Content provided by the Faculty of the Harvard Medical School The Sensitive Gut

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Your digestive system is in some ways like a car's engine — you know there's a lot going on inside, but as long as it's running, you tend not to think about it. Once trouble begins, however, your gut, just like a cranky carburetor, suddenly demands your attention.

For some folks, symptoms such as diarrhea, gas, cramps, heartburn, indigestion, belching, bloating, and nausea are infrequent and tolerable, but many people experience them far more often. An estimated one in four people has frequent gastrointestinal (GI) problems that can severely disrupt a normal lifestyle. Symptoms may occur on and off for months or even years at a time, leading people to undergo unpleasant and sometimes unnecessary medical tests, spend money on questionable cures, and miss countless days of work.

Figure 1: Incredible journey

The food you eat travels a winding 30-foot pathway known as the gastrointestinal (GI) tract or the alimentary canal. Along the way the mucosa, or surface layer of cells lining the GI tract, produces digestive enzymes and juices that help break down food to be absorbed into the bloodstream.

Though the misery that such problems inflict is real, these ailments aren't usually the product of an illness in the conventional sense. Rather, they are functional gastrointestinal disorders. That means, unlike ulcers or stomach cancer, they can't be attributed to any physical abnormality or infection. More than 20% of people who consult a gastroenterologist learn that there's no structural abnormality to explain their complaints.

Just because doctors can't find an "organic" cause — meaning that there's no evidence of a structural, biochemical, or infectious basis for the symptoms — it doesn't mean you're imagining things. The symptoms are quite real, and if they occur frequently or last more than a month, it's advisable to seek help.

You may be relieved to know that even if doctors can't pinpoint the cause of your symptoms, the chances are good that you can get relief. This report focuses on a number of disorders considered to be functional: reflux, functional dyspepsia (FD), irritable bowel syndrome (IBS), constipation, diarrhea, and excessive gas.

The good news is that our ability to treat GI disorders continues to improve. With proper knowledge — and the support of a thoughtful, caring doctor — you can make changes in your diet or lifestyle to ease your discomfort and make the right decisions about medical treatments.

Exercise - Physical And Complementary Therapies: Arthritis

Content provided by the Faculty of the Harvard Medical School

Exercise

Even the healthiest people find it difficult to maintain an exercise regimen. But those with arthritis commonly discover that if they don't exercise regularly, they'll pay the price in pain, stiffness, and fatigue. Regular exercise not only helps maintain joint function, but also relieves stiffness and decreases pain and fatigue. Feeling tired may be partly the result of inflammation and medications, but it's also caused by muscle weakness and poor stamina. If a muscle isn't used, it can lose 3% of its function every day and 30% of its bulk in just a week.
Work with your physician or physical therapist to develop your own exercise program. Most likely this will involve exercises with three goals.
Increase range of motion. These exercises aim to increase the mobility and flexibility of your joints. To increase your range of motion, move a joint as far as it can go and then try to push a little farther. These exercises can be done any time, even when your joints are painful or swollen, as long as you do them gently. For several examples of range-of-motion exercises you can do at home, see Figure 11.

Figure 11: Range-of-motion exercises for arthritis

Hand
Range-of-motion exercises for arthritis: Hand
Open your hand, holding fingers straight. Bend the middle finger joints. Next, touch your finger-tips to the tops of your palm. Open your hand. Repeat 10 times with each hand. Next, reach your thumb across your hand to touch the base of your little finger. Stretch your thumb back out. Repeat 10 times.
Knee
Range-of-motion exercises for arthritis: Knee
Sit in a chair that is high enough for you to swing your legs. Keep your thighs on the seat and straighten out one leg. Hold for a few seconds. Then bend your knee and bring your foot as far back as possible. Repeat with the other leg. Repeat 10 times.
Shoulder
Range-of-motion exercises for arthritis: Shoulder
Lie on your back with your hands at your sides. Raise one arm slowly over your head, keeping your arm close to your ear and your elbow straight. Return your arm to your side. Repeat with the other arm. Repeat 10 times.
Hip
Range-of-motion exercises for arthritis: Hip
Lie on your back, legs straight and about 6 inches apart. Point your toes toward the ceiling. Slide one leg out to the side and then back to its original position. Try to keep your toes pointed up the whole time. Repeat 10 times with each leg.

Strengthen your muscles. An excellent way to provide aching joints with more support is to strengthen the muscles surrounding them. Strengthening exercises use resistance to build muscles. You can use your own body weight as resistance. One example: Sit in a chair. Now lean forward and stand by pushing up with your thigh muscles (try to use your arms only for balance). Stand a moment, then sit back down, using your thigh muscles. This simple exercise will help ease the strain on your knees by building up your thigh muscles. Avoid these exercises during arthritis flare-ups.

Build endurance. Aerobic activities such as walking, swimming, and bicycling can all build your heart and lung function, which in turn increases endurance and overall health. Just be careful to pick activities with low impact on your joints. If you have arthritis, you should avoid high-impact activities such as jogging. If you're having a flare-up of symptoms, wait until it subsides before doing endurance exercises.