The Korea Herald

피터빈트

Bowel problems in the fall season

By Kim Young-won

Published : Sept. 20, 2012 - 22:55

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There are various causes of bowel problems so it is important to assess the progression of symptoms first. Sudden onset of fever, abdominal pain and diarrhea and occasional bloody feces may indicate acute gastroenteritis or bacterial dysentery. Abdominal pain, diarrhea and vomiting are suggestive of food poisoning.

Chronic repetition of abdominal pain and diarrhea without fever and vomiting may indicate irritable bowel syndrome. Simple pain around the navel may indicate constipation or somatization. Diarrhea following excessive consumption of water, sugar or fat may be a temporary problem due to bowel stimulation and usually does not cause abdominal pain.

With irritable bowel syndrome, there is continual diarrhea and constipation, which may alternate. Eating leads to rectal urgency with abdominal pain, which resolves following defecation. It is believed to be caused by problems with the nerves or the gut motility. However, there are no known causes for this condition, so it is difficult to treat and the condition may continue throughout the patient’s life. 

Irritable bowel syndrome does not usually cause significant health problems, so the main treatment is symptomatic relief. Psychological factors can make the condition worse, so it is important to do regular exercises and practice psychological relaxation to relieve stress. Vegetables and fruits rich in dietary fibers are helpful, in particular, carrots and sweet potatoes. It is good to consume fruits with their skin. Coffee should be avoided and beans are not good for this condition because they increase the gas content in the gut.

Of the different types of diarrhea-causing infections, bacterial gastroenteritis causes vomiting and diarrhea with blood or pus in the feces. Acute viral gastroenteritis rarely causes bloody feces and may cause white or yellow watery diarrhea.

Common conditions in early fall and early winter include infective dyspepsia and acute gastritis which is most commonly caused by viruses. Rotavirus commonly causes pseudo cholera, which leads to the production of watery diarrhea. This can lead to more than 10 bowel movements with increased frequency of vomiting and unstable pulse. In severe cases, hospitalization is needed. Most cases are managed using intravenous fluids, antibiotics and dietary modification. In the early stages of the condition, the symptoms can improve with ion drinks or medicines.

Food poisoning and bacterial colitis are common between late summer and warm days of early fall. Most cases are caused by gastro enteric Vibrio species nosocomialla, nosocomial Staphynosocomial and nosocomial E. coli. The main symptoms include diarrhea, abdominal pain, vomiting and fever, and in severe cases, dehydration and shock. Treatment includes the use of antibiotics, analgesics and agents that modify gastric motility. Electrolytes can be replaced with fluids in dehydration.

To prevent food poisoning, it is important to keep the kitchen hygienic. Pests such as cockroaches should be eliminated and cutting boards and tea towels should be sterilized. Refrigerators are set to maintain a temperature of five degrees Celsius but it should be noted that the frequent opening of the door can lead to temperature rise. Because there should be good airflow in the refrigerator, it is not good to overfill it.

In rare cases, Campylobacter can cause food poisoning. Campylobacter species are carried in humans, livestock, pets, fish and shellfish. The symptoms include fever, headache and myalgia, with nausea, abdominal pain and diarrhea in later stages. To prevent this, unpurified water should be avoided. Foods should be wrapped or placed in a container before being placed in the refrigerator.

People commonly complain of dyspepsia and indigestion following excessive eating or drinking but this is not medically classified. Dyspepsia is an uncomfortable feeling in the digestive system. If there is abdominal pain, vomiting and severe symptoms causing breathing problems, it is often referred to as acute indigestion. In dyspepsia, one should eat light meals or fast for one or two meals in order to relieve the gut. Foods such as silk hye and jeonjeok, which are rich in carbohydrates, can cause vomiting if consumed in excess. Spicy and hot foods can also cause diarrhea.

Acute indigestion can be caused by acute gastritis or bacterial food poisoning. In this case, it is best to not eat for about a day to completely empty the gut. Digestive medicines, which support gastric motility, are effective. It may also help to drink few glasses of salty water and induce vomiting by inserting the finger in the throat. Vomiting leads to a drop in body temperature so one should keep warm and lay on the side to protect the airway by preventing suffocation due to repeated vomiting.

By Chang Dong-kyung

The author is a doctor at the division of gastroenterology at Samsung Medical Center and a professor at the Department of Medicine of the Sungkyunkwan University School of Medicine. ― Ed.