Gastroenterology is the study of medical diseases of the G.I. tract. This includes the esophagus, stomach, small intestines,and colon. In addition, a gastroenterologist treats medical diseases of the liver, gall bladder and pancreas. Illnesses that are treated by gastroenterologists include acid reflux, ulcers, hepatitis, colitis and irritable bowel syndrome.

By using an endoscope – a flexible, lighted tube that enables the physician to see inside the G.I. tract – a gastroenterologist can remove polyps (small growths) and take biopsies throughout the gut. In this way, colon cancer can be diagnosed early, to result in a cure; or can even be prevented through the removal of polyps.

Acid Reflux Disease

Acid Reflux Disease is a condition in which acid and stomach contents flow back into the esophagus. This condition is often characterized by symptoms of heart burn and regurgitation. Other symptoms of acid reflux could include asthma, cough, and pneumonia as well as halitosis and dental disease.

If left untreated, acid reflux can result in chronic pain, difficulty swallowing, and internal bleeding. Although uncommon, untreated acid reflux can predispose a patient to esophageal cancer.

Acid reflux can often be diagnosed on clinical grounds. Sometimes tests are conducted and these might include x-rays or endoscopy. Endoscopy involves a look into the esophagus and stomach with a lighted tube while the patient is sedated.

Treatment of acid reflux should begin with dietary and lifestyle modifications. Smoking increases acid reflux and should be avoided. Coffee, tea, alcohol, chocolate, peppermint and fatty foods should be kept to a minimum. Late night snacks should be avoided as reflux can be worse at night; it is often recommended that patients elevate the head of the bed when sleeping.

Medicines are often employed in the treatment of acid reflux disease. Antacids, over-the-counter medications, and prescription drugs are effective. On occasion, surgery is used to prevent reflux.

Peptic Ulcer Disease

Peptic Ulcer Disease is a condition in which a portion of the linings of the stomach or duodenum (an area of the intestines) has been eroded. In the past, it was believed that ulcers were caused by stress or nerves. It is now known that a bacterial infection of the stomach is the most common cause of ulcers. In addition, aspirin, anti-inflammatory medication, alcohol, and tobacco can complicate ulcers.

The symptoms of an ulcer can be variable, but the main characteristic is abdominal pain. Usually, the pain is worse between meals and will wake the patient at night. Food or antacids often give prompt relief of the pain. Ulcers can bleed; this can result in black or bloody bowel movements, vomiting blood, or sometimes anemia.

Ulcer disease is diagnosed with x-rays or with endoscopy. Endoscopy is a procedure that involves the patient swallowing a lighted tube while under sedation.

Ulcers are treated with antacids as well as over-the-counter or prescription medications. If it is determined that the ulcer is caused by bacterial infection, antibiotics are used. Thanks to modern drugs, surgery is rarely required.

Colon Cancer Screening

Colon cancer is the second leading cause of cancer death for both men and women. The reason that colon cancer is so deadly is that it causes no symptoms. By the time a patient has symptoms and presents to the doctor, the disease is advanced and often too far advanced to be cured. Yet, it has been shown that diagnosing colon cancer at an early stage usually results in an easy cure. The only way to diagnose early colon cancer is to screen for it.

There are many ways to screen for colon cancer. Over the years, doctors have used different techniques including a digital rectal exam, testing the stool for blood, and viewing the lower portion of the colon. More recently, the American Cancer Society has recommended colonoscopy as a routine means of colon cancer screening in men and women over the age of fifty.

Colonoscopy involves placing a lighted tube into the rectum and advancing it throughout the entire colon. This is done with the patient sedated by intravenous medication. In this way the examination is completely painless. The exam is done in an outpatient setting, either in a doctor’s office or an outpatient facility, such as the Ambulatory Surgery Pavilion at NSUH-Plainview.

When colon cancer is found by screening an asymptomatic patient, it is almost always found in an early stage and can easily be cured. In addition, small benign growths called polyps can be discovered with colonoscopy. The polyps can be removed during the colonoscopy this has been shown to prevent colon cancer.

Colonoscopy is perhaps the most important tool when it comes to screening for colon cancer. Not only will it detect colon cancer at an early, curable stage, but it also offers the potential for the prevention of colon cancer.

Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is the most common of all G.I. diseases. It is the most common reason to see a doctor. More money is spent on IBS and more time is lost from work because of IBS than any other G.I. illness.

IBS is characterized by irregular bowel habits and lower abdominal crampy pain. Bowel habit changes may be diarrhea, constipation or alternation of these two symptoms. There is often frequency and urgency to the bowel movement. Some patients complain of an incomplete bowel movement. The pain of IBS is usually low in the abdominal area and on the left side. It is often described as a cramp. It may be worse just before a bowel movement, and the movement may provide some relief. While symptoms of IBS may be very debilitating, they almost never wake the patient from sleep.

The cause of IBS is not completely clear. It appears to be due to abnormal contractions and spasms of the intestines. IBS is referred to as a functional disease; that is, there is no physical or structural abnormality of the G.I. tract. The diagnosis is made by the typical symptom complex and the lack of other symptoms that might be the result of more serious diseases.

IBS is not a serious condition. It will never become serious, and does not lead to cancer or other medical conditions. However, it is a chronic illness that will come and go throughout a patient’s life. The cornerstones of therapy are education, understanding, and reassurance. Added fiber will help regulate bowel movements and will decrease pain. On occasion, anti-spasmodic medications are given to relieve pain. Most recently, a newer medication, Zelnorm, has been developed to relieve the symptoms of IBS. This medication works directly on the chemical transmitters that influence the way the intestines contract.

Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD) is an inflammatory condition of the small intestine as well as the large intestine or colon. The two conditions, Ulcerative Colitis and Chron's Disease, are of unknown cause but very effective treatments exist for both. Symptoms range from overt, bloody diarrhea to non-bloody diarrhea, abdominal pain, and perhaps fever. The two conditions can be diagnosed by x-ray procedures or perhaps colonoscopy. They can be treated by diet, oral medications, and in severe cases, intravenous medications. With our present array of medications, most patients can lead healthy and productive lives.