Test your knowledge of a range of common GI complaints. Duke gastroenterologist Rahul Shimpi, MD, helps digest the information.

1. True or false? Diet plays an important role in gastrointestinal complaints.

Often true -- but not always. “though I’m not convinced there’s a dietary link with all things digestive,” says Shimpi, “there are definitely food intolerances like lactose behind a lot of GI symptoms."

"I have patients keep a food diary to see if they can link consumption to their discomfort. Diet definitely plays a role in functional dyspepsia (indigestion), where eating lower-fat foods and smaller, more frequent meals helps.”

2. Celiac disease means the body cannot tolerate:

A. Dairy
B. Beans
C. Protein
D. Gluten

D. Gluten is a specific protein in wheat, barley, and rye that provokes an inflammatory response in people with celiac disease, damaging the lining of the small intestine and causing a range of possible symptoms, not all of them digestive.

Once considered a rare childhood disorder, “celiac disease may affect far more people than we once thought,” notes Shimpi. “Here again, keeping a food diary can be helpful -- and even if a doctor hasn’t been able to pinpoint celiac through testing, if you have relief from symptoms when you refrain from eating wheat, for example, there’s no harm in avoiding these foods.”

3. True or false? Ulcers are brought on by stress or spicy foods.

False. “Most peptic ulcers are now thought to be caused by the bacterium H. pylori or by overuse of aspirin and pain relievers known as NSAIDs, which include ibuprofen and naproxen,” says Shimpi.

Smoking and alcohol use make matters worse, and symptoms may worsen with stress and certain foods, although it is not thought anymore that these factors actually cause ulcers.

4. Which of the following is not true of irritable bowel syndrome (IBS)?

A. It may be triggered by certain foods.
B. It’s related to stress.
C. It’s more of a psychological condition than a physical one.

C. is untrue, though many physicians once believed that IBS was psychosomatic. IBS is a functional bowel disorder, and it is diagnosed by ruling out other conditions that share its symptoms: abdominal pain or discomfort related to frequent diarrhea or constipation.

Stress is a factor GI specialists address in addition to treating the physical symptoms of IBS -- and that goes for other digestive conditions, as well.

“Gastroenterologists do not discount the role stress plays in gastrointestinal health,” notes Shimpi. “We refer people to stress management services, and, not infrequently, we prescribe medications aimed at reducing anxiety and depression.”

5. To relieve constipation, you should:

A. Eat more fiber.
B. Increase your intake of fluids.
C. Increase physical activity.
D. Take laxatives.

All of these will help bring on a bowel movement, but try fiber, fluids, and activity first. “plenty of water, plenty of fiber, and moderate exercise are good for your gut,” says Shimpi.

“Inactivity slows your gut. The benefits of exercise are underappreciated -- at least anecdotally we know that people who exercise tend to feel better and have fewer GI symptoms. Generally speaking, laxatives are okay for occasional use. Constipation that requires regular use of laxatives should be evaluated by a physician.”

6. According to the American Gastroenterological Association, approximately one-third of the U.S. population has gastroesophageal reflux disease (GERD). Why is it so prevalent among Americans?

“The rise in obesity is thought to play an important role in the rise of GERD,” says Shimpi.

“Simply, the increased abdominal pressure from excess weight promotes reflux.” (“Reflux” describes the often painful backflow of stomach acid into the esophagus.) Weight loss, it follows, may bring relief. “Avoiding fatty foods, alcohol, and caffeine, and quitting smoking can help,” adds Shimpi.

Several medications are also effective. “Antacids help ease symptoms, and a class of drugs called proton pump inhibitors (PPIs) are now available over the counter (under the brand names prevacid and prilosec), but avoid prolonged use of PPIs and be sure to talk to your doctor or pharmacist about potential drug interactions.”

7. You attend a dinner party and spend much of the next day with diarrhea and vomiting. Is the culprit a virus, or bacteria?

Food-borne illnesses can come from either one, and “as long as it’s self-limiting, it really doesn’t matter which you have,” says Shimpi.

“If you’re not better in 24 to 48 hours, see a doctor. And if you can’t keep liquids down, you’re at risk for dehydration and may need medical care sooner.”

8. At what point do digestive problems warrant a specialist’s care?

“People should consider seeing a GI specialist if their symptoms are severe, last more than a few weeks, or begin to worsen,” says Shimpi.

Also, see your doctor if you’re having GI problems and also fit any of the following criteria:

• Your symptoms began after you turned 50
• There is a history in your family of gastrointestinal cancer
• Your symptoms are accompanied by weight loss, GI bleeding, difficulty swallowing, or anemia