It’s common to experience digestive problems. From embarrassing gas to uncomfortable heartburn, everyone has digestive problems from time-to-time. The good news is that there are some simple solutions for many of these troubles. Learn about what causes the discomfort, how to prevent and manage digestive problems, what questions to ask the pharmacist, and when to see a doctor. The most common digestive problems include heartburn, a symptom of acid reflux and gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD). The symptoms of such problems normally present as gas, bloating, constipation, diarrhoea, stomach pain and stomach cramps, among others. However, medics say knowing how to handle such problems is essential, and the good news is that there is a way forward when it comes to digestive problems. One of the best ways out, Daniel Gahungu, a general practitioner at Galien Clinic in Remera, Kigali, says is to understand what causes the discomfort, how to prevent and manage digestive problems in general. UNDERSTANDING THE DIGESTIVE SYSTEM Gahungu explains that digestion doesn’t only happen in the stomach, rather, it’s a long process that involves many organs, which together form the digestive tract. “For digestion to happen, it begins in the mouth, where saliva starts to break down food when it’s chewed. When the food is swallowed, the chewed food moves to the oesophagus, a tube that connects the throat to the stomach,” he explains. He adds that after that, muscles in the oesophagus push the food down to a valve at the bottom of the oesophagus, which opens to let food into the stomach. The doctor adds that after this, the stomach breaks food down using stomach acids. Then the food moves into the small intestine. There, digestive juices from several organs, like the pancreas and gallbladder, break down the food more, and nutrients are absorbed. What’s left goes through the large intestine, where the large intestine absorbs water. The waste then moves out of the body through the rectum and anus,” he adds. He notes that digestive problems can happen anywhere along the way. SYMPTOMS AND HOW TO DEAL WITH THEM Dr Charles Sindabimenya, a specialist in internal medicine at Doctors Plaza in Kimironko, says gas is one of the most common symptoms of digestive problems and it’s a normal part of healthy digestion. He explains that this happens when the air that is in the digestive tract is either released through the mouth as a burp or through the anus as gas. Gas, he says, is created when one swallows air, such as when they eat and drink. Again, he notes that gas is also a by-product of the breakdown of food, whereby some foods cause more gas than others. One may also be more sensitive to particular foods and may have more gas when they eat them, Dr Sindabimenya says. In other cases, he says, if one is taking some medications, it can as well cause gas. Some foods that cause gas, he says, include apples, asparagus, beans, cabbage, among others. He notes that if one consumes such foods, it’s easy for them to feel gassy. Bloating is another common symptom of digestive problems. Here, Gahungu says, when gas builds up in the stomach and intestines, one may experience bloating, which is swelling in the belly and a feeling of fullness. This, he says, may happen more often when one has a stomach infection and is irritable, and this digestive condition causes stomach pain, cramping, and diarrhoea or constipation. Bloating is also common in people with celiac disease. When people with this condition eat gluten, their bodies produce antibodies that attack the intestinal lining. Gahungu notes that hormonal changes that happen around women’s periods can result in bloating, adding that constipation causes bloating as well. Although bloating is usually just uncomfortable, Gahungu says in most cases it can sometimes cause pain in the belly or sides, which can interfere with one’s daily activities. HOW TO REDUCE GAS AND BLOATING Private Kamanzi, a nutritionist says diet and lifestyle is always important when it comes to correcting many health issues, adding that making diet and lifestyle changes can make a big difference in cases of bloating and gas. For instance, he says, cutting down on fatty foods, avoiding fizzy drinks, eating and drinking slowly, not chewing gum, and exercising more often, are just some of the lifestyle options that keep digestive problems away. He adds that one should also avoid sweeteners that cause gas, such as fructose, which are often found in candies, chewing gum, energy bars, and low-carb foods. CONSTIPATION How can you tell that one is constipated? Dr Sindabimenya says the normal number of bowel movements varies from person to person, and if one is straining when using the bathroom, then they are probably constipated. He points out that one may as well have hard stool or a feeling that their bowel movement isn’t complete when this happens—that is constipation. He adds that occasional constipation is common, but if one has less than three bowel movements in a week, it’s important to seek medical attention. Gahungu says there are many causes of constipation, and sometimes one has more than one. He mentions that they include not drinking enough water, eating a diet low in fibre, travelling, getting too little or no exercise at all, among other reasons. Kamanzi adds that taking certain medicines, such as antidepressants, iron, and some pain medications (particularly narcotic pain medications) can result in one being constipated. HEARTBURN Heartburn, sometimes is known as acid indigestion. Francis Kazungu, a general practitioner in Kigali, says it is a painful, burning feeling in the middle of the chest or the upper part of the stomach. The pain, he says, can also spread to the neck, jaw, or arms and can last just a few minutes or hours. How it comes about, he explains, is that there’s a muscle at the entrance of the stomach, known as the lower oesophageal sphincter (LES), which acts as a gate. “It opens to let food move from oesophagus to the stomach, and it shuts to stop food and acid from coming back out. “When the LES opens too often, or isn’t tight enough, stomach acid can rise up into the oesophagus, cause the burning feeling,” he says. Spicy food is said to cause heartburn. For heartburn to occur, Kazungu says there are triggers which vary from person to person. When one overeats, eats spicy foods, consumes caffeine or alcohol, lies down shortly after eating, they are likely to experience heartburn. He adds that some people have a higher risk of heartburn, like smokers, people who are overweight, pregnant women, as well as those with hernia, as this is where the stomach bulges up into the chest through an opening in the diaphragm. To rectify the problem, Sindabimenya says avoiding things that trigger heartburn is the way to go. Avoiding alcohol, chocolate, coffee, fatty or fried foods can help one avoid digestive problems. “Large meals can also set off heartburn, however, instead of eating three large meals a day, one should try to eat several small meals throughout the day,” he advises. editorial@newtimesrwanda.com