The esophagus is a tube that directs food from the throat to the stomach. Achalasia is a rare swallowing disorder that makes it more challenging for both foods and liquids to go through the esophagus into the stomach. A healthy esophagus can contract and guide food into the stomach, but when the nerves of the esophagus become damaged this can cause the esophagus to become dilated, which means that it can
no longer contract to push food along. If you or someone you know has achalasia, a gastroenterologist can provide you with ways to manage your symptoms.

• Difficulty swallowing
• Regurgitation of food
• Choking (often during regurgitation)
• Indigestion
• Chest discomfort, particularly after eating

1. Surgery: Traditional surgery, known as Heller myotomy, is the most common way to treat achalasia and it involves cutting the muscles of the valves that lie between the stomach and esophagus. Some patients may be candidates for laparoscopic surgery, which is a more minimally invasive technique.
2. Balloon dilation: For patients who may not be able to undergo surgery, another way to treat achalasia is with balloon dilation, which is a non-surgical technique performed under moderate sedation where a balloon is placed into the esophagus and inflated to widen the area so food can easier go from the esophagus into the stomach.
3. Botox: Botox may help to relax muscle spasms and to improve how food flows through the esophagus. Those patients who aren’t candidates for surgery or dilation may want to consider the benefits of Botox.

Approximately 750,000 people in the US are living with ulcerative colitis. While relatively less common than other bowel diseases, you probably can’t go very long without seeing an ad for medications that are designed to treat symptoms of UC. Perhaps you see these ads and realize that the symptoms they are talking about are ones you experience. Could you have ulcerative colitis? Fortunately, your gastroenterologist will be able to shed light on this issue.

• Fatigue
• Anemia
• Fevers
• Joint pain
• Sores and rashes

• Anti-inflammatory drugs such as corticosteroids
• Immunosuppressants reduce inflammation by suppressing the immune system
• Biologics, which also act on the immune system
• Pain relievers
• Dietary changes (eliminating gluten and dairy; limiting fiber intake)
• Stress management techniques
• Exercise
• Supplementation (iron may be prescribed if you have anemia caused by UC)
• Anti-diarrheal medications
• Surgery to remove the colon and rectum (in more severe cases)

Perhaps you’ve heard the news reports saying that everyone should get a colonoscopy after a certain age. Maybe you even remember when Katie Couric of the Today Show got a colonoscopy. This procedure gets a bad rap, but the benefits far outweigh the potential unpleasantness of the procedure itself or even the prep. Screening for colorectal cancer is so important for all men and women, and yet so many people still don’t see a gastroenterologist regularly for screenings. This screening, which usually takes no more than 30 minutes, could just save your life.

• You are a man or woman over the age of 50 (those over 50 years old are at an increased risk for colorectal cancer)
• You have a family history of colorectal cancer or colon polyps
• You have a personal history of cancer or colon polyps
• You’ve been diagnosed with inflammatory bowel disease (Crohn’s disease)
• You are experiencing symptoms of colorectal cancer such as blood in the stool and unexpected weight loss
• You are experiencing gastrointestinal symptoms such as rectal bleeding and abdominal pain (a colonoscopy can diagnose certain intestinal problems)

• Smoking or using tobacco products
• Leading a sedentary lifestyle
• Eating a poor diet that is high in processed foods
• Heavy alcohol consumption

Constipation is the source of plenty of jokes. However, if you deal with it--even occasionally--constipation isn't funny; you just want it resolved. Your gastroenterologist helps many patients with constipation, uncovering reasons for it, and getting people the relief they need. Here's some practical help.

• Certain medications
• Lack of exercise
• Pregnancy
• Excessive amounts of dairy products, including cheese and milk
• Stress
• Not going to the toilet frequently enough
• Irritable bowel syndrome
• Abusing laxatives

• Changing your diet to include fiber
• Drinking plenty of water throughout the day to soften stool
• Staying as active as possible
• Switching routine medications (with your doctor's approval)
• Limited use of laxatives (enemas, glycerin suppositories, stimulant laxatives)
• Daily fiber supplements (psyllium or bran cereals) or stool softeners

When the natural stomach acid produced during digestion reaches your esophagus, it causes what is known as Heartburn or Acid Reflux. It feels like stomach or chest pain, or possibly a burning sensation. You’ve most likely experienced this at some point in your life. It’s a common occurrence after eating very large meals or greasy foods. It’s only when you have heartburn all the time or every meal that you need to see a gastroenterologist.

• Chocolate
• Greasy and fatty foods
• Mint
• Spicy foods
• Onions
• Garlic

If you are experiencing rectal pain or noticing specks of blood on your toilet paper you might be dealing with hemorrhoids. Hemorrhoids, also referred to as piles, are swollen veins that form either inside or outside the rectum. While hemorrhoids are more common as a person gets older, this condition can happen to anyone. Here’s what you should know about this common rectal problem and how you can treat it.

What causes hemorrhoids?

If you have family members that deal with hemorrhoids, you may be more likely to get them too. Any kind of pressure that’s placed on the rectum and impacts the flow of blood can cause these veins to swell. Pressure may be caused by:

• Constipation and straining during bowel movements
• Heavy lifting or intense physical activity
• Being overweight or obese
• A poor diet that is low in fiber
• Pregnancy
• Leading a sedentary lifestyle

How are hemorrhoids diagnosed?

If you’ve never had hemorrhoids before you may want to see your gastroenterologist for a diagnosis, especially if you are experiencing persistent rectal bleeding. Your doctor will go through your medical history and ask questions about your symptoms before performing an exam. A simple rectal exam is usually all that’s needed to diagnose external hemorrhoids. In order to diagnose internal hemorrhoids, you may require further testing such as a colonoscopy or sigmoidoscopy.

How are hemorrhoids treated?

Sometimes hemorrhoids will go away on their own, so you won’t require special care or treatment. Home remedies include:

• Adding more fiber to your diet
• Avoiding straining during bowel movements
• Staying hydrated to aid in better digestion
• Taking a Sitz bath several times a day to ease any pain and discomfort

There are also over-the-counter medications that can alleviate symptoms including pain and itching. If your symptoms persist after using these medications you should talk with your doctor. If the hemorrhoid is large or isn’t responding to other treatment options then your GI doctor may recommend surgery. There are many minimally invasive surgical techniques that can be used to get rid of hemorrhoids.

If you notice rectal pain, bleeding or discomfort that leaves you concerned or worried about your health it’s important that you talk with your gastroenterologist to find out if you need further evaluation. While hemorrhoids may clear on their own, if you don’t experience relief a doctor will be able to help.

7 Tips for Dealing With Indigestion

Suffering from indigestion? Most people have indigestion at some point in their lives. Indigestion, also called dyspepsia, is defined as a persistent or recurrent pain or discomfort in the upper abdomen. The symptoms of indigestion can include abdominal pain, gas, belching, nausea, vomiting, or burning in the upper abdomen or stomach. Here are 7 tips for dealing with indigestion.

1. Keep a food diary. The best way to treat indigestion is to prevent it by avoiding the foods that seem to cause indigestion. Keep a food diary to work out what drinks and foods are triggers for you. Writing down what you ate and the time you ate it can help you deduce what it is that’s causing your symptoms. When possible limit these triggers - common ones include chocolate, caffeine, and spicy food.

2. Eat less. Overeating and late-night meals are the top two triggers that affect many people with indigestion. Eating five small meals per day can help. Breaking down your daily food intake into five small meals makes lighter work for your digestive system. It’s also a good idea not to eat right before bed.

3. Eat slowly. It’s not just what you eat that can cause indigestion; it’s also how quickly you eat. Sit down when you eat your meals. Take your time, chew thoroughly, and give yourself at least 20 minutes before you carry on with your day. Try to avoid lying down too soon after eating.

4. Limit caffeine. If you drink too much caffeine, you may develop indigestion as a side effect. Cut back on your daily fix to see if that helps reduce your symptoms. Caffeine affects your central nervous system and increases stomach acid production. According to Michigan State University, people who drink too much caffeine can develop abdominal pain, heartburn, diarrhea, belching, nausea, and vomiting.

5. Exercise. Exercise can help promote healthy digestion. A recent study shows that exercise can help reduce many digestive problems. In one study, scientists found a link between lack of exercise, obesity, abdominal pain, and symptoms of irritable bowel syndrome. Regular cardiovascular exercise like walking and cycling also helps strengthen abdominal muscles. Don't exercise with a full stomach. Do it before a meal or at least one hour after you eat.

6. Beware of air. Swallowing too much air while eating can cause indigestion. You can help avoid that by chewing with your mouth closed and talking less while eating. You may need to avoid sucking on hard candy or chewing gum, which can lower the amount of air you swallow. If heartburn or acid reflux makes you swallow more frequently, antacids may help.

7. See your doctor. If your indigestion lasts longer than 2 weeks, you should see a gasterontologist. Treatment for indigestion depends on the cause and may include lifestyle changes, medications, and psychological therapies. If stress is causing your symptoms, your doctor may recommend ways to help you reduce your stress, such as relaxation exercises, meditation, or counseling.

Indigestion can significantly diminish your quality of life. Stand up to indigestion and start enjoying life again. Find a board certified gastroenterologist near you and schedule a consultation. Treatment for indigestion will ease your pain and help you get back to a happy and healthy life!

One of the most effective screening methods for detecting the earliest signs of colorectal cancer is through a colonoscopy. A colonoscopy allows a gastroenterologist to be able to examine the lining of the rectum and colon (lower intestines) to look for precancerous polyps and other warning signs. These precancerous polyps can also be removed during a colonoscopy before they have the chance to develop into cancer. This is why colon cancer screenings are so important.

Who should get regular colon cancer screenings?

Men and women who are between the ages of 45 and 75 should see their gastroenterologist for regular colon cancer screenings. While there are other methods for screening for colon cancer (e.g. stool test; flexible sigmoidoscopy) a colonoscopy is the most effective and accurate screening tool available.

If a patient has never had polyps or other precancerous warning signs they may not need to get further colorectal cancer screenings after age 75. Patients with risk factors may require additional routine screenings after the age of 75.

Of course sometimes it’s necessary to get a colon cancer screening before 45 years old. You may benefit from getting tested earlier if:

• You or an immediate family member has a history of colorectal polyps or colon cancer
• You’ve been diagnosed with an inflammatory bowel disease (e.g. Crohn’s disease; ulcerative colitis)
• You lead an inactive, sedentary lifestyle
• You have a poor diet that is high in fat and low in fiber
• You’ve been diagnosed with diabetes
• You are obese
• You are a heavy alcohol consumer
• You are a smoker
• You’ve undergone radiation therapy to treat cancer

If you have any risk factors it’s important that you talk with your gastroenterologist to find out when you should start getting regular screenings and which screening is right for you based on your health coverage.

What should I expect from a colorectal cancer screening?

As we mentioned, the most common screening tool for colon cancer is a colonoscopy. During this procedure we will insert a thin flexible tube (called an endoscope) into the rectum and gently guide it through the large intestines. At the end of this endoscope is a camera. This camera will allow your GI doctor to look for polyps and other problem. If polyps are found they can be removed during your colonoscopy. If nothing is found during your diagnostic testing, a colonoscopy can take as little as 30 minutes. The patient will be under the effects of conscious sedation throughout the procedure.

Do you have questions about getting a colonoscopy? Is it time to schedule your first routine colon cancer screening? If so, then call your intestinal doctor today.

Diverticulitis is a condition in which small pouches or sacs called diverticula form in the large intestine, or colon, and become inflamed. When the sacs are inflamed, they can bulge outward and cause abdominal pain and discomfort. In addition to abdominal pain, several other symptoms can be associated with diverticulitis. If you are experiencing any of the symptoms associated with this condition, see a gastroenterologist for a diagnosis and possible treatment options.

Symptoms & Causes

The exact cause of diverticulitis is unclear. However, there seems to be a link between a diet too low in fiber and the development of diverticulitis. When fiber is lacking in the diet, the colon works harder to move stools through the intestinal tract. It is possible that the pressure from the increased effort to move the stool can lead to the formation of diverticula along the interior of the color or large intestine. Maintaining a diet with sufficient fiber intake can potentially help prevent diverticulitis.

Various symptoms can be associated with diverticulitis. Abdominal pain is a common symptom and tends to be felt primarily on the left side. Other symptoms associated with diverticulitis include:

• fever
• nausea
• vomiting
• chills
• abdominal pain
• cramping
• constipation
• bloating

Treatment

A variety of options are available for treating diverticulitis. For less severe cases, a combination of antibiotics, pain relievers and a liquid diet can be sufficient to resolve the diverticulitis. More serious cases of diverticulitis in which patients cannot drink liquids can require a hospital stay. While in the hospital, all nutrition will be obtained intravenously. Avoiding eating and drinking by mouth gives the bowel time to rest and recover and can help clear up the diverticulitis. If the condition is still severe, surgery might be required.

Diverticulitis can result in a lot of pain and discomfort. Fortunately, there are treatments that can provide relief. See a gastroenterologist for diagnosis and a treatment plan.

What is a Flexible Sigmoidoscopy?

A flexible sigmoidoscopy is a critical diagnostic tool to evaluate the health of your large intestine, or colon. An ultra-thin, flexible tube called a sigmoidoscope is inserted in the rectum and guided up through the intestine.

The tube contains a tiny camera at the end which provides the doctor with a view of your sigmoid colon, which is the last two feet of the large intestine. The sigmoidoscope also allows the doctor to take samples of tissue for later biopsy. Tissue biopsy is the definitive way to determine whether there are precancerous or cancerous changes in your tissue cells.

The sigmoidoscopy procedure is often combined with a colonoscopy because the sigmoidoscope doesn’t show the entire colon, only the lower portion. Sigmoidoscopy may be recommended over colonoscopy because it often doesn’t require anesthesia and is a faster procedure than colonoscopy.

A flexible sigmoidoscopy can be used to determine the cause of intestinal problems like abdominal pain and bowel issues like diarrhea and constipation. It is also used to look for abnormal growths or polyps. It is also a vital tool to screen for colon and rectal cancer.

Flexible sigmoidoscopy may be recommended if you are over 50 years old to help detect colon and rectal cancer in the early stages, when it is the most treatable. Colorectal cancer is the third leading cause of cancer-related deaths in the United States, according to the American Cancer Society. Each year, about 150,000 new cases are diagnosed in this country, and 50,000 people will die of the disease.

The flexible sigmoidoscopy procedure is a safe, effective way to determine the health of your sigmoid colon. It is a vital tool in maintaining your good health. If you are having abdominal issues, or you are at least 50 years old, a flexible sigmoidoscopy can help you. Your doctor can tell you more about flexible sigmoidoscopy and other procedures to help you feel better.

If you’ve been dealing with gastroesophageal reflux disease (GERD) and you have either been ignoring your symptoms or haven’t been able to get them under control then you could end up dealing with Barrett’s esophagus, a serious complication of GERD that causes the lining of the esophagus to mimic the lining of the intestines.

There are no unique symptoms associated with Barrett’s esophagus, as many of the symptoms are the same as they are for GERD; however, a reason that patients shouldn’t ignore symptoms of GERD is that Barrett’s esophagus can increase the likelihood of developing an extremely serious and life-threatening cancer of the esophagus.

Symptoms to be on the look out for include:

• Heartburn
• A burning sensation in the back of the throat
• Persistent cough
• Laryngitis
• Nausea

Even though Barrett’s esophagus is not a common complication of acid reflux, if someone experiences persistent acid reflux this can alter the cells within the esophagus over time to resemble the cells found in the lining of the intestines.

You may be screened with Barrett’s esophagus if you have some of these risk factors:

• Male
• Over 50 years old
• Hiatal hernia
• Chronic GERD
• Obesity or being overweight

A gastroenterologist will guide a small flexible tube, known as an endoscope, into the throat and down into the esophagus. This is performed under light sedation. At the end of the endoscope is a camera that allows a gastroenterology doctor to take a biopsy of the lining of the esophagus.

The biopsy sample will be tested for cancer or any precancerous cells. If Barrett’s esophagus is detected in the sample, further endoscopies may be required in the future to detect early warning signs of cancer.

Treating Barrett’s Esophagus

While this condition cannot be reversed there are ways to at least slow down or even prevent the condition from getting worse by getting your acid reflux under control. This can be done through a variety of lifestyle changes (e.g. quitting smoking; changing diet; losing weight) and either over-the-counter or prescription medications (e.g. H2 blockers; proton pump inhibitors).

If you are dealing with acid reflux a few times a week then it’s time to turn to a gastroenterologist for more information. By getting your GERD under control as soon as possible you could prevent complications such as Barrett’s esophagus. Call your gastroenterologist today.