Digestive Disorders

Digestive Disorders: Understanding and Diagnosis

Digestive system disorders causing indigestion are among the most common ailments in the population. Signs of indigestion are observed in varying degrees in almost a quarter of the world’s population, yet most do not seek medical help and self-treat, which can lead to complications in some cases. Digestive system disorders may manifest early in life or in youth and progress to become chronic.

Types of Digestive Disorders:
Digestive disorders can be divided into two main groups. The first includes diseases caused by deficiencies in enzymes in the pancreas and the necessary substances for food digestion, such as gastric juice and bile. These conditions are characterized by symptoms such as heartburn, regurgitation, abdominal bloating, cramping, and lower pelvic pain. The second group includes disorders caused by disturbances in intestinal absorption processes. These disorders are characterized by spasmodic pain, increased bowel movements (rumbling) in the abdomen, bloating, unstable bowel movements (either constipation or diarrhea), fatigue, and muscle weakness.

Possible Causes of Indigestion:

One of the most common causes of indigestion is a disorder of esophageal motility. Disorders in esophageal motility lead to difficulty in food passage to the stomach and, conversely, ease of concentrated gastric juice reaching the esophageal walls. Another important cause is functional dyspepsia, which combines cases where a temporary disorder (no more than 3 months) in the activity of the stomach, duodenum, and pancreas is involved. Patients complain of pain or discomfort in the lower pelvic area, heaviness and feeling of fullness in the stomach after eating a normal amount of food, abdominal bloating, nausea, vomiting, regurgitation, and heartburn. The pain typically occurs cyclically (in the morning on an empty stomach or at night) and quickly subsides after eating or taking medications that reduce stomach acidity. If the pain is localized on the left side of the lower pelvis or spreads, there may be suspicion of pancreatic problems, and if it’s on the right side, there may be a disorder in the liver and gallbladder.

Functional Biliary System Disorders:
Digestive problems may arise as a result of functional disorders in the biliary system (biliary secretion system). These disorders involve a disruption in the coordination of gallbladder and sphincter of Oddi muscle function, through which bile flows into the small intestines. When the Oddi sphincter muscle spasms, not only does bile accumulate in the gallbladder, but there is also a disruption in pancreatic function, leading to the appearance of acute pain, often localized on the right side of the lower pelvis and may extend to the back.

Irritable Bowel Syndrome:
Irritable bowel syndrome is a painful condition where pain or discomfort fades after bowel movements. Stools in this condition are irregular with a predominance of diarrhea or constipation. Causes of irritable bowel syndrome include infectious diseases, nervous stress, unhealthy nutrition, excessive consumption of gas-producing substances, and overeating.

Diagnosis and Tests:
When esophageal disease is suspected, a barium swallow imaging is arranged to identify barium passage disorder into the stomach and esophageal dilation. Esophageal manometry and esophageal endoscopy are performed to rule out organic diseases in the esophagus. Diagnosis of functional dyspepsia usually includes clinical blood analysis, biochemical blood analysis, stool analysis for occult blood, C-urea test to diagnose Helicobacter pylori infection, upper gastrointestinal endoscopy to evaluate the condition of the stomach wall and exclude ulcers and tumors, and ultrasound of the liver, gallbladder, and pancreas to clarify their condition. Additionally, additional tests such as computed tomography, magnetic resonance imaging, barium enema, and sphincter of Oddi manometry may be arranged.

Medical Guidance:
It is important to remember that the initial symptoms of spasms and esophageal motility disorders usually appear in childhood (regurgitation, sudden vomiting of undigested food immediately after eating, and swallowing pain) and require consultation with a pediatrician. If these symptoms persist for a long period (more than a month) in adults, they should visit a family doctor for guidance on gastrointestinal examination and referral to a gastroenterologist.

Managing Digestive Disorders:

Preventive Measures:
First and foremost, it’s important to reduce the intervals between meals and decrease meal sizes. Avoiding hot or cold food is advised, and food should be chewed carefully. Bending or lying down immediately after eating should be avoided. If there are suspicions of functional digestive disorders, consumption of fatty, fried, and spicy foods, as well as strong coffee and tea, should be reduced. It’s preferable to refrain from smoking, alcohol consumption, and taking painkillers.

Treatment of Digestive Disorders:

As an initial treatment for esophageal motility disorder, the doctor may prescribe the use of calcium channel blockers and nitrates, and as supplements, sedatives may be recommended. If medical treatment is not effective, balloon dilation of the esophagus, endoscopic botulinum toxin injection, or surgical intervention may be resorted to. In the case of functional dyspepsia, the use of proton pump inhibitors appears to be particularly effective in cases of pain, as well as in cases of increased gastric acid secretion. In the case of gastric dysfunction, medications that stimulate digestive system movement are used. When Helicobacter pylori infection is detected in the stomach, a course of antibiotics is prescribed. Neurological symptoms are treated with antidepressants or managed through psychotherapy.

To improve gallbladder function and the Oddi sphincter valve, the doctor may prescribe medications from several groups – they should work together to increase bile secretion and gallbladder movement (such as bile acid and herbal medicines), as well as provide an antispasmodic effect on the Oddi valve (such as hymecromone).

Treatment for irritable bowel syndrome mainly focuses on improving lifestyle and adopting a healthy diet. Medical treatment is aimed at improving bowel movement and relieving pain.