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IBS? Here's the Proper Treatment


Amy Lynch for GBMC

March 4, 2019
March is Colorectal Cancer Awareness Month, bringing digestive issues front and center. Digestive disorders can affect the upper or lower gastrointestinal system, from the esophagus and stomach to the intestines and colon.

A major point of focus in recent years due to media promotion of over-the-counter medications, gastroesophageal reflux disease, or GERD, is a common condition that occurs when excess stomach acid splashes back up into the esophagus.

“We’re seeing increased incidence of GERD among younger patients due to the obesity epidemic and today’s stressful lifestyles,” says Dr. Niraj Jani, director of the Greater Baltimore Medical Center’s Division of Gastroenterology. “Acid reflux can manifest in a variety of symptoms including hoarseness, chronic cough, trouble swallowing, chest pain and generalized abdominal pain.”

As a primary symptom of GERD, heartburn may not seem like a big deal, but it should merit a medical exam to rule out cardiac problems and other underlying conditions.

“Occasional heartburn after you eat pizza probably isn’t a serious issue,” Dr. Jani says. “We’re talking about patients who suffer with symptoms to the point that it’s affecting their diet, their sleep habits and their tooth enamel.”

What Dr. Jani calls “alarm symptoms” should be evaluated immediately — difficulty swallowing, vomiting blood or a sensation of food sticking in your throat.

Comprehensive treatment for acid reflux factors in nutrition, behavioral counseling, medication and, if warranted, endoscopic or surgical intervention. OTC medications vary from mucosal protectants that coat and protect the stomach and esophagus from acid, to hydrogen blockers and proton pump inhibitors. However, Dr. Jani warns against long-term use of any over-the-counter medicines to treat heartburn or reflux.

“If you have chronic symptoms, you should be seen by a gastroenterologist,” he explains. “There are patients who just self-medicate and never get any medical attention, and then they present later on with esophageal cancer or other advanced conditions.”

Another common digestive concern, irritable bowel syndrome affects between 25 and 45 million people in the United States, according to the International Foundation for Gastrointestinal Disorders. IBS is defined by abdominal pain and changes in bowel habits lasting longer than three months in the absence of infection or other contributing factors.

“Inflammatory bowel disease is a different condition, encompassing autoimmune diseases like Crohn’s and ulcerative colitis,” Dr. Jani adds. “These present mostly in younger populations with symptoms like bloody stools, diarrhea, urgent bowel movements and abdominal pain.”

As with GERD, patients with irritable bowel syndrome or inflammatory bowel disease should insist on a thorough medical evaluation.

“At GBMC’s Kroh Center for Digestive Disorders, we incorporate IBS and IBD experts, a GI cancer team, dedicated nurses, nutritionists, behavioral health and acupuncture,” Dr. Jani points out.

Colonoscopy remains the gold-standard screening for colon cancer detection, with current guidelines recommending a baseline procedure at age 50 for healthy adults, although Dr. Jani says stool-based tests that can be performed at home may serve as an initial screening tool for some patients.

“The bottom line is — don’t ignore or minimize any GI issues you may be experiencing,” he urges. “If there’s a problem, we can offer solutions to help, and early detection and diagnosis make a big difference.”

For optimal digestive health, Dr. Jani suggests following a Mediterranean-style diet high in fruits, vegetables and healthy fats; eating smaller meals four or five times a day; and limiting triggers such as caffeine, chocolate and alcohol.
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