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            The Aga Khan University Hospital Pakistan

Digestive Health and Well-Being

<p>​Digestive health is an essential component of life that impacts your overall well-being. Everyone experiences digestive issues now and then, such as food poisoning, diarrhoea, lactose intolerance, etc. However, most people tend to neglect such problems or not take them seriously, which can sometimes lead to unfortunate consequences in the long run. In Pakistan, the prevalence of digestive issues has been estimated to range from 30% to 40%, which is higher than the global average of just over 20%.</p><p>The human digestive system is responsible for breaking down food into smaller pieces by absorbing its vital nutrients and excreting the waste products not needed by the body. The digestive system encompasses various organs starting with the mouth, then the pharynx (the tube going from the nose to the oesophagus), the oesophagus (food pipe), the stomach, small intestines, large intestines, and the rectum. Every organ of the body is dependent upon nutrients for optimal functionality. Therefore, any digestive health issue would impact your overall health.   </p><p>In our part of the world, the most frequently diagnosed digestive issues include Acid Reflux, Gastroesophageal Reflux Disease (GERD) or Heart Burn, Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD), and Peptic Ulcer Disease (PUD).  </p><p>Acid Reflux is simply defined as a condition in which the acid from the stomach flows into the oesophagus, leading to a burning sensation in the chest. If left untreated, acid reflux may eventually lead to GERD. </p><p>Irritable Bowel Syndrome is characterized by recurrent abdominal pain (pain in the stomach region), bloating, and altered bowel habits (constipation or diarrhoea). These symptoms are highly distressing and can impact a person&#39;s mental health; studies suggest that IBS can also lead to depression. Important triggering factors for IBS include stress, certain foods, and hormonal fluctuations. </p><p>Inflammatory Bowel Diseases, such as Crohn&#39;s Disease and Ulcerative Colitis, are characterized by chronic inflammation of the gastrointestinal tract (the passage from the mouth to the anus). The main signs and symptoms presented by patients include diarrhoea (which may include blood or pus), abdominal pain, rectal bleeding, an urgency to have a bowel movement (passing faeces), and weight loss. Patients suffering from IBD have their daily life impaired, leading to stress and difficulty in performing everyday tasks. Therefore, it is essential for patients to work closely with their doctors for proper management of the disease to improve their quality of life.</p><p>Peptic Ulcer Disease is characterized by ulcers (sores or raw areas) that occur in the stomach and the small intestine. A peptic ulcer is caused by bacteria called Helicobacter pylori, which damages the lining of the stomach and the small intestine. Other than the bacteria, peptic ulcers can also be caused by smoking and non-steroidal anti-inflammatory drugs (NSAIDs). If we leave them untreated, peptic ulcers can lead to serious complications like bleeding and gastric cancer. It is also believed that Helicobacter pylori is an important cancer-causing bacteria in the gastrointestinal system.</p><p>A healthy lifestyle is imperative for the maintenance of digestive health. Consuming junk food leads to the intake of a diet that is inadequate in fibre and lacks essential minerals and vitamins. Moreover, urban living in our country is not usually conducive to an active lifestyle; we don&#39;t tend to walk or cycle between destinations and instead rely on motor vehicles. To tackle such sedentary lifestyles, regular exercises in the form of brisk walking, cycling, playing sports, and gyming are encouraged. Additionally, feeling stressed also has an impact on your digestive system due to the brain-gut connection.  </p><p>In most areas of Pakistan, access to clean and drinkable water is limited, with most of the population subjected to contaminated water. Unhygienic food is also a cause of worry for many gastrointestinal infections such as peptic ulcer disease, hepatitis A, and typhoid disease. Emphasis on proper food hygiene and clean water sources is of paramount importance and awareness should be raised for the general public.</p><p>Besides stress, sedentary lifestyles, and unhygienic conditions, patient negligence is another major factor hindering digestive health by delaying early diagnosis and treatment. People usually visit a general physician or gastroenterologist for digestive issues only when they cannot bear the pain or discomfort anymore and it has affected their daily routine. Until then, signs and symptoms of digestive problems are primarily neglected by patients. People also tend to diagnose themselves using the internet and assume the worst, such as gastric or colorectal cancers (which in most cases is not true). Moreover, self-medicating is another common trait in patients. Since digestive issues can lead to quite serious diseases, as seen above, you must visit a professional at the first sign or symptom instead of relying on yourself. Gastroenterologists who understand the diet and cultural values of patients can help provide accurate diagnoses and devise treatment plans.  </p><p>Another important and overshadowed culprit responsible for digestive health issues is malnutrition. Malnutrition, whether it is undernutrition or overnutrition, is a prevalent condition in Pakistan. In cases of undernutrition, the body&#39;s requirements for essential nutrients are not fulfilled, weakening the immune system, and increasing the chances of developing gastrointestinal infections. </p><p>Several approaches can be employed to deal with such unfortunate situations. Firstly, patients should eat a healthy and timely diet that includes fruits, vegetables, and whole grains. Secondly, getting regular physical exercise is crucial as this promotes bowel movements, leading to a healthy gut. It is also advised to avoid smoking and consuming alcohol as they have a direct harmful impact on the gastrointestinal system.</p><p>We recommend that whenever you feel any signs and symptoms such as abdominal pain, bloating, constipation, diarrhoea, and blood or pus in the stool, you should immediately consult a physician or gastroenterologist. Early diagnosis can both prevent and treat most of your digestive health issues.​
</strong>Dr. Om Parkash, Interventional Gastroenterologist and Section Head, Gastroenterology in Dept of Medicine.
FCPS (Medicine), FCPS (Gastroenterology), MSc in Clinical Research, FACP, FACG</p><p>
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