Tag Archives: ipoh echo digestive health

Hepatitis C


Dr Saravana.KDigestive Health

By Dr Saravana.K
Consultant Physician,
Gastroenterologist & Hepatologist

Hepatitis simply means “inflammation of the liver” (the suffix “itis” means inflammation and “hepa” means liver). Hepatitis C (HCV) is a specific type of hepatitis that is caused by a virus. There are many other hepatitis viruses such hepatitis A, B, D, E, etc. The only thing they have in common is that they all affect the liver. Most people infected with the HCV have no symptoms until liver damage shows up decades later, during routine medical tests.

It is spread when you come in contact with blood contaminated by the virus. Three per cent of the world’s population is chronically infected with HCV. In Malaysia the prevalence of HCV is about 1.5 per cent.


  • Hepatitis C-1HCV infection usually produces no signs or symptoms during its earliest stages
  • Fatigue, fever, muscle and joint pains
  • Nausea or poor appetite
  • Yellowing of the skin and whites of the eyes (jaundice)
  • Leg swelling, abdominal distension
  • Passing foul smelling blackish stool
  • Vomiting blood

How do I become infected with HCV?

  • Hepatitis C-2Health care and emergency workers who have been exposed to infected blood or accidental needle stick injury
  • Have ever injected illicit drugs
  • People with HIV infection
  • Received a piercing or tattoo in an unclean environment using non sterile equipment
  • Received a blood transfusion, clotting factor concentrates or organ transplant before 1994
  • Received hemodialysis treatments for a long period of time
  • Was born to a mother with a HCV infection
  • Sexual partners of anyone diagnosed with HCV infection
  • People with hemophilia.

People with the above risks may want to talk to their doctors about screening for hepatitis C infection, to detect it early and prevent complications. HCV infection at the initial stages produces no symptoms and if detected early treatment could be administered to prevent complications such as:

  • Scarring of the liver tissue (cirrhosis). After 20 to 30 years of HCV, cirrhosis may occur. Scarring in your liver makes it difficult for your liver to function.
  • Liver failure. A liver that is severely damaged by HCV may be unable to function adequately.
  • Liver cancer.

HCV can be diagnosed by doing simple blood tests that include:

  • HCV antibody test: To determine whether you have the HCV virus.
  • Measure the quantity of the HCV virus in your blood (viral load) and the genetic makeup of the virus (genotyping), to determine your treatment options.


Antiviral medications

HCV infection is treated with antiviral medications intended to clear the virus from your body. Your doctor will decide whether you are eligible for treatment and may recommend a combination of medications taken over several weeks. Throughout treatment your doctor will monitor your response to medications and for side effects.

Liver transplant

If your liver has been severely damaged; a liver transplant may be an option.


Protect yourself from HCV infection by taking the following precautions: stop using illicit drugs, be cautious about body piercing and tattooing and practice safer sex.

Tips To Maintain a Healthy Liver

  • Vaccinations against the hepatitis A and B viruses. These viruses can also cause liver damage and complicate treatment of hepatitis C.
  • Stop drinking alcohol.
  • Avoid medications that may cause liver damage.

For more information call Saravana.K Gastroenterologist and Liver Specialist Clinic at Hospital Fatimah (05-5487181) or email gastrosara@gmail.com.


Gastroesophageal Reflux Disease (GERD)


Dr Saravana.KDigestive Health

By Dr Saravana.K

Consultant Physician, Gastroenterologist & Hepatologist


GERD is a common chronic digestive condition that occurs when stomach acid or bile flows back into your food pipe. The backwash of acid irritates the lining of your oesophagus and causes GERD symptoms. These symptoms can interfere with your daily activities.


  • A burning sensation in your chest (heartburn)GERD-1
  • Chest pain
  • Difficulty swallowing
  • Dry cough
  • Hoarseness or sore throat
  • Regurgitation of food or liquid

When you swallow, the lower esophageal sphincter – a circular band of muscle around the bottom part of your oesophagus – relaxes to allow food and liquid to flow down into your stomach. Then it closes again.

However, if this valve relaxes abnormally or weakens, stomach acid can flow back up into your esophagus, causing frequent heartburn. Carbonated drinks, spicy food and alcohol, fatty food can also cause the valve to relax abnormally thus producing symptoms of GERD.

GERD symptoms can also be aggravated by a number of medications – either through impaired valve function or by damaging the oesophageal surface.

This constant backwash of acid can irritate the lining of your oesophagus, causing it to become inflamed. Over time, the inflammation can erode the oesophagus, causing complications:

  • Narrowing of the oesophagus (stricture). The scar tissue narrows the food pathway, causing difficulty swallowing.
  • An open sore in the oesophagus (ulcer). Stomach acid can severely erode tissues in the oesophagus, causing an open sore to form. The esophageal ulcer may bleed, cause pain and make swallowing difficult.
  • Barrett’s oesophagus. Changes occur to the tissue lining the lower oesophagus which is associated with an increased risk of esophageal cancer.


Risk factors for GERD include:

  • Obesity
  • Pregnancy
  • Smoking
  • Asthma
  • Diabetes
  • Delayed stomach emptying.

Most people can manage the discomfort of heartburn with lifestyle modifications:

  • taking  frequent small meals
  • avoid food that can aggravate the condition including alcohol
  • avoid tight fitting clothes
  • elevate the head of the  bed by 30 degrees
  • to have an interval of 3 hours between meals and bedtime
  • weight loss.


When to see a doctor

  • If you take over-the-counter medications for heartburn more than twice per week.
  • Chest pain.
  • Difficulty swallowing.
  • Loss of weight and appetite.
  • Persistent vomiting.

GERD can be diagnosed by doing an endoscopy which involves inserting a scope through the mouth down to the stomach to assess the internal surfaces of the stomach, oesophagus and duodenum. The scope will show any inflammation and enable a biopsy to be done to determine the presence of cancer.