Digestive System Health Article

Common diseases and disorders

Several disorders of the esophagus are esophagitis, esophageal spasm, and esophageal cancer. Esophagitis (heartburn) is an inflammation of the esophagus usually caused by the reflux of gastric acids into the esophagus and is treated with antacid (alkalis). Esophageal spasm is also caused by acid reflux. Esophageal cancer can be caused by smoking and is generally fatal.

Disorders of the stomach include hiatal hernia, ulcers, and gastric cancer. A hiatal hernia occurs when a portion of the stomach extends upwards into the thorax through a large opening in the diaphragm. It is a condition that commonly occurs in people over the age of 50. Stomach ulcers are sores that form in the lining of the stomach. They may vary in size from a small sore to a deep cavity, surrounded by an inflamed area, sometimes called ulcer craters. Stomach ulcers and ulcers that form in the esophagus and in the lining of the duodenum are called peptic ulcers because they need stomach acid and the enzyme pepsin to form. Duodenal ulcers are the most common type. They tend to be smaller than stomach ulcers and heal more quickly. Ulcers that form in the stomach lining are called gastric ulcers. About 4 million people have ulcers, and 20% of those have gastric ulcers. Those people who are at most risk for ulcers are those who smoke, are middle-age and older men, are chronic users of alcohol, and those who take anti-inflammatory drugs, such as aspirin and ibuprofen. It is believed that about 80% of stomach ulcers may be caused by the bacterial infection, while about 20% may be from other causes, such as the use of anti-inflammatory medicines.

The most common liver disorder in the United States and other developed countries is cirrhosis of the liver. The main cause for this disease is alcoholism. Cirrhosis is characterized by the replacement of healthy liver cells by fibrous tissue. The replacement process is gradual and takes a period of two to 10 years to complete. There is no cure for the disease. Symptoms may not be noticed in its early development, but in its advanced stages there are a number of symptoms and the condition can lead to coma. Close medical attention is required to treat the disease.

Another common liver disorder is hepatitis. It is an inflammation of the liver caused by viruses. The most noticeable symptom of this disease is jaundice, that is, the skin, eyes, and urine turn yellow. The nine viruses known to cause hepatitis include hepatitis A, B, C, D, and E; the recently discovered F and G viruses; and two herpes viruses (Epstine-Barr and cytomegalovirus).

Gallstones may form in the gallbladder. If the amount of cholesterol in the bile acids increases or the amount of acid decreases, then some of the cholesterol will settle out of the acid to form gallstones that accumulate and block the ducts to the gallbladder. Infection in the gallbladder may lead to gallstones. Gallstones may be in the gallbladder for years without giving any signs of the condition, but when they obstruct the bile duct they cause considerable pain and inflammation. Infection and blockage of the bile flow may follow. Surgical removal of the gallbladder may be necessary to treat this condition. Since the liver both produces and stores sufficient amounts of bile, the loss of the gallbladder does not interfere with the digestive process provided fat intake in the diet is regulated. If the gallstones contain mainly cholesterol, drug treatment for the stones may be possible. But if there is too much other material in the gallstones, surgery may still be necessary. Even after being treated successfully by drugs and diet, the condition can return. The drug treatment takes years to dissolve gallstones.

If food gets trapped in the appendix, an irritation of its membranes may occur leading to swelling and inflammation, a condition known as appendicitis. If the condition becomes serious, removal of the appendix is necessary to avoid a life-threatening condition if it were to rupture.

When the pancreas does not produce sufficient insulin to store dietary sugar, the blood and urine levels of sugar reach dangerous levels. Diabetes mellitus is the resultant disease. Mild cases can be controlled by a properly regulated diet, but severe cases require the regular injection of insulin.

BOOKS

Greenspan, Francis S., and David G. Gardner, eds. Basic & Clinical Endocrinology, 6th ed. Stamford, CT: Appleton & Lange, 2000.

Johnson, Leonard R., and Thomas A. Gerwin, eds. Gastrointestinal Physiology, 6th ed. London: Mosby, Inc.

Morrison, Ben. The Digestive System (Insider's Guide to the Body). New York: Rosen Publishing Group, 2001.