes to complete.
To put it simplistically, the job of the colonoscope is to take pictures of the internal part of the colon, so that the doctor can diagnose the problem. No anaesthesia is administered except in children and you may experience a minor discomfort as the colonoscope is inserted through the anus. Diseases like ulcerative colitis, crohn's disease, tuberculosis of colon, colonic cancers and polyps, infective colitis etc can be diagnosed by it.
List of digestive disorders
~ Irritable bowel syndrome (lose motions or constipation): This is a bowel disorder with abdominal pain and disordered defecation ie constipation or diarrhoea, and may be associated with mucus in the stools. It is a very common amongst those in their 20's.
~ Ulcerative colitis (ulcers in the colon ie the large intestine): An inflammatory bowel disease, for which the cause is not yet known. You will notice blood and mucus in the stools. Dr Alvares sees one new case of ulcerative colitis every week.
~ Crohn's disease: A bowel disease, which can be confused with tuberculosis. You may suffer from loose motions, weight loss, fever and intestinal obstruction.
~ Gastronomical cancer: It could be oesophageal, gastric, colonic, pancreatic or liver cancer.
According to Dr Alvares, he sees at least one patient a day with this condition. The main symptom is bleeding through the rectum.
~ Gastroesophageal reflux disease: This disease can result in esophageal narrowing (strictures) or development of barretts esophagus, which can lead to cancer of the esophagus. Smoking, alcohol and obesity can precipitate the symptoms in above patients. This disease is often caused by excessive smoking.
~ Obstructive jaundice: A term used when your bile duct gets blocked by gallstones, malignancies etc. Patients complain of jaundice and itching and an endoscopic method called ERCP is used for clearing this obstruction; if there are stones in the bile duct, they are removed without surgery by ERCP.
~ Pancreatitis: A condition where the pancreas get inflamed, and the patient complains of abdominal pain and vomiting. It can be acute or chronic. Amongst the common causes are alcohol and gallstones.
~ Cirrhosis of the liver (due to excessive consumption of alcohol): It is an end stage liver disease. The usual causes are alcohol, hepatitis B, hepatitis C, autoimmune hepatitis. There are other causes like Wilson's disease, hemachromatosis and non-alcoholic steato-hepatitis etc.
According to the findings your doctor will decide whether the problem can be healed using medication, therapeutic endoscopies or surgery. "We try to heal patients as far as possible using therapeutic endoscopies ie healing without surgery. For instance, gall stones can be removed without cutting up a patient," says Dr Alvares. Surgery is the last option when all else fails.
A balanced diet is a must for good digestive health. Here are some key mantras.
1. Limit your consumption of red meat ie beef, mutton and pork to once or twice a week.
2. Your diet must contain green, leafy vegetables.
3. Improve the fibre content in your diet by consuming vegetables and fruits, bananas in particular.
4. There's a debate on as to whether multi-vitamins supplements are beneficial. However, Dr Alvares recommends having one supplement a day.
5. Limit consumption of alcohol to not more than one drink a day.
6. Smoking is a complete no-no, period.
7. Deep-fried food or 'junk food' is not good for the stomach or the heart. It is advisable to limit consumption to maximum twice a week. Cooking with virgin olive oil is best, followed by olive oil. A more economical and healthy option would be groundnut oil.
8. If you tend to eat out a lot, it is advisable to consume lots of vegetables (however not deep-fried) and also choose hygienic venues.
9. Have your food on time. Skipping meals or delaying them could result in acidity in the stomach. This has dyspeptic symptoms like abdominal pain and discomfort in the upper abdomen. Prolonged fasting is also not good for health.
10. Consume at least eight glasses of water a day.
12. Restrict consumption of foods with extra salt like dried or salted fish (commonly consumed in Goa) to once or twice a week.
13. When pickles catch a fungus do not merely throw away the part visible with fungus. It is advisable to throw away the entire pickle bottle.
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