There are many possible causes of abdominal pain, some are related to the gastrointestinal tract and some are not. We will thoroughly assess your symptoms and order appropriate investigations so we can come up with a tailored management plan for you.
Some types of anaemia can be related to malabsorption or to chronic blood loss from the gut. If you are referred with anaemia, it is likely you will need to have some endoscopies (camera tests) and in some situations, CT scans. We will discuss all of these procedures with you in detail before you have them done.
Bile acid malabsorption
This is an uncommon condition which can cause diarrhoea but is very treatable. If we suspect you might have this after listening to your symptoms, we will arrange a dedicated scan and start you on treatment for it. Further information on this can be read at:
Coeliac disease and Non Coeliac Gluten Sensitivity
Coeliac disease is one of the commonest conditions seen in Gastroenterology clinics. It is an autoimmune condition, where overactivity of the immune system to certain things we eat results in damage to the gut lining. It is diagnosed by a combination of blood tests and intestinal biopsy, taken via endoscopy. You can find more information about coeliac disease at:
Non-coeliac gluten sensitivity (NCGS) can cause symptoms similar to coeliac disease, but it (probably) does not involve the immune system. Further information on this can be found at: https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/gluten-sensitivity/
There are various types of colitis (inflammation in the colon) and causes diarrhoea, rectal bleeding and abdominal pain. Usually a colonoscopy (camera test via the back passage) is needed to diagnose the exact type, to guide treatment.
Constipation is very common and can have many causes. The word means different things to different people, so we will discuss this in detail with you during your appointment, Managing the symptoms may involve a combination of dietary changes and medication. Sometimes there are underlying medical causes for the symptoms, so you may also need blood tests, scans or other tests.
Loose or frequent stools can be a very distressing symptom and can be caused by a wide variety of conditions. We will thoroughly assess your symptoms and arrange tests to investigate, which may include blood and stool tests, camera tests and/or scans.
Difficulty swallowing (dysphagia) can result from structural problems in the gullet (oesophagus) or problems related to the nerves and muscles which control the swallowing mechanism. There are many possible underlying reasons for this symptom so we will perform a thorough assessment in clinic and organise the right tests for you.
Endoscopy is an umbrella term for looking inside your body with an instrument that has a camera at the end of it. For looking into the gut, this can either be inserted via the mouth, into the gullet, stomach and first part of the small intestine, or via the bottom – a colonoscopy. These procedures allow us to see what your internal organs look like and take some small samples of tissue if needed (biopsies).
Gastro-oesophageal reflux (GORD)
GORD refers to the passage of small amounts of stomach contents, which are usually acidic, up into the gullet. This can cause distressing symptoms like heartburn, chest pains, a sour taste in the mouth, sore throat, nausea or bad breath. Lots of us might suffer from reflux occasionally, but if it is a new or persistent symptoms for you, it should be investigated.
Inflammatory bowel disease
Inflammatory bowel disease (IBD) generally refers to Crohn’s disease and Ulcerative colitis which both cause inflammation in parts of the gastrointestinal tract, leading to symptoms such as abdominal pain, diarrhoea, rectal bleeding and weight loss. They can also be associated with eye, joint and skin problems in some people. Symptoms often vary over time. There are lots of treatments available to reduce the gut inflammation and you can find lots of information on these at https://www.crohnsandcolitis.org.uk/
Intestinal Failure is a very uncommon condition where the gut is unable to absorb enough nutrients or fluids to survive. It can result from having a lot of the intestine removed surgically, widespread inflammation affecting the bowel, or certain motility problems. People with intestinal failure need to have their nutrition supported via intravenous feeding (we call this Parenteral Nutrition, PN).
Irritable bowel syndrome
IBS is a very common gut problem, affecting at least 1 in 5 people at some point in their lives. Sometimes the symptoms can be mild and a minor nuisance, but for some people the symptoms can be extremely disruptive and distressing. There is no specific test for IBS, diagnosis is made by assessing your symptoms and excluding other causes. Management involves dietary changes for most and drug treatments and probiotics for some. It is important for people to self-manage their symptoms too and to consider the effects of stress, poor sleep and an inactive lifestyle, which can all worsen symptoms. www.theibsnetwork.org has great tips on self-care in IBS.
The main function of the gastrointestinal tract is to digest and absorb nutrients from our food that the body can use to support the function of our organs. If something disrupts this normal process, then we may not be able to absorb all, or some, of the specific nutrients we need. This disruption can arise from problems in the stomach, small intestine, liver and biliary system, or the pancreas gland. After a thorough discussion, if we suspect you have this, we will organise the correct tests to diagnose this.
Clinical Nutrition is a branch within Gastroenterology that we specialise in and relates to the diagnosis and management of nutritional changes in patients with chronic conditions. A lot of Gastroenterological (and other) diseases can affect our nutritional state, directly or indirectly. Working with a dietitian colleague and using certain blood tests and scans, we can assess and treat any deficiencies.
The pancreas gland has two main functions – to produce the hormone insulin to regulate our blood sugar levels and to make digestive enzymes. These enzymes are released into the gut after we eat and help to break down our food into smaller molecules that can be absorbed from the gut into the bloodstream. If the pancreas is inflamed or has been damaged it may not produce enough of these enzymes, leading to weight loss, diarrhoea (sometimes with oily bowel movements that are difficult to flush away) and possible vitamin deficiencies. A poo test can help diagnose this, some people will also need a CT scan of their pancreas. Supplemental digestive enzymes are available for those with pancreatic insufficiency.
PEG (Tube) feeding
Percutaneous Endoscopic Gastrostomy (PEG) tubes may be needed for a variety of reasons – some people with extreme swallowing difficulties (dysphagia), neurological problems or undergoing cancer treatment, may need a PEG tube fitted. We can advise on whether a PEG tube is appropriate and manage problems after if they arise. For more info on PEG tubes see https://patient.info/treatment-medication/peg-feeding-tubes
Short bowel syndrome
SBS occurs when a large part of the intestine has been removed surgically. It often results in Intestinal Failure (see above) but some patients can manage with supplementation, by adapting what they eat and drink, We can provide expert advice on this and perform nutritional blood tests to ensure there are no vitamin or mineral deficiencies.
Small Intestinal bacterial overgrowth
SIBO is an under-recognised condition. People with SIBO often reports symptoms similar to IBS (see above), including bloating or feeling full after eating, abdominal pain, loose stools and weight loss. There is an increase in the number of bacteria in the small intestine, which causes the symptoms. This can happen after certain types of operations, be an adverse effect of some medications, or other conditions which slow movement through the gastrointestinal tract.
Stomach complications of cancer or other treatment
Abdominal surgery, chemotherapy and radiotherapy for cancer can all cause problems in the gut, often during or soon after treatment but sometimes delayed effects can be seen many years later. We will talk to you about the type of treatments you had and assess whether they might be causing your symptoms.
Variable bowel habits
A normal bowel habit is usually quoted as anything in the range between three bowel movements per day to once every 3 days. It is important to know what is normal for you and to seek advice if you notice a change persisting for more than 2-3 weeks, particularly if you have other symptoms such as abdominal pain, rectal bleeding, weight loss and/or abdominal swelling. Although there can be many reasons for these symptoms, sometimes these symptoms can be due to cancer so it’s important you do not wait to seek an opinion.