Overview

Indigestion — also called dyspepsia or an upset stomach — is a general term that describes discomfort in your upper abdomen. Indigestion is not a disease, but rather some symptoms you experience, including abdominal pain and a feeling of fullness soon after you start eating. Although indigestion is common, each person may experience indigestion in a slightly different way. Symptoms of indigestion may be felt occasionally or as often as daily.

Indigestion can be a symptom of another digestive disease. Indigestion that isn’t caused by an underlying disease may be eased with lifestyle changes and medication.

Symptoms

People with indigestion may have one or more of the following symptoms:

• Early fullness during a meal.

  You haven’t eaten much of your meal, but you already feel full and may not be able to finish eating.

• Uncomfortable fullness after a meal.

  Fullness lasts longer than it should.

• Discomfort in the upper abdomen.

  You feel a mild to severe pain in the area between the bottom of your breastbone and your navel.

• Burning in the upper abdomen.

  You feel an uncomfortable heat or burning sensation between the bottom of your breastbone and your navel.

• Bloating in the upper abdomen.

  You feel an uncomfortable sensation of tightness due to a buildup of gas.

• Nausea.

  You feel as though you want to vomit.

Less frequent symptoms include vomiting and belching.

Sometimes people with indigestion also experience heartburn, but heartburn and indigestion are two separate conditions. Heartburn is a pain or burning feeling in the center of your chest that may radiate into your neck or back during or after eating.

When to see a doctor

Mild indigestion is usually nothing to worry about. Consult your doctor if discomfort persists for more than two weeks. Contact your doctor right away if pain is severe or accompanied by:

• Unintentional weight loss or loss of appetite
• Repeated vomiting or vomiting with blood
• Black, tarry stools
• Trouble swallowing that gets progressively worse
• Fatigue or weakness, which may indicate anemia

Seek immediate medical attention if you have:

• Shortness of breath, sweating or chest pain radiating to the jaw, neck or arm
• Chest pain on exertion or with stress

Causes

Indigestion has many possible causes. Often, indigestion is related to lifestyle and may be triggered by food, drink or medication. Common causes of indigestion include:

• Overeating or eating too quickly
• Fatty, greasy or spicy foods
• Too much caffeine, alcohol, chocolate or carbonated beverages
• Smoking
• Anxiety
• Certain antibiotics, pain relievers and iron supplements

Sometimes indigestion is caused by other digestive conditions, including:

• Inflammation of the stomach (gastritis)
• Peptic ulcers
• Celiac disease
• Gallstones
• Constipation
• Pancreas inflammation (pancreatitis)
• Stomach cancer
• Intestinal blockage
• Reduced blood flow in the intestine (intestinal ischemia)

Indigestion with no obvious cause is known as functional or nonulcer dyspepsia.

Complications

Although indigestion doesn’t usually have serious complications, it can affect your quality of life by making you feel uncomfortable and causing you to eat less. You might miss work or school because of your symptoms. When indigestion is caused by an underlying condition, that condition can also have its own complications.

Overview

Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is stomach pain.

Peptic ulcers include:

• Gastric ulcers

  that occur on the inside of the stomach

• Duodenal ulcers

  that occur on the inside of the upper portion of your small intestine (duodenum)

The most common causes of peptic ulcers are infection with the bacterium Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Stress and spicy foods do not cause peptic ulcers. However, they can make your symptoms worse.

Symptoms

• Burning stomach pain
• Feeling of fullness, bloating or belching
• Intolerance to fatty foods
• Heartburn
• Nausea

The most common peptic ulcer symptom is burning stomach pain. Stomach acid makes the pain worse, as does having an empty stomach. The pain can often be relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication, but then it may come back. The pain may be worse between meals and at night.

Many people with peptic ulcers don’t even have symptoms.

Less often, ulcers may cause severe signs or symptoms such as:

• Vomiting or vomiting blood — which may appear red or black
• Dark blood in stools, or stools that are black or tarry
• Trouble breathing
• Feeling faint
• Nausea or vomiting
• Unexplained weight loss
• Appetite changes

When to see a doctor

See your doctor if you have the severe signs or symptoms listed above. Also see your doctor if over-the-counter antacids and acid blockers relieve your pain but the pain returns.

Overview

Gastritis is a particular phrase for a group of circumstances that have one thing in the prevalent inflammatory condition of the stomach outer layer Gastritis inflammation is most frequently the result of infection with the same bacteria that causes most stomach ulcers. Frequent use of certain pain relievers and drinking too much alcohol may also relate to gastritis. Gastritis may occur unexpectedly (acute gastritis) or occur slowly over time (chronic gastritis). In some cases, gastritis may lead to ulcers and a greater risk of stomach cancer. For most people, even so, gastritis is not serious and improves rapidly with treatment.

Symptoms

The signs and symptoms of gastritis include:

• Gnawing or burning ache or pain (indigestion) in your upper abdomen that may become either worse or better with eating
• Nausea
• Vomiting
• A feeling of fullness in your upper abdomen after eating

Gastritis doesn’t always cause signs and symptoms.

When to see a doctor

Nearly everyone has had a bout of indigestion and stomach irritation. Most cases of indigestion are short-lived and don’t require medical care. See your doctor if you have signs and symptoms of gastritis for a week or longer. Tell your doctor if your stomach discomfort occurs after taking prescription or over-the-counter drugs, especially aspirin or other pain relievers.

If you are vomiting blood, have blood in your stools or have stools that appear black, see your doctor right away to determine the cause.

Causes

Gastritis is an inflammation of the stomach lining. Weaknesses or injury to the mucus-lined barrier that protects your stomach wall allows your digestive juices to damage and inflame your stomach lining. A number of diseases and conditions can increase your risk of gastritis, including Crohn’s disease and sarcoidosis, a condition in which collections of inflammatory cells grow in the body.

Risk factors

Factors that increase your risk of gastritis include:

• Bacterial infection.

  Although infection with Helicobacter pylori is among the most common worldwide human infections, only some people with the infection develop gastritis or other upper gastrointestinal disorders. Doctors believe vulnerability to the bacterium could be inherited or could be caused by lifestyle choices, such as smoking and diet.

• Regular use of pain relievers.

  Common pain relievers — such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, Anaprox) — can cause both acute gastritis and chronic gastritis. Using these pain relievers regularly or taking too much of these drugs may reduce a key substance that helps preserve the protective lining of your stomach.

• Older age.

  Older adults have an increased risk of gastritis because the stomach lining tends to thin with age and because older adults are more likely to have H. pylori infection or autoimmune disorders than younger people are.

• Excessive alcohol use.

  Alcohol can irritate and erode your stomach lining, which makes your stomach more vulnerable to digestive juices. Excessive alcohol use is more likely to cause acute gastritis.

• Stress.

  Severe stress due to major surgery, injury, burns or severe infections can cause acute gastritis.

• Your own body attacking cells in your stomach.

  Called autoimmune gastritis, this type of gastritis occurs when your body attacks the cells that make up your stomach lining. This reaction can wear away at your stomach’s protective barrier.Autoimmune gastritis is more common in people with other autoimmune disorders, including Hashimoto’s disease and type 1 diabetes. Autoimmune gastritis can also be associated with vitamin B-12 deficiency.

• Other diseases and conditions.

  Gastritis may be associated with other medical conditions, including HIV/AIDS, Crohn’s disease and parasitic infections.

Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.

Many people experience acid reflux from time to time. GERD is mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week.

Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications or surgery to ease symptoms.

Symptoms

Common signs and symptoms of GERD include:

• A burning sensation in your chest (heartburn), usually after eating, which might be worse at night
• Chest pain
• Difficulty swallowing
• Regurgitation of food or sour liquid
• Sensation of a lump in your throat

If you have nighttime acid reflux, you might also experience:

• Chronic cough
• Laryngitis
• New or worsening asthma
• Disrupted sleep

When to see a doctor

Seek immediate medical care if you have chest pain, especially if you also have shortness of breath, or jaw or arm pain. These may be signs and symptoms of a heart attack.

Make an appointment with your doctor if you:

• Experience severe or frequent GERD symptoms
• Take over-the-counter medications for heartburn more than twice a week

Causes

GERD is caused by frequent acid reflux.

When you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again.

If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus. This constant backwash of acid irritates the lining of your esophagus, often causing it to become inflamed.

Risk factors

Conditions that can increase your risk of GERD include:

• Obesity
• Bulging of the top of the stomach up into the diaphragm (hiatal hernia)
• Pregnancy
• Connective tissue disorders, such as scleroderma
• Delayed stomach emptying

Factors that can aggravate acid reflux include:

• Smoking
• Eating large meals or eating late at night
• Eating certain foods (triggers) such as fatty or fried foods
• Drinking certain beverages, such as alcohol or coffee
• Taking certain medications, such as aspirin

Complications

Over time, chronic inflammation in your esophagus can cause:

• Narrowing of the esophagus (esophageal stricture).

  Damage to the lower esophagus from stomach acid causes scar tissue to form. The scar tissue narrows the food pathway, leading to problems with swallowing.

• An open sore in the esophagus (esophageal ulcer).

  Stomach acid can wear away tissue in the esophagus, causing an open sore to form. An esophageal ulcer can bleed, cause pain and make swallowing difficult.

• Precancerous changes to the esophagus (Barrett’s esophagus).

  Damage from acid can cause changes in the tissue lining the lower esophagus. These changes are associated with an increased risk of esophageal cancer.

Overview

Ulcerative colitis (UL-sur-uh-tiv koe-LIE-tis) is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. Symptoms usually develop over time, rather than suddenly.

Ulcerative colitis can be debilitating and can sometimes lead to life-threatening complications. While it has no known cure, treatment can greatly reduce signs and symptoms of the disease and bring about long-term remission.

Symptoms

Ulcerative colitis symptoms can vary, depending on the severity of inflammation and where it occurs. Signs and symptoms may include:

• Diarrhea, often with blood or pus
• Abdominal pain and cramping
• Rectal pain
• Rectal bleeding — passing small amount of blood with stool
• Urgency to defecate
• Inability to defecate despite urgency
• Weight loss
• Fatigue
• Fever
• In children, failure to grow

Most people with ulcerative colitis have mild to moderate symptoms. The course of ulcerative colitis may vary, with some people having long periods of remission.

Types

Doctors often classify ulcerative colitis according to its location. Types of ulcerative colitis include:

• Ulcerative proctitis.

  Inflammation is confined to the area closest to the anus (rectum), and rectal bleeding may be the only sign of the disease.

• Proctosigmoiditis.

  Inflammation involves the rectum and sigmoid colon — the lower end of the colon. Signs and symptoms include bloody diarrhea, abdominal cramps and pain, and an inability to move the bowels in spite of the urge to do so (tenesmus).

• Left-sided colitis.

  Inflammation extends from the rectum up through the sigmoid and descending colon. Signs and symptoms include bloody diarrhea, abdominal cramping and pain on the left side, and urgency to defecate.

• Pancolitis.

  This type often affects the entire colon and causes bouts of bloody diarrhea that may be severe, abdominal cramps and pain, fatigue, and significant weight loss.

When to see a doctor

See your doctor if you experience a persistent change in your bowel habits or if you have signs and symptoms such as:

• Abdominal pain
• Blood in your stool
• Ongoing diarrhea that doesn’t respond to over-the-counter medications
• Diarrhea that awakens you from sleep
• An unexplained fever lasting more than a day or two

Although ulcerative colitis usually isn’t fatal, it’s a serious disease that, in some cases, may cause life-threatening complications.

Crohn’s disorder is a form of the inflammatory intestinal disease (IBD). It induces inflammation of the digestive tract, which can result in abdominal pain, severe diarrhea, fatigue, losing weight, and malnourishment. Inflammation triggered by Crohn’s disease may involve various locations of the digestive tract in different individuals. This inflammation frequently spreads to the different levels of the intestines. Crohn’s disease can be either painful and harmful and sometimes it can lead to serious health problems.

There is effectively no cure for Crohn’s disease, and there is no singular cure that works for everybody. One objective of medical therapy is to remove the inflammation that causes clinical symptoms. Another objective is to improve long-term diagnosis by limiting health problems. In the best-case scenarios, this may contribute not only to symptom relaxation but also to long-term cure. Anti-inflammatory drugs are often the first step in the treatment of inflammatory diseases.

Criteria that affect the digestive process or cause severe pain in the abdomen are often interpreted and described as digestive issues, although the stomach may not always be affected. Most abdomen problems are related to the digestive system, although disorders may also be due to body wall situations, blood vessels, urinary tract, reproductive cells, or chest organs. When discomfort is visible, stomach difficulties may be caused by organs near the discomfort site, such as the belly or gall bladder in the abdominal area, or by an appendix in the lower abdomen. General difficulties with the stomach may be correlated with diet, infection, or swelling.

Troubles particular to the stomach and upper digestive system include belching, heartburn, gastroesophageal reflux illness (GERD), hiatal hernia

(weakened area of the abdomen that enables the stomach to protrude into the chest), gastritis, or ulcerative ulcers. Our professional will guide you to the best possible treatment as per your condition.

Overview

Chronic constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer.

Constipation is generally described as having fewer than three bowel movements a week.

Though occasional constipation is very common, some people experience chronic constipation that can interfere with their ability to go about their daily tasks. Chronic constipation may also cause people to strain excessively in order to have a bowel movement.

Treatment for chronic constipation depends in part on the underlying cause. However, in some cases, a cause is never found.

When to see a doctor

Make an appointment with your doctor if you experience unexplained and persistent changes in your bowel habits.

Symptoms

Signs and symptoms of chronic constipation include:

• Passing fewer than three stools a week
• Having lumpy or hard stools
• Straining to have bowel movements
• Feeling as though there’s a blockage in your rectum that prevents bowel movements
• Feeling as though you can’t completely empty the stool from your rectum
• Needing help to empty your rectum, such as using your hands to press on your abdomen and using a finger to remove stool from your rectum

Constipation may be considered chronic if you’ve experienced two or more of these symptoms for the last three months.

Causes

Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract or cannot be eliminated effectively from the rectum, which may cause the stool to become hard and dry. Chronic constipation has many possible causes.

Blockages in the colon or rectum

Blockages in the colon or rectum may slow or stop stool movement. Causes include:

• Tiny tears in the skin around the anus (anal fissure)
• A blockage in the intestines (bowel obstruction)
• Colon cancer
• Narrowing of the colon (bowel stricture)
• Other abdominal cancer that presses on the colon
• Rectal cancer
• Rectum bulge through the back wall of the vagina (rectocele)

Problems with the nerves around the colon and rectum

Neurological problems can affect the nerves that cause muscles in the colon and rectum to contract and move stool through the intestines. Causes include:

• Damage to the nerves that control bodily functions (autonomic neuropathy)
• Multiple sclerosis
• Parkinson’s disease
• Spinal cord injury
• Stroke

Difficulty with the muscles involved in elimination

Problems with the pelvic muscles involved in having a bowel movement may cause chronic constipation. These problems may include:

• The inability to relax the pelvic muscles to allow for a bowel movement (anismus)
• Pelvic muscles that don’t coordinate relaxation and contraction correctly (dyssynergia)
• Weakened pelvic muscles

Conditions that affect hormones in the body

Hormones help balance fluids in your body. Diseases and conditions that upset the balance of hormones may lead to constipation, including:

• Diabetes
• Overactive parathyroid gland (hyperparathyroidism)
• Pregnancy
• Underactive thyroid (hypothyroidism)

Risk factors

Factors that may increase your risk of chronic constipation include:

• Being an older adult
• Being a woman
• Being dehydrated
• Eating a diet that’s low in fiber
• Getting little or no physical activity
• Taking certain medications, including sedatives, opioid pain medications, some antidepressants or medications to lower blood pressure
• Having a mental health condition such as depression or an eating disorder

Complications

• Swollen veins in your anus (hemorrhoids).

  Straining to have a bowel movement may cause swelling in the veins in and around your anus.

• Torn skin in your anus (anal fissure).

  A large or hard stool can cause tiny tears in the anus.

• Stool that can’t be expelled (fecal impaction).

  Chronic constipation may cause an accumulation of hardened stool that gets stuck in your intestines.

• Intestine that protrudes from the anus (rectal prolapse).

  Straining to have a bowel movement can cause a small amount of the rectum to stretch and protrude from the anus.

Overview

Diarrhea — loose, watery and possibly more-frequent bowel movements — is a common problem.

Luckily, diarrhea is usually short-lived, lasting no more than a few days. But, when diarrhea lasts for weeks, it usually indicates that’s there’s another problem. If you have diarrhea for weeks or longer, you may have a condition such as irritable bowel disorder, or a more serious disorder, such as a persistent infection or inflammatory bowel disease.

Symptoms

Signs and symptoms associated with diarrhea may include:

• Loose, watery stools
• Abdominal cramps
• Abdominal pain
• Fever
• Blood in the stool
• Mucus in the stool
• Bloating
• Nausea
• Urgent need to have a bowel movement

When to see a doctor

If you’re an adult, see your doctor if:

• Your diarrhea persists beyond a few days
• You become dehydrated
• You have severe abdominal or rectal pain
• You have bloody or black stools
• You have a fever above 102 F (39 C)

In children, particularly young children, diarrhea can quickly lead to dehydration. Call your doctor if your child’s diarrhea doesn’t improve within 24 hours or if your baby:

• Becomes dehydrated
• Has a fever above 102 F (39 C)
• Has bloody or black stools

Causes

A number of diseases and conditions can cause diarrhea, including

• Viruses.

  Viruses that can cause diarrhea include Norwalk virus, cytomegalovirus and viral hepatitis. Rotavirus is a common cause of acute childhood diarrhea. The virus that causes coronavirus disease 2019 (COVID-19) has also been associated with gastrointestinal symptoms, including nausea, vomiting and diarrhea.

• Bacteria and parasites.

  Contaminated food or water can transmit bacteria and parasites to your body. When traveling in developing countries, diarrhea caused by bacteria and parasites is often called traveler’s diarrhea. Clostridium difficile is another type of bacteria that can cause serious infections that cause diarrhea, and it can occur after a course of antibiotics or during a hospitalization.

• Medications.

  Many medications, such as antibiotics, can cause diarrhea. Antibiotics destroy both good and bad bacteria, which can disturb the natural balance of bacteria in your intestines. Other drugs that cause diarrhea are cancer drugs and antacids with magnesium.

• Lactose intolerance.

  Lactose is a sugar found in milk and other dairy products. People who have difficulty digesting lactose have diarrhea after eating dairy products. Lactose intolerance can increase with age because levels of the enzyme that helps digest lactose drop after childhood.

• Fructose.

  Fructose is a sugar found naturally in fruits and honey. It’s sometimes added as a sweetener to certain beverages. In people who have trouble digesting fructose, it can lead to diarrhea.

• Artificial sweeteners. Sorbitol and mannitol — artificial sweeteners found in chewing gum and other sugar-free products — can cause diarrhea in some otherwise healthy people.
• Surgery.

  Abdominal or gallbladder removal surgeries can sometimes cause diarrhea.

• Other digestive disorders.

  Chronic diarrhea has a number of other causes, such as Crohn’s disease, ulcerative colitis, celiac disease, microscopic colitis and irritable bowel syndrome.

Complications

Diarrhea can cause dehydration, which can be life-threatening if untreated. Dehydration is particularly dangerous in children, older adults and those with weakened immune systems.

If you have signs of serious dehydration, seek medical help.

Indications of dehydration in adults

These include:

• Excessive thirst
• Dry mouth or skin
• Little or no urination
• Weakness, dizziness or lightheadedness
• Fatigue
• Dark-colored urine

Indications of dehydration in infants and young children

These include:

• Not having a wet diaper in three or more hours
• Dry mouth and tongue
• Fever above 102 F (39 C)
• Crying without tears
• Drowsiness, unresponsiveness or irritability
• Sunken appearance to the abdomen, eyes or cheeks

Prevention

Preventing viral diarrhea

Wash your hands to prevent the spread of viral diarrhea. To ensure adequate hand-washing:

• Wash frequently.

  Wash your hands before and after preparing food. Wash your hands after handling uncooked meat, using the toilet, changing diapers, sneezing, coughing and blowing your nose.

• Lather with soap for at least 20 seconds.

  After putting soap on your hands, rub your hands together for at least 20 seconds. This is about as long as it takes to sing “Happy Birthday” twice through.

• Use hand sanitizer when washing isn’t possible.

  Use an alcohol-based hand sanitizer when you can’t get to a sink. Apply the hand sanitizer as you would hand lotion, making sure to cover the fronts and backs of both hands. Use a product that contains at least 60 percent alcohol.

Vaccination

You can help protect your infant from rotavirus, the most common cause of viral diarrhea in children, with one of two approved vaccines. Ask your baby’s doctor about having your baby vaccinated.

Preventing traveler’s diarrhea

Diarrhea commonly affects people who travel to countries where there’s inadequate sanitation and contaminated food. To reduce your risk:

• Watch what you eat.

  Eat hot, well-cooked foods. Avoid raw fruits and vegetables unless you can peel them yourself. Also avoid raw or undercooked meats and dairy foods.

• Watch what you drink.

  Drink bottled water, soda, beer or wine served in its original container. Avoid tap water and ice cubes. Use bottled water even for brushing your teeth. Keep your mouth closed while you shower.

  Beverages made with boiled water, such as coffee and tea, are probably safe. Remember that alcohol and caffeine can aggravate diarrhea and worsen dehydration.

• Ask your doctor about antibiotics.

  If you’re traveling to a developing country for an extended time, ask your doctor about antibiotics before you go, especially if you have a weakened immune system.

• Check for travel warnings.

  The Centers for Disease Control and Prevention maintains a travelers’ health website where disease warnings are posted for various countries. If you’re planning to travel outside of the United States, check there for warnings and tips for reducing your risk.

Overview

Abdominal tuberculosis is an increasingly common disease that poses diagnostic challenge, as the nonspecific features of the disease which may lead to diagnostic delays and development of complications. This condition is regarded as a great mimicker of other abdominal pathology. A high index of suspicion is an important factor in early diagnosis. Abdominal involvement may occur in the gastrointestinal tract, peritoneum, lymphnodes or solid viscera. Various investigative methods have been used to aid in the diagnosis of abdominal tuberculosis. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Most of the patients respond very well to standard antitubercular therapy and surgery is required only in a minority of cases. Imaging plays an important role in diagnosis of abdominal tuberculosis because early recognition of this condition is important. We reviewed our experience with the findings on various imaging modalities for diagnosis of this potentially treatable disease.

How does abdominal TB occur?

Ingestion of the tuberculous germ by drinking unpasteurized milk of a cow infected with TB is one of the mechanisms of abdominal TB.

Abdominal TB can also occur by the spread of the TB bacillus from the lungs to the intestines by the bloodstream.

In 2/3 rd of children, there is predominant involvement of the digestive system. The involvement of the abdominal cavity (peritoneum) occurs in the remaining of the patients. The involvement of only the lymph glands in the abdomen is rare.

What are the signs and symptoms of abdominal TB?

The clinical feature of abdominal tuberculosis is varied. The most common symptoms are pain in the abdomen, loss of weight, anorexia, recurrent diarrhea, low-grade fever, cough, and distension of the abdomen.

The doctor on examination may feel a lump, fluid in the abdomen or a doughy feel of the abdomen. Also, there may be enlarged lymph glands elsewhere in the body.

How is the diagnosis of abdominal TB made?

Diagnosis can be confirmed by isolating the TB germ from the digestive system by either a biopsy or endoscopy. However, other supportive tests that may be done are the Mantoux test, Chest X-Ray, Abdominal X-Rays (with or without barium), and scans such as ultrasound and CT scan.

What are the complications of abdominal TB?

Untreated TB of the intestine may lead to intestinal obstruction, fistula or even abscess and perforation with resultant peritonitis.

What is the treatment of abdominal TB?

Abdominal TB needs to be treated with at least 3-4 anti TB drugs for the initial 2 months and subsequently 2 anti TB drugs for at least 7-10 months.

The commonly used drugs during the initial 2 months therapy (intensification phase) are Isoniazid (INH), Rifampicin, Ethambutol and Pyrazinamide. During the next 7-10 months (continuation phase) 2 the drugs commonly used are INH and Rifampicin.

When is surgery required for Abdominal TB?

Surgery is required whenever there is perforation, abscess or fistula formation.

Overview

Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.

Each time your liver is injured — whether by disease, excessive alcohol consumption or another cause — it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function (decompensated cirrhosis). Advanced cirrhosis is life-threatening.

The liver damage done by cirrhosis generally can’t be undone. But if liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed.

Symptoms

Cirrhosis often has no signs or symptoms until liver damage is extensive. When signs and symptoms do occur, they may include:

• Fatigue
• Easily bleeding or bruising
• Loss of appetite
• Nausea
• Swelling in your legs, feet or ankles (edema)
• Weight loss
• Itchy skin
• Yellow discoloration in the skin and eyes (jaundice)
• Fluid accumulation in your abdomen (ascites)
• Spiderlike blood vessels on your skin
• Redness in the palms of the hands
• For women, absent or loss of periods not related to menopause
• For men, loss of sex drive, breast enlargement (gynecomastia) or testicular atrophy
• Confusion, drowsiness and slurred speech (hepatic encephalopathy)

When to see a doctor

Make an appointment with your doctor if you have any of the signs or symptoms listed above.

Causes

A wide range of diseases and conditions can damage the liver and lead to cirrhosis.

Some of the causes include:

• Chronic alcohol abuse
• Chronic viral hepatitis (hepatitis B, C and D)
• Fat accumulating in the liver (nonalcoholic fatty liver disease)
• Iron buildup in the body (hemochromatosis)
• Cystic fibrosis
• Copper accumulated in the liver (Wilson’s disease)
• Poorly formed bile ducts (biliary atresia)
• Alpha-1 antitrypsin deficiency
• Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)
• Genetic digestive disorder (Alagille syndrome)
• Liver disease caused by your body’s immune system (autoimmune hepatitis)
• Destruction of the bile ducts (primary biliary cirrhosis)
• Hardening and scarring of the bile ducts (primary sclerosing cholangitis
• Infection, such as syphilis or brucellosis
• Medications, including methotrexate or isoniazid

Complications

• High blood pressure in the veins that supply the liver (portal hypertension).
• Swelling in the legs and abdomen.
• Enlargement of the spleen (splenomegaly).
• Bleeding.
• Infections.
• Malnutrition.
• Buildup of toxins in the brain (hepatic encephalopathy).
• Jaundice.
• Bone disease.
• Increased risk of liver cancer.
• Acute-on-chronic cirrhosis.

Overview

Alcohol Related Liver Disease is inflammation of the liver caused by drinking alcohol.

Alcohol Related Liver Disease is most likely to occur in people who drink heavily over many years. However, the relationship between drinking and alcoholic liver diseases is complex. Not all heavy drinkers develop Alcohol Related Liver Disease, and the disease can occur in people who drink only moderately.

If you’re diagnosed with Alcohol Related Liver Disease, you must stop drinking alcohol. People who continue to drink alcohol face a high risk of serious liver damage and death.

Symptoms

The most common sign of alcoholic Liver Diseases is yellowing of the skin and whites of the eyes (jaundice).

Other signs and symptoms include:

• Loss of appetite
• Nausea and vomiting
• Abdominal tenderness
• Fever, often low grade
• Fatigue and weakness

Malnutrition is common in people with alcoholic Liver Diseases. Drinking large amounts of alcohol suppresses the appetite, and heavy drinkers get most of their calories from alcohol.

Additional signs and symptoms that occur with severe alcoholic Liver Diseases include:

• Fluid accumulation in your abdomen (ascites)
• Confusion and behavior changes due to a buildup of toxins normally broken down and eliminated by the liver
• Kidney and liver failure

When to see a doctor

alcoholic Liver Diseases is a serious, often deadly disease.

See your doctor if you:

• Have signs or symptoms of alcoholic Liver Diseases
• Can’t control your drinking
• Would like help cutting back on your drinking

Overview

Fatty liver disease (FLD) is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of FLD is too much fat stored in liver cells.

FLD is increasingly common around the world, especially in Western nations. In the United States, it is the most common form of chronic liver disease, affecting about one-quarter of the population.

Some individuals with FLD can develop nonalcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease, which is marked by liver inflammation and may progress to advanced scarring (cirrhosis) and liver failure. This damage is similar to the damage caused by heavy alcohol use.

Symptoms

• Fatigue
• Pain or discomfort in the upper right abdomen

Possible signs and symptoms of NASH and advanced scarring (cirrhosis) include:

• Abdominal swelling (ascites)
• Enlarged blood vessels just beneath the skin’s surface
• Enlarged spleen
• Red palms
• Yellowing of the skin and eyes (jaundice)

When to see a doctor

Make an appointment with your doctor if you have persistent signs and symptoms that cause you concern.

Overview

Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious liver damage. The hepatitis C virus (HCV) spreads through contaminated blood.

Until recently, hepatitis C treatment required weekly injections and oral medications that many HCV-infected people couldn’t take because of other health problems or unacceptable side effects.

That’s changing. Today, chronic HCV is usually curable with oral medications taken every day for two to six months.

Still, about half of people with HCV don’t know they’re infected, mainly because they have no symptoms, which can take decades to appear. For that reason, the U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for hepatitis C, even those without symptoms or known liver disease. The largest group at risk includes everyone born between 1945 and 1965 — a population five times more likely to be infected than those born in other years.

Symptoms

Long-term infection with the hepatitis C virus is known as chronic hepatitis C. Chronic hepatitis C is usually a “silent” infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease.

Signs and symptoms include:

• Bleeding easily
• Bruising easily
• Fatigue
• Poor appetite
• Yellow discoloration of the skin and eyes (jaundice)
• Dark-colored urine
• Itchy skin
• Fluid buildup in your abdomen (ascites)
• Swelling in your legs
• Weight loss
• Confusion, drowsiness and slurred speech (hepatic encephalopathy)
• Spiderlike blood vessels on your skin (spider angiomas)

Every chronic hepatitis C infection starts with an acute phase. Acute hepatitis C usually goes undiagnosed because it rarely causes symptoms. When signs and symptoms are present, they may include jaundice, along with fatigue, nausea, fever and muscle aches. Acute symptoms appear one to three months after exposure to the virus and last two weeks to three months.

Acute hepatitis C infection doesn’t always become chronic. Some people clear HCVfrom their bodies after the acute phase, an outcome known as spontaneous viral clearance. In studies of people diagnosed with acute HCV, rates of spontaneous viral clearance have varied from 15% to 25%. Acute hepatitis C also responds well to antiviral therapy.

Causes

Hepatitis C infection is caused by the hepatitis C virus (HCV). The infection spreads when blood contaminated with the virus enters the bloodstream of an uninfected person.

Globally, HCVexists in several distinct forms, known as genotypes. Seven distinct HCV genotypes and more than 67 subtypes have been identified. The most common HCVgenotype in the United States is type 1.

Although chronic hepatitis C follows a similar course regardless of the genotype of the infecting virus, treatment recommendations vary depending on viral genotype.

Overview

The term “hepatitis” refers to syndromes or diseases causing liver inflammation, including inflammation due to viruses and chronic alcohol abuse. Viruses causing hepatitis include Hepatitis A, B, C, E, and the delta factor. Each virus causes a distinct syndrome, though they share some symptoms and consequences.

Most people who become infected with hepatitis B get rid of the virus within 6 months. A short infection is known as an “acute” case of hepatitis B.

Causes

Hepatitis B is transmitted via blood and other body fluids. Infection can occur through:

• Contact with blood in healthcare settings — this puts physicians, nurses, dentists, and other healthcare personnel at risk
• Unsafe sex with an infected person
• Blood transfusions
• Sharing needles during drug use
• Receiving a tattoo or acupuncture with contaminated instruments
• Birth — an infected mother can transmit the virus to the baby during delivery or shortly thereafter

People who are at higher risk, including healthcare workers and those who live with someone with hepatitis B, should get the hepatitis B vaccine.

In acute hepatitis, it takes about 1-6 months from the time of infection until symptoms appear. Early symptoms may include nausea and vomiting, loss of appetite, fatigue, and muscle and joint aches. Jaundice, together with dark urine and light stools, follows. About 1% of patients infected with hepatitis B die due to liver damage in this early stage.

The risk of becoming chronically infected depends on the person’s age at the time of infection. More than 90% of newborns, about 50% of children, and less than 5% of adults infected with hepatitis B develop chronic hepatitis.

Most damage from hepatitis B virus is caused by the body’s response to the infection. The body’s immune response against the infected liver cells (hepatocytes) damages the cells, causing liver inflammation (hepatitis). As a result, liver enzymes (transaminases) leak out of the liver into the blood, causing transaminase blood levels to be elevated. The virus impairs the liver’s ability to produce the clotting factor prothrombin, increasing the time required for blood clot formation (prothrombin time).

Liver damage also impairs the body’s ability to rid itself of bilirubin (a breakdown product of old red blood cells), causing jaundice (yellow discoloration of the eyes and body) and dark urine.

Symptoms

• Fatigue, malaise, joint aches, and low-grade fever
• Nausea, vomiting, loss of appetite, and abdominal pain
• Jaundice and dark urine due to increased bilirubin

Overview

Jaundice is yellow discoloration of a newborn baby’s skin and eyes. Infant jaundice occurs because the baby’s blood contains an excess of bilirubin (bil-ih-ROO-bin), a yellow pigment of red blood cells.

Infant jaundice is a common condition, particularly in babies born before 38 weeks’ gestation (preterm babies) and some breast-fed babies. Infant jaundice usually occurs because a baby’s liver isn’t mature enough to get rid of bilirubin in the bloodstream. In some babies, an underlying disease may cause infant jaundice.

Most infants born between 35 weeks’ gestation and full term need no treatment for jaundice. Rarely, an unusually high blood level of bilirubin can place a newborn at risk of brain damage, particularly in the presence of certain risk factors for severe jaundice.

Symptoms

Yellowing of the skin and the whites of the eyes — the main sign of infant jaundice — usually appears between the second and fourth day after birth.

To check for infant jaundice, press gently on your baby’s forehead or nose. If the skin looks yellow where you pressed, it’s likely your baby has mild jaundice. If your baby doesn’t have jaundice, the skin color should simply look slightly lighter than its normal color for a moment.

Examine your baby in good lighting conditions, preferably in natural daylight.

When to see a doctor

Most hospitals have a policy of examining babies for jaundice before discharge. The American Academy of Pediatrics recommends that newborns be examined for jaundice during routine medical checks and at least every eight to 12 hours while in the hospital.

Your baby should be examined for jaundice between the third and seventh day after birth, when bilirubin levels usually peak. If your baby is discharged earlier than 72 hours after birth, make a follow-up appointment to look for jaundice within two days of discharge.

The following signs or symptoms may indicate severe jaundice or complications from excess bilirubin. Call your doctor if:

• Your baby’s skin becomes more yellow
• The skin on your baby’s the abdomen, arms or legs looks yellow
• The whites of your baby’s eyes look yellow
• Your baby seems listless or sick or is difficult to awaken
• Your baby isn’t gaining weight or is feeding poorly
• Your baby makes high-pitched cries
• Your baby develops any other signs or symptoms that concern you

Causes

Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. Bilirubin, which is responsible for the yellow color of jaundice, is a normal part of the pigment released from the breakdown of “used” red blood cells.

Newborns produce more bilirubin than adults do because of greater production and faster breakdown of red blood cells in the first few days of life. Normally, the liver filters bilirubin from the bloodstream and releases it into the intestinal tract. A newborn’s immature liver often can’t remove bilirubin quickly enough, causing an excess of bilirubin. Jaundice due to these normal newborn conditions is called physiologic jaundice, and it typically appears on the second or third day of life.

Other causes

An underlying disorder may cause infant jaundice. In these cases, jaundice often appears much earlier or much later than does the more common form of infant jaundice. Diseases or conditions that can cause jaundice include:

• Internal bleeding (hemorrhage)
• An infection in your baby’s blood (sepsis)
• Other viral or bacterial infections
• An incompatibility between the mother’s blood and the baby’s blood
• A liver malfunction
• Biliary atresia, a condition in which the baby’s bile ducts are blocked or scarred
• An enzyme deficiency
• An abnormality of your baby’s red blood cells that causes them to break down rapidly

Risk factors

Major risk factors for jaundice, particularly severe jaundice that can cause complications, include:

• Premature birth.

  A baby born before 38 weeks of gestation may not be able to process bilirubin as quickly as full-term babies do. Premature babies also may feed less and have fewer bowel movements, resulting in less bilirubin eliminated through stool.

• Significant bruising during birth.

  Newborns who become bruised during delivery gets bruises from the delivery may have higher levels of bilirubin from the breakdown of more red blood cells.

• Blood type. If the mother’s blood type is different from her baby’s, the baby may have received antibodies through the placenta that cause abnormally rapid breakdown of red blood cells.
• Breast-feeding.

  Breast-fed babies, particularly those who have difficulty nursing or getting enough nutrition from breast-feeding, are at higher risk of jaundice. Dehydration or a low caloric intake may contribute to the onset of jaundice. However, because of the benefits of breast-feeding, experts still recommend it. It’s important to make sure your baby gets enough to eat and is adequately hydrated.

• Race.

  Studies show that babies of East Asian ancestry have an increased risk of developing jaundice.

Complications

High levels of bilirubin that cause severe jaundice can result in serious complications if not treated.

Acute bilirubin encephalopathy

Bilirubin is toxic to cells of the brain. If a baby has severe jaundice, there’s a risk of bilirubin passing into the brain, a condition called acute bilirubin encephalopathy. Prompt treatment may prevent significant lasting damage.

Signs of acute bilirubin encephalopathy in a baby with jaundice include:

• Listlessness
• Difficulty waking
• High-pitched crying
• Poor sucking or feeding
• Backward arching of the neck and body
• Fever

Kernicterus

Kernicterus is the syndrome that occurs if acute bilirubin encephalopathy causes permanent damage to the brain. Kernicterus may result in:

• Involuntary and uncontrolled movements (athetoid cerebral palsy)
• Permanent upward gaze
• Hearing loss
• Improper development of tooth enamel

Prevention

The best preventive of infant jaundice is adequate feeding. Breast-fed infants should have eight to 12 feedings a day for the first several days of life. Formula-fed infants usually should have 1 to 2 ounces (about 30 to 60 milliliters) of formula every two to three hours for the first week.

Pancreatitis is a disorder in which your pancreas is infected. The pancreas is a huge gland underneath your stomach and your small intestine. Your pancreas is doing two main things. It discharges powerful digestive microorganisms to your small intestine to help you digest food. It generates insulin and glucagon to your circulatory system. These hormones allow your body to regulate how food is used for energy. Your pancreas may be destroyed when enzymes commence working before your pancreas produces them.

You may require to undergo surgery, where your medication may include. Antibiotics if the pancreas is damaged, Intravenous (IV) fluids given by a needle, Low-fat diet, or dieting, you might need to quit consuming so that your pancreas can restore. In this case, you’re going to get nourishment through a feed tube, and more.

Gallstones forming in the gallbladder are the most frequent source of blocked bile ducts. In relation, bile duct stones can evolve anywhere in the bile duct where bile is present: inside the liver, the gallbladder as well as the bile ducts. Gallstones and bile duct stones are generally made up of cholesterol

or bile salts the prevalent components of bile that have toughened into a stone. These stones can cause rapid pain when the cystic duct in the gallbladder or the prevalent bile duct from the liver is obstructed. Virginia Mason gastroenterologists treat this common issue in adults and children with non-invasive endoscopic innovation.

Gallstones and bile duct stones may be cured with medications first to help control the infection. They may also be treated with miniaturized surgical techniques inserted through an ERCP at the time of treatment. Conversely, stones may be handled with drugs that decompose them, with lithotripsy that uses sound waves to break them down, or with surgery to disable the gallbladder.