More than one billion individuals worldwide experience digestive or gastrointestinal (GI) problems, including acid reflux, bloating, constipation, diarrhea, and many others. This book was written with these individuals in mind and to help guide them. In this comprehensive yet high-yield and patient-friendly book, trusted medical expert Dr. James H. Tabibian shares his professional insights and personal experiences to empower patients to gain better understanding of and control over their digestive health. This book addresses questions that commonly arise among those with GI problems, such as “What condition do I really have?”, “Should I be worried?”, “At what point do I need to see a specialist?”, “What should I tell the doctor?”, “Is the doctor ordering the right tests for me?”, “What treatment options are there and which ones work best for me?”, “Am I seeing the right subspecialist for my problem?”, and more. It presents up-to-date scientific knowledge and tenets that are relevant across the spectrum of common GI problems, providing a summary of key concepts, underlying causes of digestive problems, how to best embark on a medical evaluation, and the vast array of pharmacological and non-pharmacological therapeutic options. Drawing upon both Western and Eastern methodologies and a combination of integrative and functional medicine, this book provides important practical information to help navigate life with GI problems, the complexities of modern healthcare, and the quest for digestive wellness, debunking misconceptions along the way.
Author(s): James H. Tabibian
Edition: 1
Publisher: Springer
Year: 2023
Language: English
Tags: Digestive Diseases; Gastroenterology
Foreword
Preface
Acknowledgments
Contents
Part I: The Gastrointestinal System and Digestive Problems: A Fundamental Primer
Chapter 1: Gastrointestinal Anatomy and Function: A High-Yield Overview
Anatomy of the GI System: What it Consists of
Digestive Tract
Esophagus
Stomach
Small Intestine
Large Intestine
Accessory Organs and Structures
Liver
Gallbladder
Pancreas
Function of the GI System: How it Works
Six Main Functions of the GI System
Ingestion
Mechanical Digestion
Chemical Digestion
Movements
Absorption
Elimination
Organic Versus Functional GI Disorders
Putting it all Together
Further Reading
Chapter 2: The Burden of Digestive Problems: Common and Impactful
A Disclaimer about Assessing the Burden of Digestive Problems
Digestive Problems Are Common and Have a Profound Impact Nationally
Burden OF Digestive Problems at the Individual Level
Putting it all Together
Further Reading
Chapter 3: Distinguishing Benign Symptoms from Red Flags
What Makes a Symptom “Benign”?
The Different Meanings of “Benign”: Context Matters
Potential Confusion Surrounding the Term “Benign”
What Are “Red Flags” in Medicine?
“Red Flags” don’t Always Indicate Doom and Gloom
Putting it all Together
Further Reading
Part II: Triggers and Causes of Digestive Problems: A Broad Spectrum of Possibilities
Chapter 4: Genes, Food, Environment, and Beyond
What Types of Things can Trigger Digestive Problems?
Intrinsic Factors
Genetics
Aging
Pregnancy
Menstrual Cycle
Extrinsic Factors
Food
Water
Air
Chemicals
Medications
Behavioral Factors
Mental Health and Psychosocial Issues
Cultural Considerations
Lifestyle Habits
Caveats Regarding the Relationship Between Triggers and Digestive Problems
Putting it all Together
Further Reading
Chapter 5: Flow Problems: Digestive Tract Blockages and Dysmotility
What Causes Problems with GI Flow
Digestive Tract Blockage
Digestive Tract Dysmotility
What Are the Symptoms of Flow Problems?
Bloating: A Common Problem that Is Sometimes but Not Always Due to Flow Issues
Aerophagia
Increased Production of Gas
Abnormal Dissipation of Gas
Putting it all Together
Further Reading
Chapter 6: The Intestinal Microbiome: Friends, Foes, and Unknowns
A Primer on the Immune System: A Starting Point for Understanding the Microbiome
What Constitutes the Intestinal Microbiome?
What Is the Relationship Between the Intestinal Microbiome and Digestive Problems?
What to Do about my Intestinal Microbiome
Putting it all Together
Further Reading
Chapter 7: The Role of Stress and Psychological Factors
A Disclaimer on Stress, Psychological Factors, and Functional Disorders
Stress and Digestive Problems
What to Do about Stress?
Psychological Factors and Digestive Problems
What to Do about Psychological Factors?
Putting it all Together
Further Reading
Part III: Medical Evaluation and Diagnosis: Pearls, Pitfalls, and What I Wish I Knew Sooner
Chapter 8: Effectively Navigating the Path to Seeing a Subspecialist
An Overview of “Referrals”
What Is a “Referral”, and What Purpose Does it Serve?
Who Makes Referrals to Gastroenterology, and Why Does this Matter?
Steps after a Referral Is Received
The Nature and Quality of a Referral
The Low-quality Referral: Where Gaps Can Potentially Emerge
The Referring Provider as the Hub
Interface Between Patient and the Referring Provider: The Basis of the Referral
Things to Do Pre-Visit
Things to Do during the Visit
Interface Between the Referring Provider and Subspecialist: The Pitch of the Referral
As you Await the Subspecialist Visit
When Time Comes to See the Subspecialist
Putting it all Together
Further Reading
Chapter 9: Following a Practical Sequence in Testing
Components and Sequence of the Medical Diagnostic Evalution
When Is (Further) Testing Needed?
Instances Where the Usual Testing Sequence May Not Be Best
A Few Words on Endoscopy
How Do I Know if My Evaluation Is Complete?
Putting it all Together
Further Reading
Chapter 10: The Unifying Diagnosis: Often but Not Always Correct
Basis of the Unifying Diagnosis
Problems with the Unifying Diagnosis
The Unifying Diagnosis: Use Only if it Fits
Putting it all Together
Further Reading
Chapter 11: Seeking a Second Opinion: When and Where
Should I Obtain a Second Opinion?
The Benefits of a Second Opinion
Situations that Merit a Second Opinion
Concerns Around Getting a Second Opinion
Where and How to Obtain a Second Opinion
Where to Go for a Second Opinion
How to Go About Obtaining a Second Opinion
Digestive Problem Scenarios Where You May Benefit from a Second Opinion
Putting it all Together
Further Reading
Part IV: Treatments and Solutions: Each Patient Is Unique, and One Size Doesn’t Fit All
Chapter 12: Initial Approaches: Lifestyle and Dietary Modifications
The Association Between Lifestyle, Diet, and Digestive Problems
Areas for Reflection and Potential Modification
Exercise
Sleep
Work Dynamics
Drinking and Smoking
Dietary Intake
Specific Diets
Eating Logistics
Changes that Come with the Aging Process
Lactose Intolerance and Food Sensitivity
A Tendency Toward Constipation
Diverticulosis and Diverticular Disease
Putting it all Together
Further Reading
Chapter 13: Over-the-Counter and Prescription Medications
OTC Medications for Digestive Disorders
Advantages of OTC Medications
Disadvantages to OTC Medications
Prescription Medications for Digestive Problems: Guiding Principles
Starting Dose
How to Take
When to Anticipate the Medication to Take Effect
Even a “Good” Prescription Medication Can Be Ineffective or Cause Adverse Effects
Duration of Treatment
The Optimal Long-Term Dose
When/Whether to Consider Switching
Putting it all Together
Further Reading
Chapter 14: Complementary and Alternative Medicine Approaches
What Is “CAM”?
Confusion Regarding the Expression “CAM”
When Can CAM Be Used?
The First Subgroup of CAM: Natural Products
Things to Bear in Mind Regarding Natural Products
A Primer on Probiotics
Informed Use of Probiotics
The Second Subgroup of cam: Mind-Body Medicine
Behavioral Therapy
Cognitive Behavioral Therapy
Stress Management Therapy
Biofeedback Therapy
Integrative Medicine: Taking cam to the Next Level
Putting it all Together
Further Reading
Index
