Digestive Disorders

Has colonoscopy prep changed in the last decade?

DEAR DOCTOR K: It's been 10 years since my last colonoscopy. I'm dreading my next one, especially drinking a gallon of liquid laxative. Has colonoscopy prep gotten more tolerable in the last decade?

DEAR READER: Yes, but that still doesn't make it fun. And you can't avoid it: You want the doctor to be able to clearly see every inch of your colon. For that, you need a good cleanout. As you probably know, getting a periodic colonoscopy really is important. Simply put, it reduces your risk of getting and dying from colon cancer. These cancers, and growths that can turn into cancer (polyps), not only can be spotted by colonoscopy:

What can I do about my esophagitis caused by acid reflux?

DEAR DOCTOR K: I have esophagitis. Could this have been caused by my acid reflux? What can I do about it?

DEAR READER: Yes, it could, and there are treatments. First, some explanation. The esophagus is the muscular tube that carries food from the mouth, through the chest and into the stomach. Normally you don't feel the presence of the esophagus, except when you are swallowing. Sometimes the lining of your esophagus becomes inflamed. That's called esophagitis. By far the most common cause of esophagitis is acid reflux, or gastroesophageal reflux disease (GERD).

How can you prevent developing colon polyps?

DEAR DOCTOR K: My young son had rectal bleeding caused by a colon polyp, which the doctor surgically removed. Why did he develop a polyp? Can we do anything to prevent more polyps from forming?

DEAR READER: Colon polyps are growths of tissue inside the colon (large intestine). I've put an illustration of a colon polyp below. Most people think of colon polyps as a problem only for adults, but children also get colon polyps. In fact, they are a relatively common cause of bleeding from the rectum in children.

Aren’t antibiotics supposed to kill bacteria? If so, how did I get C. diff?

DEAR DOCTOR K: I took an antibiotic before having some dental work done. I ended up in the hospital with severe diarrhea caused by something called "C. diff." I was told it was a kind of bacteria, but aren't antibiotics supposed to kill bacteria? Can you explain?

DEAR READER: You heard the doctors correctly: "C. diff" is shorthand for a bacterium known as Clostridium difficile. It lives inside our intestines, along with trillions of other bacteria. Normally, the harmful C. diff bacteria are far outnumbered by other bacteria in our intestines. These other bacteria keep C. diff under control. For this reason, we'll call them "good" bacteria.

What is inflammatory bowel disease (IBD)?

DEAR DOCTOR K: What is inflammatory bowel disease?

DEAR READER: Inflammatory bowel disease (IBD) usually refers to two conditions: Crohn's disease and ulcerative colitis. Both cause ongoing inflammation of the digestive tract. In both types of inflammatory bowel disease, the body's immune system starts attacking the intestinal tissue. This attack may be an example of "collateral damage."

Will probiotics help my constipation?

DEAR DOCTOR K: I suffer from constipation. Do you think probiotics might help?

DEAR READER: Probiotics are living bacteria found in cultured foods, like yogurt, and in dietary supplements. They have long been touted for their ability to ease digestive woes. The strongest evidence for probiotics is in treating diarrhea caused by a viral infection or from taking antibiotics. Our bodies are home to a mix of "good" and "bad" bacteria.

Why should I cut back on my heartburn medication?

DEAR DOCTOR K: For years I've been taking a PPI twice a day for heartburn. My doctor wants me to cut back, or stop altogether. But the idea frightens me. Do you think it's possible?

DEAR READER: To anyone tormented by frequent heartburn, not taking your daily tablet -- or tablets -- of omeprazole (Prilosec) or lansoprazole (Prevacid) might seem like a scary idea. These and similar drugs, known as proton pump inhibitors (PPIs), are the foundation of treatment for heartburn, also known as gastroesophageal reflux disease (GERD).

What are natural methods of treating irritable bowel syndrome (IBS)?

DEAR DOCTOR K: I have irritable bowel syndrome with alternating constipation and diarrhea. Will eating more fiber help? What about probiotics or other non-medical treatments?

DEAR READER: Irritable bowel syndrome (IBS) is a common intestinal disorder with many unpleasant symptoms. Many people with IBS go back and forth between diarrhea and constipation, with pain and bloating in between. Others always have diarrhea or constipation. Unfortunately, there is no cure for IBS. However, there are a number of things you can do to improve your symptoms. Adding fiber to your diet can help relieve constipation.

Can lifestyle changes help relieve heartburn?

DEAR DOCTOR K: Can lifestyle changes help relieve my heartburn?

DEAR READER: Heartburn is an uncomfortable burning sensation that radiates up the middle of your chest. It results from a condition called gastroesophageal reflux disease (GERD), or "reflux." With GERD, stomach acid surges up into the esophagus, the "swallowing tube" that connects our mouth to our stomach.

How can I stop excessive burping?

DEAR DOCTOR K: I burp constantly. What can I do to stop it?

DEAR READER: Occasional burping usually results when foods produce gas during the digestive process and that gas escapes through your mouth. But if you're burping frequently, it is almost certainly the result of swallowing air. Many people swallow air when they breathe or speak without even realizing it. You can probably reduce your belching by making lifestyle changes to decrease the amount of air you swallow. For example, don't drink through a straw or chew gum. If you smoke, quit. Getting properly fitted dentures can help too, since loose dentures can also cause you to swallow air.