Stress, Anxiety and Irritable Bowel Syndrome

From WebMD: 

It's not totally clear how stress, anxiety, and irritable bowel syndrome are related -- or which one comes first -- but studies show they can happen together.

When a doctor talks to people with this digestive disorder, "what you find is that about 60% of IBS patients will meet the criteria for one or more psychiatric disorders," says Edward Blanchard, PhD, professor of psychology at the State University of New York at Albany.

The most common mental ailment people with irritable bowel syndrome have is generalized anxiety disorder, Blanchard says. He thinks more than 60% of IBS patients with a psychiatric illness have that type of anxiety. Another 20% have depression, and the rest have other disorders.

Regardless of whether they have irritable bowel syndrome, people with anxiety tend to worry greatly about issues such as health, money, or careers. Other symptoms include upset stomach, trembling, muscle aches, insomnia, dizziness, and irritability.

There are several theories about the connection between IBS, stress, and anxiety:

• Although psychological problems like anxiety don’t cause the digestive disorder, people with IBS may be more sensitive to emotional troubles.
• Stress and anxiety may make the mind more aware of spasms in the colon.
• IBS may be triggered by the immune system, which is affected by stress.

Ways to Cope With Stress and Anxiety

There's proof that keeping your stress under control can help you prevent or ease IBS symptoms. You could learn about  relaxation techniques such as deep breathing or visualization, where you imagine a peaceful scene. Or you can zap tension by simply doing something fun --  talk to a friend, read, listen to music, or go shopping.

It's also a great idea to exercise, get enough sleep, and eat a good diet for IBS.

Try different stress-busting techniques to see which may help ease your IBS symptoms.

If you’re still tense and anxious, talk with your doctor. Make sure you're getting the right medical treatment for your constipation or diarrhea. Then discuss whether talk therapy might help.

People with irritable bowel syndrome "should really start with their primary care physician, and work with that person," Blanchard says. "They should only go the next step [psychological care] if what they're doing with their doctor is not working."

Help for hemorrhoids

“This is great. I’m here if you need me. Read more here.”

— Dr. P

https://www.health.harvard.edu/diseases-and-conditions/help-for-hemorrhoids

Help for hemorrhoids

One of the most embarrassing conditions also can be one of the easiest to treat and manage.

Hemorrhoids are without doubt among the most unpleasant of health topics. But if you have suffered from them, you may find comfort in knowing that you are not alone.

More than 75% of people ages 45 and older have had hemorrhoids, with symptoms like rectal pain, itching, and bleeding after a bowel movement.

Put an end to your hemorrhoid flare-ups, with these tips from the experts at Harvard Medical School

"Hemorrhoids can be painful and embarrassing, but they often shrink on their own with simple self-help and over-the-counter remedies," says Dr. Howard LeWine, assistant professor of medicine at Harvard Medical School.

A look inside

Hemorrhoids are swollen veins near the anus. There are two types: internal and external. You can have either type by itself, or both at the same time.

Internal hemorrhoids form inside the anal canal and are often painless. However, they may cause intermittent bleeding, usually with bowel movements, and sometimes discharge mucus. Internal hemorrhoids may also protrude outside the anus, where they appear as small, grape-like masses.

External hemorrhoids form just outside the anal opening, where they primarily cause swelling, bothersome protrusions, and discomfort.

Cause and self-care

Sometimes hemorrhoids develop for no apparent reason, but often they are associated with chronic constipation or diarrhea, straining during bowel movements, and prolonged sitting on the toilet. This can interfere with blood flow to and from the rectum (the last six inches of the large intestine) and the anus, causing blood to pool in the veins around the anus, enlarging them.

The good news is that neither kind of hemorrhoid is dangerous, and severe complications are rare. Still, it's important to see your doctor if you experience rectal bleeding, feel a lump in the anus, or have ongoing rectal pain, as these might be signs of an unrelated and more serious condition, such as colorectal or rectal cancer.

Symptoms for either kind of hemorrhoid often can be relieved with self-care treatments. For example:

Sitz baths. A regular sitz bath can relieve itching and irritation. Fill a tub with three to four inches of warm (not hot) water and sit in it with your knees bent for about 10 to 15 minutes. Gently pat yourself dry with a towel.

Fiber supplements. These reduce hemorrhoid bleeding, inflammation, and enlargement by drawing water into your stool to make it easier to pass. A psyllium husk fiber supplement, such as Metamucil or a generic equivalent, is a good choice, although psyllium may cause gas or bloating. In that case, try a supplement containing wheat dextrin (Benefiber) or methylcellulose (Citrucel).

Topical therapies. Over-the-counter products are available for hemorrhoids, such as pads infused with witch hazel (Tucks), as well as soothing creams that contain lidocaine, hydrocortisone, or other ingredients like phenylephrine (Preparation H). These substances help shrink the inflamed tissue and provide relief from itching. External hemorrhoids rarely need more than self-care.

"The exception is a thrombosed hemorrhoid, the sudden formation of a hard, inflamed clot inside the hemorrhoid," says Dr. LeWine. "If this occurs, contact your doctor, since you may need a surgical procedure."

Nonsurgical options

When internal hemorrhoids continue to cause symptoms despite home treatment, your doctor may recommend an office-based nonsurgical procedure. Here are the most common options.

Rubber band ligation. This is the most widely used procedure for treating internal hemorrhoids. The doctor inserts a small elastic band into the anal canal and places it around the base of a hemorrhoid. The band cuts off the hemorrhoid's circulation, which causes the hemorrhoid to wither and die. The rubber band eventually falls off unnoticed. The procedure requires no anesthesia, although a numbing agent is sometimes used if you feel discomfort.

Sclerotherapy. The doctor inserts a proctoscope (a special metal or plastic scope used to view the hemorrhoids) into the anus. He or she then injects a chemical solution directly into the hemorrhoid or the area around it. This solution causes a local reaction that interferes with blood flow inside the hemorrhoid, causing it to shrink. Afterward, some people experience mild bleeding, pain, and pressure.

Coagulation therapy. This uses heat, laser, or electric current to cut off the hemorrhoid's blood supply. Once the hemorrhoid shrinks and dies, scar tissue forms on the anal canal wall to hold nearby veins in place so they don't bulge into the anal canal. One hemorrhoid is treated at a time, with a 10- to 14-day period between treatments.

6 Reasons to See a Gastroenterologist

https://www.healthgrades.com/right-care/digestive-health/6-reasons-to-see-a-gastroenterologist?cid=63emHLN111517C

By Mary Elizabeth Dallas

Many conditions can cause problems during digestion. Chronic pain in the belly is one warning sign that something is wrong. Nagging symptoms, such as bloating, gas and diarrhea are others. They're all reasons to see a gastroenterologist. These doctors are trained to treat conditions that affect the organs of the digestive tract, including the esophagus, stomach, colon, pancreas and liver. If you notice any of the telltale symptoms, it may be time to check in with a gastroenterologist.

Heartburn

Heartburn is pain or burning in the chest or throat. It occurs when acid from the stomach backs up into the esophagus. That's the tube that connects the mouth to the stomach. Many people get heartburn now and then. It goes away on its own or with over-the-counter medicines. But, symptoms that occur more than twice a week could be a sign of a more serious problem: gastroesophageal reflux disease (GERD).

GERD develops when acid from the stomach irritates the lining of the esophagus. GERD is more common among people who smoke or are overweight. Pregnant women also are apt to develop the condition. Medication is available to treat GERD. Severe cases may need surgery. Untreated GERD can cause more serious problems, including chronic inflammation in the esophagus and breathing problems.

Gallstones

Gallstones are small, hard nuggets that form in the gallbladder, a small organ in the belly. A gallstone can be as tiny as a grain of sand or as big as a golf ball. Some people have one large stone. Others develop multiple stones of different sizes. Sudden pain on the right side of your abdomen could be a gallstone. Pain from gallstones passes once they move. Gallstones develop because of imbalances in the substances that form bile. That's the digestive liquid made by the liver. Doctors don't know why these imbalances occur.

Obese people and pregnant women are more likely than others to have gallstones. Having gallstones also becomes more common with age. Anyone who has had one gallstone is at risk for another. Many people who develop gallstones have surgery to remove their gallbladder. In some cases, medications can dissolve the stones.

Lactose Intolerance

People who develop uncomfortable symptoms after drinking milk or eating dairy products may be lactose intolerant. Lactose is a sugar found in milk. The body produces the protein lactase to help break down milk products, including cheese and yogurt.

But, people with lactose intolerance don't make enough lactase to fully digest even small portions of these foods. This can lead to bloating, belly pain, diarrhea, gas, and upset stomach. Symptoms usually appear up to two hours after eating dairy. They can range from mild to severe. Gastroenterologists can test for lactose intolerance. Treatment may involve dietary supplements and changes to your diet.

Celiac Disease

Celiac disease is a genetic condition that involves the immune system. People with the disorder must avoid eating gluten. Gluten is a protein in wheat, rye and barley. It may also be found in certain medicines, vitamins and supplements. When people with celiac disease eat gluten, their immune system responds by damaging their small intestine. This can cause pain and diarrhea. A blood test can help diagnose celiac disease. A gastroenterologist may also need to examine a sample of the small intestine to look for damage.

Celiac disease is not the same as gluten sensitivity. The conditions share common symptoms. The main difference is that people with gluten sensitivity don't develop damage in their small intestine. Completely avoiding gluten can ease symptoms of celiac disease and gluten sensitivity. You may need additional treatment for intestinal damage.

Inflammatory Bowel Disease

Sometimes, a person's immune system mistakes food and other substances in the digestive tract for dangerous germs. It acts against healthy tissue by mistake. This causes inflammatory bowel disease (IBD). IBD includes several disorders that trigger chronic inflammation in the digestive tract. The small and large intestines become irritated and swollen, causing severe belly pain, diarrhea, and rectal bleeding, as well as symptoms that seem unrelated, such as fatigue, joint pain, and fever. Symptoms may ease up and then return during a flare.

The most common IBDs are ulcerative colitis and Crohn's disease. Ulcerative colitis affects the large intestine. Crohn's disease affects anywhere along the digestive tract. Blood tests, tissue or stool samples, X-rays, and CT scans help doctors diagnose IBD. So does endoscopy. That involves checking the inside of the intestines with a scope that has a specialized camera.

Treatment may include medication, surgery, and lifestyle changes, including taking steps to avoid stress. IBD is not the same as IBS, or irritable bowel syndrome. Some symptoms are similar, but IBS does not cause damage in the digestive tract from inflammation.

Colon Cancer Screening

A gastroenterologist can look for signs of certain diseases, such as colon cancer, even if you don't have symptoms. For a colonoscopy, for instance, the doctor will insert a thin tube with a tiny camera into the rectum to see the inside of the colon. Also, imaging scans and stool samples can help diagnose cancer.

Colon cancer usually develops from abnormal growths on the colon or rectum. Finding these growths early lets doctors remove them before they have a chance to become cancerous. Early detection and diagnosis of cancer saves lives. By the age of 50, all people should start getting regular screenings for colon cancer.