Healthy Lifestyle Changes - Living With A Sensitive Gut: Digestive Disorders
Content provided by the Faculty of the Harvard Medical School
Healthy lifestyle changes
The first thing is to eat a balanced diet that includes plenty of fiber, unless your complaint is excess gas. Eat smaller meals and drink sufficient liquids. Eliminate caffeine (especially coffee), tobacco, and alcohol. And stay away from foods and medications that seem to upset your stomach.
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 Keep your system running smoothly with regular exercise. |
Stress is a leading cause of many of these disorders, and reducing it can help you find relief not only from these gastrointestinal symptoms, but in many other ways as well. Try to relax. If you can't do it on your own, try tapes, books, or videos, or seek help from a therapist trained in stress reduction and relaxation therapies.
Exercise is a good tonic for the gut as well as for the mind. A regular exercise program under your doctor's supervision may be just the trick for turning that sensitive gut around.
Don't eat foods that seem to be unripe or spoiled. When traveling, drink only bottled water and skip the street vendors. You'll cut down on your chances of getting traveler's diarrhea.
The GI tract doesn't operate in a vacuum. Problems in other parts of the body, including the mind, can have a profound impact on the gut. Live as healthy a lifestyle as possible, in body and mind alike. Though you may still need to consult a doctor from time to time, following the approaches outlined in this report can help make such visits less frequent.
Seven strategies for the sensitive gutThe following are practical strategies to help you live with a functional gastrointestinal disorder. To apply these strategies to your specific condition, see the sections describing individual gastrointestinal disorders in this report.
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Table 2: Drugs used to treat functional gastrointestinal disorders | ||||
| Pregnant or nursing women should not take these drugs, except on the specific advice of a physician. | ||||
| Antacids | ||||
| Active ingredient* | Brand name | Use | Side effects | Comments |
| Alumina, aluminum carbonate, aluminum hydroxide | Amphojel, Basaljel, Gaviscon, Maalox, Mylanta | Relieve heartburn and functional dyspepsia pain, and promote ulcer healing by neutralizing stomach acid | Constipation; excessive and prolonged doses may cause bone pain, feeling of discomfort, appetite loss, mood changes, muscle weakness | Side effects more likely for people with kidney disease; aluminum-containing antacids not advised for elderly people with bone disease or Alzheimer's disease; do not use within 3–4 hours of taking tetracycline-type antibiotics |
| Calcium carbonate | Alka-Mints, Rolaids, Tums | Same as above | Chalky taste; constipation; excessive and prolonged doses may cause difficult, painful, or frequent urination, appetite loss, mood changes, muscle pain or twitching, nausea, restlessness, unpleasant taste | Side effects more likely for people with kidney disease |
| magaldrate | Lowsium, Riopan | Same as above | Chalky taste; constipation; excessive and prolonged doses may cause bone pain, feeling of discomfort, appetite loss, difficult or painful urination, mood changes, muscle weakness, dizziness, irregular heartbeat | A chemical combination of aluminum hydroxide and magnesium hydroxide; side effects more likely for people with kidney disease; do not use within 3–4 hours of taking tetracycline-type antibiotics |
| magnesia, magnesium carbonate, magnesium hydroxide, magnesium trisilicate | Gaviscon, Gelusil, Maalox, Mylanta, Phillips' Milk of Magnesia | Same as above | Chalky taste; excessive and prolonged doses may cause difficult or painful urination, dizziness, irregular heartbeat, loss of appetite, mood changes, muscle weakness | Side effects more likely for people with kidney disease; do not use within 3–4 hours of taking tetracycline-type antibiotics |
| sodium bicarbonate | Alka-Seltzer, baking soda | Same as above | Abdominal fullness; belching; excessive and prolonged doses may cause frequent urge to urinate, mood changes, muscle pain, nausea, restlessness | Not advisable for people on low-sodium diets; side effects more likely for people with kidney disease |
| *Most over-the-counter antacids contain two or more of these active ingredients | ||||
| Anticholinergics/Antispasmodics | ||||
| Generic name | Brand name | Use | Side effects | Comments |
| atropine with hyoscyamine and phenobarbital | Arco-Lase Plus | Relieve gastrointestinal cramps, spasms | Dry mouth, difficulty urinating or urinary retention, blurred vision, rapid heartbeat, increased ocular tension, headache, nervousness, drowsiness; antispasmodics that contain phenobarbital may cause sedation, drowsiness, or, rarely, agitation | Should not be used by people with glaucoma; a physician should be consulted about concurrent use because these drugs block or boost the actions of many other medications; phenobarbital may decrease the effect of anticoagulants and may be habit-forming |
| atropine with hyoscyamine, phenobarbital, and scopolamine | Donnatal | |||
| dicyclomine | Bentyl | |||
| hyoscyamine | Levsin | |||
| Antidiarrheal agents | ||||
| Generic name | Brand name | Use | Side effects | Comments |
| diphenoxylate and atropine | Lomotil | Stops diarrhea by slowing down intestinal movement | Abdominal discomfort; constipation; less frequently may cause blurred vision, urinary discomfort, dry mouth or skin, rapid heartbeat, restlessness, or warm, flushed skin | Drink plenty of fluids; may be habit-forming; not to be used with alcohol or other depressants |
| loperamide | Imodium, Imodium A-D | Reduces secretion of fluid by the intestine | Abdominal discomfort; constipation; less frequently may cause drowsiness, dizziness, dry mouth, nausea, vomiting, rash | Drink plenty of fluids; should be used with caution by people with liver disease |
| Histamine H2-receptor antagonists | ||||
| Generic name | Brand name | Use | Side effects | Comments |
| cimetidine | Tagamet | Relieves heartburn and functional dyspepsia pain and promotes ulcer healing by decreasing stomach acid | Rarely may cause diarrhea, constipation, dizziness, anxiety, depression, drowsiness, sleeplessness, headache, irregular heartbeat, increased sweating, burning, itching, redness of skin, fever, confusion in ill or elderly people | May interfere with the absorption of anticoagulants, antidepressants, and hypertension medications |
| famotidine | Pepcid | Same as above | Same as above | No serious drug interactions known |
| nizatidine | Axid | |||
| ranitidine | Zantac | Same as above | Same as above | At high doses may interact with anticoagulants |
| Prokinetic agents | ||||
| Generic name | Brand name | Use | Side effects | Comments |
| metoclopramide | Reglan | Treats reflux esophagitis and promotes peptic ulcer healing by suppressing secretion of stomach acid | Diarrhea; less frequently may cause involuntary movement of limbs, restlessness, drowsiness, muscle tremor, spasms | Increases the effects of alcohol and other depressants; caution advised for patients with type 1 diabetes or Parkinson's disease |
| Proton pump inhibitors | ||||
| Generic name | Brand name | Use | Side effects | Comments |
| lansoprazole | Prevacid | Treats reflux esophagitis and promotes peptic ulcer healing by suppressing secretion of stomach acid | Rarely may cause diarrhea, abdominal pain, nausea | May speed the elimination of theophylline |
| omeprazole | Prilosec, Zegerid | Same as above | Rarely may cause constipation, chest pain, headache, gas, rash, drowsiness | May prolong the effect of other prescription drugs including diazepam, warfarin, and phenytoin |
| rabeprazole | AcipHex | |||
| pantoprazole | Protonix | Same as above | Same as above | Also available as an IV formulation |
| esomeprazole | Nexium | |||
| Selective serotonin reuptake inhibitors (SSRIs) | ||||
| Generic name | Brand name | Use | Side effects | Comments |
| fluoxetine | Prozac | Relieves chronic abdominal pain | Rash; headache; dizziness; insomnia; anxiety; drowsiness; excessive sweating; nausea; diarrhea; bronchitis; weight loss; painful menstruation; sexual dysfunction; urinary tract infection; chills; muscle, joint, and back pain | Limited experience in functional bowel disorders |
| paroxetine | Paxil | Same as above | Pain, bodily discomfort, hypertension, sudden loss of strength, rapid heartbeat, itching, nausea, vomiting, weight gain or loss, central nervous system stimulation, depression, vertigo, cough | Same as above |
| sertraline | Zoloft | Same as above | Nausea, trouble sleeping, diarrhea, dry mouth, sexual dysfunction, drowsiness, tremor, indigestion, increased sweating, increased irritability or anxiety, decreased appetite | Same as above |
| Serotonin agonists/antagonists | ||||
| Generic name | Brand name | Use | Side effects | Comments |
| alosetron | Lotronex | Reduces cramping abdominal pain, urgency, and diarrhea caused by IBS | Constipation; in rare cases may cause diarrhea and intestinal bleeding | Available only under a tightly controlled program; only proven effective for women |
| Tricyclic antidepressants | ||||
| Generic name | Brand name | Use | Side effects | Comments |
| amitriptyline | Elavil, Endep | Relieve chronic abdominal pain | Dizziness, dry mouth, blurred vision, drowsiness, constipation, urinary retention, hypotension, cardiac arrhythmia | Should not be used with alcohol, other depressants, or immediately following a heart attack; side effects may be worse when cimetidine is used simultaneously; caution advised for patients with glaucoma; used at lower doses than for the treatment of depression |
| desipramine | Norpramin | |||
| nortriptyline | Pamelor | |||
| Other agents | ||||
| Generic name | Brand name | Use | Side effects | Comments |
| activated charcoal | Actidose-Aquar, CharcoCaps | Relieves intestinal gas | Black stools, abdominal pain | Effectiveness uncertain; do not take at the same time as other medications |
| alpha-galactosidase | Beano | Reduces intestinal gas by breaking down indigestible carbohydrates into digestible sugars | No known side effects | Effectiveness uncertain |
| bismuth subsalicylate | Pepto-Bismol | Relieves heartburn, indigestion, nausea, diarrhea; used with antibiotics to cure ulcers | Dark tongue, grayish-black stools; excessive doses may cause anxiety, constipation, dizziness | Avoid if allergic to aspirin or other salicylates |
| lactase | Lactaid | Relieves gas, abdominal bloating, and diarrhea by breaking down milk sugar into simpler forms that can be absorbed by the bloodstream | No known side effects | Effectiveness uncertain; available as pills or prepared products |
| rifaximin | Xifaxan | Prevents traveler's diarrhea caused by E. coli | Headache; constipation; hives and itchiness | Should not be used by people with fever or blood in stool |
| simethicone | Gas Relief, Gas-X, Mylanta Gas, Phazyme | Relieves pain from excess gas | No known side effects | Effectiveness uncertain |
| Last updated: | August 21, 2007 |
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Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
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