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.
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.
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.
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.
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:
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).
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.
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.
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."
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.