Gastroenterology

Gastroenterology is a branch of medicine dealing with treatment of digestive system disorders and diseases.

Asked by Rodrigo Schoen in Gastroenterology, Health

Why do I sometimes feel nauseous when I'm really hungry?

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I feel you—I get that a lot, too. There are two likely friendus. One is that your stomach produces excess acid when you’ve been ignoring your hunger for a while, and that acid can splash up into your esophagus and cause nausea. The other possibility is that you’re extra sensitive to ghrelin, the hormone our bodies make to alert us to our hunger. For some people, high levels of that hormone can make them slightly nauseous. If your nausea is severe, though, you should definitely talk to your doctor about it—it could be a sign of metabolic syndrome.
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What is gastroenterology oncology?

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The medical field of cancer of the GI tract.
Asked in Drug Side Effects, Medication and Drugs, Stomach and Abdominal Pain, Gastroenterology

What is pantoprazole sod 40 mg tab dr used for?

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stomach ulcers Pantoprazole is used for short-term treatment of erosion and ulceration of the esophagus caused by gastroesophageal reflux disease. Uses: Stomach ulcers and esophagus problems (such as acid reflux). It works by decreasing the amount of acid in your stomach makes. This medication relieves symptoms such as heartburn, difficulty swallowing, and persistent cough.. It helps heal acid damage to the stomach and esophagus, helps prevent ulcers, and may help prevent cancer of the esophagus. Pantoprazole belongs to a class of drugs known as proton pump inhibitors (PPIs).
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What are the duties of a gastroenterology?

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To assess ur digestive system functions thru scoping(endoscopy/colonscopy) and provide diagnosis and treatment(surveillance/medications/etc) for best possible patient outcomes.
Asked in Chemistry, Gastroenterology

What gas condense first?

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When cooling down (and/or compressing) a gas mixture, the first condensing gas has the highest boiling (= condensation) point temperature, in other words the least volatile compound.
Asked in Medication and Drugs, Gastroenterology

What is gastroenterology?

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Gastroenterology is the study of the digestive tract from beginning (mouth and esophagus) to the end (rectum and anus), and all organs and tissues in-between. Gastroenterology also includes the liver, pancreas, gall bladder, and biliary tree, but this is a sub-speciality commonly referred to as Hepatology. A gastroenterologist doctor diagnoses, treats and prevents many different digestive conditions and diseases including common ones such as indigestion, ulcers, irritable bowel syndrome and hemorrhoids, as well as other more serious cases such as colon cancer, Crohn's Disease and Diverticulitis. A GI doctor is the one who performs common preventive procedures including colon cancer screening for middle-aged men, and hemorrhoid removal for older patients.
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Bowel retraining?

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Alternative Names Fecal incontinence exercises Information A program of bowel retraining, Kegel exercises, or biofeedback therapy may be used by people with: Fecal incontinence Nerve problems (such as from multiple sclerosis or other conditions) Severe constipation The bowel program has several steps that help with regular bowel movements. Within a few weeks of beginning a bowel program, most people can have regular bowel movements. Before starting a bowel training program, get a thorough physical examination. Your health care provider can find the cause of the fecal incontinence and treat any correctable disorders, such as a fecal impaction or infectious diarrhea. The doctor will use your history of bowel habits and lifestyle as a guide for setting new bowel movement patterns. DIET The following dietary changes can help promote regular, soft, bulky stools: Add high-fiber foods to your diet, including whole-wheat grains, fresh vegetables, and beans. Use products containing psyllium, such as Metamucil, to add bulk to the stools. Try to drink 2 - 3 liters of fluid a day (unless you have a medical condition, such as kidney or heart disease, that requires you to restrict your fluid intake). BOWEL TRAINING You can use digital stimulation to trigger a bowel movement: Insert a lubricated finger into the anus and make a circular motion until the sphincter relaxes. This may take a few minutes. After you have done the stimulation, sit in a normal posture for a bowel movement. If you are able to walk, sit on the toilet or bedside commode. If you are confined to the bed, use a bedpan. Get into as close to a sitting position as possible, or use a left side lying position if you are unable to sit. Try to get as much privacy as possible. Some people find that reading while sitting on the toilet helps them relax enough to have a bowel movement. If digital stimulation does not produce a bowel movement within 20 minutes, repeat the procedure. Try to contract the muscles of the abdomen and bear down while releasing the stool. Some people find it helpful to bend forward while bearing down. This increases the abdominal pressure and helps empty the bowel. Perform digital stimulation every day until you establish a pattern of regular bowel movements. You can also stimulate bowel movements by using a suppository (glycerin or Dulcolax) or a small enema. Some people drink warm prune juice or fruit nectar to stimulate bowel movements. Consistency is crucial for the success of a bowel retraining program. Establish a set time for daily bowel movements. Choose a time that is convenient for you, keeping in mind your daily schedule. The best time for a bowel movement is 20 - 40 minutes after a meal, because feeding stimulates bowel activity. Within a few weeks, most people are able to establish a regular routine of bowel movements. KEGEL EXERCISES Strengthening the tone of the rectal muscles may help achieve some degree of bowel control in people who have an incompetent rectal sphincter. Kegel exercises strengthen pelvic and rectal muscle tone. These exercises were first developed to control incontinence in women after childbirth. To be successful with Kegel exercises, use the proper technique and stick to a regular exercise program. BIOFEEDBACK Biofeedback gives you sound or visual feedback about a bodily function, such as muscle activity. In people with fecal incontinence, biofeedback is used to strengthen the rectal sphincter. A rectal plug is used to monitor the strength of the rectal muscles. A monitoring electrode may be placed on the abdomen. The rectal plug is then attached to a computer monitor, which displays a graph showing rectal muscle contractions and abdominal contractions. You are taught how to squeeze the rectal muscle around the rectal plug. The computer display guides you to make sure you are using the correct technique. You should see an improvement in your symptoms after three sessions. References Bartz S. Constipation and fecal incontinence. In: Ham RJ, Sloane PD, Warshaw GA, Bernard MA, Flaherty E, eds. Primary Care Geriatrics: A Case-Based Approach. 5th ed. Philadelphia, Pa: Elsevier Mosby; 2006:chap 23. Mellgren A. Fecal incontinence.Surg Clin North Am. 2010 Feb;90(1):185-94. Reviewed By Review Date: 07/22/2010 Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Hepatitis virus panel?

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Definition The hepatitis virus panel is a series of blood tests used to detect current or past infection by hepatitis A, hepatitis B, or hepatitis C. It can screen blood samples for more than one kind of hepatitis virus at the same time. Antibody and antigen tests can detect each of the different hepatitis viruses. Note: Hepatitis D only causes disease in people who also have hepatitis B. It is not routinely checked on a hepatitis antibody panel. Alternative Names Hepatitis A antibody test; Hepatitis B antibody test; Hepatitis C antibody test; Hepatitis D antibody test How the test is performed Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood. Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding. In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding. The blood sample is sent to a laboratory for examination. Blood (serology) tests are used to check for antibodies to each of the hepatitis viruses. How to prepare for the test No special preparation is needed. How the test will feel When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing. Why the test is performed Your doctor may order this test if you have signs of hepatitis. It is used to: Detect current or previous hepatitis infection Determine how contagious a person with hepatitis is Monitor a person who is being treated for hepatitis Other conditions under which the test may be performed: Chronic persistent hepatitis Delta agent (hepatitis D) Nephrotic syndrome Normal Values A normal result means no hepatitis antibodies are found in the blood sample. This is called a negative result. Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results. What abnormal results mean There are different tests for hepatitis A and B. A positive test is considered abnormal. A positive test may mean: You currently have a hepatitis infection. This may be a new infection (acute hepatitis), or it may be an infection that you have had for a long time ( chronic hepatitis). You had a hepatitis infection in the past, but you no longer have the infection and cannot spread it to others. Hepatitis A test results: IgM anti-hepatitis A virus (HAV) antibodies -- you have had a recent infection with hepatitis A Total (IgM and IgG) antibodies to hepatitis A -- you have a previous or past infection, or immunity to hepatitis A Hepatitis B tests: Hepatitis B surface antigen (HBsAg) -- you have an active hepatitis B infection, either recent or chronic Antibody to hepatitis B core antigen (Anti-HBc) -- you have a recent or past hepatitis B infection Antibody to HBsAg (Anti-HBs) You have a past hepatitis B infection You have received the hepatitis B vaccine and are unlikely to become infected Hepatitis B type e antigen (HBeAg) You have a chronic hepatitis B infection You are more likely to spread the infection to others through sexual contact or by sharing needles Antibodies to hepatitis C can usually be detected 4 - 10 weeks after the infection occurs. Other types of tests may be done to decide on treatment and monitor the hepatitis C infection. What the risks are Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others. Other risks associated with having blood drawn are slight but may include: Excessive bleeding Fainting or feeling light-headed Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken) References Hoofnagle JH. Acute viral hepatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 151. Wilkins T, Malcolm JK, Raina D, Schade RR. Hepatitis C: diagnosis and treatment. Am Fam Physician. 2010;81:1351-1357. Dienstag JL. Hepatitis B virus infection. N Engl J Med. 2008;359:1486-1500. Reviewed By Review Date: 12/13/2010 George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Traveler's diarrhea diet?

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Definition Traveler's diarrhea is loose, watery stools. People can get traveler's diarrhea when they visit places where the water is not clean or the food is not handled safely. This can include third-world or developing countries in Latin America, Africa, the Middle East, and Asia. This article discusses what you should eat or drink if you have traveler's diarrhea. See also: Diarrhea Alternative Names Diet - traveler's diarrhea; Diarrhea - traveler's - diet Function Bacteria and other substances in the water and food can cause traveler's diarrhea. People living in these areas often don't get sick because their bodies are used to the bacteria. You can lower your risk for getting traveler's diarrhea by avoiding water, ice, and food that may be contaminated. The goal of the traveler's diarrhea diet is to make your symptoms better and prevent you from getting dehydrated. Side Effects Traveler's diarrhea is rarely dangerous in adults. It can be more serious in children. Recommendations How to prevent traveler's diarrhea: Water: Do not use tap water to drink or brush your teeth. Do not use ice made from tap water. Use only boiled water (boiled for at least 5 minutes) for mixing baby formula. For infants, breastfeeding is the best and safest food source. However, the stress of traveling may reduce the amount of milk you make. Other drinks: Drink only pasteurized milk. Drink bottled drinks if the seal on the bottle hasn't been broken. Sodas and hot drinks are usually safe. Food: Do not eat raw fruits and vegetables unless you peel them. Do not eat raw leafy vegetables (e.g. lettuce, spinach, cabbage) because they are hard to clean. Do not eat raw or rare meats. Avoid shellfish. Do not buy food from street vendors. Eat hot, well-cooked foods. Heat kills the bacteria. But do not eat hot foods that have been sitting around for a long time. Sanitation: Wash hands often. Watch children carefully so they do not put things in their mouths or touch dirty items and then put their hands in their mouths. If possible, keep infants from crawling on dirty floors. Check to see that utensils and dishes are clean. There is no vaccine against traveler's diarrhea. Your doctor may recommend medicines to help lower your chances of getting sick. Taking two tablets of Pepto-Bismol four times a day before you travel and while you are traveling can help prevent diarrhea. Do not take Pepto-Bismol for more than 3 weeks. Most people do not need to take antibiotics every day to prevent diarrhea while traveling. People who are at risk for more dangerous infections (because chronic bowel diseases, kidney disease, cancer, diabetes, or HIV) should talk to their doctor before traveling. If you have diarrhea, follow these tips to help you feel better: Drink 8 to 10 glasses of clear fluids every day. Water is best. Drink at least 1 cup of liquid every time you have a loose bowel movement. Eat small meals every few hours instead of three big meals. Eat some salty foods, such as pretzels, soup, and sports drinks. Eat foods that are high in potassium, such as bananas, potatoes without the skin, and fruit juices. Dehydration means your body does not have as much water and fluids as it should. It is a very big problem for children or people who are in a hot climate. Signs of severe dehydration include: Decreased urine (fewer wet diapers in infants) Dry mouth Sunken eyes Few tears when crying Give your child fluids for the first 4 - 6 hours. At first, try 1 ounce (2 tablespoons) of fluid every 30 to 60 minutes. You can use an over-the-counter drink, such as Pedialyte or Infalyte. Do not add water to these drinks. You can also try Pedialyte popsicles. Fruit juice or broth with water added to it may also help. These drinks can give your child important minerals that are being lost in the diarrhea. If you are breastfeeding your infant, keep doing it. If you are using formula, use it at half-strength for two to three feedings after the diarrhea starts. Then you can begin regular formula feedings. In third-world countries, many health agencies stock packets of salts to mix with water. If these fluids are not available, you can make an emergency solution by mixing: 1/2 teaspoon of salt 2 tablespoons sugar or rice powder 1/4 teaspoon potassium chloride (salt substitute) 1/2 teaspoon trisodium citrate (can be replaced with baking soda) 1 liter of clean water If you or your child has symptoms of severe dehydration, or if you have a fever or bloody stools, get medical attention right away. References Arguin P. Approach to the patient before and after travel. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 308. Hill DR, Ericsson CD, Pearson RD, et al. The practice of travel medicine: guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006;43:1499-1539. Ericsson CD. Travel medicine. In: Auerbach PS, ed. Wilderness Medicine. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 77. Reviewed By Review Date: 02/07/2011 George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Colon cancer screening?

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Alternative Names Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening Information Colon cancer screening can detect polyps and early cancers. Such screening can find abnormalities that can be treated before cancer develops or spreads. Regular screenings may decrease deaths and prevent pain caused by colorectal cancer. TOOLS OR TESTS Several tools may be used, either alone or together, to screen for colon cancer: The first method is a stool test that checks your bowel movements for blood. Polyps in the colon and smaller cancers often cause small amounts of bleeding that cannot be seen with the naked eye. The most common method used is the fecal occult blood test (FOBT). Newer stool tests are called the fecal immunochemical test (FIT) and stool DNA test (sDNA). The second method is a sigmoidoscopy exam. This test uses a flexible small scope to look at the lower part of your colon. Because it only looks at the last one-third of the large intestine (colon), it may miss some cancers. A stool test and sigmoidoscopy should be used together. The third method is a colonoscopy. A colonoscopy is similar to a sigmoidoscopy, but the entire colon can be viewed. You will usually be mildly sedated during a colonoscopy. Two other methods may be used: Double-contrast barium enemy, a special x-ray of the large intestine, which includes the colon and rectum Virtual colonoscopy -- a type of x-ray that uses computer software to create an image A test called capsule endoscopy (swallowing a small, pill-sized camera) is also being studied, but it is not recommended for standard screening at this time. SCREENING FOR AVERAGE-RISK PEOPLE There is not enough evidence to state which screening method is best. Discuss with your doctor which test is most appropriate for you. Beginning at age 50, both men and women should have a screening test. Some health care providers recommend that African Americans begin screening at age 45. Screening options for patients with an average risk for colon cancer: Colonoscopy every 10 years Double-contrast barium enema every 5 years Fecal occult blood test (FOBT) every year - if results are positive, a colonoscopy is needed Flexible sigmoidoscopy every 5 - 10 years, usually with stool testing FOBT done every 1 - 3 years Virtual colonoscopy every 5 years SCREENING FOR HIGHER-RISK PEOPLE People with certain risk factors for colon cancer may need earlier (before age 50) or more frequent testing. More common risk factors are: A family history of inherited colorectal cancer syndromes, such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC) A strong family history of colorectal cancer or polyps. This usually means first-degree relatives (parent, sibling, or child) who developed these conditions younger than age 60. A personal history of colorectal cancer or polyps A personal history of chronic inflammatory bowel disease (for example, ulcerative colitis or Crohn's disease) Screening for these groups of people is more likely to be done using colonoscopy. See also: Colon cancer References Whitlock EP, Lin JS, Liles E, Beil TL, Fu R. Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;149:638-658. Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM; American College of Gastroenterology. American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected]. Am J Gastroenterol. 2009;104:739-750. Lieberman DA. Clinical practice. Screening for colorectal cancer. N Engl J Med. 2009;361:1179-1187. Burt RW, Barthel JS, Dunn KB, et al. NCCN clinical practice guidelines in oncology. Colorectal cancer screening. J Natl Compr Canc Netw. 2010;8:8-61. Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin. 2008;58:130-160. Reviewed By Review Date: 11/08/2010 George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Barrett's esophagus?

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Definition Barrett's esophagus is a disorder in which the lining of the esophagus (the tube that carries food from the throat to the stomach) is damaged by stomach acid and changed to a lining similar to that of the stomach. See also: Gastroesophageal reflux - discharge Gastroesophageal reflux disease (GERD) Causes, incidence, and risk factors When you eat, food passes from your throat to your stomach through the esophagus (also called the food pipe or swallowing tube). Once food is in the stomach, a ring of muscles keeps it from leaking backward into the esophagus. If these muscles do not close tightly, stomach acid can leak back into the esophagus. This is called reflux or gastroesophageal reflux. Reflux may cause symptoms of heartburn. It may also damage the lining of the esophagus. The esophagus lining then changes in appearance and looks like the stomach lining (Barrett's esophagus). Barrett's esophagus occurs more often in men than women. You are more likely to have this condition if you have had GERD for a long time. Patients with Barrett's esophagus may develop more changes in the esophagus called dysplasia. When dysplasia is present, the risk of getting cancer of the esophagus increases. Symptoms Barrett's esophagus itself does not cause symptoms. The acid reflux that causes Barrett's esophagus often leads to symptoms of heartburn. However, many patients with this condition do not have symptoms. Signs and tests If GERD symptoms are severe or they come back after you have been treated, the doctor may perform an endoscopy. A thin tube with a camera on the end is inserted through your mouth and then passed into your esophagus and stomach. While looking at the esophagus with the endoscope, the doctor may perform biopsies in different parts of the esophagus. These biopsies help diagnose Barrett's esophagus, and look for changes that could lead to cancer. People with Barrett's esophagus have an increased risk for esophageal cancer. Still, only a small number of people with Barrett's esophagus develop cancer. Your health care provider may recommend a follow-up endoscopy to look for changes that may lead to cancer (dysplasia), or for cancer itself. Treatment TREATMENT OF GERD Treatment should improve acid reflux symptoms, and may keep Barrett's esophagus from getting worse. Treatment may involve lifestyle changes and medications such as: Antacids after meals and at bedtime Histamine H2 receptor blockers Proton pump inhibitors Lifestyle changes, medications, and anti-reflux surgery may help with symptoms of GERD, but will not make Barrett's esophagus go away. TREATMENT OF BARRETT'S ESOPHAGUS Surgery or other procedures may be recommended if a biopsy shows cell changes that are very likely to lead to cancer. Such changes are called severe or high-grade dysplasia. Some of the following procedures remove the harmful tissue in your esophagus, where the cancer is most likely to develop. Photodynamic therapy (PDT) uses a special laser device, called an esophageal balloon, along with a drug called Photofrin. Other procedures use different types of high energy to destroy the precancerous tissue. Surgery removes the abnormal lining. Expectations (prognosis) Treatment should improve acid reflux symptoms and may keep Barrett's esophagus from getting worse. None of these treatments will reverse the changes that may lead to cancer. Calling your health care provider Call your health care provider if: Heartburn lasts for longer than a few days, or you have pain or difficulty swallowing. You have been diagnosed with Barrett's esophagus and your symptoms get worse, or new symptoms (weight loss, problems swallowing) develop. Prevention Diagnosis and treatment of GERD may prevent Barrett's esophagus. References Spechler SJ, Souza RF. Barrett's esophagus. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 44. Wang, KK and Sampliner RE. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett's esophagus. Am J Gastroenterol. 2008;103:788-797. Shaheen NJ, Sharma P, Overholt BF, Wolfsen HC, Sampliner RE, Wang KK, et al. Radiofrequency ablation in Barrett's esophagus with dysplasia. N Engl J Med. 2009;360:2277-2288. Reviewed By Review Date: 08/11/2011 George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Colitis?

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Definition Colitis is swelling (inflammation) of the large intestine (colon). Causes, incidence, and risk factors Colitis can have many different causes, including: Infections, including those caused by a virus, parasite, and food poisoning due to bacteria Inflammatory disorders (ulcerative colitis and Crohn's disease) Lack of blood flow (ischemic colitis) Past radiation to the large bowel See also: CMV colitis Cryptosporidium enterocolitis Necrotizing enterocolitis Pseudomembranous colitis Symptoms Symptoms can include: Abdominal pain and bloating that is constant or comes and goes Bloody stools Chills Constant urge to have a bowel movement Dehydration Diarrhea Fever Signs and tests The health care provider will perform a physical exam and ask questions about your symptoms, including: How long you have had the symptoms How severe your pain is How often it occurs How long it lasts How often you have diarrhea Whether you have been traveling The health care provider can diagnose colitis by inserting a flexible tube into the rectum (flexible sigmoidoscopy or colonoscopy) and evaluating specific areas of the colon. Biopsies taken during these tests may show changes related to inflammation. Other studies that can identify colitis include: Abdominal CT scan Abdominal MRI Abdominal x-ray Barium enema Treatment Treatment is directed at the cause of disease (infection, inflammation, lack of blood flow, or another cause). See the conditions listed above for specific recommendations. Expectations (prognosis) The prognosis varies with each disease. See particular conditions listed above. Complications Bleeding Hole in the colon Toxic megacolon Sore (ulceration) Calling your health care provider Call your health care provider if you have symptoms such as: Abdominal pain that does not get better Blood in the stool or stools that look black Diarrhea or vomiting that does not go away Swollen (distended) abdomen Prevention Prevention depends upon the cause of colitis. See the specific condition. Reviewed By Review Date: 10/16/2011 George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Colorectal polyps?

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Definition A colorectal polyp is a growth that sticks out of the lining of the colon or rectum. Alternative Names Intestinal polyps; Polyps - colorectal; Adenomatous polyps; Hyperplastic polyps; Villous adenomas Causes, incidence, and risk factors Polyps of the colon and rectum are usually benign, meaning they are not cancer and they do not spread. There may be one or many polyps, and they become more common as people age. Common polyps include: Adenomatous polyps may develop into colon cancer over time. Hyperplastic polyp usually do not develop into colon cancer. Polyps bigger than 1 centimeter have a greater cancer risk than polyps under 1 centimeter. Risk factors include: Age Family history of colon cancer or polyps A type of polyp called villous adenoma Polyps may also be associated with some inherited disorders, including: Familial adenomatous polyposis Gardner syndrome Juvenile polyposis Lynch syndrome (HNPCC) Peutz-Jeghers syndrome Symptoms There are usually no symptoms. However, the following symptoms may occur: Blood in the stools Diarrhea (rare) Fatigue caused by losing blood over time Signs and tests The health care provider will perform a physical exam. Usually, polyps cannot be felt. However, if one is large enough, it may be felt during a rectal exam. Most polyps are found with the following tests: Barium enema Colonoscopy Sigmoidoscopy Stool test for hidden (occult) blood Virtual colonoscopy Treatment Because colorectal polyps can develop into cancer, they should be removed. In most cases, the polyps may be removed while a colonoscopy is being performed. Colonoscopy prevents colon cancer by removing polyps before they can become cancer. People over age 50 should consider having a colonoscopy or other screening test. Those with a family history of colon cancer or colon polyps may need to be screened at an earlier age. For patients with adenomatous polyps, new polyps can appear in the future. Follow-up colonoscopy is usually recommended 1 to 10 years later, depending on the: Patient's age and general health Number of polyps Size and characteristics of the polyps Rarely, for polyps that are very likely to become cancerous, the health care provider may recommend a colectomy (removing part of the colon). Expectations (prognosis) The outlook for patients with colorectal polyps is excellent if the polyps are removed. Polyps that are left behind can develop into cancer over time. Complications Polyps can cause bleeding, and over time, can develop into cancers. Calling your health care provider Call your health care provider if you have Blood during a bowel movement Change in bowel habits Prevention The following is recommended to reduce the risk of developing polyps: Eat a diet low in fat and high in fruits, vegetables, and fiber Avoid smoking and excessive alcohol intake Maintain a normal body weight Colonoscopy prevents colon cancer by removing polyps before they can become cancer. People over age 50 should consider having a colonoscopy or other screening test, which makes earlier diagnosis and treatment possible. This may reduce the odds of developing colon cancer, or at least help catch it in its most treatable stage. Those with a family history of colon cancer or colon polyps may need to be screened at an earlier age. Taking aspirin or similar medicines may help reduce your risk for new polpys. However, such medicines can have serious side effects if you take them for a long time. Side effects include bleeding from your stomach or colon and heart disease. Talk with your doctor before taking these medicines. See: Physical exam frequency for further recommendations about having a screening test. References Burt RW, Barthel JS, Dunn KB, et al. NCCN clinical practice guidelines in oncology. Colorectal cancer screening. J Natl Compr Canc Netw. 2010 Jan;8(1):8-61. Cooper K, Squires H, Carroll C, et al. Chemoprevention of colorectal cancer: systematic review and economic evaluation. Health Technol Assess. 2010 Jun;14(32):1-206. Reviewed By Review Date: 10/16/2011 George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Esophageal perforation?

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Definition An esophageal perforation is a hole in the esophagus, the tube through which food passes from the mouth to the stomach. Alternative Names Perforation of the esophagus Causes, incidence, and risk factors A perforation is a hole through which the contents of the esophagus can pass into the mediastinum, the surrounding area in the chest. This often results in infection of the mediastinum (mediastinitis). The most common cause of an esophageal perforation is injury during a medical procedure. However, because flexible instruments are now used this rarely occurs. The esophagus may also become perforated as the result of: A tumor Gastric reflux with ulceration Previous surgery on the esophagus Swallowing a foreign object or caustic chemicals, such as household cleaners, disk batteries, and battery acid Trauma or injury to the chest and esophagus Violent vomiting Less common causes include injuries to the esophagus area (blunt trauma) and injury to the esophagus during an operation on another organ near the esophagus. Symptoms The main symptom is pain at first. Patients with a perforation in the middle portion or lowermost portion of the esophagus may have difficulty swallowing, chest pain, and difficulty breathing. Signs and tests Signs include: Fast breathing Fever Low blood pressure Rapid heart rate Patients with a perforation in the top part of the esophagus may have neck pain or stiffness and air bubbles underneath the skin. A chest x-ray may reveal air in the soft tissues of the chest, fluid that has leaked from the esophagus into the space around the lungs, or a lung collapse. A chest CT scan may show an abscess in the chest or esophageal cancer. X-rays taken after you drink a non-harmful dye can help pinpoint the location of the perforation. Treatment Many patients need early surgery, depending on the location and size of the perforation. If surgery is done, it is best to have it within 24 hours of when the perforation occurred. Treatment may include: Administering fluids through a vein (IV) Administering IV antibiotics to prevent or treat infection Draining fluid that has collected around the lungs with a chest tube Mediastinoscopy to remove fluid that has collected in the area behind the breastbone and between the lungs (mediastinum) If little or no fluid has leaked, a stent may be placed in the esophagus. This may help you avoid surgery. Sometimes a perforation in the uppermost (neck region) part of the esophagus may heal by itself if you do not eat or drink for a period of time. In this case, you must get nutrition from another source, such as a stomach feeding tube. Surgery is usually needed to repair a perforation in the middle or bottom portions of the esophagus. Depending on the size and location of the perforation, the leak may be treated by simple repair or by removing the esophagus. Expectations (prognosis) The condition can progress to shock -- even death -- if untreated. For patients with an early diagnosis (less than 24 hours), the outlook is good. The survival rate is 90% when surgery is performed within 24 hours. However, this rate drops to about 50% when treatment is delayed. Complications Possible complications include: Permanent damage to the esophagus (narrowing or stricture) Abscess formation in and around the esophagus Infection in and around the lungs. Calling your health care provider Demand immediate medical attention if you are already in the hospital. Go to the emergency room or call 911 if you have recently had surgery or a tube placed in the esophagus and you have pain, difficulty swallowing or breathing, or another reason to suspect that you may have esophageal perforation. Time is of the essence in treating this condition. Prevention Because of their nature, these injuries are difficult to prevent. References Eckstein M, Henderson SO. Thoracic trauma. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 42. Reviewed By Review Date: 12/13/2010 George F. Lonstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Chronic pancreatitis?

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Definition Chronic pancreatitis is inflammation of the pancreas that does not heal or improve, gets worse over time, and leads to permanent damage. Causes, incidence, and risk factors The pancreas is an organ located behind the stomach that produces chemicals (called enzymes) needed to digest food. It also produces the hormones insulin and glucagon. When inflammation and scarring of the pancreas occur, the organ is no longer able to make the right amount of these enzymes. As a result, your body may be unable to digest fat and other important parts of food. Damage to the portions of the pancreas that make insulin may lead to diabetes. The condition is most often caused by alcohol abuse over many years. Repeat episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be a factor in some cases. Sometimes the cause is not known. Other conditions that have been linked to chronic pancreatitis: Autoimmune problems (when the immune system attacks the body) Blockage of the pancreatic duct or the common bile duct, the tubes that drain enzymes from the pancreas Complications of cystic fibrosis High levels of a fat called triglycerides in the blood (hypertriglyceridemia) Hyperparathyroidism Use of certain medicationss (especially estrogens, corticosteroids, thiazide diuretics, and azathioprine) Chronic pancreatitis occurs more often in men than in women. The condition often develops in people ages 30 - 40. Symptoms Abdominal pain Greatest in the upper abdomen May last from hours to days Eventually may be continuous May get worse from eating or drinking May get worse from drinking alcohol May also be felt in the back Digestive problems Chronic weight loss, even when eating habits and amounts are normal Diarrhea, nausea, and vomiting Fatty or oily stools Pale or clay-colored stools The symptoms may become more frequent as the condition gets worse. The symptoms may mimic pancreatic cancer. Sitting up and leaning forward may sometimes relieve the abdominal pain of pancreatitis. Signs and tests Tests for pancreatitis include: Fecal fat test Serum amylase Serum IgG4 (for diagnosing autoimmune pancreatitis) Serum lipase Serum trypsinogen Inflammation or calcium deposits of the pancreas, or changes to the ducts of the pancreas may be seen on: Abdominal CT scan Abdominal ultrasound Endoscopic retrograde cholangiopancreatography (ERCP) Endoscopic ultrasound (EUS) Magnetic resonance cholangiopancreatography (MRCP) An exploratory laparotomy may be done to confirm the diagnosis, but this is usually done for acute pancreatitis. Treatment People with severe pain or who are losing weight may need to stay in the hospital for: Pain medicines Fluids given through a vein (IV) Stopping food or fluid by mouth to limit the activity of the pancreas, and then slowly starting an oral diet Inserting a tube through the nose or mouth to remove the contents of the stomach (nasogastric suctioning) may sometimes be done. The tube may stay in for 1 - 2 days, or sometimes for 1 - 2 weeks. Eating the right diet is important for people with chronic pancreatitis. A nutritionist can help you create the best diet to maintain a healthy weight and receive the correct vitamins and minerals. All patients should be: Drinking plenty of liquids Eating a low-fat diet Eating small, frequent meals (this helps reduce digestive symptoms) Getting enough vitamins and calcium in the diet, or as extra supplements Limiting caffeine The doctor may prescribe pancreatic enzymes, which you must take with every meal. The enzymes will help you digest food better and gain weight. Avoid smoking and drinking alcoholic beverages, even if your pancreatitis is mild. Other treatments may involve: Pain medicines or a surgical nerve block to relieve pain Taking insulin to control blood sugar (glucose) levels Surgery may be recommended if a blockage is found. In severe cases, part or all of the pancreas may be removed. Expectations (prognosis) This is a serious disease that may lead to disability and death. You can reduce the risk by avoiding alcohol. Complications Ascites Blockage (obstruction) of the small intestine or bile ducts Blood clot in the vein of the spleen Fluid collections in the pancreas (pancreatic pseudocysts) that may become infected Poor function of the pancreas Diabetes Fat or other nutrient malabsorption Vitamin malabsorption (most often the fat-soluble vitamins, A, D, E, or K) Calling your health care provider Call for an appointment with your health care provider if: You develop symptoms of pancreatitis You have pancreatitis and your symptoms get worse or do not improve with treatment Prevention Determining the cause of acute pancreatitis and treating it quickly may help prevent chronic pancreatitis. Not drinking a lot of alcohol reduces the risk of developing this condition. References Nair RJ, Lawler L, Miller MR. Chronic pancreatitis. Am Fam Physician. 2007;76:1679-1688. Owyang C. Chronic pancreatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 147. Reviewed By Review Date: 01/20/2010 George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Chronic cholecystitis?

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Definition Chronic cholecystitis is swelling and irritation of the gallbladder that persists over time. The gallbladder is a sac located under the liver. It stores bile that is made in the liver. Bile helps the intestines digest fats. Alternative Names Cholecystitis - chronic Causes, incidence, and risk factors Chronic cholecystitis is usually caused by repeated attacks of acute (sudden) cholecystitis. Most of these attacks are caused by gallstones in the gallbladder. These attacks cause the walls of the gallbladder to thicken. The gallbladder begins to shrink. Over time, the gallbladder is less able to concentrate, store, and release bile. The disease occurs more often in women than in men, especially after age 40. Symptoms For symptoms of acute cholecystitis, see: Acute cholecystitis. Acute cholecystitis is a painful condition that leads to chronic cholecystitis. It is not clear whether chronic cholecystitis causes any symptoms. Signs and tests Your health care provider may order the following blood tests: Amylase and lipase -- to diagnose diseases of the pancreas Complete blood count (CBC) Liver function tests -- to evaluate how well the liver is working Tests that reveal gallstones or inflammation in the gallbladder include: Abdominal CT scan Abdominal ultrasound Gallbladder scan (HIDA scan) Oral cholecystogram Treatment Surgery is the usual treatment. Surgery to remove the gallbladder is called cholecystectomy. Laparoscopic cholecystectomy is most often done. This surgery uses smaller surgical cuts, which result in a faster recovery. Patients are often sent home from the hospital on the same day as surgery, or the next morning. Open cholecystectomy requires a larger cut in the upper-right part of the abdomen. In patients who are too ill to have surgery because of other diseases or conditions, the gallstones may be dissolved with medication taken by mouth. However, this may take 2 years or longer to work, and the stones may return after treatment. Expectations (prognosis) Cholecystectomy is a common procedure with a low risk. Complications Cancer of the gallbladder (rarely) Jaundice Pancreatitis Worsening of the condition Calling your health care provider Call for an appointment with your health care provider if you develop any symptoms of cholecystitis. Prevention The condition is not always preventable. Eating less fatty foods may relieve symptoms in people with acute cholecystitis who have not had their gallbladder removed. However, the benefit of a low-fat diet has not been proven. References Wang DQH, Afdhal NH. Gallstone disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 65. Reviewed By Review Date: 02/07/2011 George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Asked in Gastroenterology

Cholestasis?

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Definition Cholestasis is any condition in which the flow of bile from the liver is blocked. Alternative Names Intrahepatic cholestasis; Extrahepatic cholestasis Causes, incidence, and risk factors There are many causes of cholestasis. Extrahepatic cholestasis occurs outside the liver. It can be caused by: Bile duct tumors Cysts Narrowing of the bile duct (strictures) Stones in the common bile duct Pancreatitis Pancreatic tumor or pseudocyst Pressure on an organ due to a nearby mass or tumor Primary sclerosing cholangitis Intrahepatic cholestasis occurs inside the liver. It can be caused by: Alcoholic liver disease Amyloidosis Bacterial abscess in the liver Being fed through a vein (IV) Lymphoma Pregnancy Primary biliary cirrhosis Primary sclerosing cholangitis Sarcoidosis Serious infections that have spread through the bloodstream (sepsis) Tuberculosis Viral hepatitis Certain medications can also cause cholestasis. See: Drug-induced cholestasis Symptoms Clay-colored or white stools Dark urine Inability to digest certain foods Itching Nausea or vomiting Pain in the right upper part of the abdomen Yellow skin or eyes Signs and tests Blood tests may show higher than normal levels of bilirubin and alkaline phosphatase. Imaging tests are used to diagnose this condition. Tests include: CT scan of the abdomen MRI of the abdomen Endoscopic retrograde cholangiopancreatography (ERCP) (can also determine cause) Ultrasound of the abdomen Treatment The underlying cause of cholestasis must be treated. Expectations (prognosis) How well a person does depends on the disease causing the condition. Stones in the common bile duct usually can be removed, curing the cholestasis. Stents can be placed to open areas of the common bile duct that are narrowed or blocked by cancers. Complications Diarrhea Organ failure can occur if sepsis develops Poor absorption of fat and fat-soluble vitamins Severe itching Weak bones (osteomalacia) and osteoporosis (due to very long-term cholestasis) Calling your health care provider Call your health care provider if you have: Persistent itching Yellow skin or eyes Other symptoms of cholestasis Prevention Get vaccinated for hepatitis A and B if you are at risk. Avoid intravenous drug use and needle sharing. References Zollner G, Trauner M. Mechanisms of cholestasis. Clinics in Liver Disease. 2008;12:1-26. Afdhal NH. Diseases of the gallbladder and bile ducts. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 159. Reviewed By Review Date: 05/23/2010 David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California.
Asked in Swine Flu (H1N1/09), Genetic Diseases, Gastroenterology, Neurology

What causes Refsum disease?

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It is currently felt to be caused by mutations in a gene (PAHX) that encodes a protein called phyanoly-CoA hydroxylase and is important for metabolizing phytanic acid.
Asked in Biology, Gastroenterology

What is diffusion pressure deficit?

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Water potential of protoplasm of the cell is equal but opposite in sign to the diffusion pressure deficit(DPD) or suction pressure(SP).Thus DPD of an osmotic system is the water potential in terms of energy.DPD is expressed in positive value.
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Why is gas used to heat houses instead of solid fuel?

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I am 80% sure that it is because that gas is more expensive than solid fuel, wait... do you mean gas or gasoline?
Asked in Job Training and Career Qualifications, Gastroenterology

Can you get a Ph.D in gastroenterology?

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Yes, a Gastroenterologist. You can also be a certified RN in gastroenterology.
Asked in Gastroenterology

What approach would you use for gastroenterology?

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The only approach for gastroenterology would be to finish medical school and get your MD. Then another 2 or 3 years of school to specialize in the GI field of medicine.