Gastroenterologists Murdoch & Perth
ConditionsDetected by a Gastroscopy or a Colonoscopy
Conditions a Gastroscopy can detect
Coeliac disease is a condition in which the lining of the small intestine becomes damaged when it is exposed to even small amounts of gluten – a protein found in wheat, barley, rye and oats.
As a result, affected patients absorb food and nutrients poorly. This can result in bowel symptoms and deficiencies of vitamins, minerals and other nutrients.
Coeliac disease is diagnosed by a gastroscopy. During the gastroscopy if your specialist suspects coeliac disease, tiny samples (biopsies) are taken from your small bowel and sent to the lab for analysis to confirm if you have the disease.
Coeliac disease is successfully treated by removing all foods containing gluten from the diet. This is called a gluten-free diet. Following a gluten-free diet after the diagnosis of coeliac disease should allow an improvement in symptoms and restoration of health.
Gastro-Oesophageal Reflux Disease (GORD)
Reflux is due to stomach acid rising up to the oesophagus where it can cause pain in your chest (sometimes called heartburn) and inflammation that your specialist can see when you have a gastroscopy.
Heartburn is very common. Almost everyone has it at some time. It is a feeling of discomfort or burning or even pain felt rising up from the lower chest to the neck. Some people call it indigestion. Doctors call it gastro-oesophageal reflux disease, or reflux or GORD for short.
Occasionally reflux is associated with food or fluid coming into the mouth. This is called regurgitation. If reflux symptoms occur regularly, for example a few days a week or even every day, they may be distressing and need treatment.
Helicobacter pylori is a bacterium (germ) that can infect the human stomach. Its significance for human disease was first recognised in 1983 by a doctor from Western Australia called Barry Marshall.
Helicobacter lives in the lining of the stomach, and the chemicals it produces causes inflammation of the stomach lining. This can cause pain or indigestion, and sometimes stomach ulcers. Helicobacter means you are slightly more likely to get stomach cancer, although stomach cancer is still uncommon in Australia.
Infection appears to be life long unless treated with medications to eradicate it.
Helicobacter can be detected during a gastroscopy, usually by taking tiny samples (biopsies) from your stomach and sending them to the lab. Your doctor will advise treatment.
Oesophageal Stricture and Dilatation
An oesophageal stricture is a narrowing of the oesophagus, usually caused by acid reflux causing scarring but sometimes caused by an “allergic oesophagus” (also called eosionphilic oesophagitis or EoE) and uncommonly caused by oesophageal cancer.
A stricture usually presents with a feeling of food sticking or with problems swallowing. Problems with swallowing are not always caused by oesophageal stricture, although if you have this symptom you should see a doctor urgently.
Some problems swallowing are caused by oesophageal dysmotility, which is a disorder of the swallowing movement of your oesophagus. This is detected either at gastroscopy or with a special x-ray called a barium swallow.
Oesophageal dilatation is a procedure where a balloon is placed in the middle of the oesohpageal stricture or narrowing and then inflated to stretch the oesophagus and help you swallow. After the procedure the balloon is removed. This is done during a gastroscopy.
Stomach and Duodenal Ulcers (also called peptic ulcers)
A stomach or gastric ulcer is a break in the tissue lining in the stomach.
The term “peptic ulcer” refers to those that occur in either the stomach or the first part of the small intestine that leads out of the stomach, called the duodenum. It was once thought that stress, smoking and diet were the principal causes of ulcers. However, the Helicobacter pylori bug is now known to be responsible for most of them. Some ulcers are caused by taking anti-inflammatory drugs (also called Non-Steroidal Anti-Inflammatories or NSAIDs) such as ibuprofen, nurofen, or aspirin.
Treatment for stomach ulcers includes the use of antibiotics to eradicate the Helicobacter infection, avoidance of NSAIDs if necessary and acid-suppressing drugs.
Ulcers often don’t produce any symptoms. If present, they can include:
- abdominal pain just below the ribcage
- loss of appetite
- weight loss
- bright or altered blood present in vomit or bowel motions
- symptoms of anaemia, such as light-headedness shock due to blood loss – a medical emergency.
Stomach Cancer and Oesophageal Cancer
These are cancers that are detected with a gastroscopy. Neither are common in the Australian population, but if you have any of the following symptoms you will need a gastroscopy to rule them out:
- Weight loss or loss of appetite
- Problems with swallowing or a sensation of food sticking
- Abdominal pain (tummy pain) or discomfort
- A sense of fullness in the upper abdomen after eating a small meal
- Heartburn or indigestion
- Nausea or vomiting (particularly if the vomit has blood in it)
Barrett’s oesophagus is where the lining of the lower part of the oesophagus changes probably from damage caused by acid reflux.
This is seen during endoscopy. If you have Barrett’s oesophagus you are slightly more likely to develop oesophageal cancer, so you will likely need regular endoscopies to try to pick that up early.
Liver Disease, Cirrhosis, Portal Hypertension
Liver disease, which if severe can be called cirrhosis. This can be detected during gastroscopy. Portal hypertension is the name for some of the signs of liver disease that can be seen during a gastroscopy.
Conditions a Colonoscopy can detect
Irritable Bowel Syndrome
Irritable Bowel Syndrome (IBS) can not be diagnosed by colonoscopy, but if your doctor suspects you have IBS he will do a colonoscopy to make sure there is nothing else going on.
People with IBS appear to have sensitive bowels that are easily ‘upset’.
The main symptoms of IBS are:
- abdominal pain or discomfort that is often relieved by passing wind or faeces
- stomach bloating
- chronic diarrhoea or constipation, or alternating between the two
Other symptoms are:
- whitish mucus in the stool/poo
- the feeling that you have not finished a bowel movement
- nausea IBS can be painful, however, it does not damage the colon or other parts of the digestive system. IBS does not lead to other health problems.
We have more information on IBS in a specific section on our website.
Ulcerative Colitis and Crohn’s disease (also called Inflammatory Bowel Disease or IBD)
Inflammatory bowel disease is a term used to describe two main diseases: ulcerative colitis and Crohn’s disease which cause inflammation of the bowel. Ulcerative colitis and Crohn’s disease are both detectable by colonoscopy.
This inflammation is thought to be due to dysfunction of your immune system, and is not due to an infection.
Ulcerative colitis causes inflammation of only the inner lining of the colon and rectum (large bowel). When only the rectum is involved it is sometimes called ulcerative proctitis or just proctitis. When the entire colon is involved it is sometimes called pan-colitis.
Crohn’s disease causes inflammation of the full thickness of the bowel wall and may involve any part of the digestive tract from the mouth to the anus (back passage). Most frequently the ileum, which is the last part of the small bowel, the colon or both are involved.
Sometimes people get confused between IBD and Irritable Bowel Syndrome (IBS). The two conditions are quite different and so are their treatments. IBD is where there is visible inflammation or damage to the bowel, whereas in IBS there are multiple symptoms related to the bowel (abdominal pain, diarrhoea, constipation, bloating), but blood tests are normal and nothing can be seen with endoscopy/colonoscopy or x-rays. It is thought to be due to gut hypersensitivity, hence the use of the word irritable. The two conditions IBD and IBS can, however, occur in the same person.
Bowel Cancer and Polyps
Early detection, prevention and treatment of bowel cancer is one of the main reasons that colonoscopies are performed. In Australia bowel cancer (also called colorectal cancer) is the most commonly diagnosed internal cancer, and the second most common cause of cancer death.
Treatment of bowel cancer at an early stage either at the time of colonoscopy or by surgery is more often than not a cure.
If you are having a colonoscopy this does not mean that you are likely to have bowel cancer, however. Quite often just polyps, which are early signs that cancer might develop are found and then are removed during the colonoscopy.
What happens after my procedure?
After your procedure your gastroenterologist will discuss his or her findings with you. You will be given a copy of your report to take home, and a copy of the report will also be sent to your GP.
If samples are taken, then these can take a few days to be available as they are sent to the laboratory for analysis. The laboratory will send the results to your gastroenterologist and also to your GP. If the results need discussing with you then your gastroenterologist will contact you.