Specialist's Corner
Decoding digestive systems’ disorders
Digestion is an organic process that breaks down and transforms the food you eat into nutrients that pass through your intestinal wall to get into your bloodstream. It starts in your mouth, where you grind them and mix with your saliva, and then it continues in your stomach, which secretes digestive juices to break down the food for a few hours. When the predigested food leaves your stomach, your intestine continues to digest them by adding digestive juices from your pancreas and gallbladder. The resulting nutrients cross the wall of your intestine and circulate in your blood to be used by the organism. What has not been absorbed, added to the dead cells of your intestinal wall, turns into fecal matter in your colon. Disorders in the digestive system (gastrointestinal) are all problems and diseases that simultaneously affect several parts of the digestive system, while others only affect one part or one organ. There are many of them, their cause varies and can also be attributed to food allergies or intolerances.
Functional Digestive Disorders or Dyspepsia: Functional digestive disorders are not related to a digestive disease or organic lesion, but to a malfunction of the digestive system. They manifest as stomach digestive disorders, or dyspepsia (loss of appetite, nausea, heartburn, rashes, bloating) or intestinal digestive disorders (bloating, intestinal gas). Dyspepsia manifests itself in the stomach through difficult digestion that causes bloating, nausea and the impression that your stomach is constantly full. The causes of functional digestive disorders may include: A big meal that is difficult to digest (like fats, spices, and acidic foods), eating food without chewing it enough (eating too fast), drinking soft drinks or abusing alcohol, and excessive stress or emotions. Aerophagy is caused by a large amount of air in the stomach that causes swelling and pain in the intestine and rash. It usually occurs if you swallow too much air during your meals or when you swallow during the day, or if you chew gum or smoke. Pregnant women are more likely to suffer from aerophagy. Irritable bowel syndrome (or functional colopathy) manifests as intestinal pain, as well as bloating, flatulence and diarrhoea. The triggering factors are often the same as for dyspepsia, and pain is caused by the rate at which food progresses in the colon (too slow or too fast). Certain foods may promote pain (dry vegetables, cabbage, garlic, onion, fennel, celery, radish, leeks, artichokes, fries, fatty meats, sauces and fermented cheeses).
There are many diseases of the digestive system and they can be caused by multiple factors. Gastroesophageal Reflux Pathology (GERD): It occurs when some of the stomach contents rise into the esophagus (the tube connecting the mouth to the stomach). The stomach produces gastric juices, very acidic substances that help digest food. However, the esophageal wall is not designed to withstand the acidity of the stomach contents. Reflux causes inflammation of the esophagus, resulting in burning and irritation. Over time, it can result in lesions in the esophagus.
Gastroduodenal Ulcer: Called a gastric ulcer if it is located in the stomach and duodenal if it forms in the duodenum (the first part of the small intestine), this ulcer is erosion that penetrates deeply into the wall of the digestive track. It is often painful because it comes into direct contact with the acid present in the digestive tract. Non-steroid or NSAID anti-inflammatory drugs (e.g. aspirin, ibuprofen) are the second most common cause of ulcers in the digestive tract. The combination of an H. Pylori bacterial infection and anti-inflammatory use increases the risk of synergistic ulcers (the risk is 60 times greater). Excessive acid production by the stomach (hyperacidity) due to smoking, excessive alcohol consumption, major stress, or a hereditary predisposition can also cause ulcers.
Hiatal Hernia: Hiatal hernia occurs when the stomach comes up in part through a small opening called the esophageal hiatus, located in the diaphragm, the respiratory muscle that separates the chest cavity from the abdomen. There are two main types of hiatal hernia: Sliding hiatal hernia or type I, which accounts for about 85 to 90% of cases. Paraesophageal or rolling hernia or type II. This hernia usually causes no symptoms, but can be severe in some cases. The exact causes of hiatal hernia are not clearly known. In some cases, it is congenital (present at birth) and caused by an abnormality of the hiatus that is too broad, or the entire diaphragm that is poorly enclosed. However, a vast majority of these hernias appear at some point in life and are more frequent among the elderly.
Vesicular Lithiasis and Biliary Colic: Vesicular lithiasis is the formation of stones within the gallbladder, the organ that stores bile secreted by the liver. Theses stones look like little pebbles. In most cases, they are composed of crystallized cholesterol. The shape, size and number of stones (there may be several hundred) differ from one individual to another. They can be as small as a grain of sand or as large as a golf ball. Biliary lithiasis, or gallbladder stones, is quite widespread and affects 2 to 3 times more women than men. A hepatic colic or biliary colic attack is caused by the passage of a gallstone into the gallbladder, temporarily blocking it and momentarily preventing the bile from draining. These attacks can last an average of 30 minutes to 4 hours. Pain fades when the gallstone dislodges itself, allowing the bile to flow again. An attack can occur at any time of day with no triggering event. Cholesterol gallstones are formed when there is too much cholesterol in the bile; there is not enough bile salt in the bile; the gallbladder does not contract regularly. In the vast majority of cases, biliary lithiasis does not cause symptoms. Gallstones are therefore discovered when examining the bladder, most often with an ultrasound.
Diverticulosis and Diverticulitis: From the age of 40, diverticula can form in the large intestine. These are small outer protrusions, like small “pockets” the size of a marble, located in different locations in the large intestine. Diverticulosis mainly affects the colon or large intestine. However, diverticula can be found throughout the entire digestive tract, including the esophagus, stomach and small intestine. Diverticulitis is an inflammation of the diverticula associated with an infection. Diverticulosis is a common phenomenon, and in western countries it is found in about 50% of people over the age of 60. Most of the time, diverticula do not cause any symptoms. They are often discovered during a routine examination for other digestive problems. However, diverticulitis (inflammation and infection of diverticula) causes severe pain. A sedentary lifestyle with no physical activity and a diet with not enough fibre are often involved.
Appendicitis: Appendicitis is a sudden inflammation of the appendix — a small worm-shaped protrusion located at the beginning of the large intestine, on the lower right side of the abdomen. It most often occurs between the ages of 10 and 30. It affects one in 15 people, and slightly more often in men than in women. Appendicitis must be treated promptly or the appendix could burst. This can cause peritonitis, which is an infection of the peritoneum, the thin wall that surrounds the abdominal cavity and contains the intestines. In some cases, peritonitis can be fatal and requires emergency medical treatment. Initial pain symptoms usually occur near the navel and gradually progress to the lower right hand side of the abdomen. Removal of the appendix by surgery (appendicectomy) constitutes the most efficient way to treat acute appendicitis.
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