254 Thomas Street, S/C-Burg, G/Town Guyana. Ph:5922262687, 5922259673, 5926438819
Dr. Shiwnandan has been a Member of the American College of Gastroenterology and a Member of Association of West Indian Gastroenterologists since 1998. Dr. Shiwnandan is trained in ultrasound and endoscopic procedures and has be successfully preforming these procedures for more than 20 years.
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This is a procedure where a thin, flexible tube called an endoscope is used to look inside the esophagus (gullet), stomach and first part of the small intestine (duodenum).
It's usually carried out as an outpatient procedure, and it often takes less than 15 minutes, although it may take longer if it's being used to treat a condition.
The patient is asked to fast overnight. Before the procedure, your throat will be numbed with a local anesthetic spray. You can also choose to have a sedative, if you prefer. This means you will still be awake, but will be drowsy and have reduced awareness about what's happening.
Dr. Shiwnandan will place the endoscope in the back of your mouth and ask you to swallow the first part of the tube. It will then be guided down your esophagus and into your stomach.
The procedure shouldn't be painful, but it may be unpleasant or uncomfortable at times.
If samples are taken to determine the real cause of the condition , these will be sent to a pathology lab for evaluation.
A colonoscopy is an examination of your entire large bowel using a device called a colonoscope.
Your bowel needs to be empty when a colonoscopy is performed, so you'll be advised to eat a special diet for a few days beforehand and take a medication to help empty your bowel the day before the examination.
You may be given a sedative to help you relax during the test. The doctor will then insert the colonoscope into your rectum and move it along the length of your large bowel. This isn't usually painful, but can feel uncomfortable.
The camera relays images to a monitor, which allows the doctor to check for any abnormal areas within the rectum or bowel that could be the result of cancer. A biopsy may also be performed during the test.
A colonoscopy usually takes about an hour to complete, and most people can go home once they've recovered from the effects of the sedative.
If given a sedative, you will probably feel drowsy for a while after the procedure, so you'll need to arrange for someone to accompany you home.
Gastritis is inflammation to wall of your stomach. Stomach ulcers (gastric ulcers) are open sores that develop on the lining of the stomach. Ulcers can also occur in part of the intestine just beyond the stomach. These are called duodenal ulcers.
Stomach and duodenal ulcers are sometimes called peptic ulcers. This information applies to both.
Although the most common symptom of a stomach ulcer is a burning or gnawing pain in the centre of the abdomen (tummy). Not all stomach ulcers are painful.
Some people experience:
Speak to your GP immediately (or phone the 911 service) if:
These could be a sign of a serious complication.
Stomach ulcers occur when the layer protecting the stomach lining from stomach acid breaks down. This allows the stomach lining to become damaged.
This is usually caused by:
There's little evidence that stress or certain foods causes stomach ulcers.
More about the causes of stomach ulcers
You'll be treated using antibiotics if your ulcer was caused by a H. pylori infection. This kills the bacteria and should prevent the ulcer coming back.
You'll be treated using a proton pump inhibitor (PPI) if your ulcer was caused by NSAIDs. Your doctor will prescribe these and discuss whether you should keep using NSAIDs. Alternative medication to NSAIDs, such as paracetamol, may be recommended.
Most stomach ulcers take a few months to heal after treatment. However, stomach ulcers can come back after treatment, although this is less likely to happen if the underlying cause is addressed.
Complications are rare but can be very serious and potentially life-threatening.
The main complications include:
Gastro-esophageal reflux disease (GERD) is a common condition, where acid from the stomach leaks up into the esophagus (gullet).
It usually occurs as a result of the ring of muscle at the bottom of the esophagus becoming weakened.
GERD causes symptoms such as heartburn and an unpleasant taste in the back of the mouth. It may just be an occasional nuisance for some people, but for others it can be a severe, lifelong problem.
GERD can often be controlled with self-help measures and medication. Occasionally, surgery to correct the problem may be needed.
This topic focuses on GERD in adults.
Symptoms of GERD can include:
You can often control the symptoms of GERD by making some lifestyle changes and taking over-the-counter medication.
You don't necessarily need to see your GP if you only have symptoms occasionally. Ask your pharmacist for advice on treatments.
Visit your GP if you're worried about your symptoms, or if:
Your GP will usually be able to diagnose GERD based on your symptoms, although they may refer you for some tests.
The main treatments for GERD are:
You may only need to take medication when you experience symptoms, although long-term treatment may be needed if the problem continues.
Surgery to stop stomach acid leaking into your esophagus may be recommended if medication isn't helping, or you don't want to take medication on a long-term basis.
If you have GERD for a long time, stomach acid can damage your esophagus and cause further problems.
Ulcerative colitis is a long-term condition, where the colon and rectum become inflamed.
The colon is the large intestine (bowel), and the rectum is the end of the bowel where stools are stored.
Small ulcers can develop on the colon's lining, and can bleed and produce pus.
The main symptoms of ulcerative colitis are:
You may also experience fatigue (extreme tiredness), loss of appetite and weight loss.
The severity of the symptoms varies, depending on how much of the rectum and colon is inflamed and how severe the inflammation is. For some people, the condition has a significant impact on their everyday lives.
Some people may go for weeks or months with very mild symptoms, or none at all (known as remission), followed by periods where the symptoms are particularly troublesome (known as flare-ups or relapses).
During a flare-up, some people with ulcerative colitis also experience symptoms elsewhere in their body. For example, some people develop:
In severe cases, defined as having to empty your bowels 6 or more times a day, additional symptoms may include:
In most people, no specific trigger for flare-ups is identified, although a gut infection can occasionally be the cause. Stress is also thought to be a potential factor.
Read more about living with ulcerative colitis.
You should see your GP as soon as possible if you have symptoms of ulcerative colitis and you haven't been diagnosed with the condition.
They can arrange blood or stool sample tests to help determine what may be causing your symptoms. If necessary, they can refer you to hospital for further tests.
Read more about diagnosing ulcerative colitis.
If you've been diagnosed with ulcerative colitis and think you may be having a severe flare-up, contact your GP or care team for advice. You may need to be admitted to hospital.
Ulcerative colitis is thought to be an autoimmune condition. This means the immune system – the body's defence against infection – goes wrong and attacks healthy tissue.
The most popular theory is that the immune system mistakes harmless bacteria inside the colon for a threat and attacks the tissues of the colon, causing it to become inflamed.
Exactly what causes the immune system to behave in this way is unclear. Most experts think it's a combination of genetic and environmental factors.
Read more about the causes of ulcerative colitis.
It's estimated that around 1 in every 420 people living in the UK has ulcerative colitis; this amounts to around 146,000 people.
The condition can develop at any age, but is most often diagnosed in people from 15 to 25 years old.
It's more common in white people of European descent (especially those descended from Ashkenazi Jewish communities) and black people. The condition is rarer in people from Asian backgrounds (although the reasons for this are unclear).
Both men and women seem to be equally affected by ulcerative colitis.
Treatment for ulcerative colitis aims to relieve symptoms during a flare-up and prevent symptoms from returning (known as maintaining remission).
In most people, this is achieved by taking medication such as:
Mild to moderate flare-ups can usually be treated at home. However, more severe flare-ups need to be treated in hospital to reduce the risk of serious complications, such as the colon becoming stretched and enlarged or developing large ulcers. Both of these can increase the risk of developing a hole in the bowel.
If medications aren't effective at controlling your symptoms, or your quality of life is significantly affected by your condition, surgery to remove your colon may be an option.
During surgery, your small intestine will either be diverted out of an opening in your abdomen (known as an ileostomy), or used to create an internal pouch that's connected to your anus (known as an ileo-anal pouch).
Read more about:
Stomach cancer, or gastric cancer, is a fairly uncommon type of cancer. Around 7,000 people are diagnosed with it each year in the UK.
The initial symptoms of stomach cancer are vague and easy to mistake for other less serious conditions. They include:
Symptoms of advanced stomach cancer can include:
As the early symptoms of stomach cancer are similar to those of many other conditions, the cancer is often advanced by the time it's diagnosed. It's therefore important to get any possible symptoms of stomach cancer checked by your GP as soon as possible.
Read more about diagnosing stomach cancer
The exact cause of stomach cancer is still unclear, although you're more likely to develop it if you:
Types of stomach cancer
There are several different types of stomach cancer. More than 95% of stomach cancers develop in the cells of the stomach lining and are known as adenocarcinomas.
Less common types of stomach cancer include lymphoma of the stomach, which develops in the lymphatic tissue (tissue that drains away fluid and helps fight infection), and gastrointestinal stromal tumours (GISTs), which develop in the muscle or connective tissue of the stomach wall.
How stomach cancer is treated
If operable, surgery can cure stomach cancer as long as all of the cancerous tissue can be removed.
Surgery to remove some or all of the stomach is known as a gastrectomy. It will still be possible to eat normally after a gastrectomy, but you'll probably have to adjust the size of your portions.
Chemotherapy can also be used before surgery to help shrink the tumour and sometimes after surgery to help prevent the cancer returning.
Living with stomach cancer
Living with stomach cancer and the effects of surgery can be tough, but there are a range of services that can provide social, psychological and financial support.
The outlook for stomach cancer depends on several factors, including your age, your general health, and how far the cancer has spread (the stage of the condition).
Unfortunately, as stomach cancer isn't often picked up until the later stages, the outlook isn't as good as for some other cancers. Of all those with stomach cancer, about:
Bowel cancer is a general term for cancer that begins in the large bowel. Depending on where the cancer starts, bowel cancer is sometimes called colon or rectal cancer.
Cancer can sometimes start in the small bowel (small intestine), but small bowel cancer is much rarer than large bowel cancer.
Bowel cancer is one of the most common types of cancer diagnosed in the UK, with around 40,000 new cases diagnosed every year.
About 1 in every 20 people in the UK will develop bowel cancer in their lifetime.
The three main symptoms of bowel cancer are blood in the stools (faeces), changes in bowel habit – such as more frequent, looser stools – and abdominal (tummy) pain.
However, these symptoms are very common and most people with them do not have bowel cancer. For example, blood in the stools is more often caused by haemorrhoids (piles), and a change in bowel habit or abdominal pain is usually the result of something you have eaten.
As almost 9 out of 10 people with bowel cancer are over the age of 60, these symptoms are more important as people get older. They are also more significant when they persist despite simple treatments.
Most people who are eventually diagnosed with bowel cancer have one of the following combinations of symptoms:
The symptoms of bowel cancer can be subtle and don't necessarily make you feel ill.
Read about the symptoms of bowel cancer, and when you should see your GP to discuss whether any tests are necessary.
Your doctor will probably carry out a simple examination of your tummy and bottom to make sure you have no lumps.
They may also arrange for a simple blood test to check for iron deficiency anaemia – this can indicate whether there is any bleeding from your bowel that you haven't been aware of.
In some cases, your doctor may decide it is best for you to have a simple test in hospital to make sure there is no serious cause for your symptoms.
Make sure you return to your doctor if your symptoms persist or keep coming back after stopping treatment, regardless of their severity or your age.
Read more about diagnosing bowel cancer
It's not known exactly what causes bowel cancer, but there are a number of things that can increase your risk. These include:
Bowel screening is offered to men and women aged 50 to 74 across Scotland to help find bowel cancer early when it can often be cured.
Bowel screening involves taking a simple test at home every 2 years. The test looks for hidden blood in your poo, as this could mean a higher chance of bowel cancer.
Read more about screening for bowel cancer
Bowel cancer can be treated using a combination of different treatments, depending on where the cancer is in your bowel and how far it has spread.
The main treatments are:
As with most types of cancer, the chances of a complete cure depends on how far it has advanced by the time it is diagnosed. If the cancer is confined to the bowel, surgery will usually be able to completely remove it.
Overall, 7 to 8 in every 10 people with bowel cancer will live at least one year after diagnosis. More than half of those diagnosed will live at least another 10 years. Every year, around 16,000 people die as a result of bowel cancer.
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