Dr. Jan Albert Janson, MD, FACG

Patients may be asked to drink only liquids in the days before a colonoscopy, or they may be given an enema to remove residual fecal matter. Before the exam, patients are given medication to help them relax, and then lay on their side on a table. The scope is inserted into the anus and gently moved all the way through the large intestine. Air may be pumped into the intestine to improve the view for the physician. Any polyps that are found will be removed. Then the colonoscope will be withdrawn. A colonoscopy is not usually painful, but patients may feel some bloating or have some cramps right afterward. If patients have polyps removed, they might experience a small amount of bleeding. Any side effects should go away within a few hours.

Anorexia nervosa, frequently referred to as anorexia, is a disorder where people severely restrict the types and quantity of food they eat. Those with anorexia have an extreme fear of eating and gaining weight and may repeatedly weigh themselves or engage in harmful behaviors such as excessive exercise or starvation. Those with anorexia often find themselves preoccupied with food, but unable to consume a healthy amount of it. This results in symptoms such as abnormally low BMI, vitamin deficiency, fatigue, fainting, and amenorrhea (lack of menstruation in women). Anorexia may cause bluish discoloration of the hands, brittle and falling out hair, yellowish skin, and lanugo (fine, downy hair). Left untreated, anorexia can lead to organ failure, brain damage, and even death.

Bulimia nervosa, typically called bulimia, is a disorder where people binge (eat large quantities of food) and purge the food that they just consumed by vomiting, laxative abuse, fasting, or excessive exercise. This behavior is usually motivated by a feeling of powerlessness over eating and a fear of weight gain or desire for weight loss. Bulimia can occur in underweight, normal weight, and overweight people. Symptoms of bulimia include acid reflux, intestinal distress, dehydration from purging, amenorrhea, and dental erosion from vomiting. Some people with bulimia have swollen parotid glands (salivary glands near the cheeks) and red scars and marks on the backs of their knuckles. Electrolyte imbalance from bulimia can be particularly severe and may lead to heart attack or stroke.

Binge eating disorder (BED) is the most common eating disorder. People with BED feel that they are unable to control the amount of food they eat and may continue to binge after reaching a point of fullness. BED binges (consuming large amounts of food) are often accompanied by feelings of sadness, guilt, and shame. Symptoms of BED include obesity, acid reflux, weight gain, and dissatisfaction with one's body. People with BED tend to experience cycles of negative emotions and binges. Binges or BED episodes can be provoked by stress, boredom, restrictive dieting, depression, and other triggers.

Other common eating disorders include:

• Pica, eating things that are not food, such as paper, ice, or soil
• Avoidant/Restrictive Food Intake Disorder (ARFID), disinterest in eating and avoidance of food
• Other Specified Feeding or Eating Disorder (OSFED), abnormal eating that does not fall under any disorder

Many people with eating disorders do not consciously develop them, and have difficulty seeking treatment. For this reason, it's important to detect and treat eating disorders as early as possible. Treatment for eating disorders can vary from therapy visits to inpatient treatment, depending on the disorder and its severity. Treatment aims to not only restore physical health and correct negative behaviors, but to also promote psychological well-being and self-confidence.

IBS, or irritable bowel syndrome, happens when the muscles surrounding the colon contract too easily or frequently. The result is abdominal pain, cramps, diarrhea or constipation, gas and bloating. IBS attacks can often be brought on by specific triggers, so a key part of treatment is learning which foods trigger IBS attacks and avoiding them. Treatment also includes exercise, avoiding stress, and medications if needed.

Constipation, or large, hard, or infrequent stools, happens to everyone at some point. It can be caused by a disruption in routine or food, or by eating a diet without many fresh fruits and vegetables. Although it is uncomfortable, constipation is common and usually not serious, but it can sometimes become chronic. Adding fiber to the diet, exercising, and taking medications may help.

GERD, or gastroesophageal reflux disease, is a severe form of chronic heartburn where stomach acid spills back up into the esophagus. Left untreated, the acid may even eat away at the esophagus and cause serious damage. Treatment includes changing the diet to avoid trigger foods, losing weight if needed, medications, or even surgery.

Hemorrhoids are blood vessels around the rectum that become irritated, swollen or torn while straining during a bowel movement. They are most often caused by constipation, but can also be caused by pregnancy, diarrhea, or simply a genetic predisposition towards hemorrhoids. Treatment involves first treating any constipation issues, then keeping the area clean and soothed until it has healed. If these measures are ineffective, surgery is sometimes used.

Peptic ulcers are sores or spots of inflammation in the lining of the stomach or close to the stomach in the small intestine. Usually this area is coated with a protective lining that shields the tissue from the strong stomach acid, but a break in the lining can let acid in, causing the sores. It used to be thought that stress caused ulcers, but now it is known that is not the case. Most often, they are caused by an infection by H. pylori bacteria, but ulcers can also be caused by alcohol abuse or overuse of aspirin, ibuprofen, naproxen, or other NSAIDS. The symptoms of an ulcer are pain, hunger, nausea, and fatigue.

Gastrointestinal problems, perhaps more than any other area, are markedly affected by lifestyle. Many disorders can be prevented or treated at least in part by eating a healthy diet high in fiber, exercising regularly, drinking enough water, and limiting alcohol intake. Still, the frequency of digestive disorders means that even the healthiest person can be affected by them. Anyone who notices blood in their stool, experiences abdominal pain, unexplained weight loss, or any significant change in bowel movements should see a doctor.