Gastroenterology

Good Bowel Preparation Helps Adenoma Detection

Colorectal cancer (CRC) is the fourth most common cancer in South Africa, and the sixth most lethal. Approximately 25% of patients will have synchronous metastatic disease at the time of their primary CRC diagnosis. Five-year overall survival rates for CRC are 93.2% for stage I, 72.2 – 84.7% for stage II, 52.3 – 83.4% for stage III and 8.1% for stage IV.1 Early adenoma detection is possible with colonoscopy, which is dependent on adequate bowel preparation.

Modern Medicine – Issue 6 2023

Inflammatory Bowel Disease: Causes, Symptoms and Treatment

Inflammatory bowel disease (IBD) is characterised by chronic inflammation of the gastrointestinal tract. The recognition of alarm symptoms, raised levels of inflammatory markers or an elevated faecal calprotectin level should prompt referral to a gastroenterologist for appropriate assessment and treatment. New treatment targets and improved therapies are available. Patients with IBD are often under- or inappropriately treated. Anxiety and depression are common in patients with IBD and should be addressed as a part of multidisciplinary and individualised management.

Modern Medicine – Issue 6 2023

Screening for Colorectal Cancer Pays Off

Colorectal cancer (CRC) is the third most common tumour in men and the second in women, accounting for 10% of all tumour types worldwide. Incidence is 25% higher in males and differs greatly between countries. With more than 600 000 deaths estimated each year, CRC is the fourth most common cancer related cause of death globally.

Modern Medicine – Issue 4 2023

Reverse the Far-reaching Effects of Dysbiosis

The possibility of modifying the gut microbiota to replace harmful bacteria with more favourable microbiota has been widely explored since 1907, when observations that consumption of fermented products containing Lactobacillus bulgaricus was associated with longevity and good health. The advent of modern molecular techniques has provided evidence that the gut microbiota plays a pivotal role in health and disease.

Modern Medicine – Issue 2 2023

Iron Deficiency: Excluding serious causes

Iron deficiency is a common issue among patients presenting to general practice. Management requires oral or intravenous iron replacement coupled with clinical assessment and consideration of further investigations to exclude serious causes.

Modern Medicine – Issue 2 2023

GI Disruption May Underlie Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction which can have a considerable impact on quality of life. Following diagnosis, timely evidence-based management is vital to the care of patients with IBS, aiming to improve outcomes, and enhance patient satisfaction.

Modern Medicine – Issue 3 2022

The Tricky Task of Bowel Preparation for Colonoscopy

Colonoscopy procedures are routinely used for evaluating the colon, mostly for screening and early detection of colorectal cancer, which has a high incidence and mortality rate. Extensive data show that adequate bowel preparation is instrumental for the success of any colonoscopy procedure. Poor bowel preparation accounts for nearly 20% of failed colonoscopies, limiting the procedure’s diagnostic/therapeutic value.

Modern Medicine – Issue 2 2022

Diagnosing and Managing Lactose Intolerance

Lactose intolerance is a relatively new disease increasingly recognised in medicine in the last 50 years, although the symptoms were described by Hippocrates more than 2000 years ago. In the 1960s, research revealed that lactose intolerance was correlated with race and that lactose intolerance was more common globally than lactose tolerance. More recently, genetic causes of lactose intolerance have been identified.

Modern Medicine – Issue 6 2021

Managing PEI after Gastrointestinal Surgery

Pancreatic exocrine insufficiency (PEI) is associated with disorders of the pancreas such as chronic pancreatitis, acute necrotising pancreatitis and pancreatic cancer, but can also occur as a consequence of gastrointestinal (GI) and pancreatic surgery.

Modern Medicine – Issue 2 2021

Is it IBD? Making an Accurate and Prompt Diagnosis

Abdominal symptoms thought to be related to the lower gut (ileum and colon) are common, and most do not represent inflammatory bowel disease. Making an accurate and prompt diagnosis in general practice can be challenging at times. However, being aware of the range of differential diagnoses and the ways in which one can best estimate the pretest probability of each condition to enhance diagnostic accuracy is relatively straightforward

Modern Medicine – Issue 2 2021