Digestive Disorders

Is it okay to take a PPI for heartburn indefinitely?

DEAR DOCTOR K: I've had heartburn for years, and I began taking Prilosec as soon as it became available. It gives me relief, but I worry about taking any drug for a long time. Should I be worried?

DEAR READER: As I've often said, no drug is 100 percent safe. That doesn't mean that you shouldn't take one if you need it. But you should continually weigh the risks and benefits.

What is an abdominal aortic aneurysm?

DEAR DOCTOR K: I had pain in my abdomen, so my doctor did an ultrasound to check for gallstones. It turns out I have an abdominal aortic aneurysm. What is that?

DEAR READER: The aorta is the body's largest artery. It carries oxygen-rich blood from the heart to every part of the body. The aorta curves out of the heart and through the chest, then passes down the center of the body before dividing into the arteries that serve the legs.

What diet can help with IBS?

DEAR DOCTOR K: I have irritable bowel syndrome (IBS), and I hear there is a diet to help that. Can you tell me about it?

DEAR READER: Unfortunately, IBS is pretty common. Symptoms include cramping, diarrhea, gas and bloating. But you are right: Research has identified certain foods that tend to trigger IBS, and avoiding these foods can help you reduce your symptoms.

Should I stop taking my PPIs?

DEAR DOCTOR K: I've been taking PPIs for years to treat my heartburn. Now I hear they might increase my risk for a heart attack. Should I stop taking them?

DEAR READER: Proton pump inhibitors, or PPIs, are antacid drugs used to treat some ulcers, heartburn (GERD) and other causes of upset stomach. These popular drugs include the brand names Prilosec, Nexium and Prevacid. PPIs, available over the counter, have been considered quite safe.

Which laxative should I take for my constipation?

DEAR DOCTOR K: There are so many laxatives on the market. Which one should I take for my constipation?

DEAR READER: Anyone suffering from constipation should start by boosting fiber and fluid intake. That may do the trick, and you may not need a laxative. If you are age 50 years or younger, the target is 38 grams of fiber per day for men and 25 grams per day for women. For men and women over 50, aim for 30 and 21 grams per day, respectively.

Non-surgical treatments for fecal incontinence

DEAR READER: In yesterday's column I discussed non-surgical treatments for fecal incontinence. Today, I'll discuss surgical treatment options. When everything works properly, feces move from the colon into the rectum, which sits at the end of the digestive tract. The rectum has walls that stretch to hold the stool. Two circular muscles are present in the last inch of the rectum, or anal canal.

What are effective treatments for fecal incontinence?

DEAR DOCTOR K: In an earlier column, you wrote about causes of fecal incontinence. You mentioned that there are effective treatments. Can you tell us about them?

DEAR READER: Although there are surgical treatments for fecal incontinence, simpler treatments usually do the trick. They range from dietary changes to bowel training. Today I'll discuss non-surgical treatments. In tomorrow's column I'll discuss surgical treatments. One of the most effective ways to reduce fecal leakage is to increase your fiber intake.

What can I do to stop passing gas?

DEAR DOCTOR K: All my adult life I've had a tendency to pass a lot of gas. It's unpleasant for me and for others. What can I do about it?

DEAR READER: All human beings pass gas to some extent. That's because all of us have gas (mostly swallowed air) in the digestive tract. Along with the air you swallow, the bacteria that live in your gut also produce gas -- up to two quarts a day. You may have noticed that this air moves in your digestive tract. You can feel it, and you can sometimes hear it. It's not really your stomach that is "growling": It's your gut gas gurgling.

How can I get rid of bloating?

DEAR DOCTOR K: I feel bloated and my belly looks larger than normal. Is this due to excess gas? What can I do to feel better?

DEAR READER: That feeling of fullness and tightness in the abdomen is called bloating. Distension is the term for the increased size of your abdomen. Excess gas is probably not to blame for either problem. It makes sense to think that bloating and distension would be due to excess gas. But scientists have measured gas content in those who have bloating and distension, and people with these symptoms do not have more gas than people without symptoms.

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: