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What is H. Pylori?

H. pylori is a bacteria that can infect the stomach and cause complications like stomach ulcers. Here’s an overview of how doctors identify and treat this infection.

Causes and Risk Factors

H. Pylori is very common- in the United States, around 30-40% of people are estimated to have an infection with the bacteria in their lifetime. Most It may spread through contaminated food and water, and through an infected person’s saliva or other bodily fluids. As such, risk factors include eating food that is not cooked properly or safely and drinking contaminated water. Living in crowded conditions also increases risk, as does living in a developing country where living conditions may be less sanitary and more crowded. Additionally, if you live with someone who has H. pylori, you have an increased risk.

Symptoms and Complications

Most people with H. pylori never have any symptoms. For people who do experience symptoms, they can include a burning or ache in the abdomen, loss of appetite, nausea, boating, weight loss, frequent burping, and nausea. There are some complications that can occur with H. pylori as well. The infection can damage the stomach’s protective lining and allow stomach acid to create an ulcer (an open sore). Additionally, the infection can cause gastritis (inflammation) on the stomach lining. H. pylori infection is also a risk factor for some kinds of stomach cancer.

Diagnosis

There are a few ways doctors can diagnose H. pylori. They can perform blood testing to see if you have an active or past infection. They can also perform breath testing; in this case, you swallow a pill containing carbon molecules and then breathe into a bag. Doctors check for carbon in your breath- if it’s present this means the bacteria is present. Another testing option is a stool test, in which doctors analyze a stool sample for abnormal bacteria or proteins that indicate an H. pylori infection. In some cases, your doctor may perform an upper endoscopy to visualize your stomach and take a tissue biopsy.

Treatment and Prevention

Most often, doctors treat H. pylori infection with multiple antibiotics. They may use two simultaneously to hedge against the bacteria becoming resistant to one. Your doctor may recommend other treatments depending on your case. This can include prescribing proton pump inhibitors, which block stomach acid production. They may also prescribe histamine blockers, which block histamine, the substance that triggers acid production. Often times, you may undergo follow-up testing a few weeks after treatment to determine if the bacteria has been eliminated.

You can take some steps to prevent H. pylori infection. Always wash your hands thoroughly with soap and water after using the bathroom and before eating. Only consume food that has been cooked in a clean and safe manner. Avoid unclean drinking water if possible. Doing these things can cut down on risk factors for H. pylori.

Our experienced team at GHP has years of experience diagnosing and treating H. pylori. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Hereditary Diffuse Gastric Cancer: What You Need to Know

HDGC, or Hereditary Diffuse Gastric Cancer, is an inherited condition that increases your risk of stomach cancer. Here’s what you need to know about the condition.

What is Hereditary Diffuse Gastric Cancer?

Hereditary Diffuse Gastric Cancer syndrome is passed down genetically. This condition causes signet-ring shaped cells to grow on the stomach wall. It can spread throughout the stomach, and it does not usually cause a mass. As a result, it is difficult to diagnose early on before symptoms occur with typical testing like an Upper Endoscopy. Later-stage symptoms of HDGC that can indicate the condition include weight loss, loss of appetite, vomiting, nausea, trouble swallowing, and stomach pain.

Only around 1-3% of all stomach cancers are HDGC, so this is a rare condition. It puts you at a higher risk of stomach cancer and lobular breast cancer. In particular, there is a higher risk of diffuse gastric cancer for people with the syndrome. Diffuse gastric cancer is a type of stomach cancer that tends to affect most of the stomach. Somewhere around 20% of stomach cancers are of this type.

Cancer risk for people in families carrying an HDGC gene is high. The risk of developing stomach cancer by age 80 is 67% for men and 83% for women. The lifetime risk for women with HDGC developing lobular breast cancer is around 20-40%.

Diagnosis

People with a family history of HDGC can receive genetic testing to identify gene mutations associated with the condition. There is no single gene mutation that indicates HDGC most of the time. In fact, in families with a strong history of diffuse gastric cancer, the most common gene mutation (CDH1) for this condition only accounts for around 30-50% of cases. In all cases of gastric cancers, CDH1 mutation only cause around 1-3% of cases. So, there are a particular set of circumstances that dictate whether genetic testing should be pursued. Family history has to be taken into account. The guidelines for testing for a CDH1 may include:

  • A diffuse gastric cancer diagnosis before age 35
  • A diagnosis of both diffuse gastric and lobular breast cancer
  • Over two cases of diffuse gastric cancer in a family
  • Multiple cases of diffuse gastric cancer in a family, with one or more diagnoses occurring before age 50

Reducing Cancer Risk

People with an HDGC diagnosis or confirmed CDH1 gene mutation have a few treatment options. Unfortunately, as alluded to earlier, early screening for HDGC is very difficult since the diffuse cancer involved is hard to detect. People with a CDH1 mutation may want to consider getting their stomach removed through a prophylactic total gastrectomy, as this is the only proven way to completely prevent diffuse gastric cancer. This is a significant surgery with long-term side effects, so you should discuss the option thoroughly with your doctor. If you do not want to pursue the surgery, intensive surveillance is another option. This involves an annual EGD (Esophagogastroduodenoscopy) with multiple mucosal biopsies. Additionally, women at risk of HDGC should consider early breast cancer screening starting at age 30. They may also want to consider biannual clinical breast examinations, monthly self-examinations, and frequent breast imaging tests.

Our experienced team at GHP has years of experience screening for and treating conditions including HDGC. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

What is Anorectal Manometry?

Anorectal Manometry is a procedure that measures the function of anal and rectal muscles. This test helps doctors measure function and pressure in sphincter muscles involved in bowel movements. Here’s what you need to know about the procedure.

When is Anorectal Manometry used?

Anorectal Manometry is used to help evaluate patients with fecal incontinence or constipation. As a type of manometry, it measures the coordination and force of smooth muscles. In particular, it can help evaluate the strength and coordination of sphincter muscles. In short, Doctors use Anorectal Manometry to investigate in cases of abnormal bowel movements. So, if you have difficulty passing stool, struggle with uncontrolled bowels, or experience constipation, your doctor may recommend Anorectal Manometry. Doctors also use Anorectal Manometry to assess anal and rectal muscles pre and post-surgery, investigate functional anorectal pain, and make differential diagnoses regarding anal pain.

Preparing for the Procedure

There are a few preparatory steps you need to take before an Anorectal Manometry. Your doctor will give specific instructions before the procedure. You should not eat or drink anything starting midnight the night before the test. Additionally, your doctor may ask you to take one or two enemas a few hours before the test to empty your bowels. You should also discuss any medications you are taking before the procedure. In particular, you should not take smooth muscle relaxants the day before the procedure.

During the Anorectal Manometry Procedure

Anorectal Manometry does not involve any sedatives. During the procedure, you will lie on your left side with your knees bent. Your doctor will slowly insert a small catheter (tube) through your anal sphincter to your rectum. The catheter has a balloon attached at the end. Once the balloon is in place, your doctor will attach the exposed end of the tube to a machine that inflates the balloon. Your doctor will then measure the muscle coordination and strength in your rectum and anal sphincter. You may be asked to squeeze, push, and relax at various points as they are performing the testing. The machine measures subsequent pressure changes in the balloon. Your doctor may also measure other things like rectal volume, sensation, and muscle reflexes. Once they complete measurements, your doctor will deflate the balloon and remove the catheter and balloon. The procedure takes around 30-45 minutes in total.

After the Procedure

Since no anaesthetic is used during the test, recovery is immediate. You can resume normal activities and diet. Your doctor will discuss their findings with you after the procedure. This can take some time depending on their findings.

Depending on the findings, your doctor may make some recommendations. These may include dietary changes, using certain medication, and muscle strengthening exercise. In some cases, surgery may be required.

Our experienced team at GHP has years of experience performing procedures including Anorectal Manometry. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

Chronic Diarrhea: What You Should Know

Chronic diarrhea can be caused by a variety of things, including infections, GI disorders, food intolerance, and a reaction to medication. Let’s take a closer look at the condition.

Causes and Risk Factors

Diarrhea is chronic when it occurs three or more times per day for more than two weeks. It has several potential causes. Infection is one main cause. This infection can be parasitic, and from parasites like Giardia or Cyclospora. Infection can also be bacterial, from bacteria like Salmonella and E. coli. Some viral infections cause chronic diarrhea too, like some rhinoviruses and rotoviruses.

Outside of infections, there are several other potential causes. Pancreatic disorders like pancreatitis and cystic fibrosis can be a cause. GI diseases like Chrohn’s and IBS can cause diarrhea as well. Intolerance to foods can be at play too- lactose intolerance and fructose malabsorption are two examples. Additionally, some medications like laxatives and antibiotics can cause chronic diarrhea.

Symptoms of Chronic Diarrhea

As previously mentioned, diarrhea becomes chronic if it occurs three or more times per day for two or more weeks. Diarrhea is characterized by loose, watery stools that occur often more frequently than usual. Other symptoms include abdominal pain, abdominal cramps, bloating, nausea, blood or mucus in stool, and a fever. It also dehydrates you over time. If left untreated, this can be very dangerous. You should always see a doctor for chronic diarrhea.

Diagnosis

Chronic diarrhea itself is simple to diagnose, based on the definition outlined above. When you see a doctor for chronic diarrhea, they will work to diagnose the underlying cause. Depending on your symptoms, medical history, medications, the results of a physical exam, and other factors, they will select the appropriate testing measures. Stool samples can be tested to help identify if parasites, bacteria, or viruses are a cause. Your doctor may also want to do a blood test. If initial testing does not reveal a cause, your doctor may order an x-ray or endoscopy.

Chronic Diarrhea Treatment and Prevention

The cause of the condition dictates its treatment. With any case of diarrhea, fluid replacement is key. You should consume fluids and salts to replace those lost through diarrhea, unless otherwise ordered by your doctor. Some fruit juices and soup can be good options here. If liquids are upsetting your stomach, your doctor may recommend an IV to help rehydrate you.

Diarrhea caused by infection can often be treated with antibiotics or other medications. Your doctor will prescribe the proper medication for you depending on your case. If infection isn’t the cause, it will likely take more time to determine the underlying cause and therefore appropriate treatment. Conditions like IBS, Chrohn’s, fructose malabsorption, and Ulcerative Colitis all have their own treatment approaches. Your doctor will work with you to determine the best treatment options depending on the underlying cause.

Preventing chronic diarrhea involves mitigating risk factors for its various causes. To avoid infections that cause diarrhea, always drink safe, clean, properly-treated water. You should also use good food handling techniques, and practice good hand hygiene after using the bathroom and around food. If some foods trigger diarrhea for you, narrow down what they are and avoid them if possible.

Our experienced team at GHP has years of experience treating GI conditions like chronic diarrhea. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Coronavirus and the GI system: What does the evidence tell us?

The coronavirus continues to have an enormous impact on the way we live. Over the past several months, we have begun to learn more and more about the virus. We’ve learned about how it spreads, its symptoms, how to detect it, and potential approaches for vaccines. Crucially, the virus has several documented impacts and features related to the gastrointestinal system. Let’s take a look at the evidence. 

Note: As the medical and public health understanding of the coronavirus continues to evolve, there’s a lot we still don’t know for certain. It’s important to recognize the difference between evidence-based conclusions, emerging evidence without sufficient peer review, and speculation. We will carefully frame each point based on the amount and kinds of evidence supporting it. 

Coronavirus Symptoms Associated with the Gastrointestinal System

The coronavirus can cause a range of symptoms, from a fever to a loss of smell and a headache. We do know that it can cause gastrointestinal symptoms in some cases. These well-documented GI symptoms include loss of appetite, nausea, vomiting, and diarrhea. However, not everyone with coronavirus will experience these symptoms. 

Some interesting emerging research suggests that there may be clusters of symptoms. One of these clusters involves gastrointestinal symptoms. Researchers at King’s College London studied data from around 1,600 COVID-19 patients who logged their symptoms to the research group’s COVID Symptom Study app in March and April. They found six distinct clusters of symptoms from the data: 

  1. Flu-like with no fever. Headache, loss of smell, muscle pains, cough, sore throat, chest pain, no fever.
  2. Flu-like with fever. Headache, loss of smell, cough, sore throat, hoarseness, fever, loss of appetite.
  3. Gastrointestinal. Headache, loss of smell, loss of appetite, diarrhea, sore throat, chest pain, no cough.
  4. Severe level one, fatigue. Headache, loss of smell, cough, fever, hoarseness, chest pain, fatigue.
  5. Severe level two, confusion. Headache, loss of smell, loss of appetite, cough, fever, hoarseness, sore throat, chest pain, fatigue, confusion, muscle pain.
  6. Severe level three, abdominal and respiratory. Headache, loss of smell, loss of appetite, cough, fever, hoarseness, sore throat, chest pain, fatigue, confusion, muscle pain, shortness of breath, diarrhea, abdominal pain.

As you can see, the gastrointestinal cluster includes GI symptoms like diarrhea and loss of appetite. Other clusters also contain GI symptoms. Each cluster was also associated with differing proportions of patients who required hospitalization and breathing support. The escalating severe clusters had the largest percentage of patients requiring significant medical support. 

It’s important to note that while the researchers have replicated their findings with a second 1,000 person data set from June, the research is not peer-reviewed yet. However, this is certainly something to keep an eye on as more data trends emerge. 

Sewage: A Potential Method for Measuring Infection Spread

Early on in the pandemic, evidence emerged from multiple studies showing that people infected with the coronavirus shed viral particles in their poop. Whether the disease can spread through feces is still undetermined. However, there has been growing interest in sampling sewage to determine the extent of disease spread. 

This has been particularly appealing because of the lack of adequate testing in many countries. This has led to a significant undercounting of actual infection numbers. A cross-sectional CDC study conducted across multiple states used serological testing on a convenience sample with people of all ages to identify how many had developed antibodies to the disease. This gave a more accurate picture of how many people have been infected, since the presence of antibodies indicates that a person had been or was currently infected. The study found that actual infection numbers were likely 10 to 12 times higher than reported through testing. Note that large-scale seroprevalence studies like this one are continuing to be conducted to identify likely infection rates, so the results here are preliminary. 

With such a disparity between reported and actual case counts, wastewater sampling offers a convenient and accessible way to identify disease spread in a particular area. Importantly, results are quicker than those from viral and serological tests. This is helpful, timely data that can inform decisions about disease containment in the event of a flare-up. Additionally, it can help researchers see the viral ancestry of the disease, tracking different strains, viral changes over time, and spreading patterns and paths. 

There are drawbacks, though. This kind of sampling can’t prove that an entire population is completely clear of the virus. Another drawback is that we still don’t know how many copies of viral RNA need to be present in a sample for disease to be detected. This means false negatives are possible, as we don’t know the minimum number of copies that trigger detection. A lower count of copies could go undetected with an improper assumption about a minimum. 

Overall, there’s certainly a lot we still have to learn about the coronavirus and the GI system. However, as scientists conduct more and more research, we have a better opportunity to make data-informed decisions at public health, medical, governmental, interpersonal, organizational, and individual levels. 

Our experienced team at GHP has years of experience helping patients with a variety of diseases and conditions. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Endoscopic Ultrasound: How to Prepare

An Endoscopic Ultrasound (EUS) is a procedure for assessing and producing images of the digestive system with an endoscope. It is also used as a modality to treat certain gastrointestinal disorders through fine-needle aspiration (FNA). Follow along for an overview of EUS. 

When an Endoscopic Ultrasound is used

An EUS can help doctors determine the source of chest pain, abdominal discomfort, and other symptoms. It can also help them evaluate the extent of disease spread in your digestive tract, and evaluate findings from other diagnostics like MRIs or CT scans. It can help evaluate conditions including Barrett’s Esophagus, Lymphoma, and various cancers. 

There are many different therapeutic procedures that can be performed during an EUS. These include celiac plexus neurolysis (EUS-CPN), pseudocyst drainage, biliary drainage (EUS-BD) and liver biopsy. Each of these treatments has a unique set of steps involved. Below, we will take a look at some general steps and approaches involved with the various diagnostics and treatments performed through an Endoscopic Ultrasound. 

Preparing for an EUS

The way you need to prepare for an EUS depends on the specifics of the procedure and any therapeutic treatments in your case. In general, you often need to fast starting the midnight before the procedure. This helps empty your stomach. You may also need to discuss any medications you are taking with your doctor before the procedure. It is especially important to stop taking any blood-thinning medications leading up to the procedure. These medications can increase the risk of severe bleeding during the Endoscopic Ultrasound. If the EUS is being performed in the rectal area, you may need to undergo a cleansing routine to prepare your bowels. This usually consists of taking a liquid laxative and sticking to a liquid diet for a day before the procedure. 

During the procedure

On the day of your Endoscopic Ultrasound procedure, you will first go to a pre-op area where your medical information will be taken and you will be given an IV. You will also discuss sedation used during the procedure with an anaesthesiologist. 

Depending on the location in your GI tract that doctors will examine or treat, they will advance an endoscope through your mouth or a colonoscope through your anus. You will be on your left side and may be sedated as this happens. Your doctor will advance the scope to the site or sites of interest and then perform any diagnostics or treatments. This can include tissue biopsies, pain-relieving injections, pseudocyst drainage, and bile duct drainage, depending on your situation. Your doctor will be able to see your GI tract through a camera at the end of the scope, and will pass any necessary instruments through the scope to perform the procedure. Most EUS examinations take under an hour, but the exact time will vary depending on what diagnostics or treatments your doctor is administering. 

After an Endoscopic Ultrasound

After your procedure, you will go to a post-op area where you will recover from any sedation and be monitored for side effects of the procedure. Once you are recovered, your doctor will share results with you. Some biopsy results may take longer to return. Given sedation side effects, you should not operate machinery, drive, or make important decisions for 24 hours following the procedure. 

Endoscopic Ultrasounds have a relatively low risk for complications. If you underwent Celiac Plexus Neurolysis to provide pain relief for tumors, you may experience abdominal pain for a few hours and diarrhea for a few days. More rarely, bleeding, infection, and paralysis can occur. If you underwent Pseudocyst Drainage, there is a small risk of bleeding, infection, and pancreatitis. Additionally, in under one percent of cases, perforations occur, requiring surgery to repair. If you underwent Biliary Drainage, there is a 10-20% chance of mild complications associated with bile drainage. These include bleeding, infection, and bile leakage in the abdominal cavity. If you underwent a Liver Biopsy, complications are very rare, and include a small risk of bleeding and infection. In general, if you were sedated during your procedure, there are a few uncommon complications including aspiration, adverse reactions to sedative medication, and complications from lung and heart diseases. 

Our experienced team at GHP has years of experience performing Endoscopic Ultrasounds. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Endoscopic Mucosal Resection (EMR): An Overview

Endoscopic Mucosal Resection, or EMR, is a therapeutic technique that helps remove precancerous and early stage cancer lesions during an upper endoscopy or colonoscopy. This technique is a less-invasive alternative to surgery. Here’s what you need to know if you are preparing for an EMR.

When is an Endoscopic Mucosal Resection Used?

EMRs are used to remove abnormal tissues in the digestive tract. The procedure can help treat a variety of conditions including Barrett’s Esophagus, colorectal cancer, and colon polyps. This is a less invasive option than surgery for removing abnormal tissues in the digestive tract. While EMRs are often used to treat disease, your doctor may also collect tissue samples during the procedure. They can examine tissue they collect to determine a diagnosis and the scope of disease spread. 

Preparing for an EMR

There are several important steps you need to follow prior to an Endoscopic Mucosal Resection. Your physician will discuss each of these with you leading up to the procedure. First, you may need to stop taking certain medications. These include blood-thinning medications like aspirin, Plavix (clopidogrel), Xarelto (rivaroxaban), Lovenox (enoxaparin), Pradaxa (dabigatran), Coumadin (warfarin), and Eliquis (apixaban). Blood-thinners increase your risk of excessive bleeding during the procedure. Also, if you use insulin, you may need to adjust your dosage and timing before the procedure. Make sure you discuss all medications you use with your doctor. 

Additionally, you will need to follow a clear liquid diet the day before the procedure, and stay hydrated. You will also need to fast beginning the midnight before your procedure. For EMRs performed through a colonoscopy, you will also need to undergo a cleansing routine. This involves taking a liquid laxative the day before your EMR to prepare your bowels. 

During the procedure

EMRs are performed through either an upper endoscopy or a colonoscopy, depending on the location of the diseased tissue. When you arrive for your procedure, you will go to a pre-op area where nurses will take your medical information and place an IV. You will also speak with an anaesthesiologist about the sedation they will use for the procedure. 

You then will go to the procedure room and be connected to monitors that will measure your vitals during the EMR. You’ll be sedated at this point. If the procedure is done through an upper endoscopy, you will be placed on your left side and given a bite block so the endoscope can pass through your mouth safely. If it is done through a colonoscopy, you will also be placed on your left side so the colonoscope can pass through your anus and advanced into the colon. 

Your doctor will be identifying and removing lesions during the EMR. There are several ways to remove lesions. Your doctor may inject a liquid into the submucosal layer under the lesion, which acts as a pillow that lifts the lesion for easy removal. They may also use a suction or a rubber band to help lift the lesion. After the lesion is lifted, it will be captured with a snare and the removal site will be cauterized. The procedure takes around 20 to 60 minutes.  

After the Endoscopic Mucosal Resection

Following your EMR, you will move to a post-op area to recover from sedation and monitor for any complications. Once you have recovered, your doctor will talk to you about the findings and give you post-op recovery instructions. You should not drive or make important decisions for 24 hours following the EMR due to sedative effects. You should follow a clear liquid diet immediately following the procedure, and can later transition to bland foods and a more regular diet. 

Complications from an EMR are uncommon. This includes bleeding, which occurs in 5-10% of cases. Your doctor can usually stop bleeding during the procedure if they recognize it. However, bleeding can become severe if it is delayed and may require follow-up care. In other rare cases (1-2% of the time), perforation of the intestine can occur. This is often managed through antibiotics, bowel rest, and hospitalization. It may require surgery as well. Additionally, some patients have reactions to sedative medication in uncommon cases. Always contact your doctor if you have any severe symptoms like abdominal pain, a fever, or excessive rectal bleeding after the procedure, as they may indicate a severe complication. 

Our experienced team at GHP has years of experience performing EMRs. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Single Balloon Enteroscopy: A Closer Look

Single Balloon Enteroscopy is a procedure that allows doctors to examine the small intestine. Follow along for everything you need to know about the procedure.

When Single Balloon Enteroscopy used

A Single Balloon Enteroscopy is used to examine, diagnose, and treat diseases in both the upper and lower GI tract. The advantage of the procedure is that it gives access to the entire small intestine, which is around 20 feet long on average. Other procedures cannot provide reach to effectively examine or treat the small intestine. The Single Balloon Enteroscopy lets doctors get access and live imaging of parts of the GI tract that are otherwise inaccessible. This is important for examining sources of GI bleeding, taking biopsies, removing polyps or foreign objects, and enlarging strictures.

Preparing for the procedure

There are a few important pre-operative steps you need to take prior to a Single Balloon Enteroscopy. You will need to discuss any medications you are taking with your doctor. Certain blood-thinning medications can pose risks of excessive bleeding during the procedure. Additionally, if you take insulin, you may need to adjust timing and dosage leading up to the procedure.

You will need to adhere to a clear liquid diet the day before the procedure. You will also be asked to refrain from eating starting the midnight before the procedure. In addition to these steps, you will need to use a cleansing routine the day before your procedure. This entails a liquid laxative that clears and prepares your bowels for examination. Your doctor will give clear instructions for all of these important steps leading up to your Single Balloon Enteroscopy.

During Single Balloon Enteroscopy

On the day of your procedure, you will first check in to a pre-op area where nurses will place an IV and take medical information. You will also meet with an anaesthesiologist to discuss sedation during the procedure.

The procedure takes around 60-75 minutes total. Your doctor will use a balloon system consisting of a flexible endoscope with a camera, an overtube, and an attached inflatable balloon at the tip of the overtube. They first insert the endoscope down your throat and into your intestine (you will have a mouthguard to protect your teeth and the endoscope). They will inflate the balloon to anchor the overtube, and then advance the endoscope further into your small intestine. Cyclically, they can then deflate the balloon, advance the overtube, reinflate the balloon, withdraw the overtube to shorten and straighten your small intestine, and advance the endoscope further. This pleats the small intestine over the overtube, shortening the small intestine’s length.

The endoscope is also able to inflate your intestine, rinse it with water, and guide biopsy and cautery instruments. Since you will be sedated, given pain medications, and given a local oral anaesthetic, the procedure is pain-free.

After the procedure

Following the procedure, you will return to a post-op area to recover from sedation. Nurses will monitor you for potential complications. After recovery, your doctor will discuss findings with you, although some results for biopsies and polyp removal can take a few more days to be finalized). You should not drive, make important decisions, or operate machinery for 24 hours after the procedure due to sedative effects.

You may feel bloated for a few hours after the procedure, which is normal. There are few severe complications and risks associated with Single Balloon Enteroscopy. On rare occasions, the procedure can cause perforation, excessive bleeding, and complications from sedation. If you experience excessive rectal bleeding, severe abdominal pain, or a fever, contact your doctor immediately.

Our experienced team at GHP has years of experience performing Single Balloon Enteroscopies We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Capsule Endoscopy: What You Need to Know

A Capsule Endoscopy is a procedure that allows doctors to examine the middle part of the gastrointestinal tract. Patients swallow a pill that contains a video camera, battery, and light source. The camera takes pictures as it travels through the GI tract, which allow doctors to examine the GI tract. 

Here’s what you need to know about the procedure. 

When it’s used

Capsule Endoscopies are used to examine the small intestine, which is not easily reached with other endoscopy procedures that involve passing an endoscope through the throat or anus. Specifically, the procedure can help doctors investigate causes of bleeding in the area, polyps, tumors, inflammatory bowel disease, and ulcers. 

Preparing for a Capsule Endoscopy

There are a few important steps to take to prepare for a Capsule Endoscopy. Your doctor will give you specific instructions leading up to the procedure. A cleansing routine is at the core of the preparations. You should stop eating and drinking 12 hours before the procedure, and may need to follow a clear liquid diet prior to that. You may also need to take a laxative to flush out your small intestine. All of this can help improve picture quality from the procedure. Additionally, you will need to discuss your medical history and medications with your doctor. 

During the procedure

The procedure begins with you swallowing the camera capsule with water. A monitor is attached to your abdomen to record images obtained from the camera. You are then able to leave the office and go about your day. Some restrictions apply as the camera records, like strenuous activity. 

As the camera in the capsule passes through your digestive tract, it will take thousands of color pictures. The images are saved and transferred to a computer, where they are then strung together into a video format. This is what your doctor will view to examine your digestive tract. Getting results back can take a week or two. 

After the Capsule Endoscopy

Around two hours after the procedure, you can start drinking clear liquids again. After four hours, you can have a light lunch or snack. The procedure is over after eight hours or when you see the capsule after a bowel movement, whichever occurs first. Since everyone’s digestive system varies, you may pass the capsule in a few hours or in a few days. At that point, you can remove the monitor, pack it up, and follow the equipment return instructions given by your doctor. You can flush the camera capsule. If you have not seen the capsule pass within two weeks, you should contact your doctor. 

Complications from a Capsule Endoscopy are rare. In some cases, the capsule can get stuck in the digestive tract, especially where there is a stricture from surgery, a tumor, or inflammation. Symptoms of obstruction include vomiting, abdominal pain, and unusual bloating. It’s important to recognize the signs of an obstruction early on. Contact your doctor if you experience any of these symptoms after the procedure. 

Our experienced team at GHP has years of experience performing Capsule Endoscopies. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

Peptic Ulcer Disease: What You Need To Know

Peptic Ulcer Disease (PUD) occurs when a person has chronic peptic ulcers. Peptic ulcers are sores in the stomach or duodenum lining that develop when stomach acid deteriorates the lining. There are several treatment options available for PUD based on the cause of the disease in a particular person. 

Here’s what you need to know about Peptic Ulcer Disease. 

Causes and Risk Factors 

PUD is usually caused by one of two things. First, a bacterial infection from a bacteria called H. pylori can lead to inflammation in stomach lining and eventually cause ulcers. H. pylori can be transmitted from human-to-human contact, food, or water. Second, the long-term use of anti-inflammatory medications including ibuprofen and aspirin can lead to PUD because these medications can inflame the stomach lining. 

Risk factors associated with Peptic Ulcer Disease include smoking, which can increase risk of ulcers for people infected with H. pylori, and drinking, which can wear away mucus in the stomach lining and increase stomach acid production. 

Symptoms

Common symptoms of Peptic Ulcer Disease include burning stomach pain, nausea, heartburn, bloating, and fatty food intolerance. Burning stomach pain is the most common symptom, and having an empty stomach typically increases pain. While pain may be relieved by eating foods that help buffer stomach acid or taking anti-acid medication, it usually comes back between meals and at night. Notably, while spicy foods and stress may worsen symptoms, they do not cause ulcers. More severe symptoms can include vomiting blood, blood in stool, feeling faint, and trouble breathing. People with severe symptoms should seek medical attention. 

Diagnosis

Doctors diagnose PUD through a combination of a person’s medical history, symptoms, medication history, and tests. One test, an endoscopy, uses a hollow tube with an attached lens to view the throat, stomach, and small intestine to visually detect ulcers. Additionally, doctors often perform a test by blood sample, stool sample, or breath test to determine if H. pylori is present. A tissue sample from an endoscopy may also be used in this case. If an ulcer is found during an endoscopy, doctors may take a tissue sample for a biopsy. Lastly, an x-ray is sometimes used for diagnosis- patients drink barium prior to an x-ray to allow doctors to see internal organ detail. 

Treatment 

Treatments for PUD vary. For ulcers caused by H. pylori, antibiotics can help kill the bacterium through two weeks of treatment. Thereafter, antacid medication may be used to control stomach acid for the patient. Another treatment utilizes proton pump inhibitors, medications that reduce stomach acid by blocking cell production of acid. Another medication group used for treatment is H2 blockers, which reduce stomach acid along with reducing pain and helping healing. Lastly, antacids, medications that neutralize stomach acid, may be used to help relieve symptoms. 

Lifestyle changes are also an important part of treating Peptic Ulcer Disease. Avoiding smoking and alcohol can help reduce risk factors that lead to and worsen PUD. Managing stress can help too- relaxation and exercise can help lower stomach acid production. Lastly, changing diet can help treat PUD too. Unhealthy choices like junk food, fried food, and processed foods make it harder to heal, while whole grains, fresh produce, and fresh fruit may promote healing. 

Our experienced team at GHP can help you get the treatment you deserve for PUD. We can help you establish the best plan of care for your situation. Contact any of our office locations learn about the options we offer and schedule an appointment today.