A Journey through GI Disease: Structural Disorders

Jul 27, 2023 1:21:00 PM Posted by Iowa Radiology

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Gastrointestinal (GI) disease includes several different disorders and can affect any part of the digestive tract. Some are minor and resolve quickly, while others can be serious or chronic. In this two-part series, we’re exploring a few common types of GI disease, including their symptoms, diagnosis, and treatment. GI disorders are classified into two main types: functional and structural. The first article in the series focused on functional GI diseases; this one will discuss structural disorders.


Functional vs. Structural GI Disorders

As the name suggests, functional GI disease affects how the GI tract functions. Everything will look normal on imaging exams, but the digestive system isn’t processing food normally. Structural GI disorders, on the other hand, are observable changes in the organs of digestion. Examples include strictures or stenosis (two ways digestive passages become narrower), inflammatory bowel disease, polyps, cancers, diverticular disease, and more. Structural disorders often need treatment, which may include surgery to repair the structural abnormality.


Importance of Diagnosis and Care

While occasional GI symptoms like constipation, diarrhea, heartburn, or nausea are to be expected, it’s important to consult with your doctor if they become severe or persistent. Left untreated, structural GI conditions could cause malnutrition, buildup of toxins in the body, disability, or even death. The earlier you begin investigating the cause of your GI issues, the better chance you have of recovering and maintaining a high quality of life.


Common Structural GI Disorders

Structural GI disorders include both relatively minor conditions like hemorrhoids and more serious ones like strictures, stenosis, and cancers. In this article, we’ll look at two common structural GI issues: inflammatory bowel disease and colon polyps or cancer.


Inflammatory Bowel Disease

IBD describes chronic inflammation of digestive tract tissues. It can manifest as ulcerative colitis (UC) or Crohn’s disease. Ulcerative colitis involves inflammation of the large intestine (or colon) and rectum. While Crohn’s disease can affect any part of the digestive tract, it most commonly involves the small intestine. IBD can cause severe, mild, or no symptoms. However, common symptoms associated with both Crohn’s disease and ulcerative colitis include abdominal pain, diarrhea, bloody stools, reduced appetite, weight loss, and fatigue. Because symptoms of IBD can be associated with many different illnesses, doctors may use a variety of tests to arrive at an IBD diagnosis, including blood and stool tests, colonoscopy, endoscopy, X-ray exams, CT, and MRI.

Chronic inflammation is not just uncomfortable; it can also cause additional problems. Both types of IBD are associated with increased risk of colon cancer, blood clots, and inflammation of the eyes, skin, and joints. Ulcerative colitis poses additional health risks for the large intestine, and Crohn’s disease patients face heightened risks of malnutrition, bowel obstruction, and related complications.

Some patients find that making specific lifestyle changes helps keep their IBD in check. Reducing fiber intake, keeping stress low, increasing hydration, following specific dietary guidelines (like the low FOODMAPS or Mediterranean diet) and avoiding caffeine are common recommendations. If additional control is needed, doctors may prescribe anti-inflammatory drugs and limited courses of corticosteroids to induce remission. Additional pharmaceutical tools for IBD management include drugs that suppress the immune system, biologics aimed at neutralizing proteins that cause inflammation, antibiotics, and anti-diarrheal drugs. In some cases, tissues damaged by chronic inflammation may require surgical removal.


Colon Polyps & Cancer

Colon polyps are non-cancerous growths that can develop in the lining of the colon or rectum. There are two common types, hyperplastic an adenoma. While hyperplastic polyps are considered harmless, adenomas have the potential to develop into cancer. Because of this, adenomas are routinely removed when found during colonoscopy.

Polyps and even colon cancer might not produce any symptoms in the early stages, but some patients may experience weight loss, bloating, abdominal discomfort, or bloody stools. Because symptoms may not appear until the disease has progressed, however, screening for colon cancer is essential. The American Cancer Society recommends regular screening beginning at age 45. Patients have a variety of screening methods to choose from. They can undergo stool-based tests, which are performed every 1–3 years, or visual exams, including colonoscopy (performed every 10 years), CT colonography (also known as virtual colonoscopy, performed every 5 years), and flexible sigmoidoscopy (performed every 5 years).

While stool-based tests are convenient and essentially risk free, they fail to identify many polyps and also return a relatively large percentage of false positive results, which then must be followed up with colonoscopy. Traditional colonoscopy allows doctors to remove polyps during the exam, but the exam itself typically requires sedation and carries some risk of bowel damage and infection. Virtual colonoscopy allows doctors to visualize the entire colon quickly and safely, without the use of sedatives. This is because images are taken from outside the body using a CT scanner. Bowel preparation is still required, however. During the exam, the colon is inflated with carbon dioxide to create the interior space needed to capture clear images.


Habits for Healthy Digestion

GI symptoms are closely connected with mental health due to a communication pathway known as the “gut-brain axis. As a result, challenges like stress, anxiety, and depression could cause an uptick in symptoms. To support healthy digestion, it’s important to also support your mental health with appropriate self care and, when necessary, working with a therapist. You can also support good digestion with healthy dietary choices, regular exercise, and a tobacco-free lifestyle.

Iowa Radiology provides cutting-edge medical imaging, including CT, MRI, GI fluoroscopy, and virtual colonoscopy. To learn more, explore our services or our library of free resources.




American Cancer Society. Colorectal Cancer Screening Tests. Cancer.org. Updated June 29, 2020. Accessed June 27, 2023. https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/screening-tests-used.html.


American Society for Gastrointestinal Endoscopy. Understanding Polyps and Their Treatment. ASGE.org. Published June 15, 2007. Accessed June 27, 2023. https://www.asge.org/home/for-patients/patient-information/understanding-polyps


Centers for Disease Control and Prevention. What is inflammatory bowel disease (IBD)? CDC.gov. Reviewed April 13, 2022. Accessed June 27, 2023. https://www.cdc.gov/ibd/what-is-IBD.htm.


Crohn’s & Colitis Foundation. Special IBD Diets. Accessed July 5, 2023. https://www.crohnscolitisfoundation.org/diet-and-nutrition/special-ibd-diets.


Harvard Health Publishing. Try a FODMAPs Diet to Manage Irritable Bowel Syndrome. Health.Harvard.edu. Published March 14, 2022. Accessed June 27, 2023. https://www.health.harvard.edu/diseases-and-conditions/a-new-diet-to-manage-irritable-bowel-syndrome.


Mayo Clinic. Inflammatory Bowel Disease (IBD). MayoClinic.org. Published September 3, 2022. Accessed June 27, 2023. https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315.


Saville S. Diet & Lifestyle Changes for Inflammatory Bowel Disease (IBD). CDHF.ca. Updated December 1, 2022. Accessed June 27, 2023. https://cdhf.ca/en/diet-and-lifestyle-changes-for-inflammatory-bowel-disease/.

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