Glossary of Terms

What is abdominal pain?
Abdominal pain is discomfort or pain that occurs in your abdomen. Abdominal pain is also known as tummy, stomach, gut, or belly pain. Abdominal pain is experienced by everyone occasionally.

What causes abdominal pain?
The cause of abdominal pain is not always easy to diagnose. Sometimes the cause of abdominal pain is specific to a certain area of the abdomen such as the upper or lower portion, or the left or right portion of the abdomen. Pain originating in other parts of the body can also cause abdominal pain (this is called referred pain).

How is abdominal pain diagnosed?
Your doctor will complete a physical examination with emphasis on the abdominal, rectal, pelvic and genitourinary regions and review your medical history. Your doctor may also order tests such as lab tests, X-ray, computed tomography (CT) scan, ultrasound, or MRI.

How is abdominal pain treated?
The treatment for abdominal pain will depend on the cause of the abdominal pain, which can be quite varied. Keeping track of the location of the pain, what makes it better or worse, symptoms associated with pain (such as more pain with meals and with bowel movements) may be helpful in your diagnosis.

When to seek medical advice:
Seek emergency medical care or call 911 if you experience trauma such as an accident of injury or have pressure or pain in your chest. Seek medical attention immediately if you have pain that is severe or is accompanied by bloody stools, nausea, yellowing skin, swelling of the abdomen, or if your abdomen is tender to the touch.

Achalasia is a disorder characterized by difficulty swallowing. It is a rare condition that affects only 1 in every 100,000 people.

What causes achalasia?

The esophagus is a muscular tube that carries food from the mouth to the stomach. The esophagus does not function correctly in people with achalasia. In some cases, the lower part of the esophagus is ineffective in moving food into the stomach. In other cases, a circular band of muscule that separates the stomach from the esophagus, called the lower esophageal sphincter (LES), does not relax properly in response to swallowing. When this band of muscle (LES) does not relax, it creates a barrier to food entering the stomach. Damage to the LES can cause large volumes of food and saliva to accumulate in the esophagus.

What are the symptoms of achalasia?

The major symptom of achalasia is difficulty swallowing liquids or solids. Other symptoms include chest pain, heartburn, a sensation of fullness or a lump in the throat, hiccups or weight loss.

How is achalasia diagnosed?

Your doctor will review your symptoms and may order additional tests such as a chest X-ray or endoscopy. Your doctor may also order a barium swallow test, which involves swallowing a chalky mixture while a radiologist watches the swallow with an X-ray. Esophageal manometry is also frequently used to diagnosis achalasia. Manometry involves placement of a thin tube in the esophagus to measure the pressure throughout the esophagus and LES.

How is achalasia treated?

Many treatment options are available for the symptoms of achalasia; however none can reverse or correct the underlying problem. Your doctor may recommend muscle relaxing drug therapy to help the LES relax and decrease symptoms. Botox injections at the LES may also work to reduce LES pressure. Your doctor may also recommend stretching the esophagus with a balloon during endoscopy or under X-ray. Surgery may also be necessary to directly cut the muscle fibers of the LES.

When to seek medical advice

Many people delay seeking medical attention until symptoms are advanced. Contact your health care providers if you are noticing difficulty swallowing liquids or solids, or if you are experiencing chest pain, frequent heartburn or unexplained weight loss.

What is acute self-limited colitis?

In general, this is a type of inflammation of the lining of the colon that is due to an infection or drug, or other chemical or irritant. It tends to cause acute rather than chronic symptoms, and usually heals completely.

What are the symptoms of acute self-limited colitis?

This depends on the cause, but may include abdominal bloating or pain, bloody or watery diarrhea, or fever. At times the colon may appear “irritated” at the time of routine colonoscopy, and the patient may have no symptoms.

What are the causes of acute self-limited colitis?

Infection from a variety of organisms, either bacterial or viral. Bacterial infections can be caused by Campylobacter, Salmonella, Shigella, Yersinia, Vibrio, and E. coli O157:H7 to name a few. Viruses also cause colitis, but are usually not cultured easily from the stool.
Drugs. This is a major category, and includes antibiotics, non-steroidal anti-inflammatory drugs such as ibuprofen, chemotherapeutic agents used for cancer treatment, cocaine, and others.
Chemicals or irritants. Occasionally, laxatives, soap, contrast agents used in radiographic tests and even colon preparations can cause reversible irritation.
Diverticulitis – They can be associated with an acute colitis that resolves with treatment of the diverticulitis.
Inflammatory bowel disease (Crohn’s colitis, ulcerative colitis). In general, these types of colitis result in changes in the lining of the colon that are chronic rather than acute, and do not fall into the category of acute self-limited colitis Rarely, however, patients with inflammatory bowel disease may have biopsy changes that are interpreted as acute rather than chronic.
Irritable bowel syndrome does not cause acute or chronic colitis, but patients with irritable bowel syndrome may also develop acute self-limited colitis from one of the causes noted above.
What is the treatment of acute self-limited colitis?

In many cases, no specific treatment is needed, and the colitis will heal on its own. If infection is severe, it may require specific antibiotic therapy. In some cases, a medication or other offending agent will have to be stopped.