Abdominal Bloating

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Abdominal bloating is a condition in which intestinal gas builds up in the digestive tract. 

Our diet has a significant impact on the types of bacteria living in the body’s gut. Depending on the food that we consume, our gut health can change and this could cause abdominal bloating. There are other possible causes such as fluid retention, constipation, emotional stress and acid reflux[1]. 


Bloating may not cause much difficulty in some patients, but in some it may be related to serious diseases such as Crohn’s Disease and Ulcerative Colitis or IBS (Irritable Bowel Syndrome). It is recommended that you immediately seek medical assistance if along with bloating you experience symptoms such as diarrhoea, abdominal pain or weight loss[2]. Being the most common digestive disorder seen by GPs, IBS is 2-3 times more likely to be seen in women. The condition often begins in early adulthood in women with many experiencing more symptoms during their periods[3].


The exact cause remains unclear. However, the symptoms of hyperactive intestinal muscles associated with abdominal bloating are known to potentially cause pain, cramping as well as diarrhoea. While various research suggest conventional medications are of limited benefit in treating bloating, some studies have shown that acupuncture may help eliminate pain, regulate the motility of the digestive tract and reduce anxiety and depression commonly associated with this condition. According to the British Acupuncture Council treatment with acupuncture could significantly improve the quality of life for patients[4]. 


References

[1] medicalnewstoday.com/articles/321869.php

[2] healthline.com/health/crohns-disease/symptoms-trouble

[3] monashfodmap.com/blog/ibs-and-that-time-of-month/

[4] acupuncture.org.uk

Apthous (mouth) ulcers

Apthous (mouth) ulcers are common oral sores affecting around 20 to 30 per cent of the population[1]. Mouth ulcers arise from the loss or erosion of the mucous membrane or the lining tissue of the mouth. 

Commonly they are caused by:

  • mechanical injuries such as accidentally biting the inside of your cheek
  • stress
  • hard tooth brushing
  • bacterial or fungal infections and 
  • deficits in certain vitamins and minerals such as B-12, folate and iron[2]. 


Typically, mouth ulcers are round and white/pink in colour and in most cases although they can be very painful, overall they are harmless. They may resolve themselves, it can take up to 2 weeks. If ulcers are persistent you must see your medical practitioner. 


During the healing process, it is important to manage the affected area. Effective management strategies include[3]:

  • Using a soft toothbrush 
  • Salt water rinses 
  • Avoiding hard foods and foods which irritate/scratch the interior of the mouth
  • Drinking cool water and avoiding overly hot foods and drinks
  • Applying numbing agents such as topical benzocaine or lidocaine


A natural management strategy is to gargle Herbal Mix Tea for 30 seconds each time.

    

References

[1] Better Health Victoria. Mouth Ulcers betterhealth.vic.gov.au/health/conditionsandtreatments/mouth-ulcers?viewAsPdf=true

[2] ADA. Aphthous Mouth Ulcers ada.com/conditions/aphthous-ulcers/

[3] Health Direct(2017, November) Mouth sores and ulcers healthdirect.gov.au/mouth-sores-and-ulcers

Coeliac

Coeliac disease is a genetic autoimmune disease where the body reacts abnormally to gluten (found in wheat, rye, barley and oats) affecting the lining of the small intestines or bowel. Correct functioning of the small intestines is vital for proper absorption of food nutrients and minerals which prevents nutritional deficiency[1]. In Australia, 50% of the population (both males and females) carry at least one of the genes predisposed to coeliac disease with approximately 1 in every 70 Australians being affected[2].


Although there is no cure for coeliac disease, there are effective management strategies people with coeliac disease can follow. Patients affected with coeliac disease will remain with a lifelong sensitivity to gluten. Treatment initially is to try and omit gluten from your diet, however a graded gradual re-introduction of this may occur. Long term risks of undiagnosed coeliac disease can result in chronic inflammation and poor nutrition.  


References    

[1] Better Health Channel (2019, February). Coeliac disease and gluten sensitivity. Retrieved from betterhealth.vic.gov.au/health/conditionsandtreatments/coeliac-disease-and-gluten-sensitivity

[2] Coeliac Australia. Coeliac Disease. Retrieved from coeliac.org.au/coeliac-disease/

Constipation

Constipation is defined as the difficulty or the infrequency of bowel movement or stools being hard, dry and difficult to pass[1]. However it is important to note that having infrequent bowel movement does not necessarily indicate an individual is constipated as it is normal to have anywhere from 1 to 3 bowel movements per day[2]. 


Constipation is a common occurrence in the population but has been shown to be more prevalent in: 

  • older age
  • taking a large number of medications
  • not drinking enough fluids
  • a change in routine
  • lack of exercise
  • low-fibre diet and low caloric intake[3] 


Typically there are three approaches to treating constipation[2]:

1. Changing diet and behaviour. This is the most common approach recommended and consists of increasing the amount of fibre in the diet and attempting to move their bowels at the same time every day

2. Laxatives. In some cases laxatives may be used to soften the stool, add bulk to the stool and absorb water or stimulate the walls of the large intestine causing contraction resulting in stool movement. 

3. Enemas. Other cases may require the use of enemas whereby liquid or gas is injected into the rectum to flush stool out.

It should be noted that use of laxatives and enemas may cause diarrhoea, dehydration and cramps and therefore should be used with caution, and with consultation with your medical practitioner.


References

[1] Harvard Health Publishing – Harvard Medical School (2019, April) Constipation and Impaction health.harvard.edu/a_to_z/constipation-and-impaction-a-to-z

[2] Greenberger (2018, May) Constipation in Adults msdmanuals.com/home/digestive-disorders/symptoms-of-digestive-disorders/constipation-in-adults

[3] Jamshed et al (2011, August) Diagnostic Approach to Chronic Constipation in Adults aafp.org/afp/2011/0801/p299.html

Crohn’s disease

Crohn’s disease is commonly referred to as IBD (Inflammatory Bowel Disease). It is caused by an inflammation of the bowel wall in the digestive tract. 


Every year it affects more than 75,000 in Australia. The disease is most commonly seen in those aged between 15 to 30 years old, however it has been reported that in recent years we are seeing more cases of infants and children affected by the disease. Unlike abdominal bloating, it is believed that Crohn’s disease is not caused by any particular diets. 


Symptoms include diarrhoea, fever, fatigue, abdominal pain and weight loss among others[1]. Being the most common digestive disorder seen by GPs, IBD is 2-3 times more likely to be diagnosed in women. 


The exact cause of the disease remains unclear. 


The symptoms of hyperactive intestinal muscles associated with the disease are known to cause severe pain such as cramping. Various studies have shown that acupuncture may help eliminate pain, regulate the motility of the digestive tract and reduce anxiety and depression commonly associated with this condition. Treatment with acupuncture could significantly improve the quality of life for patients[2].  Furthermore, according to studies by The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) Washington DC, acupuncture reduces intestinal inflammation in patients with Crohn’s disease by reversing tissue damages[3].


References

[1] healthline.com/health/crohns-disease/symptoms-trouble

[2] acupuncture.org.uk

[3] nccaom.org

Diverticular disease

Diverticular disease is a gut condition that causes diverticulae (small bulges) in the lining of the colon (large intestine) wall[1]. The cause of diverticula to form is thought to be due to a low-fibre diet. The majority of the time, the presence of these diverticulae are usually asymptomatic (ie do not present with any problems or pain). When this is the case, it is known as diverticulosis. However, 1 in 4 people with diverticular disease will develop symptoms whereby the diverticulae become inflamed or infected from bacteria being trapped and when this occurs it is known as diverticulitis[2].


Symptoms of diverticulitis include:

  • sharp pain
  • nausea and vomiting
  • fever and bloating of the abdomen[3] 


Treatment of diverticulitis varies with severity. In some instances, the inflammation can subside without any medical intervention and in these instances medical professionals recommend alterations in diet by increasing intake of dietary fibres and avoiding food that are prone to diverticulitis such as nuts, seeds and legumes[4]. In more severe cases, treatment of diverticulitis may include oral and intravenous antibiotics. 


References

[1] Health Direct (2018, February) Diverticular disease – diverticulitis and diverticulosis.  healthdirect.gov.au/diverticular-disease-and-diverticulitis

[2] American Society of Colon and Rectal Surgeons. Diverticular Disease. fascrs.org/patients/disease-condition/diverticular-disease

[3] Better Health Channel (2014, August) Diverticulosis and diverticulitis. betterhealth.vic.gov.au/health/conditionsandtreatments/diverticulosis-and-diverticulitis

[4] The Royal Australian College of General Practitioners (2017. November) Diverticular disease practice points. Chest pain Vol 46 (11) 829-832. racgp.org.au/afp/2017/november/diverticular-disease-practice-points/

Gastric ulcers

Gastric ulcers or stomach ulcers occur in the lining of the stomach and are characterised by open and inflamed sores. For a long time it was thought the onset of gastric ulcers was due to a poor diet, smoking and stress[1]. However during the 1990’s it was found that in approximately 60% of all stomach ulcer cases, a type of bacteria known as H. Pylori was responsible. The latest medical opinion is that this bacteria may actually be present in the majority of the population and so eliminating this has in some people not been beneficial.


Traditional western treatment consists of killing the bacteria via antibiotics as well as reducing the acidity in the stomach through proton pump inhibitors such as pantoprozole or via H2 (histamine-2) blockers such as ranitidine[2]. In addition to H.Pylori, research has found long-term use of non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and aspirin to contribute to the development of ulcers in the stomach[3]. As such, patients who are at a high risk of developing gastric ulcers should seek caution before using NSAIDS as a therapeutic agent[4].


Common symptoms of gastric ulcers include[5]:

  • A dull or burning pain in the stomach (between the breast bone to your belly button)
  • Poor appetite 
  • Bloating 
  • Burping 
  • Vomiting 
  • Weight loss 


References

[1] Better Health Channel (2014, August) Stomach Ulcer betterhealth.vic.gov.au/health/conditionsandtreatments/stomach-ulcer

[2] Health Direct (2019, July) Stomach ulcers healthdirect.gov.au/stomach-ulcers

[3] Ramakrishnan et al (2007, October) Peptic Ulcer Disease aafp.org/afp/2007/1001/p1005.html

[4] Gwee et al (2018, February) Coprescribing proton-pump inhibitors with nonsteroidal anti-inflammatory drugs: risks versus benefits. Doi:10.2147/JPR.S156938

[5] National Institute of Diabetes and Digestive and Kidney Diseases (2014, November) Symptoms and causes of peptic ulcers (stomach ulcers) niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/symptoms-causes

Gastro oesophageal reflux disease (GORD)

Gastro oesophageal reflux disease (GORD) is one of the commonest gut health conditions affecting approximately 10-15% of the Australian population[1]. While acid reflux happens to almost everyone from time to time, diagnosis of GORD requires symptoms to occur at least one day a week[2].


Although a multi-faceted condition, there is strong evidence to suggest the main factor causing GORD is a defective function in the lower oesophageal sphincter[3] (the muscle surrounding the exit of the oesophagus going into the entrance of the stomach). The lower oesophageal sphincter controls the flow of gastric acid or stomach acid from oesophagus to the stomach[4]. Backward travel of gastric acid from stomach to oesophagus due to dysfunction in the lower oesophageal sphincter can result in symptoms such as:

  • heartburn
  • chest pain
  • regurgitation
  • pain, and 
  • difficulty swallowing[3] 


However, there are effective treatments and strategies to combat this. These includes both medical and non-medical treatments such as:

  1. Weight loss
  2. Reducing coffee and alcohol intake
  3. Avoiding large meals
  4. Reducing fatty foods and spicy foods
  5. Medications, and 
  6. Smoking cessation[5]


GORD may bother patients for sometimes, and not at others, and may only be transient, however in many cases it can become a chronic long term issue.

 

References

[1] Keung, C, Hebbard, G (2016, February) The management of gastro-oesophageal reflux disease. Australian Prescriber Vol 39 (1) 6-10. doi:10.18773/austprescr.2016.003

[2] Royal Australian College of General Practitioners (2004, December). Gastro-oesophageal reflux disease – Current concepts in management. Australian Family Physician Vol 33 (12) 987-991. racgp.org.au/afpbackissues/2004/200411/20041128piterman.pdf

[3] Health Direct (2018, September) GORD (reflux). healthdirect.gov.au/gord-reflux

[4] Mittal, R, Goyal, R (2006, May) Sphincter mechanisms at the lower end of the esophagus. GI Motility online. doi:10.1038/gimo14

[5] Gut Foundation Australia (2016, February). Treatment of gastro-oesophageal reflux disease in adults & children.

Herpes Labialis (Cold Sores)

Herpes Labialis (cold sores) are small blisters that typically form on the lips and skin around the mouth, nose and the chin. As cold sores are contagious the moment you feel a tingling sensation, it is important to adhere to good prevention strategies such as not sharing items that come into contact with the cold sore and refraining from kissing whilst having a cold sore. 


Cold sores are caused by the herpes simplex virus and the infection persists throughout life normally in a dormant state[1]. However, there are multiple factors which contribute in causing the virus to become active again. These include[2]:

  • A break in the skin near the affected area
  • Emotional upset or stress
  • Periods
  • Tiredness and fatigue
  • Colds, flu or fever 


Treatment of cold sores include topical agents and in some cases oral antiviral therapy[3]after review by your medical practitioner. In order to relieve any pain or discomfort, health care professionals suggest cold compresses on the affected area, intake of cold foods and drinks and ensuring pain relief[4]. 


References

[1] Better Health Victoria (2017, July) Cold sores betterhealth.vic.gov.au/health/conditionsandtreatments/cold-sores

[2] Health Direct (2018, August) Cold sores healthdirect.gov.au/cold-sores

[3] SA Health – Government of South Australia. Cold sores (herpes simplex type 1) – including symptoms, treatment and prevention sahealth.sa.gov.au/wps/wcm/connect/Public+Content/SA+Health+Internet/Health+topics/Health+conditions+prevention+and+treatment/Infectious+diseases/Cold+sores+Herpes+simplex+type+1/Cold+sores+herpes+simplex+type+1+-+including+symptoms+treatment+and+prevention

[4] Kids Health (2019, February) Cold Sores (HSV-1) kidshealth.org/en/teens/cold-sores.html

Indigestion

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Indigestion or heartburn occurs when the contents of the stomach squeezes its way back into the oesophagus. This results in discomfort or a burning feeling in the upper abdomen often accompanied with abdominal bloating, nausea and sometimes vomiting[1]. 


Common culprits of indigestion may include:

  • consumption of a large meal
  • consumption of a large meal followed by vigorous physical activity
  • too much coffee or alcohol intake, and/or 
  • psychological conditions which make the stomach “churn” such as anxiety and stress[2]. 


As food in the stomach is kept there by the force of gravity, prevention of indigestion particularly after a large meal involves sitting upright and not lying down. Regular western medicine medications such as antacids may be used initially in order to neutralise stomach acidity levels and relieve indigestion symptoms, however further duration or increasing symptoms may require further investigation and follow up with a gastroenterologist.

    

References:

[1] Queensland Government. Indigestion conditions.health.qld.gov.au/HealthCondition/condition/9/189/403/indigestion

[2] Better Health Victoria (2012, March) Indigestion betterhealth.vic.gov.au/health/conditionsandtreatments/indigestion

Polyps

Polyps are small abnormal growths of cells in the body and can develop in many areas of the body such as the uterus, throat, bladder, stomach and colon. Majority of polyps which grow are harmless (benign) but in some cases can become malignant (cancerous)[1]. One of the common sites for polyps to grow includes the gastrointestinal tract, specifically the colon and rectum. Although the exact cause is unknown, it is thought factors such as lifestyle and genetics contribute to the growth of colorectal polyps[2]. 


Common symptoms of colorectal polyps include: 

  • abdominal pain
  • diarrhoea or constipation and 
  • blood or clear mucus in the stool. 


In most cases, colorectal polyps are removed using colonoscopy or flexible sigmoidoscopy techniques. It is important to get tested regularly for polyps as there is a higher chance of developing more polyps if you have had them prior[3]. 


References 

[1] Cancer Council Australia (2017, May 22). Polyps. cancer.org.au/about-cancer/types-of-cancer/polyps.html 

[2] Better Health Channel (2014, August). Polyps. betterhealth.vic.gov.au/health/conditionsandtreatments/polyps

[3] National Institute of Diabetes and Digestive and Kidney Diseases (2017, September). Treatment for Colon Polyps. niddk.nih.gov/health-information/digestive-diseases/colon-polyps/treatment 

Ulcerative Colitis

Ulcerative colitis is commonly referred to as UC. It is caused by an inflammation of the inner lining of the large bowel. This often leads to symptoms such as abdominal pain and diarrhoea. According to Health direct, UC affects more than 75,000 in Australia with an estimated 800 new cases diagnosed annually. The disease is most commonly seen in those aged between 15 to 30 years old[1].


Although there is no known cure to treat UC, treatments are available to manage the discomfort associated with this condition. Along with dietary changes, it is believed acupuncture may help enhance the body’s natural painkillers which is believed to assist in your body regulating inflammation  minimizing the pain[2].


References  

[1] healthdirect.gov.au/ulcerative-colitis

[2] healthline.com/health/ulcerative-colitis/acupuncture-benefits#acupuncture-and-ulcerative-colitis

Xerostomia (Dry Mouth)

Xerostomia (dry mouth) is a condition characterised by not having enough saliva to keep the mouth wet and moisturised. Saliva plays an important role in ensuring bacteria is kept under control in the mouth, aiding in digestion, helping defend against tooth decay and acts as a vehicle in strengthening tooth enamel[1]. Although everyone experiences a dry mouth from time to time, persistent feelings of dry mouth may be a sign of xerostomia. 


Symptoms which persist in this condition include[2]:

  • A sticky and dry feeling in the mouth
  • Cracked lips
  • Bad breath
  • Trouble chewing, swallowing or speaking
  • More frequent tooth decay
  • Gum irritation 


There are a number of factors thought to cause dry mouth such as[3]:

  • Prescription medications
  • Autoimmune disorders such as Sjogren’s syndrome 
  • Chemotherapy in cancer treatment
  • Anxiety and stress


Fortunately there are treatments and strategies in place to reduce the discomfort from dry mouth. As dry mouth increases the chances of tooth decay, it is crucial to protect your teeth by visiting the dentist regularly, using a soft toothbrush and mouth rinse and avoiding sugary or acidic foods. 


Furthermore, staying hydrated and avoiding foods that irritate the mouth have been found to ease the discomfort of dry mouth[4].


References

[1] Queensland Government – Queensland Health (2008, April) Healthy teeth for life fact sheet. health.qld.gov.au/__data/assets/pdf_file/0023/154076/htfl_dry_mouth_v2.pdf 

[2] Colgate. Dry Mouth colgate.com/en-us/oral-health/conditions/dry-mouth 

[3] Better Health Victoria (2017, February) Dry Mouth Syndrome betterhealth.vic.gov.au/health/conditionsandtreatments/dry-mouth-syndrome

[4] Health Direct (2018, April) Dry Mouth Syndrome healthdirect.gov.au/dry-mouth-syndrome