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Conditions
Conditions I treat
I treat conditions of the food pipe, stomach, intestine, liver, gallbladder, pancreas, anus and abdominal wall, along with the metabolic problems that so often travel with them. Each is assessed with the same question in mind: what is causing it, and which treatment fits, whether that is a change in food, a medicine, an endoscopic procedure or an operation.
Food pipe and stomach
- Acid reflux and GERD: heartburn and sour fluid that keep returning. Treated with food and timing changes, medicines and, for selected patients, keyhole surgery.
- Barrett’s oesophagus: a change in the lining of the lower food pipe after years of reflux, followed with endoscopy at planned intervals.
- Hiatus hernia: part of the stomach sliding up into the chest. Small ones need reflux care only; large ones are repaired.
- Gastritis and ulcers: inflammation or a break in the stomach lining, most often from H. pylori or painkillers.
- H. pylori infection: a stomach infection confirmed by a breath, stool or biopsy test and cleared with a two-week course of medicines.
- Indigestion (functional dyspepsia): fullness, burning or discomfort after meals with a normal endoscopy. Treated through meal pattern, medicines for a sensitive stomach, and work on sleep and stress.
- Swallowing difficulty and achalasia: food or liquid that sticks. Endoscopy and oesophageal manometry find the cause.
- Gastric outlet obstruction: a blocked stomach exit that causes vomiting of old food.
Intestine and colon
- Irritable bowel syndrome (IBS): abdominal pain with diarrhoea, constipation or both, and normal tests.
- Gut-brain axis disorders: IBS, functional dyspepsia and related conditions, in which the gut and the brain do not signal smoothly and tests are normal.
- Bloating and SIBO: gas and distension, sometimes from excess bacteria in the small intestine. See bloating and SIBO.
- Chronic constipation: hard or infrequent stools for months. Treatment depends on whether the colon is slow or the pelvic floor is not relaxing. See constipation.
- Chronic diarrhoea: loose stools for more than four weeks. Stool and blood tests, a breath test and colonoscopy find causes such as infection, colitis, coeliac disease and bile acid problems.
- Crohn’s disease and ulcerative colitis: long-term inflammation of the bowel, treated with medicines, nutrition and, for complications, surgery.
- Coeliac disease: an immune reaction to gluten that damages the small intestine. Confirmed by a blood test and biopsy, and treated with a strict gluten-free diet.
- Food intolerances: reactions to lactose, fructose or wheat without coeliac disease. See lactose intolerance and gluten sensitivity.
- Diverticulitis: inflamed pouches in the colon wall.
- Colon polyps: growths in the bowel lining, removed during colonoscopy.
- Colon and rectal cancer: treated by surgery, with chemotherapy and radiotherapy planned by a team.
Emergencies of the abdomen
- Appendicitis: pain moving to the lower right abdomen. Needs assessment the same day.
- Intestinal obstruction: cramping pain, vomiting, swelling and no stool or gas.
- Intestinal perforation: sudden, severe pain with a hard abdomen.
These need an emergency department, not an appointment
Sudden severe abdominal pain, vomiting blood, black stools, a painful hernia that will not go back, or yellow eyes with fever should be seen at once at the nearest emergency department.
Liver, gallbladder and pancreas
- Fatty liver (MASLD): fat in the liver from metabolic causes. The key question is whether there is scarring, which a FibroScan answers.
- Hepatitis and cirrhosis: viral, alcohol-related and other long-term liver disease. I assess the degree of damage, treat the cause and monitor for complications.
- Gallstones: stones that cause pain are treated by keyhole removal of the gallbladder.
- Bile duct stones: stones that have moved out of the gallbladder, causing jaundice or infection. They are removed by an endoscopic procedure that I arrange with a colleague.
- Pancreatitis: inflammation of the pancreas, most often from gallstones or alcohol. Care covers finding the cause, nutrition, pain control and surgery where needed.
Anus, rectum and pelvic floor
- Piles (haemorrhoids): bleeding or a lump at the anus.
- Anal fissure: a small tear causing sharp pain with stool.
- Anal fistula: a discharging tunnel near the anus.
- Anorectal abscess and pilonidal sinus: painful collections of pus that need drainage or surgery.
- Pelvic floor disorders: muscles that do not relax or coordinate during a bowel movement. Diagnosed by anorectal manometry and treated with biofeedback.
- Bowel incontinence: leakage of stool or gas. Muscle strength and sensation are measured, and treatment follows the cause.
Hernia and abdominal wall
- Inguinal hernia: a bulge in the groin.
- Umbilical hernia: a bulge at the navel.
- Incisional hernia: a bulge through the scar of an earlier operation.
Questions patients ask me
Do I need a referral to see you?
No. You can book directly. Bring your previous reports, scans and a list of your medicines.
Will I see the same doctor each time?
Yes. I see you at the first visit and at follow-up, and if you need an endoscopy or an operation, I perform it.
My reports are normal, but I still have symptoms. Can you help?
Often, yes. Many gut conditions, such as IBS and functional indigestion, do not show on standard tests. They are diagnosed from the pattern of symptoms and respond to treatment aimed at how the gut works. See gut-brain axis disorders.
How do I know whether I need surgery?
Most people who come to me do not. When an operation is the right answer, I explain why, what the alternatives are, and what recovery involves, so that the decision is yours.