Oesophageal cancer and pre-cancerous lesions

Oesophageal cancer and pre-cancerous lesions

Conditions

Oesophageal cancer and pre-cancerous lesions

Oesophageal cancer refers to a malignant growth that affects the oesophagus, also referred to as the food pipe or gullet. The symptoms of this condition can be caused by several digestive health conditions, with varying degrees of severity. Although not all symptoms indicate cancer, it is recommended to seek medical attention for any concerning symptoms.

The oesophagus is a tubular organ made of muscles that connects the throat to the stomach, facilitating the passage of food and liquids. Individuals with oesophageal cancer exhibit abnormal cell growth in their oesophagus, which spreads uncontrollably. This type of cancer can develop at any point along the oesophagus.

Symptoms

In the initial stages, oesophageal cancer may not exhibit any noticeable symptoms. However, as the condition progresses, symptoms may start to appear. The cancer usually progresses slowly and forms a tumour that can obstruct the throat as the cells in the oesophagus multiply.

The primary symptoms of oesophageal cancer are:

  • Pain in your throat or behind your breastbone
  • Bringing food back up (regurgitation)
  • Feeling or being sick
  • Persistent indigestion or heartburn
  • Difficulty swallowing (dysphagia)
  • Pain when swallowing
  • Feeling or being sick

In the early stages of oesophageal cancer, there may be no noticeable symptoms. However, as the condition progresses, abnormal cell growth in the oesophagus can create a tumour that could potentially obstruct the throat. Some common symptoms of this cancer include experiencing difficulty in swallowing, feeling as if food is stuck in the throat, persistent clearing of the throat, and oesophageal bleeding which can cause coughing up or vomiting of blood, though this is not common. Additionally, stools may appear darker than usual or bloody. Other symptoms may also be present.

Other symptoms include: 

  • Pain or discomfort in your chest, back or upper abdomen
  • Loss of appetite or weight
  • A continued cough
  • Voice hoarseness
  • Tiredness/ fatigue

There are several conditions that can cause the symptoms mentioned above, such as gastro-oesophageal reflux disease (GORD). However, it’s worth noting that having GORD can also raise your risk of developing oesophageal cancer. Therefore, if you experience these symptoms frequently or if your current treatment doesn’t seem to be working, it’s advisable to seek medical attention from your doctor.

Diagnosis

Abnormal cell growth in the oesophagus can result in pre-cancerous lesions, known as dysplasia. During an upper endoscopy, we can extract a sample of this tissue (biopsy) for testing. This test is painless as we numb your throat, and sedation is also an option. To learn more about endoscopy, you can watch this video: “Endoscopy: All You Need to Know”.

If a pathologist identifies signs of high-grade dysplasia, the risk of cancer is higher. Cancer can arise from either of the two main cell types found in the oesophageal lining. As it progresses, cancer may affect the surrounding tissues and organs or spread to other parts of the body. If we detect cancerous cells, we will perform additional tests to determine the stage, grade, and type.

Other tests include a CT scan, PET-CT, endoscopic ultrasound, barium swallow, and laparoscopy. Blood tests may also be necessary. If you experience concerning symptoms, it is important to see your doctor promptly for evaluation.

Types

In medical terms, the type of cell in which cancer originated is known as histology. The two primary histological types of oesophageal cancer are adenocarcinoma and squamous cell carcinoma. Adenocarcinoma is frequently associated with Barrett’s oesophagus and is more common in the UK. In contrast, squamous cell cancer occurs less frequently. Other, less common histological types include small-cell carcinoma, sarcoma, melanoma, lymphoma, and choriocarcinoma. In some cases, we may not be able to identify the specific histological type of cancer, which we refer to as undifferentiated.

Causes

The precise cause of oesophageal cancer remains uncertain. However, it may result from DNA damage in the cells that line the interior of the oesophagus. DNA damage can arise from various lifestyle choices, such as smoking, or prolonged irritation caused by reflux and other medical conditions. Such DNA mutations or alterations may cause cancer. In oesophageal cancer cells, numerous genes may display changes.

Risk factors

The majority of individuals diagnosed with oesophageal cancer are over the age of 60, with men being more frequently affected than women. Other risk factors include being overweight, smoking, or consuming alcohol, particularly more than 14 units per week. Pre-existing conditions such as GORD or Barrett’s oesophagus also increase the risk of developing oesophageal cancer. Additionally, the risk slightly increases after radiotherapy for certain cancers, such as breast, lung, oropharyngeal, or laryngeal cancer. Furthermore, there are reports suggesting that consuming freshly boiled or equally hot drinks may raise the risk of developing oesophageal cancer.

Causes

The precise cause of oesophageal cancer remains unknown. Nevertheless, it is thought to result from DNA damage in the cells that line the interior of the oesophagus. This damage can be caused by certain lifestyle choices, such as smoking, or by chronic irritation from conditions such as reflux. The DNA mutations or changes that result from such damage can lead to the development of cancerous cells. In oesophageal cancer, many genes may undergo changes or mutations.

Treatment

Early stages of oesophageal cancer or pre-cancer can be treated with endoscopic procedures, such as endoscopic resection and HALO radiofrequency ablation, which can remove abnormal tissue and prevent the need for an oesophagectomy (surgical removal of part of the oesophagus). Other treatment options include chemotherapy, radiotherapy, targeted therapy, and immunotherapy.

A multidisciplinary team of highly qualified specialists will work with you to develop a personalised treatment plan based on the stage, grade, and type of cancer.

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High-resolution manometry of the oesophagus

Eosinophilic oesophagitis (EoE)

Conditions

Eosinophilic oesophagitis (EoE)

Eosinophilic oesophagitis, commonly referred to as oesophageal asthma, is an uncommon condition that affects approximately one in 3,000 individuals in the United Kingdom. This disorder results in persistent inflammation of the tissue in the oesophagus, also known as the food pipe. While some individuals experience severe and distressing symptoms, others may only experience mild discomfort.

The symptoms of eosinophilic oesophagitis can manifest differently based on an individual’s age and personal experience. In the context of this page, we will focus on EoE as it occurs in adults. However, it’s worth noting that infants and children are also susceptible to developing EoE.

Related Symptoms

  • Heartburn or reflux
  • Feeling tired/ fatigue
  • Feeling or being sick
  • Weight loss and malnutrition
  • Bringing food back up (regurgitation)
  • Food stuck in the oesophagus (impaction)
  • Centrally-located chest pain that does not respond to antacids

Certain individuals may adapt their eating habits to manage the symptoms associated with EoE. This may include chewing food thoroughly, taking longer than usual to consume a meal, preferring softer foods, or drinking frequently while eating. Additionally, the condition may hinder an individual’s ability to participate in social activities involving food consumption, such as sharing a meal with others.

When to seek emergency help

In the event that food becomes lodged in the oesophagus, it may result in severe circumstances whereby the oesophagus is entirely obstructed. Should you encounter challenges with breathing, experience noisy breathing or choking, it is imperative that you seek emergency assistance.

We recommend that you schedule a consultation with our specialist if you are persistently experiencing a sensation of an object stuck in your throat.

Diagnosis

During your visit to our specialist, a gastroenterologist, we will enquire about your symptoms in detail. This will entail understanding the nature, frequency and severity of your symptoms, as well as your personal and familial medical history.

If there is a suspicion of EoE, we may undertake a barium swallow test or an upper endoscopy (gastroscopy). Additionally, blood tests may be carried out.

The barium swallow test entails consuming barium sulphate prior to a series of X-rays. This is commonly referred to as an oesophagogram.

Upper endoscopy involves the examination of your upper digestive tract through the insertion of an endoscope into your mouth. The endoscope, which is a slender, flexible tube equipped with a light and camera, may be used to obtain a biopsy (a small tissue sample). The results of the endoscopy will inform our recommendations for treatment.

Causes

EoE occurs due to an excessive accumulation of eosinophils (white blood cells) in the tissues of the food pipe. The underlying cause of this occurrence is not entirely clear, although researchers believe that it is connected to the body’s immune response to particular foods or environmental allergens.

As a result, we often observe EoE in individuals with allergy-related conditions like asthma, eczema, and rhinitis. Alternatively, an overabundance of white blood cells might arise from a genetic disorder.

Oesophageal strictures (narrowing in the food pipe) can occur in some individuals with EoE, which further impedes their ability to swallow.

If there is a suspicion of EoE, we may undertake a barium swallow test or an upper endoscopy (gastroscopy). Additionally, blood tests may be carried out.

The barium swallow test entails consuming barium sulphate prior to a series of X-rays. This is commonly referred to as an oesophagogram.

Upper endoscopy involves the examination of your upper digestive tract through the insertion of an endoscope into your mouth. The endoscope, which is a slender, flexible tube equipped with a light and camera, may be used to obtain a biopsy (a small tissue sample). The results of the endoscopy will inform our recommendations for treatment.

Risk factors

If there is a family history of EoE, there may be an increased risk of the condition. While EoE can occur at any age, individuals aged between 30 to 50 are more frequently diagnosed with it. Additionally, EoE is more commonly diagnosed in men than women.

The following factors are also associated with EoE:

  • Caucasian race
  • Climate – dry or cold
  • Season – higher pollen levels
  • A lack of early exposure to microbes
  • Atopy (Genetically more likely to develop allergic diseases)

Treatment

Our gastroenterologist may suggest a blend of lifestyle modifications and medication as treatment for EoE, dependent on the severity of your symptoms. Dr. Sami is an authority in this area and is a co-author of the UK’s EoE guidelines.

Lifestyle changes

Dietary adjustments play a crucial role in the management of EoE. Modifying your diet can aid in identifying any foods that may be triggering your EoE symptoms, through an elimination diet approach. This approach involves eliminating the most prevalent allergens from your diet, typically through a two, four, or six-food elimination diet, depending on your specific case.

Common allergens

  • Dairy products, such as milk
  • Fish/shellfish
  • Wheat
  • Eggs
  • Soya
  • Soya
  • Nuts

It is essential to note that the elimination diet approach can be a prolonged process that may take several months to show significant improvement. Additionally, it is possible that some individuals may not experience immediate relief after removing certain foods, as their EoE symptoms could be due to environmental allergies rather than dietary factors.

Environmental allergens

  • Animals
  • Dust mites
  • Moulds
  • Pollen

Medications

Our recommended treatment plan for EoE may involve the use of proton pump inhibitors (PPIs) and topical steroids to manage inflammation and prevent narrowing of the oesophagus.

Proton Pump Inhibitors

In cases where acid reflux causes inflammation in eosinophilic oesophagitis, a proton pump inhibitor (PPI) may be prescribed. This medication targets the cells lining the stomach and decreases acid production, potentially reducing the number of eosinophils present in the oesophagus.

Swallowed Budesonide (weak steroid)

Jorveza is the first licensed medication for treating EoE. Its active ingredient is budesonide, which is a weak corticosteroid. Corticosteroids work by binding to receptors on immune cells, thereby reducing the release of inflammatory substances. Compared to other treatments, Jorveza has the highest success rate.

Endoscopic dilatation

We can perform endoscopic dilatation to expand your oesophagus if you are experiencing narrowing. This procedure involves the use of an endoscope, a thin and flexible tube that carries a dilating device to the location of the narrowing. The device is then employed to gradually stretch the narrowing.

It may require several sessions to adequately widen the oesophagus, and further procedures may be necessary if the narrowing reoccurs.

Endoscopy

If food impaction occurs, an endoscopy may be necessary to remove the food bolus. Food impaction can cause chest and neck pain and regurgitation. Depending on the size of the food bolus and the severity of symptoms, an emergency endoscopy may be required.

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Haemorrhoids

What are piles or haemorrhoids?

Conditions

What are piles or haemorrhoids?

Piles or hemorrhoids are swollen veins in the anus and lower rectum that can cause discomfort, pain, and bleeding. They are a common condition and affect millions of people worldwide.

There are two types of hemorrhoids: internal and external. Internal hemorrhoids are located inside the rectum and are usually painless. External hemorrhoids are located under the skin around the anus and can cause itching, pain, and bleeding.

Common causes of hemorrhoids include straining during bowel movements, sitting for long periods of time, constipation, and a low-fiber diet. Pregnancy and obesity can also increase the risk of developing hemorrhoids.

Symptoms of hemorrhoids may include itching or burning in the anal area, pain or discomfort during bowel movements, bright red blood in the stool or on toilet paper, and a lump or swelling near the anus.

Treatment for hemorrhoids often begins with lifestyle modifications, such as increasing fiber and fluid intake, and avoiding straining during bowel movements. Over-the-counter creams and ointments, as well as warm baths, can also help relieve symptoms. In severe cases, surgical procedures, such as hemorrhoidectomy, may be necessary.

If you have symptoms of hemorrhoids, it is important to see a healthcare provider for an accurate diagnosis and proper treatment. Early diagnosis and treatment can help reduce the risk of complications and improve quality of life.

How can you reduce your risks of haemorrhoids?

There are several ways to reduce your risk of developing hemorrhoids:

  1. Eat a high-fiber diet: Eating a diet that is rich in fiber can help prevent constipation and reduce strain during bowel movements, which are key risk factors for hemorrhoids. Foods high in fiber include whole grains, fruits, vegetables, legumes, and nuts.
  2. Drink plenty of water: Staying hydrated can help prevent constipation and make stools easier to pass, reducing the risk of developing hemorrhoids. Aim to drink at least 8 glasses of water per day.
  3. Exercise regularly: Regular physical activity can help improve bowel function and reduce the risk of constipation. Aim for at least 30 minutes of moderate exercise per day.
  4. Avoid prolonged sitting: Sitting for long periods of time can increase the pressure in the veins in the anus and rectum, leading to the development of hemorrhoids. Try to stand up and move around every 30 minutes if you have a sedentary job.
  5. Avoid straining during bowel movements: Straining during bowel movements can increase the pressure in the veins in the anus and rectum, leading to the development of hemorrhoids. Try to have regular, soft bowel movements and avoid straining.
  6. Don’t delay bowel movements: Holding in stool can lead to constipation and increase the risk of developing hemorrhoids. Try to have a bowel movement as soon as you feel the urge.
  7. Lose weight: Obesity can increase the pressure in the veins in the anus and rectum, leading to the development of hemorrhoids. If you are overweight or obese, losing weight can reduce your risk of developing hemorrhoids.

If you have symptoms of hemorrhoids or are at increased risk, it is important to see a healthcare provider for a proper diagnosis and treatment plan. Early treatment can help reduce the risk of complications and improve quality of life.

How do we treat haemorrhoids?

Treatment for hemorrhoids often begins with lifestyle modifications and over-the-counter remedies. Some common treatments include:

  1. Increasing fiber and fluid intake: Eating a high-fiber diet and drinking plenty of water can help soften stools and reduce straining during bowel movements, which can help relieve symptoms and promote healing.
  2. Over-the-counter creams and ointments: Over-the-counter creams and ointments, such as hydrocortisone, can help relieve itching and pain.
  3. Warm baths: Warm baths, especially Sitz baths, can help soothe the anal area and promote healing.
  4. Topical treatments: Topical treatments, such as witch hazel, aloe vera, and petroleum jelly, can also help relieve symptoms.

If lifestyle modifications and over-the-counter remedies are not effective, a healthcare provider may prescribe stronger medications or recommend minimally invasive procedures, such as:

  1. Rubber band ligation: A rubber band is placed around the base of the hemorrhoid to cut off the blood supply, causing the hemorrhoid to shrink.
  2. Sclerotherapy: A solution is injected into the hemorrhoid to shrink it.
  3. Infrared coagulation: A device is used to apply heat to the hemorrhoid, causing it to shrink.
  4. Hemorrhoidectomy: A surgical procedure to remove the hemorrhoid.

The treatment plan will depend on the severity of the hemorrhoids, the individual’s symptoms, and any underlying health conditions. It is important to see a healthcare provider for a proper diagnosis and treatment plan. Early treatment can help reduce the risk of complications and improve quality of life.

Can you reduce your risk of bowel cancer

Yes, there are several lifestyle changes you can make to reduce your risk of developing bowel cancer. Some of these include:

  1. Eating a healthy diet: A diet that is high in fiber and low in fat and red meat may reduce the risk of developing bowel cancer. Eating plenty of fruits, vegetables, and whole grains may help lower the risk.
  2. Maintaining a healthy weight: Being overweight or obese is a risk factor for developing bowel cancer. Maintaining a healthy weight through diet and exercise can help reduce the risk.
  3. Regular physical activity: Regular physical activity has been shown to reduce the risk of developing bowel cancer. Aim for at least 30 minutes of moderate-intensity physical activity, such as brisk walking, every day.
  4. Avoiding tobacco and excessive alcohol: Smoking and excessive alcohol consumption are both risk factors for developing bowel cancer. Quitting smoking and limiting alcohol intake can help reduce the risk.
  5. Getting regular screening: Regular screening can help detect bowel cancer in its early stages, when it is most treatable. The recommended age to start screening depends on various factors, including family history, but typically starts at age 50 or earlier if there is a personal or family history of bowel cancer.

It is important to remember that these changes can also benefit overall health and well-being, so even if they do not prevent bowel cancer, they can have many other positive health effects.

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.

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What is H pylori?

What is H pylori?

Conditions

What is H pylori?

H pylori (Helicobacter pylori) is a type of bacteria that can infect the lining of the stomach. This bacteria is a common cause of gastritis (inflammation of the stomach lining), peptic ulcers, and even stomach cancer. H. pylori infections are usually acquired during childhood and are often asymptomatic, meaning that many people infected with the bacteria don’t experience any symptoms. However, in some cases, H. pylori infections can cause symptoms such as heartburn, nausea, bloating, and abdominal pain. Treatment for H. pylori typically involves a combination of antibiotics and acid-reducing medications.

How to test for H pylori ?

There are several ways to test for H. pylori, including:

  1. Blood test: This test looks for antibodies to H. pylori in your blood, indicating that you have been infected.
  2. Stool antigen test: This test looks for H. pylori antigens in your stool, indicating that the bacteria is present in your digestive system.
  3. Urea breath test: This test involves drinking a liquid containing a special type of urea that is broken down by H. pylori. If you have H. pylori in your stomach, the bacteria will break down the urea and produce carbon dioxide. This can be detected by breathing into a machine, which measures the amount of carbon dioxide in your breath.
  4. Endoscopic biopsy: During an endoscopy, a small sample of tissue is taken from the lining of your stomach to test for the presence of H. pylori.

Your doctor may recommend one or more of these tests to diagnose H. pylori, and will help determine the best test or combination of tests for you based on your individual medical history and symptoms.

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Postcholecystectomy syndrome?

What is Postcholecystectomy syndrome?

Conditions

What is Postcholecystectomy syndrome?

Postcholecystectomy syndrome (PCS) refers to a group of symptoms that can occur after removal of the gallbladder (cholecystectomy). This can include abdominal pain, bloating, diarrhea, constipation, and reflux, among others. The exact cause of PCS is not well understood, but it is thought to be related to changes in the way bile is metabolized in the body after removal of the gallbladder. Some people may also experience changes in the gut microbiome after cholecystectomy, which may contribute to symptoms of PCS. Treatment options for PCS can vary and may include changes to diet and lifestyle, medications to manage specific symptoms, and in some cases, additional surgeries.

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Functional dyspepsia

What is Functional dyspepsia?

Conditions

What is Functional dyspepsia?

Functional dyspepsia (FD) is a digestive disorder characterized by symptoms such as bloating, fullness, upper abdominal pain, nausea, and early feeling of fullness during or after eating. Unlike other digestive disorders, FD is not associated with any structural or biochemical abnormalities in the digestive system. The exact cause of FD is unknown, but some contributing factors may include:

  • Gastric acid reflux
  • Slow stomach emptying (gastroparesis)
  • Abnormal contractions of the muscles in the stomach and intestines
  • Stress and anxiety
  • Hormonal changes in women
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Bacterial infections
  • Certain foods and drinks

It is important to see a healthcare provider for an accurate diagnosis and treatment plan.

What is post prandial distress syndrome?

Postprandial distress syndrome (PDS) is a functional gastrointestinal disorder characterized by symptoms of upper abdominal pain, fullness, bloating, and nausea after eating. PDS is similar to functional dyspepsia, but with a specific emphasis on postmeal symptoms. The exact cause of PDS is not known, but some possible factors include delayed gastric emptying, altered gut hormone secretion, and increased sensitivity of the gut to stretch and gas. PDS is often treated with dietary modifications, lifestyle changes, and medication to relieve symptoms and improve gut function.

What is Visceral pain hypersensitivity?

Visceral pain hypersensitivity is a condition in which there is increased sensitivity to pain in the internal organs, such as the intestines. This type of pain is often experienced as abdominal discomfort, cramping, bloating, and tenderness. Visceral pain hypersensitivity is seen in several gastrointestinal disorders, including irritable bowel syndrome (IBS), functional dyspepsia, and inflammatory bowel disease (IBD). The exact cause of visceral pain hypersensitivity is not well understood, but it is thought to be related to changes in the processing of pain signals by the nervous system, increased gut sensitivity, and altered gut motility. Treatment for visceral pain hypersensitivity may include dietary changes, medications to relieve symptoms, and therapy to manage stress and anxiety.

What is Supragastric belching?

Supragastric belching (SGB) is a condition characterized by frequent and excessive belching, which is not due to swallowed air or gastrointestinal (GI) causes such as acid reflux or bloating. SGB is believed to be caused by a dysfunction in the upper esophageal sphincter (UES) and/or pharyngeal muscles, leading to an overproduction of air and excessive belching. The exact cause of SGB is not well understood and the condition can be difficult to diagnose and treat. However, it has been associated with psychological factors such as stress and anxiety, as well as with certain medical conditions such as Gastroesophageal Reflux Disease (GERD). Treatment may include lifestyle modifications, medications, and in some cases, surgery to correct any underlying anatomical abnormalities.

What is Low stomach acid (achlorhydria)

Low stomach acid, also known as achlorhydria, is a condition in which the stomach does not produce sufficient amounts of hydrochloric acid. This can cause a variety of symptoms, including indigestion, heartburn, bloating, belching, and abdominal pain. Low stomach acid can result from certain medical conditions, such as gastritis, hypothyroidism, and pernicious anemia. It can also be a side effect of certain medications, such as antacids, proton pump inhibitors, and H2 blockers. In some cases, lifestyle factors, such as stress and poor dietary habits, can also contribute to low stomach acid levels.

What is Bile salt malabsorption?

Bile salt malabsorption is a condition in which the body is unable to properly absorb bile salts. Bile salts are produced by the liver and stored in the gallbladder, where they are released into the small intestine to help with the digestion of fats. When bile salts are not properly absorbed, they can accumulate in the intestine, leading to symptoms such as diarrhea, bloating, and abdominal pain. Bile salt malabsorption is often associated with other digestive conditions, such as Crohn’s disease and irritable bowel syndrome. Treatment for bile salt malabsorption may include dietary changes, such as reducing the intake of fats and increasing the intake of soluble fiber, as well as medications that help absorb or replace bile salts.

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Small intestinal bacterial overgrowth (SIBO)

What is SIBO?

Conditions

What is SIBO?

Small intestine bacterial overgrowth (SIBO) is a condition in which there is an abnormal overgrowth of bacteria in the small intestine. The small intestine is typically relatively free of bacteria, but in SIBO, bacteria that are normally found in the large intestine migrate into the small intestine, where they can ferment carbohydrates and cause symptoms.

Common symptoms of SIBO include abdominal pain, bloating, diarrhea, constipation, and malnutrition. SIBO can also lead to nutrient deficiencies, as the bacteria in the small intestine can interfere with the normal absorption of nutrients.

SIBO is often caused by a dysfunction in the mechanisms that normally control the growth of bacteria in the small intestine, such as the ileocecal valve, which separates the small and large intestines, or the migrating motor complex (MMC), which helps to clear bacteria from the small intestine.

Risk factors for SIBO include conditions that slow down gut motility, such as diabetes and hypothyroidism, and the use of certain medications, such as proton pump inhibitors (PPIs), which reduce stomach acid.

The diagnosis of SIBO involves a breath test, in which the individual is asked to ingest a sugar solution and then breathe into a bag at intervals. The presence of elevated levels of certain gases in the breath indicates the presence of SIBO.

Treatment for SIBO typically involves a combination of dietary changes, antibiotics, and probiotics. It is important to work with a healthcare provider to develop a comprehensive treatment plan, as SIBO can be a complex and persistent condition.

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Laryngopharyngeal reflux (LPR}

Laryngopharyngeal reflux

Conditions

Laryngopharyngeal reflux

Laryngopharyngeal reflux (LPR) is a type of acid reflux that occurs when stomach acid flows back into the larynx (voice box) and pharynx (throat). LPR is also known as silent reflux because many people with LPR do not experience the classic symptoms of acid reflux, such as heartburn.

Instead, people with LPR may experience symptoms such as:

  • Hoarseness or loss of voice
  • Chronic throat clearing
  • Coughing
  • Trouble swallowing (dysphagia)
  • A sensation of a lump in the throat (globus)
  • A persistent sore throat
  • A constant need to clear the throat

LPR is often more difficult to diagnose than gastroesophageal reflux disease (GERD), as the symptoms are often less specific and can be attributed to other conditions. However, proper diagnosis is important as LPR can lead to serious complications if left untreated, including inflammation of the larynx and pharynx, voice problems, and even aspiration pneumonia.

Treatment for LPR typically involves lifestyle changes, such as avoiding certain foods and drinks that trigger symptoms, losing weight, quitting smoking, and elevating the head of the bed. Medications may also be prescribed to reduce stomach acid production. In some cases, surgery may be necessary to correct the underlying problem causing LPR.

If you are experiencing symptoms of LPR, it’s always a good idea to consult a doctor for a proper diagnosis and treatment plan.

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.

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Barrett’s Oesophagus

Barrett’s Oesophagus

Conditions

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.

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Inflammatory bowel disease (IBD)

Inflammatory bowel disease

Conditions

Inflammatory bowel disease (IBD)

IBD stands for Inflammatory Bowel Disease, which is a group of chronic disorders that cause inflammation of the digestive tract, including the large intestine (colon) and small intestine (small bowel). The two most common forms of IBD are Crohn’s disease and ulcerative colitis.

Crohn’s disease can affect any part of the digestive tract from the mouth to the anus, while ulcerative colitis affects only the colon. The symptoms of IBD can vary from person to person, but may include diarrhea, abdominal pain, weight loss, fatigue, and rectal bleeding. In severe cases, IBD can lead to malnutrition and other health problems.

The exact cause of IBD is not known, but it is believed to be a combination of genetic and environmental factors, including an abnormal immune response to the normal bacteria in the gut. There is no cure for IBD, but various treatments, including medication, surgery, and dietary changes, can help manage symptoms and prevent flares.

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