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Gastrointestinal Problems


There are many minor problems that can affect the gastrointestinal tract, and even though they are usually short lived, they are often very inconvenient and can be quite distressing.
Many of the problems that affect the gastrointestinal tract can be remedied by improvements in lifestyle. The following simple measures can help prevent gastroIntestinal Problems occurring:-
  • try not to eat too quickly
  • eat a well balanced diet
  • have a good posture while eating
  • drink plenty of fluids throughout the day as well as at meal times

This page will consider the problems associated with indigestion, constipation and diarrhoea.


Indigestion

The stomach is the most common part of the gastrointestinal tract that patients report problems with, and a wide range of problems are often referred to as indigestion. Indigestion is a term with a very personal meaning as symptoms differ between individuals. Symptoms of indigestion associated with excess stomach acid that can follow a spicy or greasy meal or large intakes of alcohol include bloating, flatulence, and heartburn.

Bloating is a feeling of fullness after a meal that actually feels uncomfortable and may be quite long lived.
Flatulence is the passing on wind after it collects in the stomach, it is caused by excess stomach acid reacting with the contents of the stomach to produce gasses, mainly carbon dioxide.
Heartburn is a burning or heavy sensation down the centre of the chest ONLY. It does not spread to other areas as do the pain symptoms associated with certain heart conditions. Heartburn is caused by the reflux of stomach acid up into the oesophagus, which acts on the top layers of the mucosal membranes and produces a burning sensation.

Treatment

The choice of treatment for indigestion varies on the symptoms present. The main aim of all treatments though is to remove the excess acid, this can be done in several ways.

  • Antacids are usually tablets or sometimes liquids that contain ingredients that neutralise the acids in the stomach. Examples are Sodium Bicarbonate, Magnesium Carbonate and Aluminium Hydroxide. These work by reacting with the acid to form weaker acids that are not as damaging to the stomach. Antacids can be used for all types of indigestion but they should not be used regularly as your body can become used to them leading to almost permanent problems with indigestion. They should also be used in caution by people on a low salt diet e.g. people with heart conditions.

  • Alginates are again available in tablet and liquid form. These are derived from seaweed and work by forming a raft of tiny bubbles when they react with acid. This effect is called rafting as the alginate containing the tiny bubbles floats on top of the stomach contents and stops the reflux that causes heartburn. Again, those people on a low salt diet should use these products with caution.

  • H2-Antagonists are a fairly recent addition to the products available to combat indigestion. These have long term effects on stomach acid since they slow the production of stomach acid rather than neutralising it once it has been made. Due to the stronger nature of these medicines though they are more restricted in their uses. They should not be used for more than a week without a medical consultation and they are not recommended for use by people who have used the prescription only version of these medicines within the past year especially if it was for the treatment of an ulcer of the stomach or duodenum.

  • The latest addition to the range of indigestion products on the market is a pro-kinetic called domperidone. This agent works by encouraging the muscles around the stomach and small intestine to contract and therefore moves the contents of the bowel down and away from the stomach. This product is therefore recommended for indigestion associated with bloating. As it is a new product you should speak to your Pharmacist before you use it to ensure it is suitable.

Constipation

Constipation is described as a decrease in the frequency and volume of bowel motions. In practice this is often accompanied by discomfort on passing a motion or sometimes permanent discomfort in the lower abdomen. There are many causes of constipation and most of these can be remedied by changes to lifestyle. Constipation can be caused by a poor diet, insufficient fluid intake and too little exercise.

Treatment

The main aim of treatment is to improve bowel movement, this can be done with the use of Laxatives. There are actually four main types of laxative.
  • Stimulant Laxatives (e.g. Senna, Bisacodyl)
    These medicines work by irritating the lining of the bowel to cause contractions of the bowel muscles. This will directly lead to the passing of a motion and therefore some relief from constipation. However, because of the way in which they work they may cause cramping and gripping pains in the stomach which can make symptoms seem worse. Also, your bowel can become reliant on this type of product and as such they should only be used occasionally.
    It has also come to light recently that some of the most popular laxatives may have been causing bowel problems following long term and regular usage, this has caused regulatory bodies to withdraw many laxatives from the market.

  • Osmotic Laxatives (e.g. Lactulose, Magnesium Hydroxide)
    These medicines work by drawing water into the bowel, this action softens the contents of the bowel and reduces the likeliness of constipation. Lactulose is an altered sugar that is not absorbed into the body and water is attracted to the sugar molecules via an effect called osmosis. Magnesium Hydroxide works in the same way but is also used in indigestion. This type of laxative will not treat constipation as rapidly as a stimulant laxative but they are much safer for use in the long term perhaps following surgery or where other medication is vital but cause constipation as a side effect.

  • Bulking Agents (e.g. Isphagula Husk)
    These medicines work by adding bulk to the contents of the bowel usually in the form of fibre. This causes an outward pressure on the lining of the bowel which causes the muscles around the bowel to contract more strongly. These medicines are also slow acting when compared to stimulant laxatives but are again safer for long term use.

  • Lubricating Agents (e.g. Glycerin Suppositories, Liquid Paraffin)
    This type of laxative works by lining the bowel with a lubricant so that the passing of a motion is eased. Glycerin Suppositories are by far the fastest working laxatives but are not particularly popular due to the route of administration. Liquid Paraffin works in the same way as glycerin suppositories but is taken by mouth, this would seem ideal but it does have problems of its own. As with stimulant laxative the bowel can become over reliant on this medicine. There are problems associated with fat soluble vitamin absorption and pneumonia following aspiration of the Liquid Paraffin into the lungs.

Diarrhoea

Diarrhoea is the opposite of Constipation. There is an increase in the frequency and volume of bowel motions. This can be accompanied by many other symptoms such as nausea, vomiting and gripping pain. There are several possible causes of diarrhoea ranging from viral infections to international travel. Where an upset stomach accompanies the diarrhoea it is possible that food poisoning is the cause of the symptoms, however this is extremely difficult to prove. This is because bacteria may be the cause and tracing the bacteria to the source is almost impossible.

Treatment

The aim of treatment here is to ensure that dehydration does not occur and to try and slow the rate of movement of food through the bowel so that more fluid can be absorbed.
  • Oral Rehydration Sachets
    This should be the mainstay of treatment of diarrhoea. Most cases of diarrhoea are short lived and intervention other than regular fluids to prevent dehydration is a waste of time. Oral Rehydration Sachets replenish the body's salts that are lost along with water during diarrhoea. This protects against dehydration due to salt loss as well as fluid loss.

  • Kaolin and Morphine
    This is a popular remedy because of its reputation, however it has now been vastly improved upon by medicines like Loperamide. It is available in liquid and tablet form. The kaolin absorbs anything in the bowel that may be the cause of the diarrhoea while the morphine relaxes the bowel muscles and slows down bowelw movements.
    If you use this product remember to keep drinking plenty of fluids. Also, if you use the mixture shake the bottle well.

  • Loperamide
    Loperamide is similar in its action to Morphine but is much more effective, two capsules taken as one dose are usually sufficient to treat an episode of diarrhoea.
    If you use this product remember to drink plenty of fluids.

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