Gastroenterology Conditions
We conduct thorough evaluations to diagnose and treat a wide range of gastrointestinal conditions. We utilize the latest medical advancements and diagnostic tools to ensure accurate assessments.
Barrett’s Esophagus
Barrett’s Esophagus is a condition in which the esophageal lining is damaged by chronic GERD. Frequent acid reflux causes normal cells in the esophagus to be replaced with cells that are similar to those in the intestines. This cellular change increases the likelihood of developing esophageal cancer.
What causes this? Chronic GERD is the main cause of Barrett’s Esophagus, but other risk factors include obesity, smoking, family history, and aging.
How is this treated? An upper endoscopy and biopsy are performed to diagnose Barrett’s Esophagus. If no precancerous cells or cancer are found, regular screenings will be recommended to detect precancerous changes or cancer early and lower the risk of esophageal cancer. Treatment aims to slow the development of the condition by controlling acid reflux through lifestyle changes and medications. Some procedures that may be used to destroy or remove abnormal or cancerous cells in the esophagus are:
- Radiofrequency ablation (RFA), in which radio waves are used to destroy the precancerous or cancer cells.
- Endoscopic mucosal resection (EMR), in which the tissue is cut, and then removed with an endoscope.
- Photodynamic therapy, which involves the injection of a light-activated chemical in the arm. The patient returns in 24 to 72 hours for the remainder of the procedure, when an endoscope and laser are used to remove precancerous cells in the esophagus.
- Surgery also may be needed to remove part of the esophagus.
Celiac Disease
Celiac Disease is an inherited condition in which gluten causes inflammation and damages the small intestine. Gluten is a protein found primarily in wheat, barley, and rye, and can be present in most breads, pasta, and such baked goods as cakes, cookies, and pastries. Sources other than food also may have gluten, including medicines and vitamins. Symptoms include gas, abdominal pain, bloating, diarrhea, constipation, weight loss or gain, fatigue, headaches, and joint pain. When someone with Celiac Disease ingests gluten, the immune system responds by damaging cells lining the small intestine.
What causes this? Celiac Disease is an inherited autoimmune disorder that is more common in certain populations. About 3 million people, or 1 percent of the U.S. population, are believed to have Celiac Disease. Sometimes symptoms appear after surgery, pregnancy, or a viral infection.
How is this treated? Celiac Disease can be diagnosed through a blood test. If you have antibodies indicating the presence of Celiac Disease, your doctor probably will perform a biopsy of your small intestine to check for inflammation and damage. The treatment is a lifelong gluten-free diet. Untreated Celiac Disease causes malabsorption and can lead to serious health complications. Embarking on a gluten-free diet will require learning to recognize ingredients on food labels that indicate the item contains gluten.
Cirrhosis
Cirrhosis is a late stage of permanent scarring (fibrosis) of the liver caused by long-term, persistent liver damage and inflammation. Over time, the liver tries to protect itself with scarring, but as fibrous tissue replaces healthy liver tissue, disrupted liver function and ultimately liver failure result in fatal consequences.
What causes this? While often associated with chronic alcohol abuse, Cirrhosis can develop undetected over time from viral hepatitis (such as hepatitis B or C), fatty liver disease, genetic disorders, or cardiovascular disease. Adults over 50, diagnosed with metabolic syndrome, or have a chronic viral hepatitis infection or heavy alcohol use are at higher risk. A range of symptoms and complications include liver dysfunction, jaundice, portal hypertension, ascites (abdominal fluid buildup), hepatic encephalopathy (brain dysfunction), and an increased risk of liver cancer.
How is this treated? Early diagnosis with attention to diet and lifestyle can reduce the progression of the disease. But Cirrhosis is a chronic and irreversible condition, so treatment of its complications does not cure the underlying disease. Medications, dialysis, and blood transfusions are among the treatments for specific complications. Severe liver damage and compromised liver function could require a liver transplant.
Colitis
Colitis is the inflammation of the colon, which also is known as the large intestine. The symptoms of colitis include abdominal pain, bloating, the urgency to have diarrhea, mucous or blood in the stool and weight loss.
What causes this? There are various types of Colitis, which have different causes, including viral, parasitic, or bacterial infections, autoimmune conditions, and other underlying health issues. Colitis can be acute or chronic. Some conditions are temporary, while others require lifelong management.
Some of the common forms of Colitis are:
- Infectious Colitis: This is caused by viral, parasitic, or bacterial infections and is usually temporary.
- Pseudomembranous Colitis: This is caused by the bacterium C. diff (clostridioides difficile). People sometimes develop this after taking antibiotics, which kill off some of the good bacteria in the gut.
- Inflammatory Bowel Diseases (IBD): These include several conditions that cause chronic inflammation in the digestive tract, including Crohn’s Disease, Microscopic Colitis and Ulcerative Colitis. It is believed these are autoimmune conditions and don’t have a specific cause.
- Ischemic Colitis: This occurs when blood vessels are blocked and the intestines don’t receive an adequate supply of blood.
- Chemical Colitis: Can result from exposure to irritating substances, such as certain medications or chemicals.
How are these treated? Treatment depends on the type of colitis and will be based on a medical evaluation and diagnosis. Medications may be prescribed to treat infections, inflammation, and autoimmune conditions. Specialized diet plans may be recommended for both acute and chronic Colitis. Surgery may be needed to treat some types of Colitis, including IBD and Ischemic Colitis.
Colon Polyps
Polyps are growths that occur on the lining of the colon or rectum. Most polyps grow slowly over a period of years. They are usually benign, but some may develop into colon cancer. Though Colon Polyps don’t usually have symptoms, constipation or diarrhea that doesn’t clear up in a week, a change in the color of the stool, abdominal pain, or rectal bleeding could be a sign of a polyp or colon cancer.
What causes this? There are two types of polyps: non-neoplastic, which usually don’t become cancerous, and neoplastic, which include adenomas and serrated polyps. Adenomas are more likely to become malignant, but serrated polyps also may develop into cancer. Polyps are common, but people with a family history of Colon Polyps or colon cancer are at higher risk. Those who are over age 50, are overweight, or smoke also are at higher risk. Because Colon Polyps don’t normally have symptoms, it’s important to have regular screenings with a colonoscopy.
How is this treated? Colonoscopy is the primary procedure used for examination of the colon and to remove colon polyps. Early detection and removal of colon polyps are key to preventing colon cancer.
Dysphagia
The difficulty or discomfort experienced while swallowing food, liquids, or even saliva is called Dysphagia. Older adults are at higher risk, but dysphagia is not considered a typical sign of aging. Symptoms can include pain or inability to swallow, weight loss, gagging while swallowing, drooling, hoarseness, or frequent heartburn from GERD.
What causes this? Various underlying issues can affect the swallowing process, including damage to the muscles and nerves involved in swallowing, structural abnormalities in the throat or esophagus, or other medical conditions. Depending on its underlying cause and severity, Dysphagia can appear in different ways.
How is this treated? Treatment depends on its cause and severity. Eating more slowly, chewing food thoroughly, and treating your GERD condition are preventive measures. To address the underlying issue, dietary modifications, swallowing exercises, speech therapy, and in some cases, medical interventions or surgical procedures may be required. If you or someone you know is experiencing persistent Dysphagia, it’s important to seek medical evaluation and diagnosis as it can be a symptom of various medical conditions, including neurological disorders, esophageal problems, or cancer.
Diverticulitis
About half of those who are age 50 have developed pockets in the wall of the large intestine known as diverticula. When these pockets become inflamed, it results in Diverticulitis, a painful condition. The symptoms include abdominal pain or cramping; fever; changes in bowel habits, such as constipation or diarrhea; and nausea and vomiting.
What causes this? Diverticulitis occurs when the pockets in the large intestine tear, resulting in inflammation or an infection. Factors such as age, obesity, low-fiber diets that are high in animal fat, and smoking may increase the risk of Diverticulitis.
How is this treated? Blood tests, stool samples, or CT scans may be used to diagnose Diverticulitis. Mild cases may be treated with antibiotics, rest, and a low-fiber diet while the area heals. Severe cases or those with complications may require hospitalization and the drainage of abscesses or surgery. A high-fiber diet and exercise may be recommended to prevent recurrences.
GERD
Gastroesophageal reflux disease (GERD), also known as reflux, occurs when stomach acid or other stomach contents back up into the esophagus, which carries food from the mouth to the stomach. The acid can cause heartburn, a burning sensation in the throat or neck. Besides heartburn, symptoms include regurgitation, sore throat, hoarseness, chronic cough, chest pain, and a bitter acid taste.
What causes this? The lower esophageal sphincter (LES), a ring of muscle between the esophagus and stomach, normally opens while food is being swallowed and closes quickly to prevent stomach contents from flowing back up through the esophagus. Gastroesophageal reflux can cause the muscle to weaken, which leads it to close more slowly, allowing stomach acid to flow back into the esophagus. GERD can be caused by being overweight, pregnancy, certain medications, smoking, alcohol, and aging.
How is this treated? Heartburn is common and isn’t usually serious, though it can affect the quality of a person’s sleep and what they can eat. GERD, however, can be a long-term condition that can lead to such complications as esophagitis, ulcers and esophageal bleeding, or a narrowing of the esophagus. GERD may be diagnosed with an upper GI series or upper endoscopy, or pH monitoring. Treatment for GERD includes lifestyle and dietary changes and medications to reduce acid production. Recommendations for changes in lifestyle and diet include: eating smaller, frequent meals; not lying down after eating and not eating for two or three hours before bedtime; and avoiding such foods as chocolate, mint, tomato sauce, carbonated beverages, and citrus juices. Surgery may be necessary for some severe cases of GERD.
IBS
What causes this? IBS is a functional disorder because there is no known cause. It is often diagnosed based on the symptoms and the exclusion of other gastrointestinal diseases. Tests conducted to diagnose IBS include a stool sample and a lower GI endoscopy. Stress is believed to be a factor in causing the disorder.
How is this treated? IBS can vary in severity and its impact on people’s lives. Though there is no standard treatment for IBS, the right diet can help manage symptoms. Some medications, such as antidiarrheal medications, fiber supplements, or laxatives to alleviate constipation, may be prescribed.
IBD
Inflammatory Bowel Disease is a chronic inflammation in the digestive system. The two primary types of Inflammatory Bowel Disease (IBD) are Crohn’s Disease and Ulcerative Colitis.
What causes this? The cause of IBD isn’t known, but it is believed to be hereditary or the result of changes in a person’s immune system.
Crohn’s Disease usually causes inflammation in the lower part of the small intestine and first part of the colon, though it also can affect the upper gastrointestinal system. The condition causes abdominal pain, diarrhea, and weight loss. Complications may include blockage of the intestine.
Ulcerative Colitis causes inflammation and ulcers in the inner lining of the large intestine or rectum. The condition can cause diarrhea, abdominal cramps, rectal bleeding and the urgent need to have bowel movements.
Both Crohn’s Disease and Ulcerative Colitis may have periods of flare-ups (active inflammation), then remission, when the symptoms improve.
To determine whether you have Crohn’s Disease or Ulcerative Colitis, you will need a physical examination by a doctor. The examination may include blood tests and a stool sample. Other tests may include a flexible sigmoidoscopy, colonoscopy, or barium enema. Similar tests are used to diagnose both Crohn’s Disease and Ulcerative Colitis.
How is this treated? The goal of treatment for IBD is to reduce inflammation, alleviate symptoms, manage complications, and improve the person’s quality of life. Medications, dietary changes, emotional support and, in some cases, surgery may be part of the treatment plan.
Pancreatitis
Pancreatitis is the inflammation of the pancreas, a gland located behind the stomach that produces digestive enzymes and hormones such as insulin. Pancreatitis can be mild or severe and acute (sudden onset) or chronic (recurring). The condition can cause severe abdominal pain, nausea, vomiting, diarrhea, fever, weight loss, and jaundice.
What causes this? Acute Pancreatitis is believed to be caused by gallstones or excessive alcohol consumption and usually lasts a few days. Chronic Pancreatitis, which is more common in men than women, may be associated with frequent flare-ups, pain, and diabetes. It can cause endocrine failure, in which the pancreas stops producing the enzymes needed to digest and absorb nutrients.
How is this treated? Treatment will address the underlying cause and may involve managing symptoms and supportive care. Mild cases may be treated with pain relief, fasting, and a short hospital stay. More severe cases may require hospitalization, the drainage of fluids, or the removal of the gallbladder. A temporary diet may be recommended because you will have difficulty digesting fat. Fatty foods may need to be avoided long-term to prevent a recurrence. Some people may need to take pancreatic enzyme supplements with each meal to help them absorb food and help them regain some of their weight.
It’s important to seek medical attention if you suspect Pancreatitis because early diagnosis and treatment are essential. A pancreas function test and an imaging test such as an ultrasound or a CT scan may be done.