1. Gastroesophageal Reflux Disease (GERD)

When stomach acid backs up into your esophagus (a condition called acid reflux), you may feel a burning pain in the middle of your chest. It often occurs after meals or at night, says Neville Bamji, MD, a clinical instructor of medicine at the Icahn School of Medicine at Mount Sinai and a gastroenterologist with New York Gastroenterology Associates in New York City.

While it’s common for people to experience acid reflux and heartburn once in a while, having symptoms that affect your daily life or occur at least twice each week could be a sign of GERD, a chronic digestive condition that affects 20 percent of Americans. If you experience persistent heartburn, bad breath, unexplained tooth erosion, nausea, pain in your chest or upper part of your abdomen, or have trouble swallowing or breathing, see your doctor.

Most people find relief by avoiding certain foods and beverages that trigger their symptoms or by taking over-the-counter antacids or other medication that reduce stomach acid production and inflammation of the esophagus. Lifestyle changes like elevating the head of the bed, not lying down after a meal, and quitting smoking can also help. However, some cases of GERD require stronger treatment, such as acid-blocking medication or even surgery.

2. Gallstones

Gallstones are hard deposits that form in your gallbladder — a small, pear-shaped sac that stores and secretes bile for digestion. Nearly one million Americans have gallstones every year. Gallstones can occur when substances that make up the bile (usually cholesterol or a waste product called bilirubin) become too concentrated and form a hard stone.

When gallstones block the ducts leading from your gallbladder to your intestines, they can cause sharp pain in your upper-right abdomen. The next step is usually surgery to remove the gallbladder.

3. Celiac Disease and Gluten Intolerance

An estimated 1 in 133 Americans — about 1 percent of the population — has celiac disease. It’s an immune reaction to gluten, a protein found in wheat, rye, and barley. Eat gluten, and your immune system goes on the attack: It damages your villi, the fingerlike protrusions in your small intestines that help you absorb nutrients from the foods you eat. Symptoms may include abdominal pain and bloating, diarrhea, constipation, vomiting, and weight loss. It can lead to malnutrition and nutritional deficiencies that may cause anemia, fatigue, bone loss, depression, and seizures.

The only treatment for celiac disease is to completely avoid eating gluten. Common alternatives to gluten include rice, quinoa, lentils, soy flour, corn flour, and amaranth.

Some people may test negative for celiac disease but have a gluten intolerance or sensitivity. Some of the same symptoms of celiac disease may occur, but gluten intolerance is a digestive disorder, not an immune disorder, so it doesn’t damage the intestine or cause problems like anemia or bone loss.

Also, people with gluten intolerance can eat gluten if they’re willing to deal with the resulting digestive symptoms. About 6 percent of Americans have a gluten intolerance.

4. Crohn’s Disease

Crohn’s disease is part of a group of digestive conditions called inflammatory bowel disease (IBD). Crohn’s can affect any part of the GI tract but most commonly affects the end of the small intestine (terminal ileum) and the first part of the large intestine, or colon. More than half a million Americans are living with Crohn’s disease.

Doctors aren’t sure what causes the disease, but it’s thought to be another kind of autoimmune reaction and that genetics may play a part. Common Crohn’s symptoms are abdominal pain, diarrhea, rectal bleeding, weight loss, and fever.

“Treatment depends on the symptoms and can include topical pain relievers, immunosuppressants, and surgery,” Dr. Bamji says.

5. Ulcerative Colitis

Also an inflammatory bowel disease, ulcerative colitis may affect as many as 900,000 Americans. Symptoms of ulcerative colitis are similar to Crohn’s, but the part of the digestive tract affected is solely the colon.

The cause is also unclear, but it may be that your immune system mistakenly attacks cells in your digestive tract, causing sores or ulcers in the lining of your large intestine. If you experience frequent and urgent bowel movements, pain with diarrhea, blood in your stool, or abdominal cramps, make sure to see your doctor.

While medication is the primary treatment to suppress the inflammation, eliminating foods that cause discomfort may help as well. In severe cases, treatment for ulcerative colitis may involve surgery to remove the colon.

6. Irritable Bowel Syndrome

Is your digestive tract irritable? Do you have stomach pain or discomfort at least three times a month for several months? It could be irritable bowel syndrome (IBS).

About 5 to 10 percent of people experience IBS, and of that percentage, up to 45 million people with IBS live in the United States. Signs of IBS can vary widely from having hard, dry stools to loose, watery stools, or both. Bloating and gas are also symptoms of IBS.

What causes IBS isn’t known, but treating symptoms centers largely on diet, such as eating low-fat, high-fiber meals and avoiding common trigger foods (dairy products, alcohol, caffeine, artificial sweeteners, and foods that produce gas). Following the low-FODMAP diet, which involves eliminating foods that are high in certain carbohydrates (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), has been found to reduce IBS symptoms. In a review published in 2021, researchers analyzed 12 papers and found that the low-FODMAP diet reduces symptoms and improves quality of life in people with IBS compared to control diets.

Some research suggests probiotics, or friendly bacteria found in certain foods like yogurt and sold as supplements, may help with IBS. In a review published in the journal Nutrients, seven of the 11 studies included reported that probiotics supplements significantly improved IBS symptoms compared to placebo.

However, the American Gastroenterological Association makes no recommendation on the use of probiotics for IBS, stating more scientific evidence is needed.

Stress can trigger IBS symptoms, so some people find cognitive behavioral therapy or low-dose antidepressants to be useful treatments as well.

7. Hemorrhoids

If there’s bright red blood in the toilet bowl when you move your bowels, it could be a sign of hemorrhoids. In fact, half of Americans over age 50 have hemorrhoids.

Hemorrhoids are swollen veins found in your anus or lower rectum that can be painful and itchy. Causes include chronic constipation, diarrhea, straining during bowel movements, and a lack of fiber in your diet.

Treat hemorrhoids by eating more fiber, drinking more water, and taking sitz baths. You can avoid contributing to the irritation by wiping with baby wipes or wet toilet paper after a bowel movement to reduce friction. At-home treatments like over-the-counter creams and suppositories usually provide relief of hemorrhoid symptoms. But if symptoms persist, you may need prescription medications or a medical procedure like hemorrhoidectomy, which removes hemorrhoids surgically.

8. Diverticulitis

Small pouches called diverticula can form anywhere there are weak spots in the lining of your digestive tract, but they are most commonly found in the colon. If you have diverticula but no symptoms, the condition is called diverticulosis, which is quite common among older adults and rarely causes problems. By age 50, about half of people have diverticulosis.

But in about 5 percent of people, the pouches become inflamed or infected, a condition called diverticulitis. Symptoms include fever, chills, nausea, and abdominal pain.

Mild diverticulitis is treated with a clear liquid diet so your colon can heal. In the past, the first line of treatment for uncomplicated diverticulitis was a round of antibiotics, but the latest guidelines from the American College of Physicians state that most cases can be treated without this medication.

A low-fiber diet could be the cause of diverticulitis, so your doctor may recommend you eat a diet high in fiber — whole grains, legumes, vegetables — once you’ve recovered. Cases of complicated diverticulitis are usually treated with intravenous antibiotics and may require surgery.

If you have severe attacks that recur frequently, you may need surgery to remove the diseased part of your colon.

9. Anal Fissure

Anal fissures are tiny, oval-shaped tears found in the lining of the anus. Symptoms are similar to hemorrhoids, such as bleeding and pain after moving your bowels. Straining and hard bowel movements can cause fissures, but so can soft stools and diarrhea. About 250,000 cases of anal fissures are diagnosed each year in the United States.

A high-fiber diet that makes your stool well formed and bulky is often the best treatment. Medication to relax the anal sphincter muscles, as well as topical anesthetics and sitz baths, can relieve pain; however, chronic fissures may require surgery of the anal sphincter muscle.

Editorial Sources and Fact-Checking

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