Discussing digestive difficulties in polite company is uncomfortable for most of us and that means people often suffer from problems in silence.

The good news is there may be simple solutions for some of the more common concerns many of us experience.

Life style changes and over the counter remedies may offer relief and resolve your symptoms. The following is information about gastrointestinal concerns people often experience, along with a few tips for feeling better.


Constipation is the most common digestive complaints in the general population and is associated with substantial economic costs. Constipation is often treated by the doctors on the basis of a patient’s impression that there is a disturbance in bowel function.

The term constipation has varied meanings for different people. Stools may be too hard or too small for some, while for others, defecation is too difficult or infrequent.

“It’s important for people to realize that not everyone has a daily bowel movement,” explains Dr. Kaliamurthy, hospitalist at King Edward VII Memorial Hospital. “Some people will have bowel movements three times a day and others may only go three times a week. This is all normal”.

Dr. Kaliamurthy says determining if someone’s concerns arise from misconceptions regarding normal bowel habits may be aided by obtaining a two-week bowel diary. The prevalence of chronic constipation rises with age, most dramatically in patients 65 years of age or older. In this older age group, approximately 26 per cent of men and 34 per cent of women complain of constipation.

Our pharmacies are stocked with an extensive selection of laxatives, which indicates just how often people suffer with this complaint. But overusing stimulant laxatives, which cause the intestines to contract rhythmically, can make the gut dependant, requiring more of the drug and eventually rendering the aid ineffective.

People experiencing discomfort and having trouble with constipation can begin by making life style modification on their own to get rid of constipation” says Dr. Kaliamurthy. “Simple measures like eating foods that are high in fibre will help. Good choices include fruits, vegetables, prune juice and cereal. Regular exercise, drinking plenty of water and other fluids and going to the bathroom at regular times everyday will also help to prevent constipation.”

People who failed to resolve constipation with behavioural modification can try with an over the counter remedy like milk of magnesia. Laxatives are available as pills that can be swallowed, as well as suppositories, that go in the rectum.

However, whether you have already tried laxatives or not, going a week without a bowel movement is good reason to check with your physician. Symptoms that include passing blood, fever, weight loss and/or feeling weak could signal a more serious problem.


Symptoms of reflux, such as heartburn, occur when stomach acid backs up into the oesophagus, which carries food from your mouth to your stomach. Another term for acid reflux is gastroesophageal reflux disease or GERD. Aside from being painful, GERD can harm the oesophagus over time or even lead to oesophageal cancer.

Heartburn typically involves a hot or burning feeling rising up from the centre of the abdomen and into the chest under the breastbone or sternum. Other symptoms include a sour taste in the mouth, producing excess salivation or finding food or fluid in the mouth, particularly at night. Women who are pregnant, patients taking particular medications and people consuming alcohol or certain foods may also suffer with heartburn. Children under age 12 and some adults may have GERD without heartburn and in these cases, may experience an unexplained cough or trouble swallowing. Some may develop a raspy voice or a sore throat.

“Treatment options include life style modifications and medications,” explains Dr. Kaliamurthy. “You might feel better if you lose weight, if you are overweight, raise the head of your bed by six to eight inches, avoid foods that make your symptoms worse such as coffee, chocolate, alcohol and fatty foods, cut down on the amount of alcohol you drink, stop smoking, eat several small meals each day, rather than two or three big meals and avoid lying down for three hours after a meal,” Dr. Kaliamurthy suggests.

Drugs that reduce acid levels, such as Aciphex, Nexium, Prevacid, Prilosec, Pepcid, Tagamet and Zantac may help reflux symptoms if the above measures do not work.

But taking medications is not without risk.

In severe cases of GERD, surgeons can tighten a loose muscle between the stomach and oesophagus to inhibit the upward flow of acid. Recently, laparoscopic surgery involving small incisions, was found to lessen scarring and shorten recovery time compared with open procedures.

Irritable Bowel Syndrome (IBS)

IBS is characterized by abdominal pain, gassiness, bloating and constipation or diarrhoea.

It is also called spastic or nervous colon. Because people with IBS have a colon that appears normal structurally, IBS is considered a functional disorder, which means the system just doesn’t work right. IBS affects about one in five adults, making it one of the most common ailments diagnosed by doctors.

Women are more frequently affected than men.

“The cause of IBS is not known” says Dr. Kaliamurthy. “We believe a combination of factors, including hypersensitivity of the intestinal tract and an imbalance of neurotransmitters (chemicals that send messages between nerve cells) might play a role.”

“While there is no cure, the good news is that IBS does not lead to serious diseases such as cancer and doesn’t shorten a person’s life span. Most people are able to control their symptoms by modifying their diet, finding ways to better manage stress, and sometimes taking medications advised by their physician.

“People suffering from digestive discomfort that persists for more than a week or two and does not respond to modification in diet and exercise, should consult with their healthcare provider,” concludes Dr. Kaliamurthy.

“While many of the above complaints can be easily treated and resolved, it is imperative a physician rule out more serious medical conditions that could be causing the symptoms.”

Dr Manimaran Kaliamurthy is a Hospitalist at King Edward VII Memorial Hospital.

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