The part of you between the chest and the hips containing most of your gastrointestinal tract apart from your oesophagus that takes food from your mouth down through your chest where it joins on to the stomach. Other words commonly used to describe the abdomen are the belly, the gut or the tummy.
To help describe where you maybe feeling pain in your abdomen there are systems dividing the abdomen up into four or nine different sections. Doctors may talk about things such as epigastrium or right iliac fossa or right upper quadrant. It is much better if you have a pain in the abdomen to think carefully about where it is so that you can later accurately point out the site to your doctor. Sometimes a pain may be felt all over your abdomen or sometimes the pain may move around or be felt in different parts of the abdomen on different occasions.
An operation in which the last part of the bowel is cut out and the remaining large bowel is brought out through the lower abdominal wall and drains into a bag. This is called a colostomy.
When something is not normal. This is a vague term. Sometimes your doctor may not appreciate how worried you may be and if you are concerned you should not be afraid to ask for further explanation.
A collection of pus. Pus is made up of dead white blood cells that have been involved in trying to overcome an infection. An abscess may occur after severe appendicitis, diverticulitis, and pancreatitis or after a perforated ulcer.
Once food has been broken down by digestion it has to get from your gut in to your body. This transfer process is called absorption and occurs mainly in the small intestine and the breakdown products of food are transferred by blood vessels to your liver for further processing.
A rare disease of the muscles of the oesophagus that can cause swallowing difficulties.
Something, such as a pain, that has been there for only a short time. It does note mean that the pain is severe or bad and is one of those medical terms that is commonly misused. It is the opposite of chronic which means severe.
Scar tissue inside the abdomen that may cause loops of intestines to stick together and sometimes cause a blockage known as a bowel obstruction. In years gone by many people with abdominal pain that would now be put down to conditions such as Irritable Bowel Syndrome had operations to divide adhesions. Nowadays surgeons are reluctant to operate on adhesions unless there is clear evidence of persisting blockage. Adhesions commonly follow previous operations in the abdomen and one problem with having an operation to divide adhesions is that further adhesions may occur as a result of the operation.
This occurs when you swallow too much air. The problem is that air in the stomach causes discomfort which makes you want to belch more. Medical jargon for belching is eructation.
See Lactose intolerance.
A protein widely distributed in the body.
Chronic consumption of excessive amounts of alcohol damaging well being and health. A standard drink contains 10g of alcohol. The National Health & Medical Research Council (NH&MRC) recommends that men should not consume more than four standard drinks a day and women are advised not to consume more than two standard drinks a day.
Gastrointestinal tract or GIT.
An infection caused by a parasite that can cause diarrhoea and may sometimes cause an abscess in the liver. People usually pick up the infection when travelling overseas.
Not enough red blood cells in the body. Red blood cells contain a substance called haemoglobin that carries oxygen around the body and the level of haemoglobin in the blood is measured so that people with anaemia have low haemoglobin. This may occur if not enough red blood cells are made in the bone marrow or if blood is lost in the gastrointestinal tract.
A superficial tear at the opening of the bowel, the anus. It commonly follows severe constipation and it can be extremely painful. It may require a simple operation but recently nitro-glycerine cream has been found to be helpful in many cases.
A channel passing from inside the anus out through the skin and may be the end result of an abscess but may also occur in a chronic bowel inflammation known as Crohn’s disease.
An operation where a surgeon joins two things together such as if a portion of bowel is removed and the two free ends are sewn together again.
Abnormal blood vessels in the gastrointestinal tract that may cause bleeding.
An x-ray taken after dye is injected into blood vessels so that a picture of the blood vessels can be taken and it may be possible to see abnormal bleeding occurring from the blood vessels. Sometimes angiograms may show bleeding into the gut in conditions such as angiodysplasia.
A medicine that helps neutralise acid in the upper part of the gut.
Medicines that reduce spasm in gut muscle and were used in the past to try to reduce the amount of acid produced in the stomach.
Drugs that may help reduce diarrhoea.
Medicines that help prevent nausea and vomiting (emesis).
Medicines that may help reduce spasm of intestinal muscle.
A surgical operation to remove the last part of the stomach called the distal part. The first part of the stomach is called the proximal part.
The opening at the lower end of the gastrointestinal or digestive tract through which bowel movements/bowel actions/faeces/bowel contents leave the body.
The colon is the last part of the intestines. Ascending refers to the direction in which the bowel contents are moving through the colon. This part of the colon is found on the right side of the abdomen.
An accumulation of large amounts of fluid in the abdominal cavity. There are many cause of this condition such as cirrhosis of the liver or the spread of cancer cells to the abdominal cavity.
When a disease may be present but it is not causing and displaying and symptoms.
A blockage of various parts of the gut due to failure of normal development.
A chronic inflammation of the stomach lining causing the lining to shrink. ‘Atrophy’ means shrinking away and ‘itis’ means inflammation - so appendicitis means inflammation of the appendix; oesophagitis means inflammation of the oesophagus; and colitis means inflammation of the colon.
The body gets confused and thinks that its own tissues are foreign invaders that need to be killed, so it produces antibodies which damage itself.
Liver disease that occurs when the body’s immune system destroys its own liver cells by mistake.
Another word for germs. The gut normally contains lots of different bacteria which live there quite happily and don’t cause any problems. Sometimes bacteria can cause problems if they get where they don’t belong such as if there is a perforation or hole occurring in the gut and bacteria spill out into the abdominal cavity. This leads to an inflammation called peritonitis.
Sometimes harmful bacteria can get in to the gut and grow there and cause damage. This occurs in conditions such as food poisoning or bacterial gastroenteritis. These harmful bacteria are called pathogenic bacteria. Damage may sometimes be caused by other organisms in the gut such as viruses or parasites but these are different from bacteria.
A white substance which shows up on x-rays and is used in x-ray examinations called barium meals, where it is swallowed, or barium enemas, where it is inserted into the large bowel via a tube passed into the rectum via the anus.
Barrett’s oesophagus occurs when excessive amounts of stomach acid reflux back into the oesophagus and the lining changes as a result. The lining becomes more like the lining of the stomach which is better able to resist damage by acid.
This is also sometimes referred to as burping or eructation. The valve or sphincter at the lower end of the oesophagus relaxes and gas from the stomach is released up through the oesophagus, sometimes quite noisily. It can lead to problems if it is done to excess and can lead to a condition known as aerophagy.
Benign / non malignant
A condition which, untreated or with symptomatic therapy, will not become life-threatening. It is used in particular in relation to tumours, which may be benign or malignant. Benign tumours do not invade surrounding tissues and do note metastasize to other parts of the body. Some benign tumours can however cause life-threatening complications due to mass effect.
An older test used to try to find out whether chest pain is due to acid in the oesophagus. A tube is passed in to the oesophagus and acid similar to stomach acid is dripped in and it is helpful for the patient to let the doctor know whether this causes the sort of pain that has been previously present.
A yellow green fluid made by the liver that passes down the bile duct into the upper part of the small intestine known as the duodenum. Some of the bile is stored in the gall bladder. Bile is used by the body to help get rid of waste products that are passed out in the bowel motions or faeces. Bile is also useful in helping to get fat in the diet into solution so that it is more easily digested and absorbed.
The pipes that carry bile from the liver down to the intestine. The gall bladder and bile ducts are sometimes referred to as the biliary system/tract/tree.
This is a rare condition that some babies are born with (ie. a congenital condition). Because the bile ducts do not develop properly bile cannot pass from the liver into the intestine and this can lead to jaundice and chronic liver damage.
A narrowing of the bile duct due to things such as scar tissue, cancer or external pressure. It may lead to jaundice.
A substance found in the bile that gives bile its colour. It is caused by the breakdown of haemoglobin which is found in red blood cells. Red blood cells are broken down when the get too old to work efficiently. Bilirubin is normally passed out in the bowel motions/faeces/stools and the broken down products of bilirubin influence the colour of the bowel motions. When too much bilirubin builds up in the body a yellow colour known as jaundice appears in the skin and particularly in the whites of the eyes.
Removal of a small piece of tissue for examination by the pathologist under the microscope after careful preparation. Biopsies may be taken by various techniques such as via a needle or a small snipping may be taken using biopsy forceps during an endoscopy procedure.
A feeling of fullness in the abdomen. This may occur if we have eaten too much or if there is too much wind in the gut, but sometimes these feelings can occur with normal amounts of gut contents if the gut is oversensitive.
Abdominal rumbling sounds caused by passage of gas and liquid down through the intestines.
The small and large intestines are known as the bowel.
This is the waste products from the body that pass down through the gut and out through the rectum and anus. Other terms used to describe this matter are faeces, bowel actions or stools.
Methods that are used to clean out the large intestine before it can be properly examined with a bowel x-ray or colonoscopy.
Brain gut axis
The gastrointestinal tract has nearly as many nerve cells as the brain itself, and is sometimes called the ‘little brain’. There are many connections between the brain and the gut. This is called the ‘brain gut axis’. Events that occur within our gut, such as eating, gastrointestinal infection or contractions in the bowel all send messages to our brain. Sometimes we are aware of these messages and sometimes we are not. Patients with Irritable Bowel Syndrome are more sensitive and may be aware of more of these messages.
When we are stressed or anxious, certain hormones are released within our brain, and these same hormones can also affect the nerves in our gut. Therefore stress, particularly in patients with Irritable Bowel Syndrome, can make symptoms worse. Many healthy people may notice that when they are stressed, such as prior to public speaking, they may have tummy cramps or the need to open our bowels. Studies have shown that certain psychological treatments such as relaxation therapy, treatments changing our behaviour in response to pain, can help symptoms in Irritable Bowel Syndrome. Looking at ways to reduce stress is an important aspect of treatment in Irritable Bowel Syndrome.
These substances are swallowed and retain water in the bowel motions. This causes bowel motions to be bulky and softer enabling them to be passed more regularly and more easily. Bulking agents are commonly used to treat constipation. They sometimes help people with diarrhoea by making watery bowel motions a little more solid.
An operation in which a new passage is created so that things such as food or bile can pass more easily when there has been a blockage. Most people are probably more familiar with a coronary artery bypass procedure which is carried out when there has been a blockage to the coronary arteries supplying blood to the heart muscle.
Stones that can form in various parts of the body such as in the gallbladder or the kidneys.
A germ that causes many cases of infectious diarrhoea or food poisoning.
The old name for helicobacter pylori, the germ in the stomach that has recently been found to cause most peptic ulcers.
Cancer or carcinoma
A malignant tumour, growth or neoplasm. This occurs when cells in various organs in the body keep dividing and growing out of control and can cause problems by placing pressure on surrounding tissues and by spreading to invade other parts of the body.
A fungus that normally lives in small numbers in the gut. It rarely causes problems when it is found in increased numbers such as in thrush affecting the mouth or the oesophagus or it may cause vaginal thrush, particularly after treatment with broad spectrum antibiotics. It can occasionally cause a severe generalised infection in patients with a depressed immune system.
Carbohydrates along with fats and proteins are one of the three main components of food. Starches and sugars are carbohydrates and are broken down in the body to sugar called glucose which is stored in the liver until it is needed to be used for energy to help the body function.
Another word for laxatives, drugs that help overcome constipation.
A tube used to take fluids into or out of different parts of the body.
A type of dietary fibre derived from vegetables.
A chemical that is found naturally in the bile and is still rarely used to try to dissolve certain gallstones.
X-rays of the bile ducts.
Infection of the bile ducts.
Removal of the gall bladder. In the past this was done with an incision in the abdominal wall and was known as an open cholecystectomy. Nowadays a cholecystectomy is carried out with a procedure where several very tiny cuts are made in the abdominal wall and special long thin instruments are used and this is known as a laparoscopic cholecystectomy. Using this technique the patient is usually out of hospital much more quickly and has less post-operative discomfort.
Inflammation of the gall bladder.
A hormone that is produced in the lining of the small intestine and that causes the muscle in the gallbladder wall to contract.
Stones in the bile ducts.
Stones in the gallbladder, known as gallstones.
Obstruction to the flow of bile.
A fat like substance that is found in bile and in many gallstones as well as being found in the wall of blood vessels causing narrowing such as in coronary artery disease.
Something that is present for a long time, often years. Like the word ‘acute’ this word is commonly misused by patients who may think that it means severe or bad. When a doctor refers to chronic pain they are referring to a pain that has been present for a long time and not a severe pain.
Liver damage with scar tissue in the liver due to many causes particularly prolonged excessive consumption of alcohol.
Germs that are normally present in the large bowel but can increase dramatically in number sometimes after the use of antibiotics. The germ can produce a poison/toxin that can damage the bowel wall and cause an inflammation known as pseudomembranous colitis resulting in severe diarrhoea.
A condition in which the lining of the small intestine is damaged by foods containing gluten, such as wheat products. The damaged bowel is not able to absorb food properly leading to a condition called malabsorption. Apart from causing diarrhoea coeliac disease may also cause anaemia because of problems absorbing iron and folic acid and it may cause osteoporosis.
There is a simple blood test to suggest that the disease is present but the diagnosis needs to be confirmed with a duodenal biopsy. The diagnosis should be confirmed before starting on a gluten free diet.
A surgical operation in which part or all of the large bowel or colon is removed.
Abdominal pain coming from the large or small intestine. Typically the pain comes and goes like a labour pain.
Inflammation of the large bowel or colon.
A protein found in what is called connective tissue, such as in cartilage or bone.
A type of inflammation of the large bowel or colon where increased amounts of collagen can be seen by the pathologist who looks at biopsies from the lining of the colon using a microscope.
These are side branches of a main blood vessel that may allow some blood to bypass a blockage of the main vessel.
A test where a long thin flexible instrument is passed in through the anus to the rectum and the rest of the large bowel so that it can be inspected and if necessary photographs and biopsies taken, and polyps can be removed by a procedure known as polypectomy. Sometimes the colonoscope can be passed further up into the last part of the small intestine, the terminal ileum. The patient is given sedation with an injection prior to the procedure. A bowel preparation is given prior to the procedure because the bowel has to be empty of faeces for the test to be successful.
Something to do with the colon or the rectum or both. A colorectal surgeon is a surgeon who specialises in diseases of the colon and rectum. Colorectal cancer describes cancers that occur in the colon or large bowel or in the rectum, the last part of the large bowel.
A surgical operation where the faeces, stool or bowel motions leave the body through an opening where the colon has been joined to the abdominal wall and pass into a bag which can be emptied from time to time. This may be done as a temporary procedure to avoid leaking when a portion of the bowel has been removed and the two ends sutured together downstream from the colostomy or it may be done as a permanent procedure when the rectum is removed for cancer.
Common bile duct
The tube that carries bile from the liver to the duodenum. If the bile duct is obstructed by things such as gallstones or cancer then jaundice and also pruritus or itching of the skin may result.
Computerised tomography scanning or CT scan
A special x-ray that can be helpful in diagnosing certain gastrointestinal diseases.
Present at birth.
Condition where the stools are passed less frequently and are hard.
A group of medications that can be useful in treating various forms of inflammation such as ulcerative colitis, Crohn’s disease or chronic active hepatitis.
A chronic inflammation that can affect the entire gastrointestinal tract but commonly affects the last part of the small intestine, called the terminal ileum or the colon when it is called Crohn’s colitis. It was named after the radiologist who first described it. Although there are many theories the exact cause remains unknown. There are effective medications to help control the disease and sometimes surgical operations may be needed.
Cryptosporidia parasites that can cause gastroenteritis
This is more of a problem in patients who have a depressed immune system such as those with AIDS. The parasite may sometimes be found in the water supply.
The tube joining the gallbladder to the common bile duct. If a gallstone blocks the duct as it tries to pass from the gallbladder out into the common bile duct it causes a condition known as cystic duct obstruction.
This is an inherited disease that causes particular problems with the lungs but also can cause problems with the pancreas leading to difficulty absorbing food properly, a condition called malabsorption.
This is also referred to by other terms such as having a bowel action, emptying or opening the bowels. It is the passage of bowel contents, containing waste products and undigested food residue out through the rectum and the anus. It is a complicated process involving spontaneous contraction of muscle in the bowel wall along with relaxation of the sphincter muscles and voluntary straining of the abdominal wall muscles to increase the pressure within the abdomen.
Occurs when there is not enough fluid in the body. This may happen with decreased fluid intake and increased fluid losses due to things such as diarrhoea, vomiting and excessive sweating.
Delayed gastric emptying
This occurs when the muscles in the stomach wall don’t contract properly (gastroparesis) or when there is a blockage to the outlet of the stomach, called the pylorus.
This is the part of the colon or large bowel found on the left side of the abdomen. It is called descending because the bowel contents in this part of the colon are moving downwards when you are standing up.
The use of various machines to obtain pictures or images of various internal organs. This includes investigations such as x-rays, CT scans, ultrasound examinations, radio-isotope scans and MRI scans.
A muscle wall between the chest cavity and the abdominal cavity. It is like a partition between the two cavities and it has a hole in it through which the oesophagus passes to join the stomach. Sometimes the upper part of the stomach can slide up through this hole and this is known as a hiatus hernia. The diaphragm muscle is important in breathing.
Refers to more frequent and softer than normal bowel actions.
Widespread. For example, diffuse abdominal pain. If the pain is felt in one small area it is called ‘localised’ pain.
The breaking down of food into tiny particles that can be absorbed through the wall of the intestine.
An increase in the diameter of a section of the gut or other hollow organ.
In the gut, where contents flow all the way from the mouth right down to the anus, distal refers to a part of the gut that is downstream.
Occurs when the abdomen is swollen up. This is different from the word ‘bloating’ which refers to feeling overly full but not actually being swollen.
A medicine that increases the output of urine. In gastroenterology a diuretic is often used in treating the accumulation of fluid in the abdominal cavity, known as ascites.
This is a little out-pouching through the wall of the intestine, usually in the large bowel or colon although it can occur in other parts of the gut such as the oesophagus, the stomach or the small intestine.
Double contrast barium enema
When barium enemas are carried out they are usually done so using the double contrast technique where air and barium are introduced into the colon providing more information than older techniques where just barium was used, the so-called single contrast barium enema.
Double-blinded randomised trials
These day’s doctors like to base recommendations about patient management, like investigation and treatment, on evidence derived from the medical and scientific literature. This is not always possible but the best and most reliable form of evidence comes from so-called ‘double-blind randomised trials’.
In order to be reliable and reproducible, any medical study, for example of a new medication or treatment, needs to exclude any possible form of bias. The ‘double-blinding’ of properly conducted studies refers to the requirement that neither doctor nor patient knows which form of treatment that particular patient is receiving.
A typical trial might be designed to see whether a new pain-killing tablet works. In such a trial, the new drug would usually be compared to a placebo or to an established and effective form of treatment. If the patient knows that they are on placebo treatment only, it might influence their opinion about the efficacy of their own treatment. Similarly, were the doctor to know which tablet a given patient is receiving, their subjective assessments of efficacy might be unwittingly influenced. In either instance, the results would become unreliable.
‘Randomisation’ refers to the process by which patients are assigned to different treatment groups. These days such allocation is often done by computerised randomisation programmes. This part of the study design is important so that the two groups being treated are comparable. In the example of a new analgesic tablet referred to above, it would be unfair to enlist all patients say with more severe pain to one treatment group, since it could clearly influence conclusions about efficacy.
This occurs when food moves too quickly from the stomach into the small intestine resulting in symptoms such as faintness and sweating after eating meals.
This is the first part of the small intestine immediately beyond the stomach. Bile and pancreatic juice empty into the duodenum where they mix with food that is passed through from the stomach. An ulcer may occur in the duodenum and is called a duodenal ulcer in contrast to a gastric ulcer that occurs in the stomach. Both duodenal and gastric ulcers are known as peptic ulcers. Peptic refers to the type of ulcer and duodenal and gastric refer to where the ulcer is situated.
Occasionally an ulcer in the stomach may be an ulcerating cancer and this is referred to as a malignant ulcer in contrast to non-malignant or benign ulcers. It is extremely rare to have a cancer in the duodenum, in contrast to the stomach. Sometimes the duodenum may be diffusely inflamed and this is called duodenitis. Sometimes there may be multiple tiny superficial ulcers in the duodenum and this is called duodenal erosions.
Severe diarrhoea due to an infection of the lining of the colon, usually due to bacteria such as Campylobacter Jejuni, Salmonella, Shigella or Pathogenic E Coli. Dysentery is more likely to occur in patients travelling overseas.
This is indigestion or abdominal discomfort following meals.
Difficulty with swallowing
An electric current is passed through a thin wire which heats up the wire and can be used to cut through tissue and seal over any tiny blood vessels that are cut to prevent bleeding. This is used in the common technique of polypectomy where polyps are removed from the gut, usually in the large bowel or colon.
Salts and minerals that are found in the body and their levels can be measured with simple blood tests.
The accidental passage of a bowel movement also referred to as faecal incontinence.
A thin flexible tube used for looking inside the gut. The gastroscope is used for looking through the mouth into the upper gut and a different instrument called a colonoscope is used for looking through the anus and rectum into the colon and sometimes the last part of the small intestine called the ileum.
Endoscopic papillotomy or sphincterotomy
A technique in which a fine wire is heated up with an electric current and used to make a small cut at the lower end of the bile duct where it joins the duodenum. This is usually done so that a stone in the bile duct can then be pulled through into the duodenum using either a special basket or a balloon passed down through the endoscope.
A means of passing liquid food directly into the gut via a tube that may be passed down through the nose through the oesophagus into the stomach. This is called a naso gastric tube. Sometimes using a special technique a tube can be passed through the skin of the abdominal wall directly into the stomach or into the small intestine using an endoscope. This is known as a PEG (Percutaneous Endoscopic Gastrostomy) or PEJ (Percutaneous Endoscopic Jejunostomy). These techniques are typically used when patients are not able to swallow normally.
Is an ostomy or opening into the intestine through the wall of the abdomen.
Inflammation of the lining of the small intestine.
A protein that helps speed up chemical reactions. In the gut enzymes help breakdown food that has been eaten and this process is called digestion. The tiny particles of food can then be absorbed through the gut wall.
A rare form of inflammation of the lining of the gut.
The tissue lining the gut. The gut lining is also called mucosa and the epithelium is the surface part of the mucosa.
ERCP (Endoscopic Retrograde Cholangio-Pancreatography)
An investigation in which an endoscope is passed down via the mouth into the duodenum and then a fine tube is passed through the endoscope and into the tiny opening of the common bile duct into the duodenum. A special liquid known as dye or contrast is then injected with a syringe down through the fine pipe into the bile duct. The dye is radio opaque which means that it shows up clearly on x-rays that are taken at the time of the procedure. This enables the doctor doing the test to see the size of the bile duct and whether it contains things such as common bile duct stones.
Red painful lumps on the legs, occurring in various diseases including ulcerative colitis and Crohn’s disease.
Evidence based medicine
In medicine, doctors try to make decisions by using the evidence available from the research available and from articles published in the medical literature. Where possible doctors advise certain treatments only when there is research evidence available to prove that it is effective.
There are four levels of evidence: Level 1: Large review (metanalysis) of a collection of high quality studies. Level 2: Studies involving large numbers of patients, where the treatment is compared to other treatments or to placebo. Level 3: Studies that may not be compared to placebo, or may have been written retrospectively (after the treatment was given a decision was made to report on the outcome). Level 4a: Information gained from surveys or descriptive reports. Level 4b: The opinions of a group of experts within a certain area of medicine.
Damage to the skin such as around the anus in cases of prolonged severe diarrhoea.
The process by which the body gets rid of waste products such as through the gut or through the urine.
Extrahepatic Biliary Tree
The part of the biliary tree - the system of bile ducts that is found outside the liver. The bile ducts inside the liver are called the intrahepatic bile ducts.
Faecal fat test
The amount of fat passed in the faeces or stools or bowel motions is measured in the laboratory to see if too much fat is being passed because it is not able to be absorbed properly. Passing too much fat in the bowel motions is referred to as steatorrhoea and there are various diseases that can cause this.
Occurs when you are not able to control the release of faeces/stool/bowel motions from the rectum. It commonly occurs because of damage to the anal sphincter muscle.
Faecal Occult Blood Test (FOBT)
A test to detect tiny amounts of blood in faeces/stools, often released from bowel cancers or their precursors (polyps or adenomas) into the bowel motion. The test cannot tell if you have cancer but are used to identify those people who require further testing.
Waste matter eliminated from the body through the anus. There are many other words such as stool, bowel motion, bowel action or excreta to describe faeces.
An uncommon inherited condition in which many polyps occur in the colon. There is a high risk that some of these polyps will turn into cancer. If someone is found to have this condition it is important that other family members should consult their doctor.
A condition in which there is excessive fat stored in the liver cells. It can occur in fat people but it can also occur in thin people when there is difficulty in getting stored fat out of liver cells. It is a common cause of mild blood liver test abnormalities and fatty liver can be suggested by the appearance on an abdominal ultrasound or abdominal CT scan test.
Occurs when bacteria break down substances in the gut and it can lead to production of gas and bloating. Certain foods such as beans and cabbage are particularly likely to cause excessive gas production because of this process.
Part of the diet that comes from plants. It is not able to be easily digested in humans and it retains water and swells up which results in the bowel motions being softer and passed more easily.
Very fine, flexible glass fibres that passes light through them without heating up. These are used in instruments called endoscopes to pass light into the gut. The fibres are arranged in bundles. Previously the fibres were used to pass a picture of the inside of the gut back up to the doctor carrying out the endoscopy test. Although nowadays the fibres are used mainly just to take light down into the gut and there is a tiny video camera on the end of the endoscope. The patient actually swallows the tiny video camera and colour pictures are displayed on a monitor where they are viewed by the doctor.
A tear or crack, particularly a fissure in ano which means a tear at the anus. This can be extremely painful and the tear usually occurs when a very hard, constipated bowel motion is passed. As a result of the tear the sphincter muscle around the anus may go into spasm.
This is an abnormal passage between two organs (such as in a bowel inflammation known as Crohn’s disease when two inflamed pieces of intestine may stick together) or between an organ and the outside of the body (again such as in Crohn’s disease when an abnormal narrow passageway may pass from the rectum to the area around the anus). This region around the anus and the vagina in females or the scrotum in males is referred to as the perineum. Typically inflammation or infection is involved in the process of fistula formation. Sometimes it can be very hard to get fistulas to heal over and sometimes fistulas are deliberately kept open so that they will continue to drain and reduce the chance that they will lead to abscess formation when they are not able to drain properly.
The passage of gas from the gut out through the anus.
An accumulation of gas in the stomach or intestines.
An x-ray machine that enables the doctor to see what is happening inside the body in real time as it can be used whilst procedures are being carried out.
These are things that go wrong when the muscles and the nerves supplying the muscles are not working properly. Another word that may describe a functional disorder is a motility disturbance.
A sac that is joined to the bile duct by a short pipe called the cystic duct. The bile duct takes a steady trickle of bile from the liver down to the first part of the small intestine known as the duodenum. One of the main actions of bile is to act like soap and transform fat into a solution in the intestine so that it can be more easily digested, in other words, broken up into tiny little particles that can be absorbed through the gut wall into the blood stream. When fat reaches the duodenum a hormone called cholecystokinin is released and travels by the blood stream to the gall bladder and causes the muscle in the gall bladder wall to contract.
Some people make sticky bile and this can sediment, particularly in the gall bladder and form sludge or little hard lumps called gallstones. Commonly gallstones have cholesterol and bilirubin in them. Sometimes if there are gallstones in the gall bladder, the gall bladder may develop infection known as cholecystitis. Gallstones can cause severe pain when they pass out through the narrow pipe called the cystic duct into the common bile duct and through the narrow opening at the lower end of the common bile duct called the ampulla of vater. An ultrasound is a pretty reliable way of checking for gallstones.
There is normally a small amount of gas in the gut and most of us can hear rumbling (borborygmi) at some time as the gas and liquid move down through our intestines. Sometimes we bring up gas through the mouth and this is called belching (eructation). Gas can also be passed out from the rectum. Sometimes too much gas in the gut can cause a feeling of bloating or the abdomen maybe distended. Sometimes people think they are full of gas but they are just more sensitive to normal amounts of gas. Some gas is caused by normal breakdown of food but sometimes belching can be associated with swallowing air. Sometimes gas may cause problems if it is not able to move normally through the gut.
A surgical operation to remove some or all of the stomach.
Means to do with the stomach.
Secretions from the lining of the stomach that help digest (breakdown) food and kill harmful bacteria that may be swallowed.
Gastric resection means to remove - an operation to remove the stomach.
An ulcer in the stomach. This is usually a benign or peptic ulcer but sometimes it may be a malignant ulcer, in other words a gastric cancer.
Gastrin is a chemical substance known as a hormone which is released from the stomach lining after eating and helps cause more acid to be produced from cells in the lining of the upper part of the stomach.
Inflammation of the stomach lining. The lining of the outside of the body is called skin but the lining of the gut is referred to as mucosa.
When food gets into the stomach this may result in nerves that help control muscle activity in the wall of the gut to cause the muscle in your colon to contract, when this happens you may need to empty your bowel. This whole process is called a gastro-colic reflex.
Inflammation of the lining of the stomach and the intestines, commonly due to irritation caused by germs or bacteria that have been eaten in food.
A doctor who specialises in diagnosing and treating disorders of the digestive system.
The area of medicine concerned with the function and diseases of the gastrointestinal tract or digestive system.
A long muscular pipe that goes all the way from the mouth down to the anus where swallowed food is broken down into tiny particles (digestion) and most of it then travels through the wall of the gut into the blood stream (absorption) where it is taken to the liver for further processing. The gut is an incredibly complicated and remarkable system and its function is controlled by things such as nerves that cause muscles to contract and glands to secrete liquid into the gut and by chemicals in the blood stream known as hormones that also help control gut function. The gut has its own large nervous system called the enteric nervous system which interacts with the brain, the central nervous system.
Gastro-oesophageal Reflux Disease (GERD)
Reflux or flow of gastric contents up in to the oesophagus when the valve called the sphincter muscle between the stomach and the oesophagus does not work properly. The lining of the oesophagus becomes irritated and inflamed and this is known as oesophagitis.
Slow emptying of the stomach which may result in feelings of fullness and nausea and bloating after meals.
A technique allowing examination of the stomach lining (see endoscopy).
A common simple sugar known as a monosaccharide. When two simple sugars are joined together they form a disaccharide. When glucose and galactose are joined together they form lactose which is known as sugar of milk. A glucose molecule combined with a fructose molecule makes the disaccharide sucrose, which is the sugar we use commonly to sweeten our tea or coffee.
A sticky glutenous protein found in cereal grains such as wheat, barley and rye. A sub fraction of gluten known as gliadin can damage the gut lining and lead to a condition known as coeliac disease or coeliac sprue.
Part of the healing process of a wound when there is a heaping up of new tissue on raw and irritated skin surfaces. This is referred to as granulation tissue.
A specific appearance found under the microscope in some types of inflammation. Granulomas are sometimes seen in inflammation in tuberculosis. Special granulomas can be seen in a bowel inflammation known as Crohn’s disease and sometimes lead to the terms granulomatous colitis or granulomatous enteritis to describe Crohn’s disease.
This is one of the occult blood tests in which a tiny amount of faeces rubbed on to a special slide causes a dye to change colour. In this way tiny amounts of blood that would not be visible to the naked eye can be detected. It is not a test for cancer. It is a test to see if there are tiny amounts of blood in the stool.
H2 blockers are medicines that reduce the amount of acid produced in the stomach by blocking some of the messages from the nervous system that would normally tell the stomach to produce more acid.
Vomiting up blood. This may be red blood or if the blood has been in the stomach for a while the stomach acid will make it go a black colour.
An operation where haemorrhoids are cut out. This is often painful for the patient and these days are less common although it may still be needed when haemorrhoids are very large and have been there for a long time. Fortunately it is usually possible to treat the haemorrhoids much more simply with a procedure known as band ligation.
Haemorrhoids are dilated veins in the anal area. These can commonly bleed. Although bleeding from the anus is usually from haemorrhoids, you show consult your doctor to determine the exact cause of bleeding.
Heartburn is an uncomfortable burning feeling in the middle of the chest that typically seems to spread upwards and is caused by stomach acid flowing back in to the oesophagus. It is a misleading name because it really has nothing to do with heart disease but is a burning feeling that is near the heart which sits in the left side of the chest.
A germ or bacterium that is commonly found in the stomach. It can cause ulcers in the stomach and especially in the duodenum and it is now realised that this is the commonest cause of these peptic ulcers. Its significance was first realised by doctors in Western Australia. It was such a revolutionary idea that it took a long time to be generally recognised but it is now widely accepted that ulcers can be permanently cured if treatment with medicines can get rid of the helicobacter from the stomach. Usually a combination of three medicines is given to get rid of the germ and this is known as triple therapy.
Means related to the liver.
Means inflammation of the liver. There are a whole lot of causes of liver inflammation particularly various viral infections. Chemicals such as alcohol can also cause the liver to be inflamed and liver inflammation can be a side effect of various medicines.
A gastroenterologist who specialises in diagnosing and treating liver diseases.
A hereditary disease is a disease that runs in families. This occurs because an abnormal gene is passed on to the children from one or both parents.
This occurs when part of an internal organ pushes out through an opening in its surrounding tissue. Sometimes a hernia can occur internally and commonly a hernia occurs when there is a weakness in various parts of the abdominal wall.
The normal hole in the diaphragm which is a muscular petition dividing the chest cavity from the abdominal cavity. The oesophagus passes down through this hole to join the stomach.
This occurs when the upper part of the stomach slides up through the hiatus or hole in the diaphragm where the thinner oesophagus usually comes through. This doesn’t usually cause any symptoms but people with hiatus hernias may be a little more likely to get acid reflux and develop symptoms because of the reflux rather than the hernia.
These are a whole lot of different chemical substances produced in various parts of the body that travel by the blood stream and cause things to happen in other parts of the body when they arrive at what are know as receptor sites. Along with nerves, hormones help control the function of the gastrointestinal tract. Various diseases can occur when there are not enough or too many hormones produced.
This is an acid produced by parietal cells in the upper stomach and it helps other chemicals in the stomach to breakdown food and kill germs that may be eaten in the food.
Hydrogen breath test
This is a simple test that can be used to measure various things that could be going wrong in the gastrointestinal tract. One of the commonest hydrogen breath tests is the lactose breath hydrogen test that is used to check whether someone has not enough of a normal enzyme known as lactase.
A person may have difficulty digesting lactose or sugar of milk and this can lead to a condition known as lactose intolerance causing symptoms such as bloating and diarrhoea. There are other breath tests apart from hydrogen breath tests and one common breath test is used to check whether treatment with triple therapy has managed to get rid of the helicobacter germ from the stomach in patients with peptic ulceration.
This is inflammation of the lower small bowel known as the ileum. It is commonly due to Crohn’s disease and usually affects the last part of the small intestine when it is called terminal ileitis. Sometimes the inflammation can be found in the first part of the large bowel known as the caecum as well and this is referred to as ileo-colitis.
A surgical operation where the ileum is joined to the surface of the abdominal wall. The ileum is the last part of the small intestine. It is easy to confuse the word “ileum” with the word “ilium” which refers to a bone in the pelvis.
This is inflammation of the pelvic bone known as the ilium and it usually occurs where the ilium joins on to another bone called the sacrum which is in the lower part of the spine and this condition is called sacro-iliitis. An interesting connection with gastroenterology is that sacro-iliitis can occur in some people who have inflammatory bowel disease.
In gastroenterology this usually refers to a hard lump of faeces or bowel action that is blocking the rectum. It can be very difficult to remove and may need to be treated with very powerful laxatives, enemas or even scooped out with a gloved finger. Impaction like this can occur because of diet, a lack of fluids, or pain killing tablets that might cause constipation. Sometimes people with impaction can develop what is called spurious diarrhoea. They are not able to have a normal bowel action but small amounts of liquid bowel motion can pass around the edge of a large hard mass of bowel motion sitting in the middle of the rectum. The treatment in this case is to get rid of the impacted faeces or stool.
Abdominal discomfort after eating food. It is a vague term and has a similar meaning to dyspepsia.
A reaction of the body to damage, trauma or irritation because of a chemical substance or infection, commonly characterised heat, redness swelling and pain. Inflammation can occur for a variety of reasons throughout the gastrointestinal tract and also in the liver, bile ducts and pancreas as well as in the peritoneal cavity.
Inflammatory Bowel Disease (IBD)
A general term for any disease characterised by inflammation of the bowel. Examples include ulcerative colitis and Crohn's disease. Symptoms include abdominal pain, diarrhoea, fever, loss of appetite and weight loss. Inflammatory bowel disease should not be confused with Irritable Bowel Syndrome (IBS).
This is a common form of hernia causing a lump in the groin and usually part of the intestine has pushed through an opening in the abdominal wall. Occasionally the intestine can get pinched in the hernia in this can be complicated by things such as interference with its blood supply and blockage to the bowel and an urgent operation may be needed.
This refers to the living organisms that normally grow quite happily inside the gut and often perform useful functions. However if normal gut flora travel to where they don’t belong, such as out through a hole in the gut wall they can cause infection and inflammation in the belly or abdominal cavity. This is called peritonitis. Peritonitis may occur following a ruptured appendix or a perforated peptic ulcer.
The innermost lining of the intestines.
The intestine transfers food and waste products from the stomach to the anus where they are passed as stool, faeces or bowel actions by a process known as defecation. The long upper part of the intestines have a small diameter and are referred to as the small intestine and the last part of the intestines have a larger diameter and are referred to as the large intestine, large bowel or colon.
In the small intestine food is broken down or digested and then the tiny particles pass through the small intestinal wall into the blood stream in a process known as absorption and are then carried to the liver to be further processed. The large intestine has more of a storage function for left over waste products which are then passed at convenient intervals.
The first part of the small intestine is known as the duodenum, the jejunum and the ileum. The first part of the colon is known as the caecum, then the ascending colon, the transverse colon and then the descending colon which passes down through an ‘s’ shaped region called the sigmoid colon into the rectum. The words ascending, transverse and descending refer to the direction in which the colonic contents are moving. Things move through the intestines or guts by a process known as peristalsis. This occurs when muscle running in rings around the intestines, known as circular muscle, contracts in a regular sequential fashion squeezing contents along through the gut.
This means literally into the vein. An injection given directly into a vein is called an intravenous injection. Fluids, salts and glucose can be given by intravenous injection. Intravenous infusions are often given when people are too sick to be able to take food normally, particularly if they have had an operation or have a bowel blockage or lots of vomiting.
Irrigation means to pass a stream of liquid or flush out a cavity or wound, often to enable it to heal more quickly.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome is a disorder of the intestine that affects motility and causes abdominal pain, bloating and irregular bowel movements (constipation and/or diarrhoea). It used to be known in the past as spastic colon or colitis or irritable colon. IBS should not be confused with irritable bowel disease (IBD). IBS is one of the commonest gastrointestinal disorders.
This is the damage that occurs to a part of the body when there is interference with blood supply and this can result in death or necrosis of body tissue.
Inflammation of the colon due to decreased blood supply. This can result symptoms such as pain and diarrhoea mixed with blood.
The middle part of the small intestine lying between the duodenum and the ileum. Most of the food that we eat is absorbed in this part of the gut.
Some people don’t have enough of the enzyme lactase to digest the sugar lactose and this can cause symptoms when large amounts of the undigested lactose travel to the large intestine where they are fermented by bacteria. This can result in symptoms such as bloating and diarrhoea.
A sugar found in milk. It is called a disaccharide because it consists of two other sugars, glucose and galactose, stuck together. The enzyme lactase splits the sugar lactose into the two component parts. The galactose and glucose can then be absorbed in the small intestine.
Lactose tolerance test
This is an old test that was used to confirm lactase deficiency. Nowadays a lactose breath hydrogen test is used and sometimes duodenal biopsies can be taken at the time of endoscopy and levels of enzymes such as lactase, in the wall of the intestine can thus be directly measured.
A thin endoscope that is used to examine the abdominal or peritoneal cavity when it is passed through a tiny cut in the abdominal wall. The advantage of using this procedure is that the tiny cut heals over very quickly with very little pain so people having this procedure can leave hospital quicker. Sometimes several of these instruments are inserted at the same time to enable operations to be carried out. Laparoscopes were initially used by gynaecologists but now abdominal surgeons use them for other procedures such as operations to remove the gall bladder (laparoscopic cholecystectomy) and operations to prevent reflux of acid up into the oesophagus from the stomach (laparoscopic fundoplication).
A surgical operation in which a large incision is made in the abdominal wall so that the surgeon is able to get his hands inside and move organs around, feel things and remove things such as tumours, untwist twisted bowel and divide adhesions that might be causing bowel blockage.
This is also known as the large bowel. It is called large because it has a large diameter, in contrast to the small intestine. It is the last part of the intestine and it is used particularly as a storage bin for left over waste products. The first part of the large intestine or colon is known as the caecum and the last part the rectum.
This means washing out and it is used to clean out various hollow organs in the gut such as the stomach or colon. Sometimes a tube is inserted so that fluid can be washed in and out or sometimes a special drink containing a powerful laxative can be given. Another word for cleaning out the intestine like this is called a bowel preparation. An enema is a laxative that is introduced directly into the bowel. A colonic lavage is carried out by passing a tube into the colon and running in large amounts of liquids which then flush out. Sometimes various forms of lavage are necessary to clean out the large bowel before a major operation or a colonoscopy or in cases of very severe constipation.
A medication to treat constipation and evacuate the bowel. Another term for laxative is a cathartic.
An injury or a wound. The word is also sometimes used to refer to a lump or a tumour in the body.
A component of dietary fibre. It is like a naturally occurring form of glue that helps stick plant material together.
A method for breaking up stones such as gallstones or renal stones. It is sometimes necessary for large stones to be broken up before they can be removed through narrow openings.
This is the largest organ in the body. It processes the food that is absorbed from the gut and transported by blood vessels to it. It uses the food products to manufacture other important substances that can be transported to other parts of the body to be used and it can also store substances that can be later broken down to produce energy when it is needed by the body. It also helps the body to get rid of waste products that can be passed into the bile and then into the intestines via the bile duct and eventually discharged from the body in the faeces.
Liver function tests
These are biochemical liver tests carried out on blood samples when it is suspected that there could be something wrong with the function of the liver. Commonly these tests measure the levels of chemical substances known as enzymes that are released into the blood stream from damaged liver cells. Usually several different enzymes are measured and the pattern of abnormalities found can give important clues as to the disease likely to be causing the abnormalities.
Lower oesophageal sphincter
This is sometimes known as the LES. It is a thick ring of muscle around the lower oesophagus that relaxes to allow food to go down but then stays closed most of the time to prevent stomach contents from slopping back uphill, a condition known as gastro oesophageal reflux. When the sphincter muscle doesn’t work properly it may cause gastro oesophageal reflux disease, known as GERD for short. A common symptom of GERD is a burning sensation in the middle of the chest known as heartburn.
This is a medical term for the open part in the middle of a tube such as in the intestines or the bile ducts and pancreatic duct.
This occurs when food is not able to be broken down or digested and then absorbed, in other words transferred across the intestinal wall into the blood stream. Malabsorption can lead to problems such as diarrhoea and malnutrition.
This refers to a growth, tumour or neoplasm that has the ability to spread through the body, either directly or by getting into veins or lymphatic channels nearby. Some tumours are benign and this means that they do not spread although then can cause problems because they may gradually increase in size. The commonest form of malignant tumour is a carcinoma or cancer. Some other malignant tumours include melanoma, sarcoma and lymphoma. All cancers are malignant but not all malignant tumours are cancers.
Mallory Weiss tear
A tear in the lower oesophagus, where it joins onto the stomach, caused by violent vomiting. This will commonly result in vomiting up blood, known as a haematemesis.
A test that measures pressures in the gut and tells us indirectly how strongly the muscle in the gut wall is squeezing or contracting.
Just as human beings grow from children to adults so to do cells inside the body become fully developed or matured with the passage of time.
This occurs when you are born with an abnormal small sac protruding from the ileum. This may occasionally cause problems such as bleeding into the gut.
A very enlarged colon. It can sometimes happen in people with very severe prolonged constipation and it may also happen in infants with a condition known as Hirschsprung’s Disease where the large bowel does not empty properly.
Treatment with a vitamin dose that is much bigger than is normally needed.
Black sticky foul smelling bowel motions or stools caused by bleeding into the gut. Melaena is usually caused by bleeding high up in the gut. Bleeding lower down in the gut usually causes red blood to appear in the bowel motion or stool (haematochezia).
This is a rare condition affecting the stomach in which the ridges or folds in the stomach lining are enlarged and abnormal amounts of fluid can seep into the stomach.
This is a general term that refers to the various chemical reactions that occur within living cells in the body.
The spread of a cancer from its original or primary site to another part of the body. Malignant tumours such as cancers may spread by direct invasion or via the blood stream or lymphatic system. Abdominal cancers such as colon cancers or pancreatic cancers commonly spread to the liver, and these are referred to as secondary cancer.
This refers to movement and in the gut the movement is due to coordinated muscle contraction which propels the gut contents forward. This process is called peristalsis.
The lining of the gastrointestinal tract from the mouth to the anus.
This is one of the old fashioned names for Irritable Bowel Syndrome. Sometimes people with an overactive gut will have not only overactive muscle in the gut wall but increased mucous secretion. This may be noticed as slime in the bowel motions.
A slippery substance produced by the gut lining or mucosa, which acts as a natural lubricant and also helps protect the gut lining.
An operation named after Dr Nissen. The top part or fundus of the stomach is partly wrapped around the lower oesophagus and stitched in place with the aim of trying to reproduce the function of the cardio-oesophageal sphincter when it is not working properly and causing symptoms such as heartburn and reflux.
Pain occurring during the night.
Non ulcer dyspepsia
Upper abdominal pain suggesting a peptic ulcer but with no evidence of ulcer found at endoscopy.
This is a virus that may cause gastroenteritis, particularly in children.
A blockage - such as a blockage of the intestine. This could be due to a range of conditions such as narrowing because of scar tissue or a tumour growing and blocking the intestine. It can result in symptoms such as pain and distension of the abdomen and vomiting. Other pipes in the body may also be blocked, such as blood vessels or the bile duct draining bile from the liver into the duodenum.
Occult means hidden. Occult bleeding commonly refers to the loss of small amounts of blood in stools. The blood may not be visible to the naked eye but chemical or immunological testing may show that there are abnormal amounts of blood present. This form of testing is known as Faecal Occult Blood Testing (FOBT).
Inflammation of the lining of the oesophagus commonly resulting in a burning pain in the middle of the chest known as heartburn.
The food pipe or gullet leading from the mouth down to the stomach.
This is a gall bladder x-ray which involves taking some tablets first. It checks the function of the gall bladder as well as for the presence of things such as gallstones. The test is less common nowadays as patients with suspected gall bladder disease usually have an ultrasound examination.
This refers to a surgical operation in which a new body opening is made. It usually refers to an opening in the wall of the abdomen where the bowel is joined to the abdominal wall. When the lower part of the small bowel is used the operation is called an ileostomy and when the large bowel or colon is used the operation is called a colostomy. The bowel contents drain into a bag that is attached to the abdominal wall. Often the operation is done as a temporary measure. The opening in the abdominal wall is called a stoma and there are specially trained nurses who can help patients having ostomies and they are called stomal therapists.
A gland in the upper abdomen that makes pancreatic juice containing enzymes that drain into the duodenum via the pancreatic duct and help digest food. The hormone insulin is also made in the pancreas.
Inflammation of the pancreas. This may cause very severe abdominal pain. If pancreatitis is suspected it can often be confirmed with a simple blood test to check for the level of enzymes such as amylase or lipase in the blood.
This looks like a little nipple in the duodenum and it is where the pancreatic duct and the bile ducts drain into the duodenum. It is commonly referred to as the papilla of vater named after the doctor who first wrote about it many years ago.
These are cells found in the wall of the upper stomach and they produce stomach acid which is hydrochloric acid.
One of the many kinds of dietary fibre.
An enzyme produced in the stomach that helps digest protein in the diet.
This adjective relates to pepsin which is involved in digestion and which is found in the stomach and duodenum.
An ulcer or break in the lining of the oesophagus, stomach or duodenum. Peptic ulcers are not malignant but occasionally ulcers can be malignant and are usually due to a growth or tumour known as a cancer. Depending on where the ulcer is, it can be referred to as an oesophageal ulcer or gastric ulcer (and ulcer in the stomach) or a duodenal ulcer.
Percutaneous transhepatic cholangiogram
A test in which an x-ray specialist (radiologist) injects a dye through a needle into one of the ducts in the liver that carries bile to the duodenum. Once the dye has been injected x-rays are taken.
This is an ulcer that has extended through the wall of the stomach or duodenum allowing the gut contents to leak through into the peritoneal cavity.
This is an abnormal hole in the wall of a hollow organ.
An adjective referring to the area around the anus.
The area between the thighs extending from the anus to the external genitals. The word perineal is the adjective referring to something occurring in this area such as a perineal abscess or perineal fistula.
Progressive wave like muscle contractions that move the contents of the gut forwards.
The lining of the abdominal cavity.
Inflammation of the lining of the abdominal cavity.
An inherited disorder in which polyps grow in the intestine and there are pigmented freckle-like spots found around the lips.
This is found in the back of the mouth and both air from the nose and food from the mouth pass through it on their way to the lungs and the gut.
Tissue bulging from the surface of an organ. Polyps can be found throughout the gut. Sometimes there can be lots of polyps and this condition is referred to as polyposis. Certain polyps that occur in the colon, can develop into cancers.
These are carbohydrates in the diet that are broken down into simple sugars during the process of digestion of food.
Abnormally high pressure in the portal vein that takes blood from the gut to the liver. This commonly occurs in people who have scarring in the liver known as cirrhosis. People with portal hypertension may get swollen up veins in the oesophagus known as oesophageal varices and these may bleed.
This is the large vein that takes blood from the gut to the liver. This is the way in that the food you eat, digest and absorb is taken to the liver to be used to give you energy and to make into things that your body needs to function.
Porto systemic shunt
This is an operation used to treat people who have portal hypertension and who may have developed bleeding from oesophageal varices. The blood that is not able to easily pass through the scarred cirrhotic liver is allowed to bypass the liver because the portal vein is joined on to another vein such as the inferior vena cava and thus is shunted passed the liver or bypasses the liver.
This results in a lowering of the dangerously high pressure in the portal vein and reduces the risk of bleeding. There are other methods that may sometimes be used to stop bleeding in this situation such as banding oesophageal varices or a shunt procedure carried out by radiologists and known as a tipss procedure.
Post cholecystectomy syndrome
This refers to symptoms that may continue to worry someone who has had a cholecystectomy (removal of the gall bladder).
People who have had part of their stomach removed may have various symptoms. Fortunately these sorts of operations are needed much more rarely these days because we have available to us much better treatments for peptic ulceration. One form of postgastrectomy syndrome is referred to as dumping syndrome.
Post vagotomy syndrome
This is another condition that is rarely seen nowadays. Previously one of the ways to treat patients with peptic ulcers was to cut the vagus nerve which stimulates the parietal cells in the upper stomach to produce acid. The problem with this was that the vagus nerve also has other functions in the gut and cutting the vagus nerve can lead to problems such as diarrhoea, known as post vagotomy diarrhoea and delayed emptying of the stomach. To overcome the problem with delayed emptying procedures, gastroenterostomy or pyloroplasty were carried out.
Primary biliary cirrhosis
This is a rare form of chronic liver inflammation sometimes referred to as PBC.
This is another rare cause of liver inflammation. It usually occurs in people with ulcerative colitis. It is sometimes referred to as PSC.
This is a severe pain in the rectum caused by spasm of muscle in the rectal wall. Fugax is the Latin word for fleeting because the pain does not last for a long time. The ending - 'algia' refers to pain and the word 'proct' refers to the rectum. Other words ending in 'algia' are myalgia (pain in the muscles) and arthralgia (pain in the joints).
This is an operation to remove the rectum. The ending - 'ectomy' means to remove so cholecystectomy (remove the gall bladder) and appendicectomy (remove the appendix).
Inflammation of the rectum.
This is an instrument for inspecting the lining of the rectum for things such as proctitis or haemorrhoids.
The prediction of what is likely to happen to you when you have a disease.
This occurs when an organ slips down from its usual position or when the lining of an organ slips down. One example of this is prolapsing haemorrhoids.
Proton pump inhibitor
One of a group of drugs that help prevents the stomach from producing acid. Also sometimes known as acid pump inhibitors. These drugs are commonly used in treating gastro-oesophageal reflux disease.
Next to or nearest to a point of reference.
Itching near the anus. This is a common condition that people are often embarrassed to talk about.
An inflammation of the colon which may occur when antibiotics are given and this results in an overgrowth of clostridium difficile bacteria. These bacteria may produce a toxin which damages bowel lining. The condition will often get better of its own accord when the antibiotics are ceased. Sometimes it is necessary to give further antibiotics to kill the clostridium difficile.
A thickening of muscle in the gut wall where the stomach joins on to the duodenum. Opening and closing of this muscle ring controls the emptying of food from the stomach into the intestine.
A narrowing at the pylorus, commonly due to scarring from chronic peptic ulceration but occasionally due to other causes such as malignancy or a thickening of the muscle in the pyloric sphincter.
A surgical operation to widen the opening between the stomach and duodenum. This enables the stomach to empty more easily. This operation was commonly done in the past in association with an operation to cut the nerve to the stomach, an operation known as a vagotomy.
The vagus nerve helps stimulate the stomach to produce more acid and the operation was done to reduce acid secretion and thus help treat patients with peptic ulcers. These days’ vagotomy and pyloroplasty is rarely necessary because there are better ways to treat peptic ulcers, usually by getting rid of the helicobacter pylori germ from the stomach.
Small opening at the bottom end of the stomach where it joins on to the duodenum, which is the first part of the small intestine.
Damage to the small bowel resulting from radiation therapy.
This is a test using a tiny amount of radioactive isotope. Various scans are done and they can be helpful in determining things such as the rate of gastric emptying or passage of food through the whole of the intestine and also to determine the site of bleeding into the gut and to give information about abnormalities in the liver. Sometimes this form of test is referred to as scintigraphy.
This is one of a group of drugs known as H2 blockers or Histamine 2 Receptor Antagonists. The Histamine 2 Receptor is one of the things that causes increased acid production by parietal cells in the upper part of the stomach. If these receptors are blocked by a drug such as ranitidine the gastric acid output is decreased and this can be helpful in treating various gastrointestinal diseases.
A specialised test in which a thin tube is passed into the rectum and pressures in the rectum caused by contraction of muscles in the rectal wall are measured. This can be useful in diagnosing and treating people with problems of defecation.
A condition in which some of the last part of the intestine, the rectum, protrudes or prolapses or comes down through the anus.
The lower end of the large intestine about 20cms in length, that stores solid waste or stool until it is convenient for it to be passed from the body out through the anus in a process known as defecation, passing a stool or having a bowel action.
These are two abdominal wall muscles running from the lower ribs to the pelvic bones on either side of the midline.
Reflux / reflux oesophagitis
A backward flow or regurgitation such as gastro-oesophageal reflux when acid containing stomach contents wash back up into the oesophagus causing irritation of the oesophageal lining. This causes a burning sensation known as heartburn.
A form of bowel inflammation known as Crohn’s disease affecting the small intestine.
The backward flow of gastric juice or solid food or gas from the stomach up via the oesophagus as far as the mouth.
Flare up of activity of a chronic disease such as Crohn’s disease, ulcerative colitis or peptic ulcer. When the disease settles down and things go back to normal the medical jargon is to refer to the disease as being in remission. There are several chronic gastrointestinal diseases that can go through a cycle of relapses and remissions, sometimes as a result of treatment but sometimes spontaneously.
This is the period after a chronic disease remits when the disease has become inactive and is causing no symptoms.
This is a surgical operation in which something is removed. The thing that has been removed, such as a portion of intestine or a tumour is said to have been resected.
Vomiting when there is nothing left to come up. This is sometimes referred to as dry retching or dry vomiting.
The act of pulling something back. It commonly refers to what is done by an assistant during a surgical operation when part of the abdominal contents are drawn back to allow the surgeon to get a better view and access to the abdominal contents. Usually a metal device called a retractor is used to help in this situation.
A tear or a break of an organ or tissue.
This is a drug that is commonly used to control inflammatory bowel disease such as ulcerative colitis. Once the disease is under control it is in remission. The drug is also useful in what is known as maintenance therapy. This means that the drug is continued long-term to maintain the remission of the disease and prevent it flaring up again or relapsing.
A fluid produced in the mouth by the salivary glands that provide natural lubrication so that food is more easily swallowed and saliva also contains some digestive enzymes which are mixed with the food as it is chewed.
A germ or bacterium that is responsible for some cases of gastroenteritis. The germ may be cultured or grown from a small specimen of the stool by a pathologist known as a microbiologist or bacteriologist.
This is a thin narrowing found in the lower oesophagus in some people who find that intermittently they have swallowed solid food. This can be painful and occasionally they need to have an endoscopy to have the food removed. They don’t have problems swallowing liquids. Sometimes a procedure known as dilation where the lower oesophagus is stretched up by carefully passing a thick instrument known as a dilator can help relieve the problem.
This is another word for a radio isotopic scan.
This is a method of controlling bleeding from a blood vessel into the gut. A needle on the end of a fine plastic tube is passed through an endoscope and an injection of a special irritating fluid is made into or near the bleeding blood vessel to stop the bleeding. It is also used to try to prevent bleeding from peptic ulcers and nowadays this is usually followed by the application of heat energy with a special probe to further seal the bleeding point in the blood vessel involved.
This is checking for the presence of a disease before any symptoms have occurred. Screening is commonly done to detect colorectal cancer or polyps which could later turn into cancers. This can be done by looking for tiny amounts of blood in the stool using chemical or immunological tests.
The blood is hidden or occult. These tests are called Faecal Occult Blood Tests (FOBT).
This is a hormone produced in the duodenum and it travels via the blood stream to stimulate other organs such as the stomach, liver and pancreas.
This is another germ or bacterium that can cause gastroenteritis. It causes a condition known as bacillary dysentery.
Short bowel syndrome
If you need to have a lot of your small intestine removed then you can run into problems absorbing nutrients from your food and you can also develop severe diarrhoea.
This is the distal or lower S-shaped part of the left side of the colon that joins on to the rectum.
An instrument for examining the rectum and sigmoid colon. The examination is known as a sigmoidoscopy. The instrument used may be a stiff or rigid pipe known as a rigid sigmoidoscope. In the past these rigid sigmoidoscopes were made of metal but commonly these days disposable plastic sigmoidoscopes are used. A flexible fibre sigmoidoscope may also be used and this can be passed higher up into the bowel than the rigid sigmoidoscope.
These are gallstones that do not yet cause any symptoms. They may never cause symptoms and just because you have gallstones you don’t automatically have to have the gall bladder removed. They may be detected if they show up on a plain abdominal x-ray, on an upper abdominal ultrasound or even may be felt by your surgeon when he examines your gall bladder during an operation.
Small bowel enema
This is a diagnostic radiological procedure in which a fine tube is passed through the nose or mouth by the radiologist down through the oesophagus and stomach into the duodenum and then barium is injected into the small bowel and a series of x-rays are taken. The barium may be swallowed rather than introduced via a tube and this is known as a small bowel series.
In the past when a barium meal examination was more commonly carried out the procedure was sometimes combined with what was called a follow through examination. In this case the main purpose of the examination was to look at the oesophagus, stomach and duodenum but delayed films were taken to see if any further information could be obtained after barium had passed further down into the intestine. If it is important to obtain information about the small intestine it is more reliable to concentrate on this part of the examination with a specific small bowel enema or small bowel series. The test may be done looking for conditions such as Crohn’s disease, intestinal lymphoma or small bowel tumours. Tumours occur much more commonly in the colon than in the small bowel.
Although most people don’t know much about their small intestine it is very important because it is where most digestion and absorption of food occurs. It is the longest part of the intestine and lies between the stomach and the colon. It is divided into the duodenum, the jejunum and the ileum. There is a sphincter known as the ileo-caecal valve where the ileum joins on to the first part of the large intestinal colon known as the caecum.
An excessive muscle contraction. If this occurs in the wall of the intestine it may result in symptoms such as diarrhoea and cramping pain.
An old word for Irritable Bowel Syndrome (IBS). It describes the cramping pain that some people with irritable bowel notice.
A thick muscle ring that opens and closes a passage in the body such as at the cardio-oesophageal valve, the pyloric sphincter or the ileo-caecal valve. A sphincter may also close a natural body opening such as the anal sphincter where the contents from the rectum pass out through the anus.
Sphincter of Oddi
The bile duct and the pancreatic duct join together just where they pass into the duodenum. The thick band of muscle in a ring around these openings is named after the doctor who described it many years ago. Rarely this sphincter may contract inappropriately and too vigorously causing a condition known a biliary dyskinesia. This can cause pain like the pain sometimes seen in people with gallstones.
This organ has several functions. It helps break down and get rid of old red blood cells and it is also a site where white blood cells are made. It is found in the upper abdomen on the left side.
Splenic flexure syndrome
This is commonly a variety of irritable bowel in which pain is felt in the upper abdomen on the left side which is where the transverse colon becomes the descending colon and this bend is known as splenic flexure because it is near the spleen. The bend on the other side is known as the hepatic flexure because it is near the liver and the Latin word for liver hepar. The pain in splenic flexure syndrome is due either to spasm of the colon muscle in the region, distension, stretching of the colon upstream or proximal because of accumulation of wind due to the gaseous distension.
A condition in which there is too much fat in the stool. This occurs because fat in the diet is not able to be absorbed properly. When you have too much fat in your stools they are typically pale, sloppy and foul smelling and you may also have lots of foul smelling gas. You may have more frequent stools and you may lose weight because you are not absorbing your food properly.
See fatty liver.
The pathological narrowing of a hollow tube such as the gastrointestinal tract or of an opening of the body. Another word for stenosis is stricture.
A stoma is an artificial opening that is created by a surgeon. An example is an opening in the abdominal wall where part of the intestine drains through a stoma into a bag. (See ileostomy and colostomy.)
The stomach is a large irregularly shaped sac that is found between the oesophagus and the small intestine. When you have a big meal most of your food sits in the stomach for a while before it is gradually released through the pylorus into your small intestine so that further digestion can take place and absorption of the meal can begin.
This is one of several terms for the semi solid waste matter that passes out through the anus from the rectum as bowel movements, bowel motions or faeces. Apart from undigested food faeces contains water, mucous, dead cells that have sloughed off the lining of the intestines, tiny amounts of blood, bacteria and gas. The normal brown colour of the stool comes from breakdown of chemicals that pass into the intestine in the bile.
A stress ulcer is an acute ulcer in the stomach or duodenum occurring after severe physical injury or surgery, after major extensive burns (Curling’s ulcer) or severe head injuries (Cushing’s ulcer). Cushing and Curling were doctors who described particular varieties of a stress ulcer. These days drug treatment is commonly given in intensive care units to try to prevent these ulcers from occurring.
See stenosis. A common form of stricture is an oesophageal stricture occurring in the lower oesophagus as a complication of severe longstanding reflux oesophagitis. These days the condition can usually be well treated with endoscopic oesophageal dilatation combined with the use of potent modern drugs to reduce gastric acid production. Sometimes the oesophageal dilatation needs to be carried out on more than one occasion.
This is a drug that is commonly used to control inflammatory bowel disease such as ulcerative colitis. Once the disease is under control it is in remission. The drug is also useful in what is known as maintenance therapy. This means that the drug is continued long-term to maintain the remission of the disease and prevent it flaring up again or relapsing.
Violent straining to have a bowel movement. The bowel lining is so irritated that the sufferer will often keep straining even though there is very little to come out and it is something like dry retching occurring at the upper end of the gut. Tenesmus may occur with severe inflammation of the lower part of the bowel due to inflammatory bowel disease and it also commonly occurs in people with severe gastroenteritis due to various bacterial infections.
Total parenteral nutrition
The intravenous infusion of balanced nutrients into a vein. This form of treatment is used in severely ill or malnourished patients who are unable to take food normally by their gut. Sometimes food is given directly into a tube passed into the stomach or into the jejunum in special situations.
A chemical substance that has a harmful effect on the body.
The part of the colon that goes across the upper abdomen from the right side to the left side.
A form of gastroenteritis seen in travellers. It may be due to consuming unclean food or drink and it may be due to exposure to bacteria to which the victim does not have natural immunity.
Treating the helicobacter pylori germ is difficult but most important in trying to cure peptic ulcers. It is usually necessary to give a combination of three medications at the same time and this form of treatment is known as triple therapy.
This is a disease with similar pathology to coeliac disease but the cause is not known. It typically occurs in people who have spent time in the tropics.
This is a swelling, growth or enlargement of body tissue that has no purpose. It can be a harmless benign lump, or it may be a malignant tumour such as a cancer which has the potential to spread throughout the body.
An open sore where there is a break in the surface of the skin or of the lining of the gut. The lining of the outside of your body is known as the skin and lining of the inside of your body, such as in your gut is the mucosa. Thus a gastric ulcer is an ulcer in the gastric mucosa and a duodenal ulcer is an ulcer in the duodenal mucosa.
A deep ulcer may extend all the way through the wall of the gut and this is known as a ruptured or perforated ulcer. An ulcer may extend into a nearby organ and this is known as a penetrating ulcer. Sometimes a large duodenal ulcer can penetrate into the pancreas gland. An ulcer may also cause a break in an artery that is lying under the mucosa and this results in bleeding or haemorrhage, a so called bleeding ulcer.
A chronic inflammation of the lining of the colon of unknown cause.
This is a diagnostic test in which sound pulses are sent into the body and a picture is produced using the returning echoes. It is a painless investigation and quite safe. It is sometimes called and echo scan. Using a special type of ultrasound known as a Doppler ultrasound it is possible to tell which way blood is flowing inside a blood vessel.
Upper GI endoscopy
This is an endoscopic examination looking into your oesophagus, stomach and duodenum. It is also referred to as an endoscopy or a panendoscopy.
Upper GI series
An x-ray examination of the oesophagus, stomach and duodenum. It is commonly referred to as a barium meal examination. Sometimes when your doctor is concerned about possible oesophageal disease a barium swallow will be ordered and the radiology specialist just concentrates on the oesophagus. Sometimes if you have trouble with swallowing the radiologist may ask you to swallow a marshmallow along with the barium.
The reason for this is if the marshmallow gets stuck it will soon dissolve with the heat from your body. Sometimes if you have swallowing difficulties the pictures may be recorded with a video camera so that they can be played back in slow motion for the radiologist to study more carefully.
Urea breath test
This is a test used to see whether you have helicobacter pylori in your body. It is particularly useful after you have had triple therapy treatment to see whether the treatment has worked.
Urso deoxycholic acid
This is a drug that has been used in the past for dissolving gallstones although the problem is that the gallstones usually come back again fairly quickly and these days laparoscopic cholecystectomy is almost invariably the preferred option. Urso deoxycholic acid is also useful in treating a rare chronic liver inflammation known as primary biliary cirrhosis or PBC.
A surgical operation in which the vagus nerve is divided. This is done to reduce the amount of acid that the stomach produces because the vagus nerve is one of the things that takes messages to the stomach to make it produce more acid. With modern treatments for peptic ulceration a vagotomy is rarely needed these days but it was commonly carried out in the past.
This is a fold in the lining of an organ that prevents fluid from flowing backwards usually in this situation a thickened muscle known as a sphincter is involved and has a similar function.
These are abnormally dilated or stretched up veins due to increased pressure inside the veins. Most people are familiar with varicose veins in the legs but a much more serious condition is the dilated veins in the oesophagus known as oesophageal varices. These can cause very serious and sometimes fatal bleeding. These occur in people who have cirrhosis leading to a condition known as portal hypertension. The portal vein takes blood containing the absorbed food from the gut to the liver but when the liver contains excessive scar tissue in cirrhosis the veins in the liver are pinched and the pressure in the portal vein goes up and the blood bypasses the liver to go back to the heart. One of the ways it does this is by dilating other veins and unfortunately some of these veins run just below the lining of the oesophagus and as they become larger and larger they are likely to rupture.
These are tiny finger like projections on the surface of the small intestine. They are mechanism for greatly increasing the surface area of the small intestinal lining so that nutrients (digested food) can be more effectively absorbed.
Inflammation of the liver caused by one of a number of viruses.
A twisting of the stomach or large intestines.
Violent release of stomach contents through the mouth.
In this condition which is due to abnormal blood vessels in the stomach lining the endoscopist sees red stripes in the stomach looking very vaguely like the outside of a watermelon.
A very rare inherited disease in which there is too much copper in the liver. Apart from the liver the central nervous system can also be affected.
Zollinger Ellison syndrome
This occurs when excessive amounts of a normal hormone known as gastrin are produced. Gastrin stimulates the stomach to produce acid. Gastrin is normally made in small amounts in the stomach lining but in this condition it is produced by tumours, usually in the pancreas. It causes very severe problems with peptic ulceration because of very high production of acid by the stomach. This is one form of peptic ulceration that is not caused by helicobacter pylori. There may be other problems associated in patients with Zollinger Ellison Syndrome which may be part of a condition known as multiple endocrine neoplasia (MEN).