Gastrointestinal conditions

Gastrointestinal conditions can affect any part of the gastrointestinal tract. The following conditions are commonly treated at the Mind + Gut™ Clinic. If your specific condition is not listed please contact us to see if we can help.

Irritable bowel syndrome (IBS) is the most common functional disorder estimated to affect approximately 5-12% of the population. The condition is usually characterised by recurrent episodes of abdominal pain, bloating and altered bowel habits but can also include other gastrointestinal complaints. The exact cause of IBS is not known. There is no cure for IBS and treatment is limited to symptom management strategies.

Three common approaches to control symptoms associated with IBS include pharmacological agents, psychological treatments and dietary therapies. The two psychological treatments with the greatest evidence of effectiveness are gut-directed hypnotherapy and cognitive behavioural therapy. The first line dietary therapy for IBS is the low FODMAP diet. Fructose malabsorption and lactose intolerance identified by hydrogen breath testing may also be considered in FODMAP restriction.

Inflammatory bowel disease (IBD) principally comprises Crohn’s disease and ulcerative colitis. Crohn’s disease is characterised by inflammation and ulceration of any part of the gastrointestinal tract from the mouth to anus but most commonly affects the small intestine and/or colon. In ulcerative colitis the inflammation only occurs only in the colon. The exact cause of IBD is not known but a combination of genetic, environmental and immunological factors are thought to play a role in disease development.

The ways in which IBD affects an individual is highly variable but common symptoms tend to include abdominal pain, diarrhoea, faecal urgency, fever, loss of appetite and weight loss. Management of IBD mainly involves the use of pharmacological agents where psychological and dietary therapies are less commonly applied. Nutritional absorption and requirements may also be altered in IBD. A frequent challenge in the care of patients with IBD is differentiating gastrointestinal symptoms due to IBD and those caused by IBS. Symptoms of IBS are known to be more common in patients with IBD. However, given that IBS is a common disorder, whether this overlap is due to the co-existence of both conditions is unknown. What is clear is that IBD patients will often report symptoms without evidence of ongoing disease activity. This can lead to the increased use of anti-inflammatory medications. As a result, management strategies for IBD patients with symptoms suggestive of IBS can also be highly beneficial.

Coeliac disease is an immune mediated disease that is triggered by exposure to dietary gluten. It is a relatively common disease affecting approximately 1% of the Australian population. Symptoms of coeliac disease can be similar to those of IBS but can also involve other non-gastrointestinal presentations such as weight loss, osteoporosis, dermatitis herpetiformis, depression and cognitive impairment, amongst many others. Patients with coeliac disease can also be symptom free.

The only treatment for coeliac disease is a strict life-long gluten-free diet. The gluten-free diet should be taught by an experienced dietitian. Psychological treatments are not specifically applied to patients with coeliac disease but can be useful in those who continue to experience gastrointestinal upset despite following a strict gluten-free diet or in patients who find the disease is making them feel depressed, stressed or anxious.

Gastro-oesophageal reflux disease (GORD) describes a condition when too much acid is secreted into the stomach and the acid travels up into the oesophagus. Acid reflux is a normal bodily function but becomes GORD when it leads to physical complications to symptoms which begin to impact on a person’s well-being. GORD most commonly occurs in adults aged 40 and over. The condition is characterised by symptoms of heartburn, chest pain or discomfort after eating, regurgitation and dysphagia (difficulty swallowing).

Management of GORD usually involves pharmacological agents or dietary therapies. Psychological treatments are less commonly applied but can be trialled when pharmacological or dietary therapies are ineffective.