Dr Stuart Bloom Gastroenterologist in
London

Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a disorder of the large intestine. It is characterised by abnormal movements in the muscles of the intestine, which causes discomfort and abnormal functioning, as well as constipation and diarrhoea alternately. The cause is still unknown, although there is evidence that stress increases the symptoms. This condition is often confused with inflammatory bowel disease (IBD), which differs because IBD presents an abnormal structure of the colon. Its diagnosis is necessary to discard other diseases and although there is no cure, being a chronic condition it is recommended to follow a series of measures like reducing stress, avoiding foods that can aggravate like caffeine, tea, fried foods, alcohol and soft drinks. ...

Stomach ulcer

  Gastric ulcer is a sore or erosion that occurs in the stomach or upper duodenum, in this case as a peptic ulcer. This is a very common gastrointestinal ailment and whose size usually varies between 0.5 and 1.5 centimeters in diameter. The causes stomach ulcers are multiple, being intimately related to stress and health status of each patient. As for symptoms, gastric ulcer is characterized by an acute stomach pain, changes in bowel habits, nausea and vomiting. Your treatment begins mitigate their symptoms through gastric protectors and antacids and, in the case in question of a bleeding ulcer, it is necessary to stop the bleeding by endoscopy. Also, in the most serious cases it will be resorted to surgery, either by removing part of the stomach as intervening in the vagus nerve, responsible for monitoring the production of gastric acid in the body. ...

Abdominal pain

Abdominal pain is a symptom of a variety of conditions. It is the pain felt in the area between the chest and groin. It occurs for different reasons, some typical causes are: constipation, irritable bowel syndrome, food allergies or intolerances and food poisoning. ...

Alcohol related liver disease

This disease, also known as ARLD, is caused by excess alcohol consumption. The liver usually regenerates, but with excess alcohol consumption over time, it can cease to properly function. There are three stages: alcoholic fatty liver disease, alcoholic hepatitis, and cirrhosis. The sooner any signs of disease are detected, and the sooner the alcohol consumption is reduced or ceased, the better the chance of recovery.  ...

Anal fissure

What is an anal fissure? An anal fissure (fissures) is a tear or crack in the lining of the anal canal (anus), which causes extreme pain during bowel movements. Anal fissures affect everyone, from men and women to young and old people. It is the most common cause of rectal bleeding in infancy. A fissure tends to occur when passing hard or large stools during a bowel movement. There may also be spasms in the ring of muscle at the end of the anus. What is the cause of an anal fissure? Common causes of an anal fissure include passing large stools, constipation and straining during bowel movements, chronic diarrhoea, inflammation of the anorectal area and childbirth. The less common causes of anal fissures include anal cancer, HIV, tuberculosis, syphilis and herpes. What are the symptoms of an anal fissure? The symptoms of an anal fissure include: Pain, which can sometimes be severe during bowel movements Pain after bowel movements Blood on the stool or toilet paper Itching or irritation around the anus A visible crack in the skin around the anus A small lump on the skin near the anal fissure How is an anal fissure treated? An anal fissure will often heal within a few weeks if the stool is kept soft through increasing the intake of fibre and fluids. Soaking in a warm bath for 10 to 20 minutes daily, especially after toilet use, helps to relax the sphincter and helps it to heal. A doctor may recommend topical anaesthetic creams for pain relief. A Botox (Botulinum toxic type A) injection can paralyse the anal sphincter muscle and aids in relaxing spasms. Blood pressure medications can also help relax the sphincter. How to prevent an anal fissure? By preventing constipation it may help in preventing an anal fissure. Constipation can be prevented when eating high-fibre foods, drinking water and regularly exercising to stop from straining during bowel movements. Risk factors for developing an anal fissure Infancy – experts are not sure why but many infants experience an anal fissure during the first year of their life. Aging – as an adult ages there is a decrease in circulation and blood flow to the rectal area. Constipation – straining when trying to pass hard stool can increase the risk of tearing. Childbirth – anal fissures become common in women after they give birth. Crohn’s disease – the inflammatory bowel disease causes chronic inflammation of the intestinal tract and this makes the lining of the rectum vulnerable to tearing. Anal intercourse.  ...

Ascites

This condition is an accumulation of fluid in the peritoneal cavity, located in the abdomen area, as the fluid accumulates it distends the abdomen. It can be due to liver disease, cancer, or other conditions. To diagnose the disease a doctor will perform blood tests, ultrasound, and also fluid is extracted and tested. ...

Barrett's oesophagus

Barrett's esophagus or Barrett's syndrome is an alteration of the cells of the last portion of the esophagus. It is an injury that may result from exposure to stomach acid or reflux esophagitis. It may be asocaido some risk of cancer, although under control the risk is minimal. ...

Biofeedback

What is biofeedback? Biofeedback is based on the idea that by becoming more aware of your body and the processes going on within it, you can actually control some of those processes. It involves using instruments that provide information on the various systems in your body, such as EMGs, thermometers and electroencephalographs to teach the patient how to control such things as their brainwaves, heart function, breathing, skin temperature and muscle activity. While some professionals are still sceptical at its usefulness, it has proved useful in treating certain conditions, such as migraines, headaches, chronic pain, incontinence and high blood pressure. As it is still unclear exactly how it works, it may simply be a placebo effect.   Why would you do it? Biofeedback may be recommended by a doctor for a number of conditions, most commonly headaches (particularly migraines), chronic pain, high blood pressure, and a lack of control over bladder or bowel functions. While research into the efficacy of biofeedback is ongoing, some studies show it seems to be effective in treating several conditions, including headaches, hypertension, etc. (Yucha, C. B., Montgomery, D. (2008). Evidence-based practice in biofeedback and neurofeedback).    What does biofeedback involve? The patient is connected to electrical sensors that give him or her information (feedback) about their biological processes (hence “biofeedback”). The information provided by these sensors helps the patient to focus on the subtle changes they can make with their body, such as relaxing certain muscles. By observing the effects, the patient learns to control these subtle movements to achieve the desired result, such as reducing pain, or controlling bladder or bowel movements. Biofeedback has been described as “training” rather than “treatment” due to the active role of the patient.   Different types of biofeedback Depending on the health problem and the objective of the treatment, different methods of biofeedback may be used. Brain – an electroencephalograph (EEG) reads brainwaves via sensors attached to the scalp. Heart – an electrocardiogram (ECG) is connected to the torso via electrodes to monitor the heart beat. Blood – a photoplethysmograph measures relative bloodflow. Breathing – bands placed around the chest and abdomen measure the respiration rate and pattern. Muscles – an electromyography (EMG) detects the electrical activity in the nervous system that causes muscle contraction Sweat – An electrodermograph connected to sensors on the hands monitor the sweat glands and perspiration, indicating anxiety. Body temperature – different types of thermometers and sensors attached to the extremities measuring blood flow can demonstrate stress-related changes in temperature. By observing changes in these readings, patients may be able to learn to control their body better, and hopefully their symptoms too.   The doctor’s role During biofeedback sessions, your doctor may guide you in techniques to help you affect the readings given by the instruments, and therefore control your bodily processes. This could include deep breathing and relaxation techniques. ...

Bloated stomach

Bloated stomach is a condition that much of the population suffer from. Symptoms include air in the stomach, bloating, and abdominal distension. It can have causes including fluid accumulation in the stomach, gas in the intestine by overeating fibre-rich or heavy foods, and air swallowing (due to nervous habit), among others. Eating too much and too quickly can also produce bloating as well as swallowing too much air while eating. ...

Bowel incontinence

What is bowel incontinence? Bowel incontinence describes a loss of control over bowel movements, leading to the patient unintentionally soiling themself. It is thought that as many as one in ten people will experience some degree of bowel incontinence in their lifetime, and is nothing to be ashamed of. It is usually symptomatic of another problem or underlying condition, and is not a normal part of ageing. It usually won’t just go away on its own, but it can be treated effectively, and often cured, so it is always best to consult your GP or a specialist.   What are the symptoms of bowel incontinence? Bowel incontinence itself is usually a symptom, not a diagnosis. It may occur as a sudden need to go to the toilet, but the patient may not make it in time (urge bowel incontinence). However, other patients have no warning before they soil themselves, feeling no sensation as the stool passes (passive incontinence/passive soiling). Passing wind may also cause slight soiling.   What causes bowel incontinence? Most cases of bowel incontinence are brought on by bouts of diarrhoea, or conversely, constipation. Another common cause is weakening of the anal sphincter (the ring of muscle that opens and closes the anus). Long-term causes, such as diabetes, multiple sclerosis, spina bifida, and even dementia can also cause bowel incontinence.   How can it be prevented? Maintaining a healthy diet and lifestyle can help to reduce the chances of getting diarrhoea or constipation, which are the leading causes of bowel incontinence. This can also stave off type 2 diabetes. However, there is no guarantee of preventing these problems, and there is nothing that can be done to prevent causes such as MS or dementia.     What is the treatment? Luckily, bowel incontinence is highly treatable, enabling most patients to maintain normal bowel function for the rest of their lives. Different treatments include: Exercises to strengthen the bowel muscles and anal sphincter. Dietary and lifestyle changes – a healthier diet and lifestyle can prevent diarrhoea and constipation. Medication can also treat diarrhoea and constipation, depending on the cause. There are various surgical options. Incontinence products, e.g. anal plugs, incontinence pads, etc. can help to manage the symptoms until you regain some control In many cases, incontinence can be cured, but even if not it is usually possible to improve bowel control to some degree, and significantly improve the symptoms. ...

Capsule endoscopy

An endoscopic capsule is a device the size of a pill that contains a camera. It is used to perform examinations of the digestive system and to treat diseases of the small intestine and rectum. The endoscopic capsule is swallowed and thus runs through the digestive system providing images of the whole journey. Thanks to the endoscopic camera's build, it is a good method of recording intestinal transit and detecting any pathology of the small intestine and the colon, in a minimally invasive way. Currently, this technique is used in some medical centres as an alternative to traditional endoscopy.  ...

Cholelithiasis (gallstones)

What is cholelithiasis? Cholelithiasis refers to the presence of one or more gallstones in the gallbladder. Gallstones are little stones made of cholesterol formed in the gallbladder. The gallbladder is a small organ found underneath the liver and aids digestion by releasing a digestive fluid called bile into the small intestine. What are the symptoms of cholelithiasis? Most of time gallstones do not cause any symptoms and do not require treatment, however, if a gallstone happens to get trapped in a duct inside the gallbladder, it can cause the following symptoms: Intense and constant abdominal pain (called biliary colic) Pain between your shoulders Nausea and/or vomiting Sometimes cholelithiasis can be more serious, especially if the gallstone blocks the flow of bile, and the following symptoms can be triggered: Fever More intense pain Diarrhoea Jaundice No appetite What causes cholelithiasis? Although causes of gallstones are not totally clear, they are thought to occur when there is an imbalance in the make-up of the bile inside the gallbladder. Such imbalances are thought to occur when: High levels of cholesterol are found in the gallbladder, meaning there is not enough bile to digest the amount of cholesterol in the gallbladder. The excess cholesterol then forms into gallstones. High levels of bilirubin are found in the gallbladder. Bilirubin is a waste product made when red blood cells are broken down. Excess bilirubin contribute to the formation of gallstones. How can cholelithiasis be prevented? Research indicates that weight-loss and diet can help to prevent gallstones developing. A healthy, low-saturated fat diet is recommended. This is helps to reduce the intake of bad cholesterol which can cause gallstones to form. Also recommended, is avoiding the consumption of large amounts of alcohol. Being overweight is also a risk-factor for developing gallstones. Therefore, maintaining a healthy weight by eating healthily and exercising regularly is highly recommended. Losing weight via low-calorie diets are not recommended however, as they have been linked to disrupting bile production, and can therefore increase chances of gallstones developing. What is the treatment for cholelithiasis? If your gallstones do not cause symptoms, then most likely you will not need treatment, but will be recommended to actively monitor your condition, and to return to a specialist if symptoms occur. However, those who do experience symptoms will likely have the following treatment options: Gallbladder removal surgery (cholecystectomy) – gallstones can reoccur, so removing the gallbladder entirely is one way to ensure that gallstones do not recur. After it is removed, bile goes straight from the liver in to the small intestine. Medications – there are certain medications designed to dissolve gallstones and are taken orally. These need to be taken over a long period of time and are not always effective. ...

Chronic diarrhoea

Diarrhoea is characterised by a runnier and and larger volume of stool than normal, which may sometimes contain blood, mucus, pus and undigested food. It is considered chronic diarrhoea the one that lasts more than four weeks, and may also be accompanied by nausea, vomiting, fever, abdominal pain and weight loss. Its causes are multiple, the most common being abuse of laxatives, intestinal tumours, food allergies, inflammatory bowel diseases and intestinal motility disorders. It is imperative to know the causes of diarrhoea in order to choose a treatment. It is also important to avoid possible dehydration, so it is recommended to consume plenty of water and, if necessary, a rehydration solution. In addition, treatment for diarrhoea should include an astringent diet that includes foods that are easily digested such as rice, rice broth, boiled carrot, or grated or boiled apple. ...

Cirrhosis

Cirrhosis is the impairment of an organ due to the proliferation of fibrous tissue and the consequent atrophy of the cells. One of the most common manifestations of this disease is liver cirrhosis, which affects the liver and produces chronic organ damage. There are two main causes for liver cirrhosis: alcoholism and hepatitis C infection. Symptoms of liver cirrhosis include yellowing of the skin, mucous membranes and eyes, weakness and loss of weight, vomiting blood or blood in the stool. It is an irreversible and chronic disease that can lead to many complications and causes liver malfunction, and in extreme cases, the patient may need a transplant. Hepatic biliary cirrhosis is a rare disease that causes inflammation of the bile ducts of the liver, so it blocks the flow of bile, an essential fluid for the proper functioning of this organ. ...

Colitis

What is colitis? Colitis refers to the inner lining of the colon becoming inflamed. Colitis can be a symptom of a disease that affects other parts of the body, which causes fevers, chills, fatigue and dehydration. There are many types of colitis that are usually classified by the cause of each one. The two most common types include ulcerative colitis and Crohn’s disease, which are types of inflammatory bowel disease (IBD). Ulcerative colitis causes other manifestations in the body, which include mouth ulcers, swelling of the joints and skin inflammation. What are the different types of colitis? The types of colitis are categorised by what causes them. Some of the different types include:   • Ulcerative colitis and Crohn’s disease – these two types of colitis are classified as inflammatory bowel disease. Ulcerative colitis occurs when the immune system overreacts to bacteria in the digestive tract. It begins in the rectum and spreads to the colon. • Pseudomembranous colitis – this type of colitis occurs from the overgrowth of a bacteria known as Clostridium difficile. Normally found living in the intestine, this bacteria does not usually cause problems because of the balance with the good bacteria. Clostridium difficile takes over when medications such as antibiotics destroy the good bacteria. The toxins that are released cause inflammation. • Ischemic colitis – this occurs when the blood flow to the colon is cut off or restricted. What causes colitis? The most common causes of colitis include:   • Infections or viruses • Loss of blood supply • Chronic diseases • Allergic reactions What are the signs of colitis?   The symptoms of ulcerative colitis may include: • Diarrhoea • Abdominal pain and cramps • Rectal pain • Rectal bleeding – experiencing a small amount of blood in the stool • Desperate to use the toilet • Inability to defecate even though there is a feeling of urgency • Weight loss • Fatigue • Fever How is colitis diagnosed? A physical examination by a specialist helps to determine the cause of a patient’s symptoms. The doctor will take the patient’s blood pressure and check their temperature for fever. There is an examination of the abdomen to check if there is a feeling of tenderness. Bowel sounds are listened to through the use of a stethoscope. A blood test can measure haemoglobin and haematocrit levels to check for anaemia. Stool samples may also be collected to search for bacterial and parasitic infections as the cause of colitis. The stool may be tested for blood too. How is colitis treated? The treatment of colitis depends on how bad the disease is within the individual patient. Treatment usually involves a change in diet, nutritional supplements and medication being prescribed. In severe cases, surgery may be required. Mild colitis responds to medicines such as steroids and anti-inflammatories. More severe symptoms will require stronger medication such as immunomodulator medicines, which suppress the immune system to prevent inflammation. Surgery may be required to remove the large intestine, however this can cause other problems in different areas of the body. Foods to avoid: • Alcohol and fizzy drinks • Caffeine • Dairy products • Raw fruits and vegetables • Legumes Foods to incorporate into the diet: • Omega-3 fatty acids (found in salmon) • Probiotics (kefir) • Iron-rich foods (green vegetables) • Turmeric • Folate-rich foods ...

Colon cancer

Colon cancer is the proliferation of malignant cells in the colon, which, along with the rectum, is in charge of storing faeces which are then expelled through the anus. Its causes are determined by genetics, sedentary lifestyle and previous illnesses such as polyps, ulcerative colitis and other cancers. The most obvious symptoms of the disease become visible when the disease is advanced: alternating between diarrhoea and constipation, blood in the stool, abdominal pain, loss of appetite, weight loss and fatigue. If detected early there is a good chance of cure, with the most common treatments being radiotherapy, chemotherapy, immunotherapy to strengthen the body's defences, and surgery. ...

Colonoscopy

A colonoscopy is when an endoscope is used to examine the colon and small intestine. It is performed with a small, thin tube (endoscope), which is inserted through the anus and has a camera that records the organs and walls. To carry out this process the patient needs to be sedated partially or completely. Currently, there is an alternative to traditional colonoscopy called virtual colonoscopy, a test that uses images of the inside of the intestine and colon obtained using computerised tomography (CT or CAT). It is much less invasive and does not require sedation. ...

Colorectal cancer

Colorectal cancer begins with a polyp that develops in the colon or rectum. When this polyp is covered with adipose tissue it can change into an adenoma, a specific type of polyp, or adenocarcinoma, a type of cancer that contains mucus and other fluids. The tests to detect colon cancer are usually carried out through colonoscopy, a test that introduces a thin and flexible tube with a camera (endoscope) into the anus, and virtual colonoscopy, a radiological examination that obtains images. The purpose of these tests is to determine the presence of adenomas and polyps in the colon and to surgically remove them before they become cancerous. ...

Constipation

Constipation is the regular difficulty encountered when trying to defecate, considering a normal frequency of a minimum of three times per week, although this can vary with each person. Constipation is a condition that is produced by the lack of regular movement of the intestines and bowel evacuation may be accompanied by pain. It is a very common ailment that occurs because of sedentary lifestyle, lack of fibre consumption, fatigue and nervousness. To avoid this problem it is recommended to follow a diet rich in fibre, drink plenty of water and exercise regularly. Although it is possible to resort to laxatives sporadically, they should not be abused as they may cause the opposite effect in the long run, as well as make the body get used to them, which can make the situation worse. ...

Crohn's disease

Crohn's disease is a chronic inflammatory disease of the intestinal tract, although it can affect any area of the digestive tract, from the mouth to the anus. The symptoms are very variable, depending on the affected area, although the most prominent are abdominal pain, diarrhoea, fever, and weight loss. It can also cause skin lesions, anal abscesses, fissures, joint pain, and anal pain. The exact cause of Crohn's disease is still unknown although recent studies point to a problem in the immune system or a bacterial cause. This disease is not contagious, but has a genetic-hereditary tendency. ...

Diverticular disease

  Diverticular disease is characterized by the presence of diverticula in the colon wall, due to an increase in intraluminal pressure. Diverticula are pockets that usually form on the left side of the colon walls, although it can occupy the entire colon. When an increase in intraluminal pressure produces a pulse of the muscosa occurs through colonic muscle layers in their weak points, which correspond to the points where the neurovascular bundles penetrate. In most cases, diverticular disease have no symptoms, and only when there is bleeding or complications may appear diverticulitis. Diverticulitis (that is infection of the diverticula) in turn can cause abdominal pain, fever and chills. More serious complications can even cause an ruputura or fistulae that require surgery. The treatment of diverticular disease is essential and based on regular consumption of dietary fiber. In the case of diverticulitis, treatment should be done by antibiotics (oral or intravenous), restrictions on food and stool softeners. ...

Diverticulitis

  What is diverticulitis? Diverticulitis is a condition affecting the large intestine, or bowel. It is closely related to another condition affecting the bowel, called diverticular disease. Diverticulitis is more likely to occur in those who do not get enough fibre through their diet.   What causes diverticulitis? As we get older, small pockets or bulges called diverticula may develop in the lining of the intestine. These do not often cause symptoms and can go entirely unnoticed, but when they do cause symptoms, this is referred to as diverticular disease. Once symptoms become more severe, and the diverticula become infected, or inflamed, this is referred to as diverticulitis. What are the symptoms of diverticulitis? Diverticulitis symptoms include: Severe, constant tummy pain Feeling sick/vomiting Fatigue (feeling tired) Blood in your stool Rectal bleeding A high temperature (over 38 degrees Celsius) If you experience symptoms of diverticulitis, without any previous diagnosis of diverticular disease, you should contact your GP as soon as possible. If you have a previous diagnosis of diverticular disease the symptoms can be managed and treated from home. However, if you notice bleeding, or are experiencing severe pain, it is best to seek medical attention. How is diverticulitis diagnosed? Your doctor will take your medical history and make an assessment of your symptoms. This is because they will want to rule out other conditions which can display similar symptoms, such as IBS (irritable bowel syndrome), or bowel cancer. The doctor may also take blood tests and refer you for a colonoscopy or CT scan. What is the treatment for diverticulitis? Diverticulitis is most commonly treated at home using medication to relieve symptoms of pain, and antibiotics. In more severe cases, diverticulitis can be treated at the hospital so the doctor can monitor your progress and symptoms. Treatment in hospital may involve antibiotics administered through injections, and an intravenous drip to provide hydration and nourishment. If you have already been diagnosed with diverticular disease, a high-fibre diet may help to ease any symptoms you experience with the condition. The ideal amount of fibre for an adult is 30g per day, and your doctor will discuss targets and ways to include fibre in your diet. In more extreme cases, diverticulitis can be treated with surgery. This type of treatment is rare, and it involves removing the affected section of intestine. However, before any type of surgery, your surgeon will discuss the benefits and risks implied. ...

Drug induced liver injury

This condition is caused by ingestion of medication, supplements or herbal remedies that are toxic and damage liver function. The effects can be jaundice, liver failure or even death, and usually occur after long-term exposure to the toxin. ...

Dysphagia

Dysphagia, or discomfort when swallowing, refers to difficulty in swallowing or swallowing food, and is most common in elderly patients. In many cases it is a consequence of cerebrovascular accidents, Alzheimer's, Parkinson's or tracheotomies, diseases that cause problems in the tongue, the muscles of the throat and the oesophagus. Practical treatments focus on preventing food from getting stuck: exercises to strengthen the jaw muscles, sitting upright, waiting for three hours after eating in order to go to sleep, ingesting food in small amounts and accompanying it with plenty of liquid, and eating meals slowly. ...

Eating disorders

Eating disorders are serious behavioural problems. A person who suffers from eating disorders follows eating patterns that can seriously damage his/her health. The common causes and symptoms of this disease include excessive concern about their weight, a distorted view of the body and low self-esteem. The most common eating disorders are anorexia and bulimia nervosa. When a person suffers from anorexia, he/she avoids eating and/or takes laxatives and diuretics. In addition to this, the person may also do intense physical exercise, which could endanger her/his life. The main characteristic of bulimia is that people do binge eating, followed by purging or self-induced vomiting to eliminate and compensate for overeating. All this with a sense of guilt. In these cases, the emergency treatment of patients through a comprehensive plan that includes psychotherapy and continuous monitoring is crucial. In severe cases, the admission of patients to a specialised centre for treatment may be necessary. ...

Endoscopy

What is it? Endoscopy is the use of cameras to relay images from inside the body.  The device used, known as an endoscope, is a long thin flexible tube with a camera at one end and a light source. What does it involve? Endoscopes are inserted in to the body via a natural opening such as the mouth or the anus. There are different types of endoscopy depending on the site and function of the procedure – if the bowel is to be investigated for example, it is referred to as a colonoscopy. If the airways are to be examined, the procedure is referred to as a bronchoscopy. Endoscopy can also be used for surgery, as in the case of laparoscopic surgery – in this situation the laparoscope (a specific type of endoscope) is inserted through small incisions. Once inserted, the endoscope is able to send images from the inside of the subject’s body back to a TV screen. What is it for? Endoscopy is most commonly used to investigate symptoms and help to diagnose conditions relating to the digestive system, although it can be deployed to produce images and aid with many other parts of the body, including the respiratory system, the urinary tract and the female reproductive system. An endoscope can also be used to assist with surgery. An endoscopy is commonly used to investigate symptoms such as abdominal pain, nausea and vomiting, unexplained weight loss, diarrhoea, blood in the stool or vomiting blood. How can you prepare for it? You may be required to avoid food and liquids for a period beforehand, depending on what type of endoscopy you are undergoing. In the case of a colonoscopy, you might be given laxatives to help you evacuate any stool beforehand. You may also be required to stop taking certain medication such as blood thinners to prevent excess bleeding from the procedure. What does it feel like during the procedure? The procedure usually only causes mild discomfort although a local anaesthetic is also sometimes used. It is normally performed with the patient conscious, although sedatives can be deployed to help you relax. Antibiotics are sometimes used to reduce risk of infection. What would a “bad” result mean? An endoscopy can be used to diagnose a wide range of conditions and the results are interpreted by a specialist.  Whether the results are good or bad clearly depends on what symptoms are being investigated and on which part of the body the endoscopy is being performed. ...

Fatty liver

Fatty liver disease, also known as hepatic steatosis, is a disease characterised by the accumulation of fatty acids and triglycerides in liver cells. ...

Food intolerance test

There are foods, additives and preservatives that produce adverse reactions in our immune system, causing a series of symptoms, more or less serious, that can be detrimental to the health of the patient. Usually, food intolerances produce gastrointestinal symptoms. If symptoms of food intolerance manifest, it is advisable to take a food intolerance test, which evaluates and determines which foods cause problems or adverse reactions in the body. Currently, there are two types of tests to detect the level of intolerance to certain foods: the Alcat food intolerance test and the Alpha 200 test. Both are blood tests but in no case are they completely reliable when it comes to discerning the main problem.  ...

Gallstones

What are gallstones? Gallstones are hard lumps or stones, usually made of cholesterol or sometimes other substances like bilirubin that form in the gallbladder.   The gallbladder is a small organ situation underneath the liver which releases bile (produced by the liver but stored and concentrated in the gallbladder) into the digestive system to help the body breakdown fats into fatty acids for absorption. What are the symptoms? Gallstones don’t always produce symptoms and do not always need treating. In fact, the vast majority of people will not experience symptoms as the gallstones themselves do not cause pain. In certain circumstances however, a gallstone might become trapped, causing intense pain known as biliary colic. The pain usually starts in the upper right part of the abdomen and radiates to the shoulder. Further complications can arise whereby the gallbladder becomes inflamed - symptoms can include jaundice (a yellowing of the eyes and skin), fever, persistent pain, nausea and vomiting. What causes gallstones? The development of gallstones is thought to be due to too much cholesterol or bilirubin in the bile, leading to the formation of stones. In the majority of cases gallstones are made of cholesterol, however if the liver is producing too much bilirubin (often due to damage) this can result in the formation of stones also. Improper emptying of the gallbladder is also thought to cause stones, as the bile becomes too concentrated. How can gallstones be prevented? Risk factors for the development of gallstones include being overweight, a lack of exercise, a diet containing too much cholesterol and fat that is also low in fibre, and rapid weight loss. It stands to reason therefore that maintaining a balanced diet and a healthy weight can help to prevent the development of gallstones.  Other risk factors for the disease include liver problems and diabetes. What is the treatment? Gallstones don’t always need treatment and in many cases the best option is to monitor them and only treat them if symptoms appear. If, however they are causing complications it might be necessary to treat them immediatley. Additionally, patients who have conditions which increase the risk of complications, such as portal hypertension (high blood pressure in the liver), cirrhosis of the liver or diabetes may need more urgent treatment. In most cases, keyhole surgery is performed to remove the gallbladder, in an operation known as a cholecystectomy. Following the operation, patients can lead a normal life without the gallbladder as the liver will continue to produce bile.  ...

Gastrointestinal bleeding

Gastrointestinal bleeding is the bleeding that occurs in the digestive tract. Upper gastrointestinal bleeding is the bleeding that occurs in the oesophagus, stomach or upper part of the small intestine. Lower gastrointestinal bleeding is the one that happens in the rest of the small intestine, large intestine, rectum or anus. The condition can be detected by the presence of blood in the stool....

Gastrointestinal endoscopy

Endoscopy is a test used to diagnose or treat (therapeutic endoscopy) possible pathologies of the oesophagus, stomach and duodenum, the upper part of the digestive tract. The endoscope is inserted through the mouth and advanced to see the tract. As the test causes discomfort, it is common practice to slightly sedate the patient. The test lasts 15-30 minutes and is performed on an outpatient basis. ...

Gastroscopy

Gastroscopy is a procedure in which an endoscope is used to explore the digestive system. An endoscope is a thin, flexible tube with a small chamber at the end, and in some cases a light, which aims to obtain images of the interior of the oesophagus, stomach and duodenum. The patient is sedated for this procedure, as it causes discomfort. Once the patient is sedated, the specialist inserts the endoscopic tube through the mouth guides it through the digestive tract to assess its condition and to see if there are any diseases or conditions. In addition, gastroscopy is a procedure that has proved to be very useful in some cases, for example when there is the need to get tissue samples for biopsies or to remove polyps, etc. However, gastroscopy has side effects, which can be mild (such as abdominal pain or burning) or serious, such as perforation of some organs, bleeding, infections and possible allergic reactions. ...

Halitosis

What is halitosis? Halitosis is a common problem characterised by an unpleasant odour on the patient’s breath. Normally, halitosis is caused by poor oral hygiene, with bacteria breaking down pieces of food trapped in the teeth and releasing foul-smelling gases. Halitosis can affect the patient psychologically, due to the stigma of bad breath, and can lead to problems in their social life.   What causes halitosis? In most cases, the causes of bad breath are oral in nature. In some cases, the smell may originate from the nose, sinuses, throat, lungs, oesophagus, or stomach. Some common causes are: Poor oral hygiene – bacteria will build up in the mouth, attracted to pieces of food trapped in the teeth, and will release toxins and gases that cause the unpleasant smell. Gum disease Eating strong-smelling food, such as garlic and onions. Smoking Drinking alcohol Occasionally, certain illnesses or medications can also cause bad breath.   Can it be prevented? Halitosis can be prevented with good oral hygiene: Thoroughly brush your teeth and gums twice a day Floss daily Clean your tongue regularly. You should also book periodic check-ups with a dentist to ensure that your teeth and gums are healthy.   What is the treatment? In most cases, improving oral hygiene is enough to eliminate bad breath, brushing your teeth and gums, flossing and cleaning your tongue as a daily routine. Cutting down on or avoiding tobacco, alcohol or certain foods and drinks such as coffee may also be recommended. If the halitosis is a consequence of a different pathology, such as gastro-oesophageal reflux disease or a H. pylori infection, you may be referred to a relevant specialist to deal with the cause. ...

Helicobacter pylori

Helicobacter pylori is a genus of bacteria that affects the human stomach. It grows in the mucous layer of the stomach, secreting urease, an enzyme that converts the urea (a chemical very important for the metabolism) in ammonia. As a result, the acidity of the stomach is neutralised and an environment prone to the proliferation of the pylori bacteria is created. It is transmitted through direct contact with an infected person and is characterised by severe abdominal pain, nausea, loss of appetite and weight or bloating. In order to avoid further complications, it is crucial to eliminate the Helicobacter pylori as soon as the symptoms appear. Complications may include abdominal infection, peritonitis, haemorrhages or ulcers and it can also increase the risk of stomach cancer. The treatment includes antibiotics, to cope with or prevent infections; anti-ulcer medicines, to decrease the amount of acid produced in the stomach; and surgery, in case the infection has caused ulcers. It is also important to follow a proper diet and it is advisable to increase the fibre intake. ...

Hiatal hernia

A hiatal hernia occurs when a portion of the stomach ascends to the thorax, through an opening located in the diaphragm, the barrier that separates the thorax from the abdomen. When the stomach moves to the thorax, the aforementioned separation loses its function and a gastroesophageal reflux occurs, that is, the gastric contents return to the oesophagus and irritate it. Symptoms caused by this condition may be burning in the chest or throat, hoarseness, asthma or breathing problems. The symptoms worsen after eating, when sleeping or bending over. The treatment of hiatal hernia depends on its severity, and sometimes it does not require any type of therapy. In mild cases, the aim is to control the symptoms, which improve with changes in the diet and postural changes. In the most severe cases, an operation, usually performed with fundoplication technique (minimally invasive laparoscopy), may be chosen. ...

Indigestion (dyspepsia)

  Dyspepsia or indigestion is a term that describes pain or discomfort in the upper abdomen, especially after having a meal. It is a very common problem that can be alleviated by taking antacids and stomach protectors. Sometimes it is related to stress, alcohol consumption, smoking, eating too much fat or eating too fast. Therefore, the discomfort can be reduced with healthy habits, both in diet and in daily routine. It is a benign problem, without major consequences, even if it is chronic, and it can appear and disappear intermittently over the years. ...

Intestinal failure

Intestinal failure happens when the intestines are not able to digest food properly and absorb fluids & nutrients. Intestinal failure can be caused by digestive disorders (such as Crohn’s), causing bowel malfunction, or by short bowel syndrome. Short bowel syndrome occurs when there is less than 2m of working bowel, and it occurs  in some who have had half or more of their small intestine surgically removed. Short bowel syndrome is the commonest cause of intestinal failure. ...

Lactose intolerance

Lactose intolerance is a food intolerance that occurs after ingestion of lactose. To digest lactose, the body needs an enzyme called lactase. Lactose intolerance occurs when the small intestine does not produce enough lactase. The only treatment for lactose intolerance is to reduce or avoid the intake of products that contain lactose. ...

Lactose intolerance test

The lactose intolerance test is a method used to diagnose the ability of the intestines to break down lactose (milk sugar and its derivatives) when it is suspected that the substance is not well digested and causes discomfort. There are two types of tests for lactose intolerance: one involves performing a blood test to detect the presence of blood glucose before and after eating a lactose-containing preparation; and the second one is the breath hydrogen test, which is the storing of the breath, in special sealed bags, before and after having ingested a preparation with lactose. The patient should be blowing in these bags and filling them with air with the hourly frequency that is marked, while his/her automatic reaction to the preparation's intake (increased abdominal volume or other forms of physical discomfort) is monitored. ...

Liver function tests

What is a liver function test? Liver functions tests help diagnose and monitor liver disease by testing the blood. The tests measure the level of certain proteins and enzymes in the blood. Certain enzymes are released by the liver when it is damaged or diseased, and therefore it is helpful to measure these as an indicator. The same can be said for measuring proteins, such as bilirubin, which is a blood waste product that is usually cleared by a functioning liver. What does a liver function test involve? If your doctors recommends a liver function test, it is more than likely that a series of tests will be run which measure for different enzymes and proteins. During a liver function test, a sample of blood is taken through a small needle into a tube. The needle usually draws blood from the bend of your arm. Once a blood samples has been obtained, it will be sent to a laboratory for analysis, which can take either a few hours or a few days depending on whether the laboratory is located on-site or not.  What is a liver function test for? Typically, a liver function test is used to: Determine the severity of a disease, such as cirrhosis (scarring of the liver) Screen for liver infections (e.g. hepatitis) Measure the progression of liver disease, such as hepatitis, and to see how successful treatment is Check for any side effects to medications If you are experiencing the following symptoms, a liver function test will be carried out to help determine a diagnosis: Yellow eyes or skin (jaundice) Fatigue  Nausea Little appetite Dark urine and light-coloured stool How can you prepare for a liver function test? Before a liver function test food and drink has to be avoided for a certain period as these can affect the results. Certain medications will also have to be avoided before a liver function test.  What would a “bad” result mean? Normal results differ for men, women and children. When you receive your results, your numbers will display next to the normal, healthy range. If your results are not normal, further tests will be carried out to aid a diagnosis, or treatment plan. Ultimately, your specialist will explain your results and when the next steps will be.  ...

Malnutrition

Malnutrition is the result of eating an unbalanced diet in which there is a lack of nutrients or in which the nutrients are taken in the wrong proportion. One of the main causes may be overeating. Malnutrition increases the risk of infection or infectious diseases. ...

Nutrition

Nutrition is the science of food, diet, and their effect on the human body. A person’s diet plays an important role in their overall health, as the body needs certain nutrients in order to perform certain functions. Nutrients are categorised in different groups. Carbohydrates, fibre, fats, protein and water are considered to be macronutrients whereas vitamins and minerals are classed as micronutrients. To ensure that the suggested amount of each food group is ingested, it is recommended that people follow a healthy, balanced diet. There are many disputes between nutritionists over what constitutes a healthy, balanced diet. Furthermore, each individual is different and has different needs. For example, athletes, pregnant women and people recovering from illness will all have unique dietary requirements. However, there is a general consensus over certain principles of healthy eating: to eat plenty of fruit and vegetables as they are full of vitamins and minerals and it is advised that we should eat five portions a day, which should make up just over a third of the food we eat each day; to not eat too much sugar or saturated fat as having a high sugar intake increases the risk of obesity and tooth decay, particularly for people who regularly drink sugary, fizzy drinks; to eat starchy carbohydrates, ideally wholegrain, as potatoes, bread, rice and pasta (ideally wholegrain) are a great source of energy; to eat lean sources of protein such as fish, eggs, beans, pulses and lean meat; to drink plenty of liquid (6-8 cups or glasses a day) as keeping hydrated is essential to good health. Poor diet can cause a wide range of health problems and conditions resulting from malnutrition or from eating too much of a particular food group (such as fat and sugar), including obesity, diabetes, blindness, anaemia, scurvy, cardiovascular disease, osteoporosis. ...

Obesity

Obesity is defined as having an abnormal or excessive accumulation of fat on the body, enough so that it can be a risk to the health of the person. There most common way of classifying the amount of weight on the body, and what constitutes as a healthy balance, is the body mass index (BMI), which is calculated by dividing your weight in kilograms, by your height, squared. The NHS classifies obesity as having a body mass index of 30 to 39.9, with those over 40 being classified as severely obese, though it is not necessarily the case as those with a large amount of muscle could be classified as obese due to their weight, when it may not actually be accurate. Another way of measuring excess fat is to measure waist circumference, for men, obesity is generally considered as being larger than 94cm (37in), and 80cm (21.5in) for women.   What causes obesity?   Simply speaking, obesity is caused by consuming more calories than are burned off through physical activity. When food is consumed, especially excessive amounts of fat and sugar in the diet, the body stores it as energy, in the form of fat. There are some health conditions that can lead to obesity and weight gain, such as problems with the thyroid, especially hypothyroidism.   How is obesity treated?   The best ways of treating obesity is to increase the amount of physical activity you perform on a regular basis, and to reduce the amount of calories eaten, along with eating a healthy, balanced diet. There are a number of ways that you can do this, such as joining a weight loss group to help you manage your diet and motivate you to continue sticking to it. You can also start activities such as walking, swimming or running. You can begin with exercising for short periods of time, before building up to longer periods. There are a number of surgical procedures available to help deal with weight loss in more severe circumstances, such as gastric band, gastric bypass, and biliopancreatic diversion.   What problems can obesity lead to?   Obesity can be detrimental to the health, leading to problems in different areas of the body. It can cause strain on the heart, leading to coronary artery disease, high blood pressure, high cholesterol, and other conditions. It is one of the leading causes of diabetes type 2, polycystic ovarian syndrome (PCOS), and infertility and can also have detrimental psychiatric effects such as depression along side often having a social stigma. To see a specialist to help with obesity, click here. Obesity is one of the most common diseases of modern society, caused by bad eating habits that cause a metabolic disorder in the form of excess fat and consequently overweight. If the caloric intake that provides the body is greater than that required or consumed is stored as fat. Besides, obesity may result in the acquisition of other diseases, such as diabetes mellitus, hypertension, high cholesterol or cardiovascular risk. In any case, obesity treatment tailored to each person according to their age, physique, medical history and daily habits is required. By measuring the body mass index patient's degree of obesity it is known and established a slimming diet should be low calorie, low fat, with the establishment of a rehabilitation plan of eating habits and exercise. The tandem diet-exercise physical is essential for weight loss. Obesity is one of the most common diseases of modern society, caused by bad eating habits that cause a metabolic disorder in the form of excess fat and consequently overweight. If the caloric intake that provides the body is greater than that required or consumed is stored as fat. Besides, obesity may result in the acquisition of other diseases, such as diabetes mellitus, hypertension, high cholesterol or cardiovascular risk. In any case, obesity treatment tailored to each person according to their age, physique, medical history and daily habits is required. By measuring the body mass index patient's degree of obesity it is known and established a slimming diet should be low calorie, low fat, with the establishment of a rehabilitation plan of eating habits and exercise. The tandem diet-exercise physical is essential for weight loss. ...

Oesophageal manometry

Manometry is a diagnostic procedure used to examine pressures at different levels or the power of contraction of different organs, such as the oesophagus, the final section of the intestine, the urethra, or the pelvic floor. This test is carried out by introducing a thin probe with holes, which at its end may have a deflated balloon that inflates once the probe is placed in the desired location. It also has motion-sensitive receivers which are connected to a computer in order to record the detected activity. In the case of oesophageal manometry, movements of the oesophagus and oesophageal sphincter are recorded to verify they are working fine, as in many occasions patients present problems in swallowing or chest pain. It is also used nowadays to measure and detect possible complications arising from the lack or excess pressure in the colon (anorectal manometry) or in the urethra (urine manometry). ...

pH monitoring

pH monitoring is a test or study very widespread in gastroenterology and its main objective is to measure the levels of acidity in the oesophagus. The procedure usually takes a few minutes and is carried out by introducing a probe (equipped with acid-sensitive receptors) through the nose, slowly guiding it to the oesophagus. This probe contains an electronic device connected to a computer that measures and records the levels of acidity. This method is usually used mainly for patients suffering from gastroesophageal reflux or for those with arthritis and oesophageal pain. Normally, anaesthetics and sedatives cannot be used in this type of test. ...

Piles (haemorrhoids)

Haemorrhoids, also known commonly as piles, are the dilation of a vein in the rectum or anus. This is a very common and painful condition that is usually caused by constipation, genetic predisposition, being too long standing, or associated with pregnancy. There are two variations of this pathology:external and internal hemorrhoids. The first generate protrusions on the ring on the outside of the anus, so they are easier to diagnose and cause pain when sitting, as well as traces of blood in stool. Treatment consists in applying creams and warm water in the affected area and in cases of severe pain, taking painkillers. On the other hand, internal hemorrhoids occur inside the anus, causing bleeding in the stool and itching in the anal region. If they grow, a surgical intervention may be necessary to remove. ...

Polypectomy

Polypectomy is a minimally invasive procedure carried out with a hysteroscope to remove polyps in certain parts of the body such as the endometrium, colon or uterus. Hysteroscopy polypectomy for uterine polyps or endometrial polypectomy are procedures that are performed by inserting a hysteroscope through the vagina and cervix to remove or cut with small scissors or similar instruments the polyps. Another procedure is the bipolar electrosurgical polypectomy, which is performed with an endoscope and an electro-scalpel to remove the polyp. A polypectomy can also be performed with a resector or with a polyp forceps. In addition, nasal polypectomy is the removal of polyps that obstruct the nostrils and lead to loss of smell and recurrent sinusitis. ...

Polyps

Polyps are abnormal tissue growths. They can form in different parts of the body: Colon polyps Uterine polyps Nasal polyps, etc. Polyps are a common problem and most of them are benign, although some types have been linked to cancer.  ...

Rectal cancer

Rectal cancer is the formation of malignant cancer cells in the rectal tissues. Symptoms of rectal cancer include changes in bowel movements (diarrhoea or constipation) and blood in the stool. ...

Rectosigmoidoscopy

Sigmoidoscopy is a diagnostic test that explores the rectum and the sigmoid colon. In this test, neither the colon nor the small intestine are seen completely. ...

Second medical opinion

What is a second medical opinion? A second medical opinion is when you consult with a doctor that is not your regular doctor about a potential diagnosis and/or treatment plan. There is no legal right to a second opinion, however, it is rare for a doctor to refuse. Why would you get a second medical opinion? Patients may consider a second medical opinion if they are facing a new diagnosis or recommended treatment because sometimes this can feel confusing and a second opinion can put their mind at ease. In addition, there are certain situations where a second medical opinion is sought after: Potential treatment is risky and could be life-changing or the diagnosis is possibly life-threatening The diagnosis is not clear-cut If you are considering a new treatment approach that is experimental The aims of obtaining a second medical opinion are: To confirm whether a diagnosis is correct and/or appropriate. To confirm whether a suggested treatment is correct and/or appropriate. To compare information received from each doctor so that you can make an informed decision – sometimes a second medical opinion can rule out the need for a potentially unnecessary invasive procedure. Possible disadvantages of seeking a second medical opinion include: The process can delay the start of treatment. Logistically, seeing another specialist might be difficult and possibly time-consuming. It might be stressful to hear the same diagnosis again. How would you seek a second medical opinion? You can request a second medical opinion from your GP or consultant, but before doing so it is recommended that you ask for as much clarification and explanation about the initial diagnosis and treatment, before seeking a second opinion. Obtaining a second medical opinion does not mean that the second doctor will then take over – if that is what the patient decides, then this needs to be agreed formally between doctors and hospitals.  ...

Short bowel syndrome

Stomach cancer

Stomach cancer is the formation of malignant cells in the walls of the stomach. In the early stages of cancer, symptoms are rare, so it is important to have tests to detect it and its signs. Age, food and other diseases of the stomach are risk factors for this type of cancer. The main symptoms are indigestion, feeling of swelling after eating, slight nausea, loss of appetite, malaise or stomach pain. Diagnosis and detection are performed through physical examinations, analysing family history, blood tests to do red cell count, white cell count, check the levels of platelets and haemoglobin, the chemistry in the blood, and finally, a biopsy. Stomach cancer either affects the lining or the lymph system in the stomach. Some of the symptoms are indigestion, wind, bloating, or persistsent stomach pain. ...

Stomach flu

Gastroenteritis is a disease characterized by inflammation of the gastrointestinal tract, in other words, the stomach and small intestine. The cause is usually a norovirus infection. It spreads through contaminated food or water, or contact with another infected person. The main symptoms are: diarrhoea, vomiting, abdominal pain, headache, fever, chills and cramps. The most common problem with gastroenteritis is dehydration, which occurs when the patient does not drink enough fluids to replace those who are lost through vomiting and diarrhoea. The majority of people recover without specific treatment, although it is advisable to eat a bland diet during the illness, in addition to rehydration solutions to avoid dehydration....

Ulcerative colitis

Ulcerative colitis is a disease that causes ulcers in the lining of the rectum and colon.

Ultrasound

What is ultrasound? Ultrasound is a diagnostic imaging procedure that allows you to see organs and soft structures inside the body. At present, they can be 2D, 3D or four-dimensional images. Ultrasound is a non-invasive technique, in which radiation is not used and thanks to this, it is used to visualise developing foetuses. What does an ultrasound scan consist of? It is carried out using high frequency sound waves emitted through a transducer that captures the echo of different amplitudes which occurs when they ‘bounce’ off the organs. These signals, once processed by a computer, give a series of images. Why are ultrasounds carried out? With this procedure you can clearly differentiate the shape and size of each structure inside the body. In medicine it is used to see the heart, kidneys, liver and blood vessels, among other organs. In addition, ultrasounds are also carried out on patients who are pregnant. Another function is the study of different tissues of the body such as the blood flow of arteries and veins to detect arteriosclerosis and blood clots. Ultrasounds also allow the analysis of the thyroid gland and other soft structures of the neck as well as tendons, ligaments, muscles and joint structures, and mammary glands. Preparation for Ultrasound Usually, you do not need any type of preparation for having an ultrasound. In cases where the area to be examined is the abdomen, the specialist may tell you to drink three glasses of water approximately one hour before the test. How does it feel during the ultrasound? During the ultrasound, the patient will lie on a table or stretcher with the area to be analysed exposed. The specialist will apply a transparent gel that will allow the movement of the roller built into the transducer. During the scan the expert will interpret the images and determine which shots are correct according to each case. The only slight discomfort that can be felt is the gentle pressure that the specialist applies when passing the transducer over the body area. The gel applied can also feel quite cold when applied. Meaning of abnormal results The types of images that are considered abnormal are: Congenital anomalies An alteration to tissue due to trauma or injury Cysts ...

Upper GI surgery

Upper gastrointestinal (GI) surgery is surgery performed to treat pathologies of either the upper gastrointestinal tract (small bowel), gall bladder, liver, pancreas or oesophagus.  ...