Coeliac Disease also called gluten sensitive enteropathy is a disorder, which affects about 1% of the population and an intolerance to gluten, proteins found in wheat, barley, rye and possibly oats. The symptoms include loss of weight, diarrhoea, nausea, vomiting, abdominal pain and bloating. The condition may be successfully treated with a life long gluten-free diet. Patients are screened with blood tests; however, a definitive diagnosis can be made only after endoscopy with a small intestinal biopsy.
Irritable bowel syndrome involves a change of bowel habit that frequently comprises intermittent bouts of diarrhoea and constipation. The treatment usually comprises dietary manipulation, a high fibre and fluid diet combined with Ispaghula husks a day. In some cases other specific treatments may be offered.
Ulcerative Colitis is an inflammation of the lining of the colon of large intestine. The symptoms frequently include diarrhoea and constipation. In order to determine the severity and extent of the disease, patients will be appropriately investigated with a colonoscopy as a prelude to giving appropriate therapy.
Crohn's disease: A condition that can affect any part of the gastrointestinal tract with inflammation but particularly the distal small intestine (ileum) and colon. A colonoscopy is usually required as part of the routine investigation and evaluation prior to advising appropriate treatment.
Gastrointestinal infection: Infection of the gastrointestinal tract with specific pathogenic organisms. The diagnosis involves examination and culture of the stool. Following diagnosis, appropriate antibiotic therapy can be given.
Small bowel bacterial overgrowth: A condition caused by excessive bacteria in the small intestine that results in diarrhoea. Diagnosis involves a lactulose hydrogen breath test. Treatment involves fortnightly rotating broad spectrum antibiotics for a period of time.
Peptic Ulcer: Inflammation or ulceration of the oesophagus, stomach or duodenum, which requires diagnostic endoscopy. Treatment will depend on the cause of the inflammation, which is frequently due to infection with a specific organism Helicobacter pylori.
Stomach cancer: Symptoms often involve abdominal pain and weight loss. Endoscopy is required to diagnose and delineate the disease prior to giving advice on appropriate treatment.
Disorders of the oesophagus including hiatus hernia, reflux oesophagitis, and Barrett's oesophagus: Symptoms often include acid reflux and difficulty in swallowing. Endoscopy is usually required to diagnose and delineate the disease prior to advising appropriate therapy. Oesophagus Ph and pressure studies will be undertaken should they be required.
Hepatobiliary disease: Disorders of the liver, bile, ducts and gallbladder including gallstones.
Colon cancer: Symptoms may include change of bowel habit, rectal bleeding and/or abdominal pain. A family history may be relevant. Diagnostic colonoscopy will be required prior to advice on appropriate therapy.
Diverticular disease: A condition that involves development of small pockets in the colon (diverticular) which may cause pain and rectal bleeding. Colonoscopy is usually required for diagnosis. Treatment usually requires dietetic advice.
- Prof. Paul J Ciclitira -
Professor Paul Ciclitira Ltd
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