Celiac disease is an autoimmune disorder in which the body reacts abnormally to gluten, that is, creating antibodies that attack the body itself.

Gluten is a protein found in wheat, barley, and rye. When consuming foods derived from these ingredients, the immune system attacks part of the intestine, resulting in poor nutrient absorption, diarrhea, and other problems.

Learn what the symptoms are, how celiac disease is diagnosed, the treatment, and what is myth about this condition.

What are the symptoms of celiac disease?

The development of celiac disease can occur already in childhood, however, adults can also manifest the disease throughout life.

The symptoms are related to damage to the intestinal wall, caused by the attack of autoantibodies. These damages cause poor intestinal absorption, which can lead to symptoms such as:

• anemia;
• low nutrient absorption;
• chronic diarrhea;
• abdominal pain;
• lack of appetite;
• swelling in the belly;
• osteoporosis;
• weight loss and malnutrition.

How is the diagnosis made?

The diagnosis of celiac disease is made by a gastroenterologist, who performs a clinical examination to analyze the symptoms and a biopsy of the intestine through upper endoscopy.

Blood tests for the search of autoantibodies are also necessary for diagnostic confirmation. In some cases, genetic tests are also performed.

How is the treatment done?

Celiac disease has no cure. Being an autoimmune disease, the best treatment consists of a total gluten restriction.

By excluding this protein from the diet, the patient will notice that the symptoms disappear. Clearly, it is not an easy approach, and people usually have a lot of difficulty living with dietary restrictions.

However, since there is no cure, celiac disease directly depends on diet to be kept under control. The diet must be followed rigorously by the patient for the rest of their life.

Important: if not treated, celiac disease can lead to serious health problems, such as malnutrition, infertility, and even neoplasms such as lymphoma.

Gluten-free diet

Patients are advised by the doctor about the appropriate diet to contain the symptoms. In addition, a series of precautions must be taken to avoid the risk of cross-contamination when preparing food.

During the first months of treatment, the doctor may consider restricting the consumption of milk and derivatives to observe if the patient also suffers from lactose intolerance, which is often secondary to intestinal damage.

The doctor may also recommend that the patient seek help from a specialized nutritionist to assist in dietary adaptations.

Important: the patient with celiac disease needs to get used to reading the labels of industrialized foods. The brands themselves write a warning to those intolerant to gluten and lactose.

Attention to labels!

Federal Law No. 10.674 of 2003 ensures that all industrialized foods must mandatorily inform the presence or absence of gluten on their labels to guarantee the right to health of people with celiac disease.

Myths about celiac disease

There are still several myths surrounding celiac disease, the main ones being:

Celiac disease is a food allergy

There is confusion regarding celiac disease. Many people consider it a food allergy, but it is a much more complicated condition.

On one hand, a food allergy consists of a reaction of the body to the consumption of a certain food, occurring soon after its consumption, with symptoms such as shortness of breath and skin rashes.

Celiac disease, on the other hand, can progress slowly and silently, with mild symptoms that become increasingly pronounced until the patient realizes something is wrong with the body.

Only digestive symptoms are caused by celiac disease

Here is another common mistake regarding the understanding of the disease. Although the most classic symptoms are pains in the abdomen, nausea, gas, diarrhea, and weight loss, celiac disease can cause other problems not related to the digestive system, such as:

• mood changes;
• anemia;
• fatigue;
• dermatitis herpetiformis;
• joint pain;
• tingling in the hands and feet;
• lesions in the mouth;
• irregular menstruation;
• growth problems (in children).

Celiac disease is not serious

Celiac disease, like any autoimmune disease, can cause serious complications if not properly treated. Some of these complications involve:

• neoplasms such as lymphoma;
• malnutrition;
• infertility and spontaneous abortion;
• osteoporosis;
• neurological problems.

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Diverticulitis is a condition characterized by the inflammation of intestinal diverticula. Understand this problem and clear your doubts in this article developed by the EndoBlog team.

Diverticula are like small pouches that project out from the lining of the intestine.

The propensity to develop diverticula occurs as a person ages. Approximately, one-third of the population over 50 and two-thirds over 80 develop the condition.

See more at: Intestinal Diverticula: Causes, Symptoms, and Treatments

Important: the mere presence of diverticula in the intestine corresponds to a condition called diverticulosis. When they become inflamed, they are diagnosed with diverticulitis.

What are the symptoms of diverticulitis?

Most patients with intestinal diverticula do not present symptoms of diverticulitis. The diverticula alone do not cause symptoms and are diagnosed by exams done to analyze some other abnormality in the intestine.

However, sometimes, a diverticulum can become inflamed and cause symptoms, such as:

• abdominal pain, mainly in the lower left side of the belly, which can be constant and persist for many days;
• chills;
• nausea, nausea, and vomiting;
• fever;
• loss of appetite;
• periods of constipation or diarrhea;
• blood in the stool, in some cases.

How is diverticulitis treated?

In milder cases of diverticulitis, treatment involves a balanced, more liquid diet, as well as the prescription of antibiotics and painkillers. In some cases, when, for example, the pain is very intense and there are signs of widespread infection, hospitalization is necessary for the application of intravenous antibiotics and clinical management.

If the patient does not respond well to preliminary treatment, there are two approaches: drainage of abscesses, through percutaneous puncture, or surgery to remove the portion of the intestine affected by diverticula. The alternatives for procedures depend on the severity of the condition, and in cases of intestinal perforation, emergency surgery must be performed.

Important: diverticulitis is a condition that tends to have frequent recurrences, so surgery may be necessary after recurrent episodes.

Is it possible to prevent diverticulitis crises?

Although there are no completely effective measures to prevent crises, some things can be done to help, for example:

• drink plenty of water;
• perform physical exercises as recommended by the doctor;
• observe possible changes in bowel function. Constant diarrhea or constipation requires a consultation with the doctor;
• follow the treatment as directed by the doctor, which includes changes in eating habits;
• after recovering from a crisis, it is necessary to have a lighter diet, with foods rich in fiber, such as whole grains, fruits, and vegetables;
• the recommendation to avoid foods with seeds is controversial, as scientific studies cannot prove this direct relationship. However, it is prudent to avoid the following foods: popcorn kernels, sunflower seeds, sesame seeds, and nuts, as they can cause pain by getting trapped in diverticula.

Important: cucumber seeds, tomato, zucchini, raspberries, strawberries, and poppy seeds are usually harmless for those suffering from diverticulitis.

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Bowel cancer, also known as colorectal cancer, ranks second in the most common tumors among women and third among men.

Data from the National Cancer Institute (Inca) show that bowel cancer affects more than 40,000 people every year in Brazil. Due to the aging population, this rate is expected to increase until 2025.

Another concerning factor relates to the diagnosis of the disease. In 85% of cases, colorectal cancer is diagnosed in an advanced stage, when the chances of cure are reduced, making prevention crucial for treatment.

Understand the causes of the disease, the symptoms, and see how to prevent it:

What causes bowel cancer

Bowel cancer arises from the abnormal growth of cells in the rectum or colon. This growth leads to what is understood as a malignant tumor.

Most bowel cancers begin with the emergence of a type of polyp, also known as an adenomatous polyp, that is, an extra tissue growth located on the inner mucosa of the intestine.

Important: bowel cancer is more common in countries where the diet is low in fiber and high in fat, where obesity is more prevalent among the population, and the practice of physical exercise is not regular.

There is no confirmation that the combination of diet, obesity, and sedentarism increases the chances of developing bowel cancer, but it has been observed that it has been developing more in people of all ages (and not just among the elderly).

Risk factors:

• Tobacco smoking;
• Family history of colorectal cancer;
• Presence of adenomatous colorectal polyps;
• Being over 50 years old;
• Diagnosis of inflammatory diseases, such as ulcerative colitis or Crohn’s disease;
• Diet low in fiber or high in fats.

Symptoms of bowel cancer

In its initial stage, the disease may not present symptoms. In more advanced stages, some signs may include:

• diarrhea or constipation;
• stools that are narrower than usual;
• blood in the stool;
• feeling that the bowel does not empty completely even after a bowel movement;
• unexplained weight loss.

Prevention of bowel cancer

Bowel cancer is highly curable, but early diagnosis is necessary, which can be done through exams, such as colonoscopy.

Colonoscopy is an examination that assesses the current situation of the intestine, being able to identify changes, polyps, tumors, and other diseases.

It is recommended that all people over 50 years old (even without symptoms) undergo this examination. For people with a family history of cancer, polyps, or other intestinal diseases, the exam may need to be done before the age of 50.

Important: early diagnosis of bowel cancer is crucial for the treatment and cure of the disease. If not treated, cancer can spread through the wall of the intestine, reaching the lymph nodes or the bloodstream, moving to other parts of the body.

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Gastric cancer, also known as stomach cancer, can be understood as a growth of abnormal cells in the inner lining of the stomach.

Understand better how gastric cancer forms, its signs, symptoms, possible treatments, and how you can prevent it.

Signs and symptoms of gastric cancer

There is no defined cause for gastric cancer, but some signs may be responsible. They include:

• family history (especially in first-degree relatives) of cancer;
• family or personal history of stomach polyps;
• infection in the stomach caused by the bacterium Helicobacter pylori (H. pylori);
• being male or over 60 years old;
• having undergone previous stomach surgery;
• having a diet rich in smoked, salted, poorly preserved foods and poor in fruits and vegetables.

Symptoms of gastric cancer

The disease usually does not show symptoms. When they do appear, it is a sign that the gastric cancer is already at a very advanced stage.

Some of the main symptoms are:

• heartburn or indigestion;
• stomach pains;
• nausea or vomiting;
• unexplained loss of appetite;
• unexpected weight loss;
• feeling of fullness after eating very little food;

Diagnosis and treatment of gastric cancer

Gastric cancer is more difficult to diagnose early, as its symptoms take time to appear. Generally, the diagnosis occurs after routine examinations:

• Endoscopy, an examination that allows the doctor to identify abnormal areas inside the stomach. If suspected, a fragment of the tissue is removed for laboratory tests (biopsy);
• Computed tomography of the abdomen, chest, and pelvis.

How the treatment is done

The treatment of gastric cancer may involve:

• surgery to remove parts of the stomach;
• chemotherapy to fight cancer cells in the body with medication;
• radiotherapy to kill cancer cells in the stomach.

If the cancer is large enough to block the digestive tube, there are some procedures that can be done to deal with the situation. They are:

• placement of a stent, an expandable prosthesis, between the esophagus and the stomach to maintain an opening;
• insertion of a prosthesis between the stomach and the duodenum so that food and liquids can be administered.

In case of a blockage between the stomach and the small intestine, doctors can bypass it by attaching the upper part of the stomach to the middle part of the small intestine.

How to prevent gastric cancer

Gastric cancer should be diagnosed as soon as possible, otherwise, it tends to spread through the lining of the stomach and may not be curable at a certain point.

In the case of gastric atrophy or H. pylori infection, receiving the appropriate treatment already helps to prevent gastric cancer.

Furthermore, there are some ways to prevent gastric cancer:

• Undergo routine examinations with a gastroenterologist;
• Follow the full course of any treatment prescribed by the doctor;
• Rest appropriately;
• Have a healthy diet, rich in nutrients and low in fat and processed foods;
• Exercise;
• Seek a doctor at any sign of abnormalities;
• Undergo therapy to deal with emotional issues and problems.

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Gastric ulcer is a condition that can affect people of different ages and for various reasons. Understand how the ulcer develops and what care should be taken.

What is a gastric ulcer

An ulcer can be understood as a wound that forms on the mucosa (inner lining) of an organ.

Depending on the case, the ulcer can be more superficial or deep, and can cause the perforation of an organ in severe cases.

But do not be alarmed, an ulcer is not necessarily a very serious condition, but it is essential that the individual seeks the care of a gastroenterologist to identify the source and start treatment as soon as possible.

Symptoms and causes of gastric ulcer

Symptoms may include:

• abdominal distension;
• strong abdominal pain, which tends to present as a stabbing sensation;
• pain that can be described as a burning sensation in the pit of the stomach;
• nausea;
• bleeding in the stomach wall, which can be identified in exams, such as endoscopy, or observed in the presence of blood in the stool;
• vomiting.

Causes

The main causes of gastric ulcer are diverse, such as:

• infection by the bacterium H. Pylori: it is the main cause, since the bacterium produces toxins that affect the defenses of the stomach mucosa against gastric acid. From this, ulcers arise;
• excessive stress: most people go through periods of stress. In some, there may be an increase in the secretion of acid in the stomach, which facilitates the development of an ulcer;
• prolonged use of certain medications: nonsteroidal anti-inflammatory drugs, aspirin, and ibuprofen are some examples of medications that can progressively cause erosions in the gastric mucosa, especially among older people;
• tobacco use: smoking is another element that increases the risks of developing an ulcer, due to the high production of acid in the stomach;
• excessive alcohol consumption: alcoholic beverages alter the pH of the organ, causing the body to produce more gastric acid and, consequently, increase the chances of ulcer formation.

How to confirm the diagnosis

The endoscopy exam is used in many cases of suspected stomach ulcer after the appearance of the symptoms mentioned above.

Endoscopy is very important to identify the source of the symptoms, since other digestive problems can have similar signs.

7 tips for care

The treatment for gastric ulcer involves the use of medications and antibiotics prescribed by the doctor to reduce the production of gastric acid and protect the lining of the organ.

In addition, there are 7 actions that help treat gastric ulcer. They are:

1. Avoid citrus foods, spicy foods, and excess caffeine;

2. Avoid alcoholic beverages, tobacco, and cigarettes in general;

3. Avoid excessive use of anti-inflammatory medications;

4. Invest in activities that improve your mood;

5. Do physical exercises;

6. Seek medical follow-up with a gastroenterologist specialist;

7. Follow the treatment exactly as the doctor prescribed.

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Dysphagia is a condition that can cause pain when swallowing, frequent choking, coughing, and a sensation of food being stuck.

The symptoms of dysphagia indicate that something is wrong. It is necessary to seek a doctor to make the diagnosis through an endoscopy, otherwise the person can develop a state of malnutrition.

Generally, in addition to the digestive endoscopy exam, the investigation can also be done through esophageal manometry and X-rays of the esophagus with contrast.

Read more: Difficulty swallowing: understand about dysphagia

Understand, below, more about the disease, its symptoms, and learn how to identify it.

What is dysphagia

Dysphagia is characterized by difficulty swallowing food, whether solid or liquid. To understand how dysphagia influences the digestive process, it is important to know that swallowing consists of three phases: oral, pharyngeal, and esophageal.

In this case, the first phase occurs voluntarily, while the other two involuntarily. When there are signs of abnormality in these last two, the diagnosis will most likely indicate dysphagia.

What are the complications?

Dysphagia can have some complications, especially if the condition negatively influences the patient’s nutritional status, which occurs due to reduced consumption of water and nutrients.

The difficulty in swallowing leads the person to eat less. Consequently, the body stops receiving all the necessary nutrients for its proper functioning.

As a consequence of a weakened diet, the person begins to suffer from nutritional deficiency, possibly entering a state of malnutrition that tends to worsen over time (if dysphagia is not properly treated).

Identifying dysphagia

Follow some of the main symptoms of dysphagia and see how it can be identified through endoscopy:

Symptoms

• Difficulty in chewing food;
• Difficulty swallowing;
• Coughing during or after a meal;
• Delay in swallowing;
• Frequent choking (during meals) or unexpected;
• Sensation of shortness of breath or tiredness when eating;
• Sensation of something stuck in the throat;
• Unjustifiable weight loss;
• Recurrent pneumonia (in more severe cases).

Exams

In addition to the symptoms indicated above, the identification of dysphagia is also made through exams.

Starting with the clinical exam, it is important to evaluate the patient’s history and understand if they feel discomfort when swallowing or a sensation of something stuck in the central region of the chest, for example. At a second moment, the patient is advised to undergo a high digestive endoscopy (HDE), which allows a clearer view of the esophagus and the possibility of removing material for biopsy.

Actions that can help deal with dysphagia

• Perform all meals with an upright back to help the swallowing process occur more easily;
• Base your diet on softer foods, such as soup, puree, or finely chopped foods;
• Have a meal routine at times when you are more alert and willing;
• Remove distractions at mealtime, such as computers, cell phones, and television;
• Chew slowly, taking as much time as necessary.

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Also read: Endoscopic treatment of stomach varices | High Digestive Endoscopy | Intragastric balloon

Achalasia is a disease that can affect people of all ages, but tends to manifest more between the ages of 20 and 40, and progresses gradually over time.

Follow the main information about this condition, such as causes, symptoms, diagnostic tests, and treatments. Also, see how to access health and wellness materials on the internet.

What is achalasia?

Achalasia occurs in the esophagus due to the lack of peristaltic movements – responsible for moving food through the narrowing of the esophageal sphincter to the stomach. In achalasia, there is also difficulty in relaxing this sphincter.

The disease causes significant difficulty swallowing and weight loss (due to insufficient nutrient intake).

What are the main causes and symptoms?

The exact cause of achalasia is still unknown. In this case, scientists believe it may be caused by the immune system itself, which ends up destroying the nerves in the wall of the esophagus. In Brazil, a common cause of achalasia is Chagas disease, which can lead to megaesophagus. This condition can occur over the years, where the esophagus begins to dilate due to the difficulty of food passage through the sphincter.

As a consequence, both the movements responsible for transporting food and the relaxation of the esophageal sphincter muscle do not occur adequately. As a result, both solid and liquid foods are prevented from reaching the stomach.

Symptoms

The main symptoms of achalasia are:

• Difficulty swallowing (dysphagia);
• Chest pain and discomfort;
• Reflux and regurgitation (especially when lying down);
• Weight loss.

What tests are used for the diagnosis of achalasia?

For the diagnosis of achalasia, the following tests are used:

Endoscopy: allows the doctor to analyze the mucous membranes of the stomach, esophagus, and the initial part of the intestine.

Esophageal manometry: helps to examine the peristaltic functions of the esophagus and the degree of relaxation of the esophageal sphincter.

Esophagram: the test that evaluates the passage of food through the esophageal tube and checks the degree of dilation of the organ. It is done through X-ray, after the ingestion of a contrast food.

Read more about: Esophageal dilation

What are the possible treatments?

There are four main treatments that can help patients with achalasia. They are:

Dietary care

Even before having the diagnosis confirmed, the patient with difficulty swallowing (dysphagia) can adopt some dietary habits:

• Chew food thoroughly;
• Have meals in a calm manner, ingesting both solid and liquid foods (to help the food go down);
• Prefer easily digestible foods;
• Avoid lying down immediately after meals;
• Take medications with plenty of water to help the peristaltic movements of the esophagus.

Endoscopic treatment

Through endoscopy, it is possible:

• To apply botox injections to the esophageal sphincter to relieve symptoms, being a palliative measure that can last from 6 months to 1 year.
• To perform pneumatic dilation, which uses a dilating balloon to break the muscle of the lower esophageal sphincter and provide relief to the patient.
• In some cases, myotomy can be performed through endoscopy, with the resection of the muscle of the lower esophageal sphincter, to decrease its pressure.

Surgical procedure

In surgery, part of the lower esophageal sphincter is sectioned so that it no longer obstructs the passage of food. In more severe cases of megaesophagus, the esophagus is removed.

Important: after the surgical procedure, it is necessary to follow up and use medications to prevent reflux.

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Also read: Endoscopic treatment of stomach varices | Upper Digestive Endoscopy | Intragastric balloon

Barrett’s esophagus is a condition that can develop over time. Although it is not serious, it is important to know the causes and symptoms. Follow the main information on the subject.

What is Barrett’s Esophagus

Barrett’s esophagus begins with esophagitis, which is the inflammation of the lower portion of the esophagus. The esophagus is a tube that carries food from the throat to the stomach.

This esophagitis causes heartburn, which is a burning pain or heat in the chest, usually near the lower part of the sternum (bone at the front of the chest). Over time, reflux esophagitis can cause changes in the cells lining the esophagus, leading to a condition called Barrett’s esophagus.

What are the main symptoms of Barrett’s Esophagus?

Barrett’s esophagus does not have specific symptoms.

However, advanced cases of Barrett’s esophagus can develop esophageal cancer. The main symptoms, under these circumstances, are:

• difficulty swallowing (dysphagia);
• weight loss;
• food impaction (food gets stuck in the esophagus).

The causes of Barrett’s Esophagus

The main causes of Barrett’s esophagus involve the persistence of gastric reflux, which rises to the esophagus and can cause changes in the mucosa.

In this sense, it is important to note whether episodes of reflux occur specifically at times when they are considered normal (after eating too much, after bending over after a meal, or when lying down immediately after consuming food/liquids) or if they begin to manifest more frequently throughout the day.

Treatment for Barrett’s Esophagus

The main goal of treatment for Barrett’s Esophagus is to mitigate reflux and ensure that the inner lining of the esophagus does not become cancerous. The main actions to treat Barrett’s esophagus include:

• prescription of antacids;
• performing endoscopic exams to ensure there are no potentially cancerous changes in the esophagus;
• medications that help reduce stomach acid;
• other treatments that relieve reflux symptoms.

After medical follow-up with endoscopic exams, if abnormal tissue is present, such alteration will have to be removed. Some options for procedures are:

• removal by cutting the abnormal tissue, which can be done through an endoscope and tiny tools;
• laser removal, also applied via endoscope;
• surgery to remove esophageal cancer, if the tissue is already cancerous or severely abnormal.

How should the diet be?

To prevent or avoid worsening gastric reflux, the patient can follow some dietary and habit guidelines. They are:

• not consuming a large amount of food at once;
• not consuming alcohol excessively;
• not smoking;
• combating overweight;
• using looser clothing that does not tighten around the waist;
• avoid lying down, bending over, or stooping after meals;
• avoid physical exercise immediately after meals.

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Hiatal hernia can cause pain and reflux. Follow the main information on the subject and see how the treatment is done.

What is a hiatal hernia?

There is a small hole (diaphragmatic hiatus) located in the diaphragm that allows the esophagus to pass from the chest to the abdomen. Sometimes, this hiatus is wider than usual, allowing a small portion of the stomach to rise and enter the chest a little.

This condition is what is understood as a hiatal hernia, that is, when a small portion of the stomach rises through the diaphragm and enters the chest.

How does a hiatal hernia develop?

Although hiatal hernias are more common after middle age, they usually do not cause major problems and doctors do not reach the source of their cause.

What is known is that hiatal hernia occurs more in patients who are smokers, overweight, and a bit older.

What are the symptoms?

Hiatal hernia is not considered a disease, but a condition that is formed by the alteration of the individual’s anatomy.

In some cases, there are symptoms resulting from stomach acid that backs up into the esophagus. This moment is also called reflux and is treated as a problem called gastroesophageal reflux disease (GERD).

This condition can cause some symptoms such as:

• Heartburn: a sensation of pain, burning, or heat in the chest near the bone at the front of the chest (lower sternum), especially when the person lies down soon after eating or consumes a lot of food during the meal;

• Belching: spontaneous burps;

• Sour or bitter taste in the mouth: a symptom caused by the return of food or stomach acid.

How is the diagnosis made?

Many cases of hiatal hernia do not cause prominent symptoms and therefore are diagnosed during exams such as endoscopy to identify other problems. If there are symptoms, the doctor may direct exams to confirm the case and rule out other possible causes.

Possible treatments for hiatal hernia

Treatments for hiatal hernia are not usually applied to people who do not show symptoms. On the other hand, patients who complain of heartburn, pain, or burning are advised to make some changes in their diet, lose weight (if necessary), and not lie down with a full stomach.

In some cases, antacids are prescribed by the doctor. Patients may be referred for surgery if they have more severe conditions.

How can I take care of myself?

To take care of yourself and prevent hiatal hernia, you can follow some steps:

• Take the treatment recommended by the doctor seriously;

• Lose weight, if necessary;

• Break up large meals into smaller ones;

• Avoid wearing tight clothes or that compress the abdomen area;

• Avoid excessive consumption of: alcohol, chocolate, fatty foods, mint-flavored foods, citrus fruits, caffeine, tomato sauce, as well as tobacco;

• Have your last meal 2 to 3 hours before going to bed;

• Raise the head of the bed 6 to 8 inches (using a wooden block frame) if you feel the discomfort of reflux during sleep – an easier alternative is to place a foam wedge (anti-reflux pillow) under the head of the mattress.

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Also read: Upper Digestive Endoscopy | Intragastric Balloon | What is Dysphagia?