Treating digestive disorders
Digestive disorders range from mild to severe, from acute to chronic, and from disorders that resolve themselves to those requiring surgery and/or medication.
A range of medical professionals could be needed to treat digestive disorders: GPs, dietitians, gastro-enterologists, endocrinologists, proctologists, ear- nose- and throat specialists and surgeons.
Many digestive disorders have similar symptoms
Before any treatment can be effective, it is essential that a correct diagnosis be made. This can be complicated by the fact that many digestive disorders have similar symptoms, such as nausea, diarrhoea and abdominal pain.
Diarrhoea, one of the most common symptoms of digestive disorders, can cause serious dehydration, especially in infants, and even in adults, digestive disorders that do not resolve themselves in a day or two warrant medical attention.
In many cases that are not life-threatening, doctors will recommend short-term medication (sometimes just to relieve symptoms or clear an infection) or a change in dietary habits, before considering surgery.
Surgical treatment for digestive disorders is a lot less invasive than a few decades ago, because of the development of techniques such as laparoscopy and the use of ultrasound. The use of endoscopes for diagnostic purposes, and even some treatments, of digestive disorders, such as the removal of polyps, have cut down recovery time after surgical procedures.
Surgery for digestive disorders is roughly divided into two parts: upper gastro-intestinal surgery and lower gastro-intestinal surgery.
As the Journal Gastrointestinal & Digestive System reminds us, multiple factors need to be taken into account when choosing the most appropriate treatment or procedure for a patient, one of which is the clinical condition of the patient.
Once a correct diagnosis has been made, treatment can start. Here’s more about possible treatments for digestive disorders:
Identifying problematic foods and lifestyle choices: Certain conditions are exacerbated by particular foods, for instance spicy food increases the level of discomfort experienced by those with stomach ulcers or GORD.
Your doctor or dietician will take a careful look at your diet and lifestyle and also possible food intolerances that you may have, and advise on changes you could make to help relieve the symptoms of whatever digestive disorder you may have. Avoidance of certain foods may have to be a life-long decision, such as gluten in the case of those with Coeliac Disease. Smoking, drinking and a lack of exercise could also contribute to the severity of digestive diseases, and lifestyle changes may be necessary.
Medication: In the case of bacterial or parasitic infections, a short course of antibiotics may be prescribed. Antacids could be recommended for heartburn, and pain medication (from over-the counter painkillers to those only available on prescription) for abdominal pain caused by any of the digestive disorders. Certain conditions may require long-term medication and vigilance as far as diet is concerned. Anti-nausea medication and anti-diarrhoeal medication is available from the pharmacy without a prescription.
It is never a good idea to self-diagnose a digestive disease and take OTC medication for long periods of time without seeing a doctor. The Cleveland Clinic warns that long-term use of antacids, for instance, is linked to a vitamin B12 shortage in patients.
Surgery: Some digestive disorders constitute a medical emergency, such as appendicitis. These are usually accompanied by acute abdominal pain, as in the case of an abdominal obstruction, or a ruptured organ according to the Merck Manuals.
Gastrointestinal bleeding can also be life-threatening and can require immediate surgery. Surgery is also used to repair structural problems, such as hernias or blockages in the bile duct (gallstones), or certain ulcers. Surgery is used to remove tumours. As the digestive system is so large, and consists of so many parts, there is a long list of surgical procedures that doctors are able to perform on this system.
Endoscopic treatment: In cases of bleeding in the gastrointestinal systems, endoscopic treatment plays a major role in the diagnosis and management. Argon plasma coagulation of bleeding sites, banding of haemorrhoids in the oesophagus and rectum, injection of bleedings ulcers are a few situations where endoscopic treatment is the first choice in the management. There are also endoscopic treatments available for reflux disease and achalasia, strictures in the gastrointestinal tract, removal of gall stones, etc.
Reviewed by Dr Estelle Wilken (MBChB) (MMed Int) ,Senior Specialist, Internal Medicine and Gastroenterology, University of Stellenbosch and Tygerberg Hospital. February 2016.