By Dr Mathew V Kurien
Gastroenterology is the medical specialty for the diagnosis and treatment of gastrointestinal and liver diseases. Gastrointestinal and liver diseases are very common and unless properly diagnosed and treated; they can lead to serious complications and even death.
With the help of modern diagnostic equipments and laboratory tests, early detection is possible for most of the diseases. Awareness is most important as many diseases present with the same symptoms or even no symptoms at all.
You may look healthy, may not have any symptoms but still you can have a serious disease. Hence periodic checkups are indicated for high risk people. Certain diseases run in families.
For example, if any of your close relatives (father, mother, brother, sister etc) have cancer, diabetes or heart attacks, you have a risk of more than 30% to get it in your lifetime.
Similarly, your lifestyle leads to certain diseases. If you are overweight with a sedentary lifestyle and consume tobacco or alcohol, you are at high risk to get diseases like diabetes, heart attacks and cancer.
Recently, vitamin D deficiency is related to many diseases as it is very common due to insufficient exposure to sunlight.
What about symptoms?
Many times serious symptoms are ignored. For example, blood in stool is a common symptom for piles and cancer. Hence any patient with even a single episode of bleeding requires a colonoscopy before getting treatment as piles. Otherwise a serious disease like cancer or ulcerative colitis may be missed.
What about gas?
This is a common term and mostly due to some food or even peptic ulcer. But remember, a serious disease like cancer of stomach or pancreas can have the same presentation. Hence when you get a gas next time please remember to have a basic checkup because early detection can save a life.
Common symptoms of gastrointestinal and liver diseases:
m Difficulty in swallowing or feeling of sticky/heavy sensation in chest.
m Loss of appetite or excess appetite.
m Feeling tired and unable to work.
m Loss of weight.
m Pain abdomen and vomiting.
m Heart burn, acidity.
m Yellow colour of urine/ jaundice.
m Constipation, diarrhoea or any abnormality in going to toilet
m Blood or pus in stool, piles.
If you have any of the symptoms, you require a detailed evaluation before getting treated as gas or piles. Now a day’s endoscopy is safe, simple and totally painless. Please do not get upset to undergo an endoscopic evaluation as it is the only test to see the intestine directly and is the most effective method to find out the earliest abnormality.
Common gastrointestinal and liver diseases
These are the most common diseases in the world.
H.Pylori infection
H.Pylori is the only living organism which can survive in human stomach. Although more than 70% of the world’s population is infected, only about 20% will develop serious complications like peptic ulcer and stomach cancer. Early detection is now possible by blood tests, although confirmation require endoscopy/breath tests.
Fatty liver
Fatty liver is the most common liver disease and affects more than 50% of world’s population. It is spreading like an epidemic and can lead to serious consequences as it affects women and children as well. Fatty liver can be totally asymptomatic or may just present with some mild pain over the liver area or an increase in liver enzymes.
Fatty liver can lead to serious consequences like diabetes, liver cirrhosis and liver cancer. Insulin resistance which is associated with fatty liver can lead to diabetes, cancers, heart attacks and PCOS in young females. Early diagnosis of liver fibrosis is now possible with specialised blood tests. All cases of fatty liver should be properly evaluated to arrest the further progress and associated complication if any.
Cancers
GI tract and liver is a common site for cancer and together they account for more than 40% of all cancers in humans. Unfortunately, they may not have any symptoms at all or may have only nonspecific symptom like gas, which are usually ignored.
By the time they are diagnosed, it is too late, and the patient may not live for more than a year in spite of all treatment.
Fortunately, early detection is now possible for most of the cancers so that complete cure can be offered. This is possible by simple blood tests and endoscopic studies which are totally safe and painless.
In short, regular cancer screening is very safe and effective in detecting early stages of cancer and can determine your future risk of getting one so that with proper intervention you can enjoy a cancer-free life.
Other diseases affecting GI tract
m Peptic ulcer & GERD
m Pancreatic insufficiency (more in diabetes)
m Gall bladder stone
m Piles and ano rectal disorders.
m Liver disease
m High bilirubin
m Hepatitis (A,B,C,D,E)
m Iron/Copper over load
Newer diseases
m Celiac disease – allergy to wheat
m Lactose intolerance
m Food allergy
m Ulcerative colitis and Crohn’s diseases
m Irritable bowel syndrome
m GI dysmotility disorders
m These diseases are common but require specialised tests for correct diagnosis.
Summary
Gastrointestinal and liver diseases are very common.
Many diseases can have the same symptoms or no symptoms at all. Even if you appear healthy and have no symptoms, regular GE evaluation is advised if you are above 40 years of age and have any of the following.
m Diabetes.
m Overweight or sedentary lifestyle.
m Any close relatives having cancer, heart disease, liver disease or diabetes.
m Jaundice/liver disease earlier.
m Consume alcohol/tobacco.
Evaluation
Regular cancer screening is highly effective in early detection and can save your life.
Any patient with fatty liver disease should be evaluated for liver fibrosis and other complications.
Above all, common terms like gas, ulcer and piles are nonspecific and require proper evaluation to exclude serious disease like cancer.
Dr Mathew V Kurien is a Specialist Gastroenterologist (Digestive & Liver Diseases) at Aster Medical Centre in Al Hilal
* With the help of modern diagnostic equipments and laboratory tests, early detection is possible for most of the diseases. INSET Dr Mathew V Kurien