Gastroenterology and Advanced GI Endoscopy Center

Achalasia occurs when nerves in the esophagus become damaged. The esophagus becomes paralyzed and dilated over time and eventually loses the ability to squeeze food down into the stomach. Why the esophageal muscles fail to contract and relax normally is unknown. One theory is that achalasia is an autoimmune disease (in which your body attacks itself) triggered by a virus. More research is still needed.

Symptoms may include a backflow of food in the throat (regurgitation), chest pain, and weight loss. Achalasia can usually be managed with minimally invasive endoscopic therapy or surgery.

This term can include one or both conditions called diverticulosis and diverticulitis. Both of these conditions occur in the large intestine or colon when one or more “pockets” or “bulges” form in the wall of your colon. The conditions cause bleeding, inflammation or other complications. Diverticulosis is very common in Western populations. It occurs in 10% of people over age 40 and in 50% of people who are 60 or older.

Mild diverticulitis can be treated with rest, changes in your diet, and antibiotics. Severe or recurring diverticulitis may require surgery.

This “umbrella term” refers to conditions where the muscles in your esophagus fail to contract. When this happens, the esophagus does not properly propel food and liquids into your stomach. Esophageal motility disorders include swallowing disorders such as dysphasia, nutcracker esophagus, or achalasia.

Esophageal strictures describe an abnormal tightening or narrowing of the esophagus. The most common cause is from long-term chronic acid reflux disease. Some less-common causes are eosinophilic esophagitis, radiation therapy, treatment for esophageal varices (banding or sclerotherapy), corrosive ingestions, esophageal surgeries, cancer, and rare dermatologic diseases that involve the esophagus.

The main symptom of an esophageal stricture is difficulty in swallowing. Esophageal dilation is the treatment of choice. This is usually done endoscopically by stretching the esophagus with different dilators. Other options may include corticosteroid injections into the esophageal stricture after dilation or temporary placement of esophageal stents.

This term describes enlarged veins in the esophagus. The condition is often caused by obstructed blood flow from the portal vein, which carries blood to the liver. The obstruction, which can be caused by scar tissue in the liver from liver disease, creates pressure and enlargement. Bleeding esophageal varices is a life-threatening condition and can be fatal in up to 50% of patients.

There are two non-surgical treatments available to stop variceal bleeding. Variceal ligation is typically performed endoscopically by a gastroenterologist. A transjugular intrahepatic portosystemic shunt (TIPS) procedure is done by a radiologist using X-ray technology.

Gastirc polyps are unusual growths of tissue within the inner lining of the stomach. Most stomach polyps are not cancerous, but there are some types that have a higher risk of turning into cancer. Most stomach polyps can be removed endoscopically by a gastroenterologist. During the procedure, a biopsy of one or more of the polyps will be taken for examination to make sure the tissue is not cancerous. If several polyps are found, the doctor may recommend surgery.

This condition affects the normal movement of the muscles in your stomach (known as “motility”). Ordinarily, strong muscular contractions propel food through your digestive tract. But if you have gastroparesis, your stomach’s motility is slowed down or doesn’t work at all, preventing your stomach from emptying properly. Symptoms include heartburn, nausea, vomiting, and feeling full quickly when eating. Treatments include medications and possibly surgery.

Barrett’s esophagus is a condition closely related to gastroesophageal reflux disease (GERD). It affects about 1 in 10 patients who have acid reflux. Barrett’s esophagus occurs when acid-containing contents in your stomach persistently leak back up into your esophagus. This can happen when a valve at the end of your esophagus (the lower esophageal sphincter) doesn’t close properly when food arrives at your stomach.

To help resolve this condition, our staff works closely with other specialties in a multidisciplinary way through our Barrett’s Esophagus Center of Excellence.

A hernia occurs when an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue. Gastrointestinal hernias may include hiatal, umbilical or incisional/ventral hernias, among others. Hernias are generally repaired surgically. Repairs can be done laparoscopically, robotically or by an open surgical procedure. Our specialists work together to surgically repair all types of hernias. We use a variety of surgical approaches including robotic abdominal wall reconstruction.

A group of disorders that cause chronic inflammation in the intestines, IBD includes Crohn’s disease and ulcerative colitis. Up to 3 million Americans have some form of IBD. The condition affects all ages and genders, but most commonly occurs between the ages of 15 and 30.

There are many different tests used to diagnose IBD, including stool and blood testing, endoscopy, and imaging scans. There are also many different treatments for IBD depending on the condition and severity of disease. Medication therapies can include anti-inflammatories, antibiotics, biologics and immunomodulators. Surgical options may include bowel resection or colectomy (removal of part of intestine).

IBD is a lifelong condition, but it shouldn’t shorten life expectancy. With Proper treatment can prevent “flares” and enable long periods of remission.

We diagnose and treat an array of pre-cancerous and cancerous conditions of the gastrointestinal system. Some pre-cancerous conditions include Barrett’s esophagus, chronic gastritis with or without Helicobacter pylori infection, atrophic gastritis, intestinal metaplasia of the gastric mucosa, epithelial dysplasia, and adenoma polyps.

Cancers of the GI tract include esophageal, stomach, liver, pancreatic, colorectal, anal, carcinoid or neuroendocrine, gallbladder, small intestine, bile duct and GIST (gastrointestinal stromal).

An ulcer is a sore on the lining of your stomach or the first part of your small intestine (duodenum). The two most common causes of ulcers are infection with Helicobacter pylori (H. Pylori) and overuse of a group of medications known as NSAIDs (non-steroidal anti-inflammatory drugs).

Ulcers are typically diagnosed by a procedure called an EGD (upper endoscopy) or with an X-ray test called an “upper GI series”. An upper GI series involves drinking a white chalky substance called barium, and then taking a number of X-rays to look at the lining of the stomach. Treatment can include lifestyle changes, medicine or, in some cases, surgery.

An outpatient procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the doctor to view the inside of this area in the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy if necessary.

An outpatient procedure that allows the doctor to examine the inside of large intestine (colon and rectum). The examination uses an instrument called a colonoscope. This flexible instrument is very long and includes a camera and has the ability to remove tissue (biopsies) if necessary. A colonoscopy is commonly used to investigate abnormal gastrointestinal symptoms or for colon cancer screening.

A specialized technique which combines endoscopy and ultrasound to create images of the digestive tract and its surrounding organs and tissues. Your doctor may also use EUS to help diagnose a number of digestive disorders including  tissue sampling for cancer detection, staging of gastrointestinal cancers, and diagnosing problems in the bile ducts and gallbladder.

A specialized endoscopic technique used to study the bile ducts, pancreatic duct and gallbladder. Your doctor will pass an endoscope through your mouth, esophagus and stomach into the duodenum, then inject a contrast material (dye) into the pancreatic or biliary ducts and will take x-rays. Some reasons ERCP’s are performed are to break up and remove stones, place stents to open blocked or narrowed ducts and to remove tumors or tissue samples for biopsy.

A medical test that uses a special tool to look at the inside of the small intestine.  It is a type of endoscopy procedure that may be used to help diagnose and manage several different types of digestive conditions such as bleeding, malnutrition, severe diarrhea or suspected tumors. This advanced procedure is often used as an addition to other diagnostic testing such as an upper endoscopy, colonoscopy, capsule endoscopy, or various radiology testing.

A procedure that uses a tiny wireless camera to take pictures of your digestive tract. A capsule endoscopy camera sits inside a vitamin-size capsule that you swallow. As the capsule travels through your digestive tract, the camera takes thousands of pictures that are transmitted to a recorder you wear on a belt around your waist. The capsule endoscopy procedure is complete after eight hours or when you see the camera capsule in the toilet after a bowel movement, whichever comes first. Capsule endoscopy helps doctors see inside your small intestine, an area that isn’t easily reached with more traditional endoscopy procedures. The most common reason for doing capsule endoscopy is to search for a cause of bleeding from the small intestine. It may also be useful for detecting polyps, inflammatory bowel disease (Crohn’s disease), ulcers, and tumors of the small intestine.

An endoscopic technique that uses stains during an endoscopy to visualize differences in tissue such as abnormal or malignant changes that may not be apparent in white light.

Feeding tubes which allow you to receive nutrition directly through your stomach. You may need a PEG tube if you have difficulty swallowing or can’t get all the nutrition you need by mouth.  PEG tubes are typically placed endoscopically under anesthesia, and most patients will go home the same day.  After your feeding tube is placed, you’ll be able to see the tube outside your body. You will need to clean the tube daily and keep it dry between cleanings. If a PEG tube falls out or moves, see a healthcare provider within 24 hours. PEG tubes can last for months or years and may be temporary or permanent.

A screening test that use a thin flexible tube with a camera at the end to look at the lower part of the colon, also known as the rectum and sigmoid colon. Sigmoidoscopy is one option for colon cancer screening, but there are other options that allow your doctor to view your whole colon, such as colonoscopy. Talk with your doctor about which option is best for you.

A powerful inhibitor of muscle contraction. BOTOX can be injected through an endoscope to relax certain muscles in the GI tract.  This procedure may be used in patients with achalasia or gastroparesis.v

Polyps can be removed through open abdominal surgery, but more commonly it is performed during an endoscopy or colonoscopy.

A tube made of metal mesh, plastic, or silicone.  A stent is placed in the esophagus to keep a blocked area open so the patient can swallow soft food and liquids. This procedure is usually performed endoscopically.

Typically done endoscopically by stretching the esophagus with different dilators. If this technique fails to help patients become symptom free, other options may include corticosteroid injections into the esophageal stricture after dilation or temporary placement of esophageal stents.

SpyGlass™ technology is a new alternative to traditional ERCP.

With this cutting-edge technology, physicians use a fiberoptic probe that’s attached to a camera to examine portions of a patient’s digestive system in great detail. The probe performs biopsies from inside the bile ducts during the examination.

This technology improves a gastrointestinal physician’s ability to accurately diagnose or rule out cancer or other potentially serious conditions without the need for additional scans, tests or invasive surgery.

Fecal Microbiota Transplantation (FMT) is a new treatment that’s been shown to be over 90 percent effective for treating C. difficile infection in patients who previously failed to recover with antibiotic therapy.

The purpose of fecal transplant is to replace good bacteria that has been killed or suppressed, usually by the use of antibiotics. This causes bad bacteria to over-populate the colon.