If you are someone with Crohn’s disease, we don’t need to tell you how impactful this chronic condition can be. Frequent bowel movements, intense abdominal cramps, chronic fatigue, and disposition to a number of different bodily maladies are just some of the ways that this type of inflammatory bowel disease can complicate patients’ lives. Luckily, there are a few different precautions that those with Crohn’s can take to lessen the effects of this often-invasive disease.
What are the effects of Crohn’s?
Prior to exploring the ways that one can tamper the symptoms of Crohn’s, it’s important to establish just what exactly these unwanted effects are. Although the condition directly affects the bowels, the symptoms of Crohn’s disease can be felt throughout the body. Some examples include:
- Urgent and frequent bowel movements
- Watery stool
- Bleeding from the rectum
- Abdominal pain
- Mouth sores
- Skin and eye inflammation
Of course, these effects are not omnipresent nor always severe. Often, Crohn’s patients have long periods where they feel fine, only to eventually be faced with an intense flare-up of symptoms that leaves them feeling terrible and unable to work or go to school—this is where a gastroenterologist comes in.
What a gastroenterologist can do for you
If you are experiencing the debilitating effects of Crohn’s disease, you should schedule an appointment with your local gastroenterologist to find a treatment that’s well-suited to your issues. Possible medical approaches include:
- Medications: The right medicine can help control inflammation, and thus lighten the disease’s effects on your body.
- Bowel rest: Sometimes recommended by a doctor in cases when symptoms are severe, a bowel rest includes refraining from solid food for a few days. Don’t worry—a nutrient-containing liquid is provided in lieu of solid food so that patients do not feel hunger pain. This time of rest allows the intestines to heal and symptoms to dissipate
- Surgery: In the case of extreme symptoms, surgery becomes necessary. There are a variety of different surgeries available, and a consultation with your gastroenterologist can determine which one will benefit you.
What you can do day-to-day to lessen symptoms
As a Crohn’s patient, there are a few different lifestyle modifications that you can apply to minimize flare-ups and make your day-to-day routine more comfortable. Some simple steps include
- Take medication as prescribed: At the risk of sounding too obvious, taking medicines according to a doctor’s recommendations is an essential step to managing symptoms. In the case of corticosteroids (steroids) this is especially important, for these medications are best used in the short-term and during flare-ups—improper use can render them ineffective
- Regularly exercise: Exercise helps Crohn’s patients in a few different ways such as helping the digestive tract work efficiently, raising energy levels, and fortifying the immune system. Consult with your gastroenterologist on how to develop a routine that will benefit you most
- Adopt proper dietary habits: Maintaining a diet that is full of nutrients can help minimize the effects that Crohn’s has on the digestive tract. Of course, not all patients’ dietary needs are the same, so make sure to meet with a dietician to find out which approach will work best for you.
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Living with Crohn’s can be a struggle, but it can be made easier with professional help. Call us today to set up a consultation and get yourself on track to a better life!
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:
- abdominal pain
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.
Irritable bowel syndrome, also known as IBS, is a condition affecting the large intestine or colon. It is associated with a variety of symptoms, including abdominal discomfort and diarrhea. The exact cause of irritable bowel syndrome is not known and the condition tends to affect women more often than men. If you are experiencing any of the symptoms of irritable bowel syndrome, a gastroenterologist can determine if you truly have the condition and develop an appropriate treatment plan for your symptoms.
A variety of gastrointestinal symptoms is associated with irritable bowel syndrome. If you experience any of these symptoms regularly, consult a gastroenterologist who can make a proper diagnosis. A diagnosis of IBS is usually made by ruling out other gastrointestinal problems through blood tests, stool sample tests, x-rays, a colonoscopy or a sigmoidoscopy. Symptoms of irritable bowel syndrome include:
- abdominal pain or cramping
- mucus in stools
- recurring urgent need to have a bowel movement
Although the exact cause of irritable bowel syndrome is unknown, there are several treatment options for alleviating some of the discomfort associated with IBS. Dietary habits can have an impact on the frequency and severity of symptoms. Eating smaller meals during the day can ease digestion and lessen symptoms. Including more fiber during the day can also help with symptoms such as constipation. Eliminating foods, such as dairy, that aggravate the symptoms of IBS can also help alleviate some of the pain and discomfort.
Other strategies for treating irritable bowel syndrome include medications, probiotics and managing stress. Increased stress can aggravate IBS symptoms so keeping stress levels low can minimize symptoms. Additionally, probiotics and certain medications can also help improve digestion and alleviate some of the symptoms of IBS, such as gas or diarrhea. A gastroenterologist can help you determine which treatments options are best for your symptoms.
Irritable bowel syndrome 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.
A polyp: you may have heard of this condition, but remain unsure on what exactly it is. Most commonly developed in the colon, polyps are small clumps of cells that grow inside various parts of the body. Although some polyps are benign, others can develop into cancer, making it crucial that you receive periodic colonoscopies from your gastroloenterologist. Read on to learn more about colon polyps, and if you are in need of a colonoscopy, make sure to call your local gastroenterologist to make an appointment!
What exactly are colon polyps?
As mentioned above, polyps are small clumps of cells that generally develop in the nasal passage, uterine lining, vocals cords, stomach lining, and most commonly in the colon lining. Projected to develop in fifty percent of the population over time, colon polyps come in two distinct categories:
- Hyperplastic Polyps: Definitively noncancerous, these benign cell clumps are small and grow near the end of the colon
- Adenomatous Polyps: This polyp variety affects more people than its counterpart, and carries the possibility of becoming cancerous, although this development usually takes years to occur.
Although colon polyps generally do not show any immediate symptoms, some warning signs certainly do spring up over time. These signs include:
- Rectal bleeding
- Abnormal stool color
- Shifts in bowel habits
- Abdominal pain
How can I stay healthy?
Given that polyps usually do not exhibit any symptoms until late into their development, the best course of defense against this potentially deadly condition is to receive regular colonoscopies once you reach the age of 50.
A colonoscopy is a minor procedure in which a small, camera-equipped tool is inserted into the anus so that a doctor may examine the colon. If any polyps are discovered, the doctor can then remove them and send a sample to the lab for a biopsy. In the event that the sample tests positive for cancer, your doctor can discuss any further steps that need to be taken.
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If you are in need of a colonoscopy, be sure to give your local gastroenterologist a call and receive the treatment that you need!
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:
- A burning sensation in the back of the throat
- Persistent cough
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:
- 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.
Peptic ulcers, or stomach ulcers, are breaks or holes in the lining of the stomach. An ulcer in the first part of the intestines is known as a duodenal ulcer. An ulcer in the stomach is known as a gastric ulcer. If you think you may have an ulcer, you should see a gastroenterologist. Gastroenterologists are specialists in the diagnosis and treatment of peptic ulcers. Here are 5 signs you may have a peptic ulcer.
1. Burning pain- The most common peptic ulcer symptom is a burning sensation or gnawing pain in the middle of your abdomen. The pain may come and go for several days or weeks. Even though discomfort may be mild, peptic ulcers can worsen if they aren’t treated. Taking antacids can relieve the discomfort, but it will keep coming back until the peptic ulcer is treated by a doctor.
2. Nausea- The symptoms of peptic ulcers may include nausea. Nausea is a feeling of sickness with an inclination to vomit. Nausea has many possible causes. Some common causes of nausea include appendicitis, infection, reactions to some medicines, migraines, food poisoning or intestinal blockage.
3. Vomiting- The symptoms of peptic ulcers may include vomiting. Vomiting after consumption of food may be caused by an ulcer, food poisoning, or gastritis (inflammation of the stomach lining). Usually, vomiting is harmless, but it can be a sign of a serious condition. Some examples of serious conditions that may result in vomiting include Acute liver failure, appendicitis, Pancreatic cancer, or intestinal blockage.
4. Discolored stool- Blood in the stool is often a sign of a problem in the digestive tract. Blood in the stool may come from any area along your digestive tract. A stomach ulcer can cause discolored stools that appear darker or bloody. A bloody stool may indicate that your stomach ulcer is growing in size or is becoming more severe.
5. Heartburn- Another symptom of peptic ulcers is heartburn. Heartburn is a condition that's caused when stomach acid flows up into your esophagus. This leads to a burning discomfort below your breastbone or in your upper belly. Your doctor will prescribe medications to relieve your symptoms and help your ulcer heal.
If you have any of these signs and symptoms, you should seek treatment. A visit to the gastroenterologist will bring the relief you need. Peptic ulcers can not only be uncomfortable causing you pain but can also lead to other complications that may be dangerous.
Though many people never know they have one due to lack of symptoms, a hiatal hernia can cause complications which can affect your daily life. Knowing the signs and symptoms of this condition can help you spot its presence, alert your gastroenterologist, and get the treatment you need.
What is a hiatal hernia?
Your chest and abdomen are separated by a large muscle called the diaphragm. The esophagus passes through a small opening in the diaphragm and brings food from the mouth, down the throat, and into the stomach. A hiatal hernia occurs when the stomach pushes through the hole and begins bulging out of the other side, into the chest. Though small hiatal hernias are often nothing to worry about and do not produce symptoms, larger hernias may cause potentially serious complications.
Do I have a hiatal hernia?
A small hernia often does not produce any symptoms at all. However, larger hernias can cause some issues that can affect your day-to-day life:
- Difficulty swallowing
- Chest or abdominal pain
- Regurgitation of foods (into the mouth)
- Acid reflux
- Vomiting blood or passing black stool
- Shortness of breath
If you think you have a hiatal hernia, you should see your doctor to ensure that you receive the care you need.
How does a gastroenterologist diagnose a hiatal hernia?
It is not uncommon for a gastroenterologist to find a hernia while investigating the cause of heartburn, abdominal pain, or other symptoms. Some diagnostic tools they may use include x-rays or upper endoscopy. They will also gather your medical, family, and lifestyle history to further investigate the cause of your symptoms.
Hiatal Hernia Treatments
If a person with a hernia does not experience any symptoms or complications, they may not need any treatment at all. However, if the patient begins experiencing discomfort, their doctor will probably suggest beginning treatment for their condition. Medications, such as antacids or medication to reduce the body’s acid production, can help with symptoms of a hernia. In more severe cases, a surgical procedure to repair a hernia or make the hole in the diaphragm smaller may become necessary.
Your gastroenterologist can help you find the best treatment plan for you. If you think you have a hernia or are experiencing uncomfortable symptoms such as recurrent acid reflux or heartburn, you should speak with your doctor.
Tummy troubles? When some people are diagnosed with celiac disease, they also discover that they are lactose intolerant and have difficulty digesting milk and dairy products. Read on to learn all about lactose intolerance and celiac disease and their symptoms. Gastroenterologists are doctors who specialize in the diagnosis and treatment of digestive disorders, including lactose intolerance and celiac disease.
Lactose Intolerance Overview
Lactose intolerance is a condition in which people have digestive symptoms after eating or drinking milk or dairy products. People with lactose intolerance are unable to fully digest the sugar in dairy products. Lactose intolerance is caused by a deficiency of an enzyme in the body called lactase. Lactose intolerance is not serious. Your doctor may do a breath, blood or stool test to find out if your problems are due to lactose intolerance.
Symptoms of Lactose Intolerance
After drinking or eating dairy products, you may feel sick to your stomach. You may also have loose stools or diarrhea, gas, pain, or cramps in the lower belly, rumbling or gurgling sounds in the lower belly. or swelling in your stomach. If you are lactose intolerant, you may still be able to eat or drink small amounts of milk. Some individuals do better if they have dairy with a meal.
Celiac Disease Overview
Celiac disease is a disorder triggered by consuming a protein called gluten, which is rye, barley, and wheat. When an individual with celiac disease eats foods that contain gluten, an abnormal immune reaction is triggered that damages a small part of the intestine called villi. Long-term complications of celiac disease include intestinal cancer, liver disease, and malnutrition, which can lead to osteoporosis and anemia. The longer people go untreated, the greater the risk for long-term complications.
Symptoms of Celiac Disease
Many individuals with celiac disease have no symptoms. Digestive symptoms, including stomach bloating, flatulence, pain, diarrhea, constipation, nausea, vomiting, and irritability are more common in children. Adults may experience numbness in hands and feet, joint or bone pain, fatigue, anxiety, depression, canker sores inside the mouth, seizures, itching, and a skin rash.
If you are experiencing any symptoms of lactose intolerance or celiac disease, make an appointment with a gastroenterologist. Get your life back on track by receiving the best treatment available. A visit to the gastroenterologist will bring all the relief you need, with little hassle or expense.
Got heartburn? Heartburn, also known as acid indigestion, is a form of indigestion felt as a burning pain in the chest. It's caused when stomach acid flows up into your esophagus. More than just a minor discomfort, acid indigestion can reduce quality of life. The following tips will help you rid yourself of heartburn.
1. Change your diet. Stay away from beverages and foods that commonly cause heartburn. A good way to work out what beverages and foods trigger your heartburn symptoms is to keep track of what you eat. Common offenders include tea, coffee, tomatoes, garlic, fatty foods, spicy foods, milk, chocolate and peppermint.
2. Don't overeat. Overeating can trigger heartburn. Big meals put pressure on the muscle that helps keep stomach contents from backing up into the esophagus. The more food you eat, the longer it takes for your stomach to empty, which contributes to acid reflux. Try eating five small meals a day to keep reflux at bay.
3. Avoid alcohol. Alcohol can trigger heartburn. Alcohol can relax the sphincter muscle at the lower end of your esophagus, causing stomach acid to flow up into your esophagus If your aim is to unwind after a long day at work, try exercise, stretching, listening to soothing music, or deep breathing instead of drinking alcohol.
4. Lose weight. If you overeat, lose weight- but be sure to consult your doctor before starting a vigorous exercise program. The increased risk of heartburn is thought to be due to excess abdominal fat causing pressure on the stomach.
5. Stop smoking. Nicotine is a muscle relaxant. Nicotine can relax the sphincter muscle, causes acid from the stomach to leak upward into the esophagus. Nicotine gums, patches, and lozenges are healthier and safer than cigarettes, and they are less likely to give you heartburn.
6. Contact your doctor. Your doctor may suggest antacids for occasional heartburn. Sometimes, more powerful prescription medications such as proton pump inhibitors or H2 blockers and are needed to treat chronic heartburn. When all else fails, surgery may be required to repair the LES.
Chronic heartburn can affect your daily activities and make life frustrating and miserable. Don't hesitate to contact a gastroenterologist about heartburn.
What is diverticulitis?
Normally, we pay no attention to our large intestines, but if you have symptoms of diverticulitis, you're well aware of your bowel. Painful, inflamed bulges in the intestinal wall, diverticula are worrisome and potentially dangerous. If your physician suspects you have this GI condition common in the over-60 population, seek the services of a gastroenterologist. Specially trained in diverticulitis, and the less serious diverticulosis, a GI specialist can diagnose and treat your bowel health for better long-term function and well-being.
Symptoms of diverticulitis
Diverticulitis is serious infection which requires medical attention. Symptoms include:
- Intense lower abdominal pain
- Blood in the stool
- Pus and mucus with your bowel movements, indicating infection
- Fruits and vegetables
- Dairy products
Is it constipation? Is it diarrhea? Frankly, when a patient complains to his or her physician about GI problems, the doctor has to wonder, "Is it Irritable Bowel Syndrome?" If you alternate between infrequent and too frequent bowel movements, you may need evaluation by a gastroenterologist. An expert in all things from your esophagus through your stomach and intestines, a GI doctor can uncover the reasons behind bowel issues, including IBS.
About IBS and its symptoms
Unfortunately, no one knows the real origin of Irritable Bowel Syndrome. However, it definitely is a cluster of symptoms which millions of people in the US--more women than men--suffer, before the age of 50. The International Foundation for Gastrointestinal Disorders reports that stress appears to increase symptoms; however, anxiety and a high-pressure job or life circumstance do not actually cause the condition.
Besides constipation and/or diarrhea, individuals with IBS have:
- Bouts of gas
- Mucus in the stool
- Intolerance to a variety of foods, including those containing gluten and lactose (dairy)
- Dairy products
- Caffeinated drinks
- High fat or fried foods
- Whole grains
Wondering if you have hemorrhoids? Hemorrhoids are very common, especially among people ages 45 to 75. Hemorrhoids are inflamed and swollen veins around the anus or in the lower rectum. One of the main causes of hemorrhoids is straining when you’re trying to have a bowel movement. Other contributing factors include heredity, diarrhea, chronic constipation, pregnancy, and aging. Here's how to tell if you have hemorrhoids.
1. A lump near the anus- Although many individuals have hemorrhoids, not all experience symptoms. External hemorrhoids are felt as swelling or a hard lump near the anal area. Internal hemorrhoids protrude with bowel movements; usually, they return to the inside by themselves.
2. Painless bleeding- Hemorrhoids can cause bleeding. If you have hemorrhoids, you may see blood in the toilet bowl or on the toilet paper. Rectal bleeding is also a symptom of diverticulitis, colitis, colon polyps, and colorectal cancer. If you experience rectal bleeding, you should see a doctor. An evaluation and proper diagnosis by a gastroenterologist is important any time bleeding from the rectum lasts for more than a few days.
3. Itching around the anus- Hemorrhoids can cause severe itching around the anus. Initial treatment of anal itching is directed toward relieving the soreness and burning. Your gastroenterologist may prescribe hydrocortisone cream, gel, foam, or ointment or rectal suppositories to treat itching.
4. Pain or discomfort- Pain is a common symptom of external hemorrhoids, especially during bowel movements or when sitting. Internal hemorrhoids are typically painless, even when they produce bleeding. When hemorrhoids are painful, it’s hard to think about anything else. Your gastroenterologist may prescribe pain medication, hydrocortisone cream or rectal suppositories to ease your pain.
Why suffer? If you think you may have hemorrhoids, you should schedule an appointment with a gerontologist right away. The symptoms hemorrhoids cause are hard to ignore. Thankfully, there are many treatments that can provide relief.
Unfortunately, many of us eat the foods we crave before thinking about how it affects our digestive health. Your digestive health is directly impacted by the lifestyle you live and the foods you eat. Exercising, drinking water, and adding fiber all contribute to better digestive health. Here are five digestive problems that are caused by a poor diet.
1. GERD- GERD is a digestive disorder in which stomach acid or bile irritates the food pipe lining. Symptoms include heartburn, hoarseness, and trouble swallowing. Some foods and beverages are known to cause reflux. If you're at risk for GERD, avoid fatty foods, acidic foods, spicy foods, chocolate, and caffeinated beverages. Being overweight and obesity are also causes of GERD.
2. Cancer- Diet can also directly affect your risk of stomach and bowel cancer. Some foods, such as processed and salt-preserved foods, and red meat can increase the risk of developing stomach and bowel cancer. While others, such as vegetables and fruits, are especially potent cancer fighters. Choosing whole-grain breads, cereals, and pastas instead of refined grains, and eating poultry, fish, or beans may also help lower your risk of stomach and bowel cancer.
3. Gallstones- Slimming down (if you're overweight) and changes to your diet may help prevent gallstones. Gallstones are hardened deposits of bile inside the gallbladder. Because cholesterol plays a role in the development of gallstones, you should avoid eating too many foods that are high in saturated fat. Eating too many foods that are high in cholesterol and fat and not enough of a high-fiber diet can increase your risk of gallstones.
4. Ulcerative Colitis- Eating a high-fat diet increases the risk of developing ulcerative colitis. Ulcerative colitis is a digestive disease that results in inflammation and ulcers in your digestive tract. Symptoms of ulcerative colitis include fatigue, rectal bleeding, anemia, diarrhea, abdominal pain, and feeling an urgent need to take a bowel movement. It's a serious disease that can cause dangerous complications if you don't get the right treatment.
5. Diverticulosis- Diverticulosis is a condition in which protruding pockets develop in the digestive tract. These pouches form when high pressure inside the large intestine pushes against weak spots in the intestinal wall. A high-fiber diet will reduce the risk of developing diverticular disease. Symptoms of diverticulitis include abdominal pain, diarrhea, constipation, bloody stools, fever, nausea, and vomiting. Diverticulitis can become serious, requiring hospital admission.
We really are what we eat! Swap those poor eating habits over for better ones. A healthy diet provides important minerals, vitamins, and nutrients to keep the body healthy. You can start making proactive changes to your diet today that can benefit your digestive health now, and throughout your entire life.
Gallstones are a very common problem. You're at risk of developing gallstones if you're overweight or obese, female, or 40 or over. Gallstones are hardened deposits of bile inside the gallbladder. Many people with gallstones are unaware that they have them, as they produce no or little symptoms. For some people, however, gallstones can cause problems. Here are four signs and symptoms of a gallstone.
1. Abdominal Pain
Symptoms of a gallstone may include severe abdominal pain. This pain goes and comes back repeatedly. The pain often occurs after eating and can last a few hours before it resolves. Chronic, ongoing pain that persists beyond a few hours may also occur, and may indicate a severe gallbladder problem.
2. Referred Pain
Gallstone pain can cause referred pain to the upper back and right shoulder. The pain usually comes on suddenly and may last for several hours. Prescribed painkillers are used to relieve pain associated with gallstones. You may also be given advice about eating a healthy diet to help control the pain.
Jaundice is a symptom of gallstones. Jaundice is a yellowish appearance of the whites of the eyes and skin due to high bilirubin levels. If a stone moves out of your gallbladder and one of your bile ducts and blocks the bile flow, jaundice occurs. Sometimes the gallstone passes from the bile duct on its own. If it doesn't, you may need to have gallbladder surgery.
A gallstone can cause nausea and vomiting, which may relieve some of the abdominal pressure and discomfort. Pain that occurs with appetite loss, nausea, vomiting, and a fever may suggest the presence of infection or inflammation of the gallbladder. Vomiting and diarrhea also occur with food poisoning and the flu, but the pain tends to come and go rather than be constant.
If you're experiencing the symptoms of a gallstone, you should notify your gastroenterologist right away. When a gallstone blocks your bile ducts, it can cause excruciating pain, which means you need emergency care right away.
Diarrhea is very common. When you have diarrhea, your bowel movements are loose and watery. In most cases, diarrhea lasts a couple of days. Chronic diarrhea is diarrhea that lasts longer than two weeks. When diarrhea lasts for weeks, it can indicate a serious disorder. Although diarrhea is usually not serious, it can become dangerous or signal a more serious problem. Read on to find out how chronic diarrhea is treated.
1. Replacing lost fluids- Chronic diarrhea is treated by replacing lost fluids and electrolytes to prevent dehydration. Adults with diarrhea should drink water, sports drinks, sodas without caffeine, or fruit juices. Fluid can also be delivered through a vein (intravenously) if the dehydration is severe.
2. The use of medication- Your doctor may prescribe antibiotics and medications that target parasites to treat parasitic or bacterial infections. If a virus is causing your diarrhea, antibiotics won't help. Pain relief medications can help alleviate fever and pain. Your doctor may also prescribe medications to treat an underlying condition that may be causing your chronic diarrhea.
3. Treating medical conditions- How doctors treat chronic diarrhea depends on the cause. Chronic diarrhea is sometimes caused by an underlying medical condition that requires treatment. Common conditions that cause diarrhea include irritable bowel syndrome, Chrohn's disease, ulcerative colitis, inflammatory bowel disease, celiac disease, and chronic pancreatitis.
4. The use of probiotics- Your doctor may recommend probiotics to treat diarrhea. Probiotics are good bacteria that are very similar to the bacteria that are already in your body. Probiotics reduce the growth of harmful bacteria and promote a healthy digestive system. If your gastroenterologist recommends probiotics, talk with him or her about how much probiotics you should take and for how long.
Chronic diarrhea can affect your daily activities and make life frustrating and miserable. Don't hesitate to contact a gastroenterologist about diarrhea. A visit to the gastroenterologist will bring all the relief you need, with little hassle or expense.
Having trouble going to the bathroom? Find out what might be to blame.
Constipation is an annoying and embarrassing problem that all of us will experience at some point. Constipation is when you are unable to have a bowel movement or you have trouble passing stools. If you are having less than three bowel movements a week then you could be dealing with constipation.
This problem isn’t usually something to worry about, as it usually resolves itself on its own. Of course, there are times in which you may want to turn to a gastroenterologist for care.
What causes constipation?
This usually happens when the stool moves too slowly through the digestive tract, making it difficult to expel. Causes of constipation include:
- Poor diet
- Bowel obstruction
- Anal fissures
- Bowel stricture (narrowing of the colon)
- Conditions that affect the nerves of the colon or rectum (e.g. stroke; Parkinson’s disease)
- Weak pelvic muscles
- Hormone changes due to pregnancy, diabetes, or certain thyroid disorders
There are also certain factors that can increase your chances for chronic constipation:
- Age (older adults are more likely to experience constipation)
- Not getting enough fiber in your diet
- Living a sedentary lifestyle
- Taking certain medications (e.g. antidepressants; blood pressure medications)
- Certain mental health disorders such as depression
How can you prevent constipation?
If you deal with constipation regularly there are some ways to help lessen the chances for this problem. Make sure that you are drinking enough water throughout the day and include a lot of fiber-rich foods in your diet such as whole grains, fruits and vegetables, and beans. Stay away from processed foods, and make sure you are staying active.
When should I see a doctor?
It’s a good idea to give your GI doctor a call if you’ve been experiencing constipation for over 3 weeks or if lifestyle modifications such as drinking more water or adding more fiber to your diet just aren’t working. It’s also important to see a specialist as soon as possible if your constipation is accompanied by pain or if you see blood on the toilet paper (this could be a sign of hemorrhoids or an anal fissure).
If you are experiencing chronic or severe constipation it’s a good idea to turn to a GI specialist who will help you get to the root of the problem and help get your digestive tract moving in the right direction.
This diagnostic procedure could determine the root cause of your digestive issues.
An upper endoscopy is a simple procedure in which your gastroenterologist will insert a small, flexible tube that contains a camera in the mouth and guide it carefully into the upper digestive tract (stomach and small intestines). Why is this outpatient procedure performed? Many reasons, actually. Your gastroenterologist may recommend getting this procedure if there are signs of bleeding within the upper digestive system.
An endoscopy is also a great tool for being able to detect inflammation within the digestive tract, as well as ulcers and tumors. You may benefit from an endoscopy if you are experiencing:
- Difficulty swallowing
- Chronic heartburn
- Abdominal pain
- Chest pain
- Nausea and vomiting
An upper endoscopy is a much better and more accurate diagnostic tool for detecting growths and other abnormalities within the lining the digestive system than x-rays. Furthermore, many gastrointestinal issues can often be treated during the endoscopy. This includes the biopsy and/or removal of polyps, opening up narrowed areas of the esophagus or stomach, removing objects or obstructions within the intestinal tract or stopping a bleed.
Before your procedure, your gastroenterologist will give you detailed instructions to follow. This includes not eating or drinking anything for eight hours before your endoscopy. Patients with certain conditions such as a history of endocarditis (an infection of the heart valve) or those with artificial heart valves may need to take antibiotics beforehand to reduce their risk for an infection. Patients who take medications may still take their medication before the procedure with a little bit of water.
An endoscopy is performed under sedation so you won’t feel anything or remember the procedure. It’s important that you bring someone with you who will be able to drive you home afterwards, as sedation’s effects can last up to eight hours after. Prior to the procedure, a local anesthesia may be sprayed in the back of the throat to numb the area. You will then receive a combination or pain and sedation medication through an IV. Then the thin endoscope will be placed in the mouth and directed through the esophagus into the stomach. The procedure takes approximately 15-20 minutes.
If you are experiencing symptoms of bleeding, ulcers, or other issues within the digestive system, an endoscopy can be an amazing tool for determining what’s going on and what can be done to treat the problem.
Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes severe and even bloody diarrhea that can result in abdominal pain and unexpected weight loss. While people have probably heard about Crohn’s disease more often than they have ulcerative colitis, this condition actually affects as many as 907,000 of the 1.6 million Americans living with IBD.
While ulcerative colitis can happen to anyone, a gastroenterologist most often diagnoses it during a person’s later teen years or by early adulthood. While there is no definitive cause of ulcerative colitis, a family history of this condition can certainly increase your chances of developing this chronic GI problem.
Those with ulcerative colitis experience diarrhea, which can be bloody at times. Some patients may experience rectal pain, occasional constipation, abdominal discomfort, fever, or weight loss. In order to diagnose this gastrointestinal issue, a GI specialist will often need to perform imaging tests such as a CT scan or run an endoscopy to check the health of the gastrointestinal tract and to look for signs of ulcerative colitis.
While there is currently no cure for this condition, there are certainly an array of medications and treatment options available to help you keep your symptoms and flare-ups in check. The type of treatment plan that your GI doctor will create for you will depend on the type and severity of your symptoms.
The main goals of treating ulcerative colitis are to reduce inflammation within the colon while also speeding up the remission process and making sure that your symptoms stay in remission for as long as possible. Of course, it is still possible, even with the right medication, to experience symptoms.
Common medications for treating ulcerative colitis include:
- Antibiotics: to target any infections within the GI tract
- Aminosalicylates: to treat mild to moderate inflammation within the colon
- Corticosteroids: for short-term treatment of moderate to severe symptoms
- Biologics: to target a specific protein, which leads to inflammation
Sometimes, over-the-counter medications and supplements may be used in conjunction with prescription medications. These may include vitamins and nutritional supplements, pain medications and antidiarrheal. If your ulcerative colitis doesn’t respond to these medications then you’ll want to discuss the benefits with your gastroenterologist of getting surgery to remove parts of the colon or rectum to alleviate severe or persistent symptoms.
C. difficile (Clostridium difficile) is an infection that should be talked about more often than it is despite the fact that it infects half a million Americans each year. While C. diff bacteria can be found within the gut of healthy individuals the healthy gut bacteria work to keep the potentially harmful bacteria in check. C. diff spores can be found in our environment through the air we breathe, or even the clothes on our back or the foods we consume. This is usually how we end up with C. diff in our guts.
However, sometimes circumstances arise in which C. diff bacteria are able to multiply within the gut. This most often occurs in someone who is taking antibiotics because while antibiotics are being used to fight an infection it can also kill off some of the healthy bacteria in our gut.
Unfortunately, C. diff bacteria are resistant to many kinds of antibiotics, giving it free range to thrive and multiply quickly within the gut. These bacteria, particularly in larger numbers, can also produce toxins. It’s usually the toxins themselves that lead to symptoms such as diarrhea, stomach cramps, nausea, and fever.
C. diff infections can range from mild to severe. In milder cases, patients may liken their symptoms to an infection within the stomach (also known as gastroenteritis). These symptoms may be mild and self-limiting, lasting anywhere from a couple of days to multiple weeks. Usually, medication or treatment isn’t needed in order to treat the infection.
However, those dealing with severe diarrhea, blood in the stool, severe abdominal pain, fever, and dehydration should seek the care of a gastroenterologist as soon as possible. While these symptoms can be indicative of several different gastrointestinal issues, if you suspect that you might have a C. diff infection it’s important that you seek immediate medical treatment.
Since most people have C. diff within their gut, if it isn’t causing any issues then no treatment is necessary. As we mentioned before, those dealing with minor symptoms may be able to let the issue run its course. Those with severe infections may need to be hospitalized. If you are still taking the antibiotics that may have caused this problem then you will most likely need to stop taking it so that the healthy gut bacteria have a chance of returning and making the gut healthier.
Those with severe diarrhea or colitis (inflammation of the colon) may be prescribed very specific antibiotics known to kill the C. diff bacteria. In the meantime, make sure you are drinking enough water and fluids to keep your body hydrated. If diarrhea is severe, your doctor may need to give you fluids and nutrients through an IV.
Luckily, most people dealing with this infection will be able to fully recover, even if they don’t get treatment; however, those who are older or have a weak immune system should seek medical attention as soon as possible if they suspect an infection. While symptoms can be unpleasant, they will usually go away in a few weeks.
Do you find that most mealtimes end up being ruined by gnawing, nagging heartburn? While most people will experience heartburn at some point during their lifetime, if you are someone who suffers from this problem several times a week then you may just have a digestive disorder known as gastroesophageal reflux disease (GERD).
What is GERD?
Whenever you eat food, it travels from the esophagus to the stomach. Once food enters the stomach, the stomach produces acid to break up the food. Of course, in healthy individuals the food travels from the stomach to the intestines; however, if you have GERD then the acid and food contents actually flow back up to the esophagus from the stomach, irritating the lining of the throat and causing a nasty case of heartburn.
What are the symptoms?
Heartburn is a classic symptom of GERD. Heartburn is a burning in the chest that also affects the lining of the throat. Heartburn sometimes produces an acidic or bitter taste in the mouth. Symptoms may get worse if you eat a big meal, consume something spicy or lie down immediately after eating.
How is GERD diagnosed?
In some situations a gastroenterologist may be able to determine that you have GERD based on the symptoms you describe and through a simple physical exam; however, sometimes a diagnostic test is required in order to determine whether your symptoms are truly caused by GERD or something else. An upper endoscopy is one common diagnostic procedure performed to check for signs of inflammation or damage to the lining of the esophagus, which are indicative of GERD.
What are my treatment options?
Your treatment plan will most likely consist of lifestyle modifications and medications.
If you are overweight or obese you may be at a higher risk for developing GERD. It’s important to lose that excess weight and to maintain a healthy weight to reduce your symptoms. Quit smoking if you are currently a smoker. Make sure to eat slowly and eat smaller meals. Don’t lie down immediately after eating and eat about three hours before going to bed.
Also, there are certain foods that can trigger heartburn symptoms including chocolate, caffeine, alcohol, tomato sauce, garlic, or fatty and spicy foods. Limit or avoid any of these foods if they are known to cause you heartburn.
Those with milder symptoms may be able to use an over-the-counter antacid or medication to manage their symptoms; however, if symptoms are moderate-to-severe, or if you have damage to the lining of the esophagus, then you’ll need a stronger medication to reduce or even prevent the production of stomach acid until the damage has healed.
If you deal with heartburn on a regular basis or can’t seem to get heartburn under control it’s important that you turn to a GI doctor who can help you find the proper treatment option to prevent digestive complications and to make mealtimes more enjoyable again.
Hepatitis C is an infectious disease that causes liver inflammation, sometimes leading to serious liver damage. Most people have no symptoms right after they have been infected, and since any symptoms are likely to go away in a few weeks, you may not know you have Hepatitis C for a long time. Here are the most common signs of Hepatitis C.
Jaundice is a yellowish appearance of the whites of the eyes due to high bilirubin levels. Normally bilirubin gets broken down in the liver and released from the body in the stool. But if the liver is damaged, it cannot properly process bilirubin.
2. Dark Urine
Urine naturally has some yellow pigments called urobilin or urochrome. The color of the urine can vary when certain medications are taken and when foods of certain types are consumed. Chronic dark-colored urine can be related to serious liver conditions, including Hepatitis C and cirrhosis.
3. Chronic Fatigue
The severity of this fatigue differs from person to person. Some individuals are able to work, but then feel burned out in the evening. Some people spend a large amount of time sleeping. However, someone people feel very tired after a good night's sleep. The fatigue associated with Hepatitis C often improves with treatment.
4. Aches and Pains
Some people with Hepatitis C experience abdominal pain. Many suffer from aches and pains in their joints. A variety of different joints can be involved but the most common are in the wrists and hands. The pains can range from mild to severe. In such cases, medications can be used to ease the pain.
5. Poor Appetite
Loss of appetite implies that hunger is absent. Your appetite may worsen if you have cirrhosis or liver failure. Loss of appetite can also be caused by other diseases and conditions. Some of the conditions can be temporary, such as appetite loss from the effects of medication.
6. Low-grade Fever
Everyone gets a fever from time to time. Most usually don't indicate anything serious. However, some people with Hepatitis C experience a low-grade fever (fever up to 102°F). You should book an appointment with a doctor if you've had a fever for more than three days.
7. Cognitive Changes
Some people with Hepatitis C experience problems with concentration, short-term memory, and completing complex mental tasks such as mental arithmetic. Studies have shown that about half of those with Hepatitis C experience cognitive disturbances.
Many people are surprised to learn that they have been infected with Hepatitis C. Some people feel overwhelmed by the changes they need to make in their lives. At a time when life feels out of control, remember that you can take an active role in your health- and your life.
Hepatitis C Facts
- ~3.5 million Americans live with HCV infection.
- >15,000 Americans will become infected with HCV every year.
- >15,000 Americans will die every year from complications of HCV.
- 80% of people who get exposed to HCV will develop a chronic infection.
- HCV is acquired through direct exposure to blood of someone who is infected.
- 15-30% of people with chronic HCV will develop cirrhosis or other complications, most after more than 20 years.
- HCV with heavy alcohol use increases the risk of cirrhosis 100-fold
- Currently, no vaccine is available.
A renaissance in the treatment of Hepatitis C Virus (HCV)
Twenty-five years of HCV’s dark ages are over. Plagued by poor understanding of HCV, primitive and barbaric treatments (specifically interferon) with significant toxicity and limited success were all we had to offer—until now. In 2009, scientists discovered how to replicate HCV in mice, opening the doors to a renaissance in HCV drug development.
The new age Hepatitis C treatment
Within the past year, interferon-free drug regimens for every genotype (sub-type of HCV) have come to market. While we are still gaining important experience with these drugs, a few things are clear: The new HCV drugs are very effective with greater than 90% cure, even in those with cirrhosis, and are easy to take with minimal side effects. Better yet, several additional drugs are currently under study with very promising results; the near future will offer even more effective, shorter, easier, and less costly treatment regimens.
Hepatitis C genotype 1 (and 4)
Type 1 HCV accounts for more than 70% of infections in the United States and traditionally was very resistant to treatment. Harvoni© became available October 10th, 2014 representing the first interferon-free regimen consisting of one pill (containing ledipasvir and sofosbuvir) taken once a day for 12-weeks with >94% clearance. Side effects include headaches and fatigue, but not a single study participant stopped the drugs due to side effects—a gigantic leap forward compared to interferon-based treatments. More recently, Viekira© and Olysio-Sovaldi© treatment regimens were approved, with the promise of several more to come in 2015.
Hepatitis C genotype 2 and 3
Approval of Sovaldi© in combination with Ribavirin© has improved cure rates for HCV genotypes 2 and 3 from 70% to greater than 90%. However, this combination eliminates the need for interferon, but still relies on ribavirin—a drug with the potentially serious side effect of anemia (low red blood cell counts.) Better regimens, which avoid both interferon and ribavirin, are just around the corner.
Who should get treated for hepatitis C in this new era?
With such great new medications, it would seem that everyone should get treated, except for one serious problem: cost. The new drug regimens cost in excess of $80,000; it would cost 280 billion dollars (for the drugs alone) to treat every American with Hepatitis C. Obviously, insurance companies have balked at the thought of an $80,000 drug, and perhaps rightfully so. Less than a third of all persons infected with HCV will ever develop cirrhosis or complications—treatments should be offered to patients who are at a high risk of developing cirrhosis. Fortunately, for most it takes 30 years or more to develop cirrhosis. See a Gastroenterologist to determine if, and when, treatment might be needed.
There has been some excitement lately since the FDA recently approved ColoGuard, a genetic test performed as an additional testing option for colon cancer screening. Dr. Kevin Rufner has outlined the benefits and cost comparison for this test. To read his article, click on the document link below.
Welcome to the Blog of Colorado Gastroenterology
Colorado Gastroenterology would like to welcome you to our blog. Here you will find informative and useful postings about gastroenterology and our practice.
At Colorado Gastroenterology we believe that educated patients are better prepared to make decisions regarding the health of their digestive system. Our blog was designed to provide you with the latest gastroenterology developments and valuable health advice from our dedicated team.
Colorado Gastroenterology hopes you find our blog to be a great resource for keeping up to date with proper digestive health care and treatments.
We welcome all comments and questions.
-- Midtown Medical Center
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