Investigating symptoms

Thursday 23rd April 2013 Portrait of Dr Jeremy Tibble, Consultant Gastroentologist at Montefiore Hospital for Spire Health Care. Brighton, East Sussex, UK

Most patients are referred to me by their GP because they have symptoms that suggest they have a problem with their digestive system or liver.

From time to time, we all experience discomfort or changes in our gastrointestinal tract – usually these are quite normal and can be attributed to dietary and lifestyle changes or a simple bug. The symptoms will probably settle of their own accord. However, if the symptoms persist, become more severe or include any of the following then you should consult your GP.

• Bleeding and or pain during bowel motions
• Changes to your bowel motions, especially if they become black, dark red, pale or contain mucus (slime)
• Diarrhoea that persists
• Persistent constipation or feeling that your bowels are emptying incompletely
• Indigestion, heartburn, regurgitation or waterbrash (regurgitation of tasteless or sour fluid)
• Loss of appetite
• On-going bloating or flatulence
• Pain in your abdomen before or after eating
• Pain or difficulty in swallowing
• Persistent nausea or vomiting
• Unexplained weight loss
• Jaundice

The investigations to determine the cause of the symptoms may involve one of the following procedures:

Gastroscopy (or upper GI Endoscopy)
• Small bowel enteroscopy
ERCP
Colonoscopy
Fibroscanning (Liver)