Gastrointestinal Disease

This chapter focuses on gastric adenocarcinoma: other types are lymphomas, gastro intestinal stromal tumours and carcinoid. A history of gynaecological and obstetric interventions should be taken and any relationship of symptoms to menstrual cycle noted. Flexible fibreoptic sigmoidoscopy only requires enema preparation and is used mainly for the investigation of anal canal type rectal bleeding. First-line investigations: If this initial assessment is negative and anorexia persists, gastroscopy and ultrasound are the usual next steps. If red flags are excluded, the history may suggest a cause. If red flags are excluded, UK guidance recommends: If advanced gastric cancer is found after OGD, it is reasonable not to proceed to colonoscopy. Causal links have been proposed between an alteration in these bacteria and many GI and non-GI conditions, including IBS, IBD, obesity, fatty liver, colon cancer, poor memory and HD. When GORD is severe and prolonged, it can lead to Barrett's oesophagus, a risk factor for oesophageal adenocarcinoma.