Breath tests for SIBO

What are Breath Tests ?

Procedures

Breath Tests

Breath tests are a non-invasive diagnostic tool used in gastroenterology to diagnose certain digestive conditions. These tests involve measuring the levels of gases in a person’s breath before and after they ingest a small amount of a substance, such as lactose or glucose.

The principle behind breath tests is that when certain substances are digested or fermented by bacteria in the gut, they release gases, such as hydrogen or methane, which can be detected in a person’s breath. By measuring the levels of these gases in the breath, doctors can determine if a person is able to digest or absorb certain substances properly.

Breath tests are commonly used to diagnose lactose intolerance, a condition in which a person’s body is unable to digest lactose, a sugar found in milk and other dairy products. The lactose breath test involves drinking a lactose solution and then measuring the levels of hydrogen and methane in the breath over a period of time.

Other breath tests used in gastroenterology include the glucose breath test, which is used to diagnose small intestinal bacterial overgrowth (SIBO), and the urea breath test, which is used to detect the presence of Helicobacter pylori, a bacteria that can cause stomach ulcers and other digestive problems.

Breath tests are generally safe and non-invasive, and do not involve any radiation or needles. They are also relatively inexpensive compared to other diagnostic tests, and can provide quick results. However, breath tests may not be appropriate for everyone, and their accuracy can be affected by certain medications or medical conditions. It is important to talk to a healthcare provider to determine if a breath test is appropriate and what it can diagnose.

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Haemorrhoidal banding

Haemorrhoidal Treatment

Procedures

Haemorrhoidal Treatment

What is Haemorrhoidal banding?

Haemorrhoidal banding is a procedure used to treat symptomatic hemorrhoids. It is a minimally invasive procedure that is performed in a doctor’s office or outpatient setting.

During the procedure, a small rubber band is placed around the base of the hemorrhoid, which cuts off the blood supply to the tissue. The hemorrhoid will then shrink and eventually fall off. This procedure is typically performed under local anesthesia.

Haemorrhoidal banding is considered a safe and effective treatment for symptomatic hemorrhoids, with a low risk of complications. The procedure is typically well tolerated and patients can return to their normal activities soon after the procedure.

It is important to discuss all treatment options with a healthcare provider to determine the best option for each individual patient.

What are Botox injections for anal fissures ?

Botox injections for anal fissures are a non-surgical treatment option for people who have chronic anal fissures that have not responded to other treatments. Botox is the trade name for a type of botulinum toxin, a neurotoxin that works by temporarily paralysing the muscles in the treated area.

In the case of anal fissures, Botox injections are used to relax the internal anal sphincter muscle, which can help to reduce the pain and discomfort associated with the fissure and promote healing. The internal anal sphincter muscle is a ring of smooth muscle that surrounds the anus and controls bowel movements. When this muscle is tense or spasming, it can cause pain and delay healing of an anal fissure.

During the procedure, a small amount of Botox is injected directly into the internal anal sphincter muscle, usually under local anaesthesia. The injection temporarily relaxes the muscle, reducing spasm and improving blood flow to the area, which can help to promote healing of the fissure.

Botox injections for anal fissures have been shown to be effective in relieving pain and promoting healing, with few side effects. However, the effects of Botox are temporary and typically last for a few months. Therefore, repeat injections may be necessary to maintain symptom relief. It is important to note that Botox injections are not appropriate for all patients with anal fissures, and should only be considered after other treatments have been attempted and failed.

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Abdominal ultrasound ​

What is a private abdominal ultrasound?

Procedures

Ultrasound

What is an abdominal ultrasound?

A private abdominal ultrasound is an ultrasound examination of the abdomen that is performed by a private clinic or hospital, rather than a publicly funded healthcare facility. Patients typically choose a private abdominal ultrasound for a number of reasons, including:

  • Quicker access to an appointment: Private healthcare facilities can often provide faster access to an ultrasound appointment compared to the public healthcare system, as there may be shorter waiting lists.
  • Increased comfort and privacy: Private clinics and hospitals often offer more comfortable and private facilities compared to the public healthcare system.
  • Increased control over the examination: Patients can choose the type of private abdominal ultrasound they would like to have, and they may be able to request a specific radiologist or sonographer.
  • More detailed reports: Private clinics and hospitals may offer more detailed reports and results compared to the public healthcare system.
  • Increased flexibility: Patients can often choose the time and date of their private abdominal ultrasound appointment, which can be particularly important for those who have busy schedules.

However, it is important to note that private abdominal ultrasounds are typically not covered by healthcare insurance and must be paid for out-of-pocket by the patient. Additionally, private abdominal ultrasounds may not always be necessary, and a referral from a GP or specialist may be required.

What can you see during an abdominal ultrasound?

An abdominal ultrasound is a medical imaging test that uses high-frequency sound waves to create images of the organs and tissues within the abdomen. During an abdominal ultrasound, a doctor or a  sonographer (technitian) applies a special gel to the patient’s skin and uses a handheld probe to generate the sound waves and capture the images.

An abdominal ultrasound can provide valuable information about the following organs and structures:

  • Liver: The ultrasound can assess the size, shape, and texture of the liver and detect any abnormalities, such as cysts, tumors, or cirrhosis.
  • Gallbladder: The ultrasound can detect gallstones, evaluate the function of the gallbladder, and identify any inflammation or infection.
  • Pancreas: The ultrasound can evaluate the size and shape of the pancreas and detect any abnormalities, such as cysts or tumors.
  • Spleen: The ultrasound can assess the size and texture of the spleen and detect any abnormalities, such as an enlarged spleen or a mass.
  • Kidneys: The ultrasound can evaluate the size, shape, and texture of the kidneys and detect any abnormalities, such as cysts, tumors, or kidney stones.
  • Abdominal blood vessels: The ultrasound can evaluate the blood flow in the major arteries and veins within the abdomen, such as the aorta and the vena cava.
  • Abdominal fluid collections: The ultrasound can detect the presence of fluid within the abdomen, such as ascites, which can be a sign of liver disease or other underlying conditions.

In addition to these organs, an abdominal ultrasound can also help diagnose other conditions such as hernias, abdominal pain, and digestive tract problems. The images obtained during an abdominal ultrasound can help guide further diagnostic tests or treatments as needed.

What is a pelvic ultrasound ?

A pelvic ultrasound is a non-invasive diagnostic imaging test that uses high-frequency sound waves to produce images of the structures and organs within the pelvic area, such as the uterus, ovaries, bladder, and prostate gland.

In gastroenterology, a pelvic ultrasound may be used to evaluate the lower gastrointestinal tract, including the rectum and anus, and to assess the structures adjacent to it, such as the bladder and prostate in males, and the uterus and ovaries in females.

Some of the common uses of pelvic ultrasound in gastroenterology include:

  1. Evaluating the extent of rectal cancer: Pelvic ultrasound can help determine the size and location of rectal tumors, and can also identify any nearby lymph nodes that may be affected.

  2. Diagnosing pelvic floor disorders: Pelvic ultrasound can help diagnose pelvic floor disorders, such as fecal incontinence or rectal prolapse, by assessing the anatomy and function of the pelvic muscles.

  3. Assessing prostate enlargement: In males, pelvic ultrasound can be used to assess the size of the prostate gland and to identify any abnormalities, such as enlargement due to benign prostatic hyperplasia or the presence of tumors.

  4. Evaluating urinary incontinence: Pelvic ultrasound can be used to evaluate the bladder and urinary tract to determine the cause of urinary incontinence.

Overall, pelvic ultrasound is a useful diagnostic tool in gastroenterology, as it provides detailed images of the pelvic organs and structures, allowing physicians to accurately diagnose and treat a wide range of gastrointestinal conditions.

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Transnasal Gastroscopy

What is transnasal gastroscopy?

Procedures

What is transnasal gastroscopy?

Transnasal gastroscopy (TNG) is a minimally invasive endoscopic procedure used to examine the inside of the upper gastrointestinal (GI) tract, including the esophagus, stomach, and duodenum. Unlike traditional gastroscopy, which is performed through the mouth and requires sedation, TNG is performed through the nose and does not require sedation. During the procedure, a flexible endoscope with a tiny camera on the end is passed through the nasal passages and into the GI tract, allowing the physician to visually inspect the inside of the upper GI tract. TNG is often used to diagnose and treat conditions such as acid reflux, ulcers, and other gastrointestinal problems.

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colonoscopy

What is a private colonoscopy ?

Procedures

What is a private colonoscopy ?

A private colonoscopy is a medical procedure in which a patient pays for a colonoscopy through a private health insurance policy or out-of-pocket, rather than through the National Health Service (NHS) in the United Kingdom.

A colonoscopy is a procedure in which a thin, flexible tube with a camera at one end (called a colonoscope) is passed into the rectum and colon to examine the inside of the large intestine. The procedure is used to diagnose and treat conditions such as colon polyps, diverticulitis, and colorectal cancer.

In a private colonoscopy, the procedure is performed in a private hospital or clinic, and the cost of the procedure is usually covered by a private health insurance policy or paid for out-of-pocket by the patient. Private colonoscopies are usually performed by a consultant gastroenterologist, and the patient typically has a shorter waiting time for the procedure than they would if they were on the NHS.

While a private colonoscopy is a more convenient and potentially quicker option, it is also usually more expensive than an NHS colonoscopy. It’s important to carefully consider the cost and benefits of a private colonoscopy and to discuss any questions or concerns with a medical professional before making a decision.

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Gastroscopy

What is a private gastroscopy?

Procedures

What is a private gastroscopy?

A private gastroscopy is a medical procedure in which a patient pays for a gastroscopy through a private health insurance policy or out-of-pocket, rather than through the National Health Service (NHS) in the United Kingdom.

A gastroscopy is a procedure in which a thin, flexible tube with a camera at one end (called an endoscope) is passed down the throat and into the stomach to examine the digestive tract. The procedure is commonly used to diagnose and treat conditions such as acid reflux, indigestion, and stomach ulcers.

In a private gastroscopy, the procedure is performed in a private hospital or clinic, and the cost of the procedure is usually covered by a private health insurance policy or paid for out-of-pocket by the patient. Private gastroscopies are usually performed by a consultant gastroenterologist, and the patient typically has a shorter waiting time for the procedure than they would if they were on the NHS.

While a private gastroscopy is a more convenient and potentially quicker option, it is also usually more expensive than an NHS gastroscopy. It’s important to carefully consider the cost and benefits of a private gastroscopy and to discuss any questions or concerns with a medical professional before making a decision.

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Oesophageal strictures (narrowing of the oesophagus)

Oesophageal strictures

Conditions

Oesophageal strictures (narrowing of the oesophagus)

Medical conditions, such as chronic acid reflux, can result in other health issues. This is due to the damage inflicted on the lining of the oesophagus by stomach acid over time, as well as the rise of stomach acid and bile up the food pipe.

Medical conditions such as chronic acid reflux, where stomach acid and bile frequently rise up into the food pipe (oesophagus), can lead to other health issues. Over time, stomach acid can damage the inner lining of the oesophagus, causing inflammation that may lead to scarring.

Repeated inflammation of the tissue can lead to a continuous process of healing followed by chronic inflammation and re-healing, ultimately resulting in scarring. If scar tissue accumulates, the oesophagus may develop narrow areas known as strictures. These strictures cause dysphagia, making it difficult to swallow food and, in severe cases, liquids, which can lead to dehydration and weight loss.

Oesophageal strictures are likely to occur in around 10% of patients with gastro-oesophageal reflux disease (GORD), where the symptoms of narrowness in the oesophagus are combined with symptoms of GORD such as heartburn, vomiting, sore throat or a cough. Strictures may also occur in the oesophagus due to viral or bacterial infections, certain medications, the ingestion of corrosive substances or as a result of diseases such as eosinophilic oesophagitis (EoE) and cancer.

Diagnosis of oesophageal strictures may involve swallowing barium while an x-ray is taken of the chest to observe any strictures, or an endoscopy examination where a narrow tube (endoscope) containing a light and a camera is inserted into the oesophagus so that doctors can see inside the food pipe.

The most common treatment for oesophageal strictures is endoscopic dilation, where an endoscope is used to move a tiny balloon or another dilation device into the oesophagus to gently stretch it. Proton pump inhibitors (PPIs) may also be prescribed. However, strictures can still return after a year or so, even with treatment, and multiple dilation sessions may be necessary. In severe cases, surgery may be recommended.

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Gastritis

Gastritis

Conditions

Gastritis

Gastritis is a gastrointestinal condition characterized by inflammation (redness) of the stomach lining. The condition can arise from various factors, including bacterial infection, which may be asymptomatic in some instances. In others, gastritis may present as feelings of fullness after eating, nausea or vomiting, indigestion, and a burning sensation in the stomach.

On rare occasions, gastritis may result in severe abdominal pain, gastric bleeding (as evidenced by vomiting blood or having black stools), as well as ulcers, growths or tumours in the stomach. Such symptoms arise after regions of the stomach lining have eroded, causing tissue damage from stomach acid.

Gastritis is a digestive disorder characterized by inflammation of the stomach lining, which can result from various causes. For instance, bacterial infection, often asymptomatic, can trigger gastritis. Other symptoms of gastritis may include a feeling of fullness after eating, indigestion, nausea or vomiting, and a burning sensation in the stomach.

In rare cases, gastritis can lead to severe abdominal pain, gastric bleeding (indicated by vomiting up blood or black faeces), as well as ulcers, growths, or tumours in the stomach, caused by tissue damage from stomach acid after areas of the stomach lining have worn away.

Sometimes, chronic gastritis can develop as a result of the immune system attacking the stomach lining. Chronic gastritis can also stem from bacterial infection from Helicobacter pylori (H. pylori), smoking, excessive alcohol consumption, or prolonged use of aspirin or ibuprofen (NSAID painkillers), or from stress, major surgery, a serious illness, or injury.

If you experience indigestion that lasts for over a week, severe pain, or symptoms of gastric bleeding, you should seek medical advice. A doctor may test for chronic gastritis using a stool sample to detect blood in your faeces or the presence of H. pylori bacteria, a breath test to identify H. pylori, a barium swallow, or an endoscope to see inside your oesophagus and stomach.

Lifestyle changes such as avoiding NSAID painkillers and alcohol, not smoking, practicing relaxation techniques, eating smaller meals frequently, and cutting down on irritants such as fried, spicy, or acidic foods can help ease the symptoms of chronic gastritis. Acid-reducing medications can also be beneficial.

Tests

  • Blood tests
  • Colonoscopy
  • Stool tests

Treatments / Symptom Management

  • Proton pump inhibitors (PPIs) medications
  • Antibiotics if you have H Pylori infection
  • Other acid reducing medications

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Diverticular disease and diverticulitis

Diverticular disease and diverticulitis

Conditions

Diverticular disease and diverticulitis

Diverticular disease is a condition in which small pockets or diverticula form in the lining of the large intestine and protrude through the bowel wall. This can result in abdominal pain, which is more pronounced in the lower left side, worsens after eating, but eases later. Other symptoms may include changes in bowel movements such as constipation or diarrhoea and the presence of black stools due to blood in faeces.

If an individual has inflamed or infected diverticula, the medical condition is called diverticulitis, which can lead to severe complications. These complications may include a persistent and intense abdominal pain, a fever of 38C or higher, blood or mucus in faeces, or bleeding from the rectum.

Diverticula, which are small pockets that protrude through the bowel wall, may be present in the large intestine without any symptoms. This condition is known as diverticulosis and is typically discovered incidentally during medical scans for other reasons. The likelihood of developing diverticula and diverticulosis increases with age, affecting roughly 10% of people over the age of 45 and up to 80% of those over the age of 85. About 20% of people with diverticulosis will develop diverticular disease.

Not consuming enough fibre is the primary cause of diverticular disease and diverticulitis. Additional risk factors include smoking, being overweight or obese, consuming excessive amounts of alcohol or red meat, and regular use of ibuprofen or aspirin.

A doctor will conduct a physical examination and blood tests to rule out other conditions with similar symptoms, such as bowel cancer, coeliac disease or irritable bowel syndrome. A CT scan or colonoscopy can diagnose diverticular disease.

Treatment for diverticular disease typically involves increasing fibre intake through foods such as fruits, vegetables, wholegrain cereals, potatoes, nuts and beans. Pain relief with paracetamol is recommended. For diverticulitis, a doctor may suggest a fluid-only diet for a few days followed by a low-fibre diet to allow the digestive system to rest and, once recovered, eating a high-fibre diet. In more severe cases, antibiotics, intravenous fluids for dehydration and surgery may be required.

Tests

  • Colonoscopy

Treatments / Symptom Management

  • High fibre diet
  • Surgery for complications (bleeding, perforation)

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Burning Mouth Syndrome

Burning Mouth Syndrome

Conditions

Burning Mouth Syndrome

This condition is known as burning mouth syndrome, which can cause a persistent, painful burning sensation in the lips, tongue, or other areas of the mouth. It may also be accompanied by a dry or numb mouth, a bitter taste, or changes in saliva production. The symptoms may be constant or intermittent.

Symptoms of burning mouth syndrome

  • A hot, painful burning sensation in the tongue, lips, gums, palate, throat or whole mouth
  • A dry or numb mouth
  • Tingling or stinging in your mouth
  • Bitter or metallic taste
  • Loss of taste
  • Increased thirst

The symptoms of this condition may occur daily, with mild sensations upon waking that worsen throughout the day, or with severe sensations that persist throughout the day from the moment of waking. For some individuals, symptoms may come and go. Eating or drinking may temporarily alleviate the sensations experienced. The symptoms can persist for months or even years without treatment and typically do not result in any physical changes to the appearance of the tongue or mouth.

What causes burning mouth syndrome?

Burning mouth syndrome is a relatively uncommon condition, affecting around 0.75 to 15% of the population according to research. It appears to be more prevalent in women, especially those who are menopausal or aged over 50. The exact cause of the syndrome is not fully understood, but it may result from a dysfunction in the nerves responsible for transmitting sensations from the tongue to the brain.

Why see a burning mouth syndrome specialist?

Long-term symptoms of burning mouth syndrome can lead to other negative effects on a person’s health and wellbeing, such as disrupted sleep patterns, fatigue, frustration, and low mood. For some individuals, it can also interfere with daily activities, such as conversing or enjoying meals with others. Seeking the assistance of a specialist is advisable if you are experiencing burning mouth syndrome. A gastroenterologist specialising in this condition can diagnose and provide appropriate treatment to alleviate your symptoms, allowing you to better manage your condition.

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