The gastrointestinal (GI) system is imperative for our well being and our life-long health. A poorly functioning GI tract can be the source of many chronic health problems that can interfere with your quality of life.
GESA aims to foster better health for all Australians by providing accurate and up-to-date health information to patients and the community relating to gastroenterology and liver disease. GESA proactively promotes education and community health programs relating to gastroenterological medicine while representing more than 1,000 digestive and liver health specialists.
To support you GESA has developed a range of relevant information on gastrointestinal and liver conditions, digestive health, disease prevention, nutrition and what to expect when undergoing specific medical procedures.Information provided on this website is for general information only and not intended as medical advice. GESA encourages all readers to seek independent medical advice before making any decisions based on the information here.
AMA Informed Financial Consent Guide
For patients undergoing a colonoscopy or certain types of surgery it is essential that the colon (bowel) be thoroughly cleaned and emptied of all solid matter.
Cleansing the colon is called bowel preparation.
Download the Fact Sheet on Bowel Preparation
Bowel Polyps
Bowel polyps are small growths on the lining of the bowel wall. They are common, especially as we age. While most bowel polyps do not become cancerous, approximately 5% do. Most polyps can be safely and completely removed during a colonoscopy.
A bowel polyp is a small benign (non-cancerous) growth that looks roughly like a ball on a stalk. They can range in size from 1-2mm to 5cm or more.
Download the Fact Sheet on Bowel Polyps
Capsule Endoscopy
This procedure involves the ingestion of a small capsule that contains a tiny camera that can take 2-4 images per second for eight hours. It has been specifically developed to view the small bowel.
Capsule endoscopy is used to try and pinpoint bleeding in hidden areas in the small bowel. It is also useful for tracking small bowel tumours and obscure abdominal pain.
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Colonoscopy Factsheet
A colonoscopy is a procedure used to inspect the large bowel (colon) and is usually done in a day facility or hospital.
During a colonoscopy a thin flexible tube called a colonoscope is carefully fed into the large intestine. A small camera on the colonoscope transmits an image to a monitor, allowing close examination of the bowel and intestinal lining.
A colonoscopy can detect inflamed tissue, ulcers and abnormal growths. The procedure is used to look for early signs of colorectal cancer and can help doctors diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus and weight loss. It is also used for the screening and surveillance for colorectal cancer or removal of bowel polyps. Colonoscopy with removal of polyps is the best way to prevent bowel cancer. In order for your doctor to get the best possible view and make the colonoscopy easier, your large bowel needs to be cleaned out of all waste material.
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English
اللغة العربية (Arabic)
简体中文 (Chinese Simplified)
中國傳統的 (Chinese Traditional)
Tiếng Việt (Vietnamese)
Coeliac Disease
Coeliac disease affects approximately 1 in 100 Australians. In coeliac disease the immune system reacts abnormally to gluten. People affected do not absorb food and nutrients well.
Coeliac disease is a condition in which the lining of the small intestine becomes damaged when it is exposed to even small amounts of gluten, a protein found in wheat, barley, rye and possibly oats.
It is usually characterised by symptoms such as diarrhoea, malabsorption and weight loss.
Approximately 75% of all sufferers are undiagnosed and around 160,000 Australians have coeliac disease but do not yet know it.
Untreated, coeliac disease can lead to chronic poor health, osteoporosis, infertility, miscarriage, depression and dental enamel defects.
A gluten-free diet allows the condition to be effectively managed, improving symptoms and restoring health. It should be undertaken with medical supervision.
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Constipation
Constipation is one of the most common medical complaints in Australia. People say they are constipated when they can't empty their bowels as often or as easily as they would like.
With constipation stools are usually hard, dry, small in size and difficult to eliminate. Some people who are constipated find it painful to have a bowel movement and often experience straining, bloating and the sensation of a full bowel.
Constipation is a symptom, not a disease. A poor diet typically is the cause.
Most constipation is temporary and not serious. Understanding its causes, prevention and treatment will help most people find relief.
There is no rule about how frequently you need to go to the toilet. However, if there has been a change or if you are uncomfortable and find that you need to strain, you should talk to your general practitioner. Many healthy children have problems with constipation, particularly around the time of toilet training.
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Diet in IBD
Diverticular Disease
Diverticular disease is very common. One-third of Australians over 45 years of age, and two-thirds over 85 years have some diverticular disease. Many are unaware they have it. The main cause is not eating enough fibre.
Diverticulosis is the formation of abnormal pouches in the bowel wall. Diverticulitis is the inflammation or infection of these pouches. These conditions are collectively known as diverticular disease.
Only about a quarter of people with diverticular pockets develop symptoms which may include pain in the lower left abdomen together with feelings of nausea and loss of appetite.
A colonoscopy or barium enema is usually used to diagnose diverticular disease.
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ERCP
Fatty Liver Disease
Fatty liver disease is an accumulation of fat in the liver. It can lead to serious complications such as cirrhosis. It is one of the most common liver diseases in Australia and a common reason for abnormal liver tests and ultrasound results.
Non-alcoholic fatty liver disease (NAFLD) is a common disorder that now affects up to one-third of the adult population. It is increasingly common in children.
Increasing age, obesity, insulin resistance and diabetes are risk factors. Less common causes can include pregnancy, some medications (e.g. corticosteroids) and other diseases.
Excess liver fat is associated with an increased risk of developing liver cirrhosis, diabetes, high blood pressure, cardiovascular events or specific cancers. The good news is that fatty liver is reversible.
Downlaod the Information Sheet
Fibroscan
A FibroScan is a simple test conducted using a specialised ultrasound machine to detect the amount of scarring (fibrotic tissue) in the liver.
GESA has developed the below brochures (translated into Arabic, Simplified and Traditional Chinese, and Vietnamese) to provide clarity on this procedure and outline what patients can expect from this test. To read more, simply click on the images to view and download.
Flexible Sigmoidoscopy
Gallstones
Gallstones are small, hard deposits that form in the gallbladder. They do not produce symptoms in most patients. In cases where symptoms do occur prompt treatment is required.
Gallstones are small, hard stones, made from cholesterol, bile pigment and calcium salts.
Gallstones become common as we age. In patients over 50 years of age the prevalence is 25-30%. They are more common in women, in people who are overweight or lose weight rapidly, and in those with a family history of gallstones. They are also more common in people with Crohn's disease.
Gallstones that present no symptoms generally do not interfere with gallbladder, liver or pancreas function and do not require treatment.
In general, patients who have symptoms will need surgery right away, or after a short period of time.
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Gastroenteritis in Children
Gastroenteritis, often called 'gastro', is an infection of the gut that causes diarrhoea and sometimes vomiting, fever and abdominal pain. It is a common illness that is infectious and easily spread. It tends to be a more serious problem in babies and small children.
Gastroenteritis is usually caused by viruses, the most common is Rotavirus. Sometimes other types of germs including bacteria and parasites may also cause it.
It is commonly spread by coming into contact with another person with the illness.
It is highly infectious so your child should not attend school, day care or kindergarten while they are sick or still have diarrhoea. Good hand washing with soap and water after handling any ill person, changing nappies and before food preparation and eating is important in helping to stop the spread of infection.
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Gastroscopy
Heartburn
Heartburn (gastroesophageal reflux or indigestion) is very common. Most healthy people experience heartburn from time to time. Antacid is a suitable treatment for healthy people, but severe heartburn requires medical attention.
Heartburn (gastroesophageal reflux) is due to the contents of the stomach coming back up into the oesophagus where it can cause a burning sensation in the chest or throat.
Occasional heartburn can be caused by eating a large meal, doing physical activity too soon after eating, too much coffee or alchohol, anxiety and advanced pregnancy.
Cases of persistent heartburn are usually caused by obesity.
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Helicobacter Pylori
Helicobacter pylori (H. pylori ) is a bacterium (germ) that lives in the stomach. It causes a chronic low-level inflammation of the stomach lining and is strongly linked to the development of intestinal and gastric ulcers. It is the most wide-spread infection in the world, especially in the developing world.
The H. pylori germ commonly lives in the lining of the stomach in up to four out of 10 adults. It is responsible for most intestinal ulcers and over two-thirds of stomach ulcers. It also triggers symptoms like indigestion.
Most people infected with H. pylori never develop ulcers. Why the bacterium causes ulcers in some people and not in others is not known.<
While the risk of becoming infected is now much less than in the past, around 40% of people over 60 years of age have H. pylori . Most are infected during childhood.
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Hemochromatosis
Haemochromatosis is the most common form of iron overload disease. Primary or hereditary haemochromatosis is an inherited disease. Secondary haemochromatosis is caused by anaemia, alcoholism and other disorders.
In haemochromatosis the body takes too much iron from the diet. The iron stores keep rising and, over time, the liver enlarges and becomes damaged leading to serious diseases such as cirrhosis. Other problems include heart disease, diabetes and arthritis.
Estimates suggest one in every 300 people has the disease haemochromatosis. Both sexes are at risk, but women tend to develop the condition later in life.
Haemochromatosis tends to be under-diagnosed, partly because its symptoms are similar to those caused by a range of other illnesses.
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Heptatitis A
Hepatitis A is one of several different hepatitis viruses that can cause liver infections and damage. Anyone can be infected with hepatitis A if they come in direct contact with food, drinks or objects contaminated by the faeces of an infected person.
Hepatitis A is a viral disease that affects the liver.
Children younger than age six often have no symptoms. Older children and adults often get flu-like symptoms, abdominal pain, diarrhoea and may develop jaundice.
Hepatitis A usually gets better in a few weeks without treatment. One infection of hepatitis A will give you lifelong protection.
Immunisation against hepatitis A includes a course of injections over six to twelve months. Hepatitis A immunisation is a good idea for people travelling to places where the disease is common, or to places where hygiene standards are poor.
The vaccine may also be recommended for childcare workers, men who have sex with men, people with liver problems, food handlers and injecting drug users.
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Hepatitis B
High Protein, High Energy Diet
Many people with advanced liver disease suffer from malnutrition, and their protein requirements almost double compared to those of a healthy adult. Without adequate protein intake your body will break down muscle to meet your protein needs, leading to muscle wasting and loss of strength.
A high protein, high energy diet provides 1 to 1.5 grams of protein per kilogram of body weight per day as well as adequate energy to maintain essential fat stores.
A high protein, high energy diet includes rich food sources of protein including meat, fish, chicken, eggs, nuts, seeds, legumes and dairy products.
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Inflammatory Bowel Disease (IBD)
Iron Deficiency
Iron deficiency is still the most common nutritional deficiency in Australia, especially among children and women of childbearing age where it can lead to iron-deficiency anaemia, a serious condition where red blood cell production falls.
If dietary iron requirements are not met, the body's iron stores gradually run down.
Iron is an important dietary mineral involved in various bodily functions. Iron is part of haemoglobin, the red pigment in the blood that carries oxygen from the lungs throughout the body, and myoglobin that transports oxygen in the muscles. Iron deficiency means less oxygen is delivered to the cells leading to fatigue, tiredness and decreased immunity.
High-risk groups include menstruating women, pregnant women, babies and toddlers, teenage girls and female athletes. Indigenous Australians, refugees and recent immigrants from developing countries, vegans and vegetarians, people who repeatedly crash diet, and hospitalised or institutionalised patients are also at risk.
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Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a common problem affecting the colon or large bowel. Around one in five Australians experiences the unpleasant symptoms of IBS at some time. IBS does not damage the bowel or lead to other health problems.
Irritable bowel syndrome (IBS) refers to a disorder that involves abdominal pain and bloating, as well as changes in bowel movements. Some people suffer constipation, some have diarrhoea and some alternate between the two.
IBS is not the same as inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis.
Most people can control their symptoms with diet, stress management and prescribed medications.
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Lactose Intolerance
Lactose intolerance is the inability to digest lactose. Lactose is a type of sugar found in milk and other dairy products.
Lactose intolerance happens when the small intestine does not make enough of the enzyme lactase. Enzymes help the body absorb foods. Not having enough lactase is called lactase deficiency.
Lactase deficiency is more common in people with Aboriginal, Asian, African, Middle Eastern or Mediterranean ancestry. It is rare for Caucasians to develop it.
Many people with lactase deficiency can usually tolerate some lactose with minimal symptoms. Symptoms are often confused with irritable bowel syndrome (IBS) and can include abdominal pain, abdominal swelling, flatulence and darrhoea.
Symptoms usually go away when you remove milk products or other products containing lactose from the diet.
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Low FODMAP Diet
Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAPs) are found in the foods we eat. FODMAPs are sugars that are poorly absorbed in the small intestine and reach the large intestine where they produce gas and attract water.
FODMAPs are a large group of dietary sugars found in many common foods such as specific dairy products, wheat and other grains, and fruits and vegetables. While FODMAPs are poorly absorbed in all people, those with specific gut disorders such as IBS are thought to experience the uncomfortable symptoms due to the gut being unusually sensitive.
A Low FODMAP Diet is usually recommended for 6-8 weeks at a time. Progress should be assessed by an accredited dietitian. They will help advise which foods can be gradually re-introduced into your specific diet. It is essential to develop a strategy and plan ahead. Work with your dietitian to develop easy and tasty meal plans. Ask for a low FODMAP shopping guide. Maintaining a low FODMAP pantry is key to sustaining a Low FODMAP Diet.
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No Added Salt Diet
It is vitally important that patients with advanced liver disease maintain a balanced diet. Dietary salt should be restricted to a No Added Salt Diet. This means not adding salt while preparing, cooking or eating food. In addition, foods commercially produced with salt need to be avoided.
A common complication of advanced liver disease is the retention of excessive fluid, particularly in the abdomen (called ascites) and in the legs (oedema). Restriction of the intake of salt (sodium chloride) is an extremely important part of the management of people with fluid retention.
The typical Australian diet contains around 6 grams of sodium per day. A diet with 2.5 grams of sodium or less is recommended to help control fluid retention.
The most effective way to restrict your salt intake is by following a No Added Salt Diet. Foods to include and avoid are detailed here.
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Percutaneous Endoscopic Gastrostomy (PEG)
Make The Most of Your Time With Your Doctor
The Question Builder is a web-based tool developed by the Australian Commission on Safety and Quality in Health Care in partnership with Healthdirect Australia. It is designed to be used with general practitioners and specialists in Australia to help you prepare for a visit to the doctor. It encourages you to ask questions that matter most to you, participate in the appointment and share decisions with your doctor about your care.