WEBVTT 00:03.140 --> 00:07.350 stomach 00:07.350 --> 00:09.760 cancer , also called gastric cancer , 00:09.770 --> 00:12.040 is a disease in which malignant cells 00:12.040 --> 00:14.540 form in the mucosa or lining of the 00:14.540 --> 00:17.050 stomach . Doctor Patel . Can you tell 00:17.050 --> 00:18.772 us more about stomach cancer ? 00:18.772 --> 00:21.170 Definitely Dr Mansfield , a vast 00:21.170 --> 00:22.948 majority of stomach cancers are 00:22.948 --> 00:25.170 adenocarcinoma as meaning they began in 00:25.170 --> 00:27.281 the cells that make and release mucus 00:27.281 --> 00:29.226 and other fluids . Other more rare 00:29.226 --> 00:31.040 types of stomach cancer include 00:31.050 --> 00:33.510 gastrointestinal carcinoid tumors , 00:33.520 --> 00:37.260 gastrointestinal stromal tumors and 00:37.260 --> 00:40.620 lymphomas . Unfortunately , stomach 00:40.620 --> 00:42.640 cancer often has no early signs or 00:42.640 --> 00:44.890 symptoms , so most stomach cancers are 00:44.890 --> 00:47.270 diagnosed at an advanced stage when the 00:47.270 --> 00:50.160 survival rate is significantly lower . 00:52.440 --> 00:58.810 There 00:58.810 --> 01:00.921 are a number of factors that increase 01:00.921 --> 01:03.088 the likelihood of developing cancer of 01:03.088 --> 01:05.199 the stomach . Doctor German . Can you 01:05.199 --> 01:07.032 tell us about some of these risk 01:07.032 --> 01:10.030 factors ? Certainly major spencer risk 01:10.030 --> 01:12.870 factors for stomach cancer include age . 01:12.880 --> 01:15.690 People over the age of 55 are more 01:15.690 --> 01:18.970 likely to get stomach cancer . Gender . 01:18.980 --> 01:22.570 Men are twice as likely as women to 01:22.570 --> 01:25.600 develop stomach cancer . Race 01:25.610 --> 01:28.960 caucasians are least likely to develop 01:28.960 --> 01:32.370 stomach cancer . H . Pylori infection . 01:32.380 --> 01:36.280 The bacteria helicobacter pylori or H . 01:36.280 --> 01:38.300 Pylori can cause inflammation and 01:38.300 --> 01:40.356 ulcers in the stomach . Which raises 01:40.356 --> 01:42.633 the risk for developing stomach cancer , 01:42.633 --> 01:44.840 lower the normal production of 01:44.840 --> 01:48.020 digestive juices . This can result from 01:48.020 --> 01:50.420 stomach surgery or conditions such as 01:50.420 --> 01:52.750 pernicious anemia or gastric atrophy 01:52.840 --> 01:55.062 usually leading to intestinal meta play 01:55.062 --> 01:57.960 asia and smoking . 01:58.840 --> 02:00.980 Some evidence suggests that smoking 02:00.990 --> 02:04.150 increases the risk for stomach cancer 02:10.740 --> 02:14.110 because the stomach is such a big 02:14.110 --> 02:16.300 stretchy organ . The early stages of 02:16.300 --> 02:18.670 stomach cancer usually have no symptoms . 02:18.680 --> 02:21.030 But as the cancer grows and spreads 02:21.040 --> 02:23.940 symptoms can develop dr Malone . Can 02:23.940 --> 02:26.440 you tell us about these symptoms ? Of 02:26.440 --> 02:29.450 course ? Dr mansfield a stomach cancer 02:29.450 --> 02:32.420 grows , symptoms can include pain or 02:32.420 --> 02:35.220 discomfort in the abdomen , nausea and 02:35.220 --> 02:38.160 vomiting loss of appetite , 02:39.040 --> 02:42.340 fatigue or weakness , bleeding vomiting 02:42.340 --> 02:44.660 blood or bloody stools which can be 02:44.660 --> 02:48.160 read maroon or black , sticky and tari 02:49.740 --> 02:52.620 weight loss and being unable to eat a 02:52.620 --> 02:55.050 complete meal because of feeling full . 03:02.100 --> 03:05.920 Yeah they sent me 03:05.930 --> 03:08.490 to gastroenterology doctor and they 03:08.500 --> 03:11.110 referred me to him . He set me up with 03:11.120 --> 03:13.890 uh an upper scope and E . G . D . So I 03:13.900 --> 03:16.360 came in that next morning the monday 03:16.840 --> 03:18.951 and they didn't and disco they had to 03:18.951 --> 03:20.896 put the thing in my mouth and then 03:20.896 --> 03:23.007 spray down my throat because they had 03:23.007 --> 03:25.118 to numb it and it felt like it numbed 03:25.118 --> 03:27.550 it instantly . So uh that was pretty 03:27.550 --> 03:29.717 much other than that . Um They sprayed 03:29.717 --> 03:31.939 it and then they told me to count and I 03:31.939 --> 03:34.750 was out . So I don't even remember I 03:34.750 --> 03:36.806 don't remember other than maybe five 03:36.806 --> 03:39.028 minutes after the fact you would assume 03:39.028 --> 03:41.083 like you would have some soreness or 03:41.083 --> 03:40.840 throat or something like that . But 03:40.840 --> 03:43.650 when I woke up from the procedure um I 03:43.650 --> 03:46.320 had no symptoms from the endoscope , 03:46.320 --> 03:48.376 they diagnosed me with a silly filic 03:48.376 --> 03:50.620 esophagitis , which is known as E so I 03:50.620 --> 03:52.560 was diagnosed with a cena filic 03:52.570 --> 03:56.560 esophagitis , which was the cause of my 03:57.540 --> 03:59.762 heartburn and troubles following . They 03:59.762 --> 04:01.984 showed me pictures after I woke back up 04:01.984 --> 04:04.040 from the endoscope saying , hey here 04:04.040 --> 04:06.096 you have two little ulcers . This is 04:06.096 --> 04:08.320 what's causing your burning , that what 04:08.320 --> 04:10.660 you feel like as a heart attack . This 04:10.660 --> 04:12.938 is what we believe is causing the pain . 04:12.938 --> 04:16.540 Basically , my esophagus closes 04:16.540 --> 04:19.110 off when I'm trying to swallow food 04:19.120 --> 04:21.580 after uhh I was diagnosed , that's when 04:21.580 --> 04:23.913 I actually looked it up and seeing like , 04:23.913 --> 04:26.136 okay , so these are the problems , it's 04:26.136 --> 04:28.640 kind of common , especially with my age 04:28.640 --> 04:30.751 group and ethnicity treatment there . 04:30.751 --> 04:33.750 They put me on some medicine um which 04:33.750 --> 04:37.250 was really a uh an acid reflux medicine 04:37.640 --> 04:40.600 uh to keep any reflux from going up 04:40.600 --> 04:42.600 into the esophagus so that it would 04:42.600 --> 04:44.767 allow that area to hell . They gave me 04:44.767 --> 04:46.933 something else . I can't remember what 04:46.933 --> 04:48.989 it was , but I know they gave me two 04:48.989 --> 04:51.100 different types of pills and I was on 04:51.100 --> 04:53.100 that for about a month . So uh they 04:53.100 --> 04:55.322 gave me medication that helps expand my 04:55.322 --> 04:57.870 airway so that way um it allows the 04:57.870 --> 04:59.759 food to go down freely without it 04:59.759 --> 05:01.814 closing off and then close it off my 05:01.814 --> 05:03.926 throat . I'm glad that they found out 05:03.926 --> 05:05.981 what it was . I'm glad that they can 05:05.981 --> 05:08.480 treat it . Hope it works and it doesn't 05:08.480 --> 05:10.650 get any worse . I know they can't cure 05:10.650 --> 05:13.410 it , but as long as I don't have any 05:13.410 --> 05:15.354 problems with it , I guess I don't 05:15.354 --> 05:17.560 really mind just being treated . 05:19.340 --> 05:26.070 Many 05:26.070 --> 05:28.160 people are affected by conditions or 05:28.160 --> 05:30.540 diseases of the small intestine as well 05:30.540 --> 05:33.030 as the large intestine or colon . Some 05:33.030 --> 05:35.030 conditions are acute , meaning they 05:35.030 --> 05:37.030 come on suddenly and typically last 05:37.030 --> 05:39.750 only a short time . Others are chronic 05:39.760 --> 05:43.310 or long lasting , sometimes lifelong in 05:43.310 --> 05:45.532 this section . You can find information 05:45.532 --> 05:47.199 about some of the more common 05:47.199 --> 05:49.366 intestinal and colorectal conditions , 05:49.366 --> 05:51.421 including colon , polyps , irritable 05:51.421 --> 05:54.240 bowel syndrome and others . We also 05:54.240 --> 05:56.780 discuss colorectal cancer , including 05:56.780 --> 05:59.300 its risk factors , symptoms and 05:59.300 --> 06:01.760 treatment options . 06:09.240 --> 06:12.920 I exited the air force in 2008 and 06:12.930 --> 06:15.050 um you know how they do the closing 06:15.050 --> 06:17.217 physical before you leave to make sure 06:17.217 --> 06:19.439 everything is okay , just like you were 06:19.439 --> 06:21.494 when you came in , they want to make 06:21.494 --> 06:24.050 sure you're fit to exit . So that was 06:24.050 --> 06:26.460 one of my things . I complained of that 06:26.460 --> 06:28.738 I had going on which is abdominal pain . 06:28.738 --> 06:32.690 I was 12 years old and I noticed that 06:32.700 --> 06:35.220 you know I was bleeding when when I was 06:35.220 --> 06:37.109 using the bathroom , I was having 06:37.109 --> 06:40.190 diarrhea and a little bit of blood also 06:40.200 --> 06:42.530 and I wasn't really sure what was what 06:42.530 --> 06:45.460 was going on . I have bound to the pain 06:45.460 --> 06:48.310 of course nausea , vomiting . It was a 06:48.310 --> 06:50.940 hassle especially like with work and 06:50.950 --> 06:53.600 going having to leave patient care and 06:53.610 --> 06:55.554 everything like that to go use the 06:55.554 --> 06:57.666 restroom and you don't really want to 06:57.666 --> 06:59.888 explain that to your co workers . So it 06:59.888 --> 07:01.999 it was uncomfortable and a hassle . I 07:01.999 --> 07:04.166 didn't really have any symptoms of any 07:04.166 --> 07:06.630 kind . But when I started to come in 07:06.630 --> 07:09.320 it's my blood pressure was getting high 07:09.320 --> 07:13.290 and from that led to well we need to do 07:13.290 --> 07:16.860 some diagnostics screenings on you . Uh 07:17.440 --> 07:20.440 as best we possibly can . I reached out 07:20.450 --> 07:23.090 to the doctors and the text that I've 07:23.480 --> 07:25.660 got an appointment my parents were 07:26.340 --> 07:28.450 concern . We went to see the doctor 07:28.460 --> 07:30.790 because I had worked in the Gi clinic 07:30.800 --> 07:33.050 you see a lot of scary things and 07:33.050 --> 07:35.600 people my age , like young people . So 07:35.610 --> 07:37.610 when I saw blood in my own school I 07:37.610 --> 07:39.666 knew it was important to go check it 07:39.666 --> 07:40.666 out . At least 07:48.440 --> 07:50.930 colon polyps are fairly common . It's 07:50.930 --> 07:53.250 estimated that between 15 and 40% of 07:53.250 --> 07:55.550 adults in the United States have colon 07:55.550 --> 07:58.090 polyps . Doctor Patel . Can you tell us 07:58.090 --> 08:00.460 about this condition ? Absolutely . Dr . 08:00.460 --> 08:03.030 Mansfield colon polyps are gross on the 08:03.030 --> 08:05.197 lining of the colon or large intestine 08:05.197 --> 08:07.197 and the rectum . They are common as 08:07.197 --> 08:09.220 people age grow for a variety of 08:09.220 --> 08:11.610 reasons and are typically pre cancerous . 08:11.690 --> 08:13.690 It's possible to have more than one 08:13.690 --> 08:15.746 polyp scattered throughout the colon 08:15.746 --> 08:17.801 and they may vary in size from a few 08:17.801 --> 08:19.857 millimeters to several centimeters . 08:19.857 --> 08:21.801 Some polyps appear flat but others 08:21.801 --> 08:24.079 appear raised and resemble small bumps . 08:24.079 --> 08:27.450 These are called cecil polyps , podunk 08:27.450 --> 08:29.450 related polyps grow on short stocks 08:29.450 --> 08:31.617 like a mushroom or small cauliflower . 08:31.617 --> 08:34.020 A majority of colon polyps are benign 08:34.020 --> 08:36.180 or not cancerous , but most are pre 08:36.180 --> 08:38.640 cancerous . In fact , it's important to 08:38.640 --> 08:40.840 note that most colon cancers start as 08:40.840 --> 08:43.470 colon polyps . Pre cancerous polyps 08:43.470 --> 08:45.526 that can turn into cancer are called 08:45.526 --> 08:48.050 adenomas . Types of polyps that don't 08:48.050 --> 08:50.272 typically have cancer potential include 08:50.272 --> 08:52.580 hyper plastic polyps , inflammatory 08:52.580 --> 08:55.190 polyps and hammer to metis polyps . 08:55.200 --> 08:58.910 A cinemas In hyper plastic polyps are 08:58.910 --> 09:00.910 the two most common types of polyps 09:00.910 --> 09:03.021 found in the colon . However , it can 09:03.021 --> 09:05.243 be difficult to know what kind of polyp 09:05.243 --> 09:07.243 a person has until it's removed and 09:07.243 --> 09:09.299 examined under a microscope for this 09:09.299 --> 09:11.410 reason undergoing a screening exam to 09:11.410 --> 09:13.243 find polyps and their subsequent 09:13.243 --> 09:15.132 removal is extremely important to 09:15.132 --> 09:16.688 prevent colorectal cancer . 09:19.440 --> 09:19.950 Mm . 09:25.740 --> 09:27.962 There are several factors that increase 09:27.962 --> 09:30.129 the risk for developing colon polyps . 09:30.129 --> 09:32.280 Doctor German . Can you tell us about 09:32.280 --> 09:34.280 some of these risk factors ? Sure . 09:34.280 --> 09:36.336 Major spencer , the risk factors for 09:36.336 --> 09:38.850 developing colon polyps include smoking . 09:40.310 --> 09:42.310 The increased risk continues for at 09:42.310 --> 09:44.560 least 10 years after quitting smoking , 09:45.540 --> 09:48.430 obesity , drinking alcohol , 09:48.940 --> 09:52.740 diet , high fat diets , low fiber 09:52.740 --> 09:55.330 intake and red meat consumption are all 09:55.330 --> 09:57.540 associated with an increased risk of 09:57.540 --> 10:01.450 developing polyps . Age People over 10:01.450 --> 10:03.283 the age of 50 are more likely to 10:03.283 --> 10:06.260 develop colon Polyps inflammatory bowel 10:06.260 --> 10:09.450 disease , such as Crohn's disease or 10:09.460 --> 10:12.460 ulcerative colitis family history . 10:13.640 --> 10:15.800 This risk of developing colon polyps 10:15.800 --> 10:17.800 doubles for someone who has a first 10:17.800 --> 10:19.911 degree relative diagnosed with polyps 10:19.911 --> 10:23.240 or colon cancer before age 60 and 10:23.240 --> 10:26.570 genetics , some genetic changes and 10:26.570 --> 10:28.237 rare hereditary syndromes are 10:28.237 --> 10:30.570 associated with developing colon polyps . 10:34.340 --> 10:40.530 The 10:40.540 --> 10:42.830 vast majority of colon polyps do not 10:42.830 --> 10:44.719 cause any symptoms , which is why 10:44.719 --> 10:46.941 screening is so important . Dr Malone , 10:46.941 --> 10:48.997 can you tell us more about screening 10:48.997 --> 10:50.980 and symptoms ? Absolutely . Dr 10:50.980 --> 10:54.150 Mansfield In general colon screening is 10:54.150 --> 10:56.430 recommended every 10 years because it 10:56.430 --> 10:58.690 usually takes about 10 years for an 10:58.690 --> 11:01.070 adenoma or a pre cancerous type of 11:01.070 --> 11:03.460 polyp to develop into colon cancer . 11:03.940 --> 11:06.320 People with certain risk factors or who 11:06.320 --> 11:08.376 have had pre cancerous polyps in the 11:08.376 --> 11:10.264 past , during screenings may need 11:10.264 --> 11:13.130 screenings more often . In some cases , 11:13.140 --> 11:15.370 a polyp can cause bleeding in the colon 11:15.370 --> 11:17.590 or rectum , especially if the polyp is 11:17.590 --> 11:20.220 large . This bleeding can make stool 11:20.220 --> 11:22.350 look red maroon or black 11:23.940 --> 11:26.150 bleeding in the rectum can show up his 11:26.150 --> 11:28.120 blood on underwear or toilet paper 11:28.120 --> 11:30.550 after a bowel movement . Other rare 11:30.550 --> 11:32.606 symptoms in cases where the polyp is 11:32.606 --> 11:35.460 very large can include change in bowel 11:35.460 --> 11:39.250 habits , constipation and diarrhea . 11:48.340 --> 11:51.560 Treatment for colon polyps is removal 11:51.560 --> 11:53.671 of the polyps called polyp . Ectomy . 11:53.671 --> 11:55.810 Doctor Patel . Can you tell us about 11:55.810 --> 11:58.110 politic to me ? Sure , Major spencer . 11:58.120 --> 12:00.490 In most cases , polyps are removed with 12:00.490 --> 12:02.712 tools inserted through a channel in the 12:02.712 --> 12:04.323 Colonna scope at the time of 12:04.323 --> 12:06.490 colonoscopy , some of these tools look 12:06.490 --> 12:08.710 like little pinchers or a lasso polyp 12:08.710 --> 12:10.940 removal does not cause discomfort . 12:10.950 --> 12:13.006 Sometimes , however , a polyp is too 12:13.006 --> 12:15.460 large to remove completely at one time . 12:15.470 --> 12:17.810 In these situations a patient may have 12:17.810 --> 12:19.921 to come back for a second colonoscopy 12:19.921 --> 12:22.143 or undergo surgery to remove the entire 12:22.143 --> 12:23.460 polyp . 12:25.240 --> 12:32.110 Ulcerative 12:32.110 --> 12:34.320 colitis is a chronic or long lasting 12:34.320 --> 12:36.710 disease . It causes inflammation and 12:36.720 --> 12:38.942 ulcers on the inner lining of the large 12:38.942 --> 12:41.400 intestine . Doctor german , can you 12:41.400 --> 12:43.660 tell us more about ulcerative colitis ? 12:44.040 --> 12:46.440 Definitely ? Major Spencer ulcerative 12:46.440 --> 12:48.607 colitis belongs to a group of diseases 12:48.607 --> 12:50.920 called inflammatory bowel diseases or 12:50.930 --> 12:53.310 ivy D . This is a disease where the 12:53.310 --> 12:55.532 patient's immune system inappropriately 12:55.532 --> 12:57.640 attacks the colon or large intestine 12:57.760 --> 13:00.090 causing inflammation . The inflammation 13:00.090 --> 13:02.312 starts in the rectum and can extend all 13:02.312 --> 13:04.479 the way to where the colon starts . It 13:04.479 --> 13:06.701 can get worse over time , especially if 13:06.701 --> 13:09.390 left untreated patients with ulcerative 13:09.390 --> 13:11.723 colitis can develop other complications , 13:11.723 --> 13:13.946 both in the colon and in other parts of 13:13.946 --> 13:15.890 the body . Potential complications 13:15.890 --> 13:19.560 include toxic mega colon colon cancer , 13:19.570 --> 13:22.710 a liver condition called primary 13:22.710 --> 13:25.920 sclerosing cholangitis , sores in the 13:25.920 --> 13:29.410 mouth , rashes on the skin , 13:29.420 --> 13:33.380 red painful eyes , n 13:33.380 --> 13:37.250 joint pain and inflammation , toxic 13:37.250 --> 13:39.306 mega colon is a severe disease flare 13:39.306 --> 13:41.528 that results in the colon becoming very 13:41.528 --> 13:43.570 dilated or large and expanded and 13:43.570 --> 13:45.550 dysfunctional . This is a medical 13:45.550 --> 13:47.580 emergency and can be complicated by 13:47.580 --> 13:49.850 infection and perforation or rupture of 13:49.850 --> 13:52.210 the colon . This may lead to surgery to 13:52.210 --> 13:54.900 remove the colon . Primary sclerosing 13:54.900 --> 13:57.420 cholangitis , or PSC , is a disease of 13:57.420 --> 13:59.309 the liver where the immune system 13:59.309 --> 14:01.531 inappropriately attacks and damages the 14:01.531 --> 14:03.630 bile ducts . The bio ducks may even 14:03.630 --> 14:05.797 become blocked due to inflammation and 14:05.797 --> 14:07.741 scarring . This causes the bile to 14:07.741 --> 14:09.741 accumulate in the liver , which can 14:09.741 --> 14:12.760 eventually lead to liver failure . Oh , 14:15.040 --> 14:21.220 there 14:21.220 --> 14:23.387 are several risk factors that increase 14:23.387 --> 14:25.609 the likelihood of developing ulcerative 14:25.609 --> 14:27.770 colitis ? Dr Malone . Can you tell us 14:27.770 --> 14:30.660 about these factors ? His I can dr 14:30.660 --> 14:33.570 Mansfield risk factors that play a role 14:33.570 --> 14:35.403 in the development of ulcerative 14:35.403 --> 14:38.260 colitis include auto immune reaction . 14:38.740 --> 14:41.300 Normally the immune system protects the 14:41.300 --> 14:43.700 body from infection by identifying and 14:43.700 --> 14:45.811 destroying enemies of the body , such 14:45.811 --> 14:48.090 as bacteria , viruses and other 14:48.090 --> 14:50.650 potentially harmful foreign substances . 14:51.140 --> 14:53.580 In the case of ulcerative colitis , the 14:53.580 --> 14:55.747 immune system thinks the lining of the 14:55.747 --> 14:58.320 colon is the enemy . It's thought that 14:58.320 --> 15:01.060 bacteria and viruses mistakenly trigger 15:01.060 --> 15:03.230 the immune system to attack the inner 15:03.230 --> 15:05.580 lining of the large intestine , which 15:05.580 --> 15:09.220 causes inflammation . Other auto immune 15:09.220 --> 15:11.550 diseases . Having an auto immune 15:11.550 --> 15:13.320 disease increases the risk for 15:13.320 --> 15:15.710 developing other autoimmune conditions 15:15.720 --> 15:17.860 such as ulcerative colitis 15:19.340 --> 15:23.310 genetics , ulcerative colitis sometimes 15:23.310 --> 15:26.340 runs in families . Certain 15:26.340 --> 15:30.080 medications , some studies suggest that 15:30.080 --> 15:32.770 non steroidal anti inflammatory drugs , 15:32.780 --> 15:35.240 or Nsaids . Antibiotics and oral 15:35.240 --> 15:37.630 contraceptives may slightly increase 15:37.630 --> 15:39.519 the risk of developing ulcerative 15:39.519 --> 15:42.570 colitis and sides are known to worsen 15:42.580 --> 15:44.580 ulcerative colitis or cause an 15:44.590 --> 15:47.320 ulcerative colitis flare if taken by a 15:47.320 --> 15:50.130 patient who already has the condition 15:50.140 --> 15:54.040 diet . There's some evidence that a 15:54.040 --> 15:56.690 diet high in fat may slightly increase 15:56.690 --> 15:58.579 the risk of developing ulcerative 15:58.579 --> 16:02.370 colitis and ethnicity . Some 16:02.370 --> 16:04.592 particular groups of jewish descent are 16:04.592 --> 16:06.500 very likely to develop ulcerative 16:06.500 --> 16:08.760 colitis . 16:09.940 --> 16:16.120 The 16:16.130 --> 16:17.963 signs and symptoms of ulcerative 16:17.963 --> 16:20.074 colitis depend on the severity of the 16:20.074 --> 16:22.019 inflammation , but the most common 16:22.019 --> 16:24.300 symptoms are abdominal discomfort and 16:24.300 --> 16:26.300 loose or frequent bowel movements , 16:26.300 --> 16:28.411 including diarrhea , often with blood 16:28.411 --> 16:31.680 or pus . When severe , doctor Patel , 16:31.680 --> 16:33.458 what else can you tell us about 16:33.458 --> 16:35.180 symptoms and diagnosis of this 16:35.180 --> 16:37.291 condition ? One major spencer , other 16:37.291 --> 16:39.402 common symptoms of ulcerative colitis 16:39.402 --> 16:41.569 include an urgent need to have a bowel 16:41.569 --> 16:44.460 movement , fatigue , nausea or loss of 16:44.460 --> 16:47.530 appetite , weight loss , fever and 16:47.530 --> 16:50.370 anemia , which is a condition in which 16:50.370 --> 16:52.426 the body has fewer red blood cells . 16:52.426 --> 16:54.314 The normal often a consequence of 16:54.314 --> 16:57.760 losing blood in the stool . Less common 16:57.760 --> 17:01.270 symptoms include joint pain or soreness , 17:01.740 --> 17:05.130 irritation , and certain rashes . In 17:05.130 --> 17:07.297 order to diagnose ulcerative colitis , 17:07.300 --> 17:09.467 a provider will start with the medical 17:09.467 --> 17:11.411 history and physical examination . 17:11.411 --> 17:13.578 Blood tests may be ordered to look for 17:13.578 --> 17:16.430 signs of inflammation or anemia . A 17:16.430 --> 17:18.680 stool sample may also be analyzed for 17:18.680 --> 17:21.130 evidence of intestinal infection . A 17:21.130 --> 17:24.210 colonoscopy or a flexible sigmoidoscopy 17:24.220 --> 17:26.442 may be ordered to confirm an ulcerative 17:26.442 --> 17:28.340 colitis diagnosis . During these 17:28.340 --> 17:30.680 procedures , a thin , flexible tube 17:30.690 --> 17:33.070 with a tiny camera on the end is passed 17:33.070 --> 17:35.292 through the so the provider can see the 17:35.292 --> 17:37.800 inside of the rectum and colon . A 17:37.800 --> 17:39.800 colonoscopy provides a view of the 17:39.800 --> 17:42.240 entire colon and the rectum , whereas a 17:42.240 --> 17:44.700 flexible sigmoidoscopy is limited to 17:44.700 --> 17:46.644 viewing only the lower part of the 17:46.644 --> 17:48.811 colon called the sigmoid colon and the 17:48.811 --> 17:49.811 rectum . 17:53.840 --> 17:54.840 Mhm . 17:58.340 --> 18:00.620 Crohn's disease is an inflammatory 18:00.620 --> 18:03.090 bowel disease , or IBD . It is a 18:03.090 --> 18:04.646 chronic disease that causes 18:04.646 --> 18:06.590 inflammation and irritation in the 18:06.590 --> 18:08.990 digestive tract . Dr german , can you 18:08.990 --> 18:11.046 tell us more about Crohn's disease ? 18:11.340 --> 18:13.210 Sure thing . Dr Mansfield , it's 18:13.220 --> 18:15.387 estimated that Crohn's disease affects 18:15.387 --> 18:17.553 more than half a million people in the 18:17.553 --> 18:19.664 United States . It belongs to a group 18:19.664 --> 18:21.776 of diseases called inflammatory bowel 18:21.776 --> 18:23.890 diseases , or IBD . Although Crohn's 18:23.890 --> 18:25.834 disease can affect any part of the 18:25.834 --> 18:28.168 digestive tract , from the mouth to the , 18:28.168 --> 18:30.112 it most commonly affects the small 18:30.112 --> 18:32.057 intestine and the beginning of the 18:32.057 --> 18:34.057 large intestine or colon . It often 18:34.057 --> 18:36.168 begins gradually and can become worse 18:36.168 --> 18:37.890 over time , especially if left 18:37.890 --> 18:39.890 untreated inflammation from Crohn's 18:39.890 --> 18:41.890 disease can cause a number of other 18:41.890 --> 18:44.001 health complications . For instance , 18:44.001 --> 18:46.168 the wall of the intestines can thicken 18:46.168 --> 18:48.001 and narrow over time , which can 18:48.001 --> 18:50.001 eventually block the intestines . A 18:50.001 --> 18:52.334 partial or complete intestinal blockage , 18:52.334 --> 18:54.334 also called a bowel obstruction can 18:54.334 --> 18:56.223 prevent food or stool from moving 18:56.223 --> 18:58.400 through the intestines . Another 18:58.400 --> 19:00.344 potential complication is called a 19:00.344 --> 19:02.740 fistula . A fistula is an abnormal 19:02.740 --> 19:05.060 passage between two organs or between 19:05.060 --> 19:07.116 an organ and the outside of the body 19:07.240 --> 19:09.351 inflammation from the Crohn's disease 19:09.351 --> 19:11.462 can penetrate through the wall of the 19:11.462 --> 19:13.684 intestines and create fistulas that may 19:13.684 --> 19:15.796 become infected or may cause drainage 19:15.796 --> 19:17.962 or intestinal contents , such as stool 19:17.962 --> 19:20.073 and bacteria , into inappropriate and 19:20.073 --> 19:22.240 dangerous places , such as the bladder 19:22.240 --> 19:24.462 inflammation that goes through the wall 19:24.462 --> 19:26.351 of the intestine can also lead to 19:26.351 --> 19:28.573 abscesses , which are painful , swollen 19:28.573 --> 19:30.518 puss filled pockets of infection , 19:30.660 --> 19:33.570 fissures or small tears in the are 19:33.570 --> 19:35.459 another potential complication of 19:35.459 --> 19:37.590 Crohn's disease . fissures can cause 19:37.600 --> 19:40.810 itching pain or bleeding inflammation 19:40.820 --> 19:42.987 anywhere along the digestive tract can 19:42.987 --> 19:44.987 lead to ulcers or open sores in the 19:44.987 --> 19:48.050 mouth intestines , or perineum , 19:48.540 --> 19:50.750 nutrient absorption and absorption may 19:50.750 --> 19:52.972 be impaired , resulting in malnutrition 19:52.972 --> 19:55.000 and weight loss . In addition , the 19:55.000 --> 19:56.889 immune system may also attack the 19:56.889 --> 19:59.590 tissues in the joints , eyes and skin 19:59.640 --> 20:02.970 causing pain , swelling , redness , and 20:02.970 --> 20:04.914 even blindness if left untreated . 20:05.840 --> 20:07.951 These are all potential complications 20:07.951 --> 20:09.118 of Crohn's disease . 20:17.840 --> 20:19.970 The exact cause of Crohn's disease is 20:19.970 --> 20:22.026 unknown , but there are some factors 20:22.026 --> 20:23.803 that increase the likelihood of 20:23.803 --> 20:25.920 developing the disease . Dr Malone . 20:25.930 --> 20:28.097 Can you tell us about the risk factors 20:28.097 --> 20:30.041 for Crohn's disease ? Sure , major 20:30.041 --> 20:32.480 spencer . Risk factors for Crohn's 20:32.480 --> 20:35.970 disease include age , symptoms 20:35.970 --> 20:38.500 usually start between the ages of 15 20:38.500 --> 20:40.980 and 35 with a second peak in the 20:40.980 --> 20:43.040 fifties and sixties . Although being 20:43.040 --> 20:45.350 this age alone is not a specific risk 20:45.350 --> 20:49.160 factor . Family history , Having a 20:49.160 --> 20:51.104 first degree relative with Crohn's 20:51.104 --> 20:52.990 disease can increase the risk of 20:52.990 --> 20:55.540 developing the condition by 10 to 15 20:55.540 --> 20:57.310 times compared to the general 20:57.310 --> 21:00.350 population smoking 21:02.240 --> 21:04.184 people who smoke tend to have more 21:04.184 --> 21:06.400 severe symptoms and are at a higher 21:06.400 --> 21:09.540 risk of needing surgery . Yeah , 21:10.640 --> 21:14.220 auto immune reaction . Normally , the 21:14.220 --> 21:16.276 immune system protects the body from 21:16.276 --> 21:18.510 infection by identifying and destroying 21:18.510 --> 21:20.820 enemies of the bodies such as bacteria , 21:20.830 --> 21:23.420 viruses and other potentially harmful 21:23.420 --> 21:26.000 foreign substances . In the case of 21:26.000 --> 21:28.000 Crohn's disease , the immune system 21:28.000 --> 21:30.333 thinks the digestive tract is the enemy . 21:30.640 --> 21:32.807 It's thought that bacteria and viruses 21:32.807 --> 21:35.030 mistakenly trigger the immune system to 21:35.030 --> 21:37.010 attack the digestive tract , which 21:37.010 --> 21:40.590 causes inflammation and other 21:40.590 --> 21:44.200 autoimmune diseases . Having an auto 21:44.200 --> 21:46.311 immune disease increases the risk for 21:46.311 --> 21:48.478 developing other autoimmune conditions 21:48.500 --> 21:50.060 such as Crohn's disease . 21:53.540 --> 21:59.890 The 21:59.900 --> 22:02.122 symptoms of Crohn's disease , which can 22:02.122 --> 22:04.200 range from mild to severe , often 22:04.200 --> 22:06.420 depend on the severity and location of 22:06.420 --> 22:08.760 the inflammation . Doctor Patel . Can 22:08.760 --> 22:10.982 you tell us more about these symptoms ? 22:10.982 --> 22:13.310 Of course , Dr Mansfield symptoms 22:13.310 --> 22:15.366 usually develop gradually , but they 22:15.366 --> 22:17.699 can also start suddenly without warning . 22:17.699 --> 22:19.699 The most common symptoms of Crohn's 22:19.699 --> 22:21.930 disease include abdominal pain and 22:21.930 --> 22:24.770 cramping , persistent diarrhea , 22:25.640 --> 22:29.270 blood in the stool , fever and weight 22:29.270 --> 22:31.590 loss . Other symptoms can include 22:31.850 --> 22:34.360 ulcers in the mouth , loss of appetite , 22:34.940 --> 22:37.760 fatigue , nausea and vomiting , 22:38.340 --> 22:41.620 anemia and nutritional deficiencies . I 22:41.620 --> 22:45.240 read this or pain , joint pain and red 22:45.240 --> 22:47.840 tender bumps under the skin . For some 22:47.840 --> 22:49.896 people , stress in certain foods may 22:49.896 --> 22:52.180 trigger symptoms or make symptoms worse 22:54.440 --> 23:01.050 Dive 23:01.050 --> 23:03.270 Articulo SIS is a common condition 23:03.280 --> 23:06.380 affecting roughly 35% of adults under 23:06.380 --> 23:09.120 age 50 in the United States and more 23:09.120 --> 23:11.820 than half of adults over 60 . When 23:11.820 --> 23:13.876 diverticular Asus causes symptoms or 23:13.876 --> 23:15.900 problems it's called diverticular 23:15.900 --> 23:18.930 disease . Dr german , can you tell us 23:18.930 --> 23:20.900 more about diverticular Asus and 23:20.900 --> 23:23.230 diverticular disease ? Absolutely . 23:23.230 --> 23:25.790 Major . Spencer dive articulos is's a 23:25.790 --> 23:27.623 condition that occurs when small 23:27.623 --> 23:30.180 pouches or sacks form and push outward 23:30.180 --> 23:32.291 through weak spots in the wall of the 23:32.291 --> 23:34.513 intestines , similar to potholes in the 23:34.513 --> 23:36.124 road . One pouch is called a 23:36.124 --> 23:38.180 diverticular um and multiple pouches 23:38.180 --> 23:40.430 are called diverticular diverticular 23:40.430 --> 23:42.486 are most commonly found in the lower 23:42.486 --> 23:44.541 part of the colon called the sigmoid 23:44.541 --> 23:46.708 colon , but they can occur anywhere in 23:46.708 --> 23:48.652 the intestines . A special type of 23:48.652 --> 23:50.374 diverticular called a merkel's 23:50.374 --> 23:52.430 diverticular is usually found in the 23:52.430 --> 23:54.652 lower part of the small intestine . For 23:54.652 --> 23:56.708 most people , diverticular Asus does 23:56.708 --> 23:58.763 not cause any symptoms or problems . 23:58.763 --> 24:00.597 Diverticular disease occurs when 24:00.597 --> 24:02.770 diverticular Asus does cause symptoms 24:02.870 --> 24:04.759 such as changes in bowel movement 24:04.759 --> 24:06.660 patterns or pain in the abdomen . 24:07.240 --> 24:09.129 Diverticular in the upper , small 24:09.129 --> 24:11.351 intestine can cause bloating and nausea 24:11.351 --> 24:13.450 from bacterial overgrowth . Merkel's 24:13.450 --> 24:15.506 diverticular have an especially high 24:15.506 --> 24:18.670 risk of bleeding . Other problems that 24:18.670 --> 24:20.559 can result from diverticular Asus 24:20.559 --> 24:22.448 include diverticular bleeding and 24:22.448 --> 24:24.980 diverticulitis . Diverticular bleeding 24:24.980 --> 24:27.202 occurs when a small blood vessel within 24:27.202 --> 24:29.313 the wall of the diverticular bursts . 24:29.313 --> 24:31.900 Diverticulitis occurs when one or more 24:31.900 --> 24:34.300 diverticular become inflamed . Although 24:34.300 --> 24:36.880 diverticulitis develops in less than 5% 24:36.880 --> 24:39.010 of people with diverticular Asus , it 24:39.010 --> 24:41.360 can lead to other serious complications . 24:41.840 --> 24:43.507 One potential complication of 24:43.507 --> 24:45.618 diverticulitis is the formation of an 24:45.618 --> 24:48.070 abscess , which is a painful , swollen 24:48.070 --> 24:50.840 puss filled pocket of infection and 24:50.840 --> 24:53.190 abscess can cause nausea , vomiting , 24:53.200 --> 24:56.010 fever and severe abdominal tenderness . 24:56.940 --> 24:59.010 Diverticulitis can also cause a 24:59.010 --> 25:01.600 perforation or a small tear or hole in 25:01.600 --> 25:04.160 the diverticular um If pus and stool 25:04.160 --> 25:06.160 leak through a perforation , it can 25:06.160 --> 25:08.060 cause peritonitis , which is an 25:08.070 --> 25:10.292 inflammation or infection of the lining 25:10.292 --> 25:12.740 of the abdomen . A fistula is another 25:12.740 --> 25:14.184 potential complication of 25:14.184 --> 25:16.370 diverticulitis . A fistula is an 25:16.370 --> 25:18.820 abnormal passage between two organs or 25:18.820 --> 25:21.042 between an organ and the outside of the 25:21.042 --> 25:23.264 body . The most common types of fistula 25:23.264 --> 25:25.431 caused by diverticulitis occur between 25:25.431 --> 25:27.487 the colon and the bladder or between 25:27.487 --> 25:29.598 the colon and the vagina . In women , 25:29.598 --> 25:31.764 an intestinal obstruction , which is a 25:31.764 --> 25:33.598 partial or total blockage of the 25:33.598 --> 25:35.376 intestines may also result from 25:35.376 --> 25:37.370 diverticulitis . The obstruction 25:37.370 --> 25:39.630 prevents food stool from moving through 25:39.630 --> 25:43.560 the intestines . Yeah , 25:49.440 --> 25:51.570 the cause of diverticular Asus and 25:51.570 --> 25:54.010 diverticular disease is unknown , but 25:54.020 --> 25:55.909 people are more likely to develop 25:55.909 --> 25:58.360 diverticular Asus as they age . Dr 25:58.360 --> 26:00.416 Malone . Can you tell us about other 26:00.416 --> 26:02.416 risk factors for these conditions ? 26:02.416 --> 26:04.950 Absolutely , Dr Mansfield . Some 26:04.950 --> 26:07.260 evidence suggests that abnormal 26:07.270 --> 26:09.492 intermittent high pressure in the colon 26:09.500 --> 26:11.990 due to muscle spasm , constipation or 26:11.990 --> 26:14.320 straining with stool may contribute to 26:14.320 --> 26:17.270 the formation of diverticular to family 26:17.270 --> 26:19.381 history may also increase the risk of 26:19.381 --> 26:22.130 developing diverticular Asus . A person 26:22.130 --> 26:24.019 with a first degree relative with 26:24.019 --> 26:26.140 diverticular Asus is more likely to 26:26.140 --> 26:28.307 develop the condition than someone who 26:28.307 --> 26:30.473 has no family history of the disease . 26:31.040 --> 26:33.560 Among people over 50 women are more 26:33.560 --> 26:36.300 likely to develop diverticulitis , but 26:36.310 --> 26:38.310 men are more likely to develop it . 26:38.310 --> 26:40.360 Among people younger than 50 , 26:42.240 --> 26:48.970 most 26:48.970 --> 26:51.200 people with diverticular aosis do not 26:51.200 --> 26:53.256 have symptoms unless their condition 26:53.256 --> 26:55.311 develops into diverticular disease . 26:55.311 --> 26:57.367 Doctor Patel , Can you tell us about 26:57.367 --> 26:59.720 symptoms of diverticular disease ? I 26:59.720 --> 27:01.400 sure can't major spencer if 27:01.400 --> 27:03.690 diverticular Asus does cause symptoms , 27:03.700 --> 27:05.650 they may include bloating , 27:05.660 --> 27:08.430 constipation or diarrhea and cramping 27:08.430 --> 27:11.600 or pain in the lower abdomen . In cases 27:11.600 --> 27:13.322 where diverticular Asus causes 27:13.322 --> 27:15.290 diverticular bleeding symptoms may 27:15.290 --> 27:17.890 include a large amount of red or maroon 27:17.890 --> 27:19.834 colored blood in the stool that is 27:19.834 --> 27:21.470 painless and dizziness . 27:21.480 --> 27:24.430 Lightheadedness or weakness . When 27:24.430 --> 27:25.930 diverticular Asus leads to 27:25.930 --> 27:28.590 diverticulitis symptoms can include 27:28.600 --> 27:30.711 severe pain in the lower left side of 27:30.711 --> 27:33.130 the abdomen , constipation or diarrhoea , 27:33.140 --> 27:35.400 fevers and chills and nausea or 27:35.400 --> 27:37.060 vomiting . 27:38.740 --> 27:45.530 Irritable 27:45.530 --> 27:47.980 bowel syndrome or I . B . S . Is a 27:47.980 --> 27:50.091 group of symptoms that occur together 27:50.091 --> 27:52.680 including abdominal pain or discomfort 27:52.690 --> 27:54.968 and changes in bowel movement patterns . 27:54.968 --> 27:57.080 Doctor German , can you tell us more 27:57.080 --> 27:59.330 about I . B . S . Of course , dr 27:59.330 --> 28:01.620 Mansfield I . B . S . Is a functional 28:01.620 --> 28:04.510 gastrointestinal or GI disorder where 28:04.510 --> 28:06.750 the G . I tract behaves in an abnormal 28:06.750 --> 28:08.861 way without evidence of damage due to 28:08.861 --> 28:11.340 an organic disease . I . B . S . Has 28:11.340 --> 28:13.640 particular diagnostic criteria and 28:13.640 --> 28:15.473 cannot be diagnosed unless other 28:15.473 --> 28:17.960 organic disease has been ruled out In 28:17.960 --> 28:20.127 order to be diagnosed with I . B . S , 28:20.127 --> 28:22.293 A person must have recurrent abdominal 28:22.293 --> 28:24.560 pain on average at least one day a week 28:24.560 --> 28:26.990 in the last three months . In addition , 28:27.080 --> 28:28.969 the pain must be related to bowel 28:28.969 --> 28:31.136 movements and associated with a change 28:31.136 --> 28:33.660 in frequency or appearance of stool . I . 28:33.660 --> 28:35.882 B . S . Is classified based on patterns 28:35.882 --> 28:37.993 of stool consistency . There are four 28:37.993 --> 28:40.410 types of I . B . S . Including I . B . 28:40.410 --> 28:43.310 S with constipation or I . B . S . C . 28:43.320 --> 28:46.260 I . B . S with diarrhea or I BSD , 28:46.270 --> 28:49.600 mixed I . B . S . Or I B . S . M . And 28:49.600 --> 28:51.790 unsub typed I . B . S . Or I . B . S . 28:51.790 --> 28:55.020 You people with I . B . S more commonly 28:55.020 --> 28:57.230 suffer from other digestive conditions 28:57.240 --> 29:00.060 such as gastroesophageal reflux disease 29:00.070 --> 29:03.280 or GERD and indigestion . In addition , 29:03.280 --> 29:05.502 people with I . B . S often suffer from 29:05.502 --> 29:07.336 other non digestive conditions , 29:07.336 --> 29:09.770 including chronic fatigue syndrome , 29:09.780 --> 29:13.120 chronic pelvic pain , temporomandibular 29:13.120 --> 29:16.670 joint disorders , depression , anxiety 29:17.140 --> 29:19.250 and some uniform disorders which are 29:19.250 --> 29:21.083 psychological disorders in which 29:21.083 --> 29:23.306 physical symptoms are inconsistent with 29:23.306 --> 29:25.560 or cannot be fully explained by any 29:25.570 --> 29:26.848 underlying condition . 29:30.240 --> 29:36.850 Celiac 29:36.850 --> 29:38.950 disease is a chronic or long lasting 29:38.950 --> 29:40.839 disease in which foods containing 29:40.839 --> 29:43.190 gluten cause inflammation of the small 29:43.190 --> 29:46.090 intestine dr Malone . What can you tell 29:46.090 --> 29:48.630 us about celiac disease ? Well , Major 29:48.630 --> 29:51.520 spencer gluten describes a specific 29:51.520 --> 29:54.160 protein found in wheat , barley , rye 29:54.160 --> 29:56.770 and related grains . In people with 29:56.770 --> 29:59.160 celiac disease . When food containing 29:59.160 --> 30:01.216 gluten reaches the small intestine , 30:01.340 --> 30:03.670 the immune system reacts against the 30:03.670 --> 30:05.503 gluten , causing the wall of the 30:05.503 --> 30:08.400 intestine to become inflamed . Millions 30:08.400 --> 30:10.780 of finger like projections called villi , 30:10.790 --> 30:13.530 lined the small intestine ville . I 30:13.540 --> 30:15.380 increase the surface area of the 30:15.380 --> 30:17.491 intestines so that more nutrients can 30:17.491 --> 30:19.710 be absorbed . The inflammation from 30:19.710 --> 30:22.240 celiac disease damages these villi , 30:22.320 --> 30:24.264 which decreases the ability of the 30:24.264 --> 30:26.760 intestine to absorb nutrients from food . 30:27.340 --> 30:29.340 The good news is that the damage is 30:29.340 --> 30:32.000 reversible . When gluten is removed 30:32.000 --> 30:34.222 from the diet , inflammation is reduced 30:34.222 --> 30:36.900 and the villa I begin to heal . Many 30:36.900 --> 30:39.067 people who have celiac disease may not 30:39.067 --> 30:41.122 know they have it until symptoms are 30:41.122 --> 30:43.520 triggered . Those symptoms can include 30:43.530 --> 30:46.890 abdominal pain bloating and gas 30:46.950 --> 30:50.720 diarrhea , stools that float or smell 30:50.720 --> 30:54.300 very bad . Weight loss , Skin rash 30:54.310 --> 30:57.110 specific to celiac symptoms of 30:57.110 --> 31:00.080 nutritional deficiencies , poor growth 31:00.080 --> 31:03.850 or weight loss in Children and anemia . 31:04.340 --> 31:06.340 Sometimes symptoms are more vague , 31:06.340 --> 31:09.430 including fatigue feelings of unwell 31:09.430 --> 31:13.180 nous , other skin changes or even 31:13.180 --> 31:16.960 constipation or weight gain . It's 31:16.960 --> 31:19.182 important to note that some people with 31:19.182 --> 31:21.270 celiac disease may have few or no 31:21.270 --> 31:23.490 symptoms but damage to the lining of 31:23.490 --> 31:26.490 the intestine is still occurring . If a 31:26.490 --> 31:28.546 provider suspects that a patient may 31:28.546 --> 31:30.601 have celiac disease , they may order 31:30.601 --> 31:32.712 blood tests to check for the presence 31:32.712 --> 31:35.830 of specific antibodies . Genetic tests 31:35.830 --> 31:37.830 may also be ordered to look for the 31:37.830 --> 31:39.960 genes that enable celiac disease . 31:40.540 --> 31:42.440 However , endoscopy is the most 31:42.450 --> 31:45.080 accurate way to diagnose celiac disease . 31:45.640 --> 31:48.390 During an endoscopy , a thin , flexible 31:48.390 --> 31:50.420 tube with a tiny camera on the end 31:50.440 --> 31:52.840 called an endoscope is passed through 31:52.840 --> 31:55.020 the mouth into the stomach and small 31:55.020 --> 31:58.050 intestine Special tools can be passed 31:58.050 --> 32:00.106 through the endoscope to take tissue 32:00.106 --> 32:02.050 samples from the wall of the small 32:02.050 --> 32:03.939 intestine , which is necessary to 32:03.939 --> 32:07.130 confirm diagnosis of Celia . The 32:07.130 --> 32:08.960 treatment for celiac disease is 32:08.960 --> 32:11.460 avoiding all foods that contain gluten . 32:11.940 --> 32:14.107 When gluten is removed from the diet , 32:14.140 --> 32:16.251 the intestine will heal and return to 32:16.251 --> 32:18.460 normal . Mhm . 32:19.940 --> 32:27.060 Constipation , 32:27.060 --> 32:29.470 which can be acute or chronic , is one 32:29.470 --> 32:31.470 of the most common gastrointestinal 32:31.470 --> 32:33.637 problems in the United States . Doctor 32:33.637 --> 32:35.692 Patel . What can you tell us about ? 32:35.692 --> 32:38.060 Constipation ? Well , dr Mansfield . 32:38.070 --> 32:39.848 Some people think that they are 32:39.848 --> 32:42.014 constipated if they don't have a bowel 32:42.014 --> 32:44.014 movement every day , but this isn't 32:44.014 --> 32:46.014 true . Bowel movement patterns vary 32:46.014 --> 32:48.237 between individuals with normal healthy 32:48.237 --> 32:50.348 patterns ranging from three times per 32:50.348 --> 32:52.014 day to three times per week . 32:52.014 --> 32:54.070 Constipation means having fewer than 32:54.070 --> 32:56.014 three bowel movements per week and 32:56.014 --> 32:58.237 having bowel movements with stools that 32:58.237 --> 33:00.348 are difficult or painful to pass . It 33:00.348 --> 33:02.292 can be caused by hard stool , poor 33:02.292 --> 33:04.670 motility of the bowels , an obstruction 33:04.670 --> 33:06.640 or blockage in the bowels or some 33:06.640 --> 33:09.050 dysfunction of pelvic muscles or organs . 33:09.060 --> 33:12.270 Constipation is often accompanied by 33:12.280 --> 33:14.650 other symptoms , including abdominal 33:14.650 --> 33:17.910 cramping , mild to severe abdominal 33:17.910 --> 33:19.620 pain that comes in waves , 33:19.630 --> 33:23.320 nausea and diarrhea 33:23.320 --> 33:25.300 viruses , or excessive abnormal 33:25.300 --> 33:28.450 sweating . While acute constipation is 33:28.450 --> 33:30.590 very common and usually resolves with 33:30.590 --> 33:32.650 simple dietary changes . Chronic 33:32.650 --> 33:34.761 constipation can lead to other health 33:34.761 --> 33:37.150 complications , including hemorrhoids , 33:37.160 --> 33:39.216 which are swollen and inflamed veins 33:39.216 --> 33:42.230 around the and lower rectum , fissures , 33:42.240 --> 33:44.950 which are small tears in the rectal 33:44.950 --> 33:46.839 prolapse , which happens when the 33:46.839 --> 33:48.950 rectum slips so that it sticks out of 33:48.950 --> 33:51.810 the and fecal imp action , which 33:51.810 --> 33:53.699 happens when hard stool packs the 33:53.699 --> 33:55.754 intestine and rectum so tightly that 33:55.754 --> 33:58.060 the stool cannot be pushed out .