Gastroenterology

More Than Just Reflux: The Era of Eosinophilic Oesophagitis

More Than Just Reflux: The Era of Eosinophilic Oesophagitis

Eosinophilicoesophagit is (EoE) is a unique form of nonimmunoglobulin E (IgE) mediated food allergy. Adults with EoE typically present with food bolus impaction and/or dysphagia to solid foods. Children can have a more varied presentation, such as heartburn, failure to thrive, persistent vomiting or chronic abdominal pain. Allergy tests are not useful. First-line management options include proton pump inhibitors (PPIs), topical corticosteroids or dietary management. Response to PPIs and resolution of eosinophilia will occur in many patients with EoE.

Modern Medicine – Issue 4 2020

August 14, 2020 by Gastroenterology

All Colonoscopies are not Created Equal

All Colonoscopies are not Created Equal

Colorectal cancer is the second‑most common cause of cancer-related deaths in the world. The natural history of colorectal cancer carcinogenesis through the adenoma-carcinoma sequence permits screening programmes to detect and remove pre-cancerous lesions. Inadequate bowel preparation has been associated with a 47% lower likelihood of adenoma detection, compared with adequate preparation – defined in terms of the proportion of the bowel visible. Poor bowel preparation results in longer or repeated procedures, with further cost and risk to the patient.

Modern Medicine – Issue 3 2020

May 21, 2020 by Gastroenterology

Chronic Diarrhoea – It Happens!

Chronic Diarrhoea – It Happens!

Diarrhoea that persists beyond a few weeks can be functionally debilitating and an indication of a significant underlying medical problem. A systematic approach to diagnosis involving a thorough history, examination and carefully targeted investigations allows for identification of cause in most cases. Appropriate treatment of the underlying problem is associated with improved outcomes for patients compared with symptomatic management alone.

Modern Medicine – Issue 2 2020

April 8, 2020 by Gastroenterology

The Ins and Outs of Diverticular Disease

The Ins and Outs of Diverticular Disease

Diverticular disease is a common condition that increases in prevalence with age. Management is multidisciplinary and can range from outpatient treatment to emergency surgery. Diverticular disease is thought to be prevalent in developed countries, but contrary to this belief, an increasing trend in prevalence has been noted in Africa over the past four decades.

Modern Medicine – Issue 4 2019

August 5, 2019 by Gastroenterology

The Gut Microbiome’s Role in MS

The Gut Microbiome’s Role in MS

Multiple sclerosis (MS) is a neurodegenerative autoimmune disorder of the CNS. Recent experimental and clinical evidence suggests the presence of microbial imbalances in the gut of MS sufferers. The gut microbiome is defined as the summation of all the microbial entities as well as their genes, proteins and metabolic products in a given space and time. Studies show the MS gut microbiome as having general alterations in specific taxa, some associated with the promotion of inflammatory cytokines and overall inflammation.

Modern Medicine – Aug/Sept 2018

September 26, 2018 by Gastroenterology Multiple Sclerosis

The Stepwise Approach to Chronic Constipation

The Stepwise Approach to Chronic Constipation

Chronic constipation (CC) is an extremely common disorder with an estimated prevalence ranging between 2% and 24%. The prevalence of CC increases with age and may reach 80% in nursing home residents. Constipation has severe consequences for the quality of life of those affected and costs to individual patients and to society in general are significant.

Modern Medicine – June/July 2018

July 17, 2018 by Constipation Gastroenterology

The Gut Dysbiosis – Hypertension Link

The Gut Dysbiosis – Hypertension Link – MM1703

Recent studies have revealed that many health maladies are as a result of significant perturbation in core gut microbial communities and many parameters
such as host-microbe crosstalk which are intrinsically linked to the microbial ecology and gut functionality. The influence of gastro-intestinal microbiota
composition and their possible link to obesity, diabetes, neural disorders, brain development, insulin resistance and other metabolic disorders have been
well documented. However, recent data suggest that it may also play a role in the development and maintenance of cardiovascular disease.

Modern Medicine – February 2017

February 17, 2017 by Gastroenterology Uncategorized

Investigation of Nausea How Far to go Before Referral

Investigation of Nausea How Far to go Before Referral – MM1609

Nausea is a common clinical presentation. If the patient’s history and examination are normal then usually the diagnosis will be functional or idiopathic nausea. This is a diagnosis of exclusion and a few basic tests will often rule out serious pathology. Organic causes are usually apparent from a patient’s history and physical examination. A few basic investigations will rule in or out most underlying causes. Referral of patients to a gastroenterologist should be considered when the diagnosis is in doubt, there is the suspicion of an underlying gastrointestinal cause or to reassure the patient. Consider anxiety as an underlying or contributing factor to nausea.

Modern Medicine – September 2016

October 6, 2016 by Gastroenterology Nausea
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