021 551 8678
Colonoscopy: What to Expect by Dr. Deetlefs – Cape Town

Colonoscopy: What to Expect by Dr. Deetlefs – Cape Town

About Dr. Deetlefs and his Practice


GiDoc Capetown
is a practice founded to provide medical solutions in the area of gastroenterology.

Over the years, Dr Eduan Deetlefs has earned the reputation of a trusted health expert providing consultative, diagnostic, and therapeutic endoscopic and related services to patients in Cape Town and beyond.

Dr Eduan has a wealth of up-to-date knowledge in the management of inflammatory bowel disease and in addition he has a trial centre, Spoke Research Inc, that specialises in biological trials for inflammatory bowel disease.

Services include consultations for gastrointestinal and liver related diseases with a specific interest in inflammatory bowel disease and iron deficiency anaemia caused by obscure gastrointestinal bleeding.

He furthermore performs numerous more specialised procedures such as capsule endoscopy, double-balloon enteroscopy, ERCP and various interventional procedures including polypectomies for large polyps, haemostasis of bleeding lesions, ablation of Barrett’s oesophagus and placement of feeding tubes (PEG).

Let’s dig deeper into one of his most specialised procedures:  The Colonoscopy.
 

Colonoscopy Explained


Dr Eduan sees the whole spectrum of gastrointestinal and liver-related diseases with a special interest in inflammatory bowel disease and anaemia caused by obscure intestinal bleeding.

He performs numerous procedures including diagnostic and therapeutic gastroscopies and colonoscopies.

Millions of people have a colonoscopy every year. Here’s how it works and what to expect.

A colonoscopy is an examination of the rectum and colon to look for polyps, bleeding, ulcers and other abnormal areas that can be removed before they become cancerous. 

The colonoscope used for a colonoscopy has a camera on the end that transmits what you see inside your colon onto a large screen in the exam room. Since a colonoscopy allows doctors to directly see any abnormalities within the digestive tract, specialized tests that require biopsies aren’t needed as often. 

This means you’ll have fewer test procedures so the procedure itself is usually shorter than other diagnostic tests for similar conditions.

Also, because polyps grow over time, it’s easier to find them during examinations than it would be using non-invasive methods like virtual colonoscopies or CT scans since they’re usually too small to detect on these technologies. 

Most patients are sedated during this test, so there isn’t much discomfort involved.

The procedure typically takes about 30 to 60 minutes.
 

reasons_why_you_might_need_a_colonoscopy

Reasons Why You Might Need a Colonoscopy

When you need to boost your colon health, you’ll have many options in terms of ways to do so. One of the best known procedures is a colonoscopy. But why should you get one?

To begin with, it allows for early detection of cancerous growths that may otherwise go undetected without intervention and be treated accordingly.

It also allows patients who suffer from chronic constipation to determine whether their issue might be a result of intestinal polyps that can then be surgically removed from the bowel without causing further problems later on.

Finally, it is also capable of detecting Crohn’s disease or ulcerative colitis and may allow proper measures to be followed in an attempt to prevent further complications before they begin to appear and might otherwise require painful surgery or extreme measures later on if left untreated early on in life.

The most common reasons for colonoscopy are to evaluate the following:

  • As a screening exam for colon cancer
  • Rectal bleeding
  • A change in bowel habits, like persistent diarrhea
  • Iron deficiency anemia (a decrease in blood count due to loss of iron)
  • A family history of colon cancer
  • As a follow-up test in people with colon polyps or colon cancer
  • Chronic, unexplained abdominal or rectal pain
  • An abnormal X-ray exam, like a barium enema or CT scan 

colonoscopy_by_dr_deetlefs

 

The Importance of Getting a Colonoscopy

As the cliché goes, “prevention is better than cure”.

Colonoscopy might seem like a scary medical procedure, but it’s one that prevents you from being diagnosed with colon or colorectal cancer too late and suffering because of it.

Fear about your health should never be an excuse not to get regular check-ups. Prevention is important to keep yourself healthy and prevent unnecessary costs in the future.

After all, at the end of the day you’ll only get out what you put in. You need to take some action in order to benefit from this. 

How to Get Ready for a Colonoscopy

Having an adequate preparation for a colonoscopy is essential for getting the best results, while increasing the least amount of discomfort.

You will have to make sure that your bowels are empty prior to your procedure by having a good bowel movement in the morning, and some people opt for going through an enema procedure before scheduling their colonoscopy.

If you’re diabetic or on a special diet, then you need to inform your gastro-intestinal specialist about what medications and supplements you’re on.

This could be important for determining which type of laxatives are safe to use prior to a scheduled procedure – usually the night before, rather than early morning. 

colonoscopy_explained_gidoc_cpt


What To Expect After a Colonoscopy

After a Colonoscopy, you may experience some noticeable discomfort in the first few days, following which your bowel motions will re-establish their normal pattern. 

There are many myths and misconceptions that surround having a colonoscopy. Most people are not aware of some of the common side effects after a colonoscopy.

On the patient side of things, there are a few potential side effects that could occur following a colonoscopy that are unpleasant to experience.

The most common side effect after a colonoscopy is vomiting. This happens because food or fluid comes into contact with the intestines when the colon is being cleansed.

As it leaves the body, the food or fluid passes through the body and exits via the bowel. 

If a person experiences abdominal pain, cramping, or fever, it could be a sign of a side effect of this procedure.

Other potential side effects of the colonoscopy include: 

  • Dizziness
  • Depression
  • Diarrhea
  • Loss of appetite
  • Dry mouth
  • Yawning
  • Low blood pressure
  • Fever

If any side effects do not go away, it is a good idea to see a doctor to rule out other possible causes. While most people go home from the colonoscopy fine, a small percentage of people have side effects. 

Colonoscopy What to Expect by Dr. Deetlefs CPT

Get in Touch with GI Expert Dr. Deetlefs

Dr Deetlefs has admitting rights and performs endoscopies at both Mediclinic Milnerton and Life Vincent Pallotti Hospitals.

To learn more about the complexity of your gut and the opportunity for you to contribute to the scientific pursuit of gastrointestinal knowledge, visit our Cape Town office or visit our website.

We are gastroenterologist experts using patient-focused GI treatment and procedures in Cape Town.

If you haven’t been scheduled for a colonoscopy and want to get one, make an appointment now. 

DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.

GIDoc Cape Town

Patient-focused GI treatments and procedures in Cape Town.

Monday-Friday 8AM-4PM.

Connect with Us

© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.

Double-Balloon Enteroscopy Explained

Double-Balloon Enteroscopy Explained

                                                   What is Double-Balloon Enteroscopy?

 

Double-balloon Enteroscopy is a technique used by Gastroenterologists to gain visual access to the small bowel. 

The enteroscopy allows the doctor to have a complete internal view of the small intestine and the colon using two inflatable balloons. 

Your small bowel, which is the longest part of the intestine, is about six meters long and allows you to digest and absorb food before it gets into your colon, where the undigested food is then stored and eliminated.  

When a blockage causes the small intestine to swell, it is called a gastrointestinal obstruction, also known as a “blockage” or “obstruction.” 

Unlike single-balloon enteroscopy, a double-balloon technique is used when a patient has small bowel strictures (narrowing of the small bowel).

With the introducer device, the patient can be sedated so the procedure can be done on an outpatient basis instead of an operating room setting.

 

What Does DBE Involve? 

 

The double-balloon endoscope is inserted into the mouth and fed through the small intestines, doing a standard endoscopy of the small bowel. 

At one point during the procedure, the doctor inserts a small camera with an LED light to illuminate the small intestine. The double-balloon endoscope has two balloons — a water balloon and a gas balloon. 

The water balloon holds the endoscope in place to help the doctor view the small bowel. The gas balloon inflates later in the procedure and gives the doctor a better view.

These balloons are inflated prior to the procedure to enlarge the small intestine, so that the inner lining and tumors can be visualized.  

Most patients require sedative or general anesthesia to keep them still.
Some patients are given general anesthesia prior to the procedure, rather than local anesthesia, so they don’t require sedation or a general anesthetic. 

Also, this procedure does have a recovery time, so it is important to have time set aside immediately after the procedure.

 

small_intestine_enteroscopy

 

Why a Double-Balloon Enteroscopy is Performed? 
 

There are many different reasons as to why a Double Balloon Enteroscopy is performed.

It can be very useful if the patient is experiencing severe constipation, bloating and/or vomiting.

The procedure is minimally invasive and as for recovery, patients can go back to playing their regular sport or exercise routines within a few days. 

This procedure is both diagnostic and interventional for a variety of small intestinal diseases such as: 

  • Vascular Lesions
  • Obtaining a biopsy of Tumors
  • Placement of a Stent
  • Removal of Polyps
  • Dilating of a Stricture
  • Involvement of inflammatory bowel diseases
  • Diagnosis and treatment of mid-gastrointestinal bleeding 

 

What to Expect During the Procedure? 

  

 Many patients are worried about how they’ll feel during the Double-Balloon Enteroscopy procedure. 

There is a good chance they will feel nothing at all. 

You have two small balloons that are inflated in your small intestine.  These balloons are inflated prior to the procedure to enlarge the small intestine, so that the inner lining and tumors can be visualized. 

Your small intestine produces gas that can cause gas pains and cramping. When the balloons are inflated, the gas leaves your stomach and colon through the small intestine. 

The entire procedure takes about 10 to 15 minutes. 

 

How to Prepare for a DBE?

 

Before the Procedure

Your doctor’s office will instruct about preparation prior your procedure.
Confirm with your doctor on any medications you should stop for a time, including over-the-counter medication.

Diet

Your stomach and bowel should be empty during the procedure to make it possible to visualise the entire area. 
This decreases the possibility of food or fluid being vomited into the lungs while under sedation.

It is often a daunting task. Even though it is an outpatient procedure you will still need to plan time for rest following this procedure.  When you have to undergo a Double-balloon Enteroscopy, there are a few things you need to remember.

Should the procedure be done through the mouth, you should not eat or drink anything after midnight prior to the procedure. 

If your procedure will be done through the rectum, bowel prep will need to be done prior to your DBE.  This is similar to preparing for a colonoscopy.

Bowel prep is a necessary procedure when getting any invasive medical procedure done.

The primary side effect of bowel prep is diarrhea. However, this is only temporary and is recovered within six hours. 

 

double_balloon_enteroscopy

The Risks

  

Like many medical devices, the double-balloon enteroscope comes with a list of risks.

The biggest downside of double-balloon enteroscopy is that in certain rare instances of double-balloon enteroscopy the patient runs the risk of leaking feces into the peritoneal cavity.

There is also a chance of the procedure leading to temporary nausea and vomiting.

Therefore, double-balloon enteroscopy is not recommended for use in individuals who are critically ill or those with other health complications.

For example, a patient who is older than 65 and has chronic pulmonary disease is at a higher risk for complications from the test.

If this patient has an incisional hernia or gastric bypass surgery, the complications are elevated further. 

Similar risks involved with having a colonoscopy done, can be expected with having a DBE done.

These risks include:

  • Bleeding
  • Perforation
  • Complications of sedation

Side Effects of DBE?
 

Let’s discuss side effects. 

The unique feature of double-balloon enteroscopy is the fact that it allows you to conduct the procedure from the Oesophagus. 

This offers a number of benefits, like a reduced risk of post-procedure bleeding.
However, it also causes a few side effects like sores in the oesophagus after the procedure.

 Common Side Effects may include:

  • Sore throat
  • Nausea or vomiting
  • Excessive gas, bloating or cramping
  • Irregular heartbeat
  • Headache
  • Mild abdominal discomfort
  • Minor bowel irritation
  • Drowsiness

Your doctor will always outline exactly what you can expect after any medical procedure.   

double_balloon_enteroscopy_medical_procedure

 

What is the Recovery Time? 

 

Double-balloon enteroscopy is rapidly becoming one of the most effective and efficient ways to study the intestines.  

This procedure is a great method to use in conjunction with other procedures and the overall recovery time following a DBBE is usually around the same as for a standard colonoscopy.  

During the procedure itself there is usually little to no pain involved, however it is not uncommon for patients to suffer from some discomfort during double balloon enteroscopy.  

Other than this there may be other side effects such as temporary irregular heartbeat.  

However, these side effects are extremely uncommon and unlikely. 

You should be able to walk and talk right after and no more than 24–48 hours after the procedure is completed you should be fully active and back on your feet.  

Generally speaking, it is best to follow your doctor’s orders post-wand removal.  

 

balloon_enteroscopy_infographic

 

 

GI Doc Cape Town is a practice founded to provide medical solutions in the area of gastroenterology. 

Over the years, Dr. Eduan Deetlefs has earned the reputation of a trusted health expert providing consultative, diagnostic, and therapeutic endoscopic and related services to patients in Cape Town and beyond. 

Should you experience any of the above symptoms or need any additional information regarding the above procedure, give us a call at 021 551 8678.

DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.

GIDoc Cape Town

Patient-focused GI treatments and procedures in Cape Town.

Monday-Friday 8AM-4PM.

Connect with Us

© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.

Endoscopy Explained

Endoscopy Explained

Maybe you have heard the word endoscopy once or twice in your life, but do you know what it means? 

If you were to get one, do you know what the doctor will do?

This article would explain everything you need to know about endoscopy – from the definition, types, and procedure.

 

What is Endoscopy?

 

Endoscopy is a non-surgical technique that examines the digestive tract of a person.

A doctor can view photographs of your digestive tract on a color TV monitor using an endoscope, a flexible tube with a light and camera connected to it. 

So, what exactly is an endoscope? 

An endoscope (also called a fibrescope) is a long, thin, and flexible tube with a light and video camera inserted into the body during an endoscopy to examine an internal organ or tissue in great detail. 

This tool allows a doctor to look inside a patient’s body without having to undergo significant surgery. 

An endoscope is usually placed through a natural orifice in the body, such as the mouth, urethra, or anus.

 endoscopy_procedure

 

Why Do You Need an Endoscopy?

Now that we know the process of endoscopy, let’s discuss why you might need it.

Endoscopy is commonly used for the following purposes:

  • Investigation
    Determining the cause of any unusual symptoms one is experiencing.
  • Diagnosis confirmation
    Removing a small sample of tissue that can then be sent to a lab for further testing.
  • Treatment
    Assisting a doctor in seeing inside the body during a surgical procedure, such as repairing a stomach ulcer or removing gallstones or tumors.

Prior to your procedure, the doctor will assess your symptoms, perform a physical examination, and potentially request certain blood tests.

These tests will assist the doctor in gaining a better understanding of the cause of your symptoms.

These tests may also aid in determining whether the issues may be resolved without the use of endoscopy or surgery.

Simply put, endoscopy is used by doctors to diagnose disorders in the following body parts:

  • Oesophagus
  • Stomach
  • Colon
  • Ears
  • Nose
  • Throat
  • Heart
  • Urinary tract
  • Joints
  • Abdomen 

 

endoscopy_procedure_types

 

Common Endoscopy Procedure Types

 

Colonoscopy
Colonoscopy is a procedure that allows a doctor (typically a gastroenterologist) to look within the colon (large intestine or large bowel).

Upper GI endoscopy 
An upper GI endoscopy, often known as an EGD (esophagogastroduodenoscopy), is a treatment used to identify and treat disorders in the upper gastrointestinal (GI) tract.

Laparoscopy
Laparoscopy is a surgical procedure that allows a surgeon to view the inside of the abdomen (tummy) and pelvis without making extensive skin incisions.

Gastroscopy

A gastroscopy is a procedure to examine the oesophagus, stomach, and first part of the small intestine inside the body (duodenum). It can assist confirm or rule out medical disorders such as gastritis or peptic ulcers.

Flexible Sigmoidoscopy
A flexible sigmoidoscopy is a test that assesses the lower portion of the large intestine (colon). Irritated or swollen tissue, ulcers, polyps, and cancer can all be seen using this procedure.

Endoscopic Retrograde Cholangiopancreatography
Endoscopic retrograde cholangiopancreatography (ERCP) is a treatment that combines upper GI endoscopy with x-rays to diagnose and treat disorders with the liver, gallbladder, bile ducts, and pancreas.

Capsule Endoscopy
Capsule endoscopy, also known as capsule enteroscopy or small bowel endoscopy, examines the center of the gastrointestinal tract, which includes sections of the small intestine, with a pill-sized camera that captures hundreds of images for a doctor to analyze.

 capsule_endoscopy_explained

 

 

Other Types

Bronchoscopy is a procedure that uses a narrow, illuminated tube (called a bronchoscope) to examine directly into the lungs’ airways.The bronchoscope is inserted into the patient’s nose or mouth. It makes its way down the windpipe (trachea) and enters the airways.

Cystoscopy is a procedure that uses a narrow camera called a cystoscope to view inside the bladder.  It is put into the urethra (the tube that transports urine out of the body) and passes into the bladder, allowing a doctor to examine the inside.

Endoscopic ultrasound (EUS) is a minimally invasive method that can be used to diagnose digestive (GI) and lung problems.High-frequency sound waves are used by a special endoscope to provide comprehensive views of the lining and walls of your digestive tract and chest.

Hysteroscopy is a treatment that allows your doctor to examine the inside of your uterus to diagnose and treat irregular bleeding.

A hysteroscope, a thin, illuminated tube placed into the vaginal canal to inspect the cervix and the inside of the uterus, is used for this procedure.

 

Preparation and Procedure

 
Like any other medical procedure, endoscopies are frequently performed in hospitals.

Before having an endoscopy 

There is usually no preparation required prior to endoscopy, but your doctor will give you instructions on what to eat and drink before the procedure, as well as how to take your regular medications.

In most cases, you will be instructed to fast for hours before the surgery, depending on what area of your body is being examined.

If you need to have your large intestine or rectum and lower part of the bowel, you may be given a laxative to assist cleanse your bowels and have a low fibre diet a few days before the endoscopy.

Antibiotics may also be required in some circumstances to lower the risk of infection.

Another important thing to consider is telling your doctor everything about any serious health issues, such as heart or lung illness.

You must follow your doctor’s advice, because if you don’t, the treatment may have to be postponed.

During an endoscopy 

Although endoscopy is rarely painful, it can be unpleasant.

The majority of people have just minor discomfort, similar to that of indigestion or a sore throat.  

Endoscopy is normally performed while you are conscious.
During an upper endoscopy procedure, you will be asked to lie on your back or side on a table.

 A local anaesthetic (in the shape of a throat spray or lozenge) may be used to numb a specific area of your body.

You might also be given a sedative to help you rest and become less conscious of your surroundings.

 The endoscope will be inserted into your body with caution.

 Again, it depends on the part of the body being examined. It may be inserted into your mouth and down your throat, urethra, or anus.

 Depending on the purpose of the endoscopy, it can take anywhere from 15 to 45 minutes. You can generally go home the same day and avoid spending the night in the hospital.

After an endoscopy

After the procedure, you will be examined and supervised by your doctor or a trained professional for an hour or until the majority of the drugs’ effects have gone off.

If you’ve had general anaesthesia, you’ll be observed for a longer period.

 If necessary, you will be given pain relief although there are some endoscopic procedures, such as ERCP, that may necessitate an overnight hospital stay to ensure that everything goes smoothly.

Risks and Side Effects

 

The dangers of each type vary depending on the procedure’s location and your health.

Compared to open surgery, endoscopy offers a substantially lower risk of bleeding and infection.

Still, because endoscopy is a medical operation, there is a chance of bleeding, infection, and other risks like:

  • Chest pain
  • Organ damage, including probable perforation that usually necessitates surgery
  • Bleeding at the site of a biopsy or polyp excision
  • Fever
  • Persistent pain in the area of the endoscopy
  • Complications from pre-existing heart, lung, or liver disease
  • Irritation or redness and swelling at the incision site

Within 24 hours to a few days, most patients can resume routine activities.
However, if you feel any of these, talk to your doctor immediately.

Contact Dr. Deetlefs today for a consultation in Cape Town.

 

endoscopy_explained_infographic

DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.

GIDoc Cape Town

Patient-focused GI treatments and procedures in Cape Town.

Monday-Friday 8AM-4PM.

Connect with Us

© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.

The Importance of Colorectal Cancer Screening

The Importance of Colorectal Cancer Screening

 Colorectal cancer is, as the name suggests, cancer that occurs in the colon or rectum.

You have probably heard it referred to as colon cancer. The reason that colon and rectal cancers are grouped together in this way is because they have many features in common.

Colorectal cancer starts off, like most cancers, as a growth. This growth is found on the inner lining of the colon or rectum and is referred to as a polyp.

A polyp is not automatically referred to as cancer and some polyps never turn cancerous. However, all colorectal cancers do arise from polyps so it’s important to keep them in check.

In this article, we are going to have a look at how colon cancer starts and spreads, and then how colorectal cancer screening can help increase your treatment options.

Before we jump into that, let’s have a look at the basic structure and function of the colon and rectum.

This will help in one’s understanding of colorectal cancer.

 colon_cancer_screening

 

The Structure and Function of the Colon and Rectum

The colon and rectum are part of the gastrointestinal system which, as you know, is responsible for digestion.

The colon, a muscular type, comprises most of the large intestine coming in at around 1.5m long.

It is split into four sections anatomically with each section named according to the way in which food travels through it.

These four sections are the ascending colon (travels upward from the right side of the abdomen), the transverse colon (goes across the body from right to left), the descending colon (travels down from the left side), and the sigmoid colon (due to it’s “S” shape) which joins the rectum.

There is still water and salt in the food matter after it has passed through the small intestine. This is where the function of the colon comes in – it absorbs any water and salt that is still in the remaining food matter.

What’s left after this process then goes into the rectum where it is stored until leaving the body.

In short, your colon is crucial for extracting water and other key nutrients from waste material.

 screening_colon_cancer

How Colon Cancer Starts and Spreads

As mentioned earlier, most colorectal cancers start as a growth on the inner lining of the colon or rectum. These growths are referred to as polyps. 

They come in a variety of shapes and sizes with different polyps carrying varying risks for going on to develop into cancer. 

Apart from cancer-susceptibility between the polyps, there are also general factors that can increase someone’s risk of developing colorectal cancer. 

They can be summarised as follows: 

  • Size: If a polyp larger than 1 cm is found
  • Number: If more than 3 polyps are found
  • Dysplasia: This is a pre-cancerous condition where the tissue area contains cells that look abnormal but are not yet cancerous. If dysplasia is seen in the polyp after it is removed, then it could imply an increased risk of developing colorectal cancer. 

Now let’s take a look at the variation between the actual polyp types:

 

  1. Adenomatous polyps: These are a common type of polyp which appear as gland-like growths. On the surface, the polyp tissue looks very much like the normal lining of your colon although it is different in a number of ways when looked at under a microscope.

    There are two major growth patterns: tubular and villous. Although many adenomas have a combination of these growth patterns and are referred to as tubulovillous adenomas.

These patterns help one’s doctor determine when the next colonoscopy needs to be done to ensure that colon cancer does not develop in the future.

 2.  Hyperplastic polyps and inflammatory polyps: This refers to a further categorization of polyps. This category is referred to as non-neoplastic polyps which do not typically become cancerous.

 Inflammatory polyps may be seen with ulcerative colitis or Crohn’s Disease.

 3.  Sessile serrated polyps and traditional serrated adenomas: These polyps fall under the neoplastic category which can be pre-cancerous and it’s normally recommended to remove them.

 “Sessile” polyps refer to those that grow as slightly flattened, broad-based polyps whereas “serrated” polyps have a saw-tooth appearance under a microscope.

 Anyone can develop colon polyps but there are heightened risks if you are over the age of 50 or if you are overweight or a smoker.

 A personal or family history of colon polyps or colon cancer is also a significant risk factor for future polyp growth.

 This leads us to the next part of our article: screening.

 Colon polyps often don’t cause any symptoms so it’s crucial to go for regular screening tests so that colon polyps can be found in as early a stage as possible.

 This will allow for a higher chance of safer and more complete removal thereby dramatically reducing the chances of developing colorectal cancer.

 

why_colorectal_cancer_screening_is_important

 

Why Colorectal Cancer Screening is Important

 

Colorectal screening is a test where doctors look for precancerous polyps so that they can be removed before turning into cancer.

 Colorectal cancer can also be found with screening tests. These tests are done to look for a disease when a person does not exhibit symptoms.

 Regular and early screening is key to preventing cancer. More screening has resulted in a significant drop in the number of colorectal cancer cases.

 In the U.S., for example, where colorectal cancer is a leading cause of cancer death for men and women, has seen a steadily declining death rate for the past several decades.

 Colorectal screening is responsible for this improved survival rate – when colorectal cancer is found early, the 5-year relative survival rate is 90%. A significant figure.

 The only factor preventing the death rate from declining even further is the fact that a large percentage of those susceptible to colorectal cancer never get screened.

 There are various reasons for this but one of the most significant is that of people simply not knowing that regular screening could save their lives from this disease. 

Education is key and is the premise behind providing you, our dear reader, with articles such as this one.

Do the right thing for you and your loved ones, get a screening done.

 colon_cancer_test

Types of Colorectal Cancer Screening Tests

Now that we know why it’s important to get tested, let’s take a look at the different tests that you may encounter when you go for your screening.

 There are two main groups of testing: 

1.    Structural Exams

The physical structure of the colon and rectum is studied in order to find any abnormal areas, should there be any.

In general, these tests are performed using either a scope put into the rectum or with special imaging tests.

 A colonoscopy, for example, is a type of structural (or visual) exam. The doctor uses a colonoscope (a thin flexible tube equipped with a light and small video camera) to observe the physical structure of the colon and rectum. 

The doctor can also add additional instruments to the colonoscope for the purposes of taking a sample or remove certain polyps. 

For those that would like a less invasive test, a CT colonography is also an option.

 It serves as a “virtual colonoscopy” where x-rays and a CT scan are used to build a 3D representation of the colon and rectum structure. 

These tests do require more preparation ahead of time and can’t be done as frequently as the second type of testing group.

2.    Stool-based tests

This type of testing is less invasive than visual exams and requires less preparation by the patient but it does need to be done more frequently.

 It involves a check of the stool for signs of cancer.

 Two examples of stool-based tests include the faecal immunochemical test (FIT) and the guaiac-based faecal occult blood test (gFOBT). 

the_importance_of_colorectal_cancer_infographic

Summary

Colon polyps are common but they don’t always exhibit any symptoms. This can falsely lead people to believe that they don’t have polyps and therefore don’t need to worry about colorectal cancer.

 

The only way to be certain is to go for regular screening tests to ensure that any signs of cancer or pre-cancerous polyps are caught and treated as early as possible.

 

For more information on all things gastrointestinal, visit us at www.gidoc.co.za where we can help you navigate the tricky landscape of the gut. 

DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.

GIDoc Cape Town

Patient-focused GI treatments and procedures in Cape Town.

Monday-Friday 8AM-4PM.

Connect with Us

© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.

What is the Difference Between Gastroesophageal Reflux Disease (GERD) and Acid Reflux?

What is the Difference Between Gastroesophageal Reflux Disease (GERD) and Acid Reflux?

Finding yourself suffering from a burning pain in your chest? 

It could be acid reflux or gastroesophageal reflux disease. Read more here to learn about the differences between these two commonly confused ailments. 

 

What is the Difference Between Gastroesophageal Reflux Disease (GERD) and Acid Reflux?

 

If you are experiencing a burning feeling in your chest, you probably already know you’re experiencing heartburn. Heartburn is not a condition on its own, and it has nothing to do with the heart.

Instead, it is the main symptom one experiences when suffering from acid reflux, which is when stomach contents come back up in your esophagus.

Often the reason for this is easily identified. For example, if you have eaten an extremely chilli heavy dinner or consumed a large amount of fizzy cooldrink, you may activate symptoms of acid reflux.

If this is happening on a regular basis (multiple times per week) it could be an indication that you’re suffering from a more serious condition called gastroesophageal reflux disease (GERD).

Understanding the differences between acid reflux and GERD involves understanding the links between each.

This article will explore what each of these conditions are, their differences, similarities and symptoms, as well as how they relate to one another. 

 heartburn_experience_gerd

What is Heartburn?

 While eating, you swallow food that travels down the esophagus into your stomach.

Here there is a ring of muscles called the lower esophageal sphincter (LES) which tightens and acts as a barrier to keep the food in your stomach.

 Experiencing heartburn indicates that the LES is either weak or is not closing properly.

 This allows stomach acid to travel back up the esophagus, which then irritates the lining of the esophagus. The burning sensation this causes is indicative of the name “heartburn”, also known as acid reflux. 

Symptoms of Acid Reflux
 

  • An unpleasant burning sensation, typically experienced in the middle of your chest that can last between a few minutes to a few hours.
  • A “pressure” type feeling or pain in your chest that can worsen if you bend over or lie down.
  • Tasting an acidic, sour, or bitter taste in the back of your throat.
  • The feeling that food has not properly gone down the esophagus and is “stuck” in the middle of your chest.

 

 foods_causing_acid_reflux

 

Causes of Acid Reflux

 

  • Smoking or regular exposure to second-hand smoke
  • Consuming alcohol
  • Presence of a hiatal hernia
  • Eating large meals
  • Eating late at night or just before bed
  • Consuming high-fat or fried foods
  • Acidic drinks, such as fruit juice

Various medications can also trigger acid reflux, including: 

  • Asthma medication
  • High blood pressure medication
  • Antidepressants
  • Antihistamines
  • Pain relievers
  • Sedatives

 avoiding_heartburn_gerd

How to Avoid Heartburn

 

If you are prone to experiencing heartburn, you can minimise this by looking at your lifestyle and making some changes to reduce these bouts. 

You typically would not need to be on medication for heartburn as these lifestyle changes are usually effective enough: 

  • Make a note of the foods that you eat that trigger bouts of heartburn for you. These could include acidic, spicy, fried, or fatty foods. Some people also experience acid reflux when drinking caffeine or alcohol.
  • Not eating big meals soon before bedtime, as staying upright after consuming large amounts of food encourages digestion.
  • Losing weight, as obesity can add to the weakening of the lower esophageal sphincter.
  • If you happen to be a smoker, quitting will also assist with relieving symptoms. 

 

diagnose_gerd

What is GERD?

 

When acid reflux presents as a chronic condition, meaning it occurs more than twice a week, it is known as Gastroesophageal Reflux Disease (GERD).

If you suffer regular bouts of heartburn, it does not automatically mean that you will progress to having GERD.

The symptoms are the same as those of acid reflux (the burning sensation or lump in your chest) and you may also experience a dry cough or trouble swallowing. 

 

Diagnosing GERD

 

Because GERD can occasionally be mistaken for simple acid reflux, your GP will be able to diagnose the illness by looking at the frequency and severity of symptoms that you are experiencing. 

If the symptoms persist, especially any related to swallowing, the doctor may work with a gastroenterologist, surgeon, or another healthcare professional to confirm a diagnosis. 

Your doctor may want to perform one or more of the following tests: 

  • Upper gastrointestinal (GI) endoscopy and biopsy. This procedure involves a camera being inserted down the food pipe to look inside the stomach, or sometimes to take a tissue sample.
  • Upper GI series. Doctors will take X-rays of the body to look for complications such as a hernia, which may be causing the acid reflux.
  • Esophageal pH and impedance monitoring. A thin tube is placed inside the food pipe for about 24 hours to measure acid levels over a full day.
  • Bravo wireless esophageal pH monitoring. Acid levels are monitored by a small capsule that is inserted into the food pipe and a receiver outside the body that provides readings.

 

Treating GERD

 

As with acid reflux, the first port of call is to try managing symptoms with lifestyle changes before prescribing medication. 

Yet, as seen above in the possible lifestyle changes, some are more difficult to change than others, like giving up smoking, for example. 

If you and your GP decide it is necessary to look at medications to assist in managing your symptoms, the most commonly prescribed medication for GERD is a proton pump inhibitor (PPI), such as: 

  • Prevacid (lansoprazole)
  • Nexium (esomeprazole)
  • Prilosec (omeprazole)

The way that these PPI medications work is by decreasing the amount of acid produced by your stomach. It has been suggested that a two-month course of PPI can assist with healing of the esophageal lining that has been damaged by stomach acid.

Another medication option would be H2 blockers, which also decrease the production of stomach acid. These are conveniently available over the counter making them very easily accessible.

If your doctor diagnoses that your GERD symptoms are caused by hypersensitivity in the esophagus or excessive relaxation of the lower esophagus, you might be prescribed tricyclic antidepressants or selective serotonin uptake inhibitors. 

gerd_complications

 

Possible Complications by Delaying Treatment 

The reason it is important to be aware of the differences between acid reflux and GERD is the fact that If GERD goes untreated, it can lead to more serious complications. 

One such issue is esophagitis, which is inflammation in the esophagus. Leaving this untreated can lead to developing strictures; the narrowing of the intestine, in this instance the esophagus. This narrowing can cause esophageal pain and make it difficult to swallow.

GERD can also make one more susceptible to serious respiratory problems, such as pneumonia or laryngitis. 

Another serious possible complication of GERD is a condition called Barrett’s Esophagus (BE). This condition causes the esophagus lining to thicken and become red due to stomach acid causing cells in the lining of the esophagus to look more like the stomach lining.

If this happens, there is an increased chance, albeit small, of developing esophageal cancer so it is important to have regular check-ups with imaging and biopsies of the esophagus to check for precancerous cells (dysplasia).

If precancerous cells are discovered in these check-ups, you have a good chance to deal with it early and they can be treated to prevent esophageal cancer.

Difference Between Gastroesophageal Reflux Disease and Acid Reflux

 

Summary: How We Can Help You and Where to Find a GI Specialist

 

Ultimately, these two conditions are very similar in cause and symptoms, so if you are concerned about mild or already frequent bouts of heartburn, talk to us today about the possibility that you are suffering from GERD.

For further reading on the procedures we perform, as well as how they can assist in diagnosing illnesses such as GERD, see our article on capsule endoscopies or visit our blog page

DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.

GIDoc Cape Town

Patient-focused GI treatments and procedures in Cape Town.

Monday-Friday 8AM-4PM.

Connect with Us

© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.

Crohn’s Disease Explained – Symptoms and Treatment

Crohn’s Disease Explained – Symptoms and Treatment

Crohn’s Disease is a type of inflammatory bowel disease that can go into remission but then suddenly reappear with nasty symptoms. Doctors may prescribe medication or, in severe cases, even surgery.

Good lifestyle choices and general symptom management can help ease the hardships of this disease.

Here we will look at examining what the disease entails and the best treatment options available today.

 

What is Crohn’s Disease?

 

Crohn’s disease falls under the category of inflammatory bowel diseases. As such, it’s a condition that stays with those suffering from it for life.

While it does differ quite significantly from inflammatory bowel disease, Crohn’s disease does involve chronic inflammation of the digestive tract.

The hardest part about living with Crohn’s disease is living with life-disrupting symptoms. Even when symptoms are not present, though, the disease can be a real hindrance to a stress-free life because Crohn’s disease is prone to remission with sudden flare-ups a common occurrence.

Lifestyle changes are required by most people living with the disease to manage the disease as carefully as possible in an attempt to lower its negative effects on normal school, work, and social life.

In this article, we will look into what makes Crohn’s disease part of the Inflammatory Bowel Disease umbrella term, how it differs from ulcerative colitis, the typical signs and symptoms one can expect when dealing with Crohn’s disease, and potential treatment options.

 

crohns_disease_symptoms

  

Inflammatory Bowel Disease and Crohn’s Disease

 

Crohn’s disease is a form of inflammatory bowel disease (IBD).

IBD is the collective term for describing disorders that involve chronic inflammation of the digestive tract. The digestive tract is comprised of everything from the mouth and oesophagus through to the small and large intestine.

The digestive tract is what keeps you alive by breaking down your food, retaining the valuable parts, and ridding itself of the rest.

The definition of IBD is broad in scope but defines the parent term for two sub-categories of IBD, namely ulcerative colitis and Crohn’s disease.

It’s important to note that while we can draw clear separations between the two on paper, it can sometimes be quite a tricky task to diagnose the correct IBD in patients.

That said, let’s take a look at how Crohn’s disease is similar and contrasting to ulcerative colitis.

 

How is Crohn’s Disease Different from Ulcerative Colitis?

 

Ulcerative colitis involves inflammation of the large intestine with inflammation only present in the innermost layer of the lining of the colon.

Apart from inflammation, ulcerative colitis can also present as sores, or ulcers, on the colon lining. Another characteristic of this form of IBD is that the damaged areas are continuous.

This is in contrast to how Crohn’s disease presents.

Whereas ulcerative colitis is limited to the large intestine, Crohn’s disease can involve any part of the gastrointestinal tract from the mouth all the way to the end – the anus. 

Most commonly, it develops in the final part of the small intestine and colon. Another differentiating factor is that it occurs in distinct patches.

Unlike the continuous inflammation found in ulcerative colitis patients, those suffering from Crohn’s disease present with quite distinct healthy and inflamed areas of tissue.

Crohn’s disease seems to be increasing in occurrence with time – studies in the United States suggest that over half a million people are suffering from the disease.

The distinction between the two forms of IBD is not always crystal clear.

When a doctor is unable to determine whether a patient has ulcerative colitis or Crohn’s disease, they will classify the patient’s condition as “indeterminate colitis” implying that there are cases where it’s not always clear one way or the other.

 crohns_disease_treatment

 

Signs and Symptoms of Crohn’s Disease

 

Due to the involvement of the small or large intestine and the fact that inflammation can be spread out in multiple segments, signs and symptoms can be widespread.

When Crohn’s disease is in remission, that is to say, that when inflammation is not severe, patients will present with no signs or symptoms. This can change quite rapidly though and often without warning.

When Crohn’s disease is fully active (i.e. not in remission), a number of signs and symptoms can be found, some more painful and debilitating than others.

Depending on the location of the diseased inflammation, symptoms can vary with inflammation of the lower gastrointestinal tract possibly including some or all the following symptoms: 

  • Abdominal pain and cramping
  • Fatigue
  • Reduced appetite and weight loss
  • Persistent, sudden diarrhoea
  • The sensation of incomplete bowel evacuation
  • Constipation which could lead to bowel obstruction

Some of these symptoms may also be present if Crohn’s disease is in the upper GIT but symptoms are fewer in number and milder in severity.

Crohn’s disease has even been known to present silently (no outward symptoms) when the disease affects the small intestine. What often happens is that those with silent symptoms later exhibit symptoms such as intestinal blockage, infection, or persistent pain and fever.

There are also several symptoms, already touched on earlier, that affect one’s general health such as mouth sores, night sweats, and unusual menstrual cycles.

In more severe cases, patients with well-established Crohn’s disease may also experience inflammation of the skin, eyes, and joints, iron deficiency, delayed growth in children, and even kidney stones.

There is quite a range of displayed signs and symptoms of Crohn’s disease. It’s important to remain vigilant in monitoring one’s own health and consulting your doctor at any sign of irregularity in one’s health when Crohn’s disease is suspected. 

 crohns_disease_signs

 

Treatment of Crohn’s Disease

 

Due to the inflammation being the main problem in Crohn’s disease with cascading effects, anti-inflammatory drugs are the first step in a treatment plan.

Before starting a treatment plan, one’s doctor will first check out what kind of complications might be present, the severity of the symptoms and other medical conditions that may be present.

Apart from this, the doctor will want to understand how one’s body has responded to medication before such that he or she can ascertain what medical route to go down. Understanding potential side-effects are the primary goal here.

Apart from reducing inflammation, it is important to lower the immune response in an attempt to stop the immune system from attacking the bowel which causes inflammation. Immune suppressants are administered for this.

An example of an immune suppressant that may be administered is a corticosteroid that can help ease swelling. Immunomodulators can be given to stop inflammation but these are more intense and can take weeks or months to kick in.

Aminosalisylates are likely prescribed when one is diagnosed with Crohn’s disease but only present with mild symptoms.

There are risks of side effects with any medication, so doctor consultation is important to establish the right medication on a case-by-case basis.

Antibiotics can also be administered to target bacteria that may be triggering or worsening Crohn’s disease symptoms.

Once the main symptoms have been dealt with, it’s important to maintain good lifestyle choices to further reduce symptoms and risk of re-onset. This includes addressing the loss of fluid by drinking plenty of water and avoiding potential bowel irritants such as dairy products.

In some cases, surgery can be necessary.

For people with Crohn’s disease, surgery can be a means used to remove affected parts of the intestine.

 

 Crohn's Disease Explained

 

Get in Touch with GI Experts

 

To learn more about the complexity of your gut and the opportunity for you to contribute to the scientific pursuit of gastrointestinal knowledge, visit our Cape Town office or peruse our website.

We are gastroenterologist experts using patient-focused GI treatment and procedures in Cape Town

crohns_disease_gastroenterologist

DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.

GIDoc Cape Town

Patient-focused GI treatments and procedures in Cape Town.

Monday-Friday 8AM-4PM.

Connect with Us

© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.