The greatest risk factor for bowel cancer is age. Smoking and excess alcohol intake are also important risk factors. Bowel cancer becomes increasingly common in both men and women after the age of 50. If members of your family have been affected by bowel cancer then you may be at an increased risk of developing bowel cancer yourself. The size of this risk will depend on the number of family members affected, how closely they are related to you and how old they were when they develop bowel cancer. However, the majority of people who get bowel cancer (up to 80%) do not have a close family member with the disease.
It is thought that the risk of bowel cancer can be reduced by eating a healthy diet and exercising regularly. A low dose of aspirin taken regularly over the long term may reduce the risk of bowel cancer but aspirin does increase the risk of bleeding, particularly from the gastrointestinal tract, and a decision to use aspirin to prevent bowel cancer should be discussed with your doctor.
Screening for bowel cancer is recommended for people with no identifiable risk factors for bowel cancer from the age of 50. Those with an increased risk may need to commence screening earlier. Screening for bowel cancer with colonoscopy or
The Australian Federal Government runs the National Bowel Cancer Screening Program (www.cancerscreening.gov.au). In 2018 all Australians aged between 50 and 74 will be offered
For further information please visit https://www.bowelcanceraustralia.org/
Polyps are abnormal growths
People who develop polyps are at increased risk of developing polyps again in the future. The size of that risk and the speed at which they occur will depend on the number, size, type
What is ‘reflux’?
Gastro-oesophageal reflux (GORD) is the passage of stomach contents (food, stomach secretions and gas) into the
How do I know if I have reflux?
The symptoms of reflux (heartburn, regurgitation
Is reflux serious?
Reflux is usually not serious and is simply an inconvenience causing discomfort or other mild symptoms. Almost everyone experiences symptoms of reflux from time to time, often after overindulging. Some people have more significant symptoms or complications from reflux and may require medical treatment.
In a minority of people with
In some patients with longstanding
How is reflux treated?
Often, simple lifestyle and dietary changes are all that is needed to manage reflux. Large meals, fatty foods, coffee, alcohol, smoking and lying down with a full stomach after eating can all precipitate or aggravate reflux. Some people will be able to identify particular foods that cause reflux and can simply avoid that type of food. Reflux is often worse when people gain weight and losing weight can make a big difference.
Unfortunately, many people continue to have symptoms despite making lifestyle and dietary changes. For these people and those with oesophagitis or other complications of reflux treatment with medications may be required.
For a very small proportion of
What is Barrett’s Oesophagus?
Barrett’s oesophagus is the name given to a change in the normal lining of the lower end of the oesophagus from normal ‘squamous’ lining to an intestinal-type,
Barrett’s oesophagus is considered important because people who have Barrett’s are at increased risk of developing cancer in the oesophagus. The absolute risk of cancer is relatively small and the majority of people with Barrett’s oesophagus (up to 95%) do not ever develop cancer in the oesophagus.
How is Barrett’s oesophagus diagnosed?
Barrett’s oesophagus can only be diagnosed by taking biopsies from the part of the affected oesophagus at the time of a gastroscopy. The diagnosis is often suspected at the time of gastroscopy (endoscopy) based on the appearance of the oesophagus but confirmation with biopsies examined under the microscope is usually performed.
There are no widely accepted recommendations regarding who should have a gastroscopy to check for Barrett’s oesophagus. Firm recommendations do not exist because of the lack of strong evidence that screening for Barrett’s prevents people from dying from oesophageal cancer.
Many gastroenterologists will recommend gastroscopy to check for Barrett’s in people over the age of 40 who have had reflux symptoms for many years.
How is Barrett’s oesophagus treated?
The treatment options for Barrett’s oesophagus include treatment of gastro-oesophageal reflux, surveillance for development of complications and occasionally eradication of the affected part of the oesophageal lining.
Treatment of gastro-oesophageal reflux with medications that prevent the production of acid by the stomach usually prevents the symptoms of reflux but may be recommended even in the absence of these symptoms as it may prevent the development of cancer.
Regular checks on the oesophagus ‘ surveillance’ with gastroscopy
Treatment to eradicate the lining of the affected part of the oesophagus is recommended for some patients at highest risk of developing oesophageal cancer. This is based largely on how abnormal the biopsies from the oesophagus look when examined under a microscope. Radio-frequency ablation is currently the most widely accepted treatment but other treatments are under evaluation in clinical trials.
Helicobacter Pylori (H.pylori) is a bacterium that commonly infects the lining of the stomach. H.pylori was first identified as an important cause of stomach problems by two Australians, Barry Marshall
Most people who are infected have no symptoms however H.pylori is capable of causing indigestion, ulcers in the stomach and duodenum and is also associated with an increased risk of cancer in the stomach. People who have family members who have had ulcers or stomach cancer are at increased risk of complications.
H.Pylori infection is usually diagnosed with a breath test or at the time of endoscopy. Treatment involves a combination of two or more antibiotics together with anti-secretory treatment for 1-2 weeks and is effective in up to 90% of people. Successful eradication of the infection should be confirmed with repeat testing after treatment. If initial treatment fails then specialist advice may help.
Irritable bowel syndrome
What is IBS?
Irritable bowel syndrome is the term used to describe a group of disorders in which the normal function of the gastrointestinal tract is disturbed without obvious inflammation or damage to the structure of the bowel. The cause of IBS is not fully understood but it is thought to occur due to disturbance of the normal function of the muscles of the gut (dysmotility), the nerves supplying the gut (hypersensitivity) and the microbiological makeup of the gut contents (dysbiosis).
IBS is very common, affecting as many as 1 in 5 people during their lives. The main symptoms of IBS are abdominal pain, bloating, chronic constipation, chronic
Is IBS serious?
The symptoms of IBS may be very distressing but, fortunately, IBS never results in damage to the gut, problems with nutrition or more serious conditions.
How do you diagnose IBS?
The diagnosis of IBS can sometimes be made just by talking to your doctor. If the symptoms are typical then testing may not be required to confirm the diagnosis or exclude other causes. Certain features are never a part of IBS. These include bleeding, weight loss
Testing is usually carried out if your symptoms start after 40 years of age, there are any unusual features to the symptoms or there is a history of bowel cancer, inflammatory bowel disease or coeliac disease in your family. The tests used may include blood tests, stool tests, radiology (ultrasound or CT), or endoscopy (gastroscopy and/or colonoscopy).
What is the treatment for IBS?
There is no cure for IBS. The goal of treatment is to manage the symptoms of the condition. Treatments should be tailored to the symptoms. No single treatment works for all patients and successful management will often require
Diet and stress often contribute to IBS or make the symptoms worse and it is important to systematically identify any dietary triggers. A food diary can sometimes be helpful to identify foods or food additives that are exacerbating the symptoms.
Dietary measures such as increasing (or sometimes decreasing) dietary
Medications that relieve
Management of stress may be an important part of controlling the symptoms of IBS.
Inflammatory Bowel Disease
Ulcerative colitis causes inflammation of the mucosal lining of the colon or large bowel. Crohn’s disease can affect any part of the digestive tract. The inflammation
Both Crohn’s disease and Ulcerative colitis vary greatly between individuals. Some people with these conditions will have very mild symptoms that require little or no long-term treatment. Unfortunately, in other people the diseases can be severe, requiring long-term treatment and sometimes surgery. The symptoms of IBD may include abdominal pain,
IBD is usually diagnosed after seeing a gastroenterologist and having blood tests, stool tests
The goals of treatment in inflammatory bowel disease are to control inflammation, eliminate symptoms and prevent disease complications and the need for surgery. Once the disease is controlled long-term medical treatment may be required to prevent further ‘flare-ups’.
For further information please see the Crohn’s and Colitis Australia website: www.crohnsandcolitis.com.au
Coeliac disease is usually diagnosed in children and young adults but can be diagnosed at any age. Coeliac disease runs in families and there are genes that increase the risk of developing coeliac disease. Blood tests may be the first clue that someone has coeliac disease and some antibody tests are quite accurate however the diagnosis should always be confirmed by having a gastroscopy to take biopsies from the affected part of the small bowel. It is important that people stay on a diet containing gluten until the diagnosis has been confirmed.
For more information see the Coeliac Australia website: www.coeliac.org.au
Diverticular disease or diverticulosis is a common condition that becomes increasingly common as people age. Over 1/3 of people will have diverticulosis by the age of 50 and more than 1/2 by the age of 70. Diverticula are pockets or pouches that protrude from the wall of the bowel. Diverticulosis can occur in any part of the bowel but is most common in the lower third of the colon (but not the rectum).
Diverticulosis runs in families and is more common in people who have less
A small proportion of people with diverticulosis will develop complications including bleeding from the diverticula, infection (diverticulitis) and rarely even perforation causing peritonitis. Diverticulitis usually causes acute abdominal pain often with fever and should not be confused with diverticulosis or
Fatty liver disease
Most people with
The main treatment for
Most people diagnosed with hereditary