What's behind that bellyache?

By CARREN BERSCH

Feeling Fit Correspondent

Remember the old-fashioned "tummy ache?" Children were generally cured with some TLC and perhaps a special treat.

Mother's favorite "cure" -- perhaps a cuddle on the sofa, along with soothing words of encouragement -- somehow magically soothed the ache. Soon, back we went to some playtime fascination.

Grown-ups with stomach problems often have something more serious than a mere "tummy ache."

Feeling Fit asked Ravi Kondapalli, MD, one of the medical directors at Gulf Coast Endoscopy Center (GCED) of Venice, if there are differences in digestive concerns for young children that older adults would not generally encounter -- and vice versa.

He cited issues concerning children that, surprisingly, include acid reflux in kids below age 5.

"Food intolerances, including gluten allergy or celiac sprue, and inflammatory bowel disease (IBD), such as Crohn's disease and ulcerative colitis, can occur in childhood," Kondapalli said.

There is no "scale" to indicate what digestive disorders might affect patients at a particular age -- possibly something to look for, even when nothing seems digestively out-of-order, he explained.

"There is no 'scale,' but celiac sprue and IBD occurs in young people. Middle-aged patients have increased risk of acid reflux, fatty liver disease and IBD. Older patients commonly have constipation, diarrhea, hemorrhoids, anal incontinence and diverticulosis," Kondapalli said.

At GCED, other commonly occurring digestive disorders seen in patients include colon polyps/colon cancer, gastroesophageal reflux disease (GERD), diarrhea and anemia (low blood count). "One specialty we offer at GCED is endoscopic ultrasound, normally available only in teaching hospitals, with which we can find and evaluate pancreatic problems," Kondapalli said.

The most serious digestive conditions are cirrhosis of liver (an end-stage liver disease), as well as esophageal, colon and pancreatic cancers, and IBDs. A couple of unusual diseases considered as digestive disorders are hemochromatosis by which too much iron being absorbed from the gastrointestinal tract, and achalasia, which is marked by difficulty in swallowing properly.

Most adults over 50 are aware of the importance of having an endoscopy scheduled annually, but what other digestive healthcare should older adults obtain?

"Screening colonoscopy is recommend for everybody above 50 years, but African-Americans patients should start at age 45. We also recommend an upper endoscopy for patients who have suffered with acid reflux for more than five years," Kondapalli noted. "I ask my patients to view colonoscopy for colon cancer screening as an investment in their health, an 'insurance plan' so that they can avoid risk. If a patient has suffered with acid reflux for more than five years, we check the esophagus to make sure there is no increased risk of esophageal cancer, which is rapidly growing in this country."

The doctor also encourages a liver-function test during the yearly physical. "This especially important if a patient has risk factors, among which might be a history of drug use -- past or present -- tattoos or blood transfusions." He pointed out that many gastrointestinal conditions have simple solutions, many in lifestyle changes.

"There is no need to suffer when maintaining healthy weight by eating responsibly and regularly exercising. Get an annual health check-up with a screening colonoscopy. If you a digestive problem, there is a good chance it can be treated," Kondapalli said.

Gulf Coast Endoscopy Center is located at 1220 East Venice Ave. in Venice. For more information, call 941-484-5000 or visit http://www.gulfcoastendocenter.com.