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We provide personalized, comprehensive and compassionate care for patients with all types of digestive conditions and diseases.
If you or a loved one is experiencing recurrent indigestion, heartburn, ulcers, the discomfort and or pain of irritable bowel syndrome, or other unwelcome gastrointestinal symptoms, Baylor has the expertise and technology to address the problem.
Among the digestive diseases treated at Baylor are inflammatory bowel disease, ulcer disease, acute and chronic liver disease including hepatitis C and cirrhosis, gastroesphageal reflux disease (GERD), chronic diarrhea and irritable bowel syndrome.
Barrett's esophagus is a condition in which normal cells that line the esophagus, called squamous cells, turn into cells not usually found in humans, called specialized columnar cells. This process is called intestinal metaplasia because the specialized columnar cells are similar to the lining of the intestine. Damage to the lining of the esophagus causes the cells to change. Less than 1 percent of people with this condition develop cancer of the esophagus. However, having Barrett's esophagus may increase the risk of developing esophageal cancer.
Barrett's esophagus develops in some people who have chronic gastroesophageal reflux disease (GERD) or esophagitis (inflammation of the esophagus). It is believed that damage to the lining of the esophagus, caused by these conditions, causes these abnormal cell changes.
People who have had long-standing heartburn are at risk for Barrett's esophagus and should discuss this with their doctor.
The following are the most common symptoms of Barrett's esophagus. However, each individual may experience symptoms differently. Symptoms may include:
Waking in the night because of heartburn pain
Vomiting
Difficulty in swallowing
Blood in vomit or stool
Some people with this condition may be asymptomatic. The symptoms of Barrett's esophagus may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
In addition to physical examination, the doctor will perform an endoscopy, during which a long, thin tube, called an endoscope, is inserted through the mouth and gently guided into the esophagus. This contains instruments that allow the doctor to see the lining of the esophagus and remove a small tissue sample (a biopsy), which is examined in a laboratory to determine whether the normal squamous cells have been replaced with columnar cells. If a person complains of trouble swallowing, an upper GI barium study may be helpful in identifying areas of narrowing called strictures.
Specific treatment for Barrett's esophagus will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of this disease
Your opinion or preference
Currently, there is no cure for Barrett's esophagus. Once the cells in the esophageal lining have been replaced by columnar cells, they will not revert back to normal. Thus, treatment is aimed at preventing further damage from occurring by stopping acid reflux from the stomach. Treatment may include:
Medication. Medications such as H2 receptor antagonists and proton pump inhibitors, which reduce the amount of acid produced in the stomach, may be prescribed by your doctor.
Surgery. Surgery to remove damaged tissue or a section of the esophagus may be necessary. Known as fundoplication, part of the esophagus is removed and the remaining section is attached to the stomach.
Dilation procedure. If strictures (narrowing of the esophagus) are present, caused when the damaged lining of the esophagus becomes thick and hardened, a procedure called dilation is used. During dilation, an instrument gently stretches the strictures and expands the opening of the esophagus.
Last Modified Date: 2012-04-08T00:00:00-06:00 Created Date: 2007-03-30T00:00:00-06:00 Published Date: 2012-04-08T08:36:04.03-06:00 Copyright Date: 2012 Copyright Statement: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
Barrett's esophagus occurs when the lining of the esophagus is damaged by stomach acid that leaks backward
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Colorectal cancer is malignant cells found in the colon or rectum. The colon and the rectum are parts of the large intestine, which is part of the digestive system. Because colon cancer and rectal cancers have many features in common, they are sometimes referred to together as colorectal cancer. Cancerous tumors found in the colon or rectum also may spread to other parts of the body.
Excluding skin cancers, colorectal cancer is the third most common cancer in both men and women. It is estimated by the American Cancer Society that about 141,000 colorectal cancer cases are expected in 2011. The number of deaths due to colorectal cancer has decreased, which is attributed to increased screening and polyp removal.
A type of cancer called adenocarcinoma accounts for more than 95 percent of cancers in the colon and rectum and is usually what is meant by the term "colorectal cancer." It is the type we focus on in this section. There are other types of cancer that can be found in the colon and rectum, but they are rare.
Here is an overview of the types of cancer in the colon and rectum:
Adenocarcinoma Adenocarcinomas are tumors that start in the lining of internal organs. "Adeno" means gland. These tumors start in cells with glandular properties, or cells that secrete. They can form in many different organs, such as the lung or the breast. In colorectal cancer, early tumors start as small adenomatous polyps that continue to grow and can then turn into malignant tumors. The vast majority of colorectal cancers are adenocarcinomas.
Gastrointestinal stromal tumors (GIST) These are tumors that start in the muscle tissue of the digestive tract, although they rarely appear in the colon. They can be benign (noncancerous) at first, but many do turn into cancer. When this happens, they are called sarcomas. Surgery is the usual treatment if the tumor has not spread.
Lymphoma A lymphoma is a cancer that typically starts in a lymph node, which is part of the immune system. However, it can also start in the colon or rectum.
Carcinoids Carcinoids are tumors that start in special hormone-producing cells in the intestine. Often they cause no symptoms. Surgery is the usual treatment.
The following are the most common symptoms of colorectal cancer. However, each individual may experience symptoms differently.
People who have any of the following symptoms should check with their doctors, especially if they are over 50 years old or have a personal or family history of the disease:
A change in bowel habits such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days
Rectal bleeding, dark stools, or blood in the stool
Cramping or gnawing stomach pain
Decreased appetite
Weight loss
Weakness and fatigue
Jaundice, or a yellowing of the skin and eyes
The symptoms of colorectal cancer may resemble other conditions, such as infections, hemorrhoids, and inflammatory bowel disease. It is also possible to have colon cancer and not have any symptoms. Always consult your doctor for a diagnosis.
Risk factors may include:
Age Most people who have colorectal cancer are over age 50, however, it can occur at any age.
Race African-Americans have the highest risk for colorectal cancer.
Diet Colorectal cancer is often associated with a diet high in red and processed meats.
Polyps Benign growths on the wall of the colon or rectum are common in people over age 50, and are believed to lead to colorectal cancer.
Personal history People who have had colorectal cancer or a history of adenomatous polyps have an increased risk for colorectal cancer.
Family history People with a strong family history of colorectal cancer or polyps in a first-degree relative (especially in a parent or sibling before the age of 60 or in two first-degree relatives of any age) have an increased risk for colorectal cancer.
Ulcerative colitis or Crohn's disease People who have an inflamed lining of the colon have an increased risk for colorectal cancer.
Inherited syndromes, such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colon cancer (HNPCC)
Obesity
Physical inactivity
Heavy alcohol consumption
Type 2 diabetes
Smoking
The exact cause of most colorectal cancer is unknown, but the known risk factors listed above are the most likely causes. A small percentage of colorectal cancers are caused by inherited gene mutations. People with a family history of colorectal cancer may wish to consider genetic testing. The American Cancer Society suggests that anyone undergoing such tests have access to a doctor or geneticist qualified to explain the significance of these test results.
Although the exact cause of colorectal cancer is not known, it may be possible to lower your risk of colorectal cancer with the following:
Diet, weight, and exercise It is important to manage the risk factors you can control, such as diet, body weight, and exercise. Eating more fruits, vegetables, and whole-grain foods, and avoiding high-fat, low-fiber foods, plus exercising appropriately, even small amounts on a regular basis, can be helpful. Avoiding excess alcohol intake may also lower your risk.
Drug therapy Some studies have shown that low doses of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, and hormone replacement therapy for post-menopausal women, may reduce the risk of colorectal cancer. These drugs also have their own risks, so it is important to discuss this with your doctor.
Screenings Perhaps most important to the prevention of colorectal cancer is having screening tests at appropriate ages. Screening may find some colorectal polyps that can be removed before they have a chance to become cancerous. Because some colorectal cancers cannot be prevented, finding them early is the best way to improve the chance of successful treatment, and reduce the number of deaths caused by colorectal cancer.
The following screening guidelines can lower the number of cases of the disease, and can also lower the death rate from colorectal cancer by detecting the disease at an earlier, more treatable stage.
Screening methods for colorectal cancer, for people who do not have any symptoms or strong risk factors, include the following:
Fecal occult blood test. Checks for hidden (occult) blood in the stool. It involves placing a very small amount of stool on a special card, which is then sent to a laboratory.
Fecal immunochemical test (FIT). A test that is similar to a fecal occult blood test, but does not require any restrictions on diet or medications prior to the test.
Flexible sigmoidoscopy. A diagnostic procedure that allows the doctor to examine the inside of a portion of the large intestine. A short, flexible, lighted tube called a sigmoidoscope is inserted into the intestine through the rectum. The scope blows air into the intestine to inflate it and make viewing the inside easier.
Colonoscopy. A procedure that allows the doctor to view the entire length of the large intestine, and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the doctor to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.
CT colonography (virtual colonoscopy). A procedure that uses computerized tomography (CT) to examine the colon for polyps or masses using special technology. The images are processed by a computer to make a 3-dimensional (3-D) model of the colon. Virtual colonoscopy is noninvasive, although it requires a small tube to be inserted into the rectum to pump air into the colon. If something abnormal is seen with this test, a standard colonoscopy will be needed.
Stool DNA (sDNA). A test used to check the stool or fecal matter for specific changes in DNA (the genetic blueprint of each cell) that indicate signs of colorectal cancer. The patient is required to save an entire bowel movement and the sample is sent to a laboratory.
Barium enema with air contrast (also called a double contrast barium enema). A fluid called barium (a metallic, chemical, chalky liquid used to coat the inside of organs so that they will show up on an X-ray) is administered into the rectum to partially fill up the colon. An X-ray of the abdomen is then taken and can show strictures (narrowed areas), obstructions (blockages), and other problems.
Screening Guidelines for Colorectal Cancer
Colorectal cancer screening guidelines from the American Cancer Society for early detection include:
Beginning at age 50, both men and women should follow one of the examination schedules below:
Fecal occult blood test (FOBT) or fecal immunochemical test (FIT) every year
Flexible sigmoidoscopy (FSIG) every five years
Double-contrast barium enema every five years
Colonoscopy every 10 years
CT colonography (virtual colonoscopy) every five years
Stool DNA test (sDNA), interval uncertain
People with any of the following colorectal cancer risk factors should begin screening procedures at an earlier age and/or be screened more often:
Strong family history of colorectal cancer or polyps in a first-degree relative, especially in a parent or sibling before the age of 60 or in two first-degree relatives of any age
Family with hereditary colorectal cancer syndromes, such as familial adenomatous polyposis (FAP) and hereditary nonpolyposis colon cancer (HNPCC)
Personal history of colorectal cancer or adenomatous polyps
Personal history of chronic inflammatory bowel disease (Crohn's disease or ulcerative colitis)
If a person has symptoms that might be caused by colorectal cancer, the doctor will want to get a complete medical history and do a physical examination. The doctor may also do certain tests to look for cancer. Many of these tests are the same as those done to screen for colorectal cancer in people without symptoms.
Digital rectal examination (DRE). A doctor or health care provider inserts a gloved and lubricated finger into the rectum to feel for anything unusual or abnormal. This test can detect cancers of the rectum, but not the colon.
Colonoscopy. A procedure that allows the doctor to view the entire length of the large intestine. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the doctor to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.
Barium enema. A fluid called barium (a metallic, chemical, chalky liquid used to coat the inside of organs so that they will show up on an X-ray) is administered into the rectum to partially fill up the colon. An X-ray of the abdomen is then taken that can show strictures (narrowed areas), obstructions (blockages), and other problems.
Biopsy. a procedure in which tissue samples are removed (during a colonoscopy or surgery) from the body for examination under a microscope to determine if cancer or other abnormal cells are present.
Blood count. A test to check for anemia (a result of bleeding from a tumor).
Imaging tests. Tests such as a CT scan, ultrasound, or MRI of the abdomen may be done to look for tumors or other problems. These tests may also be done if colorectal cancer has already been diagnosed to help determine the extent (stage) of the cancer.
When colorectal cancer is diagnosed, tests will be performed to determine how much cancer is present, and if the cancer has spread from the colon to other parts of the body. This is called staging, and it is an important step toward planning a treatment program. The National Cancer Institute defines the following stages for colorectal cancer:
Stage 0 (Cancer in Situ)
The cancer is found in the innermost lining of the colon.
Stage I (also called Dukes' A colon cancer)
The cancer has spread beyond the innermost lining of the colon to the second and third layers and the inside wall of the colon. The cancer has not spread to the outer wall of the colon or outside of the colon.
Stage II (also called Dukes' B colon cancer)
The cancer has spread deeper into the wall or outside the colon to nearby tissue. However, the lymph nodes are not involved.
Stage III (also called Dukes' C colon cancer)
The cancer has spread to nearby lymph nodes, but has not spread to other organs in the body.
Stage IV (also called Dukes' D colon cancer)
The cancer has spread to other parts of the body, such as the lungs.
Specific treatment for colorectal cancer will be determined by your doctor based on:
After the colorectal cancer is diagnosed and staged, your doctor will recommend a treatment plan. Treatment may include:
Colon surgery Often, the primary treatment for colorectal cancer is an operation called a colon resection, in which the cancer and a length of normal tissue on either side of the cancer are removed, as well as the nearby lymph nodes.
Radiation therapy Radiation therapy is the use of high-energy radiation to kill cancer cells and to shrink tumors. There are two ways to deliver radiation therapy, including the following:
External radiation (external beam therapy). A treatment that precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes.
Internal radiation (brachytherapy, implant radiation). Radiation is given inside the body as close to the cancer as possible. Substances that produce radiation called radioisotopes may be injected into the blood, placed inside the rectum, or implanted directly into the tumor. Some of the radioactive implants are called "seeds" or "capsules."Internal radiation involves giving a higher dose of radiation in a shorter time span than with external radiation. Some internal radiation treatments stay in the body temporarily. Other internal treatments stay in the body permanently, though the radioactive substance loses its radiation within a short period of time. In some cases, both internal and external radiation therapies are used.
Chemotherapy Chemotherapy is the use of anticancer drugs to treat cancerous cells. In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. The oncologist will recommend a treatment plan for each individual. Studies have shown that chemotherapy after surgery can increase the survival rate for patients with some stages of colon cancer. Chemotherapy can also help slow the growth or relieve symptoms of advanced cancer.
Targeted Therapy Newer medications called targeted therapies may be used along with chemotherapy or sometimes by themselves. For example, some newer medications target proteins that are found more often on cancer cells than on normal cells. These medications have different (and often milder) side effects than standard chemotherapy medications and help people live longer.
Last Modified Date: 2011-07-27T00:00:00-06:00 Created Date: 2007-03-30T00:00:00-06:00 Published Date: 2012-02-10T14:49:38.973-07:00 Copyright Date: 2012 Copyright Statement: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
Colon cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). This type is also referred to as "colorectal cancer."
Esophageal cancer is cancer that develops in the esophagus, the muscular tube that connects the throat to the stomach. The esophagus, located just behind the trachea, is about 10 to 13 inches in length and allows food to enter the stomach for digestion. The wall of the esophagus is made up of several layers and cancers generally start from the inner layer and grow out.
The American Cancer Society estimates that 16,640 Americans will be newly diagnosed with esophageal cancer during 2010, and 14,500 deaths are expected.
No one knows exactly what causes esophageal cancer. At the top of the esophagus is a muscle, called a sphincter, that releases to let food or liquid go through. The lower part of the esophagus is connected to the stomach. Another sphincter muscle is located at this connection that opens to allow the food to enter the stomach. This muscle also works to keep food and juices in the stomach from backing into the esophagus. When these juices do back up, reflux, commonly known as heartburn, occurs.
Long-term reflux can change the cells in the lower end of the esophagus. This condition is known as Barrett's esophagus. If these cells are not treated, they are at much higher risk of developing into cancer cells.
There are two main types of esophageal cancer. The most common type, known as adenocarcinoma, develops in the glandular tissue in the lower part of the esophagus, near the opening of the stomach. It occurs in just over 50 percent of cases.
the other type, called squamous cell carcinoma, grows in the cells that form the top layer of the lining of the esophagus, known as squamous cells. This type of cancer can grow anywhere along the esophagus.
Treatment for both types of esophageal cancer is similar.
Often, there are no symptoms in the early stages of esophageal cancer. Symptoms do not appear until the disease is more advanced. The following are the most common symptoms of esophageal cancer. However, each individual may experience symptoms differently. Symptoms may include:
Difficult or painful swallowingA condition known as dysphagia is the most common symptom of esophageal cancer. This gives a sensation of having food lodged in the chest, and people with dysphagia often switch to softer foods to help with swallowing.
Pain in the throat or back, behind the breastbone or between the shoulder blades
Severe weight lossMany people with esophageal cancer lose weight unintentionally because they are not getting enough food.
Hoarseness or chronic cough that does not go away within two weeks
Blood in stool or black-looking stools
Heartburn
The symptoms of esophageal cancer may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
There is no routine screening examination for esophageal cancer; however, people with Barrett's esophagus should be examined often because they are at greater risk for developing the disease.
The following factors can put an individual at greater risk for developing esophageal cancer:
Age The risk increases with age. In the US, most people are diagnosed at 65 years of age or older.
Gender Men have a three times greater risk of developing esophageal cancer than women.
Tobacco use Using any form of tobacco, but especially smoking, raises the risk of esophageal cancer. The longer tobacco is used, the greater the risk, with the greatest risk among persons who have indulged in long-term drinking with tobacco use. Scientists believe that these substances increase each other's harmful effects, making people who do both especially susceptible to developing the disease.
Alcohol use Chronic or long-term heavy drinking, more than three alcoholic drinks per day, is another major risk factor for esophageal cancer.
Barrett's esophagus Long-term irritation from reflux, commonly known as heartburn, changes the cells at the end of the esophagus. This is a pre-cancerous condition, which raises the risk of developing adenocarcinoma of the esophagus.
Diet Diets low in fruits and vegetables and certain vitamins and minerals can increase risk for this disease.
Other irritants Swallowing caustic irritants such as lye and other substances can burn and destroy cells in the esophagus. The scarring and damage done to the esophagus can put a person at greater risk for developing cancer many years after ingesting the substance.
Medical history Certain diseases, such as achalasia, a disease in which the bottom of the esophagus does not open to release food into the stomach, and tylosis, a rare, inherited disease, increase the risk of esophageal cancer. In addition, anyone who has had other head and neck cancers has an increased chance of developing a second cancer in this area, which includes esophageal cancer.
Acid reflux Abnormal backward flow of stomach acid into the esophagus increases esophageal cancer risk.
In addition to a complete medical history and physical examination, diagnostic procedures for esophageal cancer may include the following:
Chest x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
Upper GI (gastrointestinal) series (Also called barium swallow.) - a diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray) is swallowed. X-rays are then taken to evaluate the digestive organs.
Esophagogastroduodenoscopy (Also called EGD or upper endoscopy.) - a procedure that allows the physician 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 physician to view the inside of this area of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary).
Computed tomography scan (CT or CAT scan) - diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays. If further imaging is needed, your doctor may order a MRI or PET scan.
Endoscopic ultrasound - this imaging technique uses sound waves to create a computer image of the inside of the esophagus and stomach. The endoscope is guided into the mouth and throat, then into the esophagus and the stomach. As in standard endoscopy, this allows the physician to view the inside of this area of the body, as well as insert instruments to remove a sample of tissue (biopsy).
Thoracoscopy and laparoscopy - these methods allow the physician to examine the lymph nodes inside the chest or abdomen with a hollow, lighted tube, and remove these nodes for further testing.
Specific treatment for esophageal cancer will be determined by your physician based on:
Treatment may include:
Surgery Two types of surgery are commonly performed for esophageal cancer. In one type of surgery, part of the esophagus and nearby lymph nodes are removed, and the remaining portion of the esophagus is reconnected to the stomach. In the other surgery, part of the esophagus, nearby lymph nodes, and the top of the stomach are removed. The remaining portion of the esophagus is then reconnected to the stomach.
Chemotherapy Chemotherapy uses anticancer drugs to kill cancer cells throughout the entire body.
Radiation therapy Radiation therapy uses high-energy rays to kill or shrink cancer cells.
Sometimes, several of these treatments may be combined to treat esophageal cancer.
Last Modified Date: 2011-05-27T00:00:00-06:00 Created Date: 2007-03-30T00:00:00-06:00 Published Date: 2012-03-14T10:11:22.957-06:00 Copyright Date: 2012 Copyright Statement: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
Esophageal cancer is a malignant (cancerous) tumor of the esophagus, the muscular tube that moves food from the mouth to the stomach.
The liver is one of the organs that helps with digestion but is not part of the digestive tract. It is the largest organ in the body and carries out many important functions, such as making bile, changing food into energy, and cleaning alcohol and poisons from the blood.
Hepatitis is inflammation of the liver that sometimes causes permanent damage. It is most commonly caused by viruses, bacteria, certain medications, or alcohol. It may also be caused by certain diseases, such as autoimmune diseases, metabolic diseases, and congenital (present at birth) abnormalities (biliary atresia, Wilson disease). Generally, symptoms of hepatitis include fever, jaundice, and an enlarged liver. There are several types of hepatitis.
Hepatitis C (known as HCV, once called non-A, non-B hepatitis) is a liver disease caused by a bloodborne virus. Discovered in 1989, this strain of acute viral hepatitis causes approximately 20,000 new infections in the U.S. each year.
Recovery from this infection is rare--about 75 to 85 percent of infected people become chronic carriers of the virus. Approximately 20 percent of people infected with hepatitis C virus will become sick with jaundice or other symptoms of hepatitis. Sixty to 70 percent of these people may go on to develop chronic liver disease.
Chronic liver disease due to hepatitis C causes between 8,000 and 10,000 deaths and is the leading indication for liver transplantation each year in the United States.
Transmission of hepatitis C occurs primarily from contact with infected blood, but can also occur from sexual contact or from an infected mother to her baby. Blood transfusions prior to 1992 and the use of shared needles are other significant causes of the spread of hepatitis C.
The following describes people who may be at risk for contracting hepatitis C:
Children born to mothers who are infected with the virus
People who have a blood-clotting disorder, such as hemophilia and received clotting factors before 1987
People who require dialysis for kidney failure
People who received a blood transfusion before 1992
People who may participate in high-risk activities, such as intravenous (IV) drug use and/or unprotected heterosexual or homosexual sexual contact
There is no vaccine for hepatitis C. People who are at risk should be checked regularly for hepatitis C. People who have hepatitis C should be monitored closely for signs of chronic hepatitis and liver failure.
The following are the most common symptoms for hepatitis C. However, each individual may experience symptoms differently. Symptoms may include:
Loss of appetite
Fatigue
Nausea and vomiting
Vague stomach pain
Jaundice. A yellowing of the skin and eyes.
Fever
Dark yellow urine
Light-colored stools
Muscle and joint pain
Symptoms may occur from two weeks to many months after exposure. The symptoms of hepatitis C may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for hepatitis C may include the following:
Blood tests
Liver biopsy. A procedure performed to remove tissue or cells from the body for examination under a microscope.
Specific treatment for hepatitis C will be determined by your doctor based on:
Expectations for the course of the disease
At the present time, a vaccine is not available for the prevention of hepatitis C. Treatment may include biological therapy with interferon.
Last Modified Date: 2012-04-30T00:00:00-06:00 Created Date: 2007-06-30T00:00:00-06:00 Published Date: 2012-04-30T07:23:12.393-06:00 Copyright Date: 2012 Copyright Statement: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
An injury to the liver characterized by the presence of inflammatory cells in the tissue of the organ.
Irritable bowel syndrome (IBS) is an intestinal disorder that causes the following:
Crampy pain
Gassiness
Bloating
Changes in bowel habits
IBS has inaccurately been called by many names, including the following:
Colitis
Mucous colitis
Spastic colon
Spastic bowel
Functional bowel disease
IBS is a functional disorder because there is no sign of disease when the colon is examined. Because doctors have been unable to find an organic cause, IBS often has been thought to be caused by emotional conflict or stress. While stress may worsen IBS symptoms, research suggests that other factors also are important.
IBS often causes a great deal of discomfort and distress, but it is not believed to:
Cause permanent harm to the intestines.
Lead to intestinal bleeding of the bowel.
Lead to a serious disease such as cancer.
It has not been shown to lead to serious, organic diseases, nor has a link been established between IBS and inflammatory bowel diseases such as Crohn's disease or ulcerative colitis.
The digestion and propulsion of nutrients and fluids through the gastrointestinal system (GI) is a very complicated and very well-organized process. The GI tract has its own intrinsic muscles and nerves that connect, like an electrical circuit, to the spinal cord and brain. Neuromuscular events occurring in the GI tract are relayed to the brain through neural connections, and the response of the brain is also relayed back to the gastrointestinal tract. As a result of this activity, motility and sensation in the bowel are generated. An abnormality in this process results in a disordered propulsion of the intestinal contents, which generates the sensation of pain.
The exact cause of IBS is unknown. One theory is a person with IBS may have a colon that is more sensitive and reactive than usual, so it responds strongly to stimuli that would not affect others. The colon muscle of a person with IBS then begins to spasm after only mild stimulation or ordinary events such as the following:
Eating
Distention from gas or other material in the colon
Certain medications
Certain foods
Women with IBS seem to have more symptoms during their menstrual periods, suggesting that reproductive hormones can increase IBS symptoms.
The most likely triggers for IBS are diet and emotional stress. Scientists have some clues as to why this happens. Consider the following:
Diet. Eating causes contractions of the colon, normally causing an urge to have a bowel movement within 30 to 60 minutes after a meal. Fat in the diet can cause contractions of the colon following a meal. With IBS, however, the urge may come sooner, accompanied by cramps and diarrhea.
Stress. Stress stimulates colonic spasm in people with IBS. Although not completely understood, it is believed to be because the colon is partly controlled by the nervous system. Counseling and stress reduction techniques can help relieve the symptoms of IBS; however, this does not mean IBS is the result of a personality disorder. It is at least partly a disorder of colon motility.
The following are the most common symptoms of IBS. However, each individual may experience symptoms differently. Symptoms may include:
Crampy abdominal pain
Painful constipation and/or diarrhea.
Alternating constipation and diarrhea
Mucus may be in the bowel movement
Bleeding, fever, weight loss, and persistent, severe pain are not symptoms of IBS, but indicate other problems. The symptoms of IBS may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
Your doctor will obtain a thorough medical history, perform a physical examination, and obtain screening laboratory tests to assess for infection and inflammation. More than likely, all the screening tests and physical examination will be normal. In most cases IBS is a diagnosis of exclusion. The laboratory tests, imaging studies, and procedures to be performed will be dictated by the history and physical examination. Tests and procedures that your doctor may order may include the following:
Blood tests. These are done to determine if you are anemic, have an infection, or have an illness caused by inflammation or irritation.
Urine analysis and culture. These are done to help diagnose urinary tract infections.
Stool culture. This checks for the presence of abnormal bacteria in the digestive tract that may cause diarrhea and other problems. A small sample of stool is collected and sent to a laboratory by your doctor's office. In two or three days, the test will show whether abnormal bacteria are present.
Fecal occult blood test. This checks for hidden (occult) blood in the stool. It involves placing a very small amount of stool on a special card, which is then tested in the doctor's office or sent to a laboratory. If blood is present, it may suggest an inflammatory source in the gastrointestinal tract.
Esophagogastroduodenoscopy (also called EGD or upper endoscopy). A procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum (the first part of the small intestine where absorption of vitamins, minerals, and other nutrients begins). 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 of the body, as well as to insert instruments through the scope for the removal of a sample of tissue for biopsy (if necessary).
Abdominal X-rays. A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film.
Abdominal ultrasound. A diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels. Gel is applied to the area of the body being studied, such as the abdomen, and a wand called a transducer is placed on the skin. The transducer sends sound waves into the body that bounce off organs and return to the ultrasound machine, producing an image on the monitor. A picture or video recording of the test is also made so it can be reviewed in the future.
Specific treatment for IBS will be determined by your doctor based on:
Extent of the condition
Expectations for the course of the condition
Changes in diet. Eating a proper diet is important with irritable bowel syndrome. In some cases of IBS, a high-fiber diet can reduce the symptoms. Keeping a list of foods that cause distress, and discussing the findings with a doctor or registered dietitian, can help.
Medication. Doctors may prescribe fiber supplements or occasional laxatives. Some doctors prescribe a serotonin 5-HT3 antagonist (Lotronex), antispasmodic medications, tranquilizers, or antidepressants to relieve symptoms. Lotronex is usually prescribed for women with severe IBS who have not responded to conventional therapy.
Foods
Moderate fiber
High fiber
Bread
Whole wheat bread, granola bread, wheat bran muffins, Nutri-Grain waffles, popcorn
Cereal
Bran Flakes, Raisin Bran, Shredded Wheat, Frosted Mini Wheats, oatmeal, Mueslix, granola, oat bran
All-Bran, Bran Buds, Corn Bran, Fiber One, 100% Bran
Vegetables
Beets, broccoli, brussels sprouts, cabbage, carrots, corn, green beans, green peas, acorn and butternut squash, spinach, potato with skin, avocado
Fruits
Apples with peel, dates, papayas, mangos, nectarines, oranges, pears, kiwis, strawberries, applesauce, raspberries, blackberries, raisins
Cooked prunes, dried figs
Meat substitutes
Peanut butter, nuts
Baked beans, black-eyed peas, garbanzo beans, lima beans, pinto beans, kidney beans, chili with beans, trail mix
Last Modified Date: 2012-04-18T00:00:00-06:00 Created Date: 2007-03-30T00:00:00-06:00 Published Date: 2012-04-18T07:36:46.477-06:00 Copyright Date: 2012 Copyright Statement: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
Irritable bowel syndrome (IBS) refers to a disorder that involves abdominal pain and cramping, as well as changes in bowel movements.
Pancreatic cancer is the fourth most common cause of cancer death in the U.S. According to the American Cancer Society, about 44,000 new cases of pancreatic cancer and about 38,000 deaths are expected in 2011. Pancreatic cancer occurs when malignant cells grow out of control.
Risk factors for pancreatic cancer include:
Age - most pancreatic cancer occurs in people over the age of 45.
Smoking - heavy cigarette smokers are two or three times more likely than non-smokers to develop pancreatic cancer.
Obesity and physical inactivity - pancreatic cancer is more common in people who are very overweight and in people who don't get much physical activity.
Diabetes - pancreatic cancer occurs more often in people who have diabetes than in those who do not.
Gender - more men than women are diagnosed with pancreatic cancer.
Race - African-Americans are more likely than Asians, Hispanics, or Caucasians to be diagnosed with pancreatic cancer.
Family history - the risk for developing pancreatic cancer is higher if a person's mother, father, or a sibling had the disease.
Cirrhosis of the liver - people with cirrhosis have a higher risk of pancreatic cancer.
Workplace exposures - exposure to occupational pesticides, dyes, and chemicals used in the metal industry may increase the risk of pancreatic cancer.
Some genetic syndromes - certain inherited gene mutations, such as in the BRAC2 gene, increase the risk of pancreatic cancer.
Chronic pancreatitis - long-term inflammation of the pancreas has been linked with increased risk for pancreatic cancer.
There are several types of pancreatic cancers, including the following:
Adenocarcinoma of the pancreas - the most common pancreatic cancer, which occurs in the lining of the pancreatic duct.
Adenosquamous carcinoma - a rare pancreatic cancer.
Squamous cell carcinoma - a rare pancreatic cancer.
Some neuroendocrine tumors in the pancreas include the following - they may be benign (noncancerous) or malignant (cancerous):
Insulinoma - a rare pancreatic tumor that secretes insulin, the hormone that lowers glucose levels in the blood.
Gastrinoma - a tumor that secretes above average levels of gastrin, a hormone that stimulates the stomach to secrete acids and enzymes. Gastrinoma can cause peptic ulcers.
Glucagonoma - a tumor that secretes glucagon, a hormone that raises levels of glucose in the blood, often leading to a rash.
The following are the other most common symptoms of pancreatic cancer. However, each individual may experience symptoms differently. Symptoms may include:
Pain in the upper abdomen or upper back
Jaundice (yellow skin and eyes, and dark urine)
Indigestion
Nausea
Extreme tiredness (fatigue)
The symptoms of pancreatic cancer may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for pancreatic cancer may include the following:
Ultrasound (also called sonography) - a diagnostic imaging technique that uses high-frequency sound waves to create an image of the internal organs. Ultrasounds are used to view internal organs of the abdomen such as the liver, pancreas, spleen, and kidneys and to assess blood flow through various vessels. The ultrasound may be performed using an external or internal device:
Transabdominal ultrasound - the physician places an ultrasound device on the abdomen to create the image of the pancreas.
Endoscopic ultrasound (EUS) - the physician inserts an endoscope, a small, flexible tube with an ultrasound device at the tip, through the mouth and stomach, and into the small intestine. As the physician slowly withdraws the endoscope, images of the pancreas and other organs are made.
Computed tomography scan (CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
Endoscopic retrograde cholangiopancreatography (ERCP) - a procedure that allows the physician to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. The procedure combines x-ray and the use of an endoscope - a long, flexible, lighted tube. The scope is guided through the patient's mouth and throat, then through the esophagus, stomach, and duodenum. The physician can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope, and a dye is injected which will allow the internal organs to appear on an x-ray.
Percutaneous transhepatic cholangiography (PTC) - a needle is introduced through the skin and into the liver where the dye (contrast) is deposited and the bile duct structures can be viewed by x-ray.
Pancreas biopsy - a procedure in which a sample of pancreatic tissue is removed (with a needle or during surgery) for examination under a microscope.
Special blood tests
Positron emission tomography (PET) - a type of nuclear medicine procedure. This means that a tiny amount of a radioactive substance, called a radionuclide (radiopharmaceutical or radioactive tracer), is used during the procedure to assist in the examination of the tissue under study. Specifically, PET studies evaluate the metabolism of a particular organ or tissue, so that information about the physiology (functionality) of the organ or tissue is evaluated, as well as its biochemical properties. Thus, PET may detect biochemical changes in an organ or tissue that can identify the onset of a disease process before anatomical changes related to the disease can be seen with other imaging processes such as computed tomography (CT) or magnetic resonance imaging (MRI).
Specific treatment for pancreatic cancer will be determined by your physician based on:
Type of cancer
Your tolerance of specific medicines, procedures, or therapies
Depending upon the type and stage, pancreatic cancer may be treated with the following:
Surgery - may be necessary to remove the tumor - a section or entire pancreas and/or the small intestine. The type of surgery depends on the stage of the cancer, the location and size of the tumor, and the person's health. Types of surgery for pancreatic cancer include the following:
Whipple procedure - this procedure involves removal of the head of the pancreas, part of the small intestine, the gall bladder, part of the stomach, and lymph nodes near the head of the pancreas. Most pancreatic tumors occur in the head of the pancreas, so the Whipple procedure is the most commonly performed surgical procedure for pancreatic cancer.
Distal pancreatectomy - if the tumor is located in the body and tail of the pancreas, both of these sections of the pancreas will be removed, along with the spleen.
Total pancreatectomy - the entire pancreas, part of the small intestine and stomach, the common bile duct, the spleen, the gallbladder, and some lymph nodes will be removed. This type of operation is not done often.
Palliative surgery - for more advanced cancers, surgery may be done not to try to cure the cancer, but to relieve problems such as a blocked bile duct.
External radiation (external beam therapy) - a treatment that precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes. Radiation therapy may be given alone, or in combination with surgery and/or chemotherapy.
Chemotherapy - the use of anti-cancer drugs to treat cancerous cells. In most cases, chemotherapy works by interfering with the cancer cell’s ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. The oncologist will recommend a treatment plan for each individual. Chemotherapy may be given alone, or in combination with surgery and radiation therapy.
Medication (to relieve or reduce pain)
Long-term prognosis for individuals with pancreatic cancer depends on the size and type of the tumor, lymph node involvement, and degree of metastases (spreading) at the time of diagnosis.
Last Modified Date: 2011-08-21T00:00:00-06:00 Created Date: 2007-03-30T00:00:00-06:00 Published Date: 2012-03-14T10:18:30.63-06:00 Copyright Date: 2012 Copyright Statement: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
Pancreatic cancer begins in the pancreas. The cause is unknown, but it is more common in smokers and in obese people.
Diarrhea is defined either as watery stool, or increased frequency, or both, when compared to a normal amount. It is a common problem that may last a few days and disappear on its own.
Diarrhea may be acute (short-term), which is usually related to bacterial or viral infections, or chronic (long-term), which is usually related to a functional disorder or intestinal disease.
Diarrhea may be caused by a number of conditions, including the following:
A bacterial infection
A viral infection
Food intolerances or allergies
Parasites
A reaction to medications
An intestinal disease, such as inflammatory bowel disease
A functional bowel disorder, such as irritable bowel syndrome
A result of surgery on the stomach or gall bladder
Many people suffer "traveler's diarrhea" caused by a bacterial infection or a parasite, or even food poisoning.
Severe diarrhea may indicate a serious disease, and it is important to consult your doctor if the symptoms persist or affect daily activities. Identifying the cause of the problem may be difficult.
The following are the most common symptoms of diarrhea. However, each individual may experience symptoms differently. Symptoms may include:
Cramping
Abdominal pain
Urgent need to use the restroom
Bloody stools
Dehydration
Incontinence
Dehydration is one of the more serious side effects of diarrhea. Symptoms of dehydration include:
Thirst
Less-frequent urination
Dry skin and mucous membranes (dry mouth, nostrils)
Light-headedness, headaches
Increased heart rate
Depressed fontanelle (soft spot) on infant's head
The symptoms of diarrhea may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
In addition to a complete physical examination, medical history, and laboratory tests for blood and urine, diagnostic procedures for diarrhea may include the following:
Stool culture. This is done to check for the presence of abnormal bacteria in the digestive tract that may cause diarrhea and other problems. A small sample of stool is collected and sent to a laboratory by your doctor's office. In two or three days, the test will show whether abnormal bacteria are present.
Sigmoidoscopy. A diagnostic procedure that allows the doctor to examine the inside of a portion of the large intestine, and is helpful in identifying the causes of diarrhea, abdominal pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube, called a sigmoidoscope, is inserted into the intestine through the rectum. The scope blows air into the intestine to inflate it and make viewing the inside easier.
Imaging tests. These tests are done to rule out structural abnormalities.
Fasting tests. These tests identify food intolerance or allergies.
Specific treatment for diarrhea will be determined by your doctor based on:
Treatment usually involves replacing lost fluids, and may include antibiotics when bacterial infections are the cause.
Last Modified Date: 2012-04-08T00:00:00-06:00 Created Date: 2007-03-30T00:00:00-06:00 Published Date: 2012-04-08T10:43:27.21-06:00 Copyright Date: 2012 Copyright Statement: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
Diarrhea that lasts for more than two weeks is considered chronic. In an otherwise healthy person, chronic diarrhea can be a nuisance.
Crohn's disease is an inflammatory bowel disease (IBD) that is a chronic condition that may recur at various times over a lifetime. It usually involves the small intestine, most often the lower part called the ileum. However, in some cases, both the small and large intestine are affected. Sometimes, inflammation may also affect the entire digestive tract, including the mouth, esophagus, stomach, duodenum, appendix, or anus.
Crohn's disease affects males and females equally. It appears to run in some families, with about 20 percent of people with Crohn's disease having a blood relative with some form of inflammatory bowel disease.
The following are the most common symptoms of Crohn's disease. However, each individual may experience symptoms differently. Symptoms may include:
Abdominal pain, often in the lower right area
Diarrhea, sometimes bloody
Rectal bleeding
Joint pain
Rectal fissure
Rashes
Some people have long periods of remission, sometimes for years, when they are free of symptoms. There is no way to predict when a remission may occur or when symptoms will return.
The symptoms of Crohn's disease may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
There are many theories regarding what causes Crohn's disease. One theory suggests that some agent, perhaps a virus or a bacterium, affects the body's immune system and triggers an inflammatory reaction in the intestinal wall. Although there is a lot of evidence that patients with this disease have abnormalities of the immune system, it is not known whether the immune problems are a cause or a result of the disease. There is no evidence that Crohn's disease is caused by stress.
People who have experienced chronic abdominal pain, diarrhea, fever, weight loss, and anemia may be examined for signs of Crohn's disease. In addition to a complete medical history and physical examination, diagnostic procedures for Crohn's disease may include the following:
Blood tests. These are done to determine if there is anemia resulting from blood loss, or if there is an increased number of white blood cells, suggesting an inflammatory process.
Stool culture. Checks for the presence of abnormal bacteria in the digestive tract that may cause diarrhea and other problems. A small sample of stool is collected and sent to a laboratory by your doctor's office. In two or three days, the test will show whether abnormal bacteria are present, determine if there is blood loss, or if an infection by a parasite or bacteria is causing the symptoms.
Esophagogastroduodenoscopy (also called EGD or upper endoscopy). An EGD is a procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum (the first part of the small intestine where absorption of vitamins, minerals, and other nutrients begins). 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 of the body, as well as remove tissue for further examination if necessary.
Colonoscopy. A procedure that allows the doctor to view the entire length of the large intestine. A colonoscopy can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the doctor to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.
Biopsy. A procedure performed to remove tissue or cells from the lining of the colon for examination under a microscope.
Upper GI (gastrointestinal) series (also called barium swallow). A diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum. A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an X-ray) is swallowed. X-rays are then taken to evaluate the digestive organs. An upper GI with a small bowel follow-through may be used to diagnose Crohn's disease.
Lower GI (gastrointestinal) series (also called barium enema). A procedure that examines the rectum, the large intestine, and the lower part of the small intestine. A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an X-ray) is given into the rectum as an enema. An X-ray of the abdomen shows strictures (narrowed areas), obstructions (blockages), and other problems.
At this time there is no cure for Crohn's disease; however, several methods are helpful in controlling it. The usual goals of treatment are to:
Correct nutritional deficiencies.
Control inflammation.
Relieve abdominal pain, diarrhea, and rectal bleeding.
Drug therapy (anti-inflammatory medications, cortisone or steroids, immune system suppressors, biologic therapies, antibiotics, anti-diarrheal medications, and fluid replacements). Abdominal cramps and diarrhea may be helped by medications, which often lessen the inflammation in the colon. More serious cases may require medications that affect the body's immune system.
Diet and supplements. No special diet has been proven effective for preventing or treating Crohn's disease. Some symptoms are made worse by milk, alcohol, hot spices, or fiber, but this may not be true for everyone.
Supplements. Nutritional supplements or special high-calorie liquid formulas may sometimes be suggested, especially for children with delayed growth.
Feeding through a vein. A small number of patients, who temporarily need extra nutrition, may need periods of feeding by vein (intravenously).
Surgery. Crohn's disease may be helped by surgery, but it cannot be cured by surgery. The inflammation tends to return to the areas of the intestine next to the area that has been removed. Surgery may help to either relieve chronic symptoms of active disease that does not respond to medical therapy or to correct complications, such as intestinal blockage, perforation, abscess, or bleeding.Types of surgery may include:
Drainage of abscesses or removal of a section of bowel (due to blockage, resulting in a shortened bowel).
Ostomy. Some people must have part of their intestines removed, and a new method of removing the stool from the body is created. The surgery to create the new opening is called ostomy, and the new opening is called a stoma.
Different types of ostomy are performed depending on how much and what part of the intestines are removed, and may include the following:
Ileostomy. The colon and rectum are removed and the bottom part of the small intestine (ileum) is attached to the stoma.
Colostomy. A surgically-created opening in the abdomen through which a small portion of the colon is brought up to the surface of the skin. Sometimes, a temporary colostomy may be performed when part of the colon has been removed and the rest of the colon needs to heal.
Ileoanal reservoir surgery. An alternative to a permanent ileostomy, this procedure is completed in two surgeries. First, the colon and rectum are removed and a temporary ileostomy is performed. Second, the ileostomy is closed and part of the small intestine is used to create an internal pouch to hold stool. This pouch is attached to the anus. The muscle of the rectum is left in place, so the stool in the pouch does not leak out of the anus. People who have this surgery are able to control their bowel movements.
Last Modified Date: 2012-04-17T00:00:00-06:00 Created Date: 2007-03-30T00:00:00-06:00 Published Date: 2012-04-17T12:11:22.367-06:00 Copyright Date: 2012 Copyright Statement: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
An inflammatory disease which may affect any part of the gastrointestinal tract, causing a wide variety of symptoms.
Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus.
Gastroesophageal refers to the stomach and esophagus, and reflux means to flow back or return. Gastroesophageal reflux (GER) is the return of acidic stomach juices, or food and fluids, back up into the esophagus.
The following is the most common symptom of GERD. However, each individual may experience symptoms differently.
Heartburn, also called acid indigestion, is the most common symptom of GERD. Heartburn is described as a burning chest pain that begins behind the breastbone and moves upward to the neck and throat. It can last as long as two hours and is often worse after eating. Lying down or bending over can also result in heartburn.
Most children younger than 12 years of age, and some adults, diagnosed with GERD will experience a dry cough, asthma symptoms, or trouble swallowing, instead of heartburn. Heartburn pain is less likely to be associated with physical activity.
The symptoms of GERD may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
GERD typically occurs when acid from the stomach backs up into the esophagus. The lower esophageal sphincter (LES), a muscle located at the bottom of the esophagus, opens to let food in and closes to keep it in the stomach. When this muscle relaxes too often or for too long, acid refluxes back into the esophagus, causing heartburn.
Other lifestyle contributors to GERD may include the following:
Being overweight
Overeating
Consuming certain foods, such as citrus,chocolate, fatty, and spicy foods
Caffeine
Alcohol
Use of nonsteroidal anti-inflammatory (NSAIDs) drugs, such as aspirin and ibuprofen
Other conditions associated with heartburn may include the following:
Gastritis. This is inflammation of the stomach lining
Ulcer disease
In addition to a complete medical history and physical examination, diagnostic procedures for GERD may include the following:
Upper GI (gastrointestinal) series (also called barium swallow). A diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an X-ray) is swallowed. X-rays are then taken to evaluate the digestive organs.
Esophagogastroduodenoscopy (also called EGD or upper endoscopy). An EGD (upper endoscopy) is a 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 of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary).
Bernstein test. A test that helps to confirm that the symptoms are a result of acid in the esophagus. The test is performed by dripping a mild acid through a tube placed in the esophagus.
Esophageal manometry. This test helps determine the strength of the muscles in the esophagus. It is useful in evaluating gastroesophageal reflux and swallowing abnormalities. A small tube is guided into the nostril, then passed into the throat, and finally into the esophagus. The pressure the esophageal muscles produce at rest is then measured.
pH monitoring. This measures the acidity inside of the esophagus. It is helpful in evaluating gastroesophageal reflux disease (GERD). A thin, plastic tube is placed into a nostril, guided down the throat, and then into the esophagus. The tube stops just above the lower esophageal sphincter, which is at the connection between the esophagus and the stomach. At the end of the tube inside the esophagus is a sensor that measures pH, or acidity. The other end of the tube outside the body is connected to a monitor that records the pH levels for a 24 to 48 hour period. Normal activity is encouraged during the study, and a diary is kept of symptoms experienced, or activity that might be suspicious for reflux, such as gagging or coughing. It is also recommended to keep a record of the time, type, and amount of food eaten. The pH readings are evaluated and compared to the patient's activity for that time period.
Specific treatment for GERD will be determined by your doctor based on:
In many cases, GERD can be relieved through diet and lifestyle changes, as directed by your doctor. Some ways to manage heartburn include the following:
Monitor the medications you are taking--some may irritate the lining of the stomach or esophagus.
Quit smoking.
Watch food intake and limit fried and fatty foods, peppermint, chocolate, alcohol,citrus fruit and juices, tomato products, and caffeinated drinks, such as coffee, soda pop, and energy drinks. .
Eat smaller portions.
Avoid overeating.
Watch consumption of alcohol.
Do not lie down or go to bed right after a meal. Instead, wait a couple of hours.
Lose weight, if necessary.
Elevate the head of the bed 6 inches by placing bricks or cinderblocks under the legs of the bed.
Take an antacid, as directed by your doctor.
Ask your doctor about use of over-the-counter medicines called "H2-blockers" and "protein pump inhibitors". Formerly available only by prescription, these drugs can be taken before eating to prevent heartburn from occurring. Also, promotility medications, which help to empty food from the stomach, may be prescribed by your doctor.
Occasionally, a surgical procedure called fundoplication may be performed to help keep the esophagus in proper position and prevent reflux.
Last Modified Date: 2012-04-17T00:00:00-06:00 Created Date: 2007-03-30T00:00:00-06:00 Published Date: 2012-04-17T11:23:49.87-06:00 Copyright Date: 2012 Copyright Statement: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
A condition in which the liquid content of the stomach backs up into the esophagus.
Ulcerative colitis is an inflammatory bowel disease (IBD) in which the inner lining of the large intestine (colon or bowel) and rectum become inflamed. Inflammation usually begins in the rectum and lower (sigmoid) intestine and spreads upward to the entire colon. Ulcerative colitis rarely affects the small intestine, except for the lower section, the ileum.
The inflammation causes diarrhea, or frequent emptying of the colon. As cells on the surface of the lining of the colon die and slough off, ulcers (open sores) form and may cause the discharge of pus and mucus, in addition to bleeding.
Although children and older people sometimes develop ulcerative colitis, it most often starts between the ages of 15 and 30. It affects males and females equally and appears to run in some families.
Ulcerative colitis requires long-term medical care. There may be remissions--periods when the symptoms go away--that last for months or even years. However, symptoms eventually return.
Only in rare cases, when complications occur, is the disease fatal. If only the rectum and lower colon are involved, the risk of cancer is not higher than normal. However, the risk of colon cancer is greater than normal in patients with widespread ulcerative colitis.
The following are the most common symptoms of ulcerative colitis. However, each individual may experience symptoms differently. Symptoms may include:
Bloody diarrhea
Loss of body fluids and nutrients
Anemia caused by severe bleeding
Sometimes, symptoms may also include:
Skin lesions
Inflammation of the eyes
Liver disorders
Osteoporosis
Kidney stones
The symptoms of ulcerative colitis may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
Although many theories exist regarding the cause of ulcerative colitis, none has been proven. The cause of ulcerative colitis is unknown, and currently there is no cure, except through surgical removal of the colon. One theory suggests that some agent, possibly a virus or an atypical bacterium, interacts with the body's immune system to trigger an inflammatory reaction in the intestinal wall.
Although much scientific evidence shows that people with ulcerative colitis have abnormalities of the immune system, physicians do not know whether these abnormalities are a cause or result of the disease.
There is little proof that ulcerative colitis is caused by emotional distress or sensitivity to certain foods or food products.
A thorough physical examination, including blood tests to determine whether an anemic condition exists, or if the white blood cell count is elevated (a sign of inflammation), is part of the diagnostic process. In addition, diagnostic procedures for ulcerative colitis may include the following:
Stool culture. Checks for the presence of abnormal bacteria in the digestive tract that may cause diarrhea and other problems. A small sample of stool is collected and sent to a laboratory by your doctor's office. In two or three days, the test will show whether abnormal bacteria, bleeding, or infection are present.
Esophagogastroduodenoscopy (also called EGD or upper endoscopy). A procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum (the first part of the small intestine where the absorption of vitamins, minerals, and other nutrients begins). 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 of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary).
Colonoscopy. Colonoscopy is a procedure that allows the doctor to view the entire length of the large intestine, and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the doctor to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.
Specific treatment for ulcerative colitis will be determined by your doctor based on:
While there is no special diet for ulcerative colitis, patients may be able to control mild symptoms simply by avoiding foods that seem to upset their intestines.
When treatment is necessary, it must be tailored for each case, as what may help one patient may not help another. Patients are also given needed emotional and psychological support. Treatment may include:
Drug therapy (aminosalicylates, corticosteroids, or immunomodulators). Abdominal cramps and diarrhea may be helped by medications to reduce inflammation in the colon. Abdominal cramps and diarrhea may be helped by medications to reduce inflammation in the colon. More serious cases may require steroid medications, antibiotics, or medications that affect the body's immune system.
Hospitalization. Patients with ulcerative colitis occasionally have symptoms severe enough to require hospitalization to correct malnutrition and to stop diarrhea and loss of blood, fluids, and mineral salts. The patient may need a special diet, intravenous (IV) feedings, medications, or, sometimes, surgery.
Surgery. Most people with ulcerative colitis do not need surgery. However, about 25 to 40 percent of ulcerative colitis patients eventually require surgery for removal of the colon because of massive bleeding, chronic debilitating illness, perforation of the colon, or risk of cancer. Sometimes, removing the colon is suggested when medical treatment fails, or the side effects of steroids or other drugs threaten the patient's health.
There are several surgical options, including the following:
Proctocolectomy with ileostomy. This is the most common surgery and involves proctocolectomy (removal of the entire colon and rectum) with ileostomy (creation of a small opening in the abdominal wall where the tip of the lower small intestine, the ileum, is brought to the skin's surface to allow drainage of waste).
Ileoanal anastomosis. Sometimes, ileoanal anastomosis (also called a pull-through operation), an operation that avoids the use of a pouch, can be performed. The diseased portion of the colon is removed and the outer muscles of the rectum are preserved. The ileum is attached inside the rectum, forming a pouch, or reservoir, that holds waste. This allows the patient to pass stool through the anus in a normal manner, although the bowel movements may be more frequent and watery than usual.
Last Modified Date: 2012-04-18T00:00:00-06:00 Created Date: 2007-03-30T00:00:00-06:00 Published Date: 2012-04-18T07:11:21.45-06:00 Copyright Date: 2012 Copyright Statement: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
Is a group of inflammatory conditions of the large intestine and small intestine.
The following are the latest statistics available from the Centers for Disease Control and Prevention and the American Liver Foundation:
Cirrhosis and other chronic liver diseases are common disease-related causes of death in the U.S. Approximately 31,000 people in the U.S. die each year from cirrhosis.
The vast majority of cases of cirrhosis could be prevented by eliminating chronic alcohol abuse.
Approximately 2.7 to 3.9 million people in the U.S. are chronically infected with the hepatitis C virus. Approximately 12,000 people die of hepatitis C annually in the U.S.
Hepatitis B kills approximately 3,000 people in the U.S. annually, and 800,000 to 1.4 million people in the U.S. are infected with the virus.
Last Modified Date: 2012-03-28T00:00:00-06:00 Created Date: 2007-03-30T00:00:00-06:00 Published Date: 2012-03-28T09:37:44.467-06:00 Copyright Date: 2012 Copyright Statement: © 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
The term "liver disease" applies to many diseases and disorders that cause the liver to function improperly or cease functioning.
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