A leading specialist and senior consultant in gastroenterology, liver diseases from Mount Elizabeth Hospital, Singapore Dr Yap Chin Kong recently visited Bangladesh. During his visit he shared his views on recent advances in the diagnosis and treatment of different gastrointestinal diseases.
Dr Yap talked about the common problems like irritable bowel syndrome (IBS) and constipation where he highlight the healthy eating for proper nutrition, balance diet. He also shed lights on how one can prevent gastrointestinal diseases like gastritis, ulcers and so on.
Irritable bowel syndrome (IBS) is one of the most common disorders that doctors see. Yet it is also one that many people are not comfortable talking about because the signs and symptoms may be embarrassing.
Doctors are not sure what causes IBS. The nerves and muscles in the bowel appear to be extra sensitive in people with IBS. Muscles may contract too much when you eat. These contractions can cause cramping and diarrhoea during or shortly after a meal. Or the nerves may react when the bowel stretches, causing cramping or pain.
Most people with IBS find signs and symptoms improve as they learn to control the condition. Most people can control their symptoms with diet, stress management, and prescribed medications. For some people, however, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances.
It occurs more often in women than in men, and it begins before the age of 35 in about 50 percent of people. Abdominal pain, bloating and discomfort are the main symptoms of IBS. However, symptoms can vary from person to person. Some people have constipation, which means hard, difficult-to-pass, or infrequent bowel movements. Researchers have yet to discover any specific cause for IBS.
One theory is that people who suffer from IBS have a colon, or large intestine, that is particularly sensitive and reactive to certain foods and stress. The immune system, which fights infection, may also be involved.
Stress — feeling mentally or emotionally tense, troubled, angry, or overwhelmed — can stimulate colon spasms in people with IBS. The colon has many nerves that connect it to the brain. Like the heart and the lungs, the colon is partly controlled by the autonomic nervous system, which responds to stress. Stress makes the mind more aware of the sensations that arise in the colon, making the person perceive these sensations as unpleasant.
Some evidence suggests that IBS is affected by the immune system, which fights infection in the body. The immune system is affected by stress. For all these reasons, stress management is an important part of treatment for IBS.
Constipation is a common digestive system problem in which you have infrequent bowel movements, pass hard stools, or strain during bowel movements. Constipation is defined as having a bowel movement fewer than three times per week. With constipation stools are usually hard, dry, small in size, and difficult to eliminate. Some people who are constipated find it painful to have a bowel movement and often experience straining, bloating and the sensation of a full bowel.
Constipation is a symptom, not a disease. Almost everyone experiences constipation at some point in their life, and a poor diet typically is the cause. Most constipation is temporary and not serious. Understanding its causes, prevention, and treatment will help most people find relief. Fortunately, a few common-sense lifestyle changes, including getting more exercise, eating high-fiber foods and drinking plenty of water, can go a long way toward preventing or alleviating constipation.
A number of factors can cause an intestinal slowdown, including: Inadequate fluid intake, a low-fiber diet, Inattention to bowel habits, age, lack of physical activity, some medications, changes in life or routine such as pregnancy, aging, and travel etc. Changes in your lifestyle may be the safest way to manage constipation.
To help ease symptoms, trying using a fiber supplement, such as oat bran, Metamucil, Konsyl or Citrucel. These natural supplements help make stools softer and are safe to use every day. Drinking plenty of water or other fluids every day is another great way. Otherwise, fiber supplements can actually make your constipation worse. And add fiber to your diet slowly to avoid problems with gas. Most people who are mildly constipated do not need laxatives.
However, for those who have made diet and lifestyle changes and are still constipated, a doctor may recommend laxatives or enemas for a limited time.
Gastritis is not a single disease, but several different conditions that all have inflammation of the stomach lining. Gastritis can be caused by drinking too much alcohol, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen or infection with bacteria such as Helicobacter pylori (H. Pylori).
Gastritis may occur suddenly (acute gastritis), or it can occur slowly over time (chronic gastritis). In spite of the many conditions associated with gastritis, the signs and symptoms of the disease are very similar: a burning pain in your upper abdomen and, occasionally, bloating, belching, nausea or vomiting.
In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer. For most people, however, gastritis is not serious and improves quickly with treatment. Treatment usually involves taking drugs to reduce stomach acid and thereby help relieve symptoms and promote healing. (Stomach acid irritates the inflamed tissue in the stomach).
Avoidance of certain foods, beverages, or medicines may also be recommended. If your gastritis is caused by an infection, that problem may be treated as well. For example, the doctor might prescribe antibiotics to clear up H. pylori infection. Once the underlying problem disappears, the gastritis usually does too.
Latest palliative care options for gastrointestinal diseases
Dr Yap showed the recent advancement in the high quality imaging facilities by endospcopic ultrasound by which cancer cells are more accurately detectable. Dr Yap revealed the esophageal stenting technique for the terminally ill patients suffering from the cancer of food tube.
Dr Yap told that the main purpose of stenting is to provide paliative care to the patients and improving their quality of life at the end stage of the disease. This can eventually increase the longevity of life and relief the severe discomforts. It mainly relieves from the cancer of esophagus which obstructs the passage of food.
The stent is also being used relieving other obstacles like biliary stricture, pancreatic duct obstruction.
Source: The Daily Star, December 13, 2008