EATING AROUND ULCERS
Question: I have a duodenal ulcer. What foods and beverages would I avoid?
Answer: The usual advice is to avoid foods containing substances that are capable of increasing stomach acid, such as caffeine and alcohol, as well as known stomach irritants, such as aspirin and anti-inflammatory drugs.
However, it is now known that well over 90 percent of duodenal ulcers are caused by a bacterium called Helicobacter pylori. A two-week course of certain antibiotics and an acid reducer can be curative in most instances and can also prevent recurrences, which used to be common.
BILE WITHOUT A GALLBLADDER
Question: In a report on gallstones, Consumer Reports on Health explained that the gallbladder stores bile produced by the liver and sends it into the small intestine to help digest fats. But it didn’t explain where the bile goes when a person’s gallbladder is removed. Can bile still aid in digestion—and can it form stones elsewhere?
Answer: Yes—and probably not, respectively. When the gallbladder is removed, bile will flow directly from the liver via the bile ducts into the small intestine, where it continues to aid digestion. Stones tend to form when chemically imbalanced bile is stagnant, as it is when stored in the gallbladder. They rarely form in the bile ducts, and never in the intestine.
Question: I’ve recently begun suffering from flatulence. I’m 65 have no obvious digestive problems. What could be causing this often embarrassing problem?
Answer: It could be the food you eat. Intestinal gas is the price some people pay for good nutrition.
Intestinal bacteria can ferment the remnants of certain carbohydrates, thereby producing gas. Likely culprits include bran and whole grains, as well as many fruits and vegetables, such as apples, avocados, beans, broccoli, cabbage, cauliflower, corn, cucumbers, melons, onions, peas, peppers, and radishes. Sometimes milk and other lactose-containing products (ice cream, puddings, custards) are at fault. Try cutting out suspect foods for a while, and see if it helps.
Swallowed air can also produce a small amount of gas. It may help to eat more slowly, chew with your mouth closed, and avoid gulping food. Over-the-counter remedies such as simethicone (Gas-X, Mylanta Gas Relief) and charcoal tablets are not usually very helpful.
Flatulence is nothing to worry about unless it’s accompanied by a recent change in bowel habits such as constipation or diarrhea. That could indicate an underlying disorder such as an intestinal infection or tumor, irritable bowel syndrome (spastic colon), or poor food absorption.
Question: My husband has had a burning sensation in his throat. It was diagnosed as a herniated esophagus, but I didn’t understand the doctor’s explanation. What is it, and what can be done about it?
Answer: Your husband is suffering from reflux esophagitis, or heartburn—inflammation of the swallowing tube due to backing up stomach acid. Sometimes the problem is related to a hiatal hernia, in which the stomach protrudes through the diaphragm into the chest. It can also result when the sphincter muscle at the lower end of the esophagus doesn’t close properly.
He should avoid irritants, including alcohol, aspirin, citrus juice, and coffee (caffeinated and decaffeinated). He should also avoid fats and peppermint, which tend to relax the sphincter muscle. He can help to reduce abdominal pressure by losing weight—or wearing loose-fitting clothes. And he should take advantage of gravity to keep stomach acid where it belongs by elevating the head of the bed on 4-inch blocks, and not lying down after meals.
Certain medications can help. These include antacids, such as Maalox and Riopan; acid-blocking drugs, such as cimeti-dine (Tagamet HB) and ranitidine (Zantac 75); and drugs that strengthen the lower esophageal muscle, such as metoclo-pramide (Reglan).
SORBITOL AND DIGESTIVE PROBLEMS
Question: I’ve heard that sorbitol can cause digestive problems. Is that true?
Answer: Yes. Sorbitol, a mild natural sweetener used in gum, candy, and many foods, is absorbed slowly by your digestive system. Because it remains in the gastrointestinal tract for up to eight hours, it may be broken down by bacteria in the large intestine. If you consume lots of sorbitol, excessive gas and diarrhea can result.
TEST FOR LIVER DISEASE
Question: For several years, blood tests have shown that I have a slightly elevated level of the liver enzyme known as SGPT. But all of the other tests for liver disease have found nothing wrong with me. My doctor says it’s not uncommon for a healthy person to have an elevated SGPT count. Is he right?
Answer: Most likely. In obese people, it may be due to accumulation of fat in the liver. If you’ve tested negative for hepatitis A, B, and C, you have nothing to worry about. However; to be sure, your liver function should be retested periodically.
Health handbook introducing you to read the article: TOO LITTLE IODINE?
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