9 Common Digestive Conditions From Top to Bottom
Many digestive diseases have similar symptoms. Here’s how to recognize them and when to visit your doctor.
Most people don’t like to talk about it, but having digestive problems is more common than you think. In fact, 60 to 70 million people are affected by some type of digestive disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Here’s a top-to-bottom look at nine of the most common digestive conditions, their symptoms, and the most effective treatments available. If you suspect you have one of these issues, don't delay in speaking with your doctor.
1. Gastroesophageal Reflux Disease (GERD)
When stomach acid backs up into your esophagus — a condition called acid reflux — you may feel a burning pain in the middle of your chest. It often occurs after meals or at night, says Neville Bamji, MD, a clinical instructor of medicine at the Icahn School of Medicine at Mount Sinai and a gastroenterologist with New York Gastroenterology Associates in New York City.
While it’s common for people to experience acid reflux and heartburn once in a while, having symptoms that affect your daily life or occur at least twice each week could be a sign of GERD, a chronic digestive condition that affects 20 percent of Americans, cites the NIDDK. If you experience persistent heartburn, bad breath, unexplained tooth erosion, nausea, pain in your chest or upper part of your abdomen, or have trouble swallowing or breathing, see your doctor.
Most people find relief by avoiding certain foods and beverages that trigger their symptoms, or taking over-the-counter antacids or other medication that reduces stomach acid production and inflammation of the esophagus. Lifestyle changes like elevating the head of the bed, not lying down after a meal, and quitting smoking can also help. However, some cases of GERD require stronger treatment, such as acid-blocking medication or even surgery.
2. Gallstones
Gallstones are hard deposits that form in your gallbladder — a small, pear-shaped sac that stores and secretes bile for digestion. Nearly one million Americans have gallstones every year, according to the American Gastroenterological Association. Gallstones can occur when substances that make up the bile (usually cholesterol or a waste product called bilirubin) become too concentrated and form a hard stone.
When gallstones block the ducts leading from your gallbladder to your intestines, they can cause sharp pain in your upper-right abdomen. The next step is usually surgery to remove the gallbladder.
3. Celiac Disease and Gluten Intolerance
An estimated 1 in 133 Americans — about 1 percent of the population — has celiac disease, according to Beyond Celiac (formerly the National Foundation for Celiac Awareness). In pediatric populations, the prevalence may be around 2 percent, the group reports. A study published in 2022 in the American Journal of Gastroenterology determined that the incidence of celiac disease in children varied by region, suggesting both environmental and genetic factors play a role in the development of the disease. Beyond Celiac also estimates that 83 percent of people with celiac disease don’t know they have it or have been misdiagnosed with a different condition.
Celiac disease is an immune reaction to gluten, a protein found in wheat, rye, and barley. Eat gluten, and your immune system goes on the attack: It damages your villi, the fingerlike protrusions in your small intestines that help you absorb nutrients from the foods you eat. In children, symptoms may include abdominal pain and bloating, diarrhea, constipation, vomiting, and weight loss. Symptoms in adults can also include anemia, fatigue, bone loss, depression, and seizures.
The only treatment for celiac disease is to completely avoid eating gluten. Common alternatives to gluten include brown rice, quinoa, lentils, soy flour, corn flour, and amaranth.
Some people may test negative for celiac disease but have a gluten intolerance, or sensitivity. Some of the same symptoms of celiac disease may occur, but gluten intolerance is a digestive disorder, not an immune disorder, so it doesn’t damage the intestine or cause problems like anemia or bone loss.
Also, people with gluten intolerance can eat gluten, if they’re willing to deal with digestive symptoms. About 6 percent of Americans have a gluten intolerance, per the Cleveland Clinic.
4. Crohn’s Disease
Crohn’s disease is part of a group of digestive conditions called inflammatory bowel disease (IBD). Crohn’s can affect any part of the GI tract but most commonly affects the terminal ileum and large intestine, which connects the end of the small bowel to the beginning of the large intestine, or colon. More than half a million Americans are living with Crohn’s disease, according to the NIDDK.
Doctors aren't sure what causes the disease, but it's thought that genetics and family history may play a part. The most common Crohn's symptoms are abdominal pain, diarrhea, rectal bleeding, weight loss, and fever. “Treatment depends on the symptoms and can include topical pain relievers, immunosuppressants, and surgery,” Dr. Bamji says.
5. Ulcerative Colitis
Also an inflammatory bowel disease, ulcerative colitis may affect as many as 900,000 Americans, NIDDK reports. Symptoms of ulcerative colitis are similar to Crohn's, but the part of the digestive tract affected is solely the colon.
If your immune system mistakes your colon lining or other materials for invaders, sores or ulcers develop in the colon’s lining. If you experience frequent and urgent bowel movements, pain with diarrhea, blood in your stool, or abdominal cramps, make sure to see your doctor.
Medication can suppress the inflammation, and eliminating foods that cause discomfort may help as well. In severe cases, treatment for ulcerative colitis may involve surgery to remove the colon.
6. Irritable Bowel Syndrome
Is your digestive tract irritable? Do you have stomach pain or discomfort at least three times a month for several months? It could be irritable bowel syndrome (IBS).
About 5 to 10 percent of people experience IBS, and of that percentage, up to 45 million people with IBS live in the United States, according to the International Foundation for Functional Gastrointestinal Disorders. Signs of IBS can vary widely from having hard, dry stools to loose, watery stools, or both. Bloating and gas are also symptoms of IBS.
What causes IBS isn’t known, but treating symptoms centers largely on diet, such as eating low-fat, high-fiber meals and avoiding common trigger foods (dairy products, alcohol, caffeine, artificial sweeteners, and foods that produce gas). Following the low-FODMAP diet, which involves eliminating foods that are high in certain carbohydrates (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), has been found to reduce IBS symptoms. In a review published in 2021 in the European Journal of Nutrition, researchers analyzed 12 papers and found that the low-FODMAP diet reduces symptoms and improves quality of life in people with IBS compared to control diets. But keep in mind that low-FODMAP diet doesn’t necessarily mean low fiber.
Some research suggests probiotics, or friendly bacteria found in certain foods like yogurt and sold as supplements, may help with IBS. In a review published in 2019 in the journal Nutrients, seven of the 11 studies included reported that probiotics supplements significantly improved IBS symptoms compared to placebo. However, the American Gastroenterological Association makes no recommendation on the use of probiotics for IBS, stating more scientific evidence is needed.
Stress can trigger IBS symptoms, so some people find cognitive behavioral therapy or low-dose antidepressants to be useful treatments, as well, per Mayo Clinic.
7. Hemorrhoids
If there’s bright red blood in the toilet bowl when you move your bowels, it could be a sign of hemorrhoids. In fact, 75 percent of Americans over age 45 have hemorrhoids, according to the NIDDK.
Hemorrhoids are swollen veins found in your anus or lower rectum that can be painful and itchy. Causes include chronic constipation, diarrhea, straining during bowel movements, and a lack of fiber in your diet.
Treat hemorrhoids by eating more fiber, drinking more water, and exercising. At-home treatments like over-the-counter creams and suppositories usually provide relief of hemorrhoid symptoms. But if symptoms persist, prescription medications may be used or a medical procedure like hemorrhoidectomy may be needed to remove hemorrhoids surgically.
8. Diverticulitis
Small pouches called diverticula can form anywhere there are weak spots in the lining of your digestive tract, but they are most commonly found in the colon. If you have diverticula but no symptoms, the condition is called diverticulosis, which is quite common among older adults and rarely causes problems. By age 50, about half of people have diverticulosis, according to the American Gastroenterological Association. But in about 5 percent of people, the pouches become inflamed or infected, a condition called diverticulitis. Symptoms include fever, chills, nausea, and abdominal pain. Obesity is a major risk factor for diverticulitis.
Mild diverticulitis is treated with a clear liquid diet so your colon can heal. In the past, the first line of treatment for uncomplicated diverticulitis was a round of antibiotics, but recent guidelines from the American College of Physicians state that most cases can be treated without this medication. A low-fiber diet could be the cause of diverticulitis, so your doctor may recommend you eat a diet high in fiber — whole grains, legumes, vegetables — as part of your treatment plan. Cases of complicated diverticulitis are usually treated with intravenous antibiotics and may require surgery, per Mayo Clinic.
If you have severe attacks that recur frequently, you may need surgery to remove the diseased part of your colon.
9. Anal Fissure
Anal fissures are tiny, oval-shaped tears found in the lining of the anus. Symptoms are similar to hemorrhoids, such as bleeding and pain after moving your bowels. Straining and hard bowel movements can cause fissures, but so can soft stools and diarrhea. About 250,000 cases of anal fissures are diagnosed each year in the United States, according to StatPearls.
A high-fiber diet that makes your stool well formed and bulky is often the best treatment. Medication to relax the anal sphincter muscles, as well as topical anesthetics and sitz baths, can relieve pain; however, chronic fissures may require surgery of the anal sphincter muscle.