Gastroenterology

Gastroenterologists are specialists who treat diseases of the digestive system and those affecting the gastrointestinal tract including the organs from mouth to anus ranging from indigestion to abdominal pain, appendicitis, jaundice, gallstones, lactose intolerance, hepatitis, reflux, ulcers, and hemorrhoids.

Signs and Symptoms for Gastroenterological Conditions

 

Colorectal Cancer

More commonly known as colon or rectal cancer, this disease tends to develop when cells in this particular region begin to rapidly grow out of control.

A majority of these cancers start as small polyps that can be precancerous. Though most patients show no symptoms at this stage (asymptomatic), over time these polyps can become cancerous. Depending on the size and how deep the cancer has grown, the prognosis may vary and early stages tend to not show any symptoms whatsoever.

Take note of these colorectal cancer symptoms:

- Gastrointestinal cramps or pains

- Gassiness and bloating

- Bowel habit change (constipation or diarrhea)

- Bloody/tarry stools

- Loss of weight

- Loss of appetite

- Feeling nauseous

- Vomiting

- Fatigue
Diverticulitis

Small pockets within the intestinal wall lining that tend to form with age are known as Diverticula. If these become infected, this progresses to what is known as diverticulitis and is commonly caused due to the lack of dietary fiber in one's diet.

Symptoms may include:

- Severe abdominal pains

- Fever

- Nausea

- Fatigue

- Bloody/Tarry stools
Gastroesophageal Reflux Disease (GERD)

This particular disease is due to a reflux of acid on a frequent basis, especially when stomach acid moves up and to the throat due to abnormally relaxed lower esophageal sphincter muscles.

Common GERD symptoms include:

- Heartburn after meals (burning sensation in chest or throat)

- Sour taste in mouth

You can alleviate GERD by:

- Refraining from belts or tight clothing that constrict the stomach

- Keeping a healthy weight in check

- Avoiding alcohol and cigarettes

- Keeping meal portions smaller

- Avoiding foods that trigger GERD symptoms

- Waiting awhile before lying down after a meal

- Keeping your head and neck elevated while sleeping

Inflammatory Bowel Disease (IBD)

The two main causes of IBD are Crohn's disease and ulcerative colitis where ulcerative colitis affects the innermost lining of one's large intestine and rectum, causing chronic inflammation and ulcers or sores to develop. Whereas, Crohn's disease tend to include multiple different areas throughout the entire digestive tract, often occurring towards the end of the small bowel (the ileum) or the beginning. This disease can also affect the entire bowel wall where areas that are affected can be interspersed between the healthy sections of the colon.

Symptoms of IBD may be associated with:

- Inflammation triggered by overactive immune systems

- Viral or bacterial triggers

- Environmental triggers

- Genetic factors

Other symptoms of IBD may include:

- Fatigue

- Weight loss

- Abdominal pains

- Diarrhoea

- Intermittent rectal bleeding

Haemorrhoids

More commonly known as piles, haemorrhoids are swollen veins in the anal and lower rectal region, typically occurring due to straining one's bowel movements.

Symptoms may be associated with:

- A small sensitive and/or painful lump or lumps protruding from the anus

- Pain, itching and/or discomfort around the anal region

- Painless bleeding during bowel movements

Irritable Bowel Syndrome (IBS)

This is a chronic gastrointestinal disorder that affects one's large intestine with a range of symptoms that include:

- Loss of appetite

- Gassiness and/or bloating

- Diarrhoea and/or constipation during intermittent periods

- Abdominal pain that is relieved with bowel movement

Gastroenterological diagnosis by tests

Gleneagles' range of hospitals provides you with the best diagnostic and screening services, all wrapped up in a modern and comfortable setting. Your results will be reviewed by doctors who will explain and offer the necessary treatment options based on your ailment, lifestyle and/or risk factors.

Due to the nature of gastrointestinal conditions, a wide variety of symptoms may surface thus a proper diagnosis should first begin with a gastroenterologist questioning family medical history prior to a physical examination. Additional lab tests and imaging may be required such as these below:

Stool analysis

Often used to check faecal occult blood tests for colorectal screening, this test can help assess the patient's gut health by taking into consideration the change in acidity (pH), colour and consistency of stools. The presence of mucus, red and white blood cells, sugar, fat and bile can help further understand the causes of indigestion, constipation, diarrhea, mal-absorption and infection.

Abdominal Ultrasound

Sound waves are used to produce dynamic images of organs that may not be accessed via other conventional means such as the gallbladder, pancreas and liver.

Endoscopy

This diagnosis allows for the close scrutiny of the stomach and digestive tract. A long instrument resembling a long tube with a camera called an endoscope is used to take images of the inter gastrointestinal environment. For further diagnosis, biopsies may taken to be microscopically examined to help in cancer cell detection.

CT and MRI Scans

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans help give specialists a cross-sectional view of the abdominal organs. This then helps them visualize the conditions of the internal structures of the body.

Colonoscopy

As medical test used to detect polyps and other various abnormal gastrointestinal growth, a camera is embedded at the end of a flexible tube, which is then inserted via the anus. This allows specialists to visually examine the large intestine and parts of the small intestine for any abnormalities.

Blood Tests

Liver function tests, blood counts and pancreatic enzyme tests can help determine conditions such as parasitic, viral or bacterial infections, lactose intolerance, celiac disease and diarrhoea. These blood tests may often help exclude other serious illnesses.

Treatments for Gastroenterological Conditions

We aim to get you back on track to your regular healthy daily life activities. Each treatment option like these listed below will be recommended by our medical team largely depending on your individual condition, and health and medical history.
Colorectal Cancer

The typical main treatment method for this would be surgery to remove the cancer. Your doctor may also recommend chemotherapy as well as radiation therapy before and after successful surgery.

Diverticulitis

The easiest path to treatment for this condition would be diet improvement and sometimes antibiotics. Mild cases of diverticulitis infection may only require rest, a liquid diet, stool softeners and antibiotics. However, surgery may be recommended for more severe cases along with a course of antibiotics and intravenous nutrition.

Gastroesophageal Reflux Disease (GERD)

Prescription drugs to neutralise, reduce and block excessive stomach acid production may be prescribed. Drastic measures include surgery and procedures such as these listed below may be recommended:

- Fundoplication to tighten the muscle and prevent reflux by wrapping the top of the stomach around the lower esophageal sphincter.

- Insertion of a LINX device, a string of magnetic beads, around the stomach allowing for the magnetic elements of the beads to draw the junction closer together yet still enable food to move through.
Inflammatory Bowel Disease (IBD)

In order to treat this condition, various drugs may be prescribed to reduce inflammation and suppress the immune system that is causing the inflammation, using antibiotics to treat any related infections. Pain relief as well as anti-diarrhoea medication may also be prescribed.

As bowel rest may reduce inflammation, nutrition through feeding tube inserts or via intravenous injections may be recommended for more severe cases.

For drastic measures, surgery to remove diseased parts of the large and/or small intestine may sometimes be required for much more severe cases.

Haemorrhoids

Stage 1 and 2 hemorrhoid development may require lifestyle changes and minor medical treatment which may include diets with high fibre foods, the usage of topical treatments, warm water soaks and anal area cleanliness. Haemorrhoid symptoms often go away within one or two weeks.

However, if persistent bleeding and painful haemorrhoids occur, our specialist team may perform rubber band ligation, in which one or two small bands are placed at the base of the haemorrhoid to cut off blood circulation. Alternatively, injections (sclerotherapy) and coagulation via infrared and/or lasers may be recommended for haemorrhoid size reduction.

If surgery is recommended, the two main options include:

  • Haemorrhoidectomy - the most effective and complete way to treat severe or recurring haemorrhoids.
  • Stapled haemorrhoidectomy or stapled haemorrhoidopexy - where blood flow to haemorrhoidal tissue is blocked off. This process is typically used for internal haemorrhoids. Though causing less pain, this procedure has a greater recurring risk as compared to a regular haemorrhoidectomy
Irritable Bowel Syndrome (IBS)

Changes in your diet, or completely removing foods that cause bloating may be recommended by your doctor. Depending on your range of symptoms, fibre supplements, laxative or diarrheal medication may be prescribed to you.

Certain drugs may be prescribed to:

- Ease diarrhea via reduction of muscular contraction and secretion of fluids in the intestine, while increasing rectal muscular tone

- Decrease overgrowth of bacteria

- Increase fluid secretion in small intestines to help bowel movement

Tips to Keep Your Gut Healthy

The gastrointestinal tract plays many vital roles in sustaining health and wellness, starting with water and food. Our digestive process provides us with the foundation to live and carry out daily functions while staying healthy and happy. These few important factors should be taken into consideration to maintain healthy gastrointestinal health:

- Eat healthy foods

- Keep hydration levels optimal

- Include adequate fibre in your diet

- Thoroughly chew food before swallowing

- Keep a healthy and active lifestyle

- Manage lifestyle stress

- Get routine medical screenings

- Maintain a healthy sleep schedule

- Consider probiotic supplementation

Are you or a loved one facing any of these gastrointestinal concerns? Our dedicated team of multidisciplinary healthcare professionals are eveready for consultation. Learn more at your nearest Gleneagles Hospital.

Our Specialists

Dr. John Cheng Lung Seng
Specialty
Gastroenterology
Internal Medicine
Hepatology
Location
Gleneagles Hospital Kota Kinabalu
Dr. Alvin Khoh
Specialty
Paediatrics
Gastroenterology
Location
Gleneagles Hospital Kota Kinabalu
Dr. Nagaraj Sriram
Specialty
Hepatology
Gastroenterology
Internal Medicine
Location
Gleneagles Hospital Kota Kinabalu

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EMERGENCY CONTACT
Gleneagles Hospital Kota Kinabalu
Ambulance / Emergency
+6088 518 911