Screening aims to determine whether healthy people show any early signs of bowel cancer. Bowel cancer is a common form of cancer for men and women, with approximately 1 in 20 people experiencing it in their lifetime in the UK. Detecting early signs of risk for bowel cancer can ultimately save lives. Bowel cancer in its early stages is more likely to be treated successfully.
In the UK, people over the age of 60 are invited to be screened. Following this, you are invited every two years for screening until the age of 75. Screening involves home tests that detect blood in the stool. If you are registered with a GP in the UK, you will automatically be sent this home test after the age of 60.
Additionally, at age 55 you are invited for a one-off bowel scope screening test (also known as a flexible sigmoidoscopy) where a thin tube with a camera is used to examine the inside of the bowel. This test can detect polyps, which are small growths that could eventually turn into cancer. If polyps are detected, they can be removed.
Bowel cancer screening is offered because it can save lives by detecting early signs of bowel cancer, or your possible risk of developing it. The earlier it is detected, the more successful treatment is likely to be.
For the bowel scope screening, a few weeks before the appointment you will be sent a small plastic pouch containing liquid to perform an enema before the test, as well as instructions on how to do this. On the day of the test you will need to use the enema kit. This will induce a bowel movement before the test. You will also need to wear a hospital gown for the test.
For the home test kit, no preparation is required.
During a bowel scope screening, the camera tube is inserted gently into your bottom to check for polyps. This test is painless, but you might find it slightly uncomfortable. No anaesthesia is required. The test lasts just a few minutes and you return home soon after the test is finished.
The home test kit is for sending a small poo sample to be tested in a laboratory. You will receive instructions on how to take a stool sample with the kit.
Following the bowel scope test, if polyps are found you are told immediately following the test. If polyps are found and removed but are not cancerous you might also be offered a colonoscopy to check for polyps elsewhere in the bowel. If cancerous polyps are found and removed, you will be referred to a bowel cancer specialist to discuss treatment.
A normal result from a home test kit would indicate no blood in your stool, with no further action required other than another home test kit in two years’ time. If blood is found in your stool sample you will be offered a colonoscopy to do a more thorough investigation.
Gastroesophageal reflux is a digestive disorder where acid from the stomach leaks back into the oesophagus. It usually occurs because of weakness in the lower oesophageal sphincter, the ring of muscle between the oesophagus and stomach. It also occurs regularly in healthy people, where it manifests as heartburn or acid indigestion but these are usually short, sporadic episodes compared to long-term gastroesophageal reflux disease.
Inflammatory bowel disease (IBD) is used to refer to chronic diseases affecting the intestine. the most common are Crohn’s disease (CD) and ulcerative colitis (UC).
Irritable bowel syndrome (IBS) is a functional disorder of the large intestine.
IBS is characterised by abnormal movements in the muscles of the intestine, which cause discomfort and abnormal function, as well as constipation and diarrhoea alternately. IBS can also provoke abdominal pain, gas, bloating and changes in bowel habits.
Irritable bowel syndrome is usually associated with stress-related problems, although it has been shown that stress does not provoke it, but rather increases its effects. The exact causes of IBS are not clear, although it may occur after an intestinal infection.
This condition is often confused with inflammatory bowel disease (IBD) which, unlike IBS, is caused by the abnormal structure of the colon.
IBS is different in everyone and while the condition itself cannot truly be prevented, it can be avoided after diagnosis through certain lifestyle changes and management of the symptoms. For example, if you have IBS, it is not recommended to skip meals or eat later than you usually do, in addition to not rushing meals or eating too quickly. Avoiding spicy foods or ‘trigger’ foods can also help to keep IBS at bay. Many people with IBS prefer to cook their own meals as it means they can fully control what they are eating, thus avoiding triggers.
For the diagnosis of irritable bowel syndrome, there is no specific test, but it is necessary for the doctor to rule out other conditions in which symptoms are similar. Therefore your doctor may arrange for blood tests or stool samples to be taken to make sure the right diagnosis is given.
Although there is no cure for IBS once diagnosed, as it is a chronic condition, certain measures can help to alleviate the symptoms:
A colonoscopy is a type of endoscopy that is used to examine the colon and small intestine in order to detect any abnormalities (inflammation, ulcers, etc.). The procedure usually lasts around 15-20 minutes.
It is performed using a thin tube (endoscope) that is inserted through the anus and has a video camera at the end to record the organs and walls it passes through.
A colonoscopy may be performed for various reasons:
Before the test you should follow instructions for cleansing the bowel to make it easier for the doctor to observe it. This will involve drinking only liquids in the 24 hours before the procedure, and taking a solution that will help you empty your bowels.
During the procedure, you will be partially or fully sedated. You will be placed on your side and the doctor will insert the endoscope through the anus to pass through your large intestine.
A colonoscopy is usually well tolerated and is rarely painful. At most, you will feel pressure, swelling, or cramping during the procedure. Less than one per cent of patients will experience serious complications.
If the specialist feels that a more accurate evaluation is necessary, they will obtain a biopsy of the lining of the bowel for analysis.
If polyps are found during the procedure, these can be removed straight away.
There is now an alternative to traditional colonoscopy that is much less invasive and does not require sedation. This is called a virtual colonoscopy, which is an examination that uses images of the inside of the bowel and colon obtained by means of computerised tomography (CT or CAT scan) instead of images taken by the colonoscopy camera.
Endoscopy is the use of cameras to relay images from inside the body. The device used, known as an endoscope, is a long thin flexible tube with a camera at one end and a light source.
Endoscopes are inserted in to the body via a natural opening such as the mouth or the anus. There are different types of endoscopy depending on the site and function of the procedure – if the bowel is to be investigated for example, it is referred to as a colonoscopy. If the airways are to be examined, the procedure is referred to as a bronchoscopy.
Endoscopy can also be used for surgery, as in the case of laparoscopic surgery – in this situation the laparoscope (a specific type of endoscope) is inserted through small incisions. Once inserted, the endoscope is able to send images from the inside of the subject’s body back to a TV screen.
Endoscopy is most commonly used to investigate symptoms and help to diagnose conditions relating to the digestive system, although it can be deployed to produce images and aid with many other parts of the body, including the respiratory system, the urinary tract and the female reproductive system. An endoscope can also be used to assist with surgery.
An endoscopy is commonly used to investigate symptoms such as abdominal pain, nausea and vomiting, unexplained weight loss, diarrhoea, blood in the stool or vomiting blood.
You may be required to avoid food and liquids for a period beforehand, depending on what type of endoscopy you are undergoing. In the case of a colonoscopy, you might be given laxatives to help you evacuate any stool beforehand. You may also be required to stop taking certain medication such as blood thinners to prevent excess bleeding from the procedure.
The procedure usually only causes mild discomfort although a local anaesthetic is also sometimes used. It is normally performed with the patient conscious, although sedatives can be deployed to help you relax. Antibiotics are sometimes used to reduce risk of infection.
An endoscopy can be used to diagnose a wide range of conditions and the results are interpreted by a specialist. Whether the results are good or bad clearly depends on what symptoms are being investigated and on which part of the body the endoscopy is being performed.
Dr Adam Haycock is one of London’s top consultant gastroenterologists, specialising in endoscopy and colonoscopy, acid reflux and Barrett’s oesophagus, inflammatory bowel disease, and irritable bowel syndrome.
After graduating from St Mary’s Hospital he completed his specialist training in the North-West Thames region, completing an MD in endoscopy research and going on to become a highly skilled in all aspects of gastrointestinal and hepatobiliary disorders.
Interested in cutting-edge technology, Dr Haycock has contributed to the development of new techniques including the use of virtual reality simulation in colonoscopy. Work from his research has been published in peer-reviewed journals and he has been an invited guest speaker both at home and abroad.
Dr Haycock is also committed to education and is a fellow of the Higher Education Academy. His research interest is in improving the safety and quality of endoscopy and endoscopic training.
Well regarded in his field by his peers, he can provide the very highest level of care and quality of treatment to his patients. Dr Haycock has been the Chair of the UK Federation of Endoscopy Training Centres and is a member of the British Society of Gastroenterology.
Gastroesophageal reflux is a digestive disorder where acid from the stomach leaks back into the oesophagus. It usually occurs because of weakness in the lower oesophageal sphincter, the ring of muscle between the oesophagus and stomach. It also occurs regularly in healthy people, where it manifests as heartburn or acid indigestion but these are usually short, sporadic episodes compared to long-term gastroesophageal reflux disease.
What is an anal fissure?
An anal fissure (fissures) is a tear or crack in the lining of the anal canal (anus), which causes extreme pain during bowel movements. Anal fissures affect everyone, from men and women to young and old people. It is the most common cause of rectal bleeding in infancy. A fissure tends to occur when passing hard or large stools during a bowel movement. There may also be spasms in the ring of muscle at the end of the anus.
What is the cause of an anal fissure?
Common causes of an anal fissure include passing large stools, constipation and straining during bowel movements, chronic diarrhoea, inflammation of the anorectal area and childbirth. The less common causes of anal fissures include anal cancer, HIV, tuberculosis, syphilis and herpes.
What are the symptoms of an anal fissure?
The symptoms of an anal fissure include:
How is an anal fissure treated?
An anal fissure will often heal within a few weeks if the stool is kept soft through increasing the intake of fibre and fluids. Soaking in a warm bath for 10 to 20 minutes daily, especially after toilet use, helps to relax the sphincter and helps it to heal. A doctor may recommend topical anaesthetic creams for pain relief. A Botox (Botulinum toxic type A) injection can paralyse the anal sphincter muscle and aids in relaxing spasms. Blood pressure medications can also help relax the sphincter.
How to prevent an anal fissure?
By preventing constipation it may help in preventing an anal fissure. Constipation can be prevented when eating high-fibre foods, drinking water and regularly exercising to stop from straining during bowel movements.
Risk factors for developing an anal fissure
A bloated stomach is when the tummy is stretched and puffy, leaving a person feeling uncomfortable. The most common cause of a bloated stomach is gas and air, as gas builds up in the digestive tract when undigested food gets broken down, or from swallowing too much air when eating too fast. For some people, it can be from overindulging but for others, there could be an underlying medical reason such as a food intolerance or irritable bowel syndrome.
As a bloated stomach is only temporary, it is different from gaining fat mass around the stomach. It is built-up gas in the digestive system that makes the stomach uncomfortable and extends outward. Some people have described it as looking ‘pregnant’. There may be a pain in the abdomen, which should be checked if there are other symptoms occurring in the body.
Other symptoms to check for include:
• Fever
• Hives
• Watery eyes and itchy throat (allergic reaction)
• Constipation
• Diarrhoea
• Vomiting
• Blood in the stool
• Weight loss
• Fatigue
• Irregular periods
• Haemorrhoids
A bloated stomach is mostly caused by air becoming stuck around the abdomen and is normally a problem to do with digestion. There are lots of different underlying reasons that could cause a swollen abdomen, including allergies, hormonal imbalances, thyroid dysfunction and in rare cases, cancer. The possible causes include:
• Lactose intolerance
• Acid reflux
• Constipation
• Stomach flu
• Premenstrual syndrome
• Celiac disease
• A hiatal hernia
• Ovarian cyst
• Gallstones
• Urinary tract infection (UTI)
• Stomach cancer
• Crohn’s disease
In many cases of a bloated stomach, lifestyle changes can help diminish or prevent it from recurring. As the main cause of a bloated stomach is gas and air, in order to reduce swallowing too much air you can:
• Avoid chewing gum to stop swallowing extra air
• Avoid fizzy drinks
• Avoid foods known to cause gas such as lentils, beans and vegetables like cabbage, broccoli and sprouts.
• Avoid eating quickly, be mindful of chewing more slowly
• Cut back on dairy products
If lifestyle changes, particularly with the diet, don’t help in relieving or improving a bloated stomach, then the doctor may find a medical cause. The doctor may recommend medical treatment, which depends on the condition and the reason behind the abdominal pain.
Screening aims to determine whether healthy people show any early signs of bowel cancer. Bowel cancer is a common form of cancer for men and women, with approximately 1 in 20 people experiencing it in their lifetime in the UK. Detecting early signs of risk for bowel cancer can ultimately save lives. Bowel cancer in its early stages is more likely to be treated successfully.
In the UK, people over the age of 60 are invited to be screened. Following this, you are invited every two years for screening until the age of 75. Screening involves home tests that detect blood in the stool. If you are registered with a GP in the UK, you will automatically be sent this home test after the age of 60.
Additionally, at age 55 you are invited for a one-off bowel scope screening test (also known as a flexible sigmoidoscopy) where a thin tube with a camera is used to examine the inside of the bowel. This test can detect polyps, which are small growths that could eventually turn into cancer. If polyps are detected, they can be removed.
Bowel cancer screening is offered because it can save lives by detecting early signs of bowel cancer, or your possible risk of developing it. The earlier it is detected, the more successful treatment is likely to be.
For the bowel scope screening, a few weeks before the appointment you will be sent a small plastic pouch containing liquid to perform an enema before the test, as well as instructions on how to do this. On the day of the test you will need to use the enema kit. This will induce a bowel movement before the test. You will also need to wear a hospital gown for the test.
For the home test kit, no preparation is required.
During a bowel scope screening, the camera tube is inserted gently into your bottom to check for polyps. This test is painless, but you might find it slightly uncomfortable. No anaesthesia is required. The test lasts just a few minutes and you return home soon after the test is finished.
The home test kit is for sending a small poo sample to be tested in a laboratory. You will receive instructions on how to take a stool sample with the kit.
Following the bowel scope test, if polyps are found you are told immediately following the test. If polyps are found and removed but are not cancerous you might also be offered a colonoscopy to check for polyps elsewhere in the bowel. If cancerous polyps are found and removed, you will be referred to a bowel cancer specialist to discuss treatment.
A normal result from a home test kit would indicate no blood in your stool, with no further action required other than another home test kit in two years’ time. If blood is found in your stool sample you will be offered a colonoscopy to do a more thorough investigation.
Bowel incontinence describes a loss of control over bowel movements, leading to the patient unintentionally soiling themself. It is thought that as many as one in ten people will experience some degree of bowel incontinence in their lifetime, and is nothing to be ashamed of. It is usually symptomatic of another problem or underlying condition, and is not a normal part of ageing. It usually won’t just go away on its own, but it can be treated effectively, and often cured, so it is always best to consult your GP or a specialist.
Bowel incontinence itself is usually a symptom, not a diagnosis. It may occur as a sudden need to go to the toilet, but the patient may not make it in time (urge bowel incontinence). However, other patients have no warning before they soil themselves, feeling no sensation as the stool passes (passive incontinence/passive soiling). Passing wind may also cause slight soiling.
Most cases of bowel incontinence are brought on by bouts of diarrhoea, or conversely, constipation. Another common cause is weakening of the anal sphincter (the ring of muscle that opens and closes the anus).
Long-term causes, such as diabetes, multiple sclerosis, spina bifida, and even dementia can also cause bowel incontinence.
Maintaining a healthy diet and lifestyle can help to reduce the chances of getting diarrhoea or constipation, which are the leading causes of bowel incontinence. This can also stave off type 2 diabetes. However, there is no guarantee of preventing these problems, and there is nothing that can be done to prevent causes such as MS or dementia.
Luckily, bowel incontinence is highly treatable, enabling most patients to maintain normal bowel function for the rest of their lives. Different treatments include:
In many cases, incontinence can be cured, but even if not it is usually possible to improve bowel control to some degree, and significantly improve the symptoms.
Cholelithiasis refers to the presence of one or more gallstones in the gallbladder. Gallstones are little stones made of cholesterol formed in the gallbladder. The gallbladder is a small organ found underneath the liver and aids digestion by releasing a digestive fluid called bile into the small intestine.
Most of time gallstones do not cause any symptoms and do not require treatment, however, if a gallstone happens to get trapped in a duct inside the gallbladder, it can cause the following symptoms:
Sometimes cholelithiasis can be more serious, especially if the gallstone blocks the flow of bile, and the following symptoms can be triggered:
Although causes of gallstones are not totally clear, they are thought to occur when there is an imbalance in the make-up of the bile inside the gallbladder. Such imbalances are thought to occur when:
Research indicates that weight-loss and diet can help to prevent gallstones developing.
A healthy, low-saturated fat diet is recommended. This is helps to reduce the intake of bad cholesterol which can cause gallstones to form. Also recommended, is avoiding the consumption of large amounts of alcohol.
Being overweight is also a risk-factor for developing gallstones. Therefore, maintaining a healthy weight by eating healthily and exercising regularly is highly recommended. Losing weight via low-calorie diets are not recommended however, as they have been linked to disrupting bile production, and can therefore increase chances of gallstones developing.
If your gallstones do not cause symptoms, then most likely you will not need treatment, but will be recommended to actively monitor your condition, and to return to a specialist if symptoms occur. However, those who do experience symptoms will likely have the following treatment options:
The term chronic diarrhoea is used for cases in which diarrhoea has lasted for several weeks and is quite often linked to other health issues such as weight loss, abdominal pain, vomiting, nausea, high temperature or fever, or being unable to absorb nutrients.
Diarrhoea is the frequent passage of soft and watery stools. It is thought to be frequent if a person has bowel movements more than three times a day.
Diarrhoea can be a relatively common issue that normally lasts a few days before going away on its own. When it lasts longer, it may be due to a more serious issue. In cases of chronic diarrhoea, symptoms can come and go.
Diarrhoea continues to be one of the main causes of morbidity and mortality in underdeveloped countries, affecting up to 5% of the world’s population. Risk factors include malnutrition and lack of breast milk, among many others.
It is worth noting that the prevalence of chronic diarrhoea is much lower in the western world, and deaths that arise from it tend to be isolated cases derived from untreatable congenital diarrhoea.
The patient's medical history is important for the initial diagnosis and choice of tests.
Anamnesis: a medical history of foods that have previously lead to diarrhoea. The faeces are analysed which can quite often indicate a cause.
Physical examination: signs of malabsorption and malnutrition are looked for: weight, size, body mass index, muscle mass, and many more. It is useful to note the changes from the onset of diarrhoea. During the examination, things such as hydration levels and changes in skin tone will be taken into account.
Additional tests: these tests vary depending on the patients’ age and diagnosis. The more basic tests will be done first to diagnose more frequent causes.
There are many things that could cause diarrhoea, the most common are:
To avoid viral diarrhoea, it is important to maintain good hygiene such as washing your hands with soap and water before and after meals.
To avoid bacterial or parasitic diarrhoea, it is important to have good food hygiene and to drink clean or bottled water. It is also important to have good hand hygiene as with viral diarrhoea.
In cases of diarrhoea after eating, it can sometimes be due an intolerance, which is quite difficult to prevent when unknown.
Another type is travellers’ diarrhoea, the recommendation for avoiding this is to avoid undercooked or raw food as well as cold drinks with ice. It is advisable not to drink tap water and to eat foods which have been thoroughly cooked.
Treatment will depend on the cause and the severity. One of the most important things to do is to compensate for the loss of liquids and minerals. The easiest way to do this is is to increase the amount of liquid ingested with mineral water, herbal teas, or drinks that have sodium, chloride, or potassium.
If the diarrhoea is intense, increasing the water ingested should help alleviate the problem. If it’s not possible to keep liquids down for very long, it’s recommended that you go to the doctor to get electrolytes and water replenished intravenously.
As it is a relatively common symptom, there are many specialists who could treat and solve chronic diarrhoea problems. Specialists include; gastroenterologists, internal medicine, and family medicine specialists, occasionally surgeons can help treat diarrhoea or chronic diarrhoea.
Coeliac disease is a pathology characterised by permanent intolerance to gluten. This substance is present in wheat, barley, rye and oats. Gluten damages the lining of the small intestine, causing it not to absorb the necessary components of the food, i.e nutrients. It occurs in genetically predisposed individuals who suffer from atrophy of the villi of the small intestine.
The disease can manifest itself at any time of life, from infancy to adulthood. People with family members who suffer from coeliac disease have a greater predisposition to suffer from it. It occurs more often in women than in men.
Depending on the degree of intolerance, there may be only a few symptoms which present, or a great many. It is also possible that no symptoms present.
The most common manifestations of coeliac disease are:
Other problems may also occur such as being more prone to bruising, depression, anxiety, fatigue, delayed growth in children, hair loss, dermatitis, mouth ulcers, nosebleeds, and muscle cramps, and absence of menstrual periods, among others.
The exact cause of coeliac disease is unknown. When people with coeliac disease consume foods with gluten, whether or not they are aware of their disease, their immune system causes damage to the villi in the small intestine. This in turn makes the small intestine unable to adequately absorb iron, vitamins and nutrients.
As the cause of coeliac disease is not known, there is no way to prevent its appearance. However, it is important to take into account certain risk factors such as having a family member with this disorder, for early diagnosis and treatment.
Coeliac disease cannot be cured. The treatment is to follow a gluten-free diet for life. This helps the symptoms disappear and to heal the villi in the lining of the intestines.
If adequate treatment is not given, certain complications can occur such as autoimmune disorders, bone disease, intestinal cancer, anaemia, or liver disease.
Colic is often associated with infants, but it can occur in adults too.
Infant colic: occurs in some babies during their first months. It refers to when a baby cries with no obvious cause and the crying lasts for more than 3 hours a day, 3 days a week for at least 1 week.
There can be different types of adult colic, such as biliary colic, renal colic and intestinal colic. Colic refers to the pain, usually associated with the intestines and urinary system. The colicky pain can occur once, or recur for weeks, months or years after the initial pain.
Symptoms in babies with colic include:
Symptoms of biliary colic: biliary colic is often caused by gallstones, which block the bile ducts between the gallbladder and liver, causing inflammation, pain under the right breastbone and in the abdomen.
Symptoms of renal colic: sudden and intense pain, caused by kidney or urinary stones and is usually located on one side, where the kidney stones are located. Other symptoms might include; nausea, pain when urinating and vomiting.
Symptoms of intestinal colic: intestinal cramps, caused by a blockage in the small or large intestine, causing vomiting, nausea, diarrhoea, loss of appetite and bloating.
The exact cause of infant colic is not known. However, some possible causes can be that the baby has trapped gas, is in a fussy mood and is experiencing muscle spasms as their digestive system grows or they are oversensitive to environmental stimuli, causing them to become distressed.
The cause of biliary colic in adults is mainly caused by gallstones. These bile stones block the bile ducts leading to pain and inflammation.
In the case of renal colic, the main cause is the accumulation of salts in the urine (kidney stones). Intestinal colic is caused by blockages in the large or small intestine. The blockages may be the result of an inflammatory intestinal disease like Crohn’s or IBS.
There are several measures that can be taken to prevent colic. To prevent infant colic, it is advised to hold the baby upright after eating, tapping on the back to eliminate any gas.
Biliary colic is usually related to gallstones, so controlling risk factors for gallstones can help, such as controlling your weight and following a low-fat diet can help towards prevention.
To avoid renal colic, it is recommended to drink plenty of fluids and reduce salt intake. It is recommended to drink 8 t 10 glasses of water a day and to cut back on soft drinks that contain phosphoric acid.
In cases where the patient suffers from intestinal colic, any underlying conditions that contribute to the cramps and painful muscle spasms should be properly treated, for example, IBS.
A number of things can be done to treat infant colic. Sit the baby upright during feeding, so the baby swallows less air and remember to tap the baby on the back to help them burp any gas that might get trapped after feeding. Calming your baby’s senses may also help them to stop crying. Rocking your baby, holding them in a soft blanket and gently massaging their back can help to soothe them and calm them down.
Pain medication can be prescribed for biliary colic at first and a fat-free diet. If the gallbladder becomes severely painful and inflamed, then surgery to remove the gallbladder will be advised. The surgery can be done with a laparoscope and the patient can go home on the same day.
To relieve renal colic caused by kidney stones, shock wave lithotripsy (shock waves target and break up the stones, so they can pass in the urine) or a ureteroscopy (a lighted scope is placed into the urethra and bladder to remove the stone) can be used.
To investigate intestinal colic, the specialist will look into family history, the patient’s own medical history and can perform x-rays, ultrasounds and CT scans to see if there is any blockage in the intestines. If a blockage is found, it will be treated accordingly.
What is colitis?
Colitis refers to the inner lining of the colon becoming inflamed. Colitis can be a symptom of a disease that affects other parts of the body, which causes fevers, chills, fatigue and dehydration. There are many types of colitis that are usually classified by the cause of each one. The two most common types include ulcerative colitis and Crohn’s disease, which are types of inflammatory bowel disease (IBD). Ulcerative colitis causes other manifestations in the body, which include mouth ulcers, swelling of the joints and skin inflammation.
What are the different types of colitis?
The types of colitis are categorised by what causes them. Some of the different types include:
• Ulcerative colitis and Crohn’s disease – these two types of colitis are classified as inflammatory bowel disease. Ulcerative colitis occurs when the immune system overreacts to bacteria in the digestive tract. It begins in the rectum and spreads to the colon.
• Pseudomembranous colitis – this type of colitis occurs from the overgrowth of a bacteria known as Clostridium difficile. Normally found living in the intestine, this bacteria does not usually cause problems because of the balance with the good bacteria. Clostridium difficile takes over when medications such as antibiotics destroy the good bacteria. The toxins that are released cause inflammation.
• Ischemic colitis – this occurs when the blood flow to the colon is cut off or restricted.
What causes colitis?
The most common causes of colitis include:
• Infections or viruses
• Loss of blood supply
• Chronic diseases
• Allergic reactions
What are the signs of colitis?
The symptoms of ulcerative colitis may include:
• Diarrhoea
• Abdominal pain and cramps
• Rectal pain
• Rectal bleeding – experiencing a small amount of blood in the stool
• Desperate to use the toilet
• Inability to defecate even though there is a feeling of urgency
• Weight loss
• Fatigue
• Fever
How is colitis diagnosed?
A physical examination by a specialist helps to determine the cause of a patient’s symptoms. The doctor will take the patient’s blood pressure and check their temperature for fever. There is an examination of the abdomen to check if there is a feeling of tenderness. Bowel sounds are listened to through the use of a stethoscope. A blood test can measure haemoglobin and haematocrit levels to check for anaemia. Stool samples may also be collected to search for bacterial and parasitic infections as the cause of colitis. The stool may be tested for blood too.
How is colitis treated?
The treatment of colitis depends on how bad the disease is within the individual patient. Treatment usually involves a change in diet, nutritional supplements and medication being prescribed. In severe cases, surgery may be required. Mild colitis responds to medicines such as steroids and anti-inflammatories. More severe symptoms will require stronger medication such as immunomodulator medicines, which suppress the immune system to prevent inflammation. Surgery may be required to remove the large intestine, however this can cause other problems in different areas of the body.
Foods to avoid:
• Alcohol and fizzy drinks
• Caffeine
• Dairy products
• Raw fruits and vegetables
• Legumes
Foods to incorporate into the diet:
• Omega-3 fatty acids (found in salmon)
• Probiotics (kefir)
• Iron-rich foods (green vegetables)
• Turmeric
• Folate-rich foods
A colonoscopy is a type of endoscopy that is used to examine the colon and small intestine in order to detect any abnormalities (inflammation, ulcers, etc.). The procedure usually lasts around 15-20 minutes.
It is performed using a thin tube (endoscope) that is inserted through the anus and has a video camera at the end to record the organs and walls it passes through.
A colonoscopy may be performed for various reasons:
Before the test you should follow instructions for cleansing the bowel to make it easier for the doctor to observe it. This will involve drinking only liquids in the 24 hours before the procedure, and taking a solution that will help you empty your bowels.
During the procedure, you will be partially or fully sedated. You will be placed on your side and the doctor will insert the endoscope through the anus to pass through your large intestine.
A colonoscopy is usually well tolerated and is rarely painful. At most, you will feel pressure, swelling, or cramping during the procedure. Less than one per cent of patients will experience serious complications.
If the specialist feels that a more accurate evaluation is necessary, they will obtain a biopsy of the lining of the bowel for analysis.
If polyps are found during the procedure, these can be removed straight away.
There is now an alternative to traditional colonoscopy that is much less invasive and does not require sedation. This is called a virtual colonoscopy, which is an examination that uses images of the inside of the bowel and colon obtained by means of computerised tomography (CT or CAT scan) instead of images taken by the colonoscopy camera.
An eating disorder is when someone has a very unhealthy attitude to food, body weight or shape. Eating disorders are serious illnesses that can prove fatal if not treated. The most common types of eating disorders are:
Women are more likely to suffer from these types of disorders. They tend to occur in adolescence and are often accompanied by depression and anxiety disorders.
The common symptoms of eating disorders are:
Additional physical signs include:
The exact causes of eating disorders are not known, however, some risk factors include:
Prevention of eating disorders refers to any programs or interventions that reduce the risk factors of developing such a disorder. This includes primary and secondary prevention. Primary prevention aims to prevent the onset of an eating disorder, whilst secondary prevention tries to reduce the severity and duration of an eating disorder in someone who has already been diagnosed.
Treatment may differ slightly between each case and each type of eating disorder. Recovering from an eating disorder is entirely possible, but recovery can take a while and it will be a different experience for each person.
Physically, treatment will aim to increase your nutritional intake, stop purging and reduce excessive exercise. Together, these will allow the individual to reach a healthier weight. Further to this, treatment will involve individual, group and family psychotherapy sessions (e.g. CBT), nutritional counselling, medical monitoring and medication. Medications that may be given include anti-depressants, but medication must not be the only form of treatment for eating disorders, and may not be given to patients under the age of 18.
Endoscopy is the use of cameras to relay images from inside the body. The device used, known as an endoscope, is a long thin flexible tube with a camera at one end and a light source.
Endoscopes are inserted in to the body via a natural opening such as the mouth or the anus. There are different types of endoscopy depending on the site and function of the procedure – if the bowel is to be investigated for example, it is referred to as a colonoscopy. If the airways are to be examined, the procedure is referred to as a bronchoscopy.
Endoscopy can also be used for surgery, as in the case of laparoscopic surgery – in this situation the laparoscope (a specific type of endoscope) is inserted through small incisions. Once inserted, the endoscope is able to send images from the inside of the subject’s body back to a TV screen.
Endoscopy is most commonly used to investigate symptoms and help to diagnose conditions relating to the digestive system, although it can be deployed to produce images and aid with many other parts of the body, including the respiratory system, the urinary tract and the female reproductive system. An endoscope can also be used to assist with surgery.
An endoscopy is commonly used to investigate symptoms such as abdominal pain, nausea and vomiting, unexplained weight loss, diarrhoea, blood in the stool or vomiting blood.
You may be required to avoid food and liquids for a period beforehand, depending on what type of endoscopy you are undergoing. In the case of a colonoscopy, you might be given laxatives to help you evacuate any stool beforehand. You may also be required to stop taking certain medication such as blood thinners to prevent excess bleeding from the procedure.
The procedure usually only causes mild discomfort although a local anaesthetic is also sometimes used. It is normally performed with the patient conscious, although sedatives can be deployed to help you relax. Antibiotics are sometimes used to reduce risk of infection.
An endoscopy can be used to diagnose a wide range of conditions and the results are interpreted by a specialist. Whether the results are good or bad clearly depends on what symptoms are being investigated and on which part of the body the endoscopy is being performed.
Food intolerance is the adverse reaction of the body to the intake of certain foods. It refers to a difficulty digesting particular foods.
Food intolerance is not the same as a food allergy. The latter triggers a much more rapid reaction in the immune system which is dangerous to the health. Food allergies cause hives, eczema, swelling and difficulty breathing, so it is urgent to seek urgent medical help because in these cases the patient's life is in serious danger. An intolerance, on the other hand, triggers an unpleasant physical reaction, but it is not dangerous.
Symptoms can include:
The number of people who believe that they have an intolerance has risen in the last number of years. Some may assume that they have a food intolerance when their symptoms are actually unrelated – symptoms of food intolerance are very general and typical of many other conditions.
It is not clear why some are intolerant to particular foods. Some reactions may be to additives or chemicals in the food, such as MSG, histamines, artificial preservatives, or artificial flavouring. While intolerance can happen with any food, some of the most common foods that cause food intolerance are eggs, fish, milk, nuts, seafood, soy, gluten and some flours and yeasts.
When faced with any type of food intolerance, a doctor should be consulted to detect which food or foods cause those reactions. Testing can be carried out to help detect the problem, or your doctor may encourage you to keep a food diary to help pinpoint what is causing the intolerance. Treatment usually consists of following a diet in which the consumption of the substance or substances that causes the problem is avoided.
Gastrointestinal haemorrhage, otherwise known as GI bleeding, is bleeding that occurs in the digestive system. Bleeding that occurs in the oesophagus, stomach or small intestine is known as an upper gastrointestinal haemorrhage, whereas bleeding in the rest of the small intestine, colon, rectum or anus is known as a lower gastrointestinal haemorrhage. Bleeding can sometimes be life-threatening, and is related to an underlying disorder in the gastrointestinal system.
Gastrointestinal haemorrhage can be detected with the presence of blood in the stool, although other symptoms may occur:
Gastrointestinal haemorrhage can be caused by a number of conditions, some of which are minor, such as:
More serious or long-term conditions which can cause bleeding include:
In some cases, bleeding can be a sign of a cancerous condition such as:
You should seek immediate medical advice if you have blood in your stool or have vomited blood. They will take a full medical history and will usually refer you for tests, including:
Gastrointestinal haemorrhage may require immediate primary attention. Emergency treatment may involve:
Once the condition is stabilised and your blood levels have returned to normal, treatment will depend on the cause of the bleeding.
Halitosis is a common problem characterised by an unpleasant odour on the patient’s breath. Normally, halitosis is caused by poor oral hygiene, with bacteria breaking down pieces of food trapped in the teeth and releasing foul-smelling gases. Halitosis can affect the patient psychologically, due to the stigma of bad breath, and can lead to problems in their social life.
In most cases, the causes of bad breath are oral in nature. In some cases, the smell may originate from the nose, sinuses, throat, lungs, oesophagus, or stomach. Some common causes are:
Halitosis can be prevented with good oral hygiene:
You should also book periodic check-ups with a dentist to ensure that your teeth and gums are healthy.
In most cases, improving oral hygiene is enough to eliminate bad breath, brushing your teeth and gums, flossing and cleaning your tongue as a daily routine.
Cutting down on or avoiding tobacco, alcohol or certain foods and drinks such as coffee may also be recommended.
If the halitosis is a consequence of a different pathology, such as gastro-oesophageal reflux disease or a H. pylori infection, you may be referred to a relevant specialist to deal with the cause.
Helicobacter pylori is a bug or bacterium that causes stomach infections. The bacterium affects two thirds of the world's population. It grows in the mucous layer of the stomach by secreting urease, an enzyme that converts urea (an important chemical compound for metabolism) into ammonia. As a result, it neutralises the acidity of the stomach and creates an environment ideal for the growth of the pylori bacteria.
H. pylori is characterised by the following symptoms:
Helicobacter pylori must be eradicated as soon as symptoms present to avoid further complications such as abdominal infection, peritonitis, haemorrhages or ulcers. The presence of H. pylori can also increase the risk of stomach cancer.
This bacterium is transmitted through direct contact with an infected person. The infection can be passed on by:
To prevent H. pylori, good hygiene is important. Wash your hands thoroughly after going to the bathroom and eat in clean places where good hygiene protocol is followed.
The treatment for H. pylori includes:
Dyspepsia or indigestion is a term that describes pain or discomfort in the upper abdomen, especially after having a meal. It is a very common problem that can be alleviated by taking antacids and stomach protectors. Sometimes it is related to stress, alcohol consumption, smoking, eating too much fat or eating too fast. Therefore, the discomfort can be reduced with healthy habits, both in diet and in daily routine. It is a benign problem, without major consequences, even if it is chronic, and it can appear and disappear intermittently over the years.
Inflammatory bowel disease (IBD) is used to refer to chronic diseases affecting the intestine. the most common are Crohn’s disease (CD) and ulcerative colitis (UC).
Irritable bowel syndrome (IBS) is a functional disorder of the large intestine.
IBS is characterised by abnormal movements in the muscles of the intestine, which cause discomfort and abnormal function, as well as constipation and diarrhoea alternately. IBS can also provoke abdominal pain, gas, bloating and changes in bowel habits.
Irritable bowel syndrome is usually associated with stress-related problems, although it has been shown that stress does not provoke it, but rather increases its effects. The exact causes of IBS are not clear, although it may occur after an intestinal infection.
This condition is often confused with inflammatory bowel disease (IBD) which, unlike IBS, is caused by the abnormal structure of the colon.
IBS is different in everyone and while the condition itself cannot truly be prevented, it can be avoided after diagnosis through certain lifestyle changes and management of the symptoms. For example, if you have IBS, it is not recommended to skip meals or eat later than you usually do, in addition to not rushing meals or eating too quickly. Avoiding spicy foods or ‘trigger’ foods can also help to keep IBS at bay. Many people with IBS prefer to cook their own meals as it means they can fully control what they are eating, thus avoiding triggers.
For the diagnosis of irritable bowel syndrome, there is no specific test, but it is necessary for the doctor to rule out other conditions in which symptoms are similar. Therefore your doctor may arrange for blood tests or stool samples to be taken to make sure the right diagnosis is given.
Although there is no cure for IBS once diagnosed, as it is a chronic condition, certain measures can help to alleviate the symptoms:
Malnutrition is the result of following an unbalanced diet in which there is a lack of nutrients or the intake of nutrients is not proportionate. Malnutrition increases the risk of infection and disease.
The main symptoms of malnutrition are:
Malnutrition can be caused by:
To prevent malnutrition in a child, it is recommended that the mother follow an adequate diet during pregnancy, prioritize breastfeeding and introduce foods according to the paediatrician's instructions. As an adult, it is recommended to follow a diet, balanced in all nutrients, vitamins and minerals. There should be a balanced intake of carbohydrates, fats, protein, vitamins and minerals.
The treatment depends on the cause and the severity of the malnutrition. In principle, it consists of following a balanced diet, rich in the vitamins and minerals that the person lacks, or if malnutrition is caused by an underlying medical condition, this condition will be addressed and treated first.
Morbid obesity is also known as severe obesity or class III obesity. People are considered morbidly obese when their body mass index is above 40, or even 35 if the patient has a disease or severe disability as a result of being overweight. In many countries it is a public health problem due to the new eating habits of the society.
Morbid obesity can be treated with a low calorie diet and regular exercise. In extreme cases patients can have bariatric surgery.
Obesity is defined as having an abnormal or excessive accumulation of fat on the body, enough so that it can be a risk to the health of the person.
There most common way of classifying the amount of weight on the body, and what constitutes as a healthy balance, is the body mass index (BMI), which is calculated by dividing your weight in kilograms, by your height, squared. The NHS classifies obesity as having a body mass index of 30 to 39.9, with those over 40 being classified as severely obese, though it is not necessarily the case as those with a large amount of muscle could be classified as obese due to their weight, when it may not actually be accurate. Another way of measuring excess fat is to measure waist circumference, for men, obesity is generally considered as being larger than 94cm (37in), and 80cm (21.5in) for women.
Simply speaking, obesity is caused by consuming more calories than are burned off through physical activity. When food is consumed, especially excessive amounts of fat and sugar in the diet, the body stores it as energy, in the form of fat.
There are some health conditions that can lead to obesity and weight gain, such as problems with the thyroid, especially hypothyroidism.
The best ways of treating obesity is to increase the amount of physical activity you perform on a regular basis, and to reduce the amount of calories eaten, along with eating a healthy, balanced diet.
There are a number of ways that you can do this, such as joining a weight loss group to help you manage your diet and motivate you to continue sticking to it. You can also start activities such as walking, swimming or running. You can begin with exercising for short periods of time, before building up to longer periods. There are a number of surgical procedures available to help deal with weight loss in more severe circumstances, such as gastric band, gastric bypass, and biliopancreatic diversion.
Obesity can be detrimental to the health, leading to problems in different areas of the body. It can cause strain on the heart, leading to coronary artery disease, high blood pressure, high cholesterol, and other conditions. It is one of the leading causes of diabetes type 2, polycystic ovarian syndrome (PCOS), and infertility and can also have detrimental psychiatric effects such as depression along side often having a social stigma.
To see a specialist to help with obesity, click here.
Obesity is one of the most common diseases of modern society, caused by bad eating habits that cause a metabolic disorder in the form of excess fat and consequently overweight. If the caloric intake that provides the body is greater than that required or consumed is stored as fat. Besides, obesity may result in the acquisition of other diseases, such as diabetes mellitus, hypertension, high cholesterol or cardiovascular risk. In any case, obesity treatment tailored to each person according to their age, physique, medical history and daily habits is required. By measuring the body mass index patient's degree of obesity it is known and established a slimming diet should be low calorie, low fat, with the establishment of a rehabilitation plan of eating habits and exercise. The tandem diet-exercise physical is essential for weight loss.
Obesity is one of the most common diseases of modern society, caused by bad eating habits that cause a metabolic disorder in the form of excess fat and consequently overweight. If the caloric intake that provides the body is greater than that required or consumed is stored as fat. Besides, obesity may result in the acquisition of other diseases, such as diabetes mellitus, hypertension, high cholesterol or cardiovascular risk. In any case, obesity treatment tailored to each person according to their age, physique, medical history and daily habits is required. By measuring the body mass index patient's degree of obesity it is known and established a slimming diet should be low calorie, low fat, with the establishment of a rehabilitation plan of eating habits and exercise. The tandem diet-exercise physical is essential for weight loss.
Pancreatitis is the inflammation of the pancreas, which is a gland found behind the stomach. The pancreas is key to the digestion of food, through the production of certain enzymes as well as the production of hormones that aid in the processing of blood glucose levels. There are two types of pancreatitis; acute and chronic. Acute pancreatitis is when the pancreas becomes inflamed suddenly. Chronic pancreatitis is when the pancreas becomes permanently damaged due to inflammation of the pancreas over many years.
The symptoms of acute pancreatitis include:
The symptoms of chronic pancreatitis include:
If you experience frequent abdominal pain, it is important to see a specialist.
Acute pancreatitis is thought to occur when digestive enzymes activate whilst still in the pancreas, causing irritation of the pancreatic cells and hence inflammation. Acute pancreatitis has also been linked to both gallstones, alcohol consumption, infections, and some medications.
Chronic pancreatitis has largely been attributed to long-term alcohol abuse, smoking, hereditary genetic mutations and immune system problems.
In some cases, the cause for a pancreatitis diagnosis is never confirmed.
There are a number of tests used to make a diagnosis, such as:
Treatment for acute pancreatitis looks to support bodily functions until inflammation has subsided. The first step in treating acute pancreatitis is to let the pancreas heal, and for the inflammation to subside. To do so, you must be treated in hospital where you will receive intravenous fluids to replace lost fluids, and medicines to manage pain. Fasting for a few days also helps the pancreas to recover.
Once the pancreas has recovered, doctors can get to work on treating the underlying cause of pancreatitis. Frequently, such additional treatments can include:
For those suffering from chronic pancreatitis, then further treatments might be needed, including:
Ultrasound is a diagnostic imaging procedure that allows you to see organs and soft structures inside the body. At present, they can be 2D, 3D or four-dimensional images. Ultrasound is a non-invasive technique, in which radiation is not used and thanks to this, it is used to visualise developing foetuses.
It is carried out using high frequency sound waves emitted through a transducer that captures the echo of different amplitudes which occurs when they ‘bounce’ off the organs. These signals, once processed by a computer, give a series of images.
With this procedure you can clearly differentiate the shape and size of each structure inside the body. In medicine it is used to see the heart, kidneys, liver and blood vessels, among other organs. In addition, ultrasounds are also carried out on patients who are pregnant. Another function is the study of different tissues of the body such as the blood flow of arteries and veins to detect arteriosclerosis and blood clots. Ultrasounds also allow the analysis of the thyroid gland and other soft structures of the neck as well as tendons, ligaments, muscles and joint structures, and mammary glands.
Usually, you do not need any type of preparation for having an ultrasound. In cases where the area to be examined is the abdomen, the specialist may tell you to drink three glasses of water approximately one hour before the test.
During the ultrasound, the patient will lie on a table or stretcher with the area to be analysed exposed. The specialist will apply a transparent gel that will allow the movement of the roller built into the transducer. During the scan the expert will interpret the images and determine which shots are correct according to each case. The only slight discomfort that can be felt is the gentle pressure that the specialist applies when passing the transducer over the body area. The gel applied can also feel quite cold when applied.
The types of images that are considered abnormal are:
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