Patient Tips: How to talk about bowel issues with your doctor

How to talk about bowel issues with your doctor

Patient Tips

How to talk about bowel issues with your doctor

Digestive problems are common, and many people experience symptoms such as bloating, abdominal pain, and changes in bowel habits. However, it can be challenging to discuss these symptoms with your doctor, especially if they are embarrassing or uncomfortable to talk about. In this article, we will provide tips for patients on expressing their digestive concerns to their doctor effectively.

Be honest and open

It’s essential to be honest, and open with your doctor about your digestive symptoms. Don’t be embarrassed or ashamed to discuss your symptoms, as they are common and can be treated. Your doctor needs to know about your symptoms to diagnose and treat your condition accurately.

Keep a symptom diary

Keeping a symptom diary can help you track your symptoms and provide your doctor with valuable information. Note down what you eat, when you experience symptoms and the severity of your symptoms. This information can help your doctor diagnose your condition and determine your best treatment plan.

Be specific

When discussing your digestive symptoms with your doctor, be specific about what you are experiencing. For example, describe the pain’s location, the discomfort’s severity, and any associated symptoms such as nausea or diarrhoea. Being specific can help your doctor understand your symptoms and diagnose your condition accurately.

Ask questions

Don’t be afraid to ask your doctor questions about your digestive symptoms. Ask about possible causes, diagnostic tests, and treatment options. Understanding your condition and treatment options can help you feel more in control of your health.

Discuss your medical history

Your medical history can provide valuable information about your digestive symptoms. Be sure to discuss any previous digestive conditions, surgeries, or medications you are taking with your doctor. This information can help your doctor diagnose and treat your condition accurately.

Follow up with your doctor.

The treatment for non-cardiac chest pain depends on the underlying cause. If the pain is due to muscular problems, rest and pain relief medication may be recommended. Spinal disorders may require physical therapy or surgery. Lung diseases may require medication or oxygen therapy. Anxiety, depression, or panic attacks may be treated with therapy, medication, or relaxation techniques.

In cases where chest pain is caused by GERD, oesophageal muscle relaxants and medications, such as proton pump inhibitors, may be prescribed. In some cases, botox injections may be used to relax the muscles of the oesophagus. Neuromodulators, such as amitriptyline tablets, may be used to treat the pain associated with non-cardiac chest pain.

In conclusion, non-cardiac chest pain can have a wide range of causes, and it is important to seek medical attention if you experience sudden chest pain. Your doctor can perform tests to determine the underlying cause of the pain and recommend appropriate treatment.

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Non-cardiac chest pain

Non-cardiac chest pain

Conditions

Non-cardiac chest pain

What You Need to Know

Chest pain can be a scary symptom, causing many people to worry that they are having a heart attack. However, chest pain can have a wide range of causes, including non-cardiac issues. In this article, we will explore non-cardiac chest pain, including its causes, symptoms, and treatments.

What is Non-Cardiac Chest Pain?

Non-cardiac chest pain refers to pain in the chest that is not caused by a cardiovascular disorder, such as angina or a heart attack. There are numerous causes of non-cardiac chest pain, including muscular problems, spinal disorders, fractures, lung diseases, anxiety, depression, and digestive issues.

Causes of Non-Cardiac Chest Pain

Muscular problems, such as strained muscles, can cause chest pain that is often described as a sharp, stabbing pain in a specific location. Spinal disorders, such as herniated discs, can also cause chest pain that may radiate to the chest.

Lung diseases, such as bronchitis or pneumonia, can cause pain in the chest that may be accompanied by a cough, shortness of breath, or wheezing. Anxiety, depression, or panic attacks may trigger chest pain that feels like a tightness or pressure in the chest.

In digestive health, the oesophagus is a possible location of pain in the chest. Gastro-oesophageal reflux disease (GERD) is a common condition that causes acid and bile to rise up the oesophagus from the stomach, causing inflammation and pain. The discomfort will usually feel like burning, which is why it’s described as ‘heartburn’. Other digestive issues, such as stomach ulcers, gallstones, pancreatitis, and inflammatory bowel disease, may also contribute to chest pain.

Symptoms of Non-Cardiac Chest Pain

Symptoms of non-cardiac chest pain can vary depending on the underlying cause. The pain may be specific to one point, a whole side, or more generalised within the chest cavity. The discomfort may feel like burning, stabbing, or pressure. Other symptoms, such as coughing, shortness of breath, nausea, or bloating, may also be present.

Symptoms of Non-Cardiac Chest Pain

Diagnosing non-cardiac chest pain can be challenging, as the symptoms can be similar to those of a heart attack. However, it is important to seek medical attention if you experience sudden chest pain. Your doctor may perform a physical exam, ask about your medical history and symptoms, and order tests, such as gastroscopy, barium swallow, 24-hour pH impedance, high-resolution oesophageal manometry, chest x-ray, or CT scan.

Treating Non-Cardiac Chest Pain

The treatment for non-cardiac chest pain depends on the underlying cause. If the pain is due to muscular problems, rest and pain relief medication may be recommended. Spinal disorders may require physical therapy or surgery. Lung diseases may require medication or oxygen therapy. Anxiety, depression, or panic attacks may be treated with therapy, medication, or relaxation techniques.

In cases where chest pain is caused by GERD, oesophageal muscle relaxants and medications, such as proton pump inhibitors, may be prescribed. In some cases, botox injections may be used to relax the muscles of the oesophagus. Neuromodulators, such as amitriptyline tablets, may be used to treat the pain associated with non-cardiac chest pain.

In conclusion, non-cardiac chest pain can have a wide range of causes, and it is important to seek medical attention if you experience sudden chest pain. Your doctor can perform tests to determine the underlying cause of the pain and recommend appropriate treatment.

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Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS)

Conditions

Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a common digestive condition that affects millions of people worldwide. It is estimated that 10 – 15 percent of the population has IBS. This condition is not limited to a specific age group and can affect people of all ages, although most people affected by IBS are under 50.

The symptoms of IBS can be distressing and can include bloating, flatulence, tiredness, stomach cramps, diarrhoea or, in some cases, constipation. The symptoms can be intermittent or ongoing and can affect people moderately or more severely, with some people finding that their symptoms interfere with daily life. Women may find that their symptoms are worse during their time of menstruation or if they have continuous symptoms.

Doctors do not fully understand the causes of IBS, but there is a strong association with diet and stress, leading to oversensitivity of the nerves in the gut. This oversensitivity may cause food to pass through the gut too quickly or too slowly, leading to diarrhoea or constipation. There may also be hereditary factors that make it more likely for you to develop IBS, or a previous bacterial infection in the gut, known as post-infectious IBS. Doctors have some understanding of the physical process in the gut which leads to symptoms, including a slowing down of movements in the large intestine which causes cramping, and abnormal serotonin levels in the large intestine, which affects bowel movements.

There is no known cure for IBS, but it can be managed with lifestyle changes and medication. If you suspect that you have IBS, it is important to see an IBS specialist. An IBS specialist is a gastroenterologist who specializes in diagnosing and treating IBS. IBS shares symptoms with other conditions, so it is crucial to rule out other similar conditions. An IBS specialist will not only diagnose your condition but also give you detailed advice on how to manage it.

To diagnose IBS, you will need to tell the IBS specialist about the kinds of symptoms you are experiencing, when they started, and whether they are occasional or happening all the time. You will also need to let them know if your symptoms are worse after eating particular kinds of food. Keeping a food diary plus a note of your symptoms will help you remember this information and manage the problem later. Because the causes of IBS are unclear, there is no actual test for the condition. Your doctor may run blood tests and take stool samples to rule out an infection, coeliac disease or inflammatory bowel disease. Once these other causes are ruled out, your doctor can give you an IBS diagnosis.

In conclusion, IBS is a common condition that can affect anyone, and its symptoms can be distressing. However, it can be managed with lifestyle changes and medication. If you suspect that you have IBS, it is important to seek the advice of an IBS specialist who can diagnose your condition and provide you with the necessary information to manage it effectively. Remember, self-diagnosis is not a good idea, and it is essential to rule out other similar conditions to receive an accurate diagnosis.

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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.

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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.

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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

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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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:

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: 

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

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:

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

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

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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Get In Touch

Address

23 Widegate Street, City of London, London, E1 7HP, United Kingdom

Call Us

07404861023

Email Us

contact@dralbusoda.co.uk

What are piles or haemorrhoids? Read More »