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Wednesday, March 16, 2011

Gastrointestinal Disease



ibs



Due to space constraint, we can only hold a brief discussion on the more common type of gastrointestinal diseases.

Gastrointestinal diseases otherwise referred to as irritable bowel syndrome (IBS) is often the cause of many health problems and sicknesses. Look after your Gastrointestinal health and many of your health problems will diminish.

At Beyond Medicine, we put great emphasis on Gastrointestinal health. As part of the examination, we routinely palpate the abdominal cavity for any signs of tenderness, discomfort or pain. It goes without saying that if there is any tenderness, discomfort or pain during palpation, there is invariably a problem with your Gastrointestinal health. Yet a scan will often produce a negative finding. Until and unless there are scar tissues or unless the problem is very acute, conventional scans will produce a negative finding. This can be very misleading and create false hope in a patient who knows that his/her abdominal health is in question. Considering the daily intake of processed foods, the preservatives that are added to our foods and the life style, no wonder there are many out there who suffer from one form of abdominal disorder to another.

Simply put, Gastrointestinal disorder is the cause of many types of pain. In our practice, we quickly learn that middle back pain can be a crossover of stomach problems, lower back pain can come from a problem with either kidneys or the bladder. Gall stones can cause pain to the right side of the back and so on. Therefore when a client comes in to see us complaining of back pain, our initial approach is to determine if there is a problem with the Gastrointestinal tract or the abdomen. No doubt, we will also examine the spine carefully for any symptoms of misalignment, muscles spasms and so on but abdominal health is top of the list!

When it comes to abdominal disorders, a patient would usually have experienced some sort of pain in the abdominal cavity. The abdominal pain can be stomach cramps, stomach ache, abdominal discomfort, heartburn, upper abdominal pain, kidney pain, liver pain or other related types of pain. In addition, there are discomforts caused by reflux, bloating and fluid retention.

Abdominal pain can range from severe life threatening conditions, for example aortic aneurysm, acute appendicitis to much less serious conditions such as heart burn, reflux and gastroenteritis. We would recommend prompt medical attention for any types of abdominal pain.

Abdominal pain is a very common symptom and many are not serious. Because they are not serious many cases of appendicitis in children are wrongly diagnosed as gastroenteritis. We have a way of distinguishing between appendicitis and gastroenteritis. On the other hand, certain types of Gastrointestinal problems such as helicobacter pylori, crohn’s disease and ulcerative colitis could lead to cancer. For this reason therefore, we would specifically make reference to them.

Abdominal pain can be classified into more specified types such as lower abdominal pain, upper abdominal pain, left abdominal pain, right abdominal pain and epigastric pain (pain behind the breastbone such as in heartburn, reflux or GERD or pain on the right side as caused by gallstones.
abdmonial pain


The following are some of the possible causes of abdominal pain. There could be other accompanying or possible causes so it is best to consult your doctor if in doubt. The list below is not exhaustive.
  1. Gas
  2. Gallbladder disease
  3. Colon cancer
  4. Diverticulitis
  5. Diverticulitis
  6. Appendicitis
  7. Gastroenteritis
  8. Food poisoning
  9. Peptic ulcer
  10. Kidney stones
  11. Ovarian cysts
  12. Stomach cancer
  13. Acute pancreatitis
  14. Intestinal obstruction


Helicobacter Pylori Infection:  This organism causes a spectrum of disease in humans including gastritis, ulcer disease (both gastric and duodenal) and in all probability, gastric cancer and gastric lymphoma. In all likelihood, helicobacter Pyloric Infection is one of the main causes of stomach cancer. Indigestion (dyspepsia) is a very common symptom and a very high proportion of people with indigestion will have helicobacter pylori infection causing gastritis. Up to 10% of the population will develop peptic ulcer disease at some time in their lives and most duodenal ulcers and many gastric ulcers are due to helicobacter pylori infection.
h-pylori

Conventional medicine will diagnose helicobacter pylori by biopsy with urea breath test. At Beyond medicine, we would palpate the abdominal cavity, especially, the right and left upper quadrants and the central midline posterior to the rib cage for any signs of discomfort, tenderness and pain to determine the presence of ulcers. If ulcers are suspected, the possibility of helicobacter pylori infection cannot be ruled out.

Hiatus Hernia:  The presence of a hiatus hernia is usually noted when a patient is in the process of lying down on our examination table face up. There is usually a bulge
between the oesophagus and the stomach. This bulge is very noticeable in severe cases. The junction of the oesophagus and stomach stays down within the abdomen and the top part of the stomach (the fundus) bulges up into the chest cavity.  Prolonged use of prescribed medication, excessive junk foods and extreme stress can cause it.

Hiatus hernia may cause or contribute to pain in the abdominal area, heartburns and pains in the chest area. However, there can also be symptoms of a number of other conditions such as peptic ulcers and even symptom of heart problems. Whenever there is a severe case of hiatus hernia, reflux, heartburn and symptoms of bloating are invariably present.

With enzyme therapy and certain exercises, we are able to help with the gradual reduction of the hiatus hernia and make it go away completely without surgical intervention.

Cirrhosis of the liver:  The term refers to advanced liver damage and which is characterised by dense scarring where the lobes are covered with fibrous tissues. Once cirrhosis develops, it is usually irreversible but further damage may be stabilised if the cause is removed or remedial actions taken. Cirrhosis are caused in the main by excessive alcohol consumption, iron overload, chronic viral hepatitis, autoimmune diseases, chronic bile duct obstruction. The symptoms would usually include yellowing of the skin, circulatory changes occasioned by reddening of the palms, spider veins in the chests, loss of libido and hair loss. In men, there could be breasts enlargement, testicular atrophy and impotence. In females, the symptoms may include irregular menses, absences of periods, breast atrophy. Bruising is also a symptom of cirrhosis, enlarged spleen and bleedings in the veins are common.

Hepatitis:  The term refers to an inflammatory process within the liver from whatever cause. The cause may be a virus, prolonged use of certain prescribed medication, a toxin, autoimmune related diseases which allows the immune system to attack one’s tissues. Hepatitis B & c can be chronic whilst hepatitis A is not of a chronic nature.

People with chronic hepatitis may feel quite unwell with symptoms of tiredness, loss of appetite, nausea, easy bruising and fluid retention. Clinical examination may reveal dilated blood vessels in the skin, redness in the palms, easy bruising, enlargement of the liver and spleen and fluid retention in the ankles. One must be well advised that hepatitis is highly contagious.

Crohn’s Disease:  The term refers to a chronic inflammatory process of the intestinal tract. The disease can be anywhere within one of the four parts of the intestinal tract which can be the oesophagus, the stomach, the colon and the rectum. However the two main primary sites for crohn’s disease are the ileum which is the last portion of the small bowel and the colon. The lining of the bowel can become ulcerated and thickened.
 crohns

Symptoms of crohn’s depend on the position of its occurrence. Where the ileum is involved, there is usually pain in the right lower quadrant or where the colon is involved, there is usually pain posterior to the naval (belly button) But some sort of pain is usually felt during palpation. When the colon is the site of the infection, diarrhoea sometimes with bloody stool may occur with fever and weight loss. Crohn’s disease often affects the anal area where there may be a draining sinus tract called a fistula. When the disease is fully active, the patient may experience fatigue and feeling of lethargy may appear.

In conventional medicine, there is no once conclusive diagnostic test for Crohn’s disease. Patient’s medical history and physical examination are always helpful. Certain blood and stool tests along with colonoscopy are performed to arrive at a diagnosis. In addition, a sigmoidoscopy of the lining of the rectum and lower bowel is often required. At Beyond Medicine, the whole of the abdominal cavity is routinely palpated for symptoms of crohn’s. We find that we are by far more accurate because if there is tenderness, discomfort or pain during palpation, common sense suggests something is not quite right!  Outside the bowel, other problems can develop. These can include arthritis, eye and skin problems. Open sores outside and in the vicinity of the anus can develop and these are often painful. A fistula can also be formed.  Conventional medicine resorts to cortisone, anti-inflammatory drugs and pain killers to control the disease; surgical intervention to remove the infected part of the bowel is often the treatment of choice!

Ulcerative Colitis:  In the early stage, it is extremely difficult to distinguish between crohn’s and ulcerative colitis. The treatment for both remains the same. Ulcerative colitis involves the inner lining of the large intestine (colon or bowel) and rectum with a chronic inflammatory process. The small intestines are not involved.
The most common symptoms are abdominal pain and diarrhoea which may contain blood, mucus and pus. Patients may suffer fatigue, weight loss, dehydration and malnutrition. Colonoscopy or flexible sigmoidoscopy is the preferred method of diagnosis. Palpation of the lower abdomen would give us an indication as to whether or not the patient has ulcerative colitis.

It suffices to add that both crohn’s and ulcerative colitis would lead to bowel cancer.

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