Gastroenterology – Farrer Park Hospital
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What is Gastroenterology?
​Gastroenterology is the medical specialty that focuses on the structure, functions and disorders of the digestive system. These disorders may affect the esophagus (swallowing tube), stomach, small and large intestines, rectum, pancreas, gallbladder, and liver. When these organs do not perform normally, the ability to absorb food is affected and the patient may require the expertise of a gastroenterologist.
Conditions
​Abdominal Pain
Abdominal pain affects everyone from time to time. Some call it stomachache or tummy ache. The pain can be mild or severe and can be short-lived (acute) or occur over weeks and months (chronic).
 
There are many causes for abdominal pain. If caused by too much gas or a pulled muscle in the abdomen, it is not considered serious. Other cases of food poisoning could require urgent medical attention. 
 
Peptic ulcers are open sores on the inside lining of the swallowing tube to your stomach, the stomach itself, and the upper part of your small intestine. These sores can be caused by a bacterial infection or the consumption of certain medications such as aspirin. You could also develop a peptic ulcer if you suffered trauma in a serious accident, underwent surgery, or if your stomach produces excessive amounts of acid. Those with a family history of ulcers are also susceptible to this ailment. The most common symptom of a peptic ulcer is abdominal pain. In severe cases, there may be vomiting of blood, or dark blood in stools.
 
Gallstones
Gallstones are hardened deposits of digestive fluid that appear in your gallbladder. Your gallbladder is on the right side of your abdomen, just beneath your liver, and releases a digestive fluid called bile into your small intestine.
Gallstones could be as small as a grain of sand to as large as an egg. There could only be one gallstone, or many gallstones at the same time. Gallstones that cause no symptoms usually require no treatment but if a gallstone lodges in the duct to the bladder and causes a blockage, you will suffer sudden and rapidly intensifying pain in your abdomen.
 
Other symptoms may include:
- Back pain between your shoulder blades;
- Pain in your right shoulder 

Surgery to remove gallstones is the most common treatment. Oral medications may help dissolve gallstones but it may take months or even years and sometimes it is not successful. Medications are usually used for patients who are unable to undergo surgery because of other health issues.
 
If gallstones recur frequently, your doctor may advise you to undergo surgery to remove your gallbladder. Then, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder. A missing gallbladder will not decrease your ability to digest food. It may cause diarrhea, but that is usually temporary.
 
Food Poisoning
Food poisoning, also called gastroenteritis, is a condition caused by eating food contaminated with infectious organisms such as bacteria, viruses and parasites, or their toxins. While most people develop food poisoning from eating contaminated food prepared by caterers or in food courts and restaurants, contamination of food can also occur at home if food is incorrectly handled, cooked, or kept too long.
Food poisoning symptoms, which can start within hours of eating contaminated food, often include nausea, vomiting or diarrhea. Most often, food poisoning is mild and goes away without treatment.
 
Hepatitis A
Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. The virus is one of several types of hepatitis viruses that cause inflammation and affect your liver's ability to function. You are most at risk of contracting hepatitis A from contaminated food or water or from close contact with someone who is infected. Not everyone with hepatitis A develops signs or symptoms. If symptoms appear, they may include:
- Fatigue;
- Nausea and vomiting;
- Abdominal pain or discomfort;
- Clay-colored feces;
- Fever;
- Loss of appetite;
- Dark urine;
- Joint pain;
- Yellowing of the skin and eyes.
 
Hepatitis B
Hepatitis B is a serious liver infection caused by the virus with the same name. The infection can sometimes becomes chronic, meaning it lasts more than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis — a condition that causes permanent scarring of the liver.
 
Signs and symptoms of hepatitis B, ranging from mild to severe, usually appear about a month after you have been infected. These include:
- Abdominal pain;
- Dark urine;
- Fever;
- Joint pain;
- Loss of appetite;
- Nausea and vomiting;
- Weakness and fatigue;
- Yellowing of your skin and the whites of your eyes.
 
Hepatitis C
Hepatitis C is generally considered to be among the most serious of the hepatitis viruses. It is passed through contact with contaminated blood — most commonly through needles shared with an infected person.
Since there are usually no signs and symptoms, most people do not know they have the hepatitis C infection until liver damage shows up, decades later. About one to three months after being infected by the virus, the following signs and symptoms may occur in a small proportion of infected people:
- Fatigue;
- Nausea or poor appetite;
- Stomach pain;
- Dark-colored urine;
- Yellow discoloration in the skin and eyes;
- Fever;
- Muscle and joint pains.
 
Once there is liver damage, signs and symptoms may include:
- Bleeding easily;
- Bruising easily;
- Itchy skin;
- Fluid accumulation in your abdomen;
- Swelling in your legs;
- Weight loss;
- Confusion, drowsiness and slurred speech;
- Spider-like blood vessels on your skin.
 
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine, also called the colon. It cause abdominal cramps or pain, bloating, gas, diarrhea and constipation. IBS can last for months.
 
Even though signs and symptoms are uncomfortable, IBS — unlike certain inflammatory bowel diseases — does not increase your risk of developing colorectal cancer.
 
Among the common symptoms are:
- Abdominal pain or cramping
- A bloated feeling
- Gas
- Diarrhea or constipation, or alternating bouts of constipation and diarrhea
- Mucus in the stool
 
Symptoms that may indicate a more serious condition include:
- Rectal bleeding;
- Abdominal pain that grows worse or occurs at night;
- Weight loss;
 
Inflammatory Bowel Diseases
Inflammatory bowel diseases (IBD) involves the chronic inflammation of all or part of your digestive tract and can cause severe diarrhea, pain, fatigue and weight loss, and sometimes lead to life-threatening complications. They can also cause ulcers in the innermost lining of your colon and rectum.

Symptoms vary, depending on the severity of inflammation and where it occurs. Symptoms may range from mild to severe.
Common signs and symptoms include:
- Diarrhea;
- Fever and fatigue;
- Abdominal pain and cramps, nausea and vomiting;
- Blood in your stool;
- Poor appetite;
- Weight loss because you cannot properly digest and absorb food.
Treatments
​As a general rule, see your doctor right away if you have abdominal pain so severe that you cannot move without causing more pain, or you are unable to sit still comfortably. Also, seek immediate medical help if pain is accompanied by signs and symptoms, such as fever, bloody diarrhea or severe tenderness in your abdomen. Your doctor may perform tests to help find the cause of your pain. These could be stool and urine tests, blood tests and X-rays.

Depending on its cause, treatments for food poisoning can range from medications for inflammation and ulcers to antibiotics for infections. If the diagnosis is appendicitis or a hernia, surgery may be necessary.
 
Treatments for peptic ulcers can include antibiotic medications for the bacterial infection with additional medications to reduce stomach acid. In rare cases, surgery to stop the bleeding from the peptic ulcer may be required.
 
Treatment of severe food poisoning may include: 
- Antibiotics for certain kinds of bacterial food poisoning;
- Replacement of lost fluids and minerals such as sodium, potassium and calcium that maintain the balance of fluids in your body that is lost to persistent diarrhea, to prevent and treat dehydration;
- Hospitalization for some children and adults with persistent diarrhea or vomiting so that they can receive salts and fluids intravenously through a thin tube that feeds the solution into a vein in an arm;
- Intravenous antibiotics during hospitalization for food poisoning cases caused by the listeria bacteria.
 
The sooner treatment begins, the better. During pregnancy, prompt antibiotic treatment may help keep your food poisoning from affecting the baby.
 
People with mild symptoms of hepatitis A do not require treatment, and they usually recover completely with no permanent liver damage. Treatment to relieve symptoms could be offered in severe cases.
 
If you are infected with hepatitis A, you should:
- Rest since many people with hepatitis A feel tired and sick and have less energy;
- Nausea can make it difficult to eat so you should try to snack on high-calorie food throughout the day instead of eating full meals;
- Rest your liver by not drinking alcohol as your liver may have difficulty processing the medications.
 
Your body will clear the virus on its own and in most cases, your liver will heal itself usually within six months with no lasting damage. To protect yourself against all types of hepatitis, practice good hygiene by washing hands frequently. Vaccines are also available to protect you from being infected.
While there is a vaccine to prevent hepatitis B infections, there is no cure. If your hepatitis B infection is deemed acute, meaning it will be short-lived and will go away on its own, you may not need treatment. You could be advised by your doctor to rest and consume adequate nutrition and fluids while your body fights the infection.
If you have been diagnosed with chronic hepatitis B infection, you may receive treatment to reduce the risk of liver disease and to prevent you from passing the infection to others.
 
Treatments include:
- Antiviral medications to help fight the virus and slow its ability to damage your liver.
- Injecting the synthetic version of a substance produced by the body to fight infection mainly to young people with hepatitis B who don't want to undergo long-term treatment or who might want to get pregnant within a few years.
- Liver transplant if your liver has been severely damaged. Most transplanted livers come from deceased donors, though they may come from living donors who donate a portion of their livers as these portions can grow.
 
Hepatitis C infection is treated with antiviral medications intended to clear the virus from your body. You might suffer side effects such as depression, flu-like symptoms, and loss of healthy red or white blood cells.
It is not clear what causes irritable bowel syndrome, treatment focuses on lifestyle changes and medications for the relief of symptoms so that you can live as normally as possible.
 
The following dietary changes may also be required:
- Eliminating high-gas foods such as carbonated beverages, cabbage, broccoli and cauliflower and raw fruits if you suffer bloating or are passing considerable amounts of gas;
- Eliminating carbohydrates such as fructose and lactose.
 
Your doctor might suggest fiber supplements and anti-diarrhea medications, and other medications to relieve painful bowel spasms while some people whose symptoms are due to an overgrowth of bacteria in their intestines may receive antibiotic treatment. You may also benefit from counseling if you develop depression or if stress tends to worsen your symptoms.
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