Heartburn or indigestion is a symptom of chest discomfort typically caused by excessive acid production in the stomach. The stomach acid travels up the esophagus, which connects the mouth to the stomach and causes burning and inflammation. Acid Reflux is also known as GERD, or gastro-esophageal reflux disease. It is common in all age groups and can be treated with over-the-counter or prescription medication. However, if it persists after taking medication for an extended period of time, it can lead to a potentially serious condition known as Barrett’s Esophagus. Barret’s Esophagus is a structural change in the cell type of the lower esophagus. This condition needs to be monitored carefully by a GI physician because it can lead to esophageal cancer
Irritable Bowel Syndrome (IBS)
This condition is caused by an abnormal communication between the brain, the gut and the central nervous system that causes bowel irritation and sensitivity to stimuli. Symptoms include abdominal pain or discomfort as well as diarrhea or constipation. Abdominal pain can be crampy, sharp, dull or a generalized ache with periodic crampiness. Other GI symptoms that may accompany IBS include: heartburn, an early feeling of fullness or satiety, nausea, a feeling of fullness and bloating. Non-GI symptoms can include fatigue, muscle pain, sleep disturbances, sexual dysfunction, low back pain, and headache. Symptoms wax and wane/come and go. IBS is not easy to diagnose and can often be confused with other GI conditions. Gastroenterologists at Franklin Square Health Group will diagnose your symptoms and help you plan an appropriate course of treatment.
Celiac Disease is a genetic disease where consuming gluten leads to damage to the small intestine. Approximately 1% of the world population has Celiac Disease. Gluten is a protein found in wheat, rye and barley. When a patient with Celiac Disease consumes gluten, an immune response ensues which damages the small fingerlike projections found on the inside of the small intestine known as villi. This causes diminished nutrient absorption.
Symptoms of Celiac Disease include diarrhea, gas, constipation, abdominal pain, nausea, anemia, an itchy rash, reduction in bone density, headaches, fatigue, bone and joint pain, ulcers in the mouth, weight loss and heartburn.
Diagnosis of Celiac Disease is typically made through blood/serology tests for gluten autoantibodies and a small bowel biopsy to assess gut damage. The small bowel biopsy is typically performed during an upper endoscopy/EGD.
Treatment of celiac disease involves avoiding gluten. Approximately 5% of patients with celiac disease do not respond to a gluten-free diet. These patients may have to be treated with corticosteroids and immunomodulatory medication.
Hemorrhoids are swollen veins in the anus and lower rectum that get irritated especially during straining. Symptoms include pain and severe itching and worsening pain with sitting and bowel movements. Hemorrhoids can be classified as internal or external. Internal hemorrhoids are inside the rectum and can’t be seen or felt. Typically, their only sign is bleeding. External hemorrhoids are found under the skin around the anus. They can be painful and bleed and can enlarge and bulge outside of the anus.
Causes of hemorrhoids include increased pressure in the abdomen from straining which can arise from constipation or heavy lifting. Causes also include prolonged standing or sitting, pregnancy, obesity, rectal cancer, repeated anal intercourse, Crohn’s Disease or Ulcerative Colitis and heredity.
The diagnosis of hemorrhoids is typically made by digital rectal examination or sigmoidoscopy, which is insertion of a flexible camera into the anus and rectum.
Treatments of hemorrhoids include self-remedies such as slowly increasing fiber in the diet, topical hemorrhoid cream or suppositories containing hydrocortisone, warm baths, keeping the anal area clean and avoiding alcohol or perfume containing wipes, and using moist or wet toilet paper, ice packs and over the counter pain relievers such as Advil or Tylenol.
If a blood clot develops in an external hemorrhoid, the doctor can remove the clot with a simple incision and drainage.
Rubber Band Ligation is where the physician places one or more rubber bands around the base of an internal hemorrhoid. Sclerotherapy is injection of a chemical solution into the hemorrhoid. Coagulation techniques use heat, laser or infrared light. Out of these three, rubber band ligation tends to be the most effective.
Surgical procedures are typically reserved for when other treatments fail or for very large hemorrhoids. Hemorrhoidectomy is surgical removal of excessive tissue that causes bleeding. Stapling is simpler than hemorrhoidectomy but is associated with a greater risk of recurrence and complications such as rectal prolapse, bleeding and urinary retention.
Abdominal Pain and Bloating
This condition is when the abdomen is full, gaseous and potentially swollen. Common in all age groups, causes include, but are not limited to swallowing excess air, consuming high fat foods, stress, constipation, intolerance to lactose or gluten, gastroenteritis, colitis, gastroesophageal reflux disease or GERD, intestinal obstruction, ileus, gastroparesis, irritable bowel syndrome, ectopic pregnancy, endometriosis, menstrual pain, ovarian cysts, PID pelvic inflammatory disease, appendicitis, cystitis, certain medications, cirrhosis, cancer, peptic ulcer disease or PUD, diarrhea, constipation, difficulty swallowing, painful swallowing, Crohn’s Disease, Ulcerative Colitis and rectal bleeding.
Treatment depends on the underlying condition(s). For milder conditions, symptoms typically resolve on their own. If symptoms persist, it is best to consult your primary care physician or see a gastroenterologist.