What is Acid Reflux Disease?

Normally food and liquid travel down your esophagus to your stomach. A small muscle at the end of the esophagus opens to allow food and liquid to enter the stomach where it is digested by stomach acid. Acid Reflux Disease is a condition where this muscle opens at inappropriate times and allows stomach acid to back up (reflux) into the esophagus. This acid can irritate and even damage the lining of the esophagus and lead to symptoms of acid reflux:

• Frequent and persistent heartburn (a burning feeling rising from the stomach into the chest)
• Worsening of pain after eating or when lying down
• Sour or bitter taste in the mouth
• Difficult or painful swallowing
• Hoarse or scratchy voice
• Persistent coughing or wheezing

In addition to taking medicine, changes in your diet or lifestyle may be recommended to help alleviate your symptoms:

• Eat small meals to avoid extra pressure from a full stomach
• Avoid spicy and acidic foods and drinks as they can make your symptoms worse.
• Stop smoking. Smoking can make acid leak up more easily and slow healing.
• If you are overweight, lose weight to help ease pressure on your stomach.
• Don't lie down or recline for three hours after eating to keep acid from leaking up from your stomach.
• Raise the head of your bed so acid will stay in your stomach.
• Stay away from tight clothing that may put pressure on your stomach.

---

What is Hepatitis C?

Hepatitis C is a virus that attacks your liver. It is a contagious disease that is spread by contact with human blood and blood products that are infected with the Hepatitis C virus. It causes progressive damage to your liver. If it is not treated, it can lead to cirrhosis, liver cancer and even liver failure. Hepatitis C is now the #1 reason people need liver transplants.

Who is at risk for Hepatitis C and what are the symptoms?

There is no such thing as a "typical" Hepatitis C patient and people from all walks of life are at risk. You are at risk for Hepatitis C if you've:

• had a blood transfusion before 1992, including blood received during a cesarean section
• had hemodialysis (treatment with a kidney machine)
• had your ears or other body part pierced using contaminated equipment
• had contact with blood in the workplace or military
• had a tattoo (using contaminated needles or ink)
• tried IV drugs, even just once, or snorted cocaine or other drugs from a shared straw or bill
• shared a razor, toothbrush or any item that could carry infected blood
• had unprotected sex with multiple partners

One of the reasons why many people with Hepatitis C are undiagnosed is that there are few symptoms early in the disease. A person with Hepatitis C may feel fine, but his/her liver is being slowly damaged. Symptoms often do not appear until it is too late to effectively treat Hepatitis C.

When patients do experience symptoms, they are similar to the way you feel when you have the flu, and include fatigue, nausea, muscle and joint pain, and fever. Sometimes people with Hepatitis C experience jaundice.

If you think you might have been exposed to Hepatitis C, see your doctor. A simple blood test can determine if you have been infected.

---

What is Primary Biliary Cirrhosis and how is it treated?

Primary Biliary Cirrhosis (PBC) is a disease of the bile ducts in the liver. In PBC the bile ducts become inflamed. The inflammation is chronic and eventually blocks and destroys bile ducts. If bile ducts are damaged, this affects the proper drainage of bile, a liquid substance produced by the liver that carries away waste and helps the digestive process. The bile backs up into the liver and blood causing various symptoms. This causes inflammation and scarring of the liver and eventually leads to liver cirrhosis, a disorder in which the normal liver cells are destroyed and replaced by scar tissue.

When first diagnosed, many people with PBC often have no symptoms or minor symptoms. The most common symptoms are itchy skin and fatigue. Other symptoms include:

• jaundice
• fluid accumulation (ankles and abdomen)
• cholesterol deposits in the skin
• dry eyes
• dry mouth
• darkening of the skin

Some people with PBC also have osteoporosis, arthritis and thyroid problems.

Initial therapy for PBC is designed to reduce the symptoms of the disease. Medication is used to control the itching, help reduce the build-up of bile in the body and delay the progression of the disease. Calcium and Vitamin D supplements are used to prevent osteoporosis. Artificial tears without preservatives can be used for dry eye symptoms. Sugarless gum or candy and artificial saliva may help reduce mouth dryness.

As the disease progresses and liver damage becomes more severe, some people may need a liver transplant.

---

I don't have any family history of colorectal cancer or of colorectal polyps. I just turned 50 years old. Should I still be screened?

Since the risk of developing colon cancer increases with age, everyone over age 50 should be screened. If you have a personal or family history of colon cancer or polyps or any chronic digestive condition (such as Crohn's Disease or Ulcerative Colitis), you have a higher risk for colon cancer and you should see your physician before age 50 for testing.

What are the symptoms of colon cancer?

Most early cancers produce no symptoms, which is why screening tests are so important. Some of the symptoms below can indicate the presence of colon cancer, so see your physician if any of them persist for more than a couple of weeks.

• a change in bowel habits, for example diarrhea or constipation
• rectal bleeding
• blood in or on the stool (either bright red or very dark in color)
• stools that are narrower than usual
• frequent gas pains, general stomach discomfort (bloating, fullness, cramps)
• a feeling that the bowel does not empty completely
• loss of weight for no apparent reason
• constant tiredness

What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome (IBS) is called a "syndrome" because you may experience a pattern of symptoms such as abdominal pain, constipation, diarrhea and gas that may cause discomfort in several areas of the digestive tract. IBS is known as a functional disorder because there is no sign of disease when the colon is examined.

There still is little known about the causes of IBS. Generally those who experience IBS have been shown to have hyperactive intestines that may overrespond to digesting meals, some medications and psychological stress. Some studies also show that a type of electrical stimulus in the body that governs muscle contractions in the colon is more common in patients who experience IBS.

Since stress appears to be a factor common to IBS, simple forms of relaxation and tension-relieving activities may help. An individualized diet to add foods that will aid in the digestive process and avoid potentially irritating foods such as caffeine and alcohol may be recommended. Adding high-fiber foods or a therapeutic fiber product to your diet can be helpful. Fiber, which is not digested in the body, can absorb up to 30 times its own weight in water, so material in the digestive tract takes on bulk and a soft texture as it passes through the body. Without dietary fiber, the incidence of hemorrhoids, diverticular disease, IBS and even rectal cancer has been shown to increase. Click here to view a list of some of the foods containing dietary fiber.

---

Why is fiber so important and how much should I eat?

There are some major benefits to using more fiber in our diets:

• Bowel regularity is improved. In addition to feeling more comfortable, the risks of colon cancer may be reduced.
• A full and satisfied feeling that helps to control our appetities and helps with weight loss. And high fiber foods are many times lower in calories, another benefit for those losing weight or keeping it off.
• Certain types of fiber, especially those found in oat bran, some fruits (such as apples and oranges), dry beans, peas and legumes, slow down how fast glucose is absorbed in the body. This type of fiber may have an effect on lowering blood glucose levels.
• Yet another benefit may be a decrease in blood cholesterol and triglycerides, the blood fats that increase risks for heart disease.

Most people get 10 to 15 grams of fiber per day. The ideal fiber intake has not been defined, but estimates range from 25 to 50 grams per day.

The fiber content of the diet should be increased gradually so the gastrointestinal tract can adjust to the change. Increased fiber intake may initially cause gas and abdominal distention. Increasing fiber intake gradually, in small amounts, can reduce these symptoms and promote tolerance to the diet.

Fiber from a variety of sources is the most beneficial. To get more fiber use whole grains, cereals and breads, vegetables, dried peas and beans and fruits. Click here to view a list of some of the foods containing dietary fiber.