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Settle Your Stomach
by: Erin Hobday

Dwight D. Eisenhower Was a man with guts. He served as Supreme Allied Commander to defeat the Nazis, strong-armed the Soviets in Geneva, and sat in the Oval Office for two terms during the Cold War.

And yet, the one foe he wouldn't face was inflammatory bowel disease, a condition that plagued him with stomach pain until finally, in 1956, Ike cried uncle and underwent emergency surgery. Without the procedure, he would have died. The lesson? Trusting your gut can save your life, and ignoring it could kill you.

Unfortunately, it's a lesson that millions of men still need to learn. "The majority of the time, men will endure pain and irregular digestion, even vomiting, and think, This is just how I am," says Mark Lane Welton, M.D., a Men's Health advisor and the chief of colon and rectal surgery at Stanford University medical center. The truth is, even though your body contains a food processor that rivals a Cuisinart, a lot can go wrong between the time dinner enters your esophagus and the moment it exits your, well, you know.

So stop telling yourself nothing's wrong and start listening to your body's digestive distress calls. Then read—and heed—our guide to beating the worst gastrointestinal gremlins.

Heartburn

Your body's food chute is your esophagus, a tunnel of muscle whose job it is to push what you swallow into your stomach. And although this is supposed to be a one-way street, stomach acid sometimes rises back up, causing the five-alarm fire we call heartburn.

Occasional heartburn can be caused simply by eating chocolate (it relaxes the gatekeeping muscle known as the esophageal sphincter) or lying down after a meal (the angle allows acid to escape). But a chronic burn can signal gastroesophageal reflux disease (GERD), a condition that occurs when the sphincter stops working properly. Left untreated, GERD can lead to a worse esophageal ailment: cancer.

Put out the grease fire. A forkful of fat is as bad for your heartburn as it is for your heart. In a study published in the journal Gut, researchers surveyed 371 people about their eating habits and found that those who were heartburn-free ate 10 fewer grams (g) of fat per day than the heartburn victims. "Fats cause the lower part of the esophagus to relax, making it easier for the stomach to reflux," says Hashem B. El-Serag, Ph.D., the lead study author. Eliminate 11 g saturated fat by ordering your morning latte with skim milk instead of whole, and cut out 14 g more by taking two of the yolks out of a three-egg omelet.

Train your trunk. When Norwegian researchers surveyed more than 74,000 adults, they discovered that those who exercised regularly had the lowest incidence of GERD.

In fact, the people who swam, jogged, or skied for 30 minutes once a week were 50 percent less likely to suffer from the condition than the couch potatoes were. The researchers speculate that as the diaphragm is strengthened by cardio training, it exerts pressure on the esophageal sphincter, preventing it from allowing acid to escape. And while any cardio exercise helps, according to Matt Fitzgerald, a triathlon coach and the author of Runner's World Guide to Cross-Training, freestyle swimming pushes the diaphragm's envelope like nothing else.

Ulcers

Since acid is so damaging to your esophagus, you might wonder why it doesn't burn a hole through your stomach. One reason: a protective coating of mucus. But this barrier can be breached. Consuming copious amounts of coffee, overdoing it on ibuprofen and aspirin, and falling prey to the bacteria H. pylori can all wipe out mucus and allow acid to create quarter- to half-inch holes, better known as ulcers, in your stomach.

Do some navel gazing. Is there a bug in your belly? Up to 90 percent of people with H. pylori don't know it's there, even though the bacteria may be wreaking havoc on their stomach lining, according to a German study that also evaluated the benefits of testing for the microbe. When the researchers screened 5,000 people for H. pylori—and offered treatment to those who tested positive—the incidence of ulcers plummeted by nearly two-thirds after 2 years. "Early treatment can prevent ulcers. If they start bleeding, they are fatal in 10 percent of cases," says Andreas Zober, M.D., the lead study author. "Among high-risk populations, H. pylori eradication can also prevent stomach cancer." Ask your doctor about having an ELISA test to detect levels of IgG antibodies against H. pylori.

C the end of ulcers. The best way to eat to beat H. pylori is to swallow more vitamin C. In a recent study published in the Journal of the American College of Nutrition, researchers measured the blood levels of vitamin C in more than 6,000 people and determined that those with the highest levels were the least likely to show evidence of H. pylori infection. Unfortunately, one of the best sources of C—orange juice—could aggravate an ulcer, thanks to its high acid content. So instead of ordinary OJ, pick up Tropicana's Low Acid formulation; one 8-ounce glass packs a day's supply of vitamin C, minus most of the acid.

Inflammatory Bowel Disease

All in all, digestion is a pretty seamless process—unless you're one of the 1 million people with inflammatory bowel disease (IBD), a condition in which the lining of the intestines becomes inflamed. One theory suggests this happens because the immune system mistakes food for a foreign invader. White blood cells called T cells go wild and attack the intestinal wall, causing IBD sufferers to experience pain and diarrhea. And if IBD targets the large intestine, as it does in a form called colitis, the odds of developing colon cancer increase dramatically.

Employ germ warfare. Use yogurt to yank the rug out from under IBD. A recent study published in the journal Gastroenterology shows that treating IBD-afflicted intestinal tissue with probiotics—the good bacteria found in yogurt—encourages proper immune function. Plus, "probiotics limit bacterial invasion of the tissue," says Eyal Raz, Ph.D., the lead study author. Next time you're in the dairy aisle, pick up Stonyfield Farm yogurt; it's the only U.S. brand that packs Lactobacillus reuteri, a strain of bacteria shown to act as an extra anti-inflammatory. Blend it with fruit to make smoothies, or put a dollop on oatmeal.

Use slippery science. Because IBD can raise the risk of colon cancer, don't hesitate to see your doctor if DIY treatments fail. New antiadhesion medications can bind to white blood cells, such as T-lymphocytes, rendering them incapable of producing inflammation and damaging intestinal tissue. "It's kind of like putting Teflon on the T cells," says Matthew Grisham, Ph.D., a professor in the department of molecular and cell physiology at the LSU health-science center. Ask your doctor about natalizumab (brand name Tysabri), a multiple sclerosis drug currently under FDA review for the treatment of IBD.

Colon Cancer

Your large intestine is the gastrointestinal ground zero for colon cancer, the second leading cause of cancer deaths among men. Fortunately, colon cancer is unique in that screenings can catch its precursors, called polyps, long before they mushroom into something malignant. And the current gold standard of screening is the colonoscopy, a procedure in which a flexible, camera-tipped tube is inserted up the length of the colon. It's recommended that men go for a colonoscopy every 10 years, beginning at age 50.

Put the freeze on franks. Rule of thumb: If it comes in a bun, it could be catastrophic for your colon. In a recent study published in the Journal of the American Medical Association, researchers analyzed the eating habits of 150,000 adults over a decade and found that those who ate the most red and processed meats had a 50 percent higher risk of colon cancer than those who feasted on fish or fowl. Since the study didn't distinguish between lean steaks and fat-laden Big Macs, focus on cutting back on hot dogs, hamburgers (especially the fast-food kind), and sausages of every stripe. Instead, consume more chicken and fish, which contain nutrients, such as selenium, that may help ward off colon cancer.

Dye to live. Until recently, the best a man with a family history of colon cancer could do to offset his increased odds of developing the disease was go for a colonoscopy at age 40 instead of 50. Now there's a new lifesaving option: the high-magnification chromoscopic colonoscopy, a procedure that coats the colon with a dye designed to light up in the presence of precancerous cells. "It's able to go through the layers of the bowel, almost the same way an electron microscope would," says Dr. Welton. "This lets physicians remove suspicious cells before they develop into polyps." If colon cancer is in your genes, ask your doctor about a referral to a local cancer center or university hospital that offers the test.



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