Everyone has digestive problems from time to time—an upset stomach, gas, heartburn, constipation, or diarrhea. Many digestive problems may be uncomfortable or embarrassing, but they are not serious and don't last long. Others can be controlled with simple changes in your diet. But sometimes even common digestive symptoms can be signs of a more serious problem. Knowing when you should talk to your doctor can help you take care of your digestive health.
How the digestive system works
The digestive tract is a series of hollow organs—the mouth, esophagus, stomach, small intestine, large intestine (colon), rectum, and anus—through which food and liquids pass and are absorbed or eliminated. Along the way, two solid digestive organs, the liver and the pancreas, add digestive juices to help break down food into nutrients that can be absorbed by the body. Another organ, the gallbladder, stores bile between meals. Bile is the digestive juice produced by the liver that helps digest fats. At mealtime, the gallbladder empties bile into the small intestine. Most nutrients in digested food are absorbed through the walls of the small intestine and travel through the bloodstream to other parts of the body. There, they are used to build and nourish cells and provide energy. Waste products, including the undigested parts of food known as fiber, leave the body through bowel movements.
Common signs of digestive problems
Common digestive complaints such as nausea, vomiting, bloating, gas, heart-burn, diarrhea, and constipation can be temporary. They can be caused by certain types of food, food contaminated with harmful bacteria, flu or other short-term illness, menstruation, or pregnancy. But sometimes these symptoms are signs of a more serious digestive disease or other health problem.
Some digestive problems, such as irritable bowel syndrome and gallstones, are more common in women than men. Others occur equally in both sexes, but affect women in unique ways. For example, women with inflammatory bowel disease may have irregular menstrual periods. Some women with celiac disease experience infertility or miscarriage. And heartburn caused by gastroesophageal reflux is especially common in pregnancy. Here is an overview of the most common digestive disorders affecting women.
Irritable Bowel Syndrome (IBS)
What it is
Irritable bowel syndrome (IBS) is not a disease but a syndrome, meaning a group of symptoms. Since IBS affects the way the digestive system functions but does not damage it, IBS is called a "functional disorder."
Up to one in five Americans has IBS. IBS often begins before the age of 35, but it can start at any age. IBS seems to run in families--people with IBS often report having a family member with IBS. Most people diagnosed with IBS (up to 75 percent) are women. But, it is not known for sure that IBS affects more women than men. It may be that women are more likely to talk to their doctors about their symptoms.
People with IBS most often have abdominal pain, bloating, and discomfort. Some people have constipation—infrequent bowel movements with hard, dry, or difficult-to-pass stools. Other people with IBS have diarrhea—frequent loose, watery stools. Still others go back and forth between constipation and diarrhea. Sometimes a person with IBS has a crampy urge to empty the bowels but cannot do so. Symptoms may go away for a few months, then return. Or symptoms may be constant and worsen over time.
Other symptoms include:
- mucus in the stool
- feeling like you haven't finished a bowel movement
- discomfort in the upper stomach area or feeling uncomfortably full or nauseous after eating a normal size meal
Some women with IBS have more or different symptoms during their menstrual periods. Constipation may be relieved or diarrhea may occur in the day or two before or when their period starts.
The exact cause is unknown, but in people with IBS, the colon seems to be extra sensitive to certain foods and stress. Normally, women are more sensitive to irritants in the digestive tract than men. This may help explain why IBS is more common in women. Hormones may play a role as well. Symptoms often become worse just before or at the start of a woman's period. Having IBS can disrupt your everyday life. Pain that comes on without warning and the need for frequent bathroom trips can get in the way of social activities and work. You may be embarrassed, frustrated, or anxious about the lack of control over your symptoms. IBS might cause problems in your sex life, such as painful intercourse or loss of interest in sex. These stressful feelings in turn can make symptoms worse.
If you think you may have IBS, see your doctor. Your doctor will take a medical history and ask about your symptoms and perform some medical tests.
There are no tests that can show for sure that you have IBS. But your doctor may do some medical tests to make sure you don't have any other diseases that could cause your symptoms. Other possible causes include polyps, inflammation, or intolerance of foods containing a protein called gluten. Medical tests that may be done include:
- Physical exam
- Blood tests
- X-ray of the bowel: This x-ray test is called a barium enema or lower GI (gastrointestinal) series. Barium is a thick liquid that makes the bowel show up better on the x-ray. Before taking the x-ray, the doctor will put barium into your bowel through the anus.
- Endoscopy: The doctor inserts a thin tube into your bowel. The tube has a camera in it, so the doctor can look at the inside of the bowel to check for problems.
Sometimes other tests need to be done to check how fast or slow food or liquid moves through the colon, or to check to see if the anal muscles are working correctly.
There is no cure for IBS, but there are things you can do to feel better. You can often control mild symptoms by making changes to your diet and lifestyle. Fiber supplements or over-the-counter medicines to control diarrhea may help, too. Prescription drugs are sometimes used to treat women with severe IBS, but some may have serious side effects. Researchers are studying new drugs and other approaches to relieve symptoms of IBS. Treatment may include:
Foods that can make IBS worse:
- milk products, like cheese or ice cream (people who have trouble digesting lactose, or milk sugar could be extra sensitive)
- caffeine (found in coffee, tea, and some sodas)
- carbonated drinks like soda
- Sorbitol, a sweetener found in dietetic foods and in some chewing gums
- gas-producing foods including beans and certain vegetables like broccoli or cabbage
To learn about your triggers, try keeping a food diary. Write down:
- what you eat during the day
- what symptoms you have
- when symptoms occur
- what foods always make you feel bad
Foods that may make IBS better:
Fiber lessens IBS symptoms--mainly constipation because it makes stool soft, bulky, and easier to pass. Fiber is found in bran, whole-grain bread and cereal, beans (for kidney, lima), fruits (apples, peaches), and vegetables (broccoli, cabbage, carrots, peas).
Add foods with fiber to your diet a little at a time to let your body get used to them. Too much fiber all at once might cause gas, which can trigger symptoms in a person with IBS. If you have constipation, start by adding 12 grams of fiber per day. You may have to raise or lower the amount of fiber to a maximum of 30 grams per day, based on how fiber affects your bowel function and gas production.
Your doctor might also suggest a fiber pill or drinking water mixed with a special high-fiber powder.
Opt for smaller meals
Large meals can cause cramping and diarrhea in people with IBS. If this happens, try eating four or five small meals a day. Or, have your usual three meals, but eat less at each one.
If necessary, your doctor may give you medicine to help with symptoms:
- laxatives: to treat constipation
- antispasmodics: to slow contractions in the bowel, which may help with diarrhea and pain
- antidepressants: to help with severe pain
Take your medicine exactly as your doctor tells you to. Some medicines, including laxatives, can be habit-forming, and all drugs have side effects. Remember to tell your doctor about any over-the-counter medicines you are taking.Stress relief
Stress does not cause IBS, but it can worsen your symptoms. Learning to reduce stress can help. With less stress, you may find that you have less cramping and pain.
Meditation, yoga, massage, exercise, hypnotherapy, and counseling are some things that might help. You may need to try different activities to see what works best for you.
- Drink 6 to 8 glasses of water each day.
- Exercise can help with constipation and improve your overall health. Exercise helps relieve stress and depression and helps your bowel function as it should.