Common Gastrointestinal Disorders
The experienced team of gastrointestinal specialists at Cayuga Medical Center treats the array of disorders relating to the digestive system. The following disorders are among the most common problems we diagnose and treat.
Barrett’s esophagus is a serious complication of gastroesophageal reflux disease (GERD) that occurs when the tissue in the esophagus (swallowing tube) becomes altered due to constant inflammation. About 10 percent of people with chronic symptoms of GERD develop Barrett’s esophagus. This condition increases the risk of developing esophageal adenocarcinoma, which is a rare but very serious, potentially fatal form of cancer.
Celiac disease is an allergic reaction to gluten, which is a protein found in specific grains: wheat, barley, rye, and possibly oats. Why allergic reaction occurs in certain people and not others remains unclear. When a person with celiac disease consumes gluten, it breaks down during digestion and causes painful inflammation, which damages the inside of the small intestine. This makes it difficult to absorb the nutrients from food and can lead to other chronic problems, such as anemia and osteoporosis.
Crohn’s disease is a chronic inflammatory disease of the digestive tract. Symptoms include severe abdominal pain, profuse diarrhea, bleeding in the intestinal tract, and weight loss. There is no one test to determine if a person has Crohn’s disease, as it has many symptoms that are the same as those of other health problems. To make a diagnosis of Crohn’s disease, your doctor will probably gather information from a combination of exams, lab tests, and imaging studies.
This is a common condition that is characterized by difficult, infrequent, or incomplete evacuation of bowel movements, or the inability to pass stool. The prevalence of chronic constipation increases with age and is more common in women than men. There are many causes of chronic constipation, including lesions or narrowing of the colon, medical conditions such as diabetes, thyroid disorders, or Parkinson’s disease, or it may be due to certain medications. In people over 50, the cause may be a serious bowel disease so it is important to see your doctor to rule this out.
The medical term for difficulty swallowing is called dysphagia. This can be caused by problems of the brain or nervous system (that prevent the throat and esophagus from working properly) and by conditions such as GERD.
Fatty liver disease
Fatty liver disease is also called nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH). This condition, which occurs when fat (adipose) cells infiltrate normal liver cells, is the most common cause of liver disease in the United States. If it is controlled, fatty liver disease is usually benign; however, if left uncontrolled it can lead to permanent scarring of the liver that requires a liver transplant.
GERD (gastroesophageal reflux disease)
Heartburn is an irritation of the esophagus that occurs when acid comes up into the swallowing tube (esophagus) from the stomach. This is called acid reflux. When heartburn symptoms occur frequently, it may be a sign of the more serious problem called GERD. Left untreated, GERD can cause several different problems, among them esophagitis (chronic inflammation of the esophagus), ulcers, hoarseness, and Barrett’s esophagus.
Hepatitis C is a virus that affects the liver. An estimated 3.2 million people in the United States have hepatitis C, but because it causes very few symptoms over the course of several years, most people don’t know they have it. However, this is a virus that often does not disappear on its own. Typically if you have acquired hepatitis C, it will infect your liver for the span of your life and may progress to liver cancer or cirrhosis of the liver if not successfully treated. Hepatitis C is the most common cause of liver failure.
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is the most common disorder of the digestive tract treated by gastroenterologists. This disorder does not shorten a person’s life, nor does it lead to serious illness or increase the risk for developing cancer. It is chronic, however, and causes very distressing symptoms that can have a significant impact on quality of life. IBS is called a disorder because it occurs in gastrointestinal tracts that appear healthy and have no signs of disease, such as inflammation, infection, or cancer. Nevertheless, people with IBS suffer from gastrointestinal dysfunction in the way matter moves through their digestive tracts and this abnormal function causes a variety of uncomfortable symptoms.
Peptic (or gastric) ulcers are very common in this country. Ulcers are holes in the protective lining of the stomach and the upper part of the small intestine. These are the areas in the digestive tract that come into direct contact with stomach acids and enzymes. Less common are esophageal ulcers that form in the swallowing tube. Historically it was believed that ulcers resulted from stress; however, we now know that the vast majority of ulcers are caused by a specific bacterium. Ulcers can be exacerbated, and in some cases caused, by overuse of over-the-counter painkillers, heavy alcohol use, and smoking.
Diagnostic Tests and Treatments
Endoscopy is a nonsurgical approach to examining the digestive tract. Using an endoscope (a thin, flexible tube with a tiny light source and camera attached to it) your gastroenterologist can view images of your digestive tract on a color monitor. Endoscopic exams, many of which are performed with light sedation to keep patients comfortable, are typically very well tolerated.
- Endoscopy is used to: detect the presence of disease; remove precancerous polyps that can become cancerous over time; collect small tissue samples for further examination by a pathologist; stop bleeding in the digestive tract; remove foreign objects; and treat certain other problems such as difficulty swallowing.
- During an upper endoscopy procedure, the endoscope is gently passed through the mouth and throat into the swallowing tube, enabling the gastroenterologist to see the esophagus, stomach, and upper part of the small intestine.
- In an examination of the lower gastrointestinal tract the gastroenterologist passes an endoscope through the rectum into the large intestine (or colon). This procedure is called a colonoscopy.
Some of the more common procedures and treatments performed by our gastroenterology team are described below.
Upper Gastrointestinal Tract
The EGD (esophagealgastroduodenoscopy)
The EGD (esophagealgastroduodenoscopy) examines the esophagus, the stomach, and the duodenum (the first section of the small bowel. During this procedure, the gastroenterologist examines the linings of the upper GI tract and can perform treatments as needed. Biopsies and tissue samples may be obtained.
Stricture Dilation and Stenting
Stricture Dilation and Stenting may be performed if the esophagus is narrowed and swallowing food is difficult. Narrowing of the esophagus may occur for a number of reasons, such as tumors, the presence of scar tissue, or muscle spasms. The esophagus may be opened using different methods, and occasionally a stent may be placed to keep the esophagus open.
Barrett's Esophagus/GERD Monitoring
Barrett’s Esophagus/GERD Monitoring is recommended on a regular basis for people with these conditions to ensure that no cancer is developing. Gastroesophageal reflux disease (GERD) occurs when stomach acid goes back up into the esophagus, damaging its lining over time. Barrett’s esophagus is a complication of long-term GERD and may increase the risk of esophageal cancer.
Esophageal pH Monitoring
Esophageal pH Monitoring is performed by placing a capsule in the esophagus during an EGD. The pH capsule contains a small radio that transmits data to small receiver worn on the patient’s belt or waistband, similar to a pager or mobile phone. Over 24 to 48 hours, data is collected that is analyzed by the gastroenterologist and used to develop a treatment plan.
Esophageal Manometry shows the contractions of the esophagus during swallowing. A small, highly sensitive probe is passed through the nose to the end of the esophagus. Pressures can then be measured and analyzed to assist the gastroenterologist in developing a treatment plan.
Botulinum Toxin Injection
Botulinum Toxin Injection is used to treat achalasia, an esophageal mobility disorder in which the muscles in the swallowing tube and the lower sphincter do not contract and relax the way they should to move food from the mouth to the stomach.
Foreign Body Removal
Foreign Body Removal is performed during an EGD procedure to remove food or a foreign object that has become lodged in the swallowing tube.
Percutaneous Endoscopic Gastrostomy Tube (PEG Tube)
Percutaneous Endoscopic Gastrostomy Tube (PEG Tube) can help when someone is having ongoing and serious trouble swallowing and cannot consume enough food or liquid by mouth. A PEG tube is a feeding tube placed directly into the stomach through the skin, allowing the intake of food and calories while bypassing the mouth and esophagus.
Small Bowel or Small Intestine
Small Bowel Enteroscopy
Small Bowel Enteroscopy is a procedure that places a tube through the mouth and throughout the small bowel. This may be used to assist in diagnosing irritable bowel diseases, such as Crohn’s disease or celiac disease.
Capsule Endoscopy is a procedure in which the patient swallows a small capsule containing a tiny camera that takes multiple images of the esophagus, stomach, and small bowel as it travels through the digestive tract. The images are collected by a small receiver worn on the patient’s belt and then downloaded into a computer. The gastroenterologist uses these pictures to help with the diagnosis and treatment plan. The capsule passes through the digestive tract into the toilet, where it is flushed away
Large Bowel or Lower Gastrointestinal Tract
Colonoscopy is a procedure that looks at the entire large bowel (colon) with a thin, flexible tube called a colonoscope. Pictures are taken and treatments may be performed through the colonoscope. Biopsies may be taken and polyps may be removed during this exam. Polyps have the potential to become cancerous and are therefore removed to help prevent colon cancer from starting. Screening colonoscopies are the number one way to prevent colon cancer and save lives. This procedure may also be performed through a stoma, if a patient has had a colostomy.
Sigmoidoscopy is a procedure that looks only at the sigmoid colon, which is the part of the large intestine that is closest to the rectum. Biopsies can be performed and polyps can be removed during this procedure.