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Gastrointestinal Diseases

Gastrointestinal (GI) diseases encompass a wide range of disorders affecting the digestive tract, including the oesophagus, stomach, small intestine, large intestine, and anus. These conditions can significantly impact an individual's quality of life and may require comprehensive management.

Gastroesophageal Reflux Disease (GERD)

GERD is characterised by the reflux of stomach contents into the oesophagus, resulting in symptoms such as heartburn and regurgitation. Chronic inflammation may lead to complications such as oesophagitis and Barrett's oesophagus.

Peptic Ulcer Disease

This condition involves the formation of ulcers in the stomach lining or the upper part of the small intestine. Common causes include Helicobacter pylori infection and prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Irritable Bowel Syndrome (IBS)

IBS is a functional GI disorder marked by abdominal pain, bloating, and altered bowel habits. The aetiology remains poorly understood, with stress and diet often cited as contributing factors.

Celiac Disease

Celiac disease is an autoimmune disorder triggered by gluten consumption, leading to damage of the small intestine mucosa. Symptoms may vary widely, and diagnosis requires serological tests and biopsy.

Liver failure and liver diseases

The liver is important in detoxifying the body and plays a vital role in overall health. Management of diseases like infections (viral hepatitis), metabolic-dysfunction associated steatotic liver disease (MASLD), chronic liver failure, alcoholic liver disease, and medication induced liver dysfunction is mainly facilitated by specialist physicians.

1What are the symptoms?
• The white parts of your eyeballs and skin turn yellow (jaundice)
• Pain in the upper part of your abdomen
• Nausea and vomiting
• Tiredness
• Tremor
2What does treatment involve?
If liver failure is a result of an overdose on acetaminophen, you will require another medicine to reverse the effects of the toxin. Your doctor can also prescribe medications to prevent further build-up of excess liquid in the brain, a condition known as cerebral oedema.
Your doctor may also request a blood and urine sample to check for signs of infection. Should an infection occur, your doctor will prescribe medication to treat this.
Ultimately, you may need a liver transplant which involves replacing the damaged liver with a healthy one taken from a donor.
3How often should you see a doctor?
You need to see your doctor when signs of acute liver failure develop quickly. These signs may include jaundice which is yellowing of your skin, pain in the top part of your abdomen and psychological changes.

FAQ

1Can viral hepatitis disappear without treatment?
Viral hepatitis that does not last long disappears eventually. However, hepatitis B and C can cause lifelong illness, leading to severe complications. There are vaccinations to reduce your risk of hepatitis A and B but not the case with hepatitis C.
2Can I get cancer from Crohn’s disease?
If you develop Crohn’s disease or have been diagnosed with irritable bowel syndrome, you remain at high risk of getting colon cancer or developing a liver complication due to IBS. A complication of your liver that is related to irritable bowel syndrome is a condition known as primary sclerosing cholangitis.
3Is ulcerative colitis a life-threatening illness?
Ulcerative colitis is not usually considered a deadly condition. However, complications can occur when you do not make lifestyle changes or monitor your condition.
Complications include:
• Excessive bleeding
• Dehydration
• Loss of bone density (osteoporosis)
• Skin, eye and joint inflammation
• Swollen colon
• Blood clots in your arteries and veins
Gastroenterology and hepatology

"It all starts by caring enough to engage the patient in the decision-making. Many people argue that 'We don't have time for this in the consultation. I'd rather just tell people what I think is best for them, and then, they can decide whether they want it or not.' Well, that's not very caring. This might be efficient, but it does not reflect the best that we can offer.'"

Dr Victor Montori, on shared decision-making