Disorders of the Bowel

Inflammatory Bowel Disease (IBD) is a group of inflammatory conditions of the large intestine and, in some cases, the small intestine. Two common forms of IBD are:

• Crohn’s disease, a chronic disorder that causes inflammation of the digestive or gastrointestinal (GI) tract. It most commonly affects the small intestine and/or the colon. The lining of the bowel becomes inflamed and can become ulcerated. Eventually, the bowel may become narrowed or obstructed. Crohn’s often occurs in families. The body’s immune system, which normally protects the body against many different infections, is altered in Crohn’s disease.

• Ulcerative colitis, a chronic inflammatory condition that involves only the colon. It is similar to Crohn’s disease in that it involves an abnormal response by the body’s immune system. Cases that can’t be diagnosed as either ulcerative colitis or Crohn’s disease are called indeterminate colitis.

Other bowel disorders include:

• Diverticulosis/Diverticulitis — as people age, pressure within the colon causes bulging sacs of tissue that push out from the colon walls (one sac is a diverticulum, and more than one are diverticula). These sacs are most common near the end of the colon called the sigmoid colon. The condition of having diverticula in the colon is called diverticulosis, which may have few or no symptoms. If a diverticulum becomes infected and ruptures, it is called diverticulitis.

• Irritable bowel syndrome (IBS) — a disorder involving the movement of the bowel (intestines). In IBS, the nerves and muscles in the bowel are overly sensitive. The disorder is most often identified by its symptoms: abdominal pain or discomfort associated with a change in bowel pattern, such as loose or frequent bowel movements, diarrhea or constipation. IBS is a functional disorder, which means the bowel doesn’t function correctly (vs. a problem with the structure of the bowel).

• Celiac disease — an inherited disorder that causes damage to the small intestine and interferes with the absorption of nutrients. People who have celiac disease cannot tolerate gluten, a protein found in cereal grains such as wheat, rye and barley.

• Nutritional disorders — disorders that results from eating too little or too much food, or from eating too little or too much of a particular nutrient (vitamin or mineral). Nutritional disorders can also develop when the body can’t digest the nutrients it takes in (malabsorption).

Diseases of the Stomach

Diseases and disorders of the stomach include:

• Dyspepsia — a functional disorder of the stomach involving symptoms such as heartburn, nausea, pain or general discomfort (also called an upset stomach or indigestion). The cause is unknown. Symptoms include upper abdominal pain, bloating, a feeling of fullness (with little intake of food), nausea or belching. Symptoms are often provoked by eating. Many people who have dyspepsia may also have irritable bowel syndrome.

• Cyclical vomiting syndrome (CVS) — a condition involving recurrent, prolonged episodes of severe nausea and vomiting with no apparent cause, with normal periods of health in between. See Cyclical Vomiting Syndrome Clinic.

• Gastroparesis (stomach paralysis) — a disorder in which the stomach is unable to contract normally, and cannot move food into the small intestine. This occurs when nerves to the stomach are damaged or stop working. People with autoimmune nervous system dysfunction or diabetes may experience this disorder.

• Gastric outlet obstruction — a disease (e.g., a tumor) that obstructs the channel through which the stomach empties and thus prevents the normal emptying of the stomach.

• Gastritis — inflammation of the lining of the stomach (may be acute or chronic). It can have many causes, including prolonged use of nonsteroidal anti-inflammatory medications (NSAIDs) such as aspirin or ibuprofen, H. pylori infection or alcohol abuse. Symptoms include abdominal pain, belching, bloating, nausea, vomiting and a feeling of fullness or burning. Endoscopy is used to view the stomach lining to check for inflammation and possibly remove a tissue sample for testing.

• Hiatus (hiatal) hernia — a protrusion of the upper part of the stomach into the chest through a tear or weakness in the diaphragm

• Lymphoma — MALT (mucosa-associated lymphoid tissue) is a type of lymphoma (cancer that arises from the lymph tissue) found in the stomach. H. pylori bacterium are believed to be involved in causing MALT lymphoma. (H. pylori infection is usually acquired from contaminated food and water and through person to person spread.) Endoscopic ultrasound (EUS), along with other procedures, may be used to view the size and depth of the tumor. Treatment may include the use of antibiotics to wipe out the bacteria or radiation therapy.

• Ulcer — an open sore on the lining of the stomach (gastric ulcer) or duodenum (duodenal ulcer). Peptic ulcers occur in areas that come in contact with digestive juices from the stomach. They may be caused or worsened by prolonged use of over-the-counter, nonsteroidal anti-inflammatory medications (NSAIDs) such as aspirin or ibuprofen, or by a bacterial infection (H. pylori). (H. pylori infection is usually acquired from contaminated food and water and through person to person spread.)

• Stomach tumors — tumors (benign or malignant) that form in the lining of the stomach. Symptoms may include bleeding, obstruction and weight loss.

• Varicose veins — varicose veins are blood vessels that bulge and twist due to a defect in the valves. Varicose veins may be present in the esophagus or stomach as a result of liver disease or blood clots in the portal vein system. Large varicose veins in the esophagus or stomach can rupture and bleed.