Gastrointestinal (GI) problems such as heartburn, indigestion, bloating or diarrhea are so common among people. These signs may point to several conditions affecting the stomach and nearby organs that are part of the digestive process. Unfortunately, as many different gastrointestinal issues have similar symptoms, they may be difficult to diagnose in one go.

Investigation for Gastrointestinal Problems

It is important to study the symptoms the patient complains of and conduct a physical examination along with possible further investigations. Further investigations may include blood tests and stool tests. Scans like ultrasound scan, CT scan or MRI may also be performed. Endoscopy is frequently advised to investigate Gastro-intestinal complaints. The commonest endoscopies performed are:

• Colonoscopy
• Gastroscopy

Some common gastrointestinal diseases or causes of abdominal pain:

- Acute Appendicitis (Laparoscopic Appendicectomy)

- Gallstones (Laparoscopic Cholecystectomy or Gall Bladder/Gall Stone Removal)

- Colon Diverticuli/Diverticulitis/Bleeding Diverticuli

- GERD (Gastroesophageal Reflux Disease)

GERD is commonly known as ‘heartburn’. Stomach acid is ‘refluxed’ into the esophagus and causes symptoms. It may sometimes present as severe pain in the chest that is mistaken for a heart attack. A Gastroscopy is sometimes required for diagnosis and to rule out other conditions. Treatment for GERD begins with making simple lifestyle changes, including healthy dietary habits, maintaining adequate hydration or water-intake level, quitting smoking, and taking over-the-counter medications to manage the symptoms. Patients are advised not to have heavy meals at dinner and to eat dinner earlier so that the food has time to ‘digest’ before sleeping. GERD may require prescription medications to control the symptoms. The commonest prescription medication are proton pump inhibitors like omeprazole, pantoprazole, rabeprazole. Less commonly, laparoscopic anti-reflux surgery is performed to restrict acid from coming to come up to the esophagus.

- Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome is a functional condition which has a range of symptoms. A person may complain of belly pain or bloating associated with a change in appearance or frequency of their bowel movements. Constipation, diarrhea, abdominal pain/cramps, and excessive gas, all are common in IBS. However, it is believed that certain foods, medications, stress, and lifestyle are the general factors contributing to triggering IBS. In the beginning, monitoring food habits, limiting caffeine, minimizing stress levels, quality sleep, and maintaining hydration well throughout the day help in treating the condition. Patients are also prescribed medication to help relieve symptoms. Assessment by endoscopy (Gastroscopy and Colonoscopy) may be required to rule out other sinister causes of the symptoms. Probiotics are also recommended for symptom relief.

- Ulcers

Peptic ulcers are ulcers that develop in the stomach and duodenum. Ulcers may be stress related or it may be sometimes caused by heavy use of certain drugs like Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen or naproxen. Diagnosis is usually by endoscopy (Gastroscopy). Treatment is usually with proton pump inhibitors like omeprazole, pantoprazole etc. If Helicobacter Pylori is present, it would be necessary to eradicate the Helicobacter Pylori with antibiotics. It is also necessary to ensure that ulcers are not malignant, especially gastric ulcers. This can be performed by Gastroscopy and biopsy. With medication like PPI’s and HP eradication, surgery is much less commonly required.