Nurse specialist explains causes, prevention & treatments
IN THE EARLY 1960s, then 5-year-old Rebecca Wainwright had surgery and spent a night alone in the hospital, as even parents had to abide by strict visiting hours in those days. Terrified, she was comforted by nurses who held her and slipped her lollipops. The experience sealed her future as a nurse.
The Cleveland, Ohio, native began specializing in gastrointestinal (GI) nursing at Cleveland Clinic in 2005 after six years as an internal medicine nurse. Wainwright shares her expertise on all things GI.
Conditions such as heartburn and GERD (gastroesophageal reflux disease) are on the rise. What are the most important steps patients can take to prevent them?
Stop smoking! It weakens the lower esophageal sphincter (LES) muscle that prevents stomach contents and acid from going back up into the esophagus. Losing weight also helps. Belly fat creates pressure on the stomach and weakens the LES, forcing acid back up. And don’t drink, as alcohol irritates the GI tract lining.
Do GI disorders have an emotional component?
Irritable bowel syndrome (IBS) often is accompanied by depression and anxiety, and many patients take medications for those. I see the link in practice, although I think we need more research to prove the correlation.
Which foods cause the most problems for people with these issues?
Chocolate, peppermint, onions, caffeine, carbonated drinks, and acidic foods like citrus fruits can irritate the GI tract. And high-fat foods sit longer in the stomach so they produce more acid.
How can you avoid heartburn at night?
Don’t eat within three hours of bedtime. If you lie down with a full stomach, that puts pressure on the esophageal sphincter muscle. And elevate your head. Then it’s harder for the reflux to go up.
What can patients do to prevent IBS—or diminish its symptoms?
People with IBS can have constipation, diarrhea or both. But they can lessen symptoms by exercising—a half-hour of exercise like swimming or walking five days a week helps keep bowels regular. Also, write down what you eat and when you have symptoms. Some people feel better when taking a probiotic, a preparation containing live, helpful bacteria that help balance bacteria in the gut. Look for yogurt with live cultures. Or take over- the-counter probiotic supplements.
What are the biggest mistakes you see gastro patients make?
People often overuse non-steroidal anti-inflammatories like ibuprofen and naproxen, which irritates the GI tract. And I see lactose-intolerant people who can’t give up ice cream. People also eat a lot of high-fat foods that are not good for the GI tract.
GI issues in women can be difficult to diagnose. Do you have any tips?
That’s difficult even for us to pinpoint. Urinary tract infections can cause lower abdominal pain even though they are bladder issues, not GI issues. Ovarian cysts can cause pain in the belly, and ovarian cancer can cause bloating and abdominal pain. And a lot of women have nausea and vomiting before periods. The most important thing is for women to be up to date on annual gynecological exams.
What’s the best way to get answers about any condition from your doctor?
Create the best history you can: When did symptoms start, is the pain constant, does it come and go, is it sharp and stabbing or a dull ache? Does anything make it better or worse? Our dream patients write these things down before coming in.