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Some Facts and Fallacies About Digestive Disorders and Constipation.

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Digestive Diseases

Researchers have only recently begun to understand the many, often complex diseases that affect the digestive system. Accordingly, people are gradually replacing folklore, old wives' tales, and rumors about the causes and treatments of digestive diseases with accurate, up-to-date information. But misunderstandings still exist, and while some folklore is harmless, some can be dangerous if it keeps a person from correctly preventing or treating an illness. Listed below are some common misconceptions (fallacies), about digestive diseases, followed by the facts as professionals understand them today.

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Ulcers

Spicy food and stress cause stomach ulcers.

False.

The truth is, almost all stomach ulcers are caused either by infection with a bacterium called Helicobacter pylori (H. pylori) or by use of pain medications such as aspirin, ibuprofen, or naproxen, the so-called nonsteroidal anti-inflammatory drugs (NSAIDs). Most H. pylori-related ulcers can be cured with antibiotics. NSAID-induced ulcers can be cured with time, stomach-protective medications, antacids, and avoidance of NSAIDs. Spicy food and stress may aggravate ulcer symptoms in some people, but they do not cause ulcers.

Ulcers can also be caused by cancer.

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Heartburn

Smoking a cigarette helps relieve heartburn.

False.

Actually, cigarette smoking contributes to heartburn. Heartburn occurs when the lower esophageal sphincter (LES)-- a muscle between the esophagus and stomach -- relaxes, allowing the acidic contents of the stomach to splash back into the esophagus. Cigarette smoking causes the LES to relax.

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Celiac Disease

Celiac disease is a rare childhood disease.

False.

Celiac disease affects both children and adults. About 1 in 200 people in the United States have celiac disease. Sometimes celiac disease first causes symptoms during childhood, usually diarrhea, growth failure, and failure to thrive. But the disease can also first cause symptoms in adults of any age. These symptoms may be vague and therefore attributed to other conditions. Symptoms can include bloating, diarrhea, abdominal pain, skin rash, anemia, and thinning of the bones (osteoporosis). Celiac disease may cause such nonspecific symptoms for several years before being correctly diagnosed and treated.

People with celiac disease should not eat any foods containing gluten, a protein in wheat, rye, and barley, whether they have symptoms or not. In celiac disease, gluten destroys part of the lining of the small intestine, which interferes with the absorption of nutrients. Even a small amount of gluten can cause damage, and sometimes no symptoms will be apparent.

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Bowel Regularity

Bowel regularity means a bowel movement every day.

False.

The frequency of bowel movements among normal, healthy people varies from three a day to three a week, and some perfectly healthy people fall outside both ends of this range.

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Constipation

Habitual use of enemas to treat constipation is harmless.

False.

Habitual use of enemas is not harmless. Over time, enemas can impair the natural muscle action of the intestines, leaving them unable to function normally. An ongoing need for enemas is not normal; you should see a doctor if you find yourself relying on them or any other medication to have a bowel movement.

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Irritable Bowel Syndrome

Irritable bowel syndrome is a disease.

True.

Irritable bowel syndrome is a disease, although it is also called a functional disorder. Irritable bowel syndrome involves a problem in how the muscles in the intestines work and pain perception in the bowel. It is characterized by gas, abdominal pain, and diarrhea or constipation, or both. Although the syndrome can cause considerable pain and discomfort, it does not damage the digestive tract as organic diseases do. Also, irritable bowel syndrome does not lead to more serious digestive diseases later, such as cancer.

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Diverticulosis

Diverticulosis is a serious but uncommon problem.

False.

Actually, the majority of Americans over age 60 have diverticulosis, but only a small percentage have symptoms or complications. Diverticulosis is a condition in which little sacs or out-pouchings called diverticula develop in the wall of the colon. These sacs tend to appear and increase in number with age. Most people have no symptoms and learn that they have diverticula after an x ray or intestinal examination. Less than 10 percent of people with diverticulosis ever develop complications such as infection (diverticulitis), bleeding, or perforation of the colon.

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Inflammatory Bowel Disease

Inflammatory bowel disease is caused by psychological problems.

False.

Inflammatory bowel disease is the general name for two diseases that cause inflammation in the intestines, Crohn's disease and ulcerative colitis. The cause of the disease is unknown, but researchers speculate that it may be a virus or bacteria interacting with the body's immune system. No evidence has been found to support the theory that inflammatory bowel disease is caused by tension, anxiety, or any other psychological factor or disorder.

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Cirrhosis

Cirrhosis is caused only by alcoholism.

False.

Alcoholism is just one of many causes of cirrhosis. Cirrhosis is scarring and decreased function of the liver. In the United States, alcohol causes less than one-half of cirrhosis cases. The remaining cases are from diseases that cause liver damage. For example, in children, cirrhosis may result from cystic fibrosis, alpha-1 antitrypsin deficiency, biliary atresia, glycogen storage disease, and other rare diseases. In adults, cirrhosis may be caused by hepatitis B or C, primary biliary cirrhosis, diseases of abnormal storage of metals like iron or copper in the body, severe reactions to prescription drugs, or injury to the ducts that drain bile from the liver. In adults, cirrhosis can also be caused by nonalcoholic steatohepatitis (NASH), which is becoming the most common liver disease in the United States, affecting 2 to 5 percent of Americans.

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Ostomy Surgery

After ostomy surgery, men have erectile dysfunction and women have impaired sexual function and are unable to become pregnant.

False.

Ostomy surgery does not, in general, interfere with a person's sexual or reproductive capabilities. Ostomy surgery is a procedure in which the diseased part of the small or large intestine is removed and the remaining intestine is attached to an opening in the abdomen. Although some men who have had radical ostomy surgery for cancer lose the ability to achieve and sustain an erection, most men do not, or, if they do, it is temporary. If erectile dysfunction persists, a variety of solutions are available. A urologist, a doctor who specializes in such problems, can help find the best solution. In women, ostomy surgery does not damage sexual or reproductive organs, so it is not a direct cause of sexual problems or sterility. Factors such as pain and the adjustment to a new body image may create temporary sexual problems, but they can usually be resolved with time and, in some cases, counseling. Unless a woman has had a hysterectomy to remove her uterus, she can still bear children.

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For More Information

American Liver Foundation (ALF)
75 Maiden Lane, Suite 603
New York, NY 10038-4810
Phone: 1-800-GO-LIVER (465-4837),
1-888-4HEP-USA (443-7872),
or (212) 668-1000
Fax: (212) 483-8179
Email: info@liverfoundation.org
Internet: http://www.liverfoundation.org/

Crohn's & Colitis Foundation of America Inc.
386 Park Avenue South
17th Floor
New York, NY 10016-8804
Phone: 1-800-932-2423 or (212) 685-3440
Fax: (212) 779-4098
Email: info@ccfa.org
Internet: http://www.ccfa.org/

Hepatitis Foundation International
504 Blick Drive
Silver Spring, MD 20904-2901
Phone: 1-800-891-0707 or (301) 662-4200
Fax: (301) 622-4702
Email: HFI@comcast.net
Internet: http://www.hepfi.org/

International Foundation for Functional Gastrointestinal Disorders Inc.
P.O. Box 170864
Milwaukee, WI 53217-8076
Phone: 1-888-964-2001 or (414) 964-1799
Fax: (414) 964-7176
Email: mailto:info@ccfa.org
Internet: http://www.iffgd.org/

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National Digestive Diseases Information Clearinghouse

2 Information Way
Bethesda, MD 20892-3570
Email: http://digestive.niddk.nih.gov/about/contact.htm

The National Digestive Diseases Information Clearinghouse (NDDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1980, the clearinghouse provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. NDDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases.

Publications produced by the clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.

This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.


NIH Publication No. 04-2673
October 2003

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