We know you may have questions about gastroenterology conditions, symptoms, and care. Read more from our experts about different conditions we treat, what we offer, when to come see us, and some ways you can help relieve symptoms at home.
What is heartburn and how can I control it?
Heartburn is a burning sensation behind the breastbone that results from the reflux (back flow) of acid and other stomach contents from the stomach into the esophagus (swallowing tube). Normally, acid should remain in the stomach when a meal is eaten. Heartburn happens when the "valve" (called the lower esophageal sphincter) between the esophagus and the stomach relaxes abnormally.
How well your heartburn can be controlled and how bad it is can vary a lot among different people. If heartburn is mild and occurs only once in a while, it is important to determine what led to it. In general, we recommend the following measures to relieve heartburn:
- Elevate the head of your bed between 4 and 6 inches. Don’t use extra pillows, as they may actually aggravate heartburn. If the elevation becomes uncomfortable for you or your partner, you can use a firm wedge to elevate your chest and head instead.
- Avoid coffee of any type (including decaffeinated), tomatoes and tomato products, citrus fruits and juices, chocolate, mints, caffeinated beverages, alcoholic drinks and fatty foods.
- Do not lie down for at least three hours after eating a meal.
- Stop smoking.
- Lose weight and avoid wearing tight-fitting garments.
- Use various medications, depending on how bad your heartburn is. Some medications are available without a prescription.
If you get heartburn more than two or three times a week, it is important that you talk to a gastroenterologist. They may recommend testing to look for causes and suggest treatment.
Is heartburn serious?
Although heartburn is merely annoying in the vast majority of cases, it can also be a warning sign of more serious problems If you are over age 40 and are having heartburn or "indigestion" for the first time, it is important that you see a physician as soon as possible. Many people who actually have angina (decreased blood flow to the heart) may feel like they have heartburn or indigestion, so it is essential to get a correct diagnosis right away.
If you know you have heartburn, and it happens often, it’s important to see a gastroenterologist. Acid coming into the esophagus can damage the esophagus, leading to inflammation or esophagitis, which can lead to more serious illness. In the most extreme cases, this can include cancer of the esophagus. Acid reflux can also lead to or worsen asthma, chronic cough, hoarseness, and even erosion of the teeth. While this is not common, certain individuals are at a high risk for severe complications. The most important factors include the duration of heartburn (how many years) and the severity of the symptoms.
What causes ulcers?
Ulcers are most commonly caused by infection with a bacterium called Helicobacter pylori (H. pylori). It lives in the stomach and causes an inflammation of the stomach (gastritis). Many people, especially people over the age of fifty, are infected with H. pylori, but it doesn’t cause issues in most of them. A small number, less than five percent, will develop ulcers. Currently, antibiotics are used to treat this infection if it is associated with a proven peptic ulcer.
In addition to H. pylori, one of the most common causes of ulcers is the use of aspirin and a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs include prescription medications such as such as Motrin and Naprosyn, as well as over-the-counter medications such as Advil and Aleve. Tylenol and other forms of acetaminophen do not cause ulcers. It is also important to realize that certain medications that one can purchase without prescription, such as Alka-Seltzer, Goody Powder and Standback, also contain aspirin and can lead to serious damage to the stomach.
Many people can develop ulcers without infection with H. pylori or without consuming NSAIDs. If you are experiencing pain in the center of the abdomen below the rib cage, see a gastroenterologist to determine whether or not you do have an ulcer.
What is irritable bowel syndrome?
Irritable bowel syndrome (IBS) is a common disorder of the intestine that leads to crampy pain, gas, bloating, and changes in bowel habits. Some people with IBS have constipation, others have diarrhea, and some people experience both. Sometimes a person with IBS has the urge to move the bowels but cannot do so. The cause of IBS is unknown. There is no cure, but effective treatment is available.
What is hepatitis C?
Hepatitis C is inflammation of the liver due to the hepatitis C virus. It is most commonly acquired by exposure of the blood to the virus, for example in people who use injection drugs and share needles, through contaminated tattoo needles or by transfusion with blood or blood products with hepatitis C (now very rare). Long-term liver inflammation from hepatitis C can lead to cirrhosis and liver cancer. The diagnosis of hepatitis C can be made with simple blood tests and is strongly recommended in all people with risk factors for the infection. Almost all patients with hepatitis C should receive treatment (pills) with over 90% of patients being cured.
What is a polyp?
A polyp is a growth often occurring in the large intestine, known as the colon. Polyps rarely cause symptoms. Some polyps are precancerous. This means that if they’re not removed, they could develop slowly into a cancer.
What is yellow jaundice?
Yellow jaundice is a discoloration of the skin, often seen in the eyes and under the tongue. Sometimes it is accompanied by dark urine. In almost all instances is it caused by a liver condition that must be evaluated by a physician. If you do have jaundice, see your doctor immediately.
Are hemorrhoids dangerous?
In general, no. In very rare circumstances, hemorrhoids can bleed profusely and require hospitalization.
I saw blood in my stool. What should I do?
You need to call your doctor. If you have blood in your stool, you should get an endoscopic examination of the large intestine (colon) to find a possible source of the bleeding. You should have this exam, even if you think you have hemorrhoids. If you bleed a lot, go to the nearest ER for immediate evaluation.
Why do I have trouble swallowing?
There are many reasons why you might have issues swallowing. These are usually related to the esophagus (swallowing tube), and include acid reflux or, in some cases, cancer. You must see a gastroenterologist to identify the reason of your problem.
What is pancreatitis?
Pancreatitis is a rare disease in which the pancreas becomes inflamed. This leads to digestive enzymes attacking the pancreas and damaging them. In severe cases, you may have bleeding into the gland, serious tissue damage, infection and cysts. Enzymes and toxins may enter the bloodstream and seriously injure organs, such as the heart, lungs, and kidney.
There are two forms of pancreatitis. The acute form occurs suddenly and may be a severe, life-threatening illness with many complications. Usually, however, the patient recovers completely. If injury to the pancreas continues, such as when a patient keeps drinking alcohol, a chronic form of the disease may develop. This can lead to severe pain and reduced pancreatic functioning, affecting digestion and causes weight loss.
Why is esophageal manometry performed?
An esophageal manometry helps tell your doctor if food is moving normally through your esophagus to your stomach. Your doctor may want you to have an esophageal manometry because you have difficulty swallowing, pain when swallowing, non-cardiac chest pain (a cardiac work up has ruled out heart problems), or if you have had chronic heartburn in the past and may now be considering surgery as an alternative to continued medication.
Who should be screened for colorectal cancer?
Anyone over the age of 50, regardless of gender or race/ethnicity, is at increased risk of colorectal cancer and should be screened. Individuals with a family history of colorectal cancer or polyps are at an even higher risk and should be screened at a younger age. Screening should begin around age 40 if only one first-degree relative (parent, sibling or child) had either cancer or polyps, and as early as 25 if multiple first-degree relatives were affected. Patients with a personal history of colorectal polyps, cancer, or inflammatory bowel disease (ulcerative colitis or Crohn's disease) are also at high risk and should have periodic colonoscopies.
What screenings are available for colorectal cancer?
There are four main screening tests for colorectal cancer: stool blood testing, flexible sigmoidoscopy, barium enema, and colonoscopy. The tests have different levels of accuracy, risks, convenience, discomfort, preparation, frequency of repeat testing, and costs.
While any of the tests may be right for 50 years of age or older, colonoscopy may be a better choice for those at higher risk because of personal or family history of colorectal cancer or polyps, or because of a history of chronic inflammatory bowel disease. At-risk individuals should talk to their provider about their options.
Can I reduce my risk of getting colorectal cancer?
Yes. A healthy diet can help reduce the risk. In general, eat five or more servings of fruits and vegetables a day, replace red meat with chicken, fish, nuts, and legumes, and take a multivitamin containing 0.4 mg of folic acid.
Moderate physical activity, at least 30 minutes per day, is also important. This may include brisk walking, dancing, and gardening. Start slowly and build up to 30 minutes per day. Regular exercise has many health benefits, and even moderate exercise can help reduce the risks of many diseases.
Maintain a healthy weight and avoid smoking, as well.