Achalasia and difficulty swallowing
Food sticking in the chest, bringing back undigested food and weight loss. Often mistaken for acidity. Needs endoscopy and manometry; treatments include POEM, balloon dilatation or surgery. Any new difficulty swallowing deserves a prompt visit.
GERD, acidity and heartburn
"Acidity" covers many different symptoms. True reflux is acid going the wrong way, not too much acid. Dinner 3 hours before bed, raising the head end of the bed and losing a little weight help many people. Read taking pantoprazole every day? and chest burning: acidity or heart?
H. pylori, gastritis and ulcers
H. pylori is a common stomach infection and, along with painkillers (NSAIDs), the main cause of ulcers. It's tested by breath, stool or biopsy, and treated with a two-week combination of medicines. Spicy food doesn't cause ulcers.
Gastrointestinal bleeding
Vomiting blood, black tarry stools or passing blood are signs of bleeding. Heavy bleeding is an emergency. Most bleeding is found and treated with endoscopy.
Colon polyps and bowel cancer screening
Bowel cancer is rising in younger Indians, including vegetarians. Bleeding, a lasting change in bowel habit or anaemia need a colonoscopy. Polyps can be removed in the same test (polypectomy).
Inflammatory bowel disease (ulcerative colitis and Crohn's)
Long-lasting diarrhoea, blood and mucus in stools, belly pain and weight loss. In India, Crohn's disease is often confused with intestinal TB, and careful testing matters. Modern treatment can keep most people well.
Irritable bowel syndrome (IBS) and bloating
Real, common and not dangerous. Symptoms often follow meals, stress and poor sleep. Regular meals, a walk after eating, and a structured approach to trigger foods help more than expensive "intolerance" tests.
Constipation, piles and fissures
You don't need to pass stool every day. Fibre, water, a footstool and not spending more than 10 minutes on the toilet solve most cases. Bleeding should not be assumed to be piles; see when it's not just piles.
Fatty liver (MASLD)
Very common, including in slim people. Grade 1 on an ultrasound doesn't mean liver damage; a simple fibrosis score tells us more. Weight, waist, diabetes, alcohol and activity are the levers. See grade 1 fatty liver.
Hepatitis, cirrhosis and other liver disease
Hepatitis B and C, alcohol-related liver disease and cirrhosis. Adults who aren't vaccinated against hepatitis B should consider it. Liver "detox" products and some herbal remedies can harm the liver.
Abdominal tuberculosis
TB can affect the intestine, abdominal lining and lymph nodes, causing pain, fever, weight loss and blockage. Diagnosis may need colonoscopy, imaging or EUS-guided sampling. It's curable with a full course of treatment.