The Sensitive Gut: Digestive Disorders

Content provided by the Faculty of the Harvard Medical School

The Sensitive Gut

Your digestive system is in some ways like a car's engine — you know there's a lot going on inside, but as long as it's running, you tend not to think about it. Once trouble begins, however, your gut, just like a cranky carburetor, suddenly demands your attention.

For some folks, symptoms such as diarrhea, gas, cramps, heartburn, indigestion, belching, bloating, and nausea are infrequent and tolerable, but many people experience them far more often. An estimated one in four people has frequent gastrointestinal (GI) problems that can severely disrupt a normal lifestyle. Symptoms may occur on and off for months or even years at a time, leading people to undergo unpleasant and sometimes unnecessary medical tests, spend money on questionable cures, and miss countless days of work.

Figure 1: Incredible journey The food you eat travels a winding 30-foot pathway known as the gastrointestinal (GI) tract or the alimentary canal. Along the way the mucosa, or surface layer of cells lining the GI tract, produces digestive enzymes and juices that help break down food to be absorbed into the bloodstream.

Though the misery that such problems inflict is real, these ailments aren't usually the product of an illness in the conventional sense. Rather, they are functional gastrointestinal disorders. That means, unlike ulcers or stomach cancer, they can't be attributed to any physical abnormality or infection. More than 20% of people who consult a gastroenterologist learn that there's no structural abnormality to explain their complaints.

Just because doctors can't find an "organic" cause — meaning that there's no evidence of a structural, biochemical, or infectious basis for the symptoms — it doesn't mean you're imagining things. The symptoms are quite real, and if they occur frequently or last more than a month, it's advisable to seek help.

You may be relieved to know that even if doctors can't pinpoint the cause of your symptoms, the chances are good that you can get relief. This report focuses on a number of disorders considered to be functional: reflux, functional dyspepsia (FD), irritable bowel syndrome (IBS), constipation, diarrhea, and excessive gas.

The good news is that our ability to treat GI disorders continues to improve. With proper knowledge — and the support of a thoughtful, caring doctor — you can make changes in your diet or lifestyle to ease your discomfort and make the right decisions about medical treatments.

Last updated:	August 21, 2007