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64-491: Gastroesophageal reflux disease ( GERD ) or gastro-oesophageal reflux disease ( GORD ) is a chronic upper gastrointestinal disease in which stomach content persistently and regularly flows up into the esophagus , resulting in symptoms and/or complications. Symptoms include dental corrosion, dysphagia , heartburn , odynophagia , regurgitation , non-cardiac chest pain, extraesophageal symptoms such as chronic cough , hoarseness , reflux-induced laryngitis , or asthma . In

128-505: A biopsy from the stomach. The small and large intestines may be affected by infectious , autoimmune, and physiological states. Inflammation of the intestines is called enterocolitis , which may lead to diarrhea . Acute conditions affecting the bowels include infectious diarrhea and mesenteric ischaemia . Causes of constipation may include faecal impaction and bowel obstruction , which may in turn be caused by ileus , intussusception , volvulus . Inflammatory bowel disease

192-423: A sore throat , throwing up blood , difficulty swallowing or vomiting . Chronic or congenital diseases might be investigated using barium swallows , endoscopy and biopsy , whereas acute diseases such as reflux may be investigated and diagnosed based on symptoms and a medical history alone. Gastric diseases refer to diseases affecting the stomach . Inflammation of the stomach by infection from any cause

256-539: A cause of liver failure , a state where the liver is unable to compensate for chronic damage, and unable to meet the metabolic demands of the body. In the acute setting , this may be a cause of hepatic encephalopathy and hepatorenal syndrome . Other causes of chronic liver disease are genetic or autoimmune disease, such as hemochromatosis , Wilson's disease , autoimmune hepatitis , and primary biliary cirrhosis . Acute liver disease rarely results in pain, but may result in jaundice . Infectious liver disease may cause

320-424: A combination of an antacid and alginic acid (such as Gaviscon ) may improve symptoms by 60% (NNT=4). Metoclopramide (a prokinetic) is not recommended either alone or in combination with other treatments due to concerns around adverse effects. The benefit of the prokinetic mosapride is modest. Sucralfate has similar effectiveness to H 2 receptor blockers; however, sucralfate needs to be taken multiple times

384-509: A day, thus limiting its use. Baclofen , an agonist of the GABA B receptor, while effective, has similar issues of needing frequent dosing in addition to greater adverse effects compared to other medications. The standard surgical treatment for severe GERD is the Nissen fundoplication . In this procedure, the upper part of the stomach is wrapped around the lower esophageal sphincter to strengthen

448-424: A day. They should be taken one half to one hour before a meal. There is no significant difference between PPIs. When these medications are used long-term, the lowest effective dose should be taken. They may also be taken only when symptoms occur in those with frequent problems. H 2 receptor blockers lead to roughly a 40% improvement. The evidence for antacids is weaker with a benefit of about 10% ( NNT =13) while

512-509: A device called the LINX, which consists of a series of metal beads with magnetic cores that are placed surgically around the lower esophageal sphincter, for those with severe symptoms that do not respond to other treatments. Improvement of GERD symptoms is similar to those of the Nissen fundoplication, although there is no data regarding long-term effects. Compared to Nissen fundoplication procedures,

576-481: A feeling of incomplete emptying , or pencil-thin stools. In addition to regular tests, medical tests used to investigate the anus and rectum include the digital rectal exam and proctoscopy . Hepatic diseases refers to those affecting the liver . Hepatitis refers to inflammation of liver tissue, and may be acute or chronic . Infectious viral hepatitis , such as hepatitis A , B and C , affect in excess of (X) million people worldwide. Liver disease may also be

640-427: A fever. Chronic liver disease may result in a buildup of fluid in the abdomen , yellowing of the skin or eyes , easy bruising, immunosuppression , and feminization. Portal hypertension is often present, and this may lead to the development of prominent veins in many parts of the body, such as oesophageal varices , and haemorrhoids . In order to investigate liver disease, a medical history, including regarding

704-509: A fever. Tests that specifically examine the function of the large intestine include barium swallows, abdominal x-rays , and colonoscopy . Diseases affecting the rectum and anus are extremely common, especially in older adults. Hemorrhoids , vascular outpouchings of skin, are very common, as is pruritus ani , referring to anal itchiness. Other conditions, such as anal cancer may be associated with ulcerative colitis or with sexually transmitted infections such as HIV . Inflammation of

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768-580: A hiatal hernia. In 1934 gastroenterologist Asher Winkelstein described reflux and attributed the symptoms to stomach acid. The most common symptoms of GERD in adults are an acidic taste in the mouth, regurgitation , and heartburn . Less common symptoms include pain with swallowing / sore throat , increased salivation (also known as water brash), nausea , chest pain , coughing , and globus sensation . The acid reflux can induce asthma attack symptoms like shortness of breath, cough, and wheezing in those with underlying asthma. GERD sometimes causes injury to

832-409: A malignancy. Segmental or diffuse gastrointestinal wall thickening is most often due to ischemic, inflammatory or infectious disease. Though less common, medications such as ACE inhibitors can cause angioedema and small bowel thickening. The small intestine consists of the duodenum , jejunum and ileum . Inflammation of the small intestine is called enteritis , which if localised to just part

896-581: A person's family history , travel to risk-prone areas, alcohol use and food consumption, may be taken. A medical examination may be conducted to investigate for symptoms of liver disease. Blood tests may be used, particularly liver function tests , and other blood tests may be used to investigate the presence of the Hepatitis viruses in the blood, and ultrasound used. If ascites is present, abdominal fluid may be tested for protein levels. Pancreatic diseases that affect digestion refers to disorders affecting

960-460: A positive diagnosis. Short-term treatment with proton-pump inhibitors may help predict abnormal 24-hour pH monitoring results among patients with symptoms suggestive of GERD. Endoscopy , the examination of the stomach with a fibre-optic scope, is not routinely needed if the case is typical and responds to treatment. It is recommended when people either do not respond well to treatment or have alarm symptoms, including dysphagia , anemia , blood in

1024-475: A recurrent problem. Frequent acid reflux is due to poor closure of the lower esophageal sphincter , which is at the junction between the stomach and the esophagus. Factors that can contribute to GERD: Factors that have been linked with GERD, but not conclusively: In 1999, a review of existing studies found that, on average, 40% of GERD patients also had H. pylori infection. The eradication of H. pylori can lead to an increase in acid secretion, leading to

1088-490: A result of lifestyle factors, such as fatty liver and NASH . Alcoholic liver disease may also develop as a result of chronic alcohol use, which may also cause alcoholic hepatitis . Cirrhosis may develop as a result of chronic hepatic fibrosis in a chronically inflamed liver, such as one affected by alcohol or viral hepatitis. Liver abscesses are often acute conditions, with common causes being pyogenic and amoebic . Chronic liver disease, such as cirrhosis, may be

1152-527: Is ranitidine and PPIs. Babies may see relief with smaller, more frequent feedings, more frequent burping during feedings, holding the baby in an upright position 30 minutes after feeding, keeping the baby's head elevated while laying on the back, removing milk and soy from the mother's diet or feeding the baby milk protein-free formula. They may also be treated with medicines such as ranitidine or proton pump inhibitors. Proton pump inhibitors, however, have not been found to be effective in this population and there

1216-536: Is vagotomy ("highly selective vagotomy"), the surgical removal of vagus nerve branches that innervate the stomach lining. This treatment has been largely replaced by medication. Vagotomy by itself tended to worsen contraction of the pyloric sphincter of the stomach, and delayed stomach emptying. Historically, vagotomy was combined with pyloroplasty or gastroenterostomy to counter this problem. A number of endoscopic devices have been tested to treat chronic heartburn. Gastrointestinal disease The oral cavity

1280-408: Is a common response to GERD symptoms and many people get more of this kind of treatment than their case merits. The overuse of acid suppression is a problem because of the side effects and costs. Proton-pump inhibitors (PPIs), such as omeprazole , are the most effective, followed by H 2 receptor blockers, such as ranitidine . If a once-daily PPI is only partially effective they may be used twice

1344-447: Is a condition of unknown aetiology, classified as either Crohn's disease or ulcerative colitis , that can affect the intestines and other parts of the gastrointestinal tract. Other causes of illness include intestinal pseudoobstruction , and necrotizing enterocolitis . Diseases of the intestine may cause vomiting , diarrhoea or constipation , and altered stool , such as with blood in stool . Colonoscopy may be used to examine

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1408-409: Is a lack of evidence for safety. The role of an occupational therapist with an infant with GERD includes positioning during and after feeding. One technique used is called the log-roll technique, which is practiced when changing an infant's clothing or diapers. Placing an infant on their back while having their legs lifted is not recommended since it causes the acid to flow back up the esophagus. Instead,

1472-462: Is called duodenitis , jejunitis and ileitis , respectively. Peptic ulcers are also common in the duodenum. Chronic diseases of malabsorption may affect the small intestine, including the autoimmune coeliac disease , infective tropical sprue , and congenital or surgical short bowel syndrome . Other rarer diseases affecting the small intestine include Curling's ulcer , blind loop syndrome , Milroy disease and Whipple's disease . Tumours of

1536-403: Is called gastritis , and when including other parts of the gastrointestinal tract called gastroenteritis . When gastritis persists in a chronic state, it is associated with several diseases, including atrophic gastritis , pyloric stenosis , and gastric cancer . Another common condition is gastric ulceration , peptic ulcers . Ulceration erodes the gastric mucosa , which protects the tissue of

1600-405: Is due to poor closure of the lower esophageal sphincter , which is at the junction between the stomach and the esophagus. Diagnosis among those who do not improve with simpler measures may involve gastroscopy , upper GI series , esophageal pH monitoring , or esophageal manometry . Treatment options include lifestyle changes, medications, and sometimes surgery for those who do not improve with

1664-446: Is more effective than partial anterior fundoplication surgery, and partial fundoplication has better outcomes than total fundoplication. Esophagogastric dissociation is an alternative procedure that is sometimes used to treat neurologically impaired children with GERD. Preliminary studies have shown it may have a lower failure rate and a lower incidence of recurrent reflux. In 2012 the U.S. Food and Drug Administration (FDA) approved

1728-470: Is not needed in those in whom Barrett's esophagus is seen. Investigation for H. pylori is not usually needed. The current gold standard for diagnosis of GERD is esophageal pH monitoring. It is the most objective test to diagnose the reflux disease and allows monitoring GERD patients in their response to medical or surgical treatment. One practice for diagnosis of GERD is a short-term treatment with proton-pump inhibitors, with improvement in symptoms suggesting

1792-491: Is often safer and less expensive than taking prescription drugs. Some guidelines recommend trying to treat symptoms with an H 2 antagonist before using a proton-pump inhibitor because of cost and safety concerns. Medical nutrition therapy plays an essential role in managing the symptoms of the disease by preventing reflux, preventing pain and irritation, and decreasing gastric secretions. Some foods such as chocolate, mint, high-fat food, and alcohol have been shown to relax

1856-645: Is part of the gastrointestinal system and as such the presence of alterations in this district can be the first sign of both systemic and gastrointestinal diseases. By far the most common oral conditions are plaque -induced diseases (e.g., gingivitis , periodontitis , dental caries ). Oral symptoms can be similar to lesions occurring elsewhere in the digestive tract, with a pattern of swelling, inflammation, ulcers, and fissures. If these signs are present, then patients are more likely to also have anal and esophageal lesions and experience other extra-intestinal disease manifestations. Some diseases which involve other parts of

1920-459: Is sometimes called silent reflux . Differential diagnosis of GERD can also include dyspepsia, peptic ulcer disease, esophageal and gastric cancer, and food allergies. The treatments for GERD may include food choices, lifestyle changes, medications, and possibly surgery. Initial treatment is frequently with a proton-pump inhibitor such as omeprazole . In some cases, a person with GERD symptoms can manage them by taking over-the-counter drugs . This

1984-491: Is strongly linked to alcohol use. Other rarer diseases affecting the pancreas may include pancreatic pseudocysts , exocrine pancreatic insufficiency , and pancreatic fistulas . Pancreatic disease may present with or without symptoms. When symptoms occur, such as in acute pancreatitis , a person may experience acute-onset, severe mid-abdominal pain, nausea and vomiting. In severe cases, pancreatitis may lead to rapid blood loss and systemic inflammatory response syndrome . When

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2048-436: Is uncertain, but is estimated at 20% of cases. Due to the risk of chronic heartburn progressing to Barrett's, EGD every five years is recommended for people with chronic heartburn, or who take drugs for chronic GERD. A small amount of acid reflux is typical even in healthy people (as with infrequent and minor heartburn ), but gastroesophageal reflux becomes gastroesophageal reflux disease when signs and symptoms develop into

2112-546: The Western world , between 10 and 20% of the population is affected by GERD. It is highly prevalent in North America with 18% to 28% of the population suffering from the condition. Occasional gastroesophageal reflux without troublesome symptoms or complications is even more common. The classic symptoms of GERD were first described in 1925, when Friedenwald and Feldman commented on heartburn and its possible relationship to

2176-440: The biliary duct is called cholangitis , which may be associated with autoimmune disease, such as primary sclerosing cholangitis , or a result of bacterial infection, such as ascending cholangitis . Disease of the biliary tree may cause pain in the upper right abdomen, particularly when pressed . Disease might be investigated using ultrasound or ERCP , and might be treated with drugs such as antibiotics or UDCA , or by

2240-416: The biliary tree ), which secretes bile in order to aid digestion of fats. Diseases of the gallbladder and bile ducts are commonly diet-related, and may include the formation of gallstones that impact in the gallbladder ( cholecystolithiasis ) or in the common bile duct ( choledocholithiasis ). Gallstones are a common cause of inflammation of the gallbladder, called cholecystitis . Inflammation of

2304-501: The exocrine pancreas , which is a part of the pancreas involved in digestion. One of the most common conditions of the exocrine pancreas is acute pancreatitis , which in the majority of cases relates to gallstones that have impacted in the pancreatic part of the biliary tree , or due to acute or chronic hazardous alcohol use or as a side-effect of ERCP . Other forms of pancreatitis include chronic and hereditary forms. Chronic pancreatitis may predispose to pancreatic cancer and

2368-426: The large intestine may affect it in whole or in part. Appendicitis is one such disease, caused by inflammation of the appendix . Generalised inflammation of the large intestine is referred to as colitis , which when caused by the bacteria Clostridioides difficile is referred to as pseudomembranous colitis . Diverticulitis is a common cause of abdominal pain resulting from outpouchings that particularly affect

2432-580: The GI tract can manifest in the mouth, alone or in combination, including: Oesophageal diseases include a spectrum of disorders affecting the oesophagus . The most common condition of the oesophagus in Western countries is gastroesophageal reflux disease , which in chronic forms is thought to result in changes to the epithelium of the oesophagus, known as Barrett's oesophagus . Acute disease might include infections such as oesophagitis , trauma caused by

2496-567: The Johnson-DeMeester's scoring system: 0 – None 1 – Minimal – occasional episodes 2 – Moderate – medical therapy visits 3 – Severe – interference with daily activities Other causes of chest pain such as heart disease should be ruled out before making the diagnosis. Another kind of acid reflux, which causes respiratory and laryngeal signs and symptoms, is called laryngopharyngeal reflux (LPR) or extraesophageal reflux disease (EERD). Unlike GERD, LPR rarely produces heartburn, and

2560-476: The absence of perikymata , together with intact enamel along the gum margin. It will be evident in people with restorations as tooth structure typically dissolves much faster than the restorative material, causing it to seem as if it "stands above" the surrounding tooth structure. GERD may lead to Barrett's esophagus , a type of intestinal metaplasia , which is in turn a precursor condition for esophageal cancer . The risk of progression from Barrett's to dysplasia

2624-541: The bottle or breast only to cry for it again, failure to gain adequate weight, bad breath, and burping are also common. Children may have one symptom or many; no single symptom is universal in all children with GERD. Of the estimated 4 million babies born in the US each year, up to 35% of them may have difficulties with reflux in the first few months of their lives, known as 'spitting up'. About 90% of infants will outgrow their reflux by their first birthday. Acid reflux into

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2688-439: The colon. Functional colonic diseases refer to disorders without a known cause, including irritable bowel syndrome and intestinal pseudoobstruction . Constipation may result from lifestyle factors, impaction of a rigid stool in the rectum, or in neonates , Hirschprung's disease . Diseases affecting the large intestine may cause blood to be passed with stool, may cause constipation , or may result in abdominal pain or

2752-419: The diagnosis requires both symptoms or complications and reflux of stomach content. Other investigations may include esophagogastroduodenoscopy (EGD). Barium swallow X-rays should not be used for diagnosis. Esophageal manometry is not recommended for use in the diagnosis, being recommended only prior to surgery. Ambulatory esophageal pH monitoring may be useful in those who do not improve after PPIs and

2816-579: The esophagus. These injuries may include one or more of the following: GERD sometimes causes injury of the larynx (LPR). Other complications can include aspiration pneumonia . GERD may be difficult to detect in infants and children since they cannot describe what they are feeling and indicators must be observed. Symptoms may vary from typical adult symptoms. GERD in children may cause repeated vomiting , effortless spitting up, coughing , and other respiratory problems, such as wheezing. Inconsolable crying, refusing food, crying for food and then pulling off

2880-430: The first two measures. Lifestyle changes include not lying down for three hours after eating, lying down on the left side, raising the pillow or bedhead height, losing weight, and stopping smoking. Foods that may precipitate GERD symptoms include coffee, alcohol, chocolate, fatty foods, acidic foods, and spicy foods. Medications include antacids , H 2 receptor blockers , proton pump inhibitors , and prokinetics . In

2944-434: The ingestion of corrosive substances, or rupture of veins such as oesophageal varices , Boerhaave syndrome or Mallory-Weiss tears . Chronic diseases might include congenital diseases such as Zenker's diverticulum and esophageal webbing , and oesophageal motility disorders including the nutcracker oesophagus , achalasia , diffuse oesophageal spasm , and oesophageal stricture . Oesophageal disease may result in

3008-476: The large intestine, and a person's stool may be sent for culture and microscopy . Infectious disease may be treated with targeted antibiotics , and inflammatory bowel disease with immunosuppression . Surgery may also be used to treat some causes of bowel obstruction. The normal thickness of the small intestinal wall is 3–5 mm, and 1–5 mm in the large intestine. Focal, irregular and asymmetrical gastrointestinal wall thickening on CT scan suggests

3072-428: The long term, and when not treated, complications such as esophagitis , esophageal stricture , and Barrett's esophagus may arise. Risk factors include obesity , pregnancy , smoking , hiatal hernia , and taking certain medications. Medications that may cause or worsen the disease include benzodiazepines , calcium channel blockers , tricyclic antidepressants , NSAIDs , and certain asthma medicines. Acid reflux

3136-962: The lower esophageal sphincter, increasing the risk of reflux. Weight loss is recommended for the overweight or obese, as well as avoidance of bedtime snacks or lying down immediately after meals (meals should occur at least 2–3 hours before bedtime), elevation of the head of the bed on 6-inch blocks, avoidance of smoking, and avoidance of tight clothing that increases pressure in the stomach. It may be beneficial to avoid spices, citrus juices, tomatoes and soft drinks , and to consume small frequent meals and drink liquids between meals. Some evidence suggests that reduced sugar intake and increased fiber intake can help. Although moderate exercise may improve symptoms in people with GERD, vigorous exercise may worsen them. Breathing exercises may relieve GERD symptoms. The primary medications used for GERD are proton-pump inhibitors, H 2 receptor blockers and antacids with or without alginic acid . The use of acid suppression therapy

3200-426: The mouth can cause breakdown of the enamel, especially on the inside surface of the teeth. A dry mouth, acid or burning sensation in the mouth, bad breath and redness of the palate may occur. Less common symptoms of GERD include difficulty in swallowing, water brash, chronic cough, hoarse voice, nausea and vomiting. Signs of enamel erosion are the appearance of a smooth, silky-glazed, sometimes dull, enamel surface with

3264-465: The occupational therapist would suggest rolling the child on the side, keeping the shoulders and hips aligned to avoid acid rising up the baby's esophagus. Another technique used is feeding the baby on their side with an upright position instead of lying flat on their back. The final positioning technique used for infants is to keep them on their stomach or upright for 20 minutes after feeding. In Western populations, GERD affects approximately 10% to 20% of

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3328-405: The pancreas is unable to secrete digestive enzymes , such as with a pancreatic cancer occluding the pancreatic duct , result in jaundice. Pancreatic disease might be investigated using abdominal x-rays , MRCP or ERCP , CT scans , and through blood tests such as measurement of the amylase and lipase enzymes. Diseases of the hepatobiliary system affect the biliary tract (also known as

3392-444: The patient and damage to the device. Some patients who are at an increased surgical risk or do not tolerate PPIs may qualify for a more recently developed incisionless procedure known as a TIF transoral incisionless fundoplication . Benefits of this procedure may last for up to six years. GERD is a common condition that develops during pregnancy, but usually resolves after delivery. The severity of symptoms tend to increase throughout

3456-494: The population and 0.4% newly develop the condition. For instance, an estimated 3.4 million to 6.8 million Canadians have GERD. The prevalence rate of GERD in developed nations is also tightly linked with age, with adults aged 60 to 70 being the most commonly affected. In the United States 20% of people have symptoms in a given week and 7% every day. No data supports sex predominance with regard to GERD. An obsolete treatment

3520-688: The pregnancy. In pregnancy, dietary modifications and lifestyle changes may be attempted, but often have little effect. Some lifestyle changes that can be implemented are elevating the head of the bed, eating small portions of food at regularly scheduled intervals, reduce fluid intake with a meal, avoid eating three hours before bedtime, and refrain from lying down after eating. Calcium-based antacids are recommended if these changes are not effective; aluminum- and magnesium hydroxide-based antacids are also safe. Antacids that contain sodium bicarbonate or magnesium trisilicate should be avoided in pregnancy. Sucralfate has been studied in pregnancy and proven to be safe as

3584-528: The procedure has shown a reduction in complications such as gas bloat syndrome that commonly occur. Adverse responses include difficulty swallowing, chest pain, vomiting, and nausea. Contraindications that would advise against use of the device are patients who are or may be allergic to titanium , stainless steel , nickel , or ferrous iron materials. A warning advises that the device should not be used by patients who could be exposed to, or undergo, magnetic resonance imaging (MRI) because of serious injury to

3648-431: The question of whether H. pylori -infected GERD patients are any different from non-infected GERD patients. A double-blind study, reported in 2004, found no clinically significant difference between these two types of patients with regard to the subjective or objective measures of disease severity. The diagnosis of GERD is usually made when typical symptoms are present. Reflux can be present in people without symptoms and

3712-548: The rectum is known as proctitis , one cause of which is radiation damage associated with radiotherapy to other sites such as the prostate . Faecal incontinence can result from mechanical and neurological problems, and when associated with a lack of voluntary voiding ability is described as encopresis . Pain on passing stool may result from anal abscesses , small inflamed nodules, anal fissures , and anal fistulas . Rectal and anal disease may be asymptomatic, or may present with pain when passing stools, fresh blood in stool ,

3776-518: The small intestine include gastrointestinal stromal tumours , lipomas , hamartomas and carcinoid syndromes . Diseases of the small intestine may present with symptoms such as diarrhoea , malnutrition , fatigue and weight loss . Investigations pursued may include blood tests to monitor nutrition, such as iron levels , folate and calcium , endoscopy and biopsy of the duodenum, and barium swallow . Treatments may include renutrition and antibiotics for infections. Diseases that affect

3840-416: The sphincter and prevent acid reflux and to repair a hiatal hernia. It is recommended only for those who do not improve with PPIs. Quality of life is improved in the short term compared to medical therapy, but there is uncertainty in the benefits of surgery versus long-term medical management with proton pump inhibitors. When comparing different fundoplication techniques, partial posterior fundoplication surgery

3904-406: The stomach from the stomach acids. Peptic ulcers are most commonly caused by a bacterial Helicobacter pylori infection . Epstein–Barr virus infection is another factor to induce gastric cancer. As well as peptic ulcers, vomiting blood may result from abnormal arteries or veins that have ruptured, including Dieulafoy's lesion and Gastric antral vascular ectasia . Congenital disorders of

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3968-467: The stomach include pernicious anaemia , in which a targeted immune response against parietal cells results in an inability to absorb vitamin B12 . Other common symptoms that stomach disease might cause include indigestion or dyspepsia , vomiting , and in chronic disease, digestive problems leading to forms of malnutrition . In addition to routine tests, an endoscopy might be used to examine or take

4032-433: The stool (detected chemically), wheezing , weight loss, or voice changes. Some physicians advocate either once-in-a-lifetime or 5- to 10-yearly endoscopy for people with longstanding GERD, to evaluate the possible presence of dysplasia or Barrett's esophagus. Biopsies performed during gastroscopy may show: Reflux changes that are not erosive in nature lead to "nonerosive reflux disease". Severity may be documented with

4096-529: The surgical removal of the gallbladder . The Misplaced Pages article " Gastrointestinal cancer " describes the specific malignant conditions of the gastrointestinal tract. In general, a significant factor in the etiology of gastrointestinal cancers appears to be excessive exposure of the digestive organs to bile acids . Burping Too Many Requests If you report this error to the Wikimedia System Administrators, please include

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