1. Belching is caused by swallowed air from:Eating or drinking too fastPoorly fitting dentures; not chewing food completelyCarbonated beveragesChewing gum or sucking on hard candiesExcessive swallowing due to nervous tension or postnasal dripForced belching to relieve abdominal discomfort
2. To prevent excessive belching, avoid:Carbonated beveragesChewing gumHard candies
3. Simethicone may be helpful
4. Abdominal bloating and discomfort may be due to intestinal sensitivity or symptoms of irritable bowel syndrome. To relieve symptoms, avoid:BroccoliBaked beansCabbageCarbonated drinksCauliflowerChewing gumHard candy
5. Abdominal distention resulting from weak abdominal muscles:Is better in the morningGets worse as the day progressesIs relieved by lying down
6. To prevent Abdominal distention:Tighten abdominal muscles by pulling in your stomach several times during the dayDo sit-up exercises if possible
Wear an abdominal support garment if exercise is too difficult
7. Flatulence is gas created through bacterial action in the bowel and passed rectally. Keep in mind that:10-18 passages per day are normalPrimary gases are harmless and odorlessNoticeable smells are trace gases related to food intake
8. Foods that are likely to form gas include:Milk, dairy products, and medications that contain lactose--If your body doesn't produce the enzyme (lactase) to break it down.Certain vegetables--baked beans, cauliflower, broccoli, cabbageCertain starches--wheat, oats, corn, potatoes. Rice is a good substitute.
9. If flatulence is a concern, see your doctor to determine if you are lactose intolerant.
10. Identify offending foods. Reduce or eliminate these gas-forming foods from your diet.
11. Activated Charcoal may provide some benefit.
1. Ulcers are "sores" that frequently affect the stomach and the first part of the small intestine (duodenum).
2. Bacterial infection is the most common cause of duodenal ulcers.
3. Stomach ulcers are often a side effect of pain killers and anti-inflammatory drugs used primarily to treat arthritis.
4. Alcohol ingestion, cigarette smoking, and emotional stress may also influence the development of an ulcer or interfere with its healing.
5. Upper abdominal pain is the most common symptom of ulcers, but many ulcers cause no symptoms at all.
6. Ulcers may hemorrhage (bleeding) into the gastrointestinal tract; this results in the passage of black ("tarry") stool. Very serious ulcer disease may also cause a blockage between the stomach and small intestine and this complication results in persistent vomiting. Severe pain results from the most urgent complication of ulcers - peritonitis caused by a tear through the wall of the stomach or duodenum.
7. Almost all ulcers can be treated successfully, usually without surgery. Many ulcers can be prevented.
8. Ulcer treatments include antibiotics, agents that neutralize gastric acid or reduce its secretion, and drugs that strengthen the resistance of the stomach and duodenum.
1. Despite widespread belief, constipation is not necessarily a part of growing older.
2. Bowel habits are similar in both younger and older healthy people.
3. Constipation is defined as stools that are:
Too small
Too hard
Too difficult to pass
Infrequent (less than 3 per week)
4. Constipation is caused by:
Not enough dietary fiber or fluids
Medication side effects
Emotional or physical stress
Misconception about normal bowel habits
Lack of activity
Medical problems
5. How to manage mild-to-moderate constipation:
Gradually add dietary fiber from variou sources
Increase fluids (water, soup, broth, juices)
Eat meals on a regular schedule
Chew your food well
Gradually increase daily exercise
Respond to urges to move your bowels
Avoid straining
6. See your doctor if these measures don't work
7. Dietary therapy (increased fiber and fluids) and fiber supplements are the preferred treatment for chronic constipation.
8. In some cases, your doctor may recommend the use of stool softeners.
9. Use of mineral oil or stimulant laxatives regularly, consult your doctor to make sure what you are using is right for you.
10. Incontinence of stool or fecal soiling is most often due to leakage around a fecal impaction. Removing the impaction will usually restore continence.
11. Incontinence of stool in healthy older people deserves full education and treatment. Treatment options include:
Adjustment in dietary fiber to reduce amount of stool
Medications to decrease stool frequency
Prescribed use of enemas (not soap enemas)
Biofeedback training
Surgery to restore anal function
1. Keep in mind that a high-fiber diet may tend to improve
Chronic constipation
Coronary heart disease
Hemorrhoids
Diabetes mellitus
Diverticular disease
Elevated cholesterol
Irritable bowel syndrome
Colorectal cancer
2. Try to double your daily fiber intake.
Average American intake: 10-15 grams per day
Recommended intake: 20-35 grams per day
3. Understand what fiber is, where it comes from:
Insoluble fiber
Cereals
Wheat/wheat bran
Whole grains
Soluble fiber
Brans
Fruit
Oatmeal/oat bran
Psyllium
Vegetables
4. Substitute high-fiber foods for high-fat and low-fiber foods.
5. Keep your daily fiber intake stable. Consider a fiber supplement if you:
Travel
Eat away from home often
Find it difficult to get enough fiber through food choices alone
6. Don't shock your system: Increase fiber levels in your diet gradually.
7. Always increase fluids (water, soup, broth, juices) when you increase fiber.
8. Add both soluble and insoluble fiber, from a variety of sources.
9. Compare fiber content of foods:
10. Grams of Fiber
11 1 cup of Rice Krispies®
12. 1
13. 1/3 cup of 100% Bran®
14. 9
15. 1 slice of white bread
16. 0.5
17. 1 slice of whole wheat bread
18. 1.419 1/2 cup white rice
20. 0.5
21. 1/2cup brown rice
22. 1.5
23. Bowl of chicken broth
24. 0
25. Bowl of thick vegetable (minestrone) soup
26. 1
27.
28. Choose foods high in fiber content.
29.
30. Fruits and Vegetables
31. Highest in Fiber Per Serving
32. Fruits
33. Artichokes
34. Apples, pears (with skin)
35. Berries (blackberries, blueberries, raspberries)
36 Dates
37. Figs
38. Prunes
39 Vegetables
40. Beans (baked, black, lima, pinto)
41. Broccoli
42. Chick-peas
43. Lentils
44. Parsnips Peas
45. Pumpkin
46. Rutabaga
47. Squash (winter)
48. Other Good Fiber Choices
49. Barley
50. Bread, Muffins (whole wheat, bran)
51. Cereals (branflakes, bran, oatmeal, shredded wheat)
52. Coconut
53. Crackers (rye, whole wheat)
54. Nuts (almonds, Brazil, peanuts, pecans, walnuts)
55. Rice (brown)56 Seeds (pumpkin, sunflower)Eating high-fiber foods is a healthy choice for most people. If you have ever received medical treatment for a digestive problem, however, it is very important that you check with your doctor to find out if a high-fiber diet is the right choice for you.
1. Diverticulosis is a condition with pouch-like protrusions in the colon:
Rare before age 30
Common after age 60
Usually no symptoms
2. Complications of diverticulosis include:
Bright red rectal bleeding with clots
Diverticulitis
3. Ways to prevent and manage diverticular disease include:
Increasing dietary fiber to keep bowel movements softAvoiding stimulant laxatives
4. Diverticulitis is a serious complication in which pouches become inflamed or infected. Symptoms of diverticulitis include:
Pain in left lower abdomen
Fever
Sudden change in bowel habit
5. See your doctor immediately if you have any of these symptoms.
6. Treatment of diverticulitis may include:
Antibiotics
Special feeding
Surgery
1. Gallstones typically develop over many years, although they can form in months. Gallstones are present in about 20% of women and 10% of men over the age of 55.
2. There are two basic types of gallstones: cholesterol and pigment. Cholesterol gallstones are the most common type in the United States.
3. About 75% of gallstones do not cause symptoms. The most common symptom caused by gallbladder stones is episodic upper abdominal pain.
4. For healthy patients who have no symptoms, no therapy or change in diet is needed. Patients with uncomplicated symptomatic gallbladder stones should reduce dietary fat and consider surgical removal of the gallbladder (cholecystectomy). An alternate approach is oral bile acid therapy. For complicated disease, gallbladder removal is warranted.
5. Patients who undergo rapid weight loss are at risk for the development of small cholesterol gallstones and may benefit from bile acid therapy. Gallstones can seldom be prevented, although a low-fat diet may provide some protective benefit.
1. Five different hepatitis viruses have been identified: type A; type B; type C; type D, or delta virus; and type E. Type A is probably the most prevalent type of viral hepatitis worldwide, followed by types B, E, C, and D.
2. Hepatitis A and E are transmitted through fecally contaminated food or water. Other modes of transmission include needle sharing among intravenous drug abusers; sexual contact; maternal transmission; and transmission by blood transfusion.
3. A simple blood test is used to determine that a person has one or more of the different types of hepatitis.
4. Acute hepatitis is typically characterized by flu-like symptoms (including fever, headaches, fatigue, nausea and vomiting) and jaundice. Chronic hepatitis is often asymptomatic.
5. Vaccines are available to protect against hepatitis A and B. Additionally, immune globulin for hepatitis A or hepatitis B is recommended when someone has been exposed to an infected person.
6. Among the ways to care for your liver are: limiting alcohol consumption; avoiding liver- damaging drugs; practicing safe sex; avoiding use of illegal drugs; avoiding high doses of vitamins unless prescribed; avoiding tattoos and the sharing of razors; not eating raw shellfish from questionable sources; and carefully following directions for use of toxic substances (e.g., cleaning products).
1. Inflammatory bowel disease (IBD) is an inflammation of the small or large intestine that may cause these symptoms:
Diarrhea
Rectal bleeding
Sharp abdominal pain or cramping
Intestinal obstruction
Fever
See your doctor if you have any of these symptoms
2. There are two types of IBD:
Ulcerative Colitis
Starts in rectum and spreas upward
Affects men more tham women
Crohn's Disease
More patchy inflammation
Can start anywhere in the digestive tract
Affects women more than men
3. The cause of IBD is unknown. What is known about IBD includes the following:
IBD is not Contagious.
IBD is not caused by diet
IBD is not a form of cancer.
IBD affects young and old alike.
IBD can usually be treated with medicine but sometimes requires surgery.
4. Diagnosis of IBD is based on:
Family history, travel history, current medications
Stool sample to rule out infection
Flexible sigmoidoscopy/colonoscopy and biopsy to rule out cancer and to identify
IBD
X-ray studies
5. reatment of IBD may include
Medications to reduce or eliminate inflammation
Special diet or elemental formula diet
Surgery
Time is critical. If you suspect IBD, call your doctor.
1. Irritable bowel syndrome (IBS) is a digestive problem also known as "spastic colon" or "irritable colon."
2. IBS symptoms include:
Abdominal pain (colicky, periodic or continuous dull pain)Erratic bowel activity; frequent constipation or diarrheaAccompanying symptoms of bloating, nausea, headache, fatigue
Sensitivity to intestinal gas (cramping, flatulence)
3. The cause of IBS is unknown
No evidence of specific disease
May be triggered by psychological factors or ingestion of food
4. IBS is a condition that:
Is more common in women
Usually starts at an early age (20s and 30s) and recurs from time to time
Rarely starts past age 55
X-ray studies
5. Treatment of IBS includes:
Careful explanation of the syndrome, including what it is not
Better management of key triggers: stress and dietModification of diet to reduce or exclude foods that promote gas
Drug therapy to relieve symptoms (bulk fiber products, antispasmodics, antidiarrheals)
Occasionally, psychiatric therapy and medication
1. Nutrition plays a role in cardiovascular disease, some malignancies, adult-onset diabetes, osteoporosis, alcoholism, and recovery from major injury.
2. Malnutrition can weaken the immune system, impair healing following surgery or injury, lessen mobility, and reduce mental capabilities and function. It is common in older adults.)
3.To maintain good health, total fat intake should be reduced to 30% or less of calories. Saturated fat intake should only account for 10% (one third of fat calories). Salt and alcohol intake also should be limited.
4. Dietary fat content composed primarily of monounsaturated fat (eg, olive oil) and polyunsaturated fat (eg, canola, corn and fish oils) may be associated with a lower incidence of cardiovascular disease.
5. Foods to be avoided include whole milk and dairy products (ice cream, cheese, butter); commercially baked goods (cookies and crackers); hot dogs, ham, and cold cuts; and oils, gravies, and salad dressing.
1. Abnormal swallowing is commonly perceived as food "sticking on the way down." If this complaint persists, it is sometimes due to a serious condition and should always prompt medical attention.
2. Swallowing difficulty may be caused by a number of different problems including:
Poor or incomplete chewing (possibly the result of dental problems, poorly fitted dentures, or eating too quickly)Abnormal muscle contraction
Scar tissue from chronic inflammation
Infection
Cancer
3. Heartburn is a very common problem caused by regurgitation or reflux of gastric acid into the esophagus, which connects the mouth and the stomach.
4. Heartburn can often be eliminated by avoiding:
Smoking
Fatty food in the diet
Caffeine
Chocolate
Peppermint
Overeating
Bed-time snacks
Tight-fitting clothes that constrict the abdomen
Certain medications
Heavy lifting, straining
5. It is important to consider the possibility of heart disease before attributing any kind of chest pain to gastroesophageal reflux.
1. Use of medications increases with age: 80% of older Americans who live independently receive 20 or more prescriptions per year Residents of nursing homes receive an average of 8-10 drugs per day
2. It is important to take medications as prescribed. Reasons for not following directions include:
Too many drugs
Error due to visual or mental impairment
Sharing drugs
Changing doctors
Use of over-the-counter drugs
Sparing expense
Drug side effects
Symptoms not improving
3. See your doctor regularly to check on medications and their effect (bring your medications with you for an office visit or to an emergency room): Drug effect changes with aging There is decreased absorption of drugs through the intestinal tract Decreased kidney function slows drug elimination Metabolism of drugs changes with age
4. The effect medications have on your body will change with aging. For example: Drug action may last longer Drugs may produce toxicity at a lower dose in mature adults than in younger adults
5. Remember that all changes you experience are not necessarily due to aging. For example, decrease in salivary flow is: Due to disease or medication not due to aging
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