And Other Things You Can Live With But Could Get Along Very Well Without - Troubles along the digestive tract

From childhood on, most people are occasionally bothered by minor and temporary disturbances connected with digestion. Most of the disturbances listed below can be treated successfully with common sense and, if need be, a change in habits.

The Mouth

The digestive processes begin in the mouth, where the saliva begins chemically to break down some foods into simpler components, and the teeth and the tongue start the mechanical breakdown. Disorders of the teeth such as a malocclusion or poorly fitted dentures that interfere with proper chewing, should promptly be brought to the attention of a dentist.

Inflammation of the Gums

Also known as gingivitis , inflammation of the gums is caused by the bacteria that breed in food trapped in the spaces between the gums and the teeth. The gums become increasingly swollen, may bleed easily, and be sore enough to interfere with proper chewing. The condition can be prevented by cleaning the teeth thoroughly and frequently, which includes the use of dental floss or the rubber tip on the toothbrush to remove any food particles lodged in the teeth after eating. Because gingivitis can develop into the more serious condition of pyorrhea , persistent gum bleeding or soreness should receive prompt professional treatment. See Ch. 22, The Teeth and Gums .

Canker Sores

Canker sores are small ulcers inside the lips, mouth, and cheeks. Their specific cause is unknown, but they seem to accompany or follow a virus infection, vitamin deficiency, or emotional stress. They may be additionally irritated by citrus fruit, chocolate, or nuts. A canker sore usually clears up in about a week without special treatment. A bland mouth rinse will relieve pain and, in some cases, speed the healing process.

Coated Tongue

Although a coated tongue is commonly supposed to be a sure sign of illness, this is not the case. The condition may occur because of a temporary lack of saliva.

Glossitis

Glossitis , an inflammation of the tongue causing the tongue's surface to become bright red or, in some cases, glazed in appearance, may be a symptom of an infection elsewhere in the body. It may also be a symptom of anemia or a nutritional deficiency, or it may be an adverse reaction to certain forms of medication. If the inflammation persists and is accompanied by acute soreness, it should be called to a physician's attention.

Halitosis or Bad Breath

Contrary to the millions of commercial messages on television and in print, bad breath cannot be cured by any mouthwash, lozenge, spray, or antiseptic gargle now on the market. These products can do no more than mask the odor until the basic cause is diagnosed and cured. Among the many conditions that may result in bad breath (leaving out such fleeting causes as garlic and onions) are the following: an infection of the throat, nose, or mouth; a stomach or kidney disorder; pyorrhea; respiratory infection; tooth decay; improper mouth hygiene; and excessive drinking and smoking. Anyone who has been made self-conscious about the problem of bad breath should ask his physician or dentist whether his breath is truly offensive and if it is, what to do about it.

Gastritis

Gastritis , one of the most common disorders of the digestive system, is an inflammation of the lining of the stomach that may occur in acute, chronic, or toxic form. Among the causes of acute gastritis are various bacterial or viral infections; overeating, especially heavy or rich foods; excessive drinking of alcoholic beverages; or food poisoning. An attack of acute gastritis may be severely painful, but the discomfort usually subsides with proper treatment. The first symptom is typically sharp stomach cramps, followed by a bloated feeling, loss of appetite, headache, and nausea. When vomiting occurs, it rids the stomach of the substance causing the attack but usually leaves the patient temporarily weak. If painful cramps persist and are accompanied by fever, a physician should be consulted about the possibility of medication for bacterial infection. For a few days after an attack of acute gastritis, the patient should stay on a bland diet of easily digested foods, taken in small quantities.

Toxic Gastritis

Toxic gastritis is usually the result of swallowing a poisonous substance, causing vomiting and possible collapse. It is an emergency condition requiring prompt first aid treatment and the attention of a physician. See “Poisoning” in Ch. 31, Medical Emergencies .

Chronic Gastritis

Chronic gastritis is a recurrent or persisting inflammation of the stomach lining over a lengthy period. The condition has the symptoms associated with indigestion, especially pain after eating. It can be caused by excessive drinking of alcoholic beverages, constant tension or anxiety, or deficiencies in the diet. The most effective treatment for chronic gastritis is a bland diet from which caffeine and alcohol have been eliminated. Heavy meals should be avoided in favor of eating small amounts at frequent intervals. A tranquilizer or a mild sedative prescribed by a physician may reduce the tensions that contribute to the condition. If the discomfort continues, a physician should be consulted about the possibility of ulcers. See Ch. 11, Diseases of the Digestive System .

Gastroenteritis

Gastroenteritis is an inflammation of the lining of both the stomach and the intestines. Like gastritis, it can occur in acute or toxic forms as a result of food poisoning, excessive alcohol intake, viral or bacterial infections, or food allergies. Vomiting, diarrhea, and fever may be more pronounced and of longer duration. As long as nausea and vomiting persist, no food or fluid should be taken; when these symptoms cease, a bland, mainly fluid diet consisting of strained broth, thin cereals, boiled eggs, and tea is best. If fever continues and diarrhea doesn't taper off, a physician should be called.

Diarrhea

Diarrhea is a condition in which bowel movements are abnormally frequent and liquid. It may be accompanied by cramps, vomiting, thirst, and a feeling of tenderness in the abdominal region. Diarrhea is always a symptom of some irritant in the intestinal tract; among possible causes are allergy, infection by virus or bacteria, accidentally swallowed poisonous substances, or excessive alcohol. Brief attacks are sometimes caused by emotions, such as overexcitement or anxiety.

Diarrhea that lasts for more than two days should be diagnosed by a physician to rule out a more serious infection, a glandular disturbance, or a tumor. Mild attacks can be treated at home by giving the patient a light, bland diet, plenty of fluids, and the prescribed dosage of a kaolin-pectin compound available at any drugstore.

Constipation

Many people have the mistaken notion that if they don't have a bowel movement every day, they must be constipated. This is not necessarily so. From a physician's viewpoint, constipation is determined not by an arbitrary schedule of when the bowel should be evacuated but by the individual's discomfort and other unpleasant symptoms. In too many instances, overconcern and anxiety about bowel movements may be the chief cause of constipation.

The watery waste that results from the digestion of food in the stomach and small intestine passes into the large intestine, or colon, where water is absorbed from the waste. If the waste stays in the large intestine for too long a time, so much water is removed that it becomes too solid and compressed to evacuate easily. The efficient removal of waste material from the large intestine depends on wavelike muscular contractions. When these waves are too weak to do their job properly, as often happens in the elderly or the excessively sedentary, a physician may recommend a mild laxative or mineral oil.

Treatment

Constipation is rarely the result of an organic disorder. In most cases, it is caused by poor health habits; when these are corrected, the disorder corrects itself. Often, faulty diet is a major factor. Make sure that meals contain plenty of roughage in the form of whole-grain cereals, fruit, and leafy green vegetables. Figs, prunes, and dates should be included from time to time. Plenty of liquid intake is important, whether in the form of juices, soups, or large quantities of water. Scheduling a certain amount of exercise each day strengthens the abdominal muscles and stimulates muscle activity in the large intestine. Confronting the sources of worries and anxieties, if necessary with a trained therapist, may also be helpful.

An enema or a laxative should be considered only once in a while rather than as regular treatment. The colon should be given a chance to function properly without relying on artificial stimulation. If constipation resists these commonsense approaches, the problem should be talked over with a physician.

Hemorrhoids

Hemorrhoids , commonly called piles , are swollen veins in the mucous membrane inside or just outside the rectum. When the enlargement is slight, the only discomfort may be an itching sensation in the area. Acute cases are accompanied by pain and bleeding. Hemorrhoids are a very common complaint and occur in people of all ages. They are usually the result of straining to eliminate hard, dry stools. The extra pressure causes a fold of the membranous rectal lining to slip down, thus pinching the veins and irritating them.

Because hemorrhoids may be a symptom of a disorder other than constipation, they should be treated by a physician. If neglected, they may bleed frequently and profusely enough to cause anemia. Should a blood clot develop in an irritated vein, surgery may be necessary.

Treatment

Advertised cures should be avoided because they are not only ineffective but can cause additional irritation. Laxatives and cathartics, which may temporarily solve the problem of constipation, are likely to aggravate hemorrhoids.

If pain or bleeding becomes acute, a physician should be consulted promptly. Treatment can be begun at home. Sitting for several minutes in a hot bath in the morning and again in the evening (more frequently if necessary) will provide temporary relief. Preventing constipation is of the utmost importance.

Anal Fissure

This is a condition in which a crack or split or ulcerated place develops in the area of the two anal sphincters, or muscle rings, that control the release of feces. Such breaks in the skin are generally caused by something sharp in the stool, or by the passage of an unusually hard and large stool. Although discomfort often accompanies a bowel movement when there is a fissure, the acute pain typically comes afterward. Healing is difficult because the injured tissue is constantly open to irritation. If the condition persists, it usually has to be treated by a minor surgical procedure. Intense itching in this area is called anal pruritis .