Sahil Khanna - Mayo Clinic on Digestive Health

Mayo Clinic

Medical Editor

Sahil Khanna, M.B.B.S.

Editorial Director

Paula M. Marlow Limbeck

Senior Editor

Karen R. Wallevand

Senior Product Manager

Daniel J. Harke

Art Director

Stewart (Jay) J. Koski

Illustration, Photography and Production

David A. Factor, Joanna R. King, Michael A. King, Kent McDaniel, Matthew C. Meyer, James D. Postier II, James E. Rownd, Gunnar T. Soroos

Editorial Research Librarians

Abbie Y. Brown, Eddy S. Morrow Jr., Erika A. Riggin, Katie J. Warner

Copy Editors

Miranda M. Attlesey, Alison K. Baker, Donna L. Hanson, Nancy J. Jacoby, Julie M. Mass

Indexer

Steve Rath

Administrative Assistant

Terri L. Zanto Strausbauch

Contributors

Andres J. Acosta, M.D., Ph.D.; Adil E. Bharucha, M.B.B.S., M.D.; Suresh T. Chari, M.D.; Purna C. Kashyap, M.B.B.S.; John B. Kisiel, M.D.; Heather L. LaBruna; Joseph A. Murray, M.D.; Karthik Ravi, M.D.; William Sanchez, M.D.; Jacalyn A. See, M.S., RDN, LD; William J. Tremaine, M.D.; Laura Hamilton Waxman

Cover design by Stewart (Jay) J. Koski

Published by Mayo Clinic Press

Second electronic edition published 2020 by RosettaBooks LLC, New York.

2020 Mayo Foundation for Medical Education and Research (MFMER)

MAYO, MAYO CLINIC and the Mayo triple-shield logo are marks of Mayo Foundation for Medical Education and Research. All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher.

The information in this book is true and complete to the best of our knowledge. This book is intended only as an informative guide for those wishing to learn more about health issues. It is not intended to replace, countermand or conflict with advice given to you by your own physician. The ultimate decision concerning your care should be made between you and your doctor. Information in this book is offered with no guarantees. The author and publisher disclaim all liability in connection with the use of this book.

ISBN 978-893005-53-2 (hardcover)

ISBN 978-07953-5289-8 (ebook)

Fourth edition

Your digestive system may seem easy to understand: You put food in your mouth. Your digestive organs break down the food. Nutrients in the food are absorbed in your intestines, and the rest is eliminated as waste. Sounds pretty simple, doesnt it?

In fact, the human digestive system is incredibly complex. It acts both as food transporter and food processor, requiring the efficient function of many different organs to transform what you eat and drink into a mixture that fuels good health. Sometimes, things can go wrong, or the process doesnt work as well as it should.

Mayo Clinic on Digestive Health,Fourth Edition, covers signs and symptoms, causes, diagnostic procedures, and treatment options for the most common digestive conditions, as well as preventive actions to consider. Perhaps youve experienced temporary discomfort from heartburn, diarrhea, constipation, nausea or excess gas and are trying to determine what may be triggering your symptoms. Maybe youre dealing with a common condition such as gastroesophageal reflux disease, peptic ulcers or gallstones and you want information on treatment. If you have a long-term condition, such as Crohns disease or celiac disease, you may be seeking coping skills.

In the last decade, weve seen tremendous advancements in the understanding, early recognition and treatment of many digestive conditions. As an example, today we have a much better understanding of the important role your gut plays specifically, the bacteria that reside within it in maintaining your overall health. Were also seeing a connection between the health of your gut and that of other systems within your body. All of this has led to a lot of speculation and misinformation surrounding what to eat and what not to eat for good gut health.

This book addresses a wide range of topics, providing a context for what it takes to keep your digestive system healthy and how to respond when disease occurs. Too often, people wait too long before seeking help from their doctors. In general, the earlier you address a problem, the easier it is to prevent it from becoming serious.

Heres hoping that this book can help you enjoy a higher quality of life with fewer digestive concerns. And heres wishing you good digestion!

Dr. Sahil Khanna

Sahil Khanna, M.B.B.S., is an associate professor of medicine at Mayo Clinic College of Medicine and Science and the head of the Comprehensive GI Interest Group within the Division of Gastroenterology and Hepatology at Mayo Clinic, Rochester, Minn. Dr. Khanna is a graduate of the All India Institute of Medical Sciences, New Delhi. He did postdoctoral research at the University of California San Diego, before completing his residency in internal medicine and a fellowship in gastroenterology and hepatology at Mayo Clinic, Rochester. Dr. Khannas research and clinical interests include epidemiology, patient outcomes, and emerging therapeutics for Clostridium difficile (C. diff.) infection, a topic on which he has authored several articles and made numerous presentations. Dr. Khanna serves on the editorial board of several journals and has won numerous awards including the Miles and Shirley Fiterman Award, the Mayo Brothers Distinguished Fellowship Award, the Donald C. Balfour Mayo Clinic Alumni Association Research Award, the Hartz Foundation Young Investigators Scholarship, and the Most Distinguished Resident Physician Award from the American Association of Physicians of Indian Origin.

Good health and a healthy gut go hand in hand. Digestion is one of the critical functions your body must perform in order to survive and thrive. The food you eat provides necessary nutrients that supply your cells with sustenance and energy so your body can develop, repair and maintain itself.

When you take a bite of food, what enters your mouth must be transformed before it can nourish your body. Thats the primary function of digestion to break down food into smaller components and change it chemically so nutrients can be extracted and absorbed into your bloodstream (while the remainder is eliminated as waste). The breakdown of food occurs primarily through the action of digestive juices in your mouth, stomach and intestines, with assistance from the tearing, grinding action of your teeth.

When things go according to plan, the organs of your digestive tract perform a variety of specialized functions in an efficient and timely manner. But like any complex system that contains integrated parts, sometimes the process gets disrupted, and even a slight malfunction can cause problems.

When this happens, you begin to experience signs and symptoms. Thats your bodys way of letting you know something isnt quite right. Often, the problems are minor and infrequent, but sometimes they can be complex and chronic.

Heartburn, pain, cramps, bloating, nausea, vomiting, diarrhea, constipation, bleeding these are some of the ways your digestive system alerts you to a problem. And try as you may to ignore whats happening (or isnt happening) in your stomach or gut, doing so is virtually impossible.