These common gastrointestinal symptoms may indicate an underlying health problem. If you frequently experience any of these symptoms or if they are persistent, talk to your doctor as soon as possible.
• Vomiting. Vomiting usually is preceded by nausea, sweating, and pallor (abnormally pale skin) and is accompanied by involuntary contractions of the abdominal muscles. Vomiting is a medical concern when the vomit contains blood (it may have reddish streaks or may resemble coffee grounds), when it is accompanied by sudden, severe abdominal pain, or when it lasts so long or occurs so frequently that it results in dehydration. Symptoms of dehydration include excessive thirst, infrequent urination, dry skin, fatigue, and light-headedness. Talk to your doctor if vomiting is persistent or if you experience any of these symptoms. Treatment will depend on the underlying cause of the vomiting.
• Constipation. Frequency of bowel movements varies widely; each person has his or her own usual pattern of bowel movements. Constipation refers to difficult, infrequent passing of hard, dry stool. It can be caused by a poor diet (especially a diet high in fat and sugar and low in fiber), long-distance travel, a sedentary lifestyle, poor bowel habits (such as frequently ignoring the urge to have a bowel movement), pregnancy, laxative abuse, certain medications, or specific diseases. You can prevent constipation by drinking plenty of fluids, eating a well-balanced diet that includes plenty of fiber, exercising regularly (such as taking a brisk walk every day), taking a psyllium-based fiber supple-
ment, responding promptly to the urge to have a bowel movement, and main- 261
taining a regular routine for using the toilet. Talk to your doctor if the consti- Digestive pation is severe, occurs suddenly without an identifiable cause, lasts more than System
10 days, or is accompanied by blood in the stool.
• Diarrhea. Diarrhea is frequent passage of loose, watery stool. Usually it results from consuming food or fluid contaminated by certain bacteria, parasites, or viruses. Certain medications also can cause diarrhea, as can anxiety, food allergy, and food intolerance. Diarrhea usually clears up on its own within 2 to 3 days. You can help manage the problem by drinking clear fluids and eating bland, low-fiber foods as your symptoms improve. Over-the-counter antidiarrheal drugs also are available. Contact your doctor if the diarrhea is accompanied by severe abdominal pain or a high fever (102 degrees Fahrenheit or higher), is bloody (it may be red-streaked or appear black and tarry), or lasts more than 3 days. You should also watch for symptoms of dehydration—excessive thirst, infrequent urination, dry skin, fatigue, or lightheadedness—and contact your doctor if you are unable to consume enough fluids to prevent these symptoms.
• Gas. Gas is a normal by-product of digestion. It is caused by the action of bacteria in the large intestine on carbohydrates and proteins in digested food. Air that is swallowed while eating may be belched back out through the mouth or passed along through the digestive tract until it is released through the rectum. The same is true for gases contained in carbonated beverages. Eating fatty meals can cause bloating and discomfort because the delayed emptying of the stomach that is caused by fatty foods allows gas to build up in the stomach. Persistent belching without an obvious cause may also indicate the presence of Helicobacter pylori (H pylori), a bacterium that is the most common cause of peptic ulcers (see page 264). Bloating and excess gas also may be symptoms of lactose intolerance (the inability to digest the milk sugar lactose due to a deficiency of an enzyme called lactase; see page 266). This condition can be controlled by taking over-the-counter lactase supplements, by eating only those dairy products that contain added lactase to aid digestion, or by following a dairy-free diet. Regular exercise, such as brisk walking, can help move gas along and prevent its buildup in the digestive tract, thereby eliminating cramping and bloating.
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