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Down The Hatch

The act of digestion isn’t one that comes easily for many Americans. According to the National Institute of Diabetes and Digestive and Kidney Diseases, approximately 70 million Americans have some sort of digestive disorder ranging from acid reflux and constipation to pancreatitis and liver disease. It might not always come easy, but diet, hydration, and talking to your doctor are often the best ways to improve digestion and avoid digestive issues.

Determining the Cause

The gastrointestinal tract is broken into two parts; the upper and lower GI tracts, both of which are responsible for pushing food through the digestive system. Symptoms arising from GI problems manifest in different ways, with some people choosing to seek medical help because of discomfort. 

“Typically I will see patients coming in with abdominal pain, and maybe they’ve had studies from their primary care doctor, and the studies haven’t gotten to the root of the underlying problem,” says Dr. Barry Hammaker, a surgeon at Vail Health. “Job number one is to make sure the patient doesn’t have something that’s treatable with surgery or medicine, and once that’s been done, if nothing has been found, then that’s when you look at what’s going into the GI tract and could be causing a problem.”

A computerized tomography scan (CT scan) is a common means for doctors like Hammaker to look more closely at the GI tract, along with other procedures like an upper endoscopy or a colonoscopy to rule out serious problems causing pain or irritation. Sometimes, a closer look at the digestive system can point to other sources of discomfort — thyroid problems, for instance — that might require treatment outside of a surgical setting to correct.

Other times, evaluating “what’s going into the GI tract” can be just as insightful for identifying an underlying cause of digestive problems. Foods boasting to be “healthy” often contain dozens of ingredients comprised of artificial additives and preservatives, which can lead to GI irritation. This irritation has been increasingly linked to the rise in food intolerances — gluten being a main one — by researchers and doctors as they try to diagnose patients who might experience discomfort from different types of food.

“There is a difference in the way certain products, including wheat products, are processed in the U.S. compared to other places in the world, so sometimes it’s not necessarily the gluten itself, but maybe something that’s going into the processing of a certain food that’s causing the GI tract to have problems,” explains Dr. Hammaker.

Allergy testing is an important way to diagnose intolerances to certain foods, although many doctors, researchers, and nutritionists also advocate eating wholesome diets filled with unprocessed fruits and vegetables to give your digestive system the upper hand when it comes to gastrointestinal health.

Over-the-Counter Answers

Many people look to over-the-counter assistance in the form of antacids such as TUMS® or Pepcid®, to fast-track treating problems like acid reflux and heartburn. According to Forbes, recent revenue from sales of such medications exceeded $13 billion annually, making it one of the most widely used medications in the U.S. While the over-the-counter solutions can be helpful for short-term use, dependence on such medications can be an indication of an underlying problem that’s not being treated.

“If it doesn’t get better within a few months with over-the-counter treatment, you should let your primary care doctor know that it’s happening so it can be investigated and make sure that there’s nothing that could or should be treated that might be driving the process,” explains Dr. Hammaker. 

Constipation is also something that can see improvements with the use of over-the-counter remedies, like fiber, although once again, if the problem doesn’t improve, it could be a sign that a more in-depth analysis of digestive function is needed. 

“For people with constipation issues, maintaining good hydration, and the use of fiber, many times will take care of the problem. And if that’s all it takes and everything goes back to normal, there isn’t necessarily a need for any type of medical evaluation,” adds Dr. Hammaker. “It’s when trying those simple things are not working that one should seek evaluation.”

Keeping Up with Care

Maintaining a level of communication with a primary care physician is crucial in this regard, as any negative changes in your digestive habits can indicate an underlying medical problem that needs treatment. Similarly, talking to your doctor about family history or changes in family history — a new familial diagnosis, for example — are important to get the right screenings for diseases you might be prone to from genetics. Keeping up with standard screenings like colonoscopies — beginning at age at age 45 for African-Americans, 50 for everyone else — are crucial to monitoring your body, and ensuring that the medical professionals are aware of any changes that might need further examination. Whether they give a perspective on where things have gone awry, or simply help deliver a checklist for a clean bill of health, being proactive gives you a head start.  

Fiber's Magical Properties

Uncoiled, the average GI tract is 25 feet long — half the length of a tractor-trailer. For optimal GI-tract health, fiber is one of the best things to digest. Here’s what happens to food after it’s swallowed:

2 hours
Average time food sits in the stomach is two hours. In the stomach, fiber:

• Helps you feel full.
• Regulates blood sugar by slowing down the gastric entry so food doesn’t rush into the small intestine and spike your blood sugar.

4-6 hours 
Food leaves your stomach and travels around the small intestine for a few hours. In the small intestine, fiber:

• Lowers cholesterol by entrapping fats and sugars and slowing their absorption.

16-24 hours
The bulk of our food waste sits in the large intestine for 16-24 hours. In the large intestine, fiber:

• Feeds good bacteria. The bacteria ferment the fiber and produce a fatty acid called butyrate, which helps inhibit growth of cancerous cells if they are present.
• Speeds things along — just like having food sit around in the kitchen, the sooner it’s put away and cleaned, the better. 
• Lowers stool pH, helping create anti-cancer substances in the colon.

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About
Dr. Barry Hammaker - Dr. Hammaker received his medical degree from Georgetown University School of Medicine and completed his residency at William Beaumont Army Medical Center. He is board certified by the American Board of Surgery and has an interest in advanced laparoscopic surgery, thoracic surgery, surgical endoscopy and colon cancer screening. A surgeon at Mountain Surgical Associates, Dr. Hammaker's tenure at Vail Health includes medical director, medical staff president and vice president and operating room committee chairman. Before arriving in Vail, Dr. Hammaker completed 16 years of active duty military service, including multiple tours in Iraq and Afghanistan from 2001 to 2005.

Melaine Hendershott, nutrition and dietitian services | l (970) 479-5058  vailhealth.org/nutrition