CELIAC DISEASE

Celiac disease is an uncommon disease in which your immune system

attacks the cells lining the small intestine. The reaction is provoked by
gliadin, one of the proteins in gluten that is found in wheat and some other
grains. The immune reaction results in inflammation and destruction of the
intestinal lining cells. The destruction of the lining affects the ability of the
lining to function normally, particularly in the absorption of food including
macronutrients (fat, protein, and carbohydrates) and micronutrients
(vitamins, and minerals). Thus, although some of the symptoms of celiac
disease may be a result of the ongoing inflammation and destruction, most
of the symptoms are the result of the malabsorption. The presence of celiac
disease usually is suspected on the basis of symptoms, but the diagnosis is
confirmed with a combination of blood tests and biopsy of the intestine. It
is common in both men and women.

SIGNS AND SYMPTOMS

 diarrhea,
 bloating,
 gas (flatulence, farting),
 swollen ankles (edema),
 anemia,
 fatigue,
 vitamin K deficiency, and
 excessive bruising and bleeding.

Treatment and prevention

 Get lots of advice. Dietitians, other health experts, and celiac disease support
groups can give you lots of help. Try keeping a food diary until you are more
familiar with planning meals without gluten.
 Watch out for hidden gluten . Read labels on prepared or processed food carefully.
For example, "hydrolyzed vegetable protein" may come from wheat and
contain gluten.
 Prevent contamination. It's best to keep gluten-free foods in a separate cupboard.
Make sure your kitchen counters, utensils, and appliances are clean and free of
gluten before you use them. Use a separate toaster for gluten-free breads.
 Check your (or your child's) weight weekly to make sure you're getting
enough nutrients.
 Eat plenty of fruits and vegetables to avoid constipation. If you need to, use
gluten-free commercial fiber preparations, such as those that contain rice bran.
GASTROESOPHAGEAL REFLUX DISEASE
Gastroesophageal reflux disease, or GERD, is a digestive disorder that
affects the lower esophageal sphincter (LES), the ring of muscle between
the esophagus and stomach. Many people, including pregnant women,
suffer from heartburn or acid indigestion caused by GERD.

SIGN AND Symptoms

 A burning sensation in your chest (heartburn), usually after eating, which might
be worse at night
 Chest pain
 Difficulty swallowing
 Regurgitation of food or sour liquid
 Sensation of a lump in your throat
 If you have nighttime acid reflux, you might also experience:
 Chronic cough
 Laryngitis
 New or worsening asthma
 Disrupted sleep

Treatment and prevention

 Upper GI series (barium swallow). This out-patient procedure uses X-ray imaging
to examine the upper GI tract for ulcers, reflux, and physical abnormalities like a
hiatus hernia. To aid visualization, the patient swallows a thick chalky liquid
contrast agent containing barium.
 Upper endoscopy. Endoscopy is a more invasive but accurate test for detecting
GERD-related injuries and complications, such as ulcers, tumors, and
inflammation. Once the throat is numbed, a small camera connected to a thin
flexible tube is fed down the esophagus to look for injured tissue and collect
samples if needed.
 Esophageal monitoring. pH monitoring and manometry assess the environment
and function of the esophagus. pH monitoring (often paired with upper
endoscopy) measures acid levels and the extent of reflux in the lower
esophagus, while manometry measures the strength of muscle contractions,
including that of the LES.

Lifestyle changes that help treat GERD symptoms are also effective preventative
measures. These include:

 Not smoking
 Avoiding foods and drinks that trigger acid reflux
 Eating sensible portions
 Maintaining a healthy weight
 Wearing loose-fitting clothing
 Elevating the head during sleep
ULCERATIVE COLITIS
Ulcerative colitis is an inflammatory bowel disease (IBD) that causes long-
lasting inflammation and ulcers (sores) in your digestive tract. Ulcerative
colitis affects the innermost lining of your large intestine (colon) and rectum.

SIGN AND SYMPTOMS

 abdominal pain
 increased abdominal sounds
 bloody stools
 diarrhea
 fever
 rectal pain
 weight loss
 malnutrition

Ulcerative colitis may cause additional conditions such as:

 joint pain
 joint swelling
 nausea and decreased appetite
 skin problems
 mouth sores
 eye inflammation

TREATMENT AND PREVENTION

 lcerative colitis is a chronic condition. Treatment usually involves drug therapy

or surgery. The goal of treatment is to reduce the inflammation that causes your
symptoms.
 Your doctor may prescribe a medication to reduce inflammation and swelling.
These types of medications include sulfasalazine (Azulfidine), mesalamine
(Asacol and Lialda), balsalazide(Colazal), and olsalazine (Dipentum). Reducing
inflammation will help alleviate many of your symptoms.
 More severe cases may need corticosteroids, antibiotics, medications that
suppress immune function, or antibody medications, called biologics, that help
block inflammation in a different way.
 If your symptoms are severe, you’ll need to be hospitalized to correct the effects
of dehydration and loss of electrolytes that diarrhea causes and to treat any
complications
 Surgery is necessary when there is massive bleeding, chronic and debilitating
symptoms, perforation of your colon, or a severe blockage. A CT scan or
colonoscopy can detect these serious problems.
 Surgery involves removing your entire colon with the creation of a new pathway
for waste. This pathway can be out through a small opening in your abdominal
wall or redirected back through the end of your rectum.
 To redirect waste through your abdominal wall, your surgeon will make a small
opening in your abdominal wall. The tip of your lower small intestine, or the
ileum, is then brought to the skin’s surface. Waste will drain through the
opening into a bag.
 If waste is able to be redirected through your rectum, your surgeon removes the
diseased part of your colon and rectum, but retains the outer muscles of your
rectum. The surgeon then attaches your small intestine to the rectum to form a
small pouch. After this surgery, you’re able to pass stool through your rectum.
Bowel movements will be more frequent and watery than normal.

 drinking small amounts of water throughout the day

 eating smaller meals throughout the day
 limiting your intake of high-fiber foods
 avoiding fatty foods
 lowering your intake of milk if you’re lactose intolerant
ANAL FISSURE
Anal fissure is a small tear in the thin, moist tissue (mucosa) that lines
the anus. An anal fissure may occur when you pass hard or large stools
during a bowel movement. Anal fissures typically cause pain and bleeding
with bowel movements.

SIGN AND SYMPTOMS

 Pain, sometimes severe, during bowel movements
 Pain after bowel movements that can last up to several hours
 Bright red blood on the stool or toilet paper after a bowel movement
 Itching or irritation around the anus
 A visible crack in the skin around the anus
 A small lump or skin tag on the skin near the anal fissure

TREATMENT AND PREVENTION

 You may be able to prevent an anal fissure by taking measures to prevent
constipation.
 Eat high-fiber foods,
 Drink fluids and;
 Exercise regularly to keep from having to strain during bowel movements.
 DIVERTICULITIS
Diverticulosis happens when pouches (diverticula ) form in the wall of
the colon . If these pouches get inflamed or infected, it is
called diverticulitis.

SIGN AND SYMPTOMS

 Tenderness, cramps, or pain in the abdomen (usually in the lower left side but may
occur on the right) that is sometimes worse when you move.
 Fever and chills.
 A bloated feeling, abdominal swelling, or gas.
 Diarrhea or constipation.
 Nausea and sometimes vomiting.
 Loss of appetite.

TREATMENT AND PREVENTION

The treatment you need depends on how bad your symptoms are. You may
need to have only liquids at first, and then return to solid food when you start
feeling better. Your doctor will give you medicines for pain and antibiotics.
Take the antibiotics as directed. Do not stop taking them just because you feel
better.
For mild cramps and belly pain:

 Use a heating pad, set on low, on your belly.

 Relax. For example, try meditation or slow, deep breathing in a quiet
room.
 Take medicine, such as acetaminophen (Tylenol, for example). Be safe
with medicines. Read and follow all instructions on the label.

You may need surgery only if diverticulitis doesn't get better with other
treatment, or if you have problems such as long-lasting (chronic) pain,
a bowel obstruction, a fistula, or a pocket of infection (abscess).