Functional Dyspepsia is the commonest upper digestive disorder (about >70%). This is defined as recurrent epigastric pain or discomfort with normal upper gastrointestinal endoscopy result.<\/p>\n
The exact cause of functional dyspepsia is still unknown. The symptoms are related to personal lifestyle, e.g., irregular dietary habbit, stress, poor sleep and emotional fluctuation, etc but not related to any severe disease, such as gastrointestinal inflammation, ulcer or cancer, etc.<\/p>\n
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Helicobacter pylori (H. pylori) is a bacterium found in the stomach and duodenum. It can cause mild chronic inflammation of the gastric mucosa, or even lead to gastric and duodenal ulcers or gastric cancer. About 30% - 50% of the world population is estimated to have detectable H. pylori in their gastrointestinal tract.<\/p>\n
Most individuals infected with H. pylori have few or no symptoms. They may experience a few episodes of gastritis (minor belching, bloating, nausea, vomiting, abdominal discomfort). Accurate and simple tests for the detection of H. pylori infection are available. They include blood antibody tests, urea breath tests, stool antigen tests, and endoscopic biopsies. Once H. pylori is detected in a person, a course of eradication treatment consisting of proton pump inhibitors and the antibiotics will be prescribed. About ninety percent of those who take on the full course of treatment are cured.<\/p>\n
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Gastroesophageal reflux disease (GERD) is a common condition characterized by tissue damage from or symptoms associated with the abnormal reflux of gastric contents into the esophagus.<\/p>\n
In the structure between the lower esophagus and the stomach, there is a ring of muscle called the lower esophageal sphincter (LES). Under normal conditions, it remains closed to prevent stomach acid or food from flowing back upward, and only opens when food enters the stomach or when gas needs to be released after meals. In patients with gastroesophageal reflux disease (GERD), this sphincter becomes abnormal and opens inappropriately, allowing stomach acid and food to flow back into the esophagus.<\/p>\n
Disease severity ranges from mild, infrequent acid regurgitation or heartburn to severe heartburn and erosive esophagitis, which may result in a number of different complications such as esophageal ulcers, strictures, and Barrett\u2019s metaplasia.<\/p>\n
Prevalence of GERD in the Chinese population is considerably lower when compared with the Western population, which has a prevalence of 20% to 30% with weekly reflux symptoms. A telephone survey conducted in Hong Kong reported a prevalence of 8.9% and 2.5% with monthly and weekly reflux symptoms respectively.<\/p>\n
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Peptic ulcer disease (PUD) is a common disease of the digestive system. It usually occurs in the stomach and proximal duodenum. The lifetime risk for developing a peptic ulcer is approximately 10%. Peptic ulcer disease is caused by a bacterial infection (Helicobacter pylori) in the stomach or the use of certain painkillers (nonsteroidal anti-inflammtory drugs - NSAIDs) and aspirin\/ other anti-platelet agents. Patients with peptic ulcer can be asymptomatic. If symptoms occur, they may include a burning pain in the middle or upper stomach between meals or at night, bloating, heartburn, nausea or vomiting.<\/p>\n
In severe cases, symptoms can include hematemesis, coffee ground vomiting and melena, weight loss, severe pain in the mid to upper abdomen. Individuals with PUD are at risk of developing complications such as haemorrhage, perforation and obstruction, and mortality among patients with these complications is high. Oesophagogastroduodenoscopy (OGD) is the preferred diagnostic test in the evaluation of patients with suspected PUD.<\/p>\n
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Acute upper gastrointestinal bleeding (UGIB) is a common medical emergency with an annual incidence of approximately 130 per 100,000 adults in Hong Kong. Acute gastrointestinal (GI) bleeding is a potentially life-threatening condition associated with high morbidity and mortality. Bleeding may occur throughout the GI tract. The most frequent cause of UGIB is peptic ulcer disease, which accounts for 35-50% of reported cases. Other underlying etiologies of UGIB include gastroduodenal erosions (8-15%), esophagitis (5-15%), varices (5-10%), Mallory-Weiss tears (15%), and vascular malformations (5%). Symptoms of upper gastrointestinal bleeding are hematemesis, coffee ground vomiting and tarry stool. In some severe cases, it may lead to dealth.<\/p>\n
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Stomach cancer is developed due to the abnormal proliferation of mucosal cells on the inside lining of the stomach (adenocarcinoma). Gastric adenocarcinoma is the most common type of stomach cancer, commonly known as \"stomach cancer.\"<\/p>\n
Initially gastric mucosa may be due to inflammation, into atrophic gastritis, intestinal metaplasia, after years of progress to the abnormal proliferation of cells , and finally develop to cancer, which is a series of long-term \"carcinogenic\" evolution.<\/p>\n
Gastric cancer ranks the forth most common cancer-related cause of mortality in Hong Kong. Although a gradual declining trend is observed in Europe and the United States, the incidence of stomach cancer remains rather steady in Asia.<\/p>\n
Major risk factors for gastric cancer include \"H. pylori\" infection, precancerous lesions or genetic factors of gastric cancer.<\/p>\n
Patients with early gastric cancer do not have associated symptoms. It shares similar symptoms with other gastric diseases (chronic gastritis, peptic ulcer or other symptoms of functional gastrointestinal disorders) such as: abdominal pain, flatulence, poor appetite, melena, etc. Patients having end stage of stomach cancer may also suffer from weight loss, loss of appetite, fatigue, difficulty swallowing, persistent vomiting , massive ascites and other advanced symptoms.<\/p>\n
Gastric cancer is mainly diagnosed by Oesophagogastroduodenoscopy and biopsy histopathology.<\/p>\n
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Gastrointestinal stromal tumor (GIST) is a type of mesenchymal tumor arising from the gastrointestinal tract and peritoneum. It is one of the cancers of the digestive system, and in Hong Kong there are approximately 100 new cases diagnosed each year.<\/p>\n
Gastrointestinal stromal tumor can be found in any area of the gastrointestinal (GI) track such as esophagus, stomach, pancreases, large intestine, small intestine and appendix. Small GISTs often do not cause symptoms, and are usually discovered incidentally on upper GI endoscopy or computer tomography.<\/p>\n
Large GISTs may cause abdominal discomfort\/pain, or even GI bleeding.<\/p>","protected":false},"excerpt":{"rendered":"
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