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| The lower gastrointestinal
tract |
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All the food and liquids you eat and drink end up in your
digestive system, the gastrointestinal (GI) tract. The body
absorbs the nutrients it needs for energy and growth and eliminates
what is left over.
The tract runs from the mouth to the bottom and is referred
to as the upper and lower bowel..
Remember that some medicines for bowel problems like constipation
can interfere with the absorption of medicines you are taking
for other medical conditions. Ask your pharmacist for advice
first.
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| Condition |
Constipation |
| Symptoms |
Hard and dry
faeces that can be painful and difficult to remove; stomach
pain. |
| OTC Treatment |
Laxatives are
useful if you have gone 2 – 3 days longer than usual
without a bowel movement.
- Bulk forming laxatives include bran, psyllium
ispaghula husk, methylcellulose and sterculia. They work
by absorbing water and swelling to form a gel. This retains
water in the faeces, avoiding impaction and making removal
of the faeces easier by increasing the bulk of the stool.
- Hyperosmotic laxatives include glycerine suppositories,
lactulose and lactitol. They retain water in the bowel
and faeces.
- Stimulant laxatives include bisacodyl, aloin,
cascara and senna. These promote bowel action by acting
directly on the muscle in the gut wall.
- Emollient laxatives include docusate sodium and
docusate calcium. These help aqueous and fatty substances
in the intestines to mix, softening the stools and promoting
defaecation.
- Lubricant laxatives include liquid paraffin and
mineral oil. They work by coating the stools and preventing
reabsorption of water in the large intestine. This keeps
the stools fairly soft and easy to release.
- Saline laxatives include magnesium salts and
sodium phosphate. The magnesium or sodium ions draw water
into the colon, increasing the volume of the faeces and
increasing pressure within the colon and rectum. |
| Other self-help |
The best way to avoid constipation is to eat a high-fibre
diet with plenty of fluids. The best sources of dietary
fibre are: unrefined cereals; fresh fruit; leafy green
vegetables; peas; beans; lentils and root vegetables.
Keeping active is also very important. People who are
restricted from performing regular activity often suffer
from constipation.
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| Other information |
Laxatives should not be used on a regular basis, or
‘just in case’ you can’t have a bowel
movement. Prolonged use of laxatives can cause the bowel
muscles to stop working properly actually causing constipation.
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| Condition |
Diarrhoea |
| Symptoms |
Loose, watery stools
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| OTC Treatment |
- Salt and glucose remedies to rebalance the body’s
salts.
- Loperamide and morphine help to control diarrhoea.
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| Other self-help |
Make sure you drink plenty of extra fluids to allow
for the extra fluid being lost when you have diarrhoea.
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| Other information |
Diarrhoea may
be a short-term problem or a symptom of a more chronic
or intermittent condition such as Crohn’s disease
and ulcerative colitis.
Short-term diarrhoea can be caused by bacteria, as in
food poisoning due to eating contaminated food, or as
part of a viral infection. It can also be caused by some
medicines.
Diarrhoea can also be caused by the accumulation of non-absorbed
substances in the GI tract such as in lactase deficiency,
or from gastrointestinal effects of secretory stimuli.
If you see red, fresh blood in your diarrhoea see your
GP immediately as this can be a sign of infection or other
serious bowel conditions. Black, tarry blood may be caused
by conditions such as a peptic ulcer. |
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| Condition |
Flatulence/wind |
| Symptoms |
Release of
gases from the bottom; bloated stomach and stomach ache.
This is almost always normal and caused by the particular
foods you have eaten. |
| OTC Treatment |
- ‘Health salts’ form a fizzy antacid drink
when mixed with water to make burping easier and therefore
reduce discomfort.
- Antacids also help wind to pass out of the bottom.
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| Other self-help |
Herbal remedies containing cardamon, dill or capsicum
can be effective in helping gas to be passed out of
the body.
If you are prone to wind avoiding foods such as beans
and cabbage, which are known to cause foul smelling
gases, may be helpful. It is worth remembering however,
that these foods may protect you from bowel cancer.
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| Other information |
Health salts contain large amounts of sodium and should
be avoided if you have poor kidney function or a heart
condition.
Gas trapped in the stomach or intestines may be caused
by air that has been swallowed whilst eating or drinking.
This does not usually smell.
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| Condition |
Nausea and
vomiting |
| OTC Treatment |
- Domperidone is the only available OTC treatment
for the relief of fullness, nausea, bloating and burping.
- Medicines containing bismuth salts may help with mild
nausea, whilst antihistamines and anticholinergenics
help in travel sickness.
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| Other information |
There are many causes of nausea and vomiting e.g. peptic
ulcers, obstruction of the intestinal tract, migraine,
drug and alcohol abuse, travel sickness, psychological
problems.
If nausea and vomiting persists you should visit your
GP.
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| Abdominal Pain |
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Abdominal pain should always be taken seriously as it can
indicate a range of potentially serious conditions. You should
see a GP if pain persists.
In general, treating the cause of the pain best relieves abdominal
pain, whether it be inflammation, distension or muscle spasm.
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| Condition |
Infant colic |
| Symptoms |
Babies may draw
their legs up to their chests and cry. |
| OTC Treatment |
- Analgesics can help to relieve the symptoms of pain.
- Gripe water contains sodium bicarbonate, which helps
the baby to get rid of excess gas through belching.
It also helps to reduce acidity in the gastrointestinal
tract.
- Other remedies contain dimethicone or simethicone.
- Products containing peppermint oil, hyoscine, mebeverine
or alverine will relax the muscles
- Antispasmodics.
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| Other self-help |
‘Winding’
or ‘burping’ the baby will help to remove gas.
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| Other information |
Infant colic is very common in the first few months
after birth.
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| Condition |
Gastrointestinal
spasm (colic) |
| Symptoms |
Pain of spasm
in the intestines. |
| OTC Treatment |
- Analgesics can help to relieve the symptoms of pain.
- Other remedies contain dimethicone or simethicone.
- Products containing peppermint oil, hyoscine, mebeverine
or alverine will relax the muscles
- Antispasmodics.
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| Other information |
GI spasm can be caused by:
- Irritable Bowel Syndrome which occurs when
a section of the gut revolves and causes an obstruction
- Intussuception which occurs in children where
a section of the gut ‘telescopes’, as if swallowing
itself, and causes an obstruction
- Air which is swallowed with food, causing distension
that can trigger smooth muscle contraction.
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| Condition |
Itching |
| Symptoms |
Itching around
the bottom. Can be caused by haemorrhoids or threadworm
infection. It can also be caused by liquid paraffin, a
lubricant laxative. Unfortunately there is often no obvious
cause and simple creams can help. |
| OTC Treatment |
- Haemorrhoid creams and ointments will help to reduce
the itching even when there are no haemorrhoids present.
- Threadworm can be treated with mebendazole and piperazine.
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| Other information |
Threadworm should be treated immediately as it can
be passed on to others but other than the irritating
itch does not cause any serious harm
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| Condition |
Rectal bleeding |
| Symptoms |
Bleeding from
the bottom. |
| Other information |
Bleeding from the rectum can be caused by several conditions
of the lower gastrointestinal tract such as anal fissure,
haemorrhoids or bowel cancer. You should see your GP.
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| Irritable Bowel Syndrome
(IBS) |
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| Condition |
Irritable
Bowel Syndrome (IBS) |
| Symptoms |
IBS has many
symptoms and is usually diagnosed when four or more occur
with no other obvious cause. Symptoms are:
- abdominal distension
- bloating
- abdominal pain (may be sharp, or a dull ache, widespread
or localised to the lower abdomen)
- loose and watery stools (diarrhoea)
- hard, impacted stools (constipation)
- mucus in the stools
- persistent feelings of wanting to go to the toilet
- muscle cramps in the abdomen |
| OTC Treatment |
- Laxatives can help constipation, but can also cause
bloating and trapped wind.
- Loperamide can help with diarrhoea.
- Antispasmodic drugs, such as hyoscine, mebeverine
and alverine They are not generally suitable for children
or breastfeeding women.
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| Other self-help |
If you suffer
from constipation including more dietary fibre in your
diet should help.
Peppermint oil, in specially coated capsules that do not
release their contents until they are in the intestines
is said to have a direct benefit on the muscles of the
colon.
IBS sufferers should avoid eating gas-producing foods
such as beans, peas and cabbage. Plain live yoghurt can
help to normalise the gut contents. Exercise and relaxation
techniques can help reduce stress, which is thought to
be a contributing factor of IBS. Hynotherapy may also
help. |
| Other information |
Irritable Bowel Syndrome may be associated with psychological
problems such as depression.
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| Condition |
Haemorrhoids
(Piles) |
| Symptoms |
- Itching and
pain caused by swollen blood vessels in the anus.
- Pain when passing a stool.
- Bleeding when passing a stool (and occasionally spontaneously)
can indicate internal piles.
- Spots of blood on toilet paper indicate external piles.
These external piles may go back into the bottom after
you have been to the toilet. Try gently returning them
while having a warm bath. |
| OTC Treatment |
- Anti-inflammatory agents, e.g. hydrocortisone and
heparinoids
to reduce the pain, redness, swelling and temperature
of the affected area.
Hydrocortisone should only be used short-term and
should be avoided during pregnancy.
- Antiseptics, e.g. Peru balsam and phenolic compounds
– help prevent infection and encourage healing
in the haemorrhoidal area.
- Astringents, e.g. allantoin, hamamelis (with hazel),
tannic acid and bismuth compounds – shrink piles,
harden the surrounding skin, dry up soggy areas of damaged
skin or mucous membrane and reduce minor bleeding.
- Local anaesthetics, e.g. lidocaine – relieve
the pain of the piles; they should not be used long-term
as they cause irritation.
- Soothing creams and ointments, e.g. zinc oxide –
widely used as a base for creams and ointments because
it’s soothing and mildly antiseptic.
- Laxatives of the osmotic type or bulking agents –
ease the pain of a stool and prevent constipation.
Some products contain combinations of one or more
of these ingredients.
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| Other self-help |
If you suffer
from piles including more dietary fibre in your diet may
help. |
| Other information |
Haemorrhoids are associated with constipation. Straining
to pass a stool increases the pressure in anal blood
vessels and can cause piles, or make them worse.
Piles are also common during pregnancy, but often clear
up after the birth.
Severe piles may need to be treated surgically.
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| Condition |
Coeliac
disease |
| Symptoms |
Foul, fatty
and frothy stools; anaemia and failure to thrive |
| OTC Treatment |
- Gluten-free foods
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| Other information |
Coeliac disease is caused by an intolerance to gluten.
If you suffer from Coeliac check with your pharmacist
that any medicines you are taking are gluten-free.
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| MedicineChestOnline.com
is a directory of medicines and food supplements
that are available 'over the counter' (OTC) from
your pharmacist. The links below will take you to
pages detailing products which may help treat or
relieve the following symptoms: |
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NHS
Direct - The gateway to health information
on the internet.
Contains a list of information on health, including
features, healthy living, healthcare guide, conditions
and treatments and frequently asked questions. |
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