Acid reflux into the esophagus may cause esophageal ulceration, stricture formation, or Barrett's epithelium, which may evolve into cancer of the esophagus. A hiatal hernia can usually be diagnosed by an upper GI series or an upper GI endoscopy. Therapy may require dietary changes and antacids in mild cases, or powerful anti-secretory medications or surgery in severe cases. This condition is perhaps the most common disorder seen by the gastroenterologist. The cause of IBS is unknown, but certain inciting factors are well established.
Stress is the most common, leading to tightening and spasm in the intestinal muscles.
Patients may feel cramps, bloating, urgency to defecate, nausea, or increased need to pass gas. In others, these symptoms may be precipitated by certain foods, especially dairy products, raw fruits and vegetables, or coffee. Women with IBS may have more symptoms in the week before menstruation and during menopause. IBS is a diagnosis of exclusion. All other conditions that may cause similar symptoms must be ruled out.