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Gastro Questions, Answered
Ulcers
- Are ulcers "holes" in the intestine?
- A peptic ulcer is a defect in the lining of the stomach or in the first part of the small intestine, known as the duodenum. During endoscopy, an ulcer looks like a "pothole".
- How do I know if I have an ulcer?
- The most common symptom of peptic ulcers is upper abdominal pain.
- This pain may be associated with food. Classically, the pain from duodenal ulcers may be worse when one is hungry and is better after eating. Patients with stomach ulcers may, however, experience more pain after eating.
- Other symptoms may include bloating, loss of weight and of appetite, nausea and vomiting.
- Symptoms associated with complications of peptic ulcers include vomiting of blood and melaena (black tarry stools) should the ulcers bleed.
- A perforated peptic ulcer is associated with severe abdominal pain, which does not go away.
- Is skipping meals the cause of ulcer growth?
- Ulcers are not caused by missing meals.
- The commonest causes of ulcers are:
- While missing meals will not cause peptic ulcers, as part of a healthy lifestyle, one should always try to take moderate-sized meals at regular intervals.
Irritable bowel syndrome (IBS)
- What are the symptoms of IBS?
- IBS is characterised by:
- Abdominal pain
- Discomfort and bloating
- Change in bowel pattern, such as loose or more frequent bowel movements, diarrhoea and/or constipation
- IBS is a multi-faceted disorder which can develop through a combination of factors: physiological (e.g. altered gut motility or gut movement), psychological (e.g. chronic life stress) and social (e.g. lifestyle habits).
- What is the latest treatment for IBS?
- There is increasing realisation that a holistic approach is needed in the treatment of IBS. It is important to address all factors when treating the IBS patient. Medicines make up only one aspect of the treatment.
- Medicines which increase gut motility have been used in some patients with constipation-predominant IBS.
- Other medicines are more useful in diarrhoea-predominant IBS.
- Dietary manipulation may also be useful in some patients. While dietary factors do not cause IBS, they may aggravate the symptoms in some patients. For example, meals high in fat, fried foods, coffee and alcohol may cause diarrhoea and abdominal cramps.
- Identification of stressful factors in a patient’s life and helping patients cope with them are important. A psychiatrist or psychologist may be able to assist IBS patients in coping with stress.
"Studies show that physiological, psychological and social factors play a significant role in the development of IBS. There is also ongoing research to determine if genetic factors play a role in IBS."
Dr Ling Khoon Lin, Consultant
Department of Gastroenterology & Hepatology, Singapore General Hospital
Piles problems
- My 36-year-old husband has had piles for years. What can be done?
- Piles, or haemorrhoids, create problems in and around the anus, such as itching and bleeding. With external piles, the overlying skin may ulcerate, leaving skin tags after some time. Internal piles can sag and protrude outside the anal canal (as in the case of prolapsed piles). In both external piles and internal piles, thrombosis (blood clot) in the haemorrhoidal veins can cause swelling and severe pain.
- Bleeding is a common symptom.
- There are, however, other medical conditions such as cancer that could cause any of these symptoms, especially bleeding, so it’s always best to have the problem checked by a doctor.
- Not all piles require treatment.
- Some patients live with the condition with no trouble at all.
- Some may benefit from topical ointments. These are not cures but they soothe the pain and itching.
- Overall, a person with piles will have to make dietary adjustments.
- For instance, if the patient is constipated, he or she may need to include more fibre. The person should also try to lead a healthier lifestyle by having a sensible diet, exercising regularly and cutting down on smoking and excessive alcohol consumption.
"To avoid piles, practise these four dos. Do eat everything in moderation, do increase your fluid intake, do decrease fats in your diet, and do exercise regularly. When moving your bowels, practise these two don’ts. Don’t strain – walk off and try again later; don’t read, as you may take a longer time than necessary. One final thought – using the squat toilet is not a bad thing at all."
Associate Professor Eu Kong Weng, Innovator of the Eu Technique for Piles,
Head and Senior Consultant Surgeon, Department of Colorectal Surgery, Singapore General Hospital
The Department of Gastroenterology & Hepatology at Singapore General Hospital provides diagnosis and treatment of disorders of the gastrointestinal tract, liver and pancreas with sub-speciality clinics in Hepatitis, Inflammatory Bowel Disease (IBD) and Liver Transplant. The Department of Colorectal Surgery at Singapore General Hospital is the only specialised department in Singapore for colon and rectal surgery. Our Specialists provide comprehensive investigative and emergency services for the whole range of colorectal and peri-anal conditions, and all other aspects of colorectal diseases. Call 6222 3322 or visit here.
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