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Digestive symptoms are among the most common complaints
presenting in primary medical practice. The interpretation and treatment of these symptoms
has sometimes been based on misunderstanding how the
gastrointestinal tract responds to food.
The gastrointestinal tract is a sensing, reactive device that monitors the material
flowing through it. Symptoms arising from this system provide information about its
dysfunction.
Seven basic symptoms alert the patient to gastrointestinal tract displeasure
with food choices - nausea, heartburn, vomiting, bloating, pain, constipation and
diarrhea.
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Heartburn afflicts 44% of Canadians and Americans.
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Peptic ulcer disease has an incidence of 8%
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Non-ulcer dyspepsia afflicts 20-40%.
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gastrointestinal symptoms from food is common in infants and children
Over-the-counter medications for gastrointestinal tract symptoms is a multi-billion
dollar industry and patients often self-medicate when symptoms are mild or infrequent.
Patients may first present with acute abdominal pain either in the office or emergency
room and require an expensive work-up to rule out more serious disease. Ulcer pain tends
to be distinctive with discrete pain localized to the epigastrium, and increased with an
empty stomach, waking the patient at night and the pain is relieved by food and antacids.
Other abdominal pain can be more difficult to assess.
Food allergy-intolerance is associated with almost every conceivable pain pattern, but
is most often associated with bloating and changes in stool consistency and/or frequency.
Episodes of crampy abdominal pain with diarrhea are often food-related and may be
diagnosed as "food-poisoning" if infrequent. Women especially complain of
bloating and often describe major abdominal distention associated with diffuse abdominal
discomfort. As symptoms settle into a recurrent or chronic pattern, the diagnosis of
irritable bowel syndrome is often made and medications are prescribed to alter acid
secretion or gut motility. This symptomatic approach is often not adequate. heating and cooling Apple Valley, MN
Symptoms arising from the gastrointestinal tract should suggest::
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Problems with the food supply that trigger gastrointestinal tract responses
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Problems down-stream in the body if food antigens enter through an overly permeable
gastrointestinal tract
Everyone should know two basic principles of gastrointestinal tract management:
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1. If you don't like what comes out - change what goes in.
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2. Treat symptoms as information. When the gastrointestinal tract complains, adjust your
food intake until the complaints disappear.
The Five Major Symptoms
Nausea & Vomiting ranges from feeling a little squeamish to feeling very sick, ready to
vomit at any moment. A sick intense episode of nausea will follow the ingestion of a
reactive food, or food containing toxins, as in staphylococcal food poisoning. If nausea
is associated with profuse watery salivation, vomiting soon follows. Patients with food
problems will often report chronic low-grade nausea. They often wake up feeling sick and
describe a variety of uncomfortable abdominal sensations as the day proceeds. Their nausea
is not related to eating any one food, but disappears when complete diet revision is
successful. Nausea and vomiting are also associated with migraine headaches
caused by food allergy and "abdominal migraine" places the pain in
the abdomen and not the head.
Bloating is distention of the abdomen from excess gas in the digestive tract.
Gas can accumulate from the fermentation of food materials and from air-swallowing. Food
allergy can cause rapid, dramatic bloating by a mechanism that is not understood but
probably involves increased blood flow through the small intestine with transfer to blood
gases. Women patients will describe feeling "6 months pregnant" 1 to 2 hours
after eating a reactive meal.
Constipation consists often decreased frequency of bowel movement, often with
harder stools that are difficult to pass. Skipping bowel movements for several days will
usually result in abdominal bloating and tenderness. Constipation suggests a slowing of
peristalsis, with accumulation of feces in the colon. Often the muscle of the colon will
contract in a spastic manner blocking the passage of stool. A "spastic colon" is
often painful and will produce hard, pelleted stools. Many patients report alternating
constipation and diarrhea. They will describe days with no bowel movements followed by a
burst of loose or watery stool often with crampy pain.
Diarrhea is increased frequency of bowel movements with stools that are loose to
watery. Some have defined diarrhea as more than 3 loose to watery stools per day. Often
diarrhea contains increased mucous. The colon is somewhat like the nose in its tendency to
secrete protective mucous with food allergy. The term "mucous colitis" has been
used in the past to describe mucoid diarrhea. As diarrhea increases in frequency, the
diagnosis of celiac disease or inflammatory bowel disease is considered. If blood
appears with the diarrhea, ulcerative colitis is likely. With prolonged diarrhea
nutritional deficiencies from malabsorption of nutrients becomes increasingly likely.
Abdominal pain comes in assorted patterns and intensities. Crampy pain
occurs with muscle spasms of the various abdominal organs. Severe crampy pain is often
called "colic" and ranges from the distress of a milk-allergic infant to the
acute suffering of a person passing a stone through a small, muscular tube, such as a bile
duct or ureter. Small intestinal spasm presents as crampy pain around the navel. Colon
spasm is off to the side and made be high or low, right or left. Sudden, crampy pain is
often accompanied by diarrhea if food allergy is the cause. Distention of GIT produces
more continuous or aching pain. Inflammation of GIT is associated with continuous pain and
distinct tenderness, often aggravated by movement. All patterns of pain occur in patients
with who improve with diet revision. We often see women patients with mysterious
pelvic pain who improve with diet revision. Several had
unnecessary surgery and suffered prolonged loss of normal sexual life because of
food-related pain.
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