By: Datuk Dr Muhammad Radzi Hassan

A look at common digestive health problems affecting Malaysian adults.

WHEN it comes to talking about health issues, digestive health usually takes a back seat to topics that involve the heart, sugar level and blood pressure. But maintaining your digestive health is just as important as taking care of the rest of your body. Digestive health problems can not only turn your stomach upside down, they can also do the same to your life.

The big four

Diseases that relate to the gastrointestinal (GI) tract are called digestive diseases. There are numerous digestive disorders and diseases, ranging from constipation and diarrhoea, to more serious ones like peptic ulcers and cancer. In Malaysia, the most common digestive problems affecting adults are, in order of prevalence:

1. Gastroesophageal Reflux Disease (GERD)

2. Irritable Bowel Syndrome (IBS)

3. Peptic ulcers

4. Colon cancer

Digestive system diseases should not be taken lightly as poor digestive health can lead to more serious illnesses and eventually result in death.

Gastroesophageal Reflux Disease (GERD)

This occurs when the lower oesophageal sphincter (the valve between the oesophagus and stomach) doesn't close tightly enough, thus allowing stomach acid to reflux into the oesophagus.

The most common GERD symptom is heartburn. Although it may be uncomfortable, occasional heartburn isn't dangerous. But if typical heartburn symptoms (e.g. nausea, vomiting, bloating) persist, they can indicate GERD. Other symptoms include coughing, hoarseness, belching and a sour taste in the mouth.

In Malaysia, as in most parts of Asia, GERD is increasing due to lifestyle factors, eg a sedentary lifestyle with little emphasis on physical activity as well as bad food choices, eg more oily and fattening foods. This disease, however, can be treated by prescription medicine or by making lifestyle changes, ie not overeating, losing excessive weight and exercising more.

Irritable Bowel Syndrome (IBS)

IBS is a disorder of the intestines that afflicts an estimated 430,000 Malaysians. It causes stomach aches, cramps, bloating and diarrhoea or constipation. The main symptoms are belly pains with constipation or diarrhoea.

Although IBS is a benign disorder, it can affect your quality of life and nag you for many years. It commonly afflicts those in their late 20s, women, and individuals who have a family history of IBS.

Although doctors do not know what causes IBS, there are many theories. It could result from the interplay between environmental and genetic factors. Symptoms are also thought to be connected to faulty communication between the brain and intestinal tract. Normal motility (movement) may also not be present in the colon of a person who has IBS.

Doctors ensure that there are no alarm factors e.g. weight loss or blood in the stool (which may indicate the presence of a more serious illness) before diagnosing IBS. Treatment usually includes making changes to diet and lifestyle, such as avoiding foods that trigger symptoms, getting regular exercise and managing stress.

Peptic ulcers

Peptic ulcers are small pits that penetrate the lining of the stomach or duodenum. An ulcer may or may not have symptoms, but when symptoms occur, they include a burning or gnawing pain in the middle or upper stomach, appetite and weight loss and the passing of dark or black stools (due to bleeding). Symptoms, however, may vary among individuals.

One common cause of peptic ulcers is the use of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and other medication. Another common cause is infection by a bacteria called Helicobacter pylori (H. pylori). Other causes include smoking and excessive consumption of alcohol. There are several ways to treat ulcers, including making lifestyle changes, taking medication to kill the bacteria and reduce the level of acid in the digestive system, and/or surgery.

Colon cancer

This cancer usually starts out as a polyp, which is a small bump in the surface of the colon. Most polyps are benign, but at least one type is known to be a precursor for colon cancer.

According to the 2nd report of the National Cancer Registry, colon cancer is the 3rd most frequently occurring cancer among Malaysians. The prevalence of colon cancer is also rising, especially among the young.

People over the age of 50 are at higher risk of colon cancer. Other risk factors include having a family history of colon cancer, being obese, keeping to a diet high in fat and low in fibre, smoking and leading a sedentary lifestyle. It is generally recommended that those with risk factors be screened regularly and individuals with no risk factors undergo screening at least once upon turning 50.

Take control

In most cases, taking control of your digestive health is simply a matter of implementing preventive steps such as modifying your lifestyle and diet. So don't wait until you experience digestive problems. Start right away and your digestive system will keep going today and throughout your life.

Tummy trouble worldwide

If you're not convinced that digestive diseases can be fatal, these facts will tell you otherwise.

• In 2006, the Ministry of Health (MOH) Malaysia revealed that digestive system diseases were the 6th leading cause of death in MOH hospitals.
• According to the World Health Organization (WHO), colon and rectum cancer (known collectively as colorectal cancer) were the 20th leading cause of death worldwide in 2004.

- The Star/ANN