Other Gastrointestinal Disorders

The following less common disorders of the digestive system affect men far more frequently than women:

• Primary sclerosing cholangitis. Primary sclerosing cholangitis is a rare condition that occurs most often in young men and often is the result of inflammatory bowel disease such as ulcerative colitis. With this disease, the bile ducts (the tubes that carry bile from the liver) inside and outside the liver become narrowed due to inflammation and scarring. This causes bile to accumulate in the liver, which, in turn, damages liver cells. There are no initial symptoms, and the disease is usually detected by chance through a routine blood test for liver function. Symptoms develop between ages 30 and 50 and include fatigue, itching, and jaundice (yellowing of the skin and the whites of the eyes). Specialized tests are needed to confirm the diagnosis. No specific treatment exists for this progressive disease other than treating symptoms; cholestyramine may be prescribed to relieve itching.

• Hemochromatosis. Hemochromatosis is an inherited disease in which the body absorbs and stores too much dietary iron. The excess iron accumulates in the liver, pancreas, heart, testicles, and other organs, where it damages surrounding cells. The disease can result from excessive iron absorption (such as from having frequent blood transfusions) but usually is caused by a genetic error. Hemochromatosis is most common among men of northern European descent. The disease is diagnosed with blood tests to measure levels of iron in the blood and a liver biopsy. Symptoms usually appear during middle age and include weakness, weight loss, joint pain, and abdominal pain. The disease eventually causes changes in skin pigmentation (bronze coloration), liver damage, diabetes, and cardiac arrhythmia as it progresses. Liver failure or liver cancer may result. The disease cannot be cured, but its progression can be slowed through regular removal of blood (phlebotomy), such as by routine blood donation.

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