Advice On Gut Health
Gastrointestinal problems are unpleasant to discuss and even more unpleasant to suffer. Here, a Bergen doc explains them.
If your stomach is bloated, burbling or upset, it may be time to grab an antacid or a Pepto—or to see a gastroenterologist, a medical specialist in the digestive system. Wondering when you should opt for the latter instead of the former? Nneoma Okoronkwo, M.D., a gastroenterologist at HVA Medical Group in Fair Lawn and part of the Englewood Health Physician Network, answers key questions about gastrointestinal (GI) issues.
What should people know about GI health? “You are what you eat; your diet matters. I recommend consuming a diet rich in fiber, fruits, vegetables, whole grains and lean proteins while minimizing processed foods, sugars and excessive fats to promote overall digestive health. High levels of stress can also significantly impact digestive health, so incorporate stress-reducing practices into your lifestyle.”
What lifestyle changes can help in this area? “One of the most important ones is staying well hydrated. Drinking enough water is crucial for digestion and maintaining a healthy gut. A balanced diet is also essential. Using mindful eating practices, such as thoroughly chewing food and listening to your body’s hunger cues, can help. Also avoid any kind of smoking and limit alcohol consumption. Finally, it’s important to be mindful of how certain foods affect your digestion. Keeping a food diary can help identify intolerances and sensitivities for better digestive health management.”
What’s GERD? “Gastroesophageal reflux disease, or GERD, occurs when stomach acids or contents flow back into the esophagus, leading to symptoms such as heartburn, regurgitation, a sour taste in the mouth, difficulty swallowing and abdominal discomfort. Several factors contribute to GERD, including obesity, pregnancy and smoking, as well the consumption of acidic or spicy foods, fatty meals, coffee or alcohol.
“If left untreated, GERD can result in serious complications, such as esophageal strictures (narrowing of the esophagus), esophagitis (inflammation of the esophagus), Barrett’s esophagus (changes in the esophageal lining) and an increased risk of esophageal cancer. Fortunately, most people with GERD can manage their symptoms through lifestyle changes, such as maintaining a healthy weight, steering clear of trigger foods, eating smaller meals, not lying down for at least three hours after eating and elevating the head of the bed at night. When lifestyle modifications are not enough, overthe-counter treatments like antacids, H2 blockers such as famotidine and proton pump inhibitors (PPIs) like omeprazole or pantoprazole may be helpful. However, if symptoms persist despite these measures, it’s important to seek care from a gastroenterologist for further evaluation and management.”
What’s the latest in treatments for GI ills? “There have been several advancements. For GERD, if an individual’s systems are resistant to medications and lifestyle changes, minimally invasive endoscopic treatments can help. For ulcerative colitis and Crohn’s disease, there are new and highly effective biologic therapies. These offer patients a wider array of treatment options, allowing for more personalized and targeted care.”
What if embarrassment or anxiety makes someone put off visiting a gastroenterologist? “It is completely normal to feel anxious or embarrassed when discussing GI issues, but keep in mind that gastroenterologists are trained to handle these sensitive issues with care and professionalism. We see cases like yours routinely and are bound by confidentiality. Remember—your health is the priority.”
Is there a specific myth or misconception about a GI problem that you’d like to debunk? “Yes, several. People think you need to ‘detox’ your gut regularly. This is false. The body has inbuilt mechanisms to detoxify itself, primarily through the liver and kidneys. Most people do not need special detox medicines or cleanses. Second, some people believe that heartburn is not a serious medical concern and can be ignored. That’s also false, as heartburn can lead to the more serious complications discussed above. Finally, diarrhea does not always come from food poisoning. Diarrhea has many causes, including infections, stress, antibiotics, medications, malabsorption syndromes, oversecreting syndromes and chronic conditions such as irritable bowel disease (IBD) or irritable bowel syndrome (IBS).”
Why should people try to get to the bottom of GI symptoms? “Symptoms like these need to be investigated, as they could be early signs of an underlying gastrointestinal disease. Seek care from your gastroenterologist if these symptoms are not resolved with dietary changes.”
What screening tests can rule out disease? “They vary depending on a person’s family history, genetics and the medications he or she is taking. For individuals with no family history of colon cancer, genetic risk factors or IBD, colon-cancer screenings are typically recommended starting at age 45. The gold standard for screening is a colonoscopy, but for those who are at lower risk—without symptoms or a family or genetic history—noninvasive stool tests may also be an option. It’s important to discuss with your gastroenterologist which screening tests are most appropriate based on your individual risk factors, such as family history, genetics or any underlying health conditions.”
