Haemorrhoids, also known as piles, are swollen or enlarged veins in the lower part of the anus and rectum.  Haemorrhoids can happen when the clusters of veins in your anus or rectum get swollen causing the veins to expand outward into the membranes of your anal and rectal tissues.  Haemorrhoids can be either internal and external. As the name suggests, internal haemorrhoids develop within the anus, whereas, external haemorrhoids develop outside of the anus. Haemorrhoids can cause severe itching, pain and difficult while sitting. Thankfully, haemorrhoids are treatable. You can consult a reliable consultant gastroenterologist for the diagnosis and treatment.

Types of Haemorrhoids

There are four types of haemorrhoids, which are mentioned below:

Internal- Internal haemorrhoids develop insider your rectum and cannot be seen.  Internal piles do not hurt generally and they rarely cause pain and discomfort. Some of the common symptoms of internal haemorrhoids include blood in your stool or on the toilet paper when you wipe and tissues that bulge outside your anus. The tissues can go back inside on their own. However, when they don’t they can be softly pushed back into the place.

External- External haemorrhoids develop outside of the anus. These lie under the skin around the anus. Some of the common signs and symptoms of external haemorrhoids include pain, discomfort and swelling around the anus, itching in your anal region and bleeding. External haemorrhoids are not always visible, but sometimes, they can be seen as lumps in the anal region.  These are usually not a serious medical issue, but you should get in touch with a consultant gastroenterologist if they cause trouble your daily life.

Prolapsed– A prolapsed haemorrhoid occurs when internal haemorrhoids protrude from the anus. A gastroenterologist may assign it a grade depending on how far it sticks out. These can be seen as swollen red lumps outside your anus. Prolapsed haemorrhoids may cause burning sensation, pain or discomfort.

Thrombosed– A thrombosed haemorrhoid contains a thrombosis (blood clot). It can be seen as a lump or swelling around your anus.  Though blood clots can form in both internal and external haemorrhoids, but the symptoms may vary.  Some of the common signs and symptoms of a thrombosis hemorrhoid may include swelling and redness, bluish color around the area, intense pain and itchiness.

What Causes Haemorrhoids?

The exact causes of haemorrhoids are still unknown. However, they are believed to be associated with an increase in pressure in the lower rectum which can cause swelling and inflammation in the blood vessels of the lower rectum. Some factors that can cause increased pressure within the lower rectum are mentioned below:

  • Sitting for long periods of time
  • Straining to have a bowel movement
  • Chronic constipation or diarrhea
  • Pregnancy
  • Anal intercourse
  • Low-fibre diet
  • Being overweight
  • Spinal cord injury
  • Poor posture
  • Family history of haemorrhoids
Diagnosis of Haemorrhoids

The diagosis of haemorrhoids would start with a visual inspection to see if you have external haemorrhoids.  Your doctor may carry out various tests and procedures to diagnose internal haemorrhoids, which may include:

  • A visual inspection of your anal canal using anoscope, proctoscope or sigmoidscope
  • A rectal examination in which your doctor will insert a lubricated gloved finger to feel unusual growth.
  • If more extensive examination of your entire bowel is required, then a colonoscopy may be performed.
  • Your doctor may also look for blood in the stool or examine the muscle tone of your anus.
Treatment for Haemorrhoids

Fortunately, haemorrhoids can be treated easily with simple medical procedures depending upon the severity and type of haemorrhoids you might be suffering from. Some of the common treatments for haemorrhoids are:

Topical Treatment- There are various over-the-counter hemorrhoid creams available that can be taken to soothe pain temporarily. Witch hazel wipes are highly beneficial and have no harmful effects. Moreover, sitting on a cushion rather than a hard surface can help reduce the swelling of the existing haemorrhoids.

For persistent bleeding, non-surgical procedures can be performed in a doctor’s office, which are:

Rubber band ligation– Rubber band ligation involves using a rubber band to cut off the blood supply to the hemorrhoid enabling it to die

Electrotherapy- Electrotherapy, also known as, electrocoagulation is a heat treatment that cause the hemorrhoid to harden and shrivel.

Injection– Sclerotherapy involves injecting a substance into the hemorrhoid to harden and shrink it.

If non-surgical methods are not successful, then following surgical procedures may be required:

Hemorrhoid stapling– Haemorrhoid stapling is the removal of an internal hemorrhoid with a special staple gun.

Hemorrhoidectomy- Is the removal of haemorrhoid with a laser or scalpel, under general anesthetic.

Prevention of Haemorrhoids

Haemorrhoids can be prevented by making certain changes in your lifestyle.  The best way to prevent haemorrhoid is to keep your stools soft, so they pass easily. Some methods to reduce symptoms of haemorrhoids are:

Consuming high-fiber food– Consume more fruits, vegetables and whole grains because they will help you avoid straining that can cause haemorrhoids.

Plenty of fluids– Aim to drink at least 6 to 8 glasses of water each day to keep your stools soft.

Avoid Straining- Straining when trying to pass a stool can create pressure in the lower rectum. Do not wait for too long, go as soon as you feel the urge to open your bowels.

Exercise- Maintaining an active lifestyle and exercising daily can reduce pressure on veins.

Those were some important details you need to know about haemorrhoids, their types, causes, treatment and prevention.

Following a month of indulgence, many decide to make lifestyle changes in January. Some try dietary restriction (eg ’Veganuary’) or reduce their total caloric intake, while others abstain from alcohol (eg ‘Dry January’) or jumpstart new exercise regimes. There are even some heroes among us making several changes at once. While it is advised that individuals take proper care of themselves year round, it is appreciated that this does not always happen.

Of topical interest therefore is that intermittent fasting proves beneficial for weight loss in both animal and human studies. As humans, we have not evolved to consume three large evenly-spaced meals throughout the day (plus snacks). This is a symptom of modern life and is due to an abundance of resources. Rather, we went for short stretches of time without food. We still needed to perform, to hunt prey and escape predators, but we did so in a fasted state.

Two methods of intermittent fasting in humans provide evidence-based weight loss, specifically the 5:2 regime (fasting 2 days per week), and daily time-restricted feeding (leaving, for example 18 hours between dinner and breakfast the next day, ie a 6-hour eating period). Comparatively, intermittent fasting seems to provide greater health benefits than a simple reduction in daily caloric intake, and might be considered the method of choice for effective weight control, metabolism of energy, and improved health across the lifespan.

Healthcare professionals may not understand how to prescribe intermittent fasting regimes. Patients may also be unwilling to start one. This may be due to several unpleasant short-term effects, such as increased levels of hunger and irritability, and decreased concentration. Ideally, a patient would ease into the plan over a number of months, in order to minimise any unpleasant effects. This allows time for the body to adjust. The following plans can be considered for 5:2 intermittent fasting and daily time-restricted feeding, respectively:

5:2 Intermittent Fasting

    • For month 1: 1000 calories 1 day per week
    • For month 2: 1000 calories 2 days per week
    • For month 3: 750 calories 2 days per week
    • For month 4: 500 calories 2 days per week

Daily Time-Restricted Feeding

    • For month 1: 10 hour feeding period 5 days per week
    • For month 2: 8 hour feeding period 5 days per week
    • For month 3: 6 hour feeding period 5 days per week
    • For month 4: 6 hour feeding period 7 days per week

A new year provides a convenient opportunity for a fresh start, and widespread participation and media coverage provides a sense of camaraderie between friends, family and colleagues. This may increase the odds of success, and if nothing else, at least everyone is miserable together. If you still find yourself feeling unsatisfied with any lifestyle changes you may have made in January, then what about trying ‘Fasting February’?

For more information, please contact Dr Adam Harris.

Colon cancer is more common than you might think. It is the third most common type of cancer in the United Kingdom. Though it can happen at any age, it typically affects older adults. Colon cancer begins in the large intestines. The colon or large intestine is responsible for drawing out water and salt from solid wastes and moving this through the rectum. Colon cancer begins as small noncancerous clumps of cells which form inside of the colon. These polyps can become cancerous over time. Removal of colon polyps can help in preventing colorectal cancer.

Symptoms of Colon Cancer

Colon cancer does not show symptoms in the earliest stages. However, the symptoms may tend to show up as it progresses to advanced stages. Some of the common signs and symptoms of colon cancer are:

  • Constipation or Diarrhoea
  • Change in stool consistency
  • Abdominal pain, cramping and bloating
  • Blood in the stool
  • Weakness and fatigue
  • Unexplained weight loss
  • Irritable bowel syndrome
  • Iron deficiency
  • A Continuous urge to defecate

If colon cancer is not treated on time, it can spread to other parts of the body such as the liver causing other sets of symptoms.

Who is at a Risk of Getting Colon Cancer?

Factors that may increase your chances of getting colon cancer include:

Older age- Although colon cancer can occur at any age, but people who are older than fifty are at a higher risk of getting colon cancer. The studies suggest that the rate of colon cancer in people who are older than fifty is higher than those who are not.

Inflammatory Intestinal Conditions- Chronic inflammatory diseases of the colon can increase your chances of colon cancer. If you suffer from diseases such as Crohn’s disease and ulcerative colitis, you are at high risk of colon cancer.

Family History– If you have a family history of colon cancer, you are more likely to develop colon cancer. If one or more members of your family have colon cancer, your risk of getting cancer is even higher.

High-fat diet- Colorectal cancer may be linked with low-fibre and high-fat diet. Research has shown that the risk of colon cancer is higher in people who eat diets which are high in fats and calories and low in fibre.

Sedentary Life style- People who are not active or do not exercise are more likely to develop this cancer. It is advisable undertake regular physical activity and maintain a healthy life style in order to reduce your chances of colon cancer.

What is a Colonoscopy?

A colonoscopy is a life-saving procedure that is used as a screening test for colon cancer. Colonoscopy is proven to detect diseases early. A colonoscopy doctor can spot and remove polyps during a colonoscopy.  During a colonoscopy, a long narrow tube that has an HD camera attached at the end of it is used to evaluate the rectum and colon.

A colonoscopy can also detect conditions like diverticulosis, inflammatory bowel disease and colitis. If a colonoscopy doctor spots polyps, he can painlessly remove them during the same colonoscopy.

Important Details You Should Know About Colonoscopy

A Colonoscopy is Painless- Yes, you heard it right! Colonoscopy is painless. The patients will be given the medicine through IV sedation to keep them comfortable and pain-free during the procedure. Soreness is only generally noted at the site of the IV..

You Need to prepare for colonoscopy- Some people feel that the colonoscopy preparation is unpleasant, but it is crucial to prepare for the procedure. A colonoscopy doctor will ask you to drink a prescribed laxative that will cause loose bowels for some time. After a period of rest, you will again need to take the second half of the laxative. This session of passing bowel motions will not be as intense as the first one because the majority of your faecal matter has already been flushed out. After this you are ready for the quick colonoscopy procedure.

A Colonoscopy is Quick- A colonoscopy procedure takes less than a half day, but it is recommended to take a day off to recover from the sedation.

You are not too young for a colonoscopy- No matter what your age, if you experience blood in the stool, fatigue, weakness or change in your bowel habits talk to your doctor immediately.  Recent studies have shown that there has been a rise in colorectal cancer among adults in their twenties and thirties..

The above facts are some of the important details you need to know about colonoscopy. The procedure is typically done at an endoscopy centre by an experienced colonoscopy doctor. If you have been experiencing weakness, fatigue, change in your bowel movements, make an appointment with a colonoscopy doctor immediately.

Colonoscopy is a life-saving procedure that can remove cancer-causing polyps, hence reducing the chances of death from colorectal cancer.

This is a very common bacterial infection of the stomach lining. It was first discovered by Drs Warren and Marshall (subsequently awarded Nobel prizes for their amazing finding). It is thought to be caught in childhood and is very common in developing countries. In about 10% of infected individuals the bacterium may lead to a significant increase in the amount of acid produced by the stomach and this may lead to a duodenal ulcer or in older people, a stomach ulcer. Curing the infection (called eradication) will heal the ulcer and prevent it recurring.

Most people with H. pylori infection will be unaware of the infection or may develop intermittent indigestion (dyspepsia); the benefit of eradication therapy in such cases is less clear cut.

There is an association between long standing infection with H. pylori and an increase in the risk of developing cancer of the stomach. The latter condition is however getting less and less common in the UK and this is probably related, at least in part, to the decrease in the number of people infected with H pylori.  Large studies in South East Asia and more recently from Sweden, have shown a decrease in stomach cancer after eradication of the infection.

The infection has evolved with humans and some believe that is may confer a health benefit in some people (ie in those where it doesn’t cause an ulcer or stomach cancer). Thus, recent data found a possible protective role against Barrett’s oesophagus, eosinophilic oesophagitis (a chronic inflammatory disease of the oesophagus) and inflammatory bowel disease (a chronic inflammatory disease of the colon).

Patients who see their GP with indigestion (dyspepsia) may be checked (by a blood, stool or breath test) to see if they are infected with H. pylori and if so, offered treatment to cure the infection to see if the dyspepsia improves. This improvement in symptoms is most likely if the dyspepsia was due to a duodenal or stomach ulcer caused by the bacterial infection. Success or failure may be determined either by improvement in symptoms or by performing a special breath test (can be prescribed by your GP and undertaken either at home or in the GP surgery).

Curing (or eradicating) infection with H. pylori is more difficult than treating other infections. It requires treatment with 2 antibiotics (eg metronidazole, amoxicillin or clarithromycin) and an acid-lowering drug (eg omeprazole or lansoprazole) all taken twice or three times daily for 7-10 days. This treatment will work in about 80-90% of cases. In an era of growing antibiotic resistance, there is no evidence-based treatment for H. pylori patients with penicillin allergy and prior exposure to clarithromycin.

For more information about H. pylori and potential treatment options, please do not hesitate to contact Dr. Adam Harris.

Acid reflux is a condition that causes the contents from your stomach to move up into your oesophagus. If you experience symptoms of acid reflux more than twice a week, you might have a condition called Gastroesophageal Reflux Disease (GORD). The studies conducted by the National Institute of Diabetes and Digestive and Kidney Diseases suggests that GORD affects approximately twenty percent of people in the United States. GORD, if left untreated can cause serious complications.

Causes of Acid Reflux

Under normal conditions, the lower oesophageal sphincter relaxes and opens when you swallow, which again tightens and closes when you have swallowed the food. Acid reflux happens when the lower oesophageal sphincter does not tighten or close properly. This causes the contents from your stomach to rise up into your oesophagus.

Symptoms of Acid Reflux

Individuals suffering from acid reflux often experience an uncomfortable burning sensation in their chest which radiates up toward your neck. If you have acid reflux, you might develop a bitter or sour taste at the back of your mouth.  In some cases, GORD can also cause difficulty while swallowing and can lead to breathing problems like a chronic cough.  Some of the symptoms of acid reflux are mentioned below:

  • Bloating
  • Burping
  • Nausea
  • Dry Cough
  • Dysphagia
  • Trouble swallowing
  • Hoarseness
  • Hiccups
  • Weight loss, etc.

No one likes the hot burning sensation in the throat, putting pressure on the chest. If you suffer from acid reflux, you would be already aware of how uncomfortable and disruptive it is. A leading gastroenterologist Dr. Jorge Rodriguez, author of “The Acid Reflux Solution” says that heartburn drugs do more harm than good by increasing the likelihood of contracting pneumonia and the risk of intestinal infections.  In this post, we will be giving you several easy ways to alleviate heartburn symptoms without swallowing a pill.

Chewing gum– According to the study conducted by the Journal of Dental Research, chewing sugar-free gum for at least thirty minutes after eating can give relief from acid reflux symptoms. This is because chewing gum stimulates the salivary glands, which increases the production of saliva. The saliva helps wash away any acid that might be causing you trouble.

Ginger Tea- Ginger tea is extremely beneficial for various stomach ailments including chronic acid reflux. Boil small slices of ginger roots in water for a few minutes. To reap the maximum benefits, it is advisable to drink this tea before a meal. This highly effective home remedy works wonders to relieve GORD symptoms.

 Limit Alcohol Intake– Drinking too much alcohol can increase the chances of heartburn and acid reflux. It triggers the symptoms by increasing stomach acid and impairs the ability of the oesophagus to clear the acid itself. By limiting your alcohol intake, you can help ease the pain and discomfort related to acid reflux.

Limit Caffeine Intake- Drinking too much coffee can weaken the oesophageal sphincter, hence increasing the risk of acid reflux. The studies have suggested that coffee intake may worsen acid reflux. The intake of coffee had different consequences on different people. If you think coffee intake is worsening your condition, simply do not take it. 

Avoid Raw Onions– Eating a meal containing raw onions can increase the likelihood of heartburn and acid reflux. The higher amounts of fermentable fibre contained in onions can irritate the lining of the oesophagus, hence worsening the condition. Eat meals that do not contain raw onions to keep your digestive system in good condition.

When You Should Visit a Gastroenterologist?

Despite following all the natural remedies mentioned below, you are not able to get relief from heartburn symptoms, you must make an appointment with a gastro specialist. Since a gastroenterologist is a digestive diseases specialist, he/she can guide you on the problems faced by you and the solutions for them. Make an appointment with a gastroenterologist immediately, if:

  • Your heartburn symptoms have worsened
  • You have experienced unexplained weight loss
  • Your heartburn is causing you nausea or vomiting
  • You have a chronic cough
  • You have chronic wheezing or hoarseness

If you notice any of the above-mentioned symptoms, it is time to check in with a gastroenterologist who can evaluate your digestive health and offer you the right solutions. Apart from the symptoms mentioned above, abnormal bowel movement, abdominal pain, rectal bleeding, trouble swallowing, etc. are all triggers for scheduling a consultation with a leading gastroenterologist.

When you visit a gastro specialist, give a detailed description of your symptoms to your doctor. Describe your diet that could be related to your symptoms.  If you have a family history of digestive disease, be sure to tell your doctor about that as well. All these things are crucial for understanding the underlying causes of the problem and recommend necessary treatments for it.

Stomach pains are quite common. If you experience something unusual in your stomach, it may be hard to pinpoint the exact cause without further investigation. If you are experiencing symptoms such as abdominal pain, bloating, frequent heartburn, etc, you should immediately visit a gastroenterologist clinic. However, if the symptoms are brand new, you may visit your regular physician for regular testing. Upon determining the symptoms, he may advise you whether or not you should be referred to a specialist.

What is Abdominal Pain?

Abdominal pain refers to the pain between the chest and pelvis area. Many times, abdominal pain resolves on its own without requiring medical attention. However, in other cases, sudden or intense pain may require immediate medical attention. Since the abdomen comprises of various organs, vessels, connective tissues, etc, a thorough examination is required to get to the underlying causes of the stomach pain.  In most of the cases, digestive problems are considered the common cause of abdominal pain and discomfort.

Common Causes for Abdominal Pain

Abdominal pain is caused due to many reasons. Some of the common reasons that could cause abdominal pain are mentioned below:

You ate contaminated food- The new dish you try at a restaurant could leave your stomach feeling wonky. Foodborne illness can come up in hours or days after eating contaminated food. Food poisoning can cause symptoms such as cramping, nausea, vomiting, bloody or watery diarrhoea, abdominal pain and a fever.

Burping or passing wind– Abdominal pain during burping or passing wind is also common. Gas is often developed in the body when it is unable to break down carbohydrates. You may also burp or pass wind if you swallow too much air during chewing or drinking.

 Swollen stomach- When you are unable to pass unwanted things down your digestive tract, your stomach may become swollen.  It could be a sign of intestinal obstruction that blocks food and fluids from passing down the digestive tract. In addition to it, the pain may be accompanied with loss of appetite, constipation and vomiting.

Stomach pain along with fever, nausea and rectal bleeding– If you are experiencing stomach pain along with fever, nausea and rectal bleeding, you must immediately get in touch with a doctor because this could be a case of viral gastroenteritis (stomach flu).

There could be many reasons why you should consult a gastroenterologist. A gastroenterologist is a specialist that can help treat conditions for different areas of your body ranging from your oesophagus to all the way down to your rectum. If you are experiencing abdominal pain due to any reason, you must immediately get in touch with a private gastroenterologist who can assess your condition and offer you the right advice and care. Mentioned below are several reasons to visit a gastroenterologist when you experience stomach pain due to any reasons.

When You Should Visit a Private Gastroenterologist?

Constipation– You are believed to be constipated, if you have less than three bowel movements a week. It could indicate there is a serious digestive issue causing it.  Constipation is more common in older people, people who stay dehydrated or who eat diets that are low in fiber.

Diarrhoea– Diarrhoea is having too many loose bowel movements. It can indicate an issue with your digestive system. Regularly occurring diarrhoea could be an indication of some serious underlying conditions such as Irritable Bowel Syndrome.

Coeliac disease– Coeliac disease is an autoimmune disease that makes it difficult for the body to process gluten. The common symptoms of celiac disease include- gas, diarrhoea, fatigue, weight loss, depression or itchy rashes.

Inflammatory bowel disease- Inflammatory bowel disease causes inflammation of the intestines. The most common symptoms of IBD are- loss of appetite, diarrhoea, severe abdominal pain, joint pain, fever, rectal bleeding, etc. You should immediately get in touch with a private gastroenterologist, if you experience any of these symptoms.

Rectal Bleeding- The cause of blood in the stool means there is bleeding somewhere in the digestive tract. This may be caused due to an anal fissure, haemorrhoids or cancer.

Heartburn– Frequent heartburn may be associated with GORD (Gastroesophageal Reflux Disease). You may need to begin medications to alleviate your discomfort.

It is extremely important to visit a gastroenterology clinic, if you experience all these problems frequently. When digestive symptoms occur, the first step is to get an appointment with a doctor. A doctor can perform a physical exam and determine what tests should be done to find out the underlying problems.

Stomach issues are not uncommon. According to the Centres for Disease Control and Prevention, about 50 million Americans experience digestive issues each year. Usually abdomen symptoms resolve on their own. However, in certain cases, chronic symptoms may be a sign of more serious underlying medical conditions such as cancer or organ failure.

Irritable bowel syndrome, also known as the nervous colon, mucus colitis and spastic colitis, is expected to affect between 25 and 45 million Americans. It is a chronic condition that can cause persistent discomfort and pain. IBS is known to be more prevalent in women than in men. Though IBS is not believed to be a life-threatening problem, but it can have a significant impact on the way you live your life. The signs and symptoms of IBS may vary from person to person. Some people are able to control their symptoms by managing diet, stress and lifestyle, however others may require taking counseling and medications from an IBS specialist.

 Different Types of Irritable Bowel Syndrome

There are three different types of irritable bowel syndrome based on different patterns of changes in your bowel movements. It is important to consult an IBS specialist to determine which type of IBS you have.

IBS with Constipation (IBS-C)

If you have IBS-C,

  • More than a quarter of your stools would be hard or lumpy
  • Less than a quarter of your stools would be watery or loose

IBS with constipation comes with discomfort, stomach pain and bloating. You may also experience delayed or infrequent bowel movement.

IBS with Diarrhoea (IBS-D)

When you have IBS with diarrhea,

  • Less than a quarter of stools are lumpy or hard
  • More than a quarter of your stools are loose or watery

IBS with diarrhoea comes with symptoms of stomach pain, discomfort, abnormal frequent bowel movements or watery or loose stool.

IBS with mixed bowel habits (constipation and diarrhoea)

Patients with IBS- M experience both hard and soft stools more than 25% of the time. Since the bowel habits often vary over time, this is why the IBS-Alternating (IBS-A) is used in place of IBS-M.

What are the Symptoms of Irritable Bowel Syndrome?

The common signs and symptoms of irritable bowel syndrome are mentioned as below:

  • Constipation
  • Diarrhoea
  • Abdominal pains or cramps that get worse after meals
  • Gas or bloating
  • Harder or looser stools than normal
  • Passing of mucus from rectum
  • Change in bowel habits

Symptoms are known to get worse after eating. IBS can also affect other parts of the body and can cause- headache, halitosis, frequent urination, joint or muscle pain, irregular menses, sexual dysfunction, persistent fatigue, etc.  In some cases, depression and anxiety may also occur because of the discomfort and embarrassment that accompany the condition. 

Diagnosis of IBS

Your gastroenterologist consultant will ask for the details which might be bothering you.  Your doctor is likely to start with asking your medical history and get a physical exam done to determine the type of IBS you have. One of the diagnostic criteria could be used for diagnosis purposes.

Rome criteria- Rome criteria is used for the diagnosis of irritable bowel syndrome. It requires patients to have recurrent abdominal pain and discomfort that last for at least three months. It is often associated with change in frequency of stool, defecation and change in appearance of stool.

 Manning criteria– Manning criteria focus on pain relieved by passing stool and having incomplete bowel movements, changes in stool consistency and mucus in the stool.

Type of IBS– IBS can be divided into three types for treatment purposes. As we discussed earlier, there are three types of IBS- IBS-C, IBS-D and IBS-M.

When to Consult an Irritable Bowel Syndrome Specialist?

Learning to live with IBS is a bit difficult when you have been diagnosed with it. You have to think over what changes to make when any new symptoms pop up. Your doctor will ask you a wide range of questions, such as is the pain related to meals? Do you have frequent bloating? Do you have a feeling of fullness in the rectum? Do you have a history of depression or mental illness? How often you get the pain? Is the pain related to meals? After having a detailed conversation with the patient, a doctor may ask you to carry out the careful abdominal and rectal exam.  Not just this, he might ask you to get some lab tests done such as- complete blood count and other blood tests, endoscopy, abdominal x-rays and stool testing for cultures and blood.

Depending on the type of IBS you have, you may be asked to make certain changes in your diet and lifestyle to combat the IBS symptoms. You may be asked to decrease your stress levels, exercise regularly, change the amount of fiber in your diet and identify foods that worsen your symptoms. Sometimes people are also prescribed some medications to help them deal with the symptoms they experience.

An accurate diagnosis of IBS is necessary so that symptoms can be properly managed. Therefore, it makes sense to get in touch with an IBS specialist who can diagnose IBS and help you treat symptoms.

In the 19th edition of the Gut Reaction series, I suggested that patients with Laryngo-Pharyngeal Reflux (LPR) may consider an alkaline water & plant-based Mediterranean style diet. As discussed in that blog, a paper published in JAMA Otolaryngology (October 2017) suggested that diet and consumption of alkaline water might be as effective as treatment with a PPI. The main outcome of the study was a change in Reflux Symptom Index (RSI) – the 1st group were treated with PPI and standard anti-reflux precautions (PS) and the 2nd group with alkaline water, a plant-based Mediterranean-style diet and standard anti-reflux precautions (AMS). Results from the study showed that the percentage of patients achieving a clinically meaningful reduction in RSI was 54% in PS-treated patients and 63% in AMS-treated patients.

How alkaline water and dietary change help the symptoms of LPR is unclear but it may change the biodiversity of the gut bacteria (microbiome) in the oro-pharynx, gullet (oesophagus) and stomach.

In this blog, I will provide some further information regarding alkaline water and what the Mediterranean-style diet involves.

First of all, the “alkaline” in alkaline water refers to its pH level. The pH level is a number that measures how acidic or alkaline a substance is on a scale of 0 to 14. Alkaline water has a higher pH level than regular drinking water. Because of this, some advocates of alkaline water believe it can help maintain balance by neutralising the acid in your body. Drinking water generally has a neutral pH of 7 while alkaline water typically has a pH 8-9.

It is relatively straightforward to make your own alkaline water at home. Here is a suggested recipe:

  • Pour a half-gallon of the filtered water (preferable to tap water) into a gallon jug with a lid. If using tap water, a filtration system is recommended.
  • Add one teaspoon each of baking soda, sea salt and coral calcium powder to the container.
  • Wash a lemon and slice it in half. Squeeze the juice into a small bowl.
  • Pour the juice into the water/baking soda/coral calcium mix.
  • Secure the container lid and then shake it vigorously to thoroughly mix all the ingredients.
  • Add the rest of the distilled water to the container, being sure to leave an inch of space at the top of the container for air.
  • Close the container tightly and shake it to mix the water.
  • Use pH strips to test the water to see the level, ideally around level 8 or 9. If that is not the case, add another ¼ teaspoon of baking soda and mix again until the proper pH level is reached.

Equally, many supermarkets stock alkaline water along with other specialty waters in the bottle water aisle. It can also be ordered online from a number of retailers.

Here is some basic information about the plant-based Mediterranean style diet:

  • Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts.
  • Replace butter and other dairy with healthy fats such as olive oil and canola oil.
  • Use herbs and spices instead of salt to flavour foods.
  • Limit red meat to consume no more than a few times a month.
  • Eat fish and poultry at least twice a week.

If you have any questions about alkaline water or a plant-based Mediterranean style diet, please do not hesitate to contact Dr. Harris.

Most people with IBS find that making certain changes in diet and/or lifestyle can help reduce their symptoms. However, there is no single dietary modification that works for everyone, owing to the range of different symptoms experienced by any given individual.

Traditional dietary advice has been to maintain regular meal patterns, avoid large meals, reduce fat intake, avoid excessive insoluble fiber intake & reduce caffeine. More recently a low FODMAP (Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols) diet has also been shown to help symptoms of IBS. These types of carbohydrates aren’t easily broken down by the gut bacteria and the gases released during this slow process may lead to bloating and discomfort. A low FODMAP diet involves restricting the intake of various foods that are high in FODMAPs, such as some fruits and vegetables, animal milk, wheat products and beans.

However, a recent article in Gastroenterology (2015;149:1295-97) highlighted a study which compared two popular diets (i.e. traditional vs low FODMAP) in people with IBS. The main finding was that both diets were equally effective in improving symptoms. Although there is still a lack of basic science to explain how either diet works, we recommend spending time with an experienced dietician, who can help create the diet and lifestyle plan that works most effectively for you.

Studies conducted in recent years have explored the relationship between the gut microbiota, consisting of around 800 different bacteria species, and metabolism. It has been suggested that specific intestinal microbial compositions can either protect from, or contribute to, obesity and other metabolic diseases.

First, I would like to discuss short-chain fatty acids (SCFA) and the vital role they play in influencing gut health. SCFA are produced by bacteria from fermentation of dietary products, mostly fibre, within the colon. Their primary role is to serve as a source of energy for cells within the colon and to stimulate repair and replacement. Of potential interest, butyrate may influence how energy (including glucose) is metabolised in the body and so hold a possible protective effect against metabolic disease and obesity.

The potential relationship between gut microbiota and obesity was analysed in this excellent 2017 study when faecal microbiota from both lean and obese subjects was transferred into mice, which then changed their feeding behaviour and subsequently their body mass to reflect the human source. The researchers suggested that butyrate positively influences energy balance and thus protects from diet-induced obesity.

Subsequent research has shown a broad variety of possible effects of butyrate on metabolism including an increase in mitochondrial activity, preventing metabolic endotoxemia, improving insulin sensitivity, increasing intestinal barrier function and protecting against diet-induced obesity.

These fascinating findings suggest a relationship between the gut microbiota and human metabolism. Further research is needed in humans to extend the experimental findings in mice and to establish if the gut microbiome may be changed (by prebiotics, probiotics, antibiotics or even faecal transplantation) to help reduce obesity and even, diabetes.

If you have any questions about gut microbiota and its relationship to obesity, please do not hesitate to contact Dr. Harris

At Digestive Health City & Docklands, we work hard to provide our patients with top-class care. You will enjoy friendly, fast and modern treatment by a highly experienced gastroenterologist. We carefully review patient satisfaction and feedback, and at Digestive Health we are continuously making improvements to our services, ensuring the highest level of care possible.

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