The digestive tract is one of the most significant and sensitive parts of the body. Any failure in its function will affect one’s quality of life. Dr. Sophie Buyse encourages everyone not to postpone a visit to a gastroenterologist as, due to modern technologies, all examinations are now performed comfortably under sedation. A timely diagnosis can help you avoid serious conditions in the future.
– Dr. Buyse, the digestive tract is sometimes called – along with the spine – the core of our body. What diseases do you have to deal with most frequently?
– We treat all digestive diseases – from the oesophagus to the bowels, via the stomach, liver, pancreas and intestines… the list is quite long. The most frequent procedure in our clinic is digestive endoscopy: an examination of the internal digestive organs using video appliances, which makes it possible to diagnose inflammatory conditions of the stomach and the colon with very great accuracy.
I recommend that my patients have a screening colonoscopy from the age of 50 onwards, in order to detect any small polyps and prevent the development of colon cancer. This procedure is especially vital for people who have had cases of cancer in their family.
Another area of our work is hepatology – a clinical examination and treatment of the liver.
We also deal with chronic inflammatory bowel diseases and more functional issues such as gastric reflux or irritable bowel, for example.
– What causes digestive disorders?
– If I had a single answer to this question, I’d become a worldwide celebrity. Much research has been conducted which shows that the main reasons are our lifestyles, the food we eat and our internal microbiota. Our food and environment are part of numerous problems that we were not even aware of 10-15 years ago. We are encountering more and more cases of intolerance to certain food products. Liver diseases can also affect your heart, brain, kidneys and skin. To successfully tackle a disease and to prescribe proper treatment, we need a global and comprehensive approach.
– Lately, much has been said about lactose and gluten intolerance. Is this really a problem for many people?
– In Europe, up to 20 per cent of people are intolerant to lactose. It is an even higher percentage in Asia and Africa. Digestive disorders may also be caused by an allergy or hypersensitivity to gluten (but usually in a much smaller percentage of cases). Different cases need different therapies.
– How do you diagnose lactose and gluten intolerance?
– To test for lactose intolerance, the procedure is simple. It takes 3 hours in our clinic using a breath analyzer. Patients need to breathe into a special device every 30 minutes after ingesting a lactose solution and wait for the results – while reading a magazine, listening to music or relaxing.
Gluten intolerance is divided into coeliac disease, which only which affects 1% of the population, and gluten sensitivity, which is more frequent but much less severe. It is important to make the right diagnosis in order to have the right follow-up for the patient.
Coeliac disease (commonly known as gluten allergy) causes chronic inflammation of the small intestine that may lead to cancer. The correct diagnosis is achieved through a blood test and intestinal biopsies. In case of coeliac disease, you must follow a strict diet that completely excludes gluten. This can be difficult, as gluten is now found everywhere, even in lipstick and toys.
Gluten sensitivity is a much milder disease. It leads to feelings of ‘bloating’ after the ingestion of gluten. It can be annoying, but does not lead to any serious complications.
– Why has gluten seemingly become our enemy? People have always eaten bread containing gluten.
– Modern food processing has resulted in bread being overfilled with gluten for the benefit of the industry. Bread has been made crisp and tasty, but not very well adjusted to our digestive tract. Sensitivity to gluten could be connected with our microbiota. Patients may feel bloating, but the intestinal biopsy reveals no inflammation. In this case, we help our patients to choose a new diet without necessarily excluding gluten.
– And why have liver diseases become more frequent?
– The main reasons are obesity-linked fatty liver disease, alcohol abuse and viral hepatitis. Excessive weight or alcohol consumption, together with a lack of physical activity, can lead to cirrhosis or other complications. Most liver disease in Europe is a consequence of lifestyle choices.
– Now, the problem of viral hepatitis C is a pressing one all over the world. What can you say about this disease? Can it be successfully diagnosed and treated?
– Earlier, this disease was difficult to manage. However, in 2015 new drugs were released that provide a complete cure. Despite the current high cost of treatment, we can now cure hepatitis C with a success rate of 97-99 percent. The process lasts for 3 to 6 months, depending on the virus genotype.
– Not long ago, CNN presented news of revolutionary hepatitis C treatments as if an AIDS vaccine had been discovered…
– Yes, this is a real revolution! Unlike previous drugs, the effect of the new drug is to completely destroy the virus – it’s a complete cure! The technology is really unique. Previously, patients had to suffer numerous side effects but now the treatment is relatively easy to handle. I’m excited even to talk about it – and so happy for my patients.
– I’m glad to hear that! Can we say the same about other types of hepatitis?
– Currently, we know of five different types of hepatitis – some are acute while others can become chronic and lead to severe liver disease. There is an individual treatment scheme for each type. First, we perform blood tests and sometimes a liver biopsy. Only after we know the type of hepatitis, as well as the stage of the disease, can we decide which option is best for the patient.
– What other tests do you perform at your clinic?
– Firstly, we offer a complete physical examination. We also perform an ultrasound and blood tests, analyze stool samples, do breath tests and much more. It is important that everything we do is necessary. We don’t conduct unnecessary tests. The main purpose is to improve the patient’s health in a friendly, relaxing environment.
– How much time do you need to get a full picture of the patient’s health?
– Normally this can be achieved in less than half a day – if we only need a consultation and analyses. When an endoscopy is also required, this will take a full day.
We conduct fast-turnaround blood and stool tests – they are sent to our partner laboratory twice daily. It is convenient for our patients to be able to have everything done in one place.
– Many people may delay a diagnosis because endoscopies and similar procedures are associated with significant discomfort…
– Thankfully, these stereotypes are now in the past. 15-20 years ago, endoscopy was really not a very pleasant procedure. Nowadays, endoscopes are much thinner and more flexible. The only inconvenience is the necessity to abstain from food for several hours before the procedure. Then patients are briefly put to sleep so that they feel nothing, and when they wake up, they may only feel slight bloating that usually passes within half an hour.
Propofol is used as a short-term anaesthestic and patients generally wake up after the experience feeling very rested. We use CO2 insufflation to temporarily expand the colon to aid the examination. This gas is quickly absorbed into the body, leaving no after-effects or bloating.
For patients with heart or lung conditions, we perform procedures under general anesthesia. Our clinical staff are fully certified for these activities. Patient safety is the highest priority.
All of our medical equipment is of the latest generation. Patients do not feel anything during the procedure! While they are sleeping, we carefully examine their large intestine and/or their oesophagus, stomach and duodenum (part of the small intestine).
We later show the resulting HD photos to our patients so they have a clear understanding of everything going on in their digestive tract.
– Why did you decide to start your own clinic?
– I wanted to provide premium medical services in a comforting and private environment. Our patients have access to the same services as in large hospitals, but in a calm and homely atmosphere. Here they personally get to know the doctors, nurses and assistants. Sometimes I may also need to send my patients to nearby clinics to meet with other specialist surgeons, nutritionists or oncologists.
Another important point – digestive disorders are very personal and many patients want them to be handled in private. I have many female patients, as I am the only female gastroenterologist in the region. My nurses are also all women. Of course, I also happily deal with many male patients. We have everything arranged in our clinic so that our patients do not actually see each other, even if there are many of them. For our VIP clients, we have special safety and confidentiality measures in place. Our reception staff can speak English, French, German, Spanish, Russian and Arabic, if necessary.
– Do you often have foreign patients?
– Yes, regularly. I personally have quite an «international» status: my father is Belgian, my mother is French, I’m married to an Australian, and I live in Switzerland. I have studied in Paris, while my childhood was spent in Africa and Asia. I guess that is why I can easily adapt to people of many different cultures!
– Soon the holiday season will be upon us, and one of the symbols of midwinter is generous feasts. Can we minimize the consequences and do something to help our liver?
– The secret to a healthy lifestyle is by no means to be found in over-indulgence. Of course, delicious food and wine are part of the feast. We all enjoy them. But if you think that you can get away with excessive drinking, high-calorie fatty food, and watching TV all day long by just doing an occasional ‘detoxification’, you are wrong.
To be healthy, it is crucial to find and maintain a balance between good food and physical exercise. I can help balance your lifestyle. But I can’t give you a magic pill, as there is no such thing. One has to make it part of their daily routine to stay healthy.
– What is your personal philosophy?
– I try to savour the moment, as you never know what tomorrow will bring. Health must be uppermost in one’s life. You can’t achieve anything if you are not feeling well.
– Do you have any hobbies?
– I do! My clinic is part of them. I love my job and I do it with great energy and enthusiasm. On my days off, I like to hike or ski in the surrounding mountains with my family and friends. I am also a regular runner – it helps me to clear my mind. Moreover, I enjoy everything related to dancing and ballet. I am looking forward to visiting the Bolshoi Theater in Moscow and the Mariinsky Theater in St. Petersburg.
Dr. Buyse is a gastroenterology, hepatology and gastrointestinal endoscopy specialist. She graduated from the Department of Medicine at Paris’s Pierre & Marie Curie University in 2001, and then practiced in various gastroenterology, hepatology and intensive care departments in leading Paris institutions. From 2008 to 2010 she was in charge of the University Hospitals Clinic of Paris (Hopitaux Universitaires de Paris). She received additional education in proctology, the treatment of liver diseases, organ transplantation and artificial nutritional therapy. In 2010, she moved to Switzerland and worked in the department of Intensive Care and Gastroenterology at the University Hospital of Vaud (CHUV) in Lausanne. In 2013 she founded BuyseMed Gastroenterology Clinic in Yverdon-les-Bains.