Indigestion or Dyspepsia

Pain or discomfort in the upper abdomen or behind the chest are common problems. There are several causes including gastro-oesophageal reflux, where acidic stomach contents go back up into the gullet causing irritation and inflammation. Peptic ulcers in the stomach or just beyond in the duodenum may also cause these symptoms. People with these symptoms sometimes worry they have stomach cancer. Fortunately this is quite unusual and easily excluded by endoscopy where the upper part of the gut is viewed with a flexible telescope called an endoscopy. It is particularly important to seek prompt assessment if you unintentionally lose weight, have problems swallowing, develop unexplained anaemia, bring up blood or pass sticky dark altered blood in your stools.

Change in bowel habit or abdominal discomfort

You may have had long standing problems with diarrhoea or constipation or cramping abdominal discomfort. The most common cause for this is probably irritable bowel syndrome (IBS) but there are many others. Typically, patients with IBS have had the symptoms on and off for months or even years with either diarrhoea or constipation or sometimes in an alternating pattern often associated with cramping abdominal pain or distension. The condition is not life threatening but symptoms can be very troublesome. Fortunately, symptoms can be improved by a variety of  dietary and medical steps. When diagnosing IBS it is important to exclude other important gut problems such as inflammatory bowel disease (IBD) and bowel cancer. This can usually be done by simple blood tests and sometimes colonoscopy  where the lower bowel (or colon) is viewed with a flexible telescope. It is very important to seek advice if you have had a recent change in bowel habit or have been passing blood with your motions, particularly if you are 40 years old or more. You should also seek advice if you have recently developed any of these symptoms and have a family history of bowel cancer or inflammatory bowel disease.

Family screening for bowel cancer and polyps

Someone in your family may have had bowel cancer (also called colorectal cancer) and you may be concerned about your risk. Having a close relative with bowel cancer or bowel polyps increases your chance of developing these conditions. If you are in this situation it may be worth considering a "screening" colonoscopy where the colon is viewed with a flexible telescope. This test can pick up polyps in the colon. If left, over years these little lumps can develop into bowel cancer and removing them during colonoscopy stops this happening. Bowel cancer is a common cancer and can be prevented by bowel screening. A national screening programme for all individuals over 60 is starting to be introduced in the UK by looking for traces of blood in faeces. In the US all people over 50 are now being offered colonoscopy.

Useful links

www.bsg.org.uk                  medical society providing info on bowel problems

www.nacc.org.uk               info for sufferers of Crohn's disease or Colitis

www.ibsnetwork.org.uk     patient-led site on Irritable Bowel Syndrome (IBS).

www.bowelcancer.tv        patient friendly site about bowel cancer