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Gastrointestinal diseases are among the most common problems in tropical countries and commonly manifest as diarrhea, abdominal pain, abdominal distention, gastrointestinal bleeding, intestinal obstruction, malabsorption, or malnutrition. Infectious diarrheal diseases are an important cause of morbidity and mortality in childhood. This chapter covers acute and chronic diarrheal syndromes, as well as a range of illnesses that affect the mouth, esophagus, stomach, hepatobiliary, and pancreatic systems; small and large bowel; and rectum and anus. Special attention is paid to illnesses more common in the tropics, including duodenal ulcer, gastrointestinal infections, tuberculosis of the abdomen and intestine, malabsorption, tropical enteropathy, tropical sprue, chronic calcific pancreatitis, Helicobacter infection, and intestinal intussusception. Improvement in sanitation and improving socioeconomic conditions have reduced the burden of many infectious diseases, but is associated with an emergence of previously uncommon diseases in the tropics such as inflammatory bowel diseases and celiac disease.
Most common diseases:
Celiac disease: Celiac disease is a serious autoimmune disorder where the small intestine is hypersensitive to gluten. Ingestion of gluten causes the immune system of the body to attack the small intestine, leading to damage to the villi of the small intestine, which are small fingerlike projections that promote nutrient absorption.
Gastroesophageal Reflux Disease (GERD): GERD is also known as heartburn or acid reflux. It occurs when the ring of muscle fibers that surrounds the entrance to our stomach (known as the lower esophageal sphincter) becomes weak, and instead of remaining tightly closed to prevent the backflow of food back up our esophagus, it remains partially open, allowing partially digested food and stomach acid to leak back up the esophagus, causing irritation.The primary symptoms associated with GERD are regurgitation, heartburn, chest pain, and nausea. GERD is most commonly treated with antacids, H2 blockers, or Proton Pump Inhibitors.
Lactose intolerance: People with lactose intolerance do not produce enough of the enzyme lactase, and find it difficult to digest lactose, which is a type of sugar found in cows’, goats’, and sheep's milk. It is more common in people of Asian, Middle Eastern, Mediterranean, South American, or African descent, and can also be brought on by gut damage (such as that following gastroenteritis or surgery) or with conditions such as Celiac or Crohn’s disease.
Peptic Ulcer Disease (PUD): Peptic ulcer disease is an umbrella term used to describe both gastric and duodenal ulcers, which are small holes that can occur in the lining of your stomach (gastric ulcer) or upper part of your small intestine (duodenal ulcers). Duodenal ulcers are the most common type and are more likely in men aged between 30 and 50 years. Gastric ulcers most often affect middle-aged or elderly people.
The most common cause is an infection with a bacteria called Helicobacter pylori (H. pylori), which is usually acquired in childhood, although most people never develop ulcers.
Vomiting: Vomiting is when the contents of the stomach are forcefully expelled through the mouth, usually involuntarily. Nausea is the term used to describe feeling sick – or like you are just about to vomit. Infection from bacteria, viruses, or other micro-organisms is one of the most common causes of vomiting. Overindulgence in alcohol, food allergies, migraines, and pregnancy may also cause vomiting. Treatment depends on the cause and may include antiemetics and rehydration solutions, depending on how suitable these are for the person with the vomiting.
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