Bowel Symptoms, Advice from Dr Gareth Latin, Gastroenterologist

Health advice from our Gastroenterologist

Stomach problems are many and varied and issues such as gas, bloating, constipation and diarrhoea can affect most of us at one time or another. It can be an embarrassing issue and one we’re reluctant to speak about, but it’s important that you seek help from a medical professional if you are struggling with ongoing gastrointestinal problems.

We spoke to our Consultant Gastroenterologist Gareth Latin and asked him common questions that sometimes can feel embarrassing to ask, as well as finding out more about Gastroenterology in general.

Thanks for speaking to us Gareth, firstly can you give us some tips on keeping our gut healthy?

Whilst your gut health can be helped with the use of supplements such as probiotics, I believe that the most important thing that someone can do for their gut is to look carefully at their diet and the food they consume. Many of the unpleasant symptoms people experience in relation to their bowels can be traced back to how their bowels respond to the food that requires digesting.

What should people do if they are experiencing bloating?

Bloating is very common and in most cases completely harmless. I’d recommend exercising regularly, drinking plenty of water and eating little and often. If you’re prone to bloating, try to avoid fizzy drinks, alcohol and caffeine I’d also recommend limiting processed, sugary, spicy or fatty foods. In some people the Low FODMAP diet can be very helpful to minimise bloating. Although it’s normally nothing to worry about, occasionally it can be a sign of something more serious, especially if associated with other symptoms such as weight loss. Talk to your doctor, or make an appointment with a gastroenterologist if your bloating continues after following the advice above to rule out anything more serious.

What could it mean if a patient sees blood in their stool?

Blood in the stool can be a result of a number of conditions affecting the bowel. These range from the relatively simple such as haemorrhoids or anal fissures to inflammation of the bowel such as ulcerative colitis and bowel cancer. The colour of the blood and whether it is mixed into the stool can help identify where the bleeding may be coming from, but it is a symptom which should never be ignored.

Have you seen any increase in IBD since COVID?

It is probably too early to assess whether there has been an increase in Inflammatory Bowel Disease as levels of this were already increasing in the western world prior to Covid. However, the pandemic has had a clear negative impact on the world’s mental health, which is likely to lead to a worsening of conditions such as IBS, as they are directly impacted by our mental wellbeing.

What general advice do you have for people experiencing IBS on how to minimise symptoms?

IBS (irritable bowel syndrome) affects around 11% of the population globally. It is a common and long-term condition with symptoms including stomach cramps, bloating, diarrhoea and/or constipation. There are many strategies for managing IBS depending on the most troublesome symptoms. I find the most useful strategy is dietary modification, often along the principles of a low FODMAP diet, although this varies from patient to patient.

Probiotics can be helpful for some people, and there are many over the counter remedies which can be effective for bloating. Antispasmodics can help with cramps, as can peppermint oil or peppermint tea for those who want to avoid medication if possible. There are a number of second line treatments and medications which can be used for specific symptoms when first line options fail.

What is a colonoscopy and does it hurt?

A colonoscopy is a test to check inside your bowel, using a long, thin, flexible tube with a small camera inside, which is inserted into your bottom. Reasons for having a colonoscopy are quite varied and include following up of a known illness such as Inflammatory Bowel Disease, bowel cancer screening and following up abnormal stool or blood results. Some of the most common reasons are investigating changes in bowel habit or blood in the stool.

If you need to have one, don’t worry! Colonoscopies are carried out under deep sedation and should not be painful, there a number of techniques we can use to minimise any discomfort. Ahead of the procedure you’ll be given a laxative to empty the bowels. Often people find the bowel preparation to be more uncomfortable than the procedure itself. Don’t be afraid to talk to your Gastroenterologist about the test to put your mind at rest and calm your nerves.

Tell us why you became a Gastroenterologist

Gastroenterology is an interesting mix of hands-on practical skills, with the use of endoscopic procedures, and the management of often complex medical therapies such as those used in Inflammatory Bowel Disease. Gastroenterology covers a wide variety of illnesses affecting the entire gastrointestinal tract as well as the liver, so there’s considerable variety within the role.

It’s very rewarding to be able to help patients in the following ways –

• Investigation and reassurance with respect to worrying bowel symptoms
• Management of difficult to control Inflammatory Bowel Disease
• Management of acid reflux, indigestion and swallowing difficulties
• Investigation and management of liver disease

Why do you think it’s such an important role?

Most people will experience unpleasant “gastro” symptoms in their lifetimes. These are mostly harmless but can cause significant distress and anxiety. As gastroenterologists we can both provide reassurance and relief from many of these symptoms. We cover both Bowel and Liver disease. Conditions affecting these organs are becoming more and more common, with bowel cancer unfortunately being one of the most common cancers affecting people today.

When should patients book an appointment with a Gastroenterologist?

There are a number of reasons why people tend to come and see a gastroenterologist. I’d recommend contacting me or one of my colleagues if:

• You have any concerns about either your bowel or liver health.
• You are experiencing unpleasant bowel symptoms such as abdominal pain, bloating, a change in bowel habit or blood in your poo.
• You need further advice or help with managing existing bowel or liver problems.
• You have recurrent episodes of indigestion or acid reflux which are not responding to initial treatments.

If you are experiencing any of the issues above, please contact us to make an appointment with Dr Latin. You can call the clinic on (+350) 200 49999, send an email to info@smg.gi, or visit us on the first floor of the ICC Building.

About our Expert

Gareth Latin is a UK Trained Gastroenterologist, with nine years’ experience working in the NHS including the Scottish Liver Transplant Unit and Western General Hospital of Edinburgh in the Regional Unit for the management of Inflammatory Bowel Disease. He returned to Gibraltar in 2015 to become a Consultant Gastroenterologist for the GHA and joined the team at the Specialist Medical Clinic in 2022. His specialisms are General Gastroenterology, with a focus on Inflammatory Bowel Disease, Irritable Bowel Syndrome and Bowel Cancer Screening.