Between 3 percent and 20 percentTrusted Source of Americans experience irritable bowel syndrome (IBS) symptoms. The condition affects more women than men. Some people with IBS have minor symptoms. However, for others the symptoms are significant and disrupt daily life.
IBS is also known as spastic colon, irritable colon, mucous colitis, and spastic colitis. It is a separate condition from inflammatory bowel disease and isn’t related to other bowel conditions. IBS is a group of intestinal symptoms that typically occur together. The symptoms vary in severity and duration from person to person. However, they last at least three months for at least three days per month.
IBS can cause intestinal damage in some cases. However, that is not common.
IBS doesn’t increase your risk of gastrointestinal cancers, but it can still have a significant effect on your life.
The symptoms of IBS typically include:
- abdominal pain
- bloating and gas
It’s not uncommon for people with IBS to have episodes of both constipation and diarrhea. Symptoms such as bloating and gas typically go away after you have a bowel movement.
Women may tend to have symptoms around the time of menstruation, or they may have more symptoms during this time. Menopausal women have fewer symptoms than women who are still menstruating. Some women have also reported that certain symptoms increase during pregnancy.
Symptoms of IBS in men are the same as the symptoms in women. However, a lot fewer men report their symptoms and seek treatment.
Symptoms of IBS aren’t always persistent. They can resolve, only to come back. However, some people do have continuous symptoms.
IBS pain may feel like cramping. With this cramping, you will also have at least two of the following experiences:
- some relief of pain after a bowel movement
- a change in how often you have a bowel movement
- changes in the way your stools look
Your doctor may be able to diagnose IBS based on your symptoms. They may also take one or more of the following steps to rule out other possible causes of your symptoms:
- have you adopt a certain diet or cut out specific food groups for a period to rule out any food allergies
- have a stool sample examined to rule out infection
- have blood tests done to check for anemia and rule outceliac disease
- perform a colonoscopy
A colonoscopy is typically only done if your doctor suspects that your symptoms are being caused by colitis, inflammatory bowel disease (Crohn’s disease), or cancer.
For some people, dietary changes can go a long way in helping ease symptoms. Because the symptoms of IBS vary among people with the condition, approaches to dietary changes need to vary.
There is no cure for IBS. Treatment is aimed at symptom relief. Initially, your doctor may have you make certain lifestyle changes. These “home remedies” are typically suggested before the use of medication.
Certain home remedies or lifestyle changes may help to relieve your IBS symptoms without the use of medication. Examples of these lifestyle changes include:
- participating in regular physical exercise
- cutting back on caffeinated beverages that stimulate the intestines
- eating smaller meals
- minimizing stress (talk therapy may help)
- taking probiotics (“good” bacteria normally found in the intestines) to help relieve gas and bloating
- avoiding deep-fried or spicy foods
Managing your diet when you have IBS may take a little extra time but is often worth the effort. Modifying amounts or eliminating certain foods such as dairy, fried foods, indigestible sugars, and beans may help to reduce different symptoms. For some people, adding spices and herbs such as ginger, peppermint, and chamomile has helped to reduce some IBS symptoms.
If your symptoms do not improve through home remedies, such as lifestyle or dietary changes, your doctor may suggest the use of medications. Different people can respond
differently to the same medication, so you may need to work with your doctor to find the right medication for you.
As with all medication, when considering new medication, it’s important to tell your doctor what you are already taking, including herbal remedies and over-the-counter medications. This will help your doctor avoid any medication that could interact with what you are already taking.
Some drugs are used to treat all symptoms of IBS, while other drugs are focused on specific symptoms. Drugs that are used include medications to control muscle spasms, anticonstipation drugs, tricyclic antidepressants to ease pain, and antibiotics. If your main IBS symptom is constipation, linaclotide and lubiprostone are two drugs that are recommended by the American College of Gastroenterology (ACG).
Although there are many ways to treat IBS, the exact cause of IBS is unknown. Possible causes include an overly sensitive colon or immune system. Postinfectious IBS is caused by a previous bacterial infection in the gastrointestinal tract. The varied possible causes make IBS difficult to prevent.
The physical processes involved in IBS can also vary, but may consist of:
- slowed or spastic movements of the colon, causing painful cramping
- abnormal serotonin levels in the colon, affecting motility and bowel movements
- mild celiac disease that damages the intestines, causing IBS symptoms
For many people, the key to managing IBS symptoms is to avoid triggers. Certain foods as well as stress and anxiety can be triggers for IBS symptoms for many people.
Certain foods are common triggers for many people with IBS. However, some of these foods may have a greater effect on you than others. It may help to keep a food diary for a period to learn which foods are triggers for you.
Recognizing in advance situations that may increase your levels of stress and anxiety can help. This can give you time to either plan to avoid these situations when possible or develop strategies to limit the stress and anxiety.
The automatic movement, or motility, of your digestive system is controlled to a great degree by your nervous system. Stress can affect your nerves, making your digestive system overactive. If you have IBS, your colon may be overly responsive to even slight disruption of your digestive system. It is also believed that IBS is affected by the immune system, which is affected by stress.
IBS doesn’t affect the weight of everyone with the condition. However, it can potentially lead to weight loss if you don’t eat enough to maintain your weight to avoid symptoms. Cramping may come more often right after you eat. If frequent diarrhea is one of your symptoms, your body may not be getting all of the nutrients from the food you eat. Your weight may decrease as a result of this.
IBS with diarrhea is a specific type of IBS. It primarily affects your large intestine. Common symptoms of IBS with diarrhea include frequent stools and nausea. Some people with IBS with diarrhea occasionally lose bowel control.
IBS with constipation is a type of IBS that typically affects adolescents and young adults. Stools that are hard and happen less often as well as constipation are the most common symptoms of this type of IBS.
NASH stands for Non-Alcoholic SteatoHepatitis.
It can be defined as the liver manifestation of a metabolic disorder, and is the most severe form of non-alcoholic fatty liver disease (NAFLD). NASH is closely related to the triple epidemic of obesity, pre-diabetes, and diabetes.1 But its symptoms are often silent or non-specific to NASH, making it difficult to diagnose. As a result, NASH patients can remain unaware of their condition until late stages of the disease.
WHAT IS NAFLD?
Non-alcoholic fatty liver disease (NAFLD) is an umbrella term that encompasses the entire spectrum of fatty liver disease, from isolated steatosis to NASH.
A MODERN LIFESTYLE DISEASE
NASH is heavily influenced by lifestyle (e.g., chronic excessive calorie intake, sedentary activity) and is distinct from other fatty liver diseases caused by alcohol abuse or medication side effects.
The symptoms of NASH are often invisible until the liver is damaged beyond repair.2,3 But understanding the risk factors for NASH can help at-risk patients get the right diagnosis.
A PROGRESSIVE & LIFE-THREATENING DISEASE
NASH worsens the cardiometabolic condition of patients, and is related to higher risk of death caused by cardiovascular events. Up to 38% of deaths in patients with NASH are directly related to cardiovascular events.
While patients remain unaware of their liver condition, NASH can progress to more serious disease stages, such as advanced fibrosis, cirrhosis, liver failure, or liver cancer, driven by hepatocellular ballooning and inflammation.
In advanced stages of the disease, liver transplant may be a patient’s only option. But this risky surgical procedure is associated with various complications, not to mention long waiting lists due to the lack of available healthy organs from donors, or eligibility issues related to patient condition.
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.
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
- 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
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.
Conditions that can increase your risk of GERD include:
- Bulging of the top of the stomach up into the diaphragm (hiatal hernia)
- Connective tissue disorders, such as scleroderma
- Delayed stomach emptying
Factors that can aggravate acid reflux include:
- 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
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.
Tinnitus is when you experience ringing or other noises in one or both of your ears. The noise you hear when you have tinnitus isn’t caused by an external sound, and other people usually can’t hear it. Tinnitus is a common problem. It affects about 15% to 20% of people, and is especially common in older adults.
Tinnitus is usually caused by an underlying condition, such as age-related hearing loss, an ear injury or a problem with the circulatory system. For many people, tinnitus improves with treatment of the underlying cause or with other treatments that reduce or mask the noise, making tinnitus less noticeable.
Tinnitus is most often described as a ringing in the ears, even though no external sound is present. However, tinnitus can also cause other types of phantom noises in your ears, including:
Most people who have tinnitus have subjective tinnitus, or tinnitus that only you can hear. The noises of tinnitus may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In some cases, the sound can be so loud it interferes with your ability to concentrate or hear external sound. Tinnitus may be present all the time, or it may come and go.
In rare cases, tinnitus can occur as a rhythmic pulsing or whooshing sound, often in time with your heartbeat. This is called pulsatile tinnitus. If you have pulsatile tinnitus, your doctor may be able to hear your tinnitus when he or she does an examination (objective tinnitus).
When to see a doctor
Some people aren’t very bothered by tinnitus. For other people, tinnitus disrupts their daily lives. If you have tinnitus that bothers you, see your doctor.
Make an appointment to see your doctor if:
- You develop tinnitus after an upper respiratory infection, such as a cold, and your tinnitus doesn’t improve within a week.
See your doctor as soon as possible if:
- You have hearing loss or dizziness with the tinnitus.
- You are experiencing anxiety or depression as a result of your tinnitus.
A number of health conditions can cause or worsen tinnitus. In many cases, an exact cause is never found.
Common causes of tinnitus
In many people, tinnitus is caused by one of the following:
- Hearing loss. There are tiny, delicate hair cells in your inner ear (cochlea) that move when your ear receives sound waves. This movement triggers electrical signals along the nerve from your ear to your brain (auditory nerve). Your brain interprets these signals as sound.If the hairs inside your inner ear are bent or broken — this happens as you age or when you are regularly exposed to loud sounds — they can “leak” random electrical impulses to your brain, causing tinnitus.
- Ear infection or ear canal blockage. Your ear canals can become blocked with a buildup of fluid (ear infection), earwax, dirt or other foreign materials. A blockage can change the pressure in your ear, causing tinnitus.
- Head or neck injuries. Head or neck trauma can affect the inner ear, hearing nerves or brain function linked to hearing. Such injuries usually cause tinnitus in only one ear.
- Medications. A number of medications may cause or worsen tinnitus. Generally, the higher the dose of these medications, the worse tinnitus becomes. Often the unwanted noise disappears when you stop using these drugs.Medications known to cause tinnitus include nonsteroidal anti-inflammatory drugs (NSAIDs) and certain antibiotics, cancer drugs, water pills (diuretics), antimalarial drugs and antidepressants.
Other causes of tinnitus
Less common causes of tinnitus include other ear problems, chronic health conditions, and injuries or conditions that affect the nerves in your ear or the hearing center in your brain.
- Meniere’s disease. Tinnitus can be an early indicator of Meniere’s disease, an inner ear disorder that may be caused by abnormal inner ear fluid pressure.
- Eustachian tube dysfunction. In this condition, the tube in your ear connecting the middle ear to your upper throat remains expanded all the time, which can make your ear feel full.
- Ear bone changes. Stiffening of the bones in your middle ear (otosclerosis) may affect your hearing and cause tinnitus. This condition, caused by abnormal bone growth, tends to run in families.
- Muscle spasms in the inner ear. Muscles in the inner ear can tense up (spasm), which can result in tinnitus, hearing loss and a feeling of fullness in the ear. This sometimes happens for no explainable reason, but can also be caused by neurologic diseases, including multiple sclerosis.
- Temporomandibular joint (TMJ) disorders. Problems with the TMJ, the joint on each side of your head in front of your ears, where your lower jawbone meets your skull, can cause tinnitus.
- Acoustic neuroma or other head and neck tumors. Acoustic neuroma is a noncancerous (benign) tumor that develops on the cranial nerve that runs from your brain to your inner ear and controls balance and hearing. Other head, neck or brain tumors can also cause tinnitus.
- Blood vessel disorders. Conditions that affect your blood vessels — such as atherosclerosis, high blood pressure, or kinked or malformed blood vessels — can cause blood to move through your veins and arteries with more force. These blood flow changes can cause tinnitus or make tinnitus more noticeable.
- Other chronic conditions. Conditions including diabetes, thyroid problems, migraines, anemia, and autoimmune disorders such as rheumatoid arthritis and lupus have all been associated with tinnitus.
Anyone can experience tinnitus, but these factors may increase your risk:
- Loud noise exposure. Loud noises, such as those from heavy equipment, chain saws and firearms, are common sources of noise-related hearing loss. Portable music devices, such as MP3 players, also can cause noise-related hearing loss if played loudly for long periods. People who work in noisy environments — such as factory and construction workers, musicians, and soldiers — are particularly at risk.
- Age. As you age, the number of functioning nerve fibers in your ears declines, possibly causing hearing problems often associated with tinnitus.
- Sex. Men are more likely to experience tinnitus.
- Tobacco and alcohol use. Smokers have a higher risk of developing tinnitus. Drinking alcohol also increases the risk of tinnitus.
- Certain health problems. Obesity, cardiovascular problems, high blood pressure, and a history of arthritis or head injury all increase your risk of tinnitus.
Tinnitus affects people differently. For some people, tinnitus can significantly affect quality of life. If you have tinnitus, you may also experience:
- Sleep problems
- Trouble concentrating
- Memory problems
- Anxiety and irritability
- Problems with work and family life
Treating these linked conditions may not affect tinnitus directly, but it can help you feel better.
In many cases, tinnitus is the result of something that can’t be prevented. However, some precautions can help prevent certain kinds of tinnitus.
- Use hearing protection. Over time, exposure to loud sounds can damage the nerves in the ears, causing hearing loss and tinnitus. Try to limit your exposure to loud sounds. And if you cannot avoid loud sounds, use ear protection to help protect your hearing. If you use chain saws, are a musician, work in an industry that uses loud machinery or use firearms (especially pistols or shotguns), always wear over-the-ear hearing protection.
- Turn down the volume. Long-term exposure to amplified music with no ear protection or listening to music at very high volume through headphones can cause hearing loss and tinnitus.
- Take care of your cardiovascular health. Regular exercise, eating right and taking other steps to keep your blood vessels healthy can help prevent tinnitus linked to obesity and blood vessel disorders.
- Limit alcohol, caffeine and nicotine. These substances, especially when used in excess, can affect blood flow and contribute to tinnitus.
Vertigo is a symptom, rather than a condition itself. It’s the sensation that you, or the environment around you, is moving or spinning.
This feeling may be barely noticeable, or it may be so severe that you find it difficult to keep your balance and do everyday tasks.
Attacks of vertigo can develop suddenly and last for a few seconds, or they may last much longer. If you have severe vertigo, your symptoms may be constant and last for several days, making normal life very difficult.
Other symptoms associated with vertigo may include:
- loss of balance – which can make it difficult to stand or walk
- feeling sick or being sick
Seeking medical help
You should see your GP if you have persistent signs of vertigo or it keeps coming back.
Your GP will ask about your symptoms and can carry out a simple examination to help determine some types of vertigo. They may also refer you for further tests.
What causes vertigo?
Vertigo is commonly caused by a problem with the way balance works in the inner ear, although it can also be caused by problems in certain parts of the brain.
Causes of vertigo may include:
- benign paroxysmal positional vertigo (BPPV) – where certain head movements trigger vertigo
- migraines – severe headaches
- labyrinthitis – an inner ear infection
- vestibular neuronitis – inflammation of the vestibular nerve, which runs into the inner ear and sends messages to the brain that help to control balance
Depending on the condition causing vertigo, you may experience additional symptoms, such as a high temperature, ringing in your ears (tinnitus) and hearing loss.
How is vertigo treated?
Some cases of vertigo improve over time, without treatment. However, some people have repeated episodes for many months, or even years, such as those with Ménière’s disease.
There are specific treatments for some causes of vertigo. A series of simple head movements (known as the Epley manoeuvre) is used to treat BPPV.
Medicines, such as prochlorperazine and some antihistamines, can help in the early stages or most cases of vertigo.
Many people with vertigo also benefit from vestibular rehabilitation training (VRT), which is a series of exercises for people with dizziness and balance problems.
Depending on what’s causing your vertigo, there may be things you can do yourself to help relieve your symptoms. Your GP or the specialist treating you may advise you to:
- do simple exercises to correct your symptoms
- sleep with your head slightly raised on two or more pillows
- get up slowly when getting out of bed and sit on the edge of the bed for a minute or so before standing
- avoid bending down to pick up items
- avoid extending your neck – for example, while reaching up to a high shelf
- move your head carefully and slowly during daily activities
- do exercises that trigger your vertigo, so your brain gets used to it and reduces the symptoms (do these only after making sure you won’t fall, and have support if needed)
Fear of heights
The term vertigo is often incorrectly used to describe a fear of heights. The medical term for a fear of heights and the dizzy feeling associated with looking down from a high place is “acrophobia”.