What's up doc - gastrointestinal

05 February 2014

‘What’s Up Doc’ is a health column in association with The Crawley Observer, which gives you the opportunity to ask questions regarding general health and wellbeing.

Answers are provided weekly from our specialist consultants at Spire Gatwick Park Hospital, Surrey. If it’s a long-standing illness or simply a worry which you would like to get off your mind then we would like to help.

This question appeared in The Crawley Observer on Wednesday, to readers across Surrey and Sussex. The question and answer is below, as it appeared in the newspaper.

Read the response by Mr Alan James, upper gastrointestinal and laparoscopic surgeon:

Mr James consultant profile


Doc, over a month ago I became very ill as I wasn’t eating anymore. My doctor made me do a barium swallow, he said it is an ulcer, I have been on every pill for ulcers and acid reflux and the pills make me worse. But how can it be? Feel like a big ball is in my stomach. Please can you help? I don’t think my body can handle the pills anymore – I just need to know what to do and what this could be? Ali, Furnace Green.


Dear Ali, when there is a problem with eating it is important to identify where the main problem lies. It may be that swallowing is difficult, if food gets stuck in the oesophagus; it may be that abdominal pain, which follows eating, is the problem, or it may be that a patient loses their appetite for a variety of reasons. The first investigations that are usually arranged to look into such symptoms are an endoscopy, which is an examination by a flexible camera passed down the throat into the stomach and an abdominal ultrasound, which is the best initial test for gallstones.

Gallstones are a common cause of pain in the upper abdomen felt after eating. While there may have been a reason to arrange a barium swallow in this case an endoscopy is generally a better first line investigation. If the problem here was an ulcer it should have responded by now to antacid medication so it would be wise to request this be looked into further. If there has been significant weight loss then in addition to the endoscopy and ultrasound scan mentioned it might be appropriate for a CT scan of the abdomen to be arranged.

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