Gastrointestinal Health

Gastrointestinal health covers the whole digestive tract: the food pipe, the stomach, the small and large bowel, and the liver and gallbladder. Problems here range from heartburn and constipation through to long-term inflammation of the bowel. This page is a way in, with a plain-language page for each condition.

Conditions in this area

• Gastroesophageal reflux disease (GERD): stomach contents come back up into the food pipe, causing heartburn, a sour taste or a cough. It affects about 1 in 6 adults in Canada.
• Erosive esophagitis: reflux has inflamed or worn away the lining of the food pipe, which a doctor sees at endoscopy rather than something you feel directly.
• Dyspepsia, or indigestion: ongoing pain, burning or fullness in the upper abdomen when tests find no ulcer or other cause.
• Irritable bowel syndrome (IBS): abdominal pain and bloating with diarrhoea, constipation or both, affecting 13 to 20 per cent of Canadians.
• Ulcerative colitis: inflammation and ulcers in the lining of the large bowel, causing urgent, often bloody diarrhoea in flares.
• Crohn’s disease: inflammation that can appear anywhere along the digestive tract and reaches deeper into the bowel wall.
• Chronic constipation: bowel movements that are infrequent, hard to pass or incomplete, going on for months rather than days.
• Anal fissure: a small tear in the anal canal causing sharp pain during and after a bowel movement, often with bright red blood.
• Gallstones and gallbladder disease: hard stones form in the bile stored under the liver, silent in many people and causing attacks of pain in others.
• Fatty liver disease: fat builds up in the liver, usually with no symptoms, and in some people leads to scarring over years.

What these conditions have in common

The digestive tract works as one connected system, so symptoms overlap. Pain, bloating, a change in bowel habit and bleeding can each come from several causes, which is why the same first tests keep coming up: blood tests, stool tests, an ultrasound, and often a look inside with a camera. Diet, alcohol, smoking, sleep and body weight shape several of these conditions.

It is worth being honest about the grouping. Reflux and Crohn’s disease have little in common biologically. What they share is the organ system, the specialists who assess them and the tests used to tell one from another. Fatty liver disease sits here because the liver is part of digestion, and it also appears under kidney and liver diseases.

Treatment and care in Canada

Clinical research for Gastrointestinal Health is enrolling. See the current studies ↓

Most digestive problems are first assessed by a family doctor or nurse practitioner, with referral to a gastroenterologist when symptoms persist or a look inside is needed. Care usually involves some combination of:

• Diet support, often with a registered dietitian, since triggers differ between people
• Medicines chosen by class, including acid-reducing medicines, laxatives, antispasmodics, and anti-inflammatory or biologic medicines for inflammatory bowel disease
• Endoscopy and colonoscopy, to look and to treat
• Surgery where it is needed, from gallbladder removal through to bowel surgery
• Support for pain, sleep and mood, which affect gut symptoms directly
• Provincial colorectal cancer screening programs, which run separately from symptom-based care

Which of these fits depends on the diagnosis and on what matters to you. Those are decisions for you and your own clinician, and nothing here is a recommendation about any of them.

When to talk to a doctor

• Vomiting blood, or passing black tarry or bloody stools, needs emergency care. Call 911 or go to an emergency department.
• Severe abdominal pain with fever, a rigid abdomen or repeated vomiting needs same-day assessment.
• Yellowing of the skin or eyes, dark urine or pale stools should be assessed promptly.
• Trouble swallowing, food sticking or unintended weight loss should be assessed, not watched.
• A change in bowel habit lasting more than a few weeks, or any bleeding from the bowel, is worth an appointment.

Why research in this area matters

Several conditions here have no cure and are managed over decades. Inflammatory bowel disease comes down to controlling inflammation with medicines that do not work for everyone, and Canada has among the highest rates in the world. IBS and dyspepsia are common yet poorly served by existing treatments. Studies in Canada are testing new immune-targeting medicines, approaches to gut and brain signalling, treatments for liver scarring, and better ways to deliver diet support.

Studies are how any of that gets tested. Taking part is voluntary, you give informed consent first, and you can stop at any time without affecting the care you get from your own doctor. No one can say in advance whether a study will help you personally.

Learn more from Canadian sources

• Canadian Digestive Health Foundation
• Gastrointestinal Society: digestive topics A to Z
• Crohn’s and Colitis Canada: about Crohn’s and colitis
• Canadian Liver Foundation
• Canadian Association of Gastroenterology