One Stop Solution
For All Digestive Problems

CIH’s Digestive Disease (GI) Center specializes in preventing and treating of disorders of GI tract, liver, gallbladder, pancreas, and other organs of the digestive system.

Our goal is to pave the most comprehensive patient journey even after being discharged. Our unique multidisciplinary teams approach that work cohesively across specialties to ensure our service and healthcare outcomes equate to world-class level.

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We are all have different diet, which may lead to a variety of digestiveproblem. At CIH, we create screening package that are tailored just for you. Base on your behavior, such as drinking, smoking, we would suggest a package that could reveal your problem as early as possible.a

Painless and worry-free Gastrointestinal Endoscopy

A 20 minutes nap every year can save your life. We feel your pain. Therefore, the CIH’s unique endoscopic procedure will be performed under the care of an addition anesthesiologist, you may take gastroscopy or colonoscopy without any pain, which not only substantially reduces your fear but also makes the examination of colonoscopy easier and safer. The low dosage of anesthesia won’t affect your memory.

Overview

The liver is an organ about the size of a football that sits just under your rib cage on the right side of your abdomen. The liver is essential for digesting food and ridding your body of toxic substances.

Liver disease can be inherited (genetic) or caused by a variety of factors that damage the liver, such as viruses and alcohol use. Obesity is also associated with liver damage.

Over time, damage to the liver results in scarring (cirrhosis), which can lead to liver failure, a life-threatening condition.

Symptoms

Signs and symptoms of liver disease include:
  • Skin and eyes that appear yellowish (jaundice)
  • Abdominal pain and swelling
  • Swelling in the legs and ankles
  • Itchy skin
  • Dark urine color
  • Pale stool color, or bloody or tar-colored stool
  • Chronic fatigue
  • Nausea or vomiting
  • Loss of appetite
  • Tendency to bruise easily
When to see a doctor

Make an appointment with your doctor if you have any persistent signs or symptoms that worry you. Seek immediate medical attention if you have abdominal pain that is so severe that you can't stay still.

Causes

Liver disease has many causes.
Infection

Parasites and viruses can infect the liver, causing inflammation that reduces liver function. The viruses that cause liver damage can be spread through blood or semen, contaminated food or water, or close contact with a person who is infected. The most common types of liver infection are hepatitis viruses, including:

  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
Genetics

An abnormal gene inherited from one or both of your parents can cause various substances to build up in your liver, resulting in liver damage. Genetic liver diseases include:

  • Hemochromatosis
  • Hyperoxaluria and oxalosis
  • Wilson's disease
  • Alpha-1 antitrypsin deficiency
Immune system abnormality

Diseases in which your immune system attacks certain parts of your body (autoimmune) can affect your liver. Examples of autoimmune liver diseases include:

  • Autoimmune hepatitis
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis
Cancer and other growths

Examples include:

  • Liver cancer
  • Bile duct cancer
  • Liver adenoma
Other

Additional, common causes of liver disease include:

  • Chronic alcohol abuse
  • Fat accumulating in the liver (nonalcoholic fatty liver disease)

Risk factors

Factors that may increase your risk of liver disease include:

  • Heavy alcohol use
  • Injecting drugs using shared needles
  • Tattoos or body piercings
  • Blood transfusion before 1992
  • Exposure to other people's blood and body fluids
  • Unprotected sex
  • Exposure to certain chemicals or toxins
  • Diabetes
  • Obesity

Complications

Complications of liver disease vary, depending on the cause of your liver problems. Untreated liver disease may progress to liver failure, a life-threatening condition.

Prevention

To prevent liver disease:
  • Drink alcohol in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men. Heavy or high-risk drinking is defined as more than eight drinks a week for women and more than 15 drinks a week for men.
  • Avoid risky behavior. Get help if you use illicit intravenous drugs, and don't share needles used to inject drugs. Use a condom during sex. If you choose to have tattoos or body piercings, be picky about cleanliness and safety when selecting a shop.
  • Get vaccinated. If you're at increased risk of contracting hepatitis or if you've already been infected with any form of the hepatitis virus, talk to your doctor about getting the hepatitis A and hepatitis B vaccines.
  • Use medications wisely. Take prescription and nonprescription drugs only when needed and only in recommended doses. Don't mix medications and alcohol. Talk to your doctor before mixing herbal supplements or prescription or nonprescription drugs.
  • Avoid contact with other people's blood and body fluids. Hepatitis viruses can be spread by accidental needle sticks or improper cleanup of blood or body fluids.
  • Take care with aerosol sprays. Make sure the room is ventilated, and wear a mask when spraying insecticides, fungicides, paint and other toxic chemicals. Always follow the manufacturer's instructions.
  • Protect your skin. When using insecticides and other toxic chemicals, wear gloves, long sleeves, a hat and a mask.
  • Maintain a healthy weight. Obesity can cause nonalcoholic fatty liver disease.

Gastrointestinal Disorders

Gastrointestinal disorders include such conditions as constipation, irritable bowel syndrome, hemorrhoids, anal fissures, perianal abscesses, anal fistulas, perianal infections, diverticular diseases, colitis, colon polyps and cancer. Many of these can be prevented or minimized by maintaining a healthy lifestyle, practicing good bowel habits, and submitting to cancer screening.

What are functional gastrointestinal disorders?

Functional disorders are those in which the gastrointestinal (GI) tract looks normal but doesn't work properly. They are the most common problems affecting the GI tract (including the colon and rectum). Constipation and irritable bowel syndrome (IBS) are two common examples.

Many factors may upset the GI tract and its motility (or ability to keep moving), including:
  • Eating a diet low in fiber
  • Not enough exercise
  • Traveling or other changes in routine
  • Eating large amounts of dairy products
  • Stress
  • Resisting the urge to have a bowel movement
  • Resisting the urge to have bowel movements due to pain from hemorrhoids
  • Overusing laxatives (stool softeners) that, over time, weaken the bowel muscles
  • Taking antacid medicines containing calcium or aluminum
  • Taking certain medicines (especially antidepressants, iron pills, and strong pain medicines such as narcotics)
  • Pregnancy

Constipation

Constipation means it is hard to have a bowel movement (or pass stools), they are infrequent (less than three times a week), or incomplete. Constipation is usually caused by inadequate "roughage" or fiber in the diet, or a disruption of the regular routine or diet.

Constipation causes a person to strain during a bowel movement. It may cause small, hard stools and sometimes anal problems such as fissures and hemorrhoids. Constipation is rarely the sign of a more serious medical condition.

You can treat your constipation by:
  • Increasing the amount of fiber you eat
  • Exercising regularly
  • Moving your bowels when you have the urge (resisting the urge causes constipation)

If these treatment methods don't work, laxatives are a temporary solution. Note that the overuse of laxatives can actually make symptoms of constipation worse. Always follow the instructions on the laxative medicine, as well as the advice of your doctor.

Irritable bowel syndrome (IBS)

Irritable bowel syndrome (also called spastic colon, irritable colon, or nervous stomach) is a condition in which the colon muscle contracts more often than in people without IBS. Certain foods, medicines, and emotional stress are some factors that can trigger IBS.

Symptoms of IBS include:
  • Abdominal pain and cramps
  • Excess gas
  • Bloating
  • Change in bowel habits such as harder, looser, or more urgent stools than normal
  • Alternating constipation and diarrhea
Treatment includes:
  • Avoiding caffeine
  • Increasing fiber in the diet
  • Monitoring which foods trigger IBS (and avoiding these foods)
  • Minimizing stress or learning different ways to cope with stress
  • Sometimes taking medicines as prescribed by your healthcare provider

What are structural gastrointestinal disorders?

Structural disorders are those in which the bowel looks abnormal and doesn't work properly. Sometimes, the structural abnormality needs to be removed surgically. Common examples of structural GI disorders include hemorrhoids, diverticular disease, colon polyps, colon cancer, and inflammatory bowel disease.

Anal disorders

Hemorrhoids

Hemorrhoids are swollen blood vessels that line the anal opening. They are caused by chronic excess pressure from straining during a bowel movement, persistent diarrhea, or pregnancy.

There are two types of hemorrhoids: internal and external.

Internal hemorrhoids

Internal hemorrhoids are blood vessels on the inside of the anal opening. When they fall down into the anus as a result of straining, they become irritated and start to bleed. Ultimately, internal hemorrhoids can fall down enough to prolapse (sink or stick) out of the anus.

Treatment includes:
  • Improving bowel habits (such as avoiding constipation, not straining during bowel movements, and moving your bowels when you have the urge).
  • Your doctor using elastic bands to eliminate the vessels.
  • Your doctor removing them surgically. Surgery is needed only for a small number of patients with very large, painful, and persistent hemorrhoids.
External hemorrhoids

External hemorrhoids are veins that lie just under the skin on the outside of the anus. Sometimes, after straining, the external hemorrhoidal veins burst and a blood clot forms under the skin. This very painful condition is called a pile.

Treatment includes removing the clot and vein under local anesthesia and /or removing the hemorrhoid itself.

Anal fissures

Anal fissures are splits or cracks in the lining of the anal opening. The most common cause of an anal fissure is the passage of very hard or watery stools. The crack in the anal lining exposes the underlying muscles that control the passage of stool through the anus and out of the body. An anal fissure is one of the most painful problems because the exposed muscles become irritated from exposure to stool or air, and leads to intense burning pain, bleeding, or spasm after bowel movements.

Initial treatment for anal fissures includes pain medicine, dietary fiber to reduce the occurrence of large, bulky stools, and sitz baths (sitting in a few inches of warm water). If these treatments don't relieve pain, surgery might be needed to repair the sphincter muscle.

Perianal abscesses

Perianal abscesses can occur when the tiny anal glands that open on the inside of the anus become blocked, and the bacteria always present in these glands cause an infection. When pus develops, an abscess forms. Treatment includes draining the abscess, usually under local anesthesia in the doctor's office.

Anal fistula

An anal fistula often follows drainage of an abscess and is an abnormal tube-like passageway from the anal canal to a hole in the skin near the opening of the anus. Body wastes traveling through the anal canal are diverted through this tiny channel and out through the skin, causing itching and irritation. Fistulas also cause drainage, pain, and bleeding. They rarely heal by themselves and usually need surgery to drain the abscess and "close off" the fistula.

Other perianal infections

Sometimes the skin glands near the anus become infected and need to be drained. Just behind the anus, abscesses can form that contain a small tuft of hair at the back of the pelvis (called a pilonidal cyst).

Sexually transmitted diseases that can affect the anus include anal warts, herpes, AIDS, chlamydia, and gonorrhea.

Diverticular disease

Diverticulosis is the presence of small outpouchings (diverticula) in the muscular wall of the large intestine that form in weakened areas of the bowel. They usually occur in the sigmoid colon, the high-pressure area of the lower large intestine.

Diverticular disease is very common and occurs in 10% of people over age 40 and in 50% of people over age 60 in Western cultures. It is often caused by too little roughage (fiber) in the diet. Diverticulosis rarely causes symptoms.

Complications of diverticular disease happen in about 10% of people with outpouchings. They include infection or inflammation (diverticulitis), bleeding, and obstruction. Treatment of diverticulitis includes antibiotics, increased fluids, and a special diet. Surgery is needed in about half the patients who have complications to remove the involved segment of the colon.

Colon polyps and cancer

Each year 130,000 Americans are diagnosed with colorectal cancer, the second most common form of cancer in the United States. Fortunately, with advances in early detection and treatment, colorectal cancer is one of the most curable forms of the disease. By using a variety of screening tests, it is possible to prevent, detect, and treat the disease long before symptoms appear.

The importance of screening

Almost all colorectal cancers begin as polyps, benign (non-cancerous) growths in the tissues lining the colon and rectum. Cancer develops when these polyps grow and abnormal cells develop and start to invade surrounding tissue. Removal of polyps can prevent the development of colorectal cancer. Almost all precancerous polyps can be removed painlessly using a flexible lighted tube called a colonoscope. If not caught in the early stages, colorectal cancer can spread throughout the body. More advanced cancer requires more complicated surgical techniques.

Most early forms of colorectal cancer do not cause symptoms, which makes screening especially important. When symptoms do occur, the cancer might already be quite advanced. Symptoms include blood on or mixed in with the stool, a change in normal bowel habits, narrowing of the stool, abdominal pain, weight loss, or constant tiredness.

Most cases of colorectal cancer are detected in one of four ways:
  • By screening people at average risk for colorectal cancer beginning at age 50
  • By screening people at higher risk for colorectal cancer (for example, those with a family history or a personal history of colon polyps or cancer)
  • By investigating the bowel in patients with symptoms
  • A chance finding at a routine check-up

Early detection is the best chance for a cure.

Colitis

There are several types of colitis, conditions that cause an inflammation of the bowel. These include:

  • Infectious colitis
  • Ulcerative colitis (cause not known)
  • Crohn's disease (cause not known)
  • Ischemic colitis (caused by not enough blood going to the colon)
  • Radiation colitis (after radiotherapy)

Colitis causes diarrhea, rectal bleeding, abdominal cramps, and urgency (frequent and immediate need to empty the bowels). Treatment depends on the diagnosis, which is made by colonoscopy and biopsy.

Can gastrointestinal disease be prevented?

Many diseases of the colon and rectum can be prevented or minimized by maintaining a healthy lifestyle, practicing good bowel habits, and submitting to cancer screening.

Colonoscopy is recommended for average risk patients at age 50. If you have a family history of colorectal cancer or polyps, colonoscopy may be recommended at a younger age. Typically, colonoscopy is recommended 10 years younger than the affected family member. (For example, if your brother was diagnosed with colorectal cancer or polyps at age 45, you should begin screening at age 35).

If you have symptoms of colorectal cancer you should consult your doctor right away. Common symptoms include:
  • A change in normal bowel habits
  • Blood on or in the stool that is either bright or dark
  • Unusual abdominal or gas pains
  • Very narrow stool
  • A feeling that the bowel has not emptied completely after passing stool
  • Unexplained weight loss
  • Fatigue

Unique Multidisciplinary approach could save your life

Nearly 9 in 10 people who go for a second opinion after seeing a doctor are likely to leave with a refined or new diagnosis from what they were first told. At CIH, every treatment plan for you are reviewed and approved by the best specialists from Cho Ray Hospital, Medical University Hospital, etc to ensure the best possible outcome for you

Private ICU rooms The highest level of healing environment with the lowest infection rate.

A Private ICU room isn’t just for luxury. A Private ICU room can reduce your chance of infection by 54%. Post-operating infection is responsible for 90% of complication.

Antimicrobial stewardship programs
mandatory for all ICUs

Antimicrobial stewardship involves a multifaceted approach aimed at combating the emergence of antibiotic resistance, improving patient outcomes, and controlling healthcare costs by optimizing antimicrobial use