Nutrition and Common Digestive Disorders:

This article outlines how changes in your eating habits can help certain gastrointestinal complaints. A word of caution though, no matter how simple a complaint may seem, always make any change in consultation with your doctor.

Gastroesophageal reflux

Gastroesophageal reflux occurs when stomach contents flow upwards into the esophagus. It may be associated with a hiatal hernia. Symptoms include heartburn, pressure and pain with swallowing. The following suggestions may help improve reflux and may help alleviate symptoms without medications.

1. Avoid eating large amounts of food at a time.
2. Elevate the head in bed while sleeping.
3. Do not eat for 2 - 3 hours before bedtime.
4. Avoid coffee, tea, carbonated beverages, alcohol, chocolate and peppermint.
5. Avoid high fat food and smoking.
6. Maintain ideal body weight.

Peptic ulcers

Peptic ulcers are erosions in the central portion of the GI tract (stomach or duodenum). Symptoms may be those of upper abdominal pain, hunger or night time pain, nausea or vomiting. In the past, a bland diet has been prescribed for peptic ulcers however, this has not been proven to have a beneficial effect. The current dietary recommendation include:

1. Eat three well balanced meals per day and avoid bedtime snacking.
2. Avoid alcohol, caffeine, decaffeinated coffee and smoking.
3. Limit as much as possible any foods or spices known to cause you discomfort.

Symptoms of Irritable Bowel Syndrome (IBS)

Functional constipation or diarrhea, and diverticular disease may be improved by a high fiber diet. IBS is one of the most common GI conditions. It is characterized by irregular bowel habits (intermittent diarrhea/constipation), abdominal distension, gas, and cramping. There is no anatomical or organic disease detected. Symptoms are frequently exacerbated with stress. This condition is diagnosed only after an examination by a physician to rule out other conditions first.

Fiber may help these symptoms because with increased fecal bulk and absorption of water, softer, more frequent formed bowel movements results. Fiber rich foods include fruits, vegetables, and whole grain breads and cereals. The 1990 Dietary Guidelines for Americans recommend a daily intake of:

1. Three or more servings of vegetables, including dried peas and beans. Good choices include chick peas, broccoli, carrots, and eggplant.
2. Two or more servings of fruits. For example, apples, pears, nectarines, and raspberries.
3. Six servings of whole grain breads, cereals, rice or pasta.

Ulcerative Colitis and Crohn's Disease

These are frequently grouped together and are referred to as Inflammatory Bowel Disease. Common symptoms include cramping, abdominal pain, diarrhea, weight loss or bleeding. Malnutrition may be present due to poor intake, increased needs, decreased absorption, and increased loss through diarrhea.

Again do not assume that you have any condition, as symptoms of different conditions overlap. These conditions must be diagnosed by your physician.

The diet needs to be individualized based on each patient's food tolerances. During and after acute phases of the disease, doctors usually recommend a low residue diet. A low residue diet may also be used during and after acute episodes of diverticulitis and after gastrointestinal surgery. This gradually advances to a regular diet based on each patients' condition. Guidelines for a low residue diet include:

1. Limit milk products to two cups /day.
2. Limit fruits to juice (except prune), bananas and canned fruit.
3. Limit vegetables to juice and soft, cooked vegetables.
4. Avoid nuts, seeds, dried beans and peas.

Lactose Intolerance

Lactose Intolerance occurs if you have a deficiency of the enzyme lactase, which breaks down the carbohydrate in milk and dairy products. The amount of lactose that can be tolerated varies greatly among individuals. Foods containing the following ingredients may need to be limited: milk, lactose, milk solids, whey, curd, skim milk powder and skim milk solids.

Gluten Intolerance or Sensitivity

Gluten Intolerance or Sensitivity is an inherited disorder. The lining of the small intestine of people with Gluten sensitivity is damaged by foods containing wheat, rye, oats and barley. Careful attention to food labels is necessary to avoid these foods.

Achieving and maintaining ideal or desirable body weight may help to improve many digestive complaints. A registered dietitian can help guide you in achieving your goals. The Kroh Center for Digestive Disorders provides expert dietary services for patients with gastrointestinal complaints.
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