Brief, factual descriptions of conditions that may be discussed during a gastroenterology consultation.
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Stomach & bowel
Helicobacter pylori infection
H. pylori is a bacterium that infects the stomach lining. It can cause chronic gastritis and peptic ulcers and is associated with an increased risk of stomach cancer. Infection may be identified by breath or stool testing, or by biopsy during gastroscopy.
Many people with the infection have no symptoms. Treatment usually combines acid suppression with antibiotics; the choice of medicines takes account of factors such as previous antibiotic exposure. A follow-up test can establish whether the infection has been cleared.
For discussion in consultation
Whether testing or treatment is appropriate, and how eradication is confirmed, depends on your circumstances.
Gastric intestinal metaplasia is a change in the stomach lining identified on biopsy. It is not cancer, but it can be a marker of increased future stomach-cancer risk. Risk differs according to factors such as the extent of change and H. pylori status.
A biopsy is needed to identify this microscopic change; the appearance of the stomach alone may not establish it. Involvement of more than one part of the stomach and a family history of stomach cancer are among the factors that may affect risk assessment.
For discussion in consultation
Biopsy findings, H. pylori testing and whether any further endoscopy is useful require individual review; surveillance is not automatic for everyone.
Colonic polyps are growths in the lining of the large bowel. Some types, including certain adenomas and serrated polyps, can develop into cancer over time; others have little or no malignant potential. Polyps found during colonoscopy may be removed and examined by a pathologist.
Polyps often cause no symptoms and can differ greatly in shape and size. Pathology distinguishes types that matter for cancer prevention from those with little risk. Complete removal and how clearly the bowel could be examined also matter when interpreting a colonoscopy report.
For discussion in consultation
The type, number, size and pathology of polyps, together with examination quality and personal history, guide any follow-up plan.
Gallstones are solid deposits in the gallbladder. Many cause no symptoms. A stone that blocks the outlet of the gallbladder or a bile duct can cause pain and complications such as inflammation, infection or pancreatitis.
Ultrasound is commonly used to detect stones in the gallbladder. Stones that move into the main bile duct can obstruct bile flow and may cause jaundice or infection; a gallbladder stone without symptoms is a different situation from a stone causing a complication.
For discussion in consultation
Symptoms, examination and imaging determine whether observation, further tests or treatment should be considered.
A gallbladder polyp is a projection from the gallbladder wall, usually seen on ultrasound. Many are benign. A small proportion may be neoplastic, so the significance of a finding cannot be judged from the word “polyp” alone.
Some apparent polyps are cholesterol deposits rather than true tumours. Ultrasound findings cannot always identify the tissue type with certainty, so comparison with previous scans and the overall clinical picture can be useful.
For discussion in consultation
Size, appearance, change over time and individual risk factors affect decisions about repeat imaging or surgery.
Liver cysts are fluid-filled lesions. A simple cyst with characteristic imaging features is usually benign and often found incidentally. A lesion that is not clearly a simple cyst may need further characterization.
A simple cyst typically appears as a thin-walled, fluid-filled space on imaging and may never cause symptoms. Internal partitions, a solid area or other atypical features make a finding different from a straightforward simple cyst.
For discussion in consultation
The scan appearance, symptoms and medical history determine whether any additional imaging or follow-up is needed.
Pancreatic cysts are fluid-filled lesions in or around the pancreas. Different cyst types carry different risks; some have potential to progress towards cancer, while others do not. They are often found incidentally on imaging.
Some cysts are related to past inflammation; others arise from the pancreatic ducts or cyst-forming tumours. MRI/MRCP or, in selected cases, endoscopic ultrasound may help characterize a cyst. Finding a cyst does not by itself mean surgery is required.
For discussion in consultation
The cyst type and features such as size, growth, duct changes or a solid component guide whether observation, further assessment or intervention is considered.
Hepatitis B is a viral infection of the liver. Chronic infection can cause ongoing liver injury and increase the risk of cirrhosis and liver cancer, even when there are no symptoms. Blood tests are needed to establish infection and assess viral activity.
The virus can spread through blood, sexual contact or from mother to child around birth; it is not spread by ordinary casual contact. Hepatocellular carcinoma (HCC), the most common primary liver cancer, can occur in some people with chronic hepatitis B even without cirrhosis.
For discussion in consultation
Monitoring, treatment and liver-cancer surveillance depend on blood results, liver health and other individual factors.
Hepatitis C is a blood-borne viral infection that can become chronic and damage the liver over time. An antibody test indicates exposure; a viral RNA test confirms whether infection is currently present. Modern antiviral medicines can cure most people.
A positive antibody test alone does not distinguish a current infection from one that has cleared. Direct-acting antiviral treatment is highly effective, but people who already have cirrhosis may still need liver-cancer monitoring after the virus is cured.
For discussion in consultation
Confirmatory testing, assessment of liver damage and a suitable treatment plan belong in a consultation.
Fibrosis is scar tissue that forms in response to long-standing liver injury. It can range from mild scarring to advanced fibrosis. Blood-based risk scores and liver stiffness measurements can help assess the likelihood of advanced disease.
Fibrosis is not the same as cirrhosis, which represents advanced structural change. Noninvasive tests estimate the chance of significant scarring rather than measuring every scar directly; results may be affected by other conditions and must be read alongside the clinical history.
For discussion in consultation
Results must be interpreted in context; the cause of injury and the degree of scarring determine follow-up.
Steatotic liver disease means excess fat has accumulated in the liver. It is often associated with metabolic factors such as diabetes or excess body weight, although causes vary. Some people develop inflammation and progressive fibrosis.
When excess liver fat occurs with metabolic risk factors, the term metabolic dysfunction-associated steatotic liver disease (MASLD) may apply. Not everyone with liver fat has inflammation or advanced scarring, and a normal liver blood test does not always rule out fibrosis.
For discussion in consultation
Assessment looks at possible causes and the risk of significant fibrosis; management depends on the individual findings.
Cirrhosis is advanced scarring that changes the structure of the liver. It may cause few symptoms initially, but can lead to complications including fluid build-up, bleeding from enlarged veins and liver cancer.
Doctors distinguish compensated cirrhosis, in which major complications have not occurred, from decompensated disease. Portal hypertension can contribute to enlarged veins or fluid build-up. The risk of hepatocellular carcinoma (HCC) is one reason ongoing assessment may be needed.
For discussion in consultation
The underlying cause, liver function and risk of complications determine monitoring and treatment in a consultation.
These summaries are for general information only. They cannot establish a diagnosis or determine whether you need tests, surveillance or treatment. Your own results, risks and options must be reviewed in an actual consultation with a qualified clinician. Do not start, stop or change treatment based on this page.
References are provided for background reading; they do not replace a consultation.
Questions about a finding on your scan, blood test or endoscopy report? Discuss the full report and your history in a consultation.