Dr Robert Jalleh
Consultant Surgeon and founder member, Malaysia Society of Gastroenterology and Hepatology (MSGH)
Issue: The Expat Megazine
Many patients complain of symptoms related to the abdomen. Distension, bloating or ''abdominal wind'' are common experience. These can be accompanied by problems such as constipation or diarrhea. More worrying features will include passage of mucus and blood in the stools and weight loss.
''Bloating'' can be caused by disorders involving any of the abdominal organs. Common disease include food poisoning or gastroenteritis and a dysfunctional condition of the intestines called irritable bowel syndrome (IBS). Gallstones and peptic ucler disease are often seen. They are fairly easily identified with appropriate tests and have definitive treatments. Gallstones are diagnosed with ultrasound scans. Ulcers in the stomach or duodenum are visualised during gastroscopy. The latter condition is often associate with a bacterium known as Helicobacter pylori or lifestyle habits such as smoking and excessive consumption of alcohol. The most serious abdominal disease is cancer. Cancers of the large intestine (colon and rectum) are amongst the most common cancers in humans.
Your family physician (general practitioner) will be able to deal with many conditions. Otherwise, he will refer you to a specialist who deals with such problems. A complete history and thorough physical examination will allow the doctor to arrive at a fairy accurate diagnosis in 70% to 80% of the time. Investigations of tests are neened to confirm the diagnosis or to aid in the process of arriving at the diagnosis if symptoms and signs are non-conclusive. Helpful blood tests include full blood count (FBC) and the tumour markers. An important feature of FBC is the haemoglobin (Hb) level.
A low Hb means that one is anaemic. It often implies that one is losing blood in the gastrointestinal tract. It is a serious matter and cannot be left alone! Tumour markers are proteins in the blood which become raised in the presence of cancers. Examples are CEA which is elevated in patients with colon and rectal cancers and alpha-fetoprotein (AFP) in liver cancer.
The two frequently employed radiological imaging techniques for the abdomen are ultrasound and CT (computed tomography) scans. They are execellent fot the identification of disorders of the solid organs.
The best modality to examine the inside of the gastrointestinal tract is endoscopy. This is the insertion of video fibreoptic tube into the lumen of the hollow organs. Gastroscopy is used to visualize the throat, oesophagus, stomach and duodenum. Colonoscopy examines the rectum and colon.
The endoscopist can biopsy. ie.obtain tissue for sampling when abnormalities are detected. This is done under sedation on an ambulatory or day-care basis. Once a diagnosis is made, your doctor will recommend appropriate treatment. Depending of the diagnosis and its severity, treatment can range from taking oral medication to a major surgical operation.
Gastroscopy : RM900*Colonoscopy : RM1,240*Gastroscopy and Colonoscopy : RM2,000*CT-Colonoscopy : RM500**subject to revision
- CT-Colonoscopy -
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