At Home Christian Jessen 2014 - 86

| PROMOTION|

Get that
peace of
mind
Irritable bowel
syndrome - discover the
therapeutic solutions

Mr Romi Navaratnam
(pictured, left) trained in
Nottingham, Cambridge,
London and Sri Lanka,
prior to being appointed
consultant laparoscopic
colorectal surgeon at the
North Middlesex University Hospital
and Honorary Senior Lecturer at the
Royal Free Medical School in 2002.
Mr Navaratnam is one of the founding
consultants of the gastrointestinal (GI) units at
The Wellington Hospital and The Hospital of
St John and St Elizabeth, London, in 2006.
Both are widely recognised as national
and international centres of excellence. His
research interests incorporate improving
outcomes in laparoscopic (minimally invasive,
keyhole) surgery and surgical education.

Common conditions

Mr Navaratnam's specialist interests include the
investigation and management of gastrointestinal
problems, such as irritable bowel syndrome
(IBS), and common anal conditions including
rectal bleeding, haemorrhoids (piles), ﬁssures and
ﬁstulae. He has a major interest in diagnostic
and therapeutic colonoscopy, endoscopy and
undertakes laparoscopic surgery for conditions of
the gall bladder, appendix, groin and abdominal
herniae and benign colonic disease (Crohn's and

'PROBIOTICS ALTER
THE INTESTINAL
FLORA AND ARE
USEFUL IN PATIENTS
WITH BLOATING'
diverticular disease) and colorectal cancer,
all with extremely positive outcomes.

What actually happens?

IBS is a common condition which affects a
large number of the adult population. Classic
symptoms include: abdominal pain, abdominal
bloating and an alteration in bowel habit,
either diarrhoea or constipation. There are
three main sub-types: constipation predominant
IBS, diarrhoea predominant IBS, or mixed IBS.
Management of the condition includes
lifestyle and dietary modiﬁcations. Faecal
calprotectin testing has some use in excluding
inﬂammatory bowel disease. Colonoscopy is
indicated in the presence of rectal bleeding
or a persistent alteration in bowel habit.

Relieving symptoms

A low FODMAPs diet (short chain carbohydrates
that are poorly absorbed in the small intestine)

has been found to be useful in the management
of a diarrhoea predominant IBS (in conjunction
with constipating agents) and in patients with
signiﬁcant bloating. Probiotics which alter the
intestinal ﬂora have also been found to be
useful in patients with bloating. Patients with
a constipation predominant IBS beneﬁt from
laxatives and may obtain relief from trans
anal (colonic) irrigation. The management of
refractory IBS involves cognitive behavioural
therapy and other relaxation and bowel
retraining techniques. Once a diagnosis has
been established, avoiding catalysts and
acknowledging how to live with it, are all
important in the overall management of IBS.

FOR MORE INFORMATION
Email romi.navaratnam@hje.org.uk
Visit www.colorectalspecialists.co.uk
Secretary and appointments 020 7078
3832. Hospital of St John and St Elizabeth
enquiries 020 7806 4060.
Wellington Hospital (Platinum Medical
Centre) enquiries 020 3214 3631.
http://www.colorectalspecialists.co.uk
At Home Christian Jessen 2014

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