GERD or GORD

Conditions

What is Acid reflux?

Acid reflux, also known as gastroesophageal reflux disease (GERD), is a condition in which stomach acid flows back into the esophagus, causing heartburn and other symptoms. The esophagus is the tube that connects the mouth to the stomach.

In a normal digestive system, a ring of muscle at the bottom of the esophagus called the lower esophageal sphincter (LES) opens to allow food and liquid to flow into the stomach, and then closes to prevent the contents of the stomach from flowing back into the esophagus. However, in people with acid reflux, the LES is weak or relaxed, allowing stomach acid to flow back into the esophagus.

Common symptoms of acid reflux include heartburn, regurgitation, chest pain, and difficulty swallowing. If left untreated, acid reflux can cause damage to the esophagus and increase the risk of developing other health problems, such as esophageal cancer.

Treatment for acid reflux may include lifestyle changes, such as avoiding trigger foods and losing weight, as well as medications to reduce acid production and heal the esophagus. In severe cases, surgery may be recommended to tighten the LES and prevent acid reflux.

If you are experiencing symptoms of acid reflux, it is important to consult with a healthcare provider for an accurate diagnosis and appropriate treatment plan.

How can I cure acid reflux without medications ?

There are several lifestyle changes that can help to reduce the symptoms of acid reflux and avoid the need for medication:

  1. Lose weight: Extra weight puts pressure on the stomach and can cause acid to leak back into the esophagus.
  2. Avoid trigger foods: Common trigger foods include citrus, tomato-based products, chocolate, alcohol, caffeine, fatty and fried foods, and spicy foods.
  3. Eat smaller, more frequent meals: Eating smaller, more frequent meals instead of three large meals can help to reduce the amount of pressure in the stomach and reduce the risk of acid reflux.
  4. Avoid eating close to bedtime: Eating a large meal close to bedtime can cause acid to flow back into the esophagus while lying down.
  5. Avoid tight-fitting clothing: Wearing tight-fitting clothing can put pressure on the stomach and increase the risk of acid reflux.
  6. Raise the head of your bed: Elevating the head of your bed can help to prevent acid from flowing back into the esophagus while you sleep.
  7. Practice relaxation techniques: Stress and anxiety can increase the risk of acid reflux, so practicing relaxation techniques such as deep breathing, meditation, and yoga can be helpful.
  8. Chew gum: Chewing gum can help to increase saliva production and neutralize stomach acid.
  9. Drink herbal tea: Drinking herbal tea, such as chamomile or fennel, can help to soothe the digestive system and reduce symptoms of acid reflux.

It’s important to note that these lifestyle changes may not work for everyone, and some people may still require medication to manage their symptoms. It’s always best to consult with a healthcare provider to determine the best treatment plan for you.

How to diagnose acid reflux?

Acid reflux can be diagnosed through a combination of medical history, physical examination, and diagnostic tests. Some common tests used to diagnose acid reflux include:

  1. Esophagogastroduodenoscopy (EGD): This test involves inserting a flexible scope with a camera through the mouth into the esophagus, stomach, and small intestine to visualize any damage or irritation caused by acid reflux.
  2. pH monitoring: This test involves placing a device in the esophagus to measure the acidity of the esophagus and track when symptoms occur.
  3. Barium swallow X-ray: This test involves drinking a chalky liquid that helps to highlight any abnormalities in the esophagus and stomach, such as narrowing or blockages caused by acid reflux.
  4. Chest X-ray: A chest X-ray can help rule out other possible causes of chest pain or discomfort, such as a lung problem.
  5. Blood tests: Blood tests may be done to check for anemia, which can be a sign of acid reflux-related damage to the esophagus.

Your doctor may also ask about your symptoms and medical history, including what you eat, how often you experience symptoms, and if you take any medications. This information can help your doctor determine if you have acid reflux and what treatment options may be best for you.

Surgical options for acid reflux

There are several surgical options available for treating acid reflux and gastroesophageal reflux disease (GERD). The surgical options include:

  • Fundoplication: This is the most common surgical procedure for treating GERD. It involves wrapping the top part of the stomach around the lower esophagus to create a barrier that prevents acid from flowing back into the esophagus.
  • Transoral Incisionless Fundoplication (TIF): This is a minimally invasive procedure that uses an endoscope (a thin, flexible tube with a camera) to create a tight valve at the base of the esophagus. TIF is performed through the mouth and does not require any incisions.
  • LINX® Reflux Management System: This is a small device made of magnetic beads that is placed around the lower esophageal sphincter (LES) to help prevent acid from flowing back into the esophagus.
  • Nissen Fundoplication: This is a more extensive form of fundoplication that involves wrapping the entire circumference of the stomach around the esophagus. Nissen fundoplication is typically used for more severe cases of GERD.
  • Gastric inlet patch: This procedure is used to treat a specific type of hernia called a hiatal hernia, which can contribute to acid reflux. The procedure involves placing a patch or mesh over the hernia to reinforce the weakened area of the diaphragm and prevent the hernia from recurring.

Surgical options for acid reflux are typically recommended for patients who have not responded to other treatments, such as lifestyle changes and medications, or for patients with severe or complicated cases of GERD. The success rate of these procedures is high, and most patients experience significant relief from their symptoms after the surgery. However, as with any surgical procedure, there are potential risks and complications that should be discussed with your doctor prior to the surgery.

What is Bravo acid reflux testing?

Bravo pH testing is a type of diagnostic test used to measure the acidity in the esophagus over an extended period of time. It is used to diagnose gastroesophageal reflux disease (GERD) and other acid reflux-related conditions.

The Bravo test involves the placement of a small capsule in the esophagus, near the lower esophageal sphincter. The capsule is attached to a thin wire and remains in place for two to three days. During this time, it measures the pH levels in the esophagus and sends the data to a recorder worn on a belt around the waist.

The data from the Bravo test can help determine the frequency, duration, and severity of acid reflux and provide information that can help guide treatment decisions. The test is usually performed when other diagnostic tests, such as a traditional pH monitoring test or an endoscopy, have not provided a clear diagnosis or have not accurately measured the severity of acid reflux symptoms.

What is oesophageal high resolution manometry?

Oesophageal high-resolution manometry (HRM) is a diagnostic test used to evaluate the muscle contractions and pressure changes within the esophagus. It is used to diagnose and evaluate a variety of digestive disorders, particularly those affecting the oesophagus, including gastroesophageal reflux disease (GERD), achalasia, and other motility disorders.

HRM is a specialized form of manometry that provides a more detailed and accurate assessment of the functioning of the esophagus. It uses a specialized catheter that is inserted through the nose or mouth and into the esophagus. The catheter contains multiple sensors that measure the pressure and contractions of the esophageal muscles.

The results of HRM can help diagnose digestive disorders, determine the cause of symptoms, and guide treatment decisions. The test is usually performed when other diagnostic tests, such as an endoscopy or a traditional manometry test, have not provided a clear diagnosis or have not accurately measured the severity of symptoms.

What is Barrett’s oesophagus?

Barrett’s esophagus is a condition in which the normal tissue lining the lower part of the esophagus (the tube that carries food from the mouth to the stomach) is replaced with abnormal tissue. It is a complication of gastroesophageal reflux disease (GERD), a condition in which stomach acid and other contents flow back into the esophagus.

The abnormal tissue in Barrett’s esophagus is believed to be a response to the irritation and damage caused by repeated exposure to stomach acid. In some cases, this abnormal tissue can develop into a type of pre-cancerous condition called dysplasia.

Symptoms of Barrett’s esophagus can include heartburn, difficulty swallowing, and chest pain. The condition is usually diagnosed through endoscopy, a procedure in which a lighted scope is used to examine the esophagus and stomach. Treatment for Barrett’s esophagus typically involves medications to control GERD and prevent further irritation to the esophagus, as well as periodic endoscopic surveillance to monitor for the development of dysplasia. In some cases, treatment may involve removal of the abnormal tissue.

What are the risks of obesity?

Obesity is defined as having a body mass index (BMI) of 30 or higher, and it is associated with several serious health risks, including:

  1. Cardiovascular disease: Obesity increases the risk of heart disease, stroke, high blood pressure, and high cholesterol.
  2. Type 2 diabetes: Obesity is a leading risk factor for the development of type 2 diabetes.
  3. Cancer: Obesity increases the risk of several types of cancer, including breast, colon, endometrial, kidney, and esophageal cancer.
  4. Sleep apnea: Obesity is a major risk factor for the development of sleep apnea, a serious sleep disorder that can cause fatigue, decreased productivity, and other health problems.
  5. Joint problems: Obesity can increase the risk of joint problems, such as osteoarthritis, as extra weight puts stress on joints and cartilage.
  6. Liver disease: Obesity can increase the risk of liver disease, such as nonalcoholic fatty liver disease and cirrhosis.
  7. Gallbladder disease: Obesity increases the risk of gallstones and other gallbladder problems.
  8. Mental health problems: Obesity is associated with an increased risk of depression, anxiety, and other mental health problems.
  9. Reproductive problems: Obesity can cause infertility and increase the risk of complications during pregnancy and childbirth.

It’s important to maintain a healthy weight to reduce the risk of these and other health problems. This can be achieved through a combination of healthy eating, regular physical activity, and a commitment to a healthy lifestyle.

How can I lose weight?

Here are some strategies for losing weight:

  1. Eat a balanced diet: Focus on eating a balanced diet that includes plenty of fruits and vegetables, lean protein, whole grains, and healthy fats. Limit your intake of sugar, salt, and unhealthy fats.
  2. Reduce portion sizes: Pay attention to the portion sizes of the foods you eat, and try to reduce the amount of food you consume at each meal.
  3. Avoid high-calorie drinks: Limit your intake of high-calorie drinks such as soda, fruit juice, and sweetened coffee or tea.
  4. Increase physical activity: Try to get at least 30 minutes of physical activity most days of the week. This can include walking, cycling, swimming, or any other form of exercise that you enjoy.
  5. Get enough sleep: Aim for 7-8 hours of sleep per night to help regulate your metabolism and reduce stress levels, which can both contribute to weight gain.
  6. Practice mindful eating: Pay attention to your hunger and fullness signals and eat slowly and without distractions. This can help you be more mindful of what and how much you are eating.
  7. Reduce stress: High levels of stress can lead to overeating and weight gain. Try to find healthy ways to manage stress, such as exercise, meditation, or talking to a therapist.
  8. Get support: Consider joining a weight loss support group or working with a registered dietitian or personal trainer to help you stay on track.

Remember, weight loss is a gradual process and it’s important to be patient and kind to yourself. It’s also important to consult with a healthcare professional before starting any weight loss program, especially if you have any underlying medical conditions.

Why do people do not stick to diet and exercise?

There are many reasons why people may struggle to stick to a diet and exercise plan. Some common reasons include:

  1. Lack of motivation: People may lose their initial motivation to eat healthier or exercise regularly over time.
  2. Lack of time: Many people have busy schedules and finding time for exercise or preparing healthy meals can be a challenge.
  3. Lack of variety: Eating the same foods repeatedly or doing the same exercises over and over can get boring, leading people to abandon their diet or exercise plan.
  4. Emotional eating: Some people turn to food for comfort or as a way to cope with stress, making it difficult to stick to a healthy diet.
  5. Unrealistic expectations: Setting unrealistic goals or expectations can lead to disappointment and frustration, which can cause people to abandon their diet or exercise plan.
  6. Stress: High levels of stress can disrupt eating and exercise habits, making it difficult to stick to a plan.
  7. Social pressure: Going against the norm, such as ordering a salad instead of a burger at a social gathering, can be difficult and cause people to abandon their healthy habits.
  8. Travel: Traveling can make it difficult to stick to a diet and exercise plan, as you may be in a new place with limited access to healthy foods or opportunities for physical activity.

It’s important to find ways to overcome these challenges and maintain a healthy lifestyle. For example, finding an accountability partner, tracking progress, and finding healthy ways to manage stress can help you stay on track.

What are the medications for weight loss?

There are several types of medications that can be used for weight loss, including:

  1. Orlistat (Xenical): This medication works by blocking the absorption of fat in the gut, leading to fewer calories being absorbed and stored as fat.
  2. Liraglutide (Saxenda): This medication is a glucagon-like peptide-1 (GLP-1) receptor agonist that helps regulate appetite and reduces food cravings.
  3. Bupropion/naltrexone (Contrave): This medication is a combination of an antidepressant and an opioid antagonist, and it helps regulate appetite and reduce cravings for food.
  4. Phentermine (Adipex-P, Ionamin): This medication is an appetite suppressant that works by decreasing hunger and increasing feelings of fullness.
  5. Lorcaserin (Belviq): This medication works by activating certain brain receptors that control appetite and food intake.

It’s important to note that these medications should not be used as a sole method of weight loss, but rather as part of a comprehensive weight loss program that includes a healthy diet and regular exercise. Additionally, the safety and efficacy of these medications can vary, so it’s important to talk to your doctor to determine the best option for you and to understand any potential risks or side effects.

Surgical options for weight loss

There are several surgical options for weight loss, also known as bariatric surgery, that can help people with obesity lose weight. These procedures are typically recommended for individuals who have not been able to achieve significant weight loss through diet and exercise alone and for those who have a BMI of 40 or higher, or a BMI of 35 or higher with significant obesity-related health problems such as type 2 diabetes or sleep apnea. Some common surgical options for weight loss include:

  1. Roux-en-Y gastric bypass: This procedure involves creating a small pouch at the top of the stomach and connecting it directly to the small intestine, bypassing the rest of the stomach and part of the small intestine. This reduces the amount of food that can be eaten and the number of calories and nutrients absorbed.
  2. Sleeve gastrectomy: This procedure involves removing about 80% of the stomach, leaving a sleeve-shaped stomach that is about the size of a banana. This smaller stomach restricts food intake and promotes weight loss.
  3. Adjustable gastric banding: This procedure involves placing an adjustable band around the upper part of the stomach to create a small pouch that restricts food intake and slows the passage of food into the rest of the stomach.
  4. Biliopancreatic diversion with duodenal switch: This procedure involves removing a large portion of the stomach and rerouting the small intestine to the remaining portion of the stomach, resulting in significant restriction of food intake and malabsorption of calories.

These surgical options can lead to significant weight loss and improvement in related health conditions, but they are not without risks and side effects, and they also require significant lifestyle changes, including changes to diet and physical activity habits. It’s important to discuss the potential benefits and risks of bariatric surgery with your doctor to determine if it is right for you.

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Functional heartburn

Conditions

Functional heartburn

Functional heartburn pertains to the manifestation of painful burning sensations located behind the chest bone, in instances where there exists no evidence of heart issues, gastro-oesophageal reflux disease (GORD), or related ailments. It can also occur concomitantly with irritable bowel syndrome.

GORD and functional heartburn share many symptoms, which can lead to confusion between the two. Nevertheless, functional heartburn is distinguishable by the absence of inflammation in the food pipe’s (oesophagus) lining or related ailments.

The discomfort caused by functional heartburn typically appears in waves and is more likely to occur after meals. It may be accompanied by belching, regurgitation, bloating, feeling full too quickly when eating, or pain in the upper abdomen. The symptoms are usually experienced during the daytime.

Functional heartburn is prevalent, affecting about 20% of people, and is more common in women than in men. The symptoms can be mild, short-lived, or easily treated with over-the-counter antacid remedies.

If the symptoms become more frequent, more painful, or persist despite treatment, it is advisable to consult a doctor who will likely recommend an endoscopy. This procedure entails passing a narrow tube (endoscope) containing a light and camera through the oesophagus to enable doctors to examine the food pipe’s lining.

In cases where there is no evidence of inflammation, doctors may employ pH monitoring to measure the frequency of gastric acid in the oesophagus. This helps to exclude GORD, which is characterised by the frequent reflux of stomach acid into the oesophagus. If the pH readings are within normal range, the condition may be diagnosed as functional heartburn.

This chronic condition can be categorised in different ways. In a minority of cases, heartburn is caused by acid reflux. However, it could be due to hypersensitivity to normal levels of acid. In such situations, conventional acid reflux medications such as proton pump inhibitors (PPIs) can be effective.

The other category includes individuals whose symptoms are not related to acid reflux and are not relieved by anti-reflux medications. It is believed that such individuals may have a heightened awareness of sensations in their oesophagus. While the exact cause of this is not fully understood, stress is thought to exacerbate symptoms. Possible treatments include relaxation techniques and positive lifestyle changes, among others.

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Coeliac disease

What is coeliac disease?

Conditions

What is coeliac disease?

Coeliac disease is a chronic autoimmune disorder that affects the small intestine. It occurs when the body’s immune system reacts abnormally to gluten, a protein found in wheat, barley, and rye. This immune reaction damages the lining of the small intestine, leading to malabsorption of nutrients and a range of symptoms.

The symptoms of coeliac disease can vary widely, but common symptoms include abdominal pain, bloating, diarrhea, constipation, fatigue, weight loss, and anemia. Some people with coeliac disease may have no symptoms at all.

Diagnosis of coeliac disease typically involves a combination of blood tests, a biopsy of the small intestine, and a gluten challenge, in which gluten is reintroduced into the diet after a period of gluten avoidance.

The only treatment for coeliac disease is a strict gluten-free diet, in which all sources of gluten must be eliminated. This can be a challenging diet to follow, but with proper guidance and support, most people with coeliac disease are able to manage their symptoms and lead healthy lives.

It is important to work with a registered dietitian who is knowledgeable about coeliac disease and the gluten-free diet to ensure that all nutrient requirements are met and to avoid any potential negative consequences of the diet.

What is gluten and where do you find it?

Gluten is a type of protein found in certain grains, including wheat, barley, and rye. It gives dough its elasticity and helps baked goods retain their shape.

Gluten is found in many different types of foods, including bread, pasta, cereal, baked goods, and many processed foods. It can also be found in unexpected places, such as in soups, sauces, and processed meats.

For individuals with coeliac disease or non-celiac gluten sensitivity, it is important to avoid all sources of gluten in order to prevent symptoms and prevent damage to the small intestine. There are many gluten-free alternatives available, including gluten-free bread, pasta, and baked goods, as well as naturally gluten-free foods such as fruits, vegetables, meat, poultry, and fish.

It is important to carefully read food labels and ingredient lists to identify sources of gluten and to always choose products that are labeled gluten-free. A registered dietitian who is knowledgeable about gluten can also provide guidance on navigating the gluten-free diet and help ensure that all nutrient needs are met.

What is non coeliac gluten intolerance?

Non-celiac gluten intolerance, also known as non-celiac gluten sensitivity (NCGS), is a condition in which individuals experience symptoms similar to those of coeliac disease, but without the presence of the autoimmune markers or intestinal damage seen in coeliac disease.

The exact cause of NCGS is not well understood, but it is believed to be related to an intolerance to gluten rather than an autoimmune reaction. Common symptoms of NCGS include abdominal pain, bloating, diarrhea, constipation, headache, fatigue, and skin rashes.

Diagnosis of NCGS typically involves excluding coeliac disease and wheat allergy, and then conducting a gluten challenge, in which gluten is reintroduced into the diet after a period of gluten avoidance. If symptoms improve on a gluten-free diet and worsen when gluten is reintroduced, a diagnosis of NCGS may be made.

The treatment for NCGS is a gluten-free diet, similar to that for coeliac disease. However, it is important to work with a registered dietitian to ensure that all nutrient needs are met, as a gluten-free diet can be restrictive and may result in nutrient deficiencies if not properly followed.

It is important to note that NCGS is not yet fully understood and more research is needed to better define the condition and its underlying mechanisms. Additionally, some individuals who have been diagnosed with NCGS may actually have another underlying condition that is causing their symptoms. It is important to work with a healthcare provider to rule out other potential causes and to properly diagnose and manage NCGS.

The manifestation of abrupt swallowing difficulties may indicate an allergic response. Additionally, the presence of blood in vomit or stool may signify internal bleeding within the digestive system.

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Endometriosis

Endometriosis

Conditions

Endometriosis

Endometriosis is a persistent medical condition characterised by the growth of cells that bear resemblance to those normally found in the lining of the uterus, in other parts of the body. This chronic disease is known to affect approximately one in ten women and girls of reproductive age and can result in significant debilitation.

Individuals diagnosed with endometriosis typically experience abnormal cellular growth, which reacts in a similar manner to cells found within the uterus, in response to hormonal cycles. Nevertheless, given that these cells are located outside the uterus, the resulting bleeding cannot be expelled from the body as menstrual blood would. This, in turn, causes inflammation, pain, and the formation of scar tissue.

The symptoms of endometriosis can encompass notably painful or heavy menstrual periods, along with feelings of fatigue, depression, and issues relating to bowel, bladder, or fertility.

As it pertains to the digestive system, endometriosis can affect the bowel in two ways: by occurring on the surface of the bowel (referred to as ‘superficial’ endometriosis) or by endometrial cells penetrating the bowel wall (known as ‘deep’ endometriosis).

Bowel endometriosis can produce symptoms akin to those of irritable bowel syndrome, though they typically worsen in the lead up to and during the menstrual cycle, presenting a noticeable pattern. Symptoms may include pain during bowel movements, pain felt deeply in the pelvic region during or after intercourse, and on occasion, rectal bleeding during menstruation.

A range of techniques are employed by clinicians to diagnose endometriosis, such as a vaginal examination, ultrasound scans, or (if deep endometriosis is suspected) CT and MRI scans or surgical intervention to inspect the abdomen or bowel.

Several of the complications resulting from endometriosis can be regulated by painkillers and hormone treatments, which aid in making the associated symptoms more controllable.

Concerning bowel endometriosis, surgery is typically recommended. The surgical approach taken, whether laparoscopy or open surgery, will depend on the severity of the patient’s condition and the areas affected. Multiple operations may be necessary.

Surgical interventions for this chronic condition are patient-specific and include the option of excising the nodules or affected regions of the bowel, leaving the bowel intact but possibly leaving some endometriosis tissue in place. In cases involving smaller regions of endometriosis, a disc-shaped section of the affected tissue is removed and subsequently sealed. For more severe cases, an affected section of the bowel is excised and then rejoined (a procedure referred to as re-anastomosis).

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achalasia

Achalasia

Conditions

Achalasia

Achalasia is a rare condition of the esophagus, the tube that connects the mouth to the stomach. It occurs when the muscle at the bottom of the esophagus (the lower esophageal sphincter) fails to relax properly, making it difficult for food and liquid to pass into the stomach.

Symptoms of achalasia can include difficulty swallowing, regurgitation of food, chest pain, and weight loss. The exact cause of achalasia is not known, but it is believed to be related to a problem with the nerve supply to the lower esophageal sphincter.

Diagnosis of achalasia may involve a series of tests, including X-rays, a barium swallow test, and an esophageal manometry test to measure the pressure in the lower esophageal sphincter.

Treatment for achalasia typically involves procedures to relax the lower esophageal sphincter and improve the passage of food into the stomach. This can include medications, dilation of the esophagus with a balloon, or surgical procedures to cut the muscle at the bottom of the esophagus. In some cases, dietary modifications and lifestyle changes may also be recommended to manage symptoms.

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belching burping

Belching and burping

Symptoms

Belching and burping

Belching and burping arise due to the presence of excessive air within the oesophagus that is expelled through the mouth. The underlying cause is commonly linked to dietary intake or rapid ingestion. However, persistent occurrences may signify an underlying issue in the upper digestive tract, such as acid reflux. We recommend scheduling an appointment with one of our medical professionals for a thorough examination and diagnosis.

Related Symptoms

What’s the difference between burping and belching?

  • - Acid reflux (heartburn) and indigestion
  • - Chest pain and discomfort
  • - Abdominal pain
  • - Bloating

Belching and burping are synonymous in meaning, referring to the act of expelling gas from the mouth, with some regarding belching as producing a more audible sound. An alternative term for this process is eructation.

While typically a natural bodily function, it is only a cause for concern when coupled with other symptoms. If excessive belching and burping persist, we recommend seeking guidance from a medical professional.

As well as trouble swallowing, signs of dysphagia include:

When to seek emergency help

Burping and belching rarely require emergency care, though seek urgent treatment if you experience the following symptoms.

  • - Tarry or black stools
  • - Severe abdominal pain
  • - Sudden difficulty swallowing
  • - Blood in your poo (stools) or vomit
  • - Vomit that resembles coffee grounds

The manifestation of abrupt swallowing difficulties may indicate an allergic response. Additionally, the presence of blood in vomit or stool may signify internal bleeding within the digestive system.

Causes of burping and belching

Transient episodes of excessive belching may be triggered by the ingestion of specific foods and beverages, including carbonated beverages, curry, chewing gum, and dairy products. Furthermore, temporary burping may also accompany gastrointestinal distress. Nevertheless, persistent belching and burping warrant further evaluation as they could signify an underlying gastrointestinal (GI) ailment requiring medical attention.

Conditions linked to belching and burping

Outlined below are several medical conditions that may give rise to belching and burping, alongside their typical symptoms.

  • - Peptic ulcers – also cause blood in your poo
  • - Gastritis – can also cause nausea and vomiting
  • - Functional or non-ulcer dyspepsia – also causes indigestion
  • - H. Pylori – also causes abdominal pain and bloating
  • - Gastroparesis – can also cause unintended weight loss
  • - Aerophagia – you may experience air gulping and flatulence
  • - Food intolerance – symptoms may occur after specific foods
  • - Hiatal hernia – may cause bad breath, heartburn and acid reflux
  • - Gastro-oesophageal reflux disease (GORD) – frequent acid reflux
  • - Irritable bowel syndrome (IBS) – also causes diarrhoea and constipation

Should you present with any of the aforementioned symptoms, we advise seeking guidance from our specialist team to obtain a comprehensive diagnosis.

Diagnosis

The diagnostic approach to identifying the underlying cause of your belching and burping hinges upon the presence of accompanying symptoms. During your consultation, our medical professionals will conduct a thorough evaluation of any additional symptoms, their duration, and possible triggers.

Furthermore, we will delve into your medical history, both personal and familial, to help establish a probable cause for your symptoms. For enhanced visualisation of your digestive system, our specialist may conduct various gastrointestinal (GI) tests.

Testing may involve

  • - H. pylori test
  • - Maldigestion tests
  • - A blood or stool test
  • - Hydrogen and methane breath tests
  • - Gastroscopy (if we suspect it is GORD)
  • - Abdominal scans, such as MRI, CT, or ultrasound scans

Treatment

Prior to seeking professional guidance, there are several lifestyle modifications that you may consider implementing to alleviate belching. Digestive disruptions, including belching, can arise due to poor gut health and heightened stress levels. 

If your symptoms cause discomfort, we suggest consulting with a specialist at the earliest convenience. Maintaining a symptom tracker and food diary may prove beneficial in providing our team with an accurate depiction of your condition during your appointment.

After identifying the underlying cause of your symptoms, our specialists will recommend the most suitable course of treatment. In the event that we diagnose a gastrointestinal (GI) ailment, follow-up testing, medication, or surgery may be necessary.

Lifestyle changes to prevent belching and burping

  • - Quit smoking
  • - Don’t drink through a straw
  • - Avoid eating or drinking quickly
  • - Eat less fatty or high-fibre foods
  • - Try taking a short walk after eating
  • - Stop chewing gum or similar products
  • - Limit carbonated drinks, such as beer
  • - Avoid certain other foods, such as mushrooms, beans, cabbage, broccoli, lentils, onions, and some fruits.

Over-the-counter medications

Some over-the-counter medications may alleviate your symptoms, such as antacids. Your local pharmacist can advise you on the medicines that may help.

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Swallowing-Problems

Swallowing Problems

Symptoms

Swallowing Problems (Dysphagia)

Occasionally, food can become lodged in the throat or oesophagus for a brief period. However, if this becomes a frequent occurrence, lasts longer than a few seconds or causes pain when swallowing, it is advisable to seek medical attention.

Dysphagia is the medical term for difficulty swallowing, which can result in difficulties swallowing certain foods or liquids, or an inability to swallow altogether. If you are experiencing any of these symptoms, it is recommended that you consult with one of our specialists.

Further information on the symptoms, causes, diagnosis and treatment for swallowing problems is detailed below.

Related Symptoms

  • - Cough and throat clearing
  • - Hoarseness of voice

Symptoms of dysphagia

As well as trouble swallowing, signs of dysphagia include:

  • - Choking or coughing when eating
  • - Bringing food back up
  • - Feeling like food is stuck in your throat or behind your chest bone
  • - Excess salivation
  • - Trouble chewing food

Left untreated, dysphagia can cause weight loss and chest infections.

Causes

The following health conditions can cause swallowing problems: 

  • - Eosinophilic oesophagitis (EoE)
  • - Gastro-oesophageal reflux disease (GORD)
  • - Achalasia
  • - Oesophageal cancer

The narrowing of the oesophagus, which can lead to difficulty swallowing, can be caused by various digestive health conditions. Additionally, neurological conditions like stroke and multiple sclerosis can also contribute to dysphagia. If you are experiencing difficulty swallowing and have one of these conditions, it is recommended to consult with our specialists to better understand the impact on your swallowing ability.

Diagnosis

If your doctor suspects that your difficulty in swallowing is due to a digestive health issue, they may refer you to one of our gastroenterologists for further consultation. To diagnose the underlying condition, we may conduct one or more of the following tests :

  • - Gastroscopy
  • - Barium swallow
  • - High-resolution oesophageal manometry
  • - 24 hour pH impedance
  • - 96 hour pH capsule (BRAVO or Alpha)

Treatment

The optimal treatment for dysphagia varies based on its root cause. Endoscopic dilation is a viable treatment option for eosinophilic oesophagitis (EoE) and achalasia. Additionally, other potential treatment options for EoE include:

  • - 6 food elimination diet
  • - Proton pump inhibitors (PPIs) medications
  • - Topical swallowed steroids (Budesonide)

We can treat GORD with:

  • - Medications to suppress or counteract acid
  • - Lifestyle modifications (diet, weight loss, exercise)
  • - Anti-reflux procedures (Stretta, transoral incisionless fundoplication (TIF), LINX)
  • - Anti-reflux surgery (laparoscopic/keyhole Nissen fundoplication)

The treatment for oesophageal cancer varies depending on the stage of the disease. For early stages, endoscopic resection (ER) and HALO radiofrequency ablation (RFA) may be appropriate. However, more advanced stages require surgical intervention, such as an oesophagectomy to remove the affected part of the oesophagus. Other treatments, such as chemotherapy or radiotherapy, may also be considered.

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Mouth-sores-and-ulcers

Mouth sores and ulcers

Symptoms

Mouth sores and ulcers

It is possible that a gastrointestinal (GI) problem, such as acid reflux, could be the cause of a mouth sore or ulcer. While occasional sores and ulcers are normal, if you continue to experience them, it is advisable to consult a GP or dentist. After evaluating your symptoms, they may suggest seeing a gastroenterologist to investigate whether a GI condition is contributing to your problems. Our gastroenterologist is available to determine if an upper GI problem is causing your mouth sore or ulcer.

Related Symptoms

  • - Acid reflux, heartburn, and indigestion
  • - Cough and throat clearing
  • - Hoarseness of voice
  • - Swallowing problems (dysphagia)

What are mouth ulcers and sores?

An ulcer is a type of sore that can occur in various parts of the body, including the mouth. Mouth sores, which are painful lesions, can appear on the lips, gums, tongue, cheeks, and the floor or roof of the mouth.

Mouth sores and ulcers can cause redness, inflammation, and pain, and you may experience just one or many at a time. If you experience multiple ulcers or sores, or they keep returning, it is advisable to consult a healthcare professional.

If you are experiencing severe pain along with a fever, a skin rash, joint pain, or diarrhoea, it is recommended to book an appointment with your doctor. Additionally, seek help if your pain does not improve with medication or you experience no pain.

What do sores and ulcers look like?

A sore or ulcer in the mouth can take on a round or oval shape and may vary in colour depending on the underlying cause. Mouth sores can appear red, white, grey, yellow or purple.

If you notice a white/grey sore with a red halo, it may be a canker sore or aphthous ulcer. These are usually small and oval-shaped and may indicate a folate (vitamin B9) deficiency and anaemia, which are signs of coeliac disease. These sores can be white, grey, yellow or red. Anaemia can cause pale gums and skin.

Patches or lesions in the mouth could be a result of acid reflux, appearing anywhere inside the mouth or on the gums, tongue or palate.

It is important to note that patches or lesions may also be a sign of mouth cancer. These can appear red or white and would not heal. You may also experience persistent lumps in the mouth or neck and unexplained loose teeth. If you experience any of these symptoms, seek medical attention immediately.

Frequent mouth ulcers and sores

Mouth ulcers and sores can have various causes, including minor injuries (trauma), hormonal changes, stress, and underlying medical conditions.

Common causes of mouth sores and ulcers include stress, gum damage, and vitamin deficiencies. Although discomfort may be present for a brief period, healing should occur quickly. If a vitamin deficiency is detected, supplements may be recommended.

If new sores or ulcers continue to appear before the previous ones have fully healed, it is advisable to speak with a healthcare professional. These symptoms may indicate an underlying gastrointestinal condition, particularly an upper GI condition.

Symptoms that indicate an upper GI problem

If your mouth sores or ulcers are due to an upper GI condition, you may experience the following additional symptoms.

  • - Frequent acid reflux, heartburn, and indigestion
  • - Abdominal pain and cramping
  • - Hoarseness of voice
  • - Constant sore throat
  • - Difficulty swallowing
  • - Reduced appetite
  • - Bloating and gas

Many of these symptoms overlap with various upper GI conditions.

Upper GI conditions linked to mouth sores

  • - Gastro-oesophageal reflux disease (GORD/GERD)
  • - Laryngopharyngeal reflux (LPR)
  • - Barrett’s oesophagus
  • - Oesophagitis

Other symptoms that indicate a GI condition

Mouth ulcers or sores can be caused by various gastrointestinal conditions, including Crohn’s disease (IBD) and coeliac disease, in addition to upper GI conditions. The following symptoms may be experienced:

  • - Weight loss
  • - Chronic diarrhoea
  • - Frequent constipation
  • - Feeling sick and vomiting

When to speak to a gastroenterologist

After receiving a visual examination to confirm the presence of mouth sores or ulcers, further investigation may be necessary to determine the underlying cause. Before referring you to a gastroenterologist, your GP or dentist may want to eliminate causes related to your oral hygiene.

If you are experiencing gastrointestinal symptoms, such as the ones mentioned above, you may wish to consult with a gastroenterologist first. Based on your symptoms, our gastroenterologist can recommend the most appropriate tests to diagnose the cause of your sores or ulcers.

Testing

If a patient presents with symptoms of acid reflux in addition to mouth ulcers, a gastroscopy (upper endoscopy) may be performed to investigate the possibility of gastro-oesophageal reflux disease (GORD). To further confirm or rule out GORD, a 96-hour wireless pH capsule (BRAVO) test may also be conducted.

If inflammatory bowel disease (IBD) is suspected, a colonoscopy, as well as blood and stool tests, may be performed. A diagnosis of coeliac disease can be confirmed through blood tests and a biopsy via endoscopy.

Treatment

The treatment for mouth sores and ulcers depends on their type and underlying cause. If mouth ulcers are accompanied by other upper GI symptoms, or if they are recurring, further tests may be necessary to diagnose the root cause of the problem.

For cases where mouth ulcers are the only concern, lifestyle changes such as modifying the diet and reducing stress levels, or over-the-counter medication such as corticosteroid lozenges and anti-inflammatory drugs, may provide relief.

It is not recommended to squeeze the sores, as this can exacerbate pain and lead to scarring.

Mouth sores and ulcers are often associated with upper GI conditions that cause acid reflux. In cases where severe acid reflux is the cause of the problem, we may suggest lifestyle changes and medications to reduce reflux. If these methods are ineffective, anti-reflux surgery or other procedures may be recommended.

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Chronic-diarrhoea

Chronic diarrhoea

Symptoms

Chronic diarrhoea

Chronic diarrhoea is a prevalent problem that can impact individuals of all ages, occurring suddenly and typically resolving spontaneously. Generally, it is not a cause for alarm. Conversely, if diarrhoea persists or occurs frequently, it is deemed ‘chronic’. In the event of chronic diarrhoea, it is advisable to seek medical assistance.

If you are experiencing continuous or persistent (chronic) diarrhoea, we recommend scheduling an appointment with one of our highly-rated specialists to alleviate any concerns you may have.

Related Symptoms

  • - Nausea and vomiting
  • - Blood in your poo
  • - Abdominal pain
  • - Constipation

Symptoms

Passing watery stools with blood or mucus can be a sign of severe diarrhoea. In addition, a fever, cramps, or weight loss may also occur. Chronic diarrhoea can lead to dehydration, which can have serious consequences if left untreated.

Symptoms of dehydration include fatigue, lightheadedness, dizziness, loss of appetite, sunken eyes, dark urine, muscle cramps, a dry tongue, and a rapid heart rate. If you experience any of these symptoms alongside chronic diarrhoea, seek medical attention promptly.

Causes

Short-term diarrhoea may be caused by various factors, including excessive alcohol consumption, food allergies, and gastrointestinal infections. Additionally, psychological factors such as stress, anxiety, and depression can have an impact on your digestive system. Furthermore, some medications can cause loose stools, and if you suspect this is the case, it’s essential to speak to your doctor about the side effects.

There are also long-term causes of diarrhoea that may require medical attention, including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), chronic infections, and some forms of cancer.

  • - Coeliac disease
  • - Bile acid malabsorption
  • - Irritable bowel syndrome (IBS)
  • - Inflammatory bowel disease (IBD)
  • - Microscopic colitis
  • - Diverticular disease and diverticulitis
  • - Pancreatic exocrine insufficiency (PEI)
  • - Small intestinal bacterial overgrowth (SIBO)

 Another, much less common, cause is bowel cancer. Our experienced specialists will perform a series of tests depending on your symptoms to determine the cause.

Diagnosis

At your initial consultation, we will inquire about your symptoms and medical history. We will need to know the duration and severity of your symptoms, any medication you are taking, and your bowel habits, including stool consistency and frequency.

Following our discussion, we may conduct a physical examination of your abdomen and recommend stool and blood tests to detect blood, infection or inflammatory bowel disease.

It is important to continue with your regular diet before these tests to ensure accurate results. Discontinuing gluten consumption before testing may interfere with the diagnosis of coeliac disease, which involves high levels of gluten antibodies after gluten intake.

For individuals over 50, we may recommend a digital rectal examination (DRE) to detect abnormalities in the bowel or rectum.

After the initial assessment, we may advise additional tests such as an upper endoscopy (gastroscopy), colonoscopy or a hydrogen breath test to identify the cause of your symptoms.

Treatment

After identifying the underlying cause of your diarrhoea, we can provide guidance on how to manage your symptoms effectively. To prevent dehydration, it’s crucial to drink fluids frequently, including water. However, we recommend avoiding sweet or carbonated beverages while experiencing diarrhoea.

Medications

Acute cases of diarrhoea can often be effectively treated with over-the-counter medicines available at a pharmacy. However, if there is blood in your stool, it is not advisable to take these medications. Prescription medications that may be recommended include absorbents to make the stools less watery, antidiarrhoeal medicines like loperamide (the active ingredient in Imodium), muscle relaxants to reduce cramps and slow down digestion, antibiotics if a severe bacterial infection is present, and medicine to treat bile acid malabsorption. In cases of chronic diarrhoea, dietary changes can also help manage symptoms associated with conditions such as coeliac disease and IBS.

 

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constipation

Constipation

Symptoms

Constipation

If an individual is experiencing constipation, they may encounter difficulty in having a bowel movement more than three times a week. Additionally, their stools (faeces) may vary in size, appearing smaller or larger than usual, with a harder consistency that could make their passage challenging.

It is a common condition, and many individuals encounter constipation at some point in their lifetime. It often occurs without a definite cause.

However, if someone experiences constipation persistently for several weeks, it is recommended that they consult one of our specialists as it could be a sign of chronic constipation.

This page aims to provide an understanding of constipation and its associated symptoms.

Related Symptoms

  • - Abdominal pain
  • - Bloating
  • - Diarrhoea
  • -Nausea and vomiting

Symptoms

  • - Dry, lumpy, hard poo
  • - Strenuous bowel movement
  • - Painful bowel movements
  • - Frequent full feeling

You may also feel like you haven’t fully emptied your bowels or as if something is blocking your bowels.

  • - Abdominal pain or cramping
  • - Feeling sick (nausea)
  • - Blood in your stool
  • - Loss of appetite
  • - Back pain
  • - Bloating

If you encounter symptoms such as bleeding, intense pain, or any other concerning signs, it is recommended to schedule an appointment with your doctor without delay. Such symptoms could be indicative of complications associated with or causing your constipation and should be evaluated by a medical professional.

Causes

There are numerous factors that may lead to constipation, some of which are prevalent, while others require medical attention. If you are uncertain about the underlying cause of your constipation, seeking advice from one of our specialists is recommended.

Several common causes of constipation are as follows:

  • - Dehydration, by not drinking enough water or overusing laxatives
  • - Not eating enough fibre
  • - Eating or drinking too many dairy products
  • - Another change in your diet
  • - Heightened stress levels
  • - Upper abdominal pain
  • - Being inactive, or less active than usual
  • - Ignoring the urge when you need to go to the bathroom

In order to prevent constipation, it is important to maintain proper hydration by consuming a minimum of three litres of water daily. If you are exposed to circumstances such as high temperatures or engage in physically demanding work that causes excessive sweating, it may be necessary to consume even more water to ensure adequate hydration levels.

Other causes include:

  • - Anal fissure, also a complication of chronic constipation
  • - A blockage in your colon or rectum
  • - Problems with your pelvic muscles or nerves
  • - Irritable bowel syndrome (IBS)
  • - Inflammatory bowel disease (IBD)
  • - Diverticulitis

Risk Factors

There are specific factors that can increase the likelihood of experiencing constipation, although their presence does not necessarily guarantee its occurrence. These risk factors may comprise:

  • - Over the age of 60
  • - People who are pregnant
  • - Recently gave birth (6 weeks or less)
  • - Diabetes, upsetting your hormone balance
  • - Certain cancers, such as colon and bowel cancer
  • - People with certain mental health conditions, such as depression and eating disorders

When is constipation an emergency?

Certain symptoms warrant immediate medical attention and should not be ignored. If you experience any of the following symptoms, it is recommended to seek prompt medical advice:

  • - More than a little blood in your stool
  • - Bleeding from your back passage
  • - Very dark or black stool
  • - Severe abdominal pain
  • - Constipation between bouts of diarrhoea

If you encounter these symptoms, it may indicate that you are bleeding in your digestive tract or experiencing an intestinal blockage, which can potentially become life-threatening emergencies. Therefore, seeking urgent medical attention is crucial.

Diagnosis

In order to diagnose your constipation, we will begin by enquiring about your medical history and conducting an assessment of your symptoms. This will include obtaining information about the duration of your symptoms, the nature of the symptoms, and any dietary alterations you have implemented.

If you observe that certain foods exacerbate your constipation, maintaining a record of these foods and notifying us of them would be beneficial.

It is imperative that we are aware of any other underlying medical conditions that you may have, as they could be contributing to or causing your symptoms.

Further diagnostic tests may be necessary to investigate the cause of your constipation. If we suspect that a problem with your colon is the root cause of your symptoms, we may suggest a colonoscopy.

In addition, we may perform blood tests to evaluate your hormone levels.

Treatment

As a preliminary step, it may be worthwhile to attempt some home remedies before seeking the advice of one of our specialists.

The following are some examples of home remedies that you may consider:

Lifestyle changes

If you are currently taking medication for another medical condition, such as diabetes or depression, it is important to discuss the potential side effects with your doctor. If your symptoms of altered taste persist, it is not advisable to simply tolerate them. Instead, we recommend scheduling an appointment with a qualified doctor or gastroenterologist for further evaluation and potential treatment options.

  • - Drinking plenty of water (at least 3 litres a day)
  • - Eating more high fibre foods
  • - Exercise regularly – daily walks can make a difference if you struggle with activity
  • - Managing your stress levels

If the aforementioned home remedies are ineffective, we recommend consulting with one of our specialists for further guidance.

We may prescribe medications to relieve your symptoms or suggest modifications to your current medication regimen if it is found to be contributing to your symptoms.

Following any necessary diagnostic testing, we may determine that a specific condition, such as IBS, is responsible for your symptoms. We can subsequently provide guidance on lifestyle modifications that may assist in reducing your symptoms and offer additional advice regarding your condition.

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