Diagnosing conditions and Treating symptoms

These are often small fleshy lumps that exist in the colon. They may lead to symptoms including blood loss and or a change in bowel habit. They are usually found at the time of colonoscopy and most are removed as they may lead to bowel cancer in the future. Once removed they are analysed in the pathology laboratory and maybe described as innocent (hyperplastic) or non innocent polyps (villous adenomas or serrated adenomas). Based on this assessment your colonoscopist will advise you when your next colonoscopy will be due.

This is a cancer or growth that can develop from small polyps that grow in the bowel over many years. Bowel or colon cancer is the second most common cancer in Australia with over 15,000 patients being diagnosed with the condition in 2015. It can give varying symptoms but commonly causes changes in bowel habit, bleeding, wind and pain. It may be associated with weight loss and loss of appetite. Diagnosis is made with stool tests and colonoscopy. Further investigations such as CT scans may also be required. Once diagnosed the patient will require surgical treatments and possible oncology input. If picked up early it is curable.

This is an inflammatory disorder where the body’s immune system for some reason (as yet unknown) decides that the lining of the bowel (can affect mouth, stomach, small bowel and large bowel and skin) is foreign and therefore mounts a reaction against it. This leads to the bowel wall being inflamed and this leads to symptoms including changed bowel habit, wind, pain and can also sometimes include painful joints and sore eyes. Diagnosis is made with endoscopy and colonoscopy tests, but may also include capsule endoscopy, CT and MRI scans. Once diagnosed treatments aim to reduce the inflammation and therefore longterm damage to areas affected. This condition can run in families.

Coeliac disease is a relatively common disorder of your own immune system that causes the immune system to react against an area in the small bowel that deals with processing gluten. It can affect children and adults, and can even come on late in life. Patients can be symptom free or can have a wide range of symptoms from loss of appetite, abdominal pain, change in bowel habit, weight loss, nausea, vomiting and in children may cause growth retardation. The immune system is activated by gluten and so by excluding gluten from the diet it can sometimes alleviate symptoms. This is diagnosed with a combination of blood tests, genetic tests but the definitive test is an endoscopy and biopsies of the affected area.

This is also another inflammatory disorder where the body’s immune system for some reason (as yet unknown) decides that the lining of the bowel (usually only the colon) is foreign and therefore mounts a reaction against it. This leads to the bowel wall being inflamed and this leads to symptoms including changed bowel habit, wind, pain and can also sometimes include painful joints and sore eyes. Diagnosis is made with endoscopy and colonoscopy tests, but may also include capsule endoscopy, CT and MRI scans. Once diagnosed treatments aim to reduce the inflammation and therefore longterm damage to areas affected. This condition can run in families.

IBS is a very common disorder worldwide and is a ‘functional bowel disorder’. It presents with a wide range of symptoms that can vary from mild to severe. They include, nausea, indigestion, abdominal pain, change in bowel habit (both diarrhoea, constipation or sometimes both), urgency and may lead to weight loss and low mood. It is diagnosed again with a combination of blood tests, breath tests, stool tests, endoscopy and colonoscopy. Once diagnosed it usually requires detailed investigation of diet and eating and lifestyle behaviour. Successful treatments involve possible attention in all three domains including mood and behavioural modification, and aims to reduce symptoms.

Iron deficiency is a common worldwide disorder. Decreased iron may occur due to lack of iron consumption in the diet (vegetarian diet) or due to iron or blood loss. Iron is used in the body for many essential functions including being a core component of blood. Lack of iron in children can lead to lack of concentration, inhibit learning, growth issues. In adults in its extreme form can lead to fatigue, shortness of breath and poor exercise tolerance. It may be a sign of other health issues, such as presence of polyps in the bowel. Diagnosis is by blood tests, finding a cause may require someone to have stool tests, endoscopy, colonoscopy and small bowel investigations like capsule endoscopy.

Diverticular disease is commonly found in the Australian population. Small blind ending pockets can open up on the wall of the large bowel. This is thought to be due to dietary change in communities and societies with intake of low fibre diets being a possible cause. It presents often with abdominal pain, change in bowel habit and occasionally bleeding. In severe cases it may require hospitilisation and the use of antibiotics. Diagnosis occurs with radiological tests such as CT scans and / or colonoscopy. Standard approach to treatment is encouraging increased fluid and fibre in the diet, but this needs to be guided as sometimes too much of the wrong fibre can exacerbate the problem.

This is a bacteria that was discovered by Australian doctors and occurs worldwide. It is usually harmless but can be associated with ulcers. In Japan it is thought to be strongly associated with stomach cancer. Symptoms may lead to loss of appetite, weight loss, indigestion and nausea. It can be diagnosed with blood tests, breath tests, stool tests and with endoscopy. Treatment requires combinations of antibiotics.

Fatty liver disease is a very common condition especially in Western societies. The liver is a chemical processing factory and processes all the food that we eat. One of the processes is converting ingested fats (from the gut) into fat components the body can then use, for example cholesterol, triglyceride, LDL and HDL. Over years of having processed food diets (often high fat and carbohydrate) and or alcohol, not all the fat processed leaves the liver and so is stored. This store builds up and when picked up on an ultrasound tests gives a characteristic ultrasound pattern, that can then be diagnosed as fatty liver. It is important as it has NO symptoms and in the longterm 3-10% of people can develop cirrhosis of scarring of the liver which is not reversible. Diagnosis is made with ultrasound tests and now Fibroscan can help give patients an idea if scarring also exists. This helps to manage an individuals risk of getting cirrhosis. Treatments start with diet, behavioural and lifestyle modification. It may also involve medication.

Gallstones are found in the gall bladder. They can remain in the gall baldder lifelong and not cause a problem. They often run in families and present often with nausea, vomiting and abdominal pain. Occasionally, one can become jaundiced or go yellow as the draining system for the gallbladder can become blocked by a stone and this leads to pain and the skin and eyes going yellow. Diagnosis is made with an ultrasound test, occasionally MRI is required. Patients who have the gall bladder removed can at a later date have similar problems again and this maybe related to gritty material of small gallstones developing in the drainage system of the gallbladder, this area is not removed at the time of a gallbladder operation.

HAV is a virus that is commonly spread via the faecal oral route (poor hand hygiene). It is normally harmless but can cause jaundice (yellow skin and eyes) and abnormal liver tests. If this happens people can feel unwell from anywhere from 3 months to one year. Diagnosis is made with blood tests but often ultrasound is also required. There is no treatment for this as it normally resolves. It can be prevented by having a HAV vaccination via the GP or a Travel Clinic.

HBV is blood borne virus that can only infect someone if blood to blood transmission takes place. This can occur from using infected toothbrushes, razors, needles and any other item that may pierce the skin. It can also be transmitted sexually. It often has no symptoms but occasionally can make one feel unwell just like in HAV. In a small number of people it may be fatal. In most cases it may make one feel unwell at the time of infection (appr. 3 months) but most people will not be able to eliminate the virus and it makes its home in the liver. In the longterm people with HBV are at risk of getting cirrhosis and also of liver cancer. Diagnosis is made with blood tests, ultrasound and require fibroscanning to determine risk of cirrhosis. Treatments in the form of a daily tablet are available but these do not cure the disease, but can reduce the incidence of cirrhosis and liver cancer.

HCV is blood borne virus that can only infect someone if blood to blood transmission takes place. This can occur from using infected toothbrushes, razors, needles and any other item that may pierce the skin or condition where the skin is damaged or broken. It can also be transmitted sexually. It often has no symptoms but occasionally can make one feel unwell just like in HAV. In most cases it is without symptoms but in some it may make one feel unwell at the time of infection (appr. 3 months). Most people will not be able to eliminate the virus and it makes its home in the liver. In the longterm people with HCV are at risk of getting cirrhosis and also of liver cancer. Diagnosis is made with blood tests, ultrasound and require fibroscanning to determine risk of cirrhosis. Treatments will soon be available that are successful and without the side effects of previous interferon based treatments. We anticipate these being available in April 2016.

The is an iron storage genetic disorder commonly affecting men and women originating from the Northern Hemisphere. The genetics of the disease were discovered in Brisbane. It occurs due to a malfunction of the iron sensing mechanisms in the small bowel. Due to this susceptible patients cannot regulate iron levels in the body and all iron is absorbed and stored. In the longterm this leads to diabetes, heart disease, joint disease, liver disease and can cause early death. Diagnosis is made with blood tests, including a genetic blood test. Other tests required in management include ultrasound and fibroscan. Treatment is by performing venesections (removal of blood), this leads to the stored iron being released from stores (eg liver, pancreas, heart, bones) and overall the total iron overload being reduced. Family counselling is required as others may also be affected without their knowledge. If discovered early then all the complications above can be avoided leading to normal length of life.

Cirrhosis is scarring of the liver, it is not reversible. It is usually symptom free until so much of the liver has scarred that it is no longer able to perform its complex role as the chemical processing and detoxifying unit of the body. Symptoms often include fatigue which can be extreme, ‘brain fog’ where the ability to perform complex mental of coordinated activities decreases, loss of libido, impotence, loss of body muscle and reversal of the sleep / wake cycle so people cannot sleep at night and cat nap in the day. Severe advanced liver disease leads to conditions such as ascites and increase the risk of life threatening haemhorrage.

Diagnosis requires blood tests, ultrasound, fibroscan and other tests maybe required such as endoscopy. No treatments are currently available except for liver transplantation.

Pancreatitis is a condition where the the pancreas is damaged often by the chemicals that it is producing, which are powerful digestive enzymes that help us digest our food. Insult to the pancreas in the form of viruses, alcohol, trauma or blocked tubes within the pancreas lead to injury. It can range from mild to severe and also life threatening. Symptoms include abdominal and back pain, loss of appetite, nausea and sometimes jaundice. Diagnosis is with blood tests, ultrasound, CT scan and MRI scans. Treatments are mainly supportive but may require a prolonged stay in hospital and very rarely involve surgery.

This is one of the most common cancers in the world. It is usually caused in people who have cirrhosis or have HBV. It can occasionally occur without these factors being present. The liver may also be the site of metastases (spread) from other cancers, for example colon or lung.

This is an increasingly common cancer, usually found in those consuming above average quantities of alcohol.  It is often silent in terms of symptoms until it is advanced. At this stage, patients may have loss of appetite, nausea, weight loss and abdominal and back pain. Diagnosis is made with blood tests, ultrasound, endoscopy, CT and MRI scans.  Treatments are limited but if picked up early operations may be successful.