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Lower Digestive Tract Disorders

  • Common Conditions Affecting the Lower Digestive Tract

    Conditions of the lower digestive tract

    The lower gastrointestinal (GI) tract begins at the midsection of the small intestine, extending throughout the large intestine till the anus.

    Common conditions associated with the lower GI tract include diverticular disease, polyps, irritable bowel syndrome (IBS), cancer, or Crohn's disease, and usually require prompt clinical care by a gastroenterologist or a colorectal surgeon. Find out more about these conditions, the symptoms, diagnosis methods, and treatment options available.

    Don't let digestive disorders cause you to miss out on another good meal. Please call +65 6812 3770 to make an appointment with a specialist doctor today.

  • Irritable Bowel Syndrome (IBS)

    irritable bowel syndrome

    Irritable bowel syndrome (IBS) is a chronic disorder that affects the colon (large intestine). It affects the normal functioning of the colon, and causes discomfort and pain, changes in bowel habits (constipation or diarrhoea), gas and bloating. Irritable bowel syndrome is not life-threatening as it does not lead to permanent damage to the colon or serious complications such as cancer.

    Causes

    There is no exact cause for irritable bowel syndrome but people suffering from the disease tend to report one of the following conditions:

    • Food passing through the bowel quickly and forcefully, leading to diarrhoea
    • Food passing very slowly through the bowel, leading to constipation
    • Sensitive muscles and nerves in the bowel. Excessive contraction of these muscles when you eat can lead to cramps in the abdomen (belly)
    • There are other risk factors that increase the chance of Irritable Bowel Syndrome, and these include:
      • Being young
      • Having a family history of irritable bowel syndrome
      • Leading a stressful life
      • Suffering from infection or inflammation of the gut

    Signs & Symptoms

    The symptoms of irritable bowel syndrome can vary greatly between affected individuals. Your symptoms can range from mild to disabling, and these include:

    • Changes to your stools (small hard pellets or loose stools)
    • Changes to your bowel habits (diarrhoea or constipation)
    • Feeling that your bowel doesn’t empty completely
    • Finding mucus in the stools
    • Excess gas and bloating
    • Having pain or cramps in the abdomen

    These symptoms are similar to that of colon cancer, and you need to get your condition evaluated by your doctor.

    There are also less common symptoms of irritable bowel syndrome such as general tiredness, backache, headache, sweating, nausea, vomiting and pain when going to the toilet.


    Treatment

    There is no cure for irritable bowel syndrome. Treatment options consist of treating your symptoms and avoiding the risk factors that trigger the onset of your irritable bowel syndrome. Your doctor will suggest a treatment plan that works best for you, and it may include a combination of the following:

    • Activities and medication to keep your stress in check
    • Dietary changes such as:
      • Avoiding alcohol, fatty foods, chocolate and caffeinated drinks
      • Increasing or reducing your intake of fibre, depending on your condition
      • Eating small meals
      • Medication to help alleviate your constipation, diarrhoea, or abdominal pain and cramps

  • Diverticular Disease

    • Diverticular disease

    Diverticular disease occurs when small pockets or bulges (diverticula) develop within lining of the large intestine (colon). Diverticula is usually associated with inadequate fibre intake or ageing, and is caused by hard stools passing through the large intestine. Diverticulitis occurs when the diverticula become infected or inflamed. Lifestyle factors such as obesity, smoking, history of constipation, family history, or medication such as NSAIDs may contribute to the development of diverticular disease.

    Signs & Symptoms

    Common symptoms include:

    • Abdominal pain
    • Bloody stools
    • Nausea
    • Fever
    • Constipation
    • Diarrhoea

    Diagnosis

    Your doctor may perform a physical examination with the following tests:

    • Barium enema
    • Colonoscopy
    • Flexible sigmoidoscopy
    • CT scan

    Treatment

    For mild cases, your doctor may prescribe antibiotics and recommend lifestyle or dietary changes such as a diet high in fibre, or probiotics. For severe cases of diverticulitis or diverticular bleeding, surgical treatment may be required.

  • Polyps

    Polyps

    Polyps are abnormal growths, usually forming on the lining of the colon (large intestine). Whilst the majority of polyps are non-cancerous, certain types may eventually become cancerous. Due to the risk of polyps developing into cancer, it is recommended to go for regular screenings and to seek treatment promptly, especially if one has any of the following risk factors: Family history, obesity, smoking, or certain gastrointestinal disorders such as Crohn's disease.

    Signs & Symptoms

    Most polyps do not cause any symptoms unless of a certain size, which is why regular screening is important. Symptoms that can be caused by polyps include:

    • Blood in the stools
    • Changes in bowel habits
    • Abdominal pain

    If you have any of the above symptoms, consult a gastroenterologist or colorectal surgeon. Early detection can prevent future complications.


    Diagnosis

    A colonoscopy is usually prescribed to detect polyps. A colonoscopy is a simple outpatient procedure whereby your doctor will examine your colon. If polyps are found, this procedure will remove the polyps at the same time. Your doctor may also recommend the following tests:

    • Faecal occult blood testing
    • Barium enema
    • Sigmoidoscopy
    • CT scan

    Treatment

    Removal of polyps is usually performed during the colonoscopy procedure. Depending on your condition, your doctor may prescribe medication such as aspirin or non-steroidal anti-inflammatory drugs (NSAIDs). Dietary and lifestyle changes may also be recommended. Talk to your doctor to understand the treatment options available.

  • Crohn's Disease (Inflammatory Bowel Disease)

    Crohn's disease and IBD

    Crohn's disease is a chronic (long-term) inflammatory disease that primarily affects the small and large intestines. People with family history or gastrointestinal disorders such as irritable bowel syndrome may be more prone towards the condition.

    Signs & Symptoms

    Common symptoms of Crohn's disease include:

    • Weight loss
    • Abdominal pain
    • Diarrhoea
    • Cramping

    If you have any of the above symptoms, consult a gastroenterologist or colorectal surgeon. Early detection can prevent future complications.

    Diagnosis

    Your doctor may enquire about your family history and perform a physical examination. Additional tests may be prescribed such as:

    • Blood test
    • Barium x-ray
    • Colonoscopy
    • CT scan
    • Endoscopy

    Treatment

    Depending on severity of condition, your doctor may prescribe medications such as corticosteroids. The goal of the treatment is to reduce inflammation and prevent future flare-ups. Talk to your doctor to understand your treatment options.



    • References:
    • Colon polyps. American College of Gastroenterology. http://patients.gi.org/topics/colon-polyps
    • Overview of the medical management of mild to moderate Crohn's disease in adults. http://uptodate.com

  • Ulcerative Colitis

    Ulcerative Colitis

    Ulcerative colitis occurs in the colon (large intestine) when there is continuous inflammation and, if severe, ulceration of the colon, typically at the innermost lining. The inflammation can be of varying extents, starts in the rectum, and may affect the entire colon. The more affected the colon is, the worse the symptoms will be.

    Signs & Symptoms

    Common symptoms of ulcerative colitis include:

    • Abdominal pain and cramping
    • Bloating or distension
    • Blood or mucus in the stools
    • Loss of appetite
    • Persistent diarrhoea
    • Fever and fatigue
    • Unintended weight loss
    • Inflammation of the skin, eyes or joints

    If you have any of the above symptoms, consult a gastroenterologist or colorectal surgeon. Early detection can prevent future complications.

    Diagnosis

    Your doctor may run some diagnostic tests to identify the cause of your symptoms. These tests may include:

    • Blood and stool tests
    • CT scans and MRI
    • Gastroscopy and colonoscopy

    Treatment

    Treatment of ulcerative colitis depends on the severity of the disease and its responsiveness to available therapies. For example, a mild case of ulcerative colitis may be controlled with anti-inflammatory medication such as Mesalazine. But for more severe cases, immunosuppressives such as corticosteroids may also be required.

    In severe cases where the disease isn’t responding to medication or where the patient’s life is in danger, surgery may be necessary as the last resort.

    Speak to a gastroenterologist to find the best treatment option for your condition.


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