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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change-in-taste

Change in taste

Symptoms

Change in taste

A transient alteration in taste is often attributed to viral infections such as colds and flu, or recent food intake. However, certain digestive health disorders may also be responsible for dysgeusia or a change in taste perception. If you frequently encounter such changes, it is recommended to consult one of our specialists for a thorough evaluation.

Further in this text, we provide insights into the symptoms and underlying causes of taste alteration, as well as effective treatment options.

Related Symptoms

  • - Swallowing Problems (Dysphagia)
  • - Acid reflux (heartburn) and indigestion
  • - Mouth sores and ulcers
  • - Hoarseness of voice

When to seek emergency care

In most cases, a change in taste does not require emergency treatment, but accompanying symptoms may indicate otherwise. For instance, if you encounter a sudden loss of taste coupled with difficulty breathing or swallowing, immediate medical attention may be necessary. It is also essential to seek emergency care if you experience a sudden change or loss of taste following a head injury.

Symptoms

Eating at least three times a day is essential to maintain good health. Therefore, it can be distressing when you lose your enjoyment of food due to altered taste. We have five primary tastes which are sweet, sour, bitter, salty, and umami. However, digestive health conditions can cause an altered sense of taste.

You may notice that all the foods you eat have a similar taste or a particular tang to them. Some people experience a lack of taste or a complete loss of taste (ageusia). These symptoms may occur intermittently or persistently.

A change in taste may be a sign of an underlying condition. We advise speaking to one of our specialists for an accurate diagnosis and appropriate treatment.

  • - Sour
  • - Foul
  • - Bitter
  • - Salty
  • - Metallic

An altered taste sensation may persist even after brushing your teeth, which can be an unpleasant experience. However, the type of taste experienced may vary depending on the underlying cause. For instance, acid reflux and indigestion can cause a bitter taste in the mouth, while a metallic taste may be a side effect of over-the-counter medications or vitamins, gastritis, or a temporary infection. Both can also be an indication of pregnancy.

Symptoms that could indicate digestive problems

A change in taste may be an isolated symptom, or it may manifest along with a range of other symptoms. In addition to altered taste, you may experience:

  • - Acid reflux (heartburn) and indigestion
  • - Swallowing Problems (Dysphagia)
  • - Coughing and throat clearing
  • - Chest pain and discomfort
  • - Mouth sores and ulcers
  • - Upper abdominal pain
  • - Hoarseness of voice
  • - Nausea and vomiting
  • - Constipation
  • - A dry mouth
  • - Bad breath
  • - Bloating

Causes of a change in taste

An altered sense of taste may be a result of certain lifestyle choices such as smoking or dental issues. It can also be a side effect of certain medications or oral supplements. Additionally, undergoing cancer treatment can lead to a change in taste.

Moreover, some digestive health conditions can cause persistent or frequent changes in taste. These conditions include:

  • - Gastritis
  • - Functional heartburn
  • - Nutrient deficiencies
  • - Functional dyspepsia
  • - Gastrointestinal infection
  • - Laryngopharyngeal reflux (LPR)
  • - Burning mouth syndrome (BMS)
  • - Gastro-oesophageal reflux disease (GORD)

GORD

Gastro-oesophageal reflux disease (GORD) is a prevalent cause of an enduring unpleasant taste in the mouth. It results in long-term acid reflux. Along with a persistent bad taste, GORD may also lead to bloating, halitosis, dysphagia, and chronic sore throat (oesophagitis). Laryngopharyngeal reflux (LPR), also known as silent reflux, presents with the same symptoms as GORD but is often asymptomatic.

Burning mouth syndrome

Burning mouth syndrome, though uncommon, frequently results in a bitter or metallic taste in the mouth. The primary symptom is a burning sensation that occurs on the lips, tongue, or other regions of the mouth. You may notice that your symptoms worsen as the day progresses, whereas symptoms of GORD tend to be strongest in the morning, after sleep.

 

Medications

Certain medications can impact your sense of taste and smell. These include:

  • - Diuretics
  • - Beta blockers
  • - Antihistamines
  • - Antidepressants
  • - Blood pressure medications
  • - Antibiotics, such as metronidazole
  • - Multivitamins containing minerals or metals, such as copper, iron, or zinc

Diagnosis

In your initial consultation, we will conduct a visual assessment and discuss your symptoms in depth. We will enquire about any associated symptoms, the severity and discomfort of your symptoms, and if this change in taste is more prominent at certain times of the day or after consuming certain foods. We will also ask for your medical history and possibly the medical history of your close family.

The specific diagnostic tests we recommend will depend on the information gathered during your initial consultation. An upper endoscopy, also known as gastroscopy, is a common diagnostic test that can be used to investigate various digestive problems, such as GORD, LPR, functional heartburn, functional dyspepsia, and gastritis.

If we suspect burning mouth syndrome, a blood test may be recommended to identify any nutritional deficiencies that could be contributing to your symptoms. Additionally, a mouth swab may be performed to rule out a fungal infection, such as oral thrush, which could lead to secondary BMS.

Treatment

We customize our treatment plans to suit your specific symptoms and diagnosis. The recommended treatment will be based on the results of the diagnostic tests we perform. If you suspect that a dental problem is causing your symptoms, we advise you to consult a dentist.

The treatment options range from simple lifestyle modifications to prescription medications and in some cases, surgery. Surgical intervention may be considered if the symptoms, such as acid reflux, are severe and do not respond to medications.

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.

  • - Quit smoking
  • - Drink plenty of fluids
  • - Chewing sugar-free gum
  • - Try eating more cold foods
  • - Avoiding acid reflux risk factors
  • - Limit spicy and extremely sweet foods
  • - Add flavour to foods with herbs, lemon, and sauces
  • - Regular dental care, e.g. flossing and tongue-scraping
  • - Replace metal cutlery and bottles with plastic or glass versions

Lifestyle changes

If we identify a deficiency in vitamins, we may suggest taking a vitamin supplement. We may also recommend consulting a dietician to discuss how to modify your diet. You may need to alter any supplements you are currently taking if we believe they are causing your symptoms.

If you frequently experience acid reflux, we may prescribe medications to reduce your reflux. These may include H2 blockers, such as famotidine, or proton pump inhibitors (PPIs), such as omeprazole. We may also suggest lifestyle changes, such as limiting your consumption of coffee and alcohol and sleeping at an incline.

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bloating

Bloating

Symptoms

Bloating

This article  provides guidance on bloating symptoms, including how to identify its causes and how to begin addressing digestive issues. If you are experiencing bloating, we recommend consulting with one of our gastroenterologists to receive expert care and advice.

Related Symptoms

  • - Abdominal pain
  • - Acid reflux (heartburn) and indigestion
  • - Belching and burping
  • - Diarrhoea

What is bloating?

Abdominal bloating, medically known as abdominal distension, is a condition that causes swelling or a feeling of fullness in the belly. Common symptoms of bloating include discomfort such as abdominal pain, excessive wind, burping or flatulence, and the urgent need to have a bowel movement. This is a prevalent health issue that can be caused by several factors, such as a build-up of gas in the lower digestive tract or fluid retention. Our team of specialists can assist in identifying the underlying cause of your bloating symptoms. Please book an appointment with one of our gastroenterologists for further evaluation and treatment.

Symptoms

  • - Belching and burping
  • - Constipation
  • - Diarrhoea
  • - Fever
  • - Heartburn (acid reflux)
  • - Indigestion (dyspepsia)
  • - Nausea and vomiting

These symptoms may be caused by a gastrointestinal infection. We recommend reviewing any medications you are currently taking as certain drugs, such as ibuprofen, can result in stomach irritation and bloating as side effects.

Typically, gas and bloating are regarded as more of an annoyance than a cause for concern. Bloating symptoms are not always accompanied by abdominal pain, and there are typically no reasons for alarm.

Causes

  • - What or how you eat
  • - Your physical fitness
  • - Your age
  • - Hormone changes (especially during the menstrual cycle and pregnancy)
  • - Lifestyle factors such as stress, anxiety or depression.

Bloating symptoms often emerge after eating a big meal, especially if you’ve eaten nothing for a few hours. In some cases, though, bloating is a symptom of a chronic disease or condition.

Other common bloating symptom triggers include:

  • - Spicy foods
  • - Dairy products
  • - Gluten
  • - Foods that are high in carbohydrates, salt or fat
  • - Alcohol
  • - Caffeine
  • - Fizzy carbonated drinks

Maintain a food diary over several weeks to keep track of specific items that may trigger a sensitivity in your body. Eliminate these items from your diet one by one, making it easier to identify potential causes. Our specialists can assist in identifying the probable triggers in your diet.

Diagnosis

It is crucial to be mindful that there may be significant underlying factors that can impact your digestive system. These include:

  • - Irritable bowel syndrome (IBS)
  • - Coeliac disease
  • - Diabetes
  • - Inflammatory bowel disease/ Crohn’s disease
  • - Small intestine bacterial overgrowth (SIBO)
  • - Endometriosis
  • - Diverticular disease and diverticulitis
  • - Cancer
  • - Liver disease

If you encounter one or more of the subsequent symptoms, it is recommended that you consult with one of our specialists to receive an accurate diagnosis.

  • - Persistent pain and/or swelling
  • - Blood in your bowel movements (stools will appear very dark)
  • - Vaginal bleeding when you’re not having your period
  • - Frequent, severe vomiting
  • - A high fever
  • - Unexpected weight loss.

To rule out any serious conditions you may need tests and scans. These can involve:

  • - X-ray, sometimes involving a barium swallow test
  • - Abdominal scans such as a CT or MRI
  • - Blood tests and stool tests to check for infections, allergies such as lactose intolerance or diseases

Diagnostic procedures such as imaging or biopsy can be performed using a thin and flexible instrument known as an endoscope. A gastroscopy is used when the instrument is passed through the mouth, while a colonoscopy is used when it is passed through the rectum. Our specialists may recommend these procedures to diagnose the cause of your digestive symptoms.

 

Treatments

Determining the underlying cause of bloating symptoms can be a challenging task. If you are experiencing persistent bloating, begin by assessing your diet. Consider if you are drinking sufficient water, eating too quickly, or chewing gum, which can cause you to swallow air.

We suggest consuming smaller portions of food and eating slowly. Avoid consuming unhealthy food and restrict the intake of gas-producing ingredients, such as beans and cabbage.

Following a diagnostic test, our specialists can recommend the most appropriate treatment for any specific conditions detected.

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Clinic Address

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

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07404861023

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020 7377 0939

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