Your health
Digestive issues: aggravating challenges

By John McElligott, M.D.

Over-the-road truck driving is a challenging profession for symptomatic sufferers of digestive conditions or diseases. Triggers need to be thoroughly understood and avoided. After diagnosis, the disorder needs careful management of diet, stress, lifestyle and medication. Here are some questions I’ve been asked regarding various digestive issues, including the big question: Is there a cure?

My wife was going to join me on the truck but every time she eats she gets sick and quickly has diarrhea. Her doctor says it’s Celiac Disease, but she’s had no tests. Can you tell me what kind of condition this is and whether it can be cured?

Celiac Disease is a genetic autoimmune disorder in which you develop an allergy to a protein know as gluten. When one’s immune system develops an allergy to gluten, damage occurs to the lining of the small intestine causing abdominal pain, distension, cramping and malabsorption.

Diagnosis is usually made by an internist or gastrointestinal doctor and may require blood testing and endoscopy with biopsy of the small bowel. Once diagnosed, the current treatment is to strictly observe a gluten-free diet. That may seem daunting, but there’s more gluten-free food available than ever before. It’s probably a good idea for her to get a handle on this type of diet before committing to road trips.

What exactly is lactose, and what does it mean to be lactose intolerant? What are common symptoms? Can it be cured?

Lactose is a natural sugar found in milk and dairy products. Some of us develop problems digesting this milk sugar, and the condition is known as lactose intolerance. The severity depends on the person’s ability to metabolize this sugar. Symptoms can begin in infancy or later in life. Symptoms are due to a lack of an enzyme called lactase in the small bowel, essential for breaking down the sugar. Premature infants almost always have this problem.

Although there’s no known cure, there are a number of over-the-counter products that are dairy digestive aids. In my opinion, you can diagnose it yourself by eliminating dairy products and seeing whether symptoms like painful gas, diarrhea, cramps, bloating and even nausea subside.

My brother wants to be a trucker but has a spastic colon. The list of food triggers is so long it’s unreal. The poor guy can’t eat anything. As a longtime driver, I don’t think it’s the best job for a person with irritable bowel syndrome. Are there "sure cure" medications or a no-fail treatment for this?

Spastic colon is one of a few different conditions or types of IBS. First is IBD (irritable bowel diarrhea) and second is IBC (irritable bowel constipation). Occasionally, both can occur. This is typically a large bowel issue and is symptomatic in the mid-to-lower part of the abdomen. I have seen the condition run in families and alternate between IBD and IBC. The cause is not clear, but some health experts think this is a brain-colon disconnect.

In my experience, nothing works for everyone. My advice is to "use what works for you" and the list of options is long. My first choice is lots of water and at night, Metamucil. Your co-driver definitely needs to be under the care of a GI doctor.

John McElligott, M.D., is a Fellow of the American College of Physicians. He is a certified medical examiner with the FMCSA’s National Registry of Certified Medical Examiners.

This column is the opinion of the writer and does not necessarily reflect the opinions of Land Line Magazine or its publisher. Everyone’s health situation is different. If you have questions regarding medical issues, consult your personal physician.