GORD — commonly called acid reflux — is one of the most common digestive conditions. It occurs when stomach acid flows back into the oesophagus (food pipe), irritating its lining and causing uncomfortable symptoms that can include heartburn, acid regurgitation or a sour taste in the mouth, chest discomfort, chronic cough, throat irritation or hoarseness, a feeling of something stuck in the throat, difficulty swallowing, bloating or nausea.

Symptoms can be occasional for some people, while some may experience them persistently — affecting sleep and daily life. In many cases, GORD can be diagnosed from symptoms alone, and treatment typically involves lifestyle changes alongside medications that reduce stomach acid commonly referred to as PPIs.

Lifestyle measures that may help include avoiding large meals late at night, reducing spicy, fatty, or acidic foods, limiting alcohol and caffeine, maintaining a healthy weight, elevating the head of the bed and avoiding smoking. It is important to have these measures in place if PPI are indicated.

A gastroscopy (upper endoscopy) may be suggested if  there are  persistent or worsening symptoms, difficulty swallowing, unexplained bleeding, anaemia, or weight loss,  no response to medication or if there is a family history of Barrett’s oesophagus.

In selected cases, specialised tests such as oesophageal pH monitoring or manometry may also be required.

Irritable Bowel Syndrome is a common condition where the bowel does not function as it should, but no structural or inflammatory disease is found. It is a “functional” gut disorder — meaning symptoms arise from how the gut and brain interact, rather than visible damage to the intestine.

IBS affects around 1 in 10 people worldwide. It is seen more often in younger adults and in women, though anyone can be affected. Symptoms often fluctuate over time — periods of flare-ups followed by times when things settle.

Common symptoms include ongoing abdominal pain or discomfort, often cramping, changes in bowel habits including diarrhoea, constipation, or both, bloating and abdominal distention.

IBS subtypes include IBS-C (constipation-predominant), IBS-D (diarrhoea-predominant), and mixed IBS. The subtype can shift over time.

There is no single test for IBS. Diagnosis is based on symptoms and by ruling out other conditions. A careful medical assessment usually includes:

• Physical examination and medical history
• Blood tests (including full blood count)
• Routine bowel cancer screening where appropriate

If diarrhoea is prominent, additional tests may include stool inflammation markers, tests for infections such as Giardia and coeliac disease blood tests — as IBS can mimic other conditions.

Further testing is recommended if any of the following are present:

• Symptoms starting after age 50
• Rectal bleeding or black stools
• Unexplained weight loss
• Persistent or worsening abdominal pain
• Night-time diarrhoea
• Abnormal blood test results (such as anaemia or raised inflammation markers)
• Family history of bowel cancer or inflammatory bowel disease

IBS is a common, long-term functional condition. While it can significantly affect quality of life, it does not cause structural damage to the bowel and can often be well managed with a treatment approach tailored to one’s sumptoms and triggers.

Coeliac disease is a lifelong condition in which the immune system reacts abnormally to gluten — a protein found in wheat, barley and rye. This reaction causes inflammation and damage to the small intestine, affecting how nutrients are absorbed.

Coeliac disease affects about 1 in 100 people. Many remain undiagnosed because symptoms can be mild, vague or even absent. It is more likely in people with a family history of the condition, type 1 diabetes, autoimmune thyroid disease, Down syndrome, or Turner syndrome.

Symptoms vary widely. Digestive symptoms may include:

• Diarrhoea or loose stools
• Bloating and wind
• Abdominal pain or discomfort
• Weight loss
• Fatty or bulky stools

Some people have no gut symptoms at all, but may experience tiredness, iron deficiency or anaemia, reduced bone strength, or a skin rash known as dermatitis herpetiformis.

Ongoing bowel inflammation can lead to poor absorption of nutrients, vitamin and mineral deficiencies, reduced bone density, and a small increased risk of certain intestinal cancers and lymphoma.

The main treatment is a strict gluten-free diet (GFD) for life — avoiding wheat, barley and rye. With a gluten-free diet, the small bowel usually heals, symptoms improve or resolve and long-term complications are significantly reduced. Most people feel considerably better once gluten is removed from their diet, though improvement can take weeks to months. It is important to have a repeat endoscopy to check response to GFD.

Inflammatory Bowel Disease is a term for long-term conditions that cause inflammation in the digestive tract. The two main types are Crohn’s disease and ulcerative colitis. IBD is quite distinct from IBS and involves visible, measurable inflammation in the bowel.

Crohn’s Disease

• Can affect any part of the digestive tract from mouth to anus
• Inflammation can be patchy and may involve deeper layers of the bowel wall

Ulcerative Colitis

• Affects only the large bowel (colon and rectum)
• Inflammation is continuous and involves the inner lining of the bowel

Symptoms may be:

• Ongoing diarrhoea (sometimes with blood or mucus)
• Abdominal pain and cramping
• Urgency to open the bowels
• Fatigue and low energy
• Weight loss
• Reduced appetite
• Occasionally fever during flare-ups

IBD typically follows a relapsing and remitting pattern — periods of active symptoms (flare-ups) followed by periods of remission when symptoms settle. It is a long-term condition, but symptoms can often be well controlled with treatment.

Treatment is tailored to the type and severity of IBD, and may include anti-inflammatory medications, immunosuppressive therapies, biologic (targeted) treatments, short-term steroids, or in some cases surgery. The goal is to control inflammation, reduce symptoms, maintain remission, and prevent complications.

IBD is a chronic inflammatory condition, but modern treatments are highly effective. Many people with IBD live full and active lives with the right treatment and regular follow-up that can include  doing a colonoscopy check using a special dye or using a special light on the colonoscope to check for early pre-cancerous changes.

Constipation is a common digestive problem where bowel movements become infrequent, difficult to pass, or associated with a feeling of incomplete emptying. It can affect people of all ages and, while usually not serious, can significantly affect quality of life.

Constipation may involve passing stools fewer than three times per week, hard or lumpy stools, straining, a feeling of incomplete emptying, or abdominal discomfort and bloating. Because normal bowel habits vary from person to person, constipation is often best defined as a change from a usual pattern.

Some causes may be:

Lifestyle Factors

• Low fibre diet
• Insufficient fluid intake
• Lack of physical activity
• Ignoring the urge to open the bowels

Medical Causes

• Certain medications (opioid pain relief, iron tablets, some antidepressants)
• Hormonal conditions such as an underactive thyroid
• Neurological conditions affecting the bowel

In many cases, no underlying disease is found — the bowel simply moves more slowly than usual and may have a delayed colonic transit or an abnormal muscle function in the rectum.

See a doctor if constipation is new and persistent, or if it is associated with:

• Significant abdominal pain
• Rectal bleeding or black stools
• Unexplained weight loss
• Anaemia or fatigue
• A clear change in usual bowel habits, especially in older adults

Treatment usually starts with lifestyle changes — increasing dietary fibre (fruit, vegetables, whole grains), drinking more water, regular physical activity and establishing a regular toilet routine.

Gentle laxatives or stool softeners may also be recommended, adjusted to find the most comfortable option for you.

Gallstones are small stones that form in the gallbladder — the small organ under the liver that stores bile. They can range from tiny grains to larger stones. Many people with gallstones have no symptoms at all and may not know they are present.

Some risk factors are:

• Female sex
• Increasing age
• Pregnancy
• Obesity or rapid weight loss
• High-fat or high-cholesterol diet
• Family history of gallstones
• Certain medical conditions, such as diabetes or liver disease

Most gallstones are “silent” and cause no problems. When symptoms occur, they are usually due to a stone temporarily blocking the gallbladder outlet:

• Pain in the upper right abdomen, sometimes spreading to the back or right shoulder
• Pain that often comes on after eating, especially fatty meals
• Episodes of severe, cramping pain (known as biliary colic)
• Nausea or vomiting
• Bloating or indigestion-like discomfort

In some cases, gallstones can lead to more serious problems — including an inflamed gallbladder (cholecystitis), a blocked bile duct causing jaundice or pancreatitis. These conditions usually require urgent medical attention.

If there are no symptoms, monitoring is usually all that is needed. When symptoms are present, gallbladder removal surgery (cholecystectomy) is the most common and definitive treatment, and effectively prevents further attacks.

Metabolic dysfunction-associated steatotic liver disease (MASLD) — previously called non-alcoholic fatty liver disease (NAFLD) — is a common condition where excess fat builds up in the liver. It is not caused by alcohol and most people with MASLD have no symptoms, often being diagnosed incidentally through blood tests or imaging done for other reasons.

MASLD develops when the body stores too much fat in liver cells, usually related to:

• Excess body weight, especially around the abdomen
• Insulin resistance or type 2 diabetes
• High cholesterol or triglycerides
• Sedentary lifestyle and unhealthy diet

In many people, MASLD remains stable. However, in some cases it can progress through stages of increasing liver damage:

• Simple fatty liver
• Liver inflammation (steatohepatitis / MASH)
• Liver scarring (fibrosis)
• Advanced scarring (cirrhosis) in a small proportion of patients

Advanced disease can increase the risk of liver failure and liver cancer, which is why early detection matters.

In many people, fatty liver can improve — or even resolve — with sustained lifestyle changes and weight loss. Even a 5–10% reduction in body weight can meaningfully improve liver fat.

Treatment focuses on improving metabolic health through weight loss, regular physical activity, a healthy diet (reduced sugar and refined carbohydrates) and good control of diabetes, cholesterol and blood pressure.

Gastritis (inflammation of the stomach lining) and peptic ulcer disease (open sores in the stomach or duodenum) are common, related conditions that share similar causes and symptoms. Both are usually very treatable. Some causes include:

• Infection with Helicobacter pylori (H. pylori)
• Regular use of anti-inflammatory pain medications (NSAIDs such as ibuprofen or aspirin)
• Excess alcohol intake or smoking
• Excess stomach acid production

Some people have no symptoms, but common features include:

• Burning or gnawing upper abdominal pain
• Pain that may be worse when the stomach is empty
• Bloating or fullness after eating
• Nausea or vomiting
• Indigestion or heartburn

Seek prompt medical attention if you experience vomiting blood, black tarry stools, severe or persistent abdominal pain, unexplained weight loss or difficulty swallowing.

If H. pylori is present, treatment involves a combination of antibiotics and acid-suppressing medication (proton pump inhibitors). If NSAIDs are the cause, stopping or reducing the medication — alongside acid-reducing treatment — usually allows healing. Most people improve significantly with appropriate treatment.

H. pylori is a common spiral-shaped bacterium that infects the stomach lining. It is a major cause of gastritis, peptic ulcers and is associated with an increased risk of stomach cancer if left untreated.

H. pylori infection is usually acquired in childhood, spreading via contaminated food or water or close household contact. Many people carry the infection without ever having symptoms.

H. pylori can be detected through a urea breath test (non-invasive and most used), a stool antigen test, a blood antibody test or endoscopy with biopsy in more complex cases.

Standard treatment is a course of triple or quadruple therapy — a proton pump inhibitor combined with two or three antibiotics (such as clarithromycin, amoxicillin, and metronidazole), typically for 10–14 days. Treatment is highly effective when completed as directed.

Anti-inflammatory medicines (such as ibuprofen, naproxen and diclofenac) are widely used for pain, arthritis, and muscle injuries. While helpful, they can sometimes irritate the stomach and intestines by reducing the stomach’s natural protective lining. Some side effects are:

• Stomach irritation (gastritis) — upper tummy discomfort, burning, nausea or bloating
• Stomach or duodenal ulcers — sore or burning upper abdominal pain, sometimes worse on an empty stomach
• Bleeding — black sticky stools, vomiting blood, tiredness or dizziness (more serious; seek urgent care)

High risk groups may include:

• People aged over 60
• Those with a history of stomach ulcers
• People taking aspirin, steroids or blood thinners
• Those taking anti-inflammatory medicines at high doses or for long periods
• People with an H. pylori infection

Risk can be reduced by using the following precautions:

• Take the lowest effective dose for the shortest time needed
• Take tablets with food
• Your doctor may prescribe a stomach-protecting medicine (such as omeprazole)
• Paracetamol ( maximum 3-4g in 24 hours) may be a safer alternative for some types of pain

Contact a doctor urgently if you notice black stools, vomiting blood, severe or persistent stomach pain or dizziness and weakness.

Lower GI symptoms relate to the bowel and back passage (rectum and anus). They are common and often not serious — but some causes require medical assessment.

Rectal Bleeding

Rectal bleeding means passing blood from the back passage. It may appear as bright red blood on toilet paper or in the toilet bowl or as darker blood if the bleeding is higher up in the bowel. Most causes are benign (such as haemorrhoids or a small tear in the anal skin) but persistent or unexplained bleeding should always be assessed by a doctor to rule out bowel polyps, inflammatory bowel disease or bowel cancer.

Haemorrhoids (Piles)

Haemorrhoids are swollen blood vessels in the lower rectum or anus. They are very common. Symptoms include bright red rectal bleeding, itching or irritation around the anus, discomfort when sitting and occasionally a small lump near the anus. They are often triggered by constipation and straining, prolonged sitting on the toilet, pregnancy or a low-fibre diet.

Other Common Anorectal Disorders:

Anal Fissure

A small tear in the anal lining causing sharp pain during or after bowel movements, often associated with a small amount of bright red bleeding.

Anal Abscess

An infection causing a painful swelling near the anus, sometimes with fever. This usually requires urgent treatment.

Anal Fistula

A small abnormal tunnel from the anal canal to the skin, which can cause persistent discharge or recurrent infection.

Many lower GI symptoms may improve with simple measures:

• Increase dietary fibre (fruit, vegetables, whole grains)
• Drink plenty of water
• Avoid straining on the toilet
• Respond promptly to the urge to open your bowels
• Consider stool softeners if needed

Management includes creams or suppositories, small office procedures for persistent haemorrhoids or in severe cases, surgery.

Seek medical advice if you experience persistent or recurrent rectal bleeding, blood mixed with stool, a new change in bowel habits, ongoing pain or a lump near the anus or dizziness and unexplained weight loss. Seek urgent care if heavy bleeding occurs or if you feel faint or develop severe abdominal or rectal pain.

Bowel cancer screening is a way to find bowel cancer early — before symptoms develop — when it is most treatable. In Australia, this is primarily done through the National Bowel Cancer Screening Program.

The Screening Test: FOBT

The main test is the FOBT (Faecal occult blood test -Immunochemical Test). It checks for tiny traces of blood in a stool sample, which you collect at home and post to a lab using a provided kit. It does not diagnose cancer but identifies who may need further investigation. Kits are automatically sent to eligible people aged 45–74 every two years.

Normal (Negative) result is when no blood is detected are to continue routine screening in two years.

Positive Result is when blood has been detected.  Many causes of a positive result are benign. However a colonoscopy is indicated to investigate further.

Liver fibrosis is a condition where the liver becomes scarred over time due to repeated injury or ongoing inflammation. It often develops gradually and can be reversed in the early stages if the underlying cause is identified and treated.

Some common causes are:

• Fatty liver disease (MASLD)
• Excessive alcohol intake
• Viral hepatitis (hepatitis B or C)
• Autoimmune liver disease

Liver fibrosis usually causes no symptoms in the early stages. As it progresses, some people may notice tiredness and low energy, mild discomfort in the upper right abdomen, loss of appetite or unexplained weight loss.

If untreated, liver fibrosis can progress to cirrhosis (advanced scarring), liver failure and an increased risk of liver cancer. Early detection is important because fibrosis can often be slowed or reversed when the underlying cause is addressed.

Liver fibrosis can be evaluated through blood tests (including fibrosis scoring tests), ultrasound or specialised scans such as Fibroscan and in some cases a liver biopsy, though this is rarely needed.

Treatment focuses on the underlying cause — weight loss for fatty liver disease, treating viral hepatitis, managing metabolic risk factors (diabetes, cholesterol) and avoiding alcohol. Lifestyle changes are the cornerstone of management.

Cirrhosis is a condition where the liver becomes severely scarred after long-term, repeated damage. This extensive scarring makes it progressively harder for the liver to function Common causes are Fatty liver disease (MASLD), Long-term alcohol use, Chronic hepatitis B or C infection or Autoimmune liver disease.

In the early stages, cirrhosis may cause no symptoms. As it progresses, symptoms can include tiredness and weakness, loss of appetite and weight loss, nausea or bloating, swollen legs or abdomen (fluid build-up), yellowing of the skin or eyes (jaundice), easy bruising or bleeding and itchy skin. Complications may include:

• Fluid in the abdomen (ascites)
• Enlarged veins in the oesophagus (varices) that can bleed
• Confusion or drowsiness (hepatic encephalopathy)
• Increased risk of liver cancer

While cirrhosis cannot usually be fully reversed, progression can often be slowed significantly. Key steps include treating the underlying cause, avoiding alcohol completely, eating well and maintaining a healthy weight and attending regular monitoring appointments. Medications, endoscopic procedures and surveillance scans may all form part of your ongoing care.

Seek urgent care if you develop vomiting blood or black stools, sudden confusion or drowsiness, severe abdominal swelling or pain, or fever with worsening abdominal symptoms.