FAQ’s

Hepatitis (literally ‘inflamed liver’) has many different causes, including infection by a virus, exposure to chemicals, taking certain drugs or drinking too much alcohol. Viral infection the most common causes of chronic hepatitis.

Hepatitis C is a virus that can damage the liver. Unlink hepatitis A and B, there is no vaccine to protect against hepatitis C.

Hepatitis C is carried in the blood. The virus is mainly spread through contact with the blood of a person who has hepatitis C. You can’t catch it through everyday contact such as holding hands or hugging and kissing, orthrough sharing toilets, plates and cups and kitchen utensils.

• By sharing equipment for injecting drugs, even if you only did this once or twice, or a long time ago. Needles and syringes are the greatest risk, but other drug-injecting equipment (such as spoons, filters, and water) could also carry infection if they are contaminated with blood from someone who
  has the virus.
• Through a blood transfusion (before September 1991), or blood products like clotting factors (before 1986).

• From a mother with hepatitis C to her baby, before or during the birth.
• Through unprotected sex (without a condom) with someone who has the virus.
• By having a tattoo, an ear piercing, a body piercing or acupuncture with equipment that is not sterile.
• During medical and dental treatment abroad in countries where hepatitis C is common and where equipment may not be sterilised properly.
• By sharing razors ortoothbrushes which have been contaminated with blood from someone who has the virus.
• See your doctor if you think you could have been in contact with the virus in any of these ways.

Most people who have the hepatitis C virus have no signs or symptoms at all for many years. But even if you have no symptoms, you can still pass the virus on to others.

Around one in four people who become infected with hepatitis C will get rid of the virus naturally. However, most people who become infected will have it for a very long time.

• Some people will stay well throughouttheir life.
• About one in five people may develop severe liver damage (cirrhosis). In some people, cirrhosis can lead to liver cancer or liverfailure.

If you think you could have been in contact with the hepatitis C virus at any time in the past, you can have a testto find out if you have been infected.

The test will tell you whether you have been infected with the virus in the past. It will not tell you if you still have the virus. You will need another test to find this out, and you may need to see a specialist.

If you have the virus, stop drinking alcohol or reduce the amount of alcohol you drink. This is the most important thing you can do to reduce the damage to your liver.

You can’t pass on the virus by sneezing, coughing, kissing, sharing cutlery or dishes, using bathrooms or toilets, so you can continue with most of your
daily activities as usual. The main ways in which the hepatitis C virus could be passed to someone else is through blood-to-blood contact or having
unprotected sex.
Here are some simple steps you can take so you don’t infect other people :

Don’t share needles or use unsterilised equipment (e.g. fortattoos, ear/ body piercing or acupuncture).

Avoid sharing personal toiletry items (e.g. toothbrushes, razors or nail clippers) as these may have traces of dried blood on them.

Advise anyone who could come into contact with your blood – such as your doctor or dentist, or possibly people you work with -that you are infected with the hepatitis B virus.

Avoid high – risk sexual activities that cause bleeding and avoid sex during menstruation. Even oral sex can transmit the virus, but condoms can lowerthe risk of infection (if your partner has been vaccinated, there is no need for additional protection).

Clean up blood spills (wear rubber gloves and use a disinfectant such as undiluted bleach).

Hepatitis B is a virus carried in the blood that can cause damage to your liver.

If you have contracted hepatitis B, the virus initially passes from your blood to your liver, where it infects the liver cells. The virus multiplies inside the liver cells (a process called replication) and goes on to infect other liver cells. Your body’s immune system recognises the infected cells and attacks them. This causes your liverto become inflamed and can ultimately lead to liver damage. Damage due to the hepatitis B virus can build up slowly over many years, so it is important to detect it early. If left untreated over a long period of time, the hepatitis B virus can cause severe scarring of the liver (cirrhosis), liver failure and liver cancer.

You may not know how you got infected and you are not alone. In parts of the world where hepatitis B is common, people are most likely to contract the virus from their mothers at or soon after birth.

Not everyone who is exposed to the hepatitis B virus will be infected for life. Some people are able to ‘clear the virus’ during the first 6 months of infection (known as ‘acute’ hepatitis B infection) before it becomes chronic. The chance of clearing the virus varies with age : over 90% of adults with strong, healthy immune systems will recover from an acute infection. However, people infected as newborns or infants are unlikely to clear the virus during the acute phase because their immune systems are not fully developed. These people could go on to develop chronic hepatitis B and will be infected for the rest of their lives.

If you are diagnosed with chronic hepatitis B, your doctor will be able to help you decide whether to start treatment, when to start treatment and what medication would be most appropriate for you.

You can’t pass on the virus by sneezing, coughing, kissing, sharing cutlery or dishes, using bathrooms or toilets, so you can .continue with most of your daily activities as usual. The main ways in which the hepatitis B virus could be passed to someone else is through blood to-blood contact or having unprotected sex. There is a highly effective vaccine for hepatitis B, which can prevent the spread of infection. Your friends and family should speak to their doctor to find out if vaccination would be appropriate forthem. Here are some simple steps you can take so you don’t infect other people:
1. Don’t share needles or use unsterilised equipment (e.g. for tattoos, ear/ body piercing or acupuncture)
2. Avoid sharing personal toiletry items (e.g. toothbrushes, razors or nail clippers) as these may have traces of dried blood on them.
3. Advise anyone who could come into contact with your blood – such as your doctor or dentist, or possibly people you work with – that you are infected with the hepatitis B virus.
4. Avoid high-risk sexual activities that cause bleeding and avoid sex during menstruation. Even oral sex can transmit the virus, but condoms can lower the risk of infection (ifyour partner has been vaccinated, there is no need for additional protection).
5. Clean up blood spills (wear rubber gloves and use a disinfectant such as undiluted bleach).

You may not notice any symptoms when you are first infected with hepatitis B. Symptoms are often experienced some time after infection – up to 6 weeks later in some people. The symptoms are generally mild, and may come and go. Some people have described the symptoms as similar to having flu.
If you have been infected with hepatitis B, you may experience one or more of the following symptoms

• Feeling tired (fatigue)
• Loss of appetite
• Nausea and vomiting
• Diarrhoea
• Itching all overthe body
• Unexplained weight loss
• Jaundice (when the skin and whites of the eyes turn yellow; also associated with dark urine)
• Tenderness in the abdomen or abdominal pain
• Headaches and fever
• Joint pain or muscle aches

Although cirrhosis cannot be cured, successfully treating hepatitis B will stop the liver damage from getting any worse and may even reverse it.

Treatments for hepatitis C are improving all the time. A form of drug therapy is available that can cure the infection people treated. Your doctor and specialist will discuss with you whether treatment is appropriate.

Gastroenterology is the study of normal function and diseases of the digestive tract (GI tract) that is food pipe (oesophagus), stomach, small intestine, large intestine including rectum and anal canal, and pancreas, gallbladder, bile ducts and liver.

A Medical Gastroenterologist is a doctor who specialises in the diagnosis, treatment and management of conditions affecting the gastrointestinal tract.

Gastroenterologists specialise in providing a complete, accurate and thorough care for patients with gastrointestinal conditions with a high-quality and comprehensive approach which distinguishes them from other physicians.

What is IBS?

Irritable bowel syndrome (IBS) is a common disorder of the intestines with symptoms that include colicky pain, gassiness, bloating of abdomen and changes in bowel habits. An individual with IBS may have constipation (difficult or infrequent bowel movements) or diarrhea (frequent loose stools, often with an urgent need to move the bowels), and some experience both. IBS does not cause permanent harm to the intestines and does not lead to cancer. For many people, eating a proper diet and living a healthy lifestyle may lessen IBS symptoms.

IBS Triggers

Many people report that their symptoms occur following a meal. Eating causes contractions of the colon. Normally, this response may cause an urge to have a bowel movement within 30 to 60 minutes after a meal. In people with IBS, the urge may come sooner and may be associated with pain, cramps and diarrhea. Certain foods may trigger spasms in some people. Sometimes the spasm delays the passage of stool, leading to constipation. Certain food substances, like complex carbohydrates and caffeine, fatty foods, or alcoholic drinks, can cause loose stools in many people, but are more likely to affect those with IBS.

How is IBS diagnosed?

IBS is a diagnosis of exclusion. The doctor excludes organic and pathological diseases before labelling the symptoms due to IBS. This is done by taking a good history and clinical examination followed by blood tests, stool tests and diagnostic endoscopy.

Treatment of IBS

Diet: Eating a proper diet and avoidance of eating a large amount of food items at once helps avoid IBS symptoms. Changes in the diet can be made by avoiding the food item which leading to symptoms for example dairy products. Eating small portions more frequently helps.

Recent attention has been drawn to the FODMAP (FODMAP= fermentable oligo-, di- and mono-saccharides and polyols) concept; this relates to avoiding the ingestion of fermentable sugars, such as fructose or lactose, sorbitol, and fructans. These food items, if poorly absorbed, are broken down by bacteria to produce symptoms of gaseousness, bloating, abdominal discomfort and diarrhea, which are seen in IBS.

Pharmacological treatment: Constipation is treated by prescribing stool softners, polyethene glycol and fibers which increase intestinal fluid and help in easy passage of stool. Probiotics and antibiotics are used to treat bacterial overgrowth which can trigger IBS symptoms. Antidepressant drugs are used when abdominal pain is more severe, because they can help reduce visceral sensitivity and brain-gut dysfunction that contribute to the symptoms.

Psychological treatment: There are several psychological treatments that can help reduce the symptoms of IBS. These include cognitive-behavioral treatment, hypnosis, stress management, meditation and relaxation methods. These treatments seem to reduce abdominal discomfort and the psychological distress associated with IBS symptoms, improve coping skills, and help patients adapt to their symptoms.

Gastrointestinal (GI) symptoms include mild symptoms such as pain in abdomen, nausea, vomiting, heartburn, indigestion/dyspepsia, bloating or constipation, diarrhoea (loose stools), as well as abdominal pain or severe symptoms like acute pain in abdomen, difficulty or inability to swallow, Jaundice, blood vomiting or passage of blood in stools, post-surgical complications etc.

If you are experiencing any digestive symptoms (listed above) for the first time, firstly get an appointment with your family physician/primary care physician. If your doctor decides that your symptoms need the attention of a specialist, you should then contact a gastroenterologist.

Also, people who are diagnosed with a long-standing digestive condition and experience a recurrence or a flare-up of an existing condition should contact the gastroenterologist

Gastrointestinal (GI) cancer is a term used for cancer of the organs of the digestive system. The commonly occurring cancers of GI tract include esophageal, stomach, gall bladder, pancreas, colon and liver cancer.

Most of the cancers of GI tract have immense malignant potential except a few which include neuroendocrine tumors. Early detection of cancer before it has invaded locally or spread to distant organs can offer a chance of complete cure.

It is imperative not to neglect red flag signs in GI cancer which include loss of weight, blood in vomit or stools, black colour stools or vomit, difficulty in swallowing food and a falling hemoglobin

.
With the advance of diagnostic and therapeutic GI endoscopy an early cancer of the luminal gastrointestinal tract can be removed through advanced techniques viz. endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD).

Individuals with family history of GI cancer should ideally undergo screening at least 10 years earlier from the age at which the family member got affected with cancer.

What is IBS?

Irritable bowel syndrome (IBS) is a common disorder of the intestines with symptoms that include colicky pain, gassiness, bloating of abdomen and changes in bowel habits. An individual with IBS may have constipation (difficult or infrequent bowel movements) or diarrhea (frequent loose stools, often with an urgent need to move the bowels), and some experience both. IBS does not cause permanent harm to the intestines and does not lead to cancer. For many people, eating a proper diet and living a healthy lifestyle may lessen IBS symptoms.

IBS Triggers

Many people report that their symptoms occur following a meal. Eating causes contractions of the colon. Normally, this response may cause an urge to have a bowel movement within 30 to 60 minutes after a meal. In people with IBS, the urge may come sooner and may be associated with pain, cramps and diarrhea. Certain foods may trigger spasms in some people. Sometimes the spasm delays the passage of stool, leading to constipation. Certain food substances, like complex carbohydrates and caffeine, fatty foods, or alcoholic drinks, can cause loose stools in many people, but are more likely to affect those with IBS.

How is IBS diagnosed?

IBS is a diagnosis of exclusion. The doctor excludes organic and pathological diseases before labelling the symptoms due to IBS. This is done by taking a good history and clinical examination followed by blood tests, stool tests and diagnostic endoscopy.

Treatment of IBS

Diet: Eating a proper diet and avoidance of eating a large amount of food items at once helps avoid IBS symptoms. Changes in the diet can be made by avoiding the food item which leading to symptoms for example dairy products. Eating small portions more frequently helps.

Recent attention has been drawn to the FODMAP (FODMAP= fermentable oligo-, di- and mono-saccharides and polyols) concept; this relates to avoiding the ingestion of fermentable sugars, such as fructose or lactose, sorbitol, and fructans. These food items, if poorly absorbed, are broken down by bacteria to produce symptoms of gaseousness, bloating, abdominal discomfort and diarrhea, which are seen in IBS.

Pharmacological treatment: Constipation is treated by prescribing stool softners, polyethene glycol and fibers which increase intestinal fluid and help in easy passage of stool. Probiotics and antibiotics are used to treat bacterial overgrowth which can trigger IBS symptoms. Antidepressant drugs are used when abdominal pain is more severe, because they can help reduce visceral sensitivity and brain-gut dysfunction that contribute to the symptoms.

Psychological treatment: There are several psychological treatments that can help reduce the symptoms of IBS. These include cognitive-behavioral treatment, hypnosis, stress management, meditation and relaxation methods. These treatments seem to reduce abdominal discomfort and the psychological distress associated with IBS symptoms, improve coping skills, and help patients adapt to their symptoms.

Abdominal pain is pain that occurs between the chest and pelvic regions. Abdominal pain can be crampy, achy, dull, intermittent or sharp. It’s also called a stomachache.

What causes abdominal pain?

Abdominal pain is caused by irritation of the nerve endings in the gastrointestinal tract due an underlying inflammatory cause or the pain can be functional (without inflammation). The various causes of abdominal pain include:

Abdominal or chest wall pain:

• Shingles (herpes zoster infection)
• Costochondritis (inflammation of the rib cartilages)
• Injury (blunt trauma, muscle pulls)
• Nerve irritation (neuropathy)
• Hernias (protrusions of structures through the abdominal wall)
• Scars
  

  Inflammatory conditions of the abdomen:

  • Ulcer disease (duodenal ulcer, gastric ulcer)
  • Esophagitis (gastroesophageal reflux disease)
  • Gastritis (irritation of the lining of the stomach)
  • Pancreatitis (inflammation of the pancreas)
  • Cholelithiasis (gall bladder stones)
  • Cholecystitis (inflammation of the gall bladder)
  • Choledocholithiasis (bile duct stones)
  • Hepatitis (infection or inflammation of the liver)
  • Colitis (infection or inflammation of the colon)
  • Enteritis (infections of the small bowel, Crohn’s disease) Diverticulitis (inflammation of pouches that form in the colon) Appendicitis
  • Mesenteric vascular insufficiency (blocked arteries or veins)
  • Renal or ureteric calculi (stones in the kidney or ureter)
    

    Functional problems of the abdomen:

    • Non-ulcer dyspepsia (discomfort after eating not due to ulcers)
    • Functional abdominal pain (pain without clear cause)
    • Irritable bowel syndrome (pain associated with bowel movements)