Conditions & Diseases

Barrett's esophagus is a condition in which part of the lining of the esophagus near the stomach has changed due to acid reflux that occurs with GERD. To protect itself, the esophagus may develop a more acid-resistant lining. This is Barrett's esophagus. The changes to the esophagus lining are not normal. If the lining continues to change, it may be more likely to become cancer in the future. The best way to diagnose Barrett's is with an upper endoscopy. This test lets your doctor look into your esophagus and biopsy tiny samples of tissue. The samples will be examined later for signs of cancer. To keep track of the changes in your esophagus, your doctor may suggest regular tests. He or she may also suggest ways for you to control GERD and help keep your Barrett's from getting worse.   Your doctor may recommend an endoscopy every 1-2 years to help catch any signs of cancer early, when it is easier to treat.

Cancer of the colon is a major health problem in the United States. It ranks as a leading form of cancer, along with lung and breast cancer. Importantly, colon cancer is also one of the most curable forms of cancer. When detected early, more than 90 percent of patients can be cured.

This disease begins in the cells that line the colon. A polyp is a growth that occurs in the colon and other organs. These growths, or fleshy tumors, are shaped like a mushroom or a dome-like button, and occur on the inside lining of the colon. They may be as small as a tiny pea or larger than a plum. It is important to note that while colon polyps start out as benign tumors, some polyps, in time, become malignant. In fact, the larger the polyp, the more likely it is to contain cancer cells. In most cases, it is a polyp called an adenoma polyp that develops into colon cancer.

The key to early detection of colon polyps and cancer is the concern and willingness of each person to seek medical attention from a physician. Colon cancers and large polyps release minute quantities of blood; therefore, examination of the stool for occult(hidden) blood is an important exam. Removal of colon polyps reduces the risk of subsequent development of cancer of the colon. Polyps are usually removed using a colonoscope which allows the physician to visualize the inside of the colon. Biopsy equipment and snares (wire loops) are passed through the endoscope and, with electrical heat (electrocautery), remove polyps and small tumors. This procedure is performed in the outpatient setting under sedation. Cancer of the colon is a serious but readily detected malignancy. Early detection promises a particularly high chance of survival. Most colon cancers start as polyps, which can usually be removed through a colonoscopic exam. Today, there is much that can be done to prevent and cure this cancer. The essential first step involves action by the patient.

Crohn's disease is inflammation (swelling and irritation) of the digestive tract. Any part of the digestive tract, from the mouth to the anus, can be affected. Crohn's is often found in the intestines, especially the area where the small intestine and colon meet. All layers of the digestive tract may be inflamed, including the lining and inner and outer walls. The symptoms of Crohn's disease can include abdominal pain and bloating after meal, high fever and chills, loss of appetite; possible weight loss, bloody diarrhea, nausea or vomiting. While Crohn's disease has no cure, the symptoms can be treated. Help manage your symptoms by following your doctor's advice and watching what you eat. Certain medications can help control your symptoms.

Diverticulosis is a condition in which outpouchings form in the walls of the intestines. These pouches, known as diverticula, are about the size of large peas. They form in weakened area of the bowels, most often in the lower part of the colon (large bowel). Most people with diverticula do not have any symptoms from them. They may never know they have the condition. Sometimes the pouches become infected and inflamed, a more serious condition known as diverticulitis. When inflammation is present, there may be fever and an increased white blood cell count, as well as acute abdominal pain. Diverticulitis also may result in large abscesses, bowel blockage, or breaks and leaks through the bowel wall. For most people, diverticulosis is not a problem. Diverticulitis, on the other hand, is a problem, sometimes a serious one. For instance, when one of the sacs (a diverticulum) becomes infected and inflamed, bacteria enter small tears in the surface of the bowel. This leads to small abscesses. Such an infection may remain localized and go away within a few days. In rare cases, the infection spreads and breaks through the wall of the colon causing peritonitis (infection of the abdominal cavity) or abscesses in the abdomen. Such infections are very serious and can lead to death unless treated without delay.

Fatty liver is just what its name suggests: the build-up of fat in the liver cells. Although this is not a normal condition, fat in the liver usually causes no damage by itself. However, on some occasions it can be a sign that other more harmful conditions are at work. Fatty liver may be associated with or may lead to inflammation of the liver. This can cause scarring and hardening of the liver. It is known that fat accumulates in the liver with a number of conditions. The most common is obesity. Fatty liver is also associated with diabetes mellitus, high blood triglycerides, and the heavy use of alcohol. There are usually no symptoms that are noticeable to the patient. In fact, fatty liver is frequently uncovered during a routine physical examination. There may be a rise in certain liver enzymes found in the blood, and sometimes the liver is slightly enlarged. Fatty liver may also be discovered while the physician is evaluating a patient for other illnesses.

Gallstone disease is a common medical problem, affecting 10-16 percent of the population of the United States. The gallbladder is a sac, about the size and shape of a pear, which lies on the undersurface of the liver in the upper right-hand portion of the abdominal cavity. It is connected to the liver and the intestine by a series of small tubes, or ducts. The primary job of the gallbladder is to store bile, which is produced and secreted continuously by the liver, until the bile is needed to aid in digestion. After a meal, the gallbladder contracts and sends the bile into the intestine. When digestion of the meal is over, the gallbladder relaxes and once again begins to store bile. Gallstones are pieces of hard solid matter in the gallbladder. The most typical symptom of gallstone disease is severe steady pain in the upper abdomen or right side. The pain may last for as little as 15 minutes or as long as several hours. The pain may also be felt between the shoulder blades or in the right shoulder. Sometimes patients also have vomiting or sweating. Attacks of gallstone pain may be separated by weeks, months, or even years.

It is thought that gallstone pain results from blockage of the gallbladder duct by a stone. When the blockage is prolonged the gallbladder may become inflamed. This condition, called acute cholecystitis, may lead to fever, prolonged pain and eventually infection of the gallbladder. Hospitalization is usually necessary for observation, treatment with antibiotics and pain medications, and frequently surgery. More serious complications may occur when a gallstone passes out of the gallbladder duct and into the main bile duct. If the stone lodges in the main bile duct, it can lead to a serious bile duct infection. If it passes down the bile duct, it can cause an inflammation of the pancreas, which has a common drainage channel with the bile duct. Either of these situations can be extremely dangerous. Stones in the bile duct usually cause pain, fever, and jaundice (yellow discoloration of the eyes and skin).

Gastroesophageal reflux disease (GERD) occurs when the muscle that blocks the opening of the esophagus into the stomach is weakened. This weakened muscle allows stomach acids and digestive juices to travel back up your esophagus. Acid can cause irritations of your esophagus and the discomfort you experience with GERD. Symptoms include weight loss and chronic cough. Eating smaller meals, eliminating tobacco and alcohol, avoiding caffeine and peppermint and any other aggravating food, will help alleviate symptoms. Your physician may also prescribe medications called PPI or Proton Pump Inhibitor to help control the acid production in your stomach. Untreated reflux can cause other problems including ulcers in the esophagus, difficulty swallowing, and a precancerous condition called Barrett's esophagus. An upper endoscopy can be performed to determine how much irritation there is and to rule out Barrett's esophagus.

Viral hepatitis is a common contagious disease caused by several viruses that attack the liver. Hepatitis means inflammation of the liver, usually producing swelling and tenderness and sometimes permanent damage to the liver. There are three types of hepatitis. Hepatitis A is caused by fecal contamination of food and water. Although symptoms similar to the flu and fatigue may occur, the disease is rarely life threatening. Hepatitis B is one of the most serious forms of hepatitis with over 300,000 new acute cases each year and an estimated one million carriers in the United States. This disease may lead to scarring of the liver, called cirrhosis, and cancer of the liver. Hepatitis C affects approximately 170,000 Americans each year. It may develop into a chronic form in approximately 50% of patients. Hepatitis B and C are major health problems. Specific blood tests for both hepatitis B and C are necessary to help physicians evaluate whether treatment is indicated. Most people have no symptoms and feel quite healthy. Some individuals will develop fatigue, mild fever, muscle and joint aches, nausea, vomiting, diarrhea, abdominal discomfort and changes in the color of urine and stools. There are specific tests to identify hepatitis B and C.

The esophagus is a muscular tube that extends from the mouth to the stomach, normally entering the stomach through a small hole in the diaphragm. The diaphragm is a muscle that separates the stomach from the chest and helps to keep the stomach in place. It also helps to prevent the reflux of stomach acid back up into the esophagus. Obesity, coughing, vomiting, straining, or sudden physical exertion can cause increased pressure in the abdomen, which allows the upper portion of the stomach to slide up into the chest cavity through the hole in the diaphragm. The portion of the stomach that is now located above the diaphragm is known as a hiatal hernia. Food and acid can accumulate in this hernia "sac" and easily reflux into the esophagus causing heartburn and irritation of the esophagus.

Irritable bowel syndrome (IBS) usually affects a patient's colon or large intestine. IBS is a disorder of the colon but not a disease. A patient who has IBS can have a perfectly healthy colon. IBS is sometimes called spastic colon. A patient with IBS experiences irregular and unnatural contractions of their colon. These abnormal contractions can be painful and uncomfortable and may lead to constipation or diarrhea. Air can accumulate in your colon and produce cramping and bloating. Symptoms can come and go. IBS usually affects patients under 40 years old. Sometimes symptoms can be triggered by certain foods, such as caffeine, alcohol, raw fruits, vegetables, and milk products. However, by far, the most common factor associated with IBS syndrome is stress. The actual cause of IBS is unknown.

The pancreas produces juices and enzymes that flow through the tubes into the intestine, where they mix with food. The enzymes digest fat, protein, and carbohydrates so they can be absorbed by the intestine. Pancreatic juices, therefore, play an important role in maintaining good health. The pancreas also produces insulin, which mixes with the blood flowing through the organ. Insulin is important in regulating the amount of sugar (glucose) in the blood.

Acute pancreatitis occurs when the pancreas becomes quickly and severely inflamed. The main symptoms of pancreatitis are acute, severe pain in the upper abdomen, frequently accompanied by vomiting and fever. The abdomen is tender, and the patient feels and looks severely ill. The condition is treated by resting the pancreas while the tissues heal. This is accomplished through hospitalization, bed rest, intravenous feeding and, at times, the use of certain medications which stop the pancreas from producing enzymes.

Diagnosis of this condition is made by measuring blood enzymes and by performing x-ray and ultrasound exams, as well as a test called an ERCP. In this test, a flexible tube is passed through the mouth into the intestine while the patient is lightly sedated. A small plastic catheter is inserted into the pancreas ducts and an x-ray dye is injected. The internal anatomy of the pancreas can then be viewed.

Ulcerative colitis is a chronic, recurring disease of the large bowel. When ulcerative colitis affects the colon, inflammation and ulcers, or sores, form in the lining of the colon. The disease may involve the entire colon, only the rectum or more commonly, some area between the two.

The cause of ulcerative colitis is unknown. Some experts believe there may a defect in the immune system in which the body's antibodies actually injure the colon. Others speculate that an unidentified microorganism or germ is responsible for the disease. It is probable that a combination of factors, including heredity, may be involved in the cause. The disorder can occur in both sexes, all races and all age groups. It is a disease that usually begins in young people. The disorder typically begins gradually, with crampy abdominal pain and diarrhea that is sometimes bloody. In more severe cases, diarrhea is very severe and frequent. Loss of appetite and weight loss occur. The patient may become weak and very sick. When the disease is localized to the rectum, the symptoms are rectal urgency and passage of small amounts of bloody stool. Usually the symptoms tend to come and go, and there may be long periods without any symptoms at all. Usually, however, they recur.

An ulcer is an open sore that has developed along your digestive tract. Although ulcers can occur in a variety of locations, they are most commonly found in your stomach (gastric ulcers), and the first part of your small bowel known as the duodenum (duodenal ulcers). Ulcers, like any open sore, can be painful but can also cause no symptoms.

Helicobacter pylori (H. pylori) is a bacteria that has been found in the stomach of 60-80% of people with gastric ulcers and in almost all with duodenal ulcers. Physicians believe that an infection with this bacteria in some way acts to cause an ulcer, and ongoing research is being done to determine how this occurs. Ulcers may or may not cause symptoms, and the symptoms can come and go. Common symptoms include burning, crampy or gnawing abdominal pain, nausea and vomiting. Pain usually occurs shortly after a meal or when lying down. Ulcers can also cause internal bleeding which results in black, tarry looking stools. In order to diagnose an ulcer, your physician performs an Upper Endoscopy (EGD) to see the lining of your esophagus and stomach. The physician can also take tissue samples to test for H. pylori.


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