Baylor Health Care SystemAbout B
 
Need something? Call us: 1.800.4BAYLOR(1.800.422.9567)
Text Size:

Conditions Treated 

We provide personalized, comprehensive and compassionate care for patients with all types of digestive diseases and conditions.

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, gastroesophageal reflux disease (GERD), chronic diarrhea and irritable bowel syndrome.

Barrett's Esophagus Esófago de Barrett

Barrett's Esophagus

Illustration of the anatomy of the digestive system, adult
Click Image to Enlarge

What is Barrett's esophagus?

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.

What causes Barrett's esophagus?

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.

Illustration demonstrating gastroesophageal reflux
Click Image to Enlarge

People who have had long-standing heartburn are at risk for Barrett's esophagus and should discuss this with their doctor.

What are the symptoms of Barrett's esophagus?

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.

Illustration of an esophagogastroduodenoscopy procedure
Click Image to Enlarge

How is Barrett's esophagus diagnosed?

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.

Treatment for Barrett's esophagus

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.

Barrett’s Esophagus

Barrett's esophagus occurs when the lining of the esophagus is damaged by stomach acid that leaks backward.

Learn More

Colorectal Cancer

Colon Cancer

Whether you want to learn about colon cancer symptoms, prevention or treatment, Baylor is here for you. Our system of hospitals and outpatient centers offers the experience, expertise and technology you can trust.

What is colon cancer?

Colon 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 colorn cancer. Cancerous tumors found in the colon or rectum also may spread to other parts of the body.

Excluding skin cancers, colon cancer is the third most common cancer in both men and women. The American Cancer Society estimates that about 140,000 colon cancer cases and about 50,000 deaths from colon cancer occur each year. The number of deaths due to colon cancer has decreased, which is attributed to increased screening and polyp removal and to improvements in cancer treatment. 

What are the types of cancer in the colon and rectum?

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 specialized cells in the wall of the digestive tract called the interstitial cells of Cajal. These tumors may be found anywhere in 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, rectum, or other organs.

  • Carcinoids. Carcinoids are tumors that start in special hormone-producing cells in the intestine. Often they cause no symptoms at first. Surgery is the usual treatment.

  • Sarcoma. Tumors that start in blood vessels, muscle, or connective tissue in the the colon and rectum wall. 

What are the symptoms of colon cancer?

The following are the most common colon cancer symptoms. 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

  • Vomiting

  • Unintended weight loss

  • Weakness and fatigue

  • A feeling that you need to have a bowel movement that is not relieved by doing so 

The symptoms of colon 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 health care provider for a diagnosis.

If you have been diagnosed with colon cancer, search online to find a physician, or call 1.800.4BAYLOR for cancer treatment in Dallas-Fort Worth.

What are the risk factors for colorectal cancer?

Risk factors may include:

  • Age. Most people who have colon cancer are over age 50; however, it can occur at any age.

  • Race and ethnicity. African-Americans have the highest risk for colon cancer of all racial groups in the U.S. Jews of Eastern European descent (Ashkenazi Jews) have the highest colon cancer risk of any ethnic group in the world. 

  • Diet. Colon cancer is often associated with a diet high in red and processed meats.

  • Personal history of colorectal polyps. Benign growths on the wall of the colon or rectum are common in people over age 50, and may lead to colon cancer.

  • Personal history of colon cancer. People who have had colon cancer have an increased risk for another colon cancer.

  • Family history. People with a strong family history of colon cancer or polyps in a first-degree relative (especially in a parent or sibling before the age of 45 or in two first-degree relatives of any age) have an increased risk for colon 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 or hereditary nonpolyposis colon cancer, also known as Lynch syndrome 

  • Obesity

  • Physical inactivity

  • Heavy alcohol consumption

  • Type 2 diabetes

  • Smoking

What causes colon cancer?

The exact cause of most colon cancer is unknown, but the known risk factors listed above are the most likely causes. A small percentage of colon 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.

Prevention of colon cancer

Although the exact cause of colon cancer is not known, it may be possible to lower your risk of colon 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 limiting red and processed meats, 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, such as aspirin, and hormone replacement therapy for postmenopausal women, may reduce the risk of colon cancer. But these drugs also have their own potentially serious risks, so it is important to discuss this with your health care provider.

  • Screenings. Perhaps most important to the prevention of colon 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 colon 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.

Methods of screening for colon cancer

Screening methods for colon cancer, for people who do not have any symptoms or strong risk factors, include the following:

  • Fecal occult blood test (FOBT). 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 FOBT, 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 with a small video camera on the end, 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) scans to examine the colon for polyps or masses. The images are processed by a computer to make a three-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 as follow up.

Illustration demonstrating a colonoscopy, part 1
Click Image to Enlarge

Illustration demonstrating a colonoscopy, part 2

  • 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. Air is then pumped in to expand the colon and rectum. An X-ray of the abdomen is then taken and can show strictures (narrowed areas), obstructions (blockages), and other problems.

Screening guidelines for colon cancer

Colon 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 or fecal immunochemical test every year

    • Flexible sigmoidoscopy every five years

    • Double-contrast barium enema every five years

    • Colonoscopy every 10 years

    • CT colonography (virtual colonoscopy) every five years

  • 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 45 or in two first-degree relatives of any age

    • Family with hereditary colorectal cancer syndromes, such as familial adenomatous polyposis and hereditary nonpolyposis colon cancer

    • Personal history of colorectal cancer or adenomatous polyps

    • Personal history of chronic inflammatory bowel disease (Crohn's disease or ulcerative colitis)

Diagnostic procedures for colon cancer

If a person has symptoms that might be caused by colon 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 colon cancer in people without symptoms.

  • Digital rectal examination. A doctor or other health care provider inserts a gloved and lubricated finger into the rectum to feel for anything unusual or abnormal. This test can detect some cancers of the rectum, but not the colon.

  • Fecal occult blood test. This 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.

  • 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 with a small video camera on the end, 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. 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 (also called 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 that can show strictures (narrowed areas), obstructions (blockages), and other problems.

  • Biopsy. a procedure in which polyps or 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 (that can be a result of bleeding from a tumor).

  • Imaging tests. Tests, such as a CT scan, PET scan, ultrasound, or MRI of the abdomen, may be done to look for tumors or other problems. These tests may also be done if colon cancer has already been diagnosed to help determine the extent (stage) of the cancer.

What are the stages of colon cancer?

When colon cancer is diagnosed, tests will be performed to determine how much cancer is present, and if the cancer has spread from the colon or rectum to other parts of the body. This is called staging, and it is an important step toward planning a treatment program. The stages for colon cancer are as follows:

Stage 0 (Cancer in situ)

The cancer is found in the innermost lining of the colon or rectum.

Stage I (also called Dukes' A colon cancer)

The cancer has spread beyond the innermost lining of the colon or rectum to the second and third layers. The cancer has not spread to the outer wall or outside of the colon or rectum.

Stage II (also called Dukes' B colon cancer)

The cancer has spread through into the wall or outside the colon or rectum 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.

Treatment for colon cancer

Specific treatment for colon cancer will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent and location of the disease

  • Results of certain lab tests 

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of this disease

  • Your opinion or preference

After the colon cancer is diagnosed and staged, your doctor will recommend a treatment plan. Treatment may include:

  • Colon surgery. Often, the primary treatment for colon cancer is an operation, 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. Radioactive material is placed next to or directly into the cancer, which limits the effects of surrounding healthy tissues. 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 may increase the survival rate for patients with some stages of colon cancer. It can also be helpful before or after surgery for some stages of rectal 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 may help people some live longer.

If you're experiencing colon cancer symptoms, Baylor Health Care System offers personalized, comprehensive and compassionate care, with the experience, expertise and technology you can trust. Search online to find a physician, or call 1.800.4BAYLOR for cancer treatment in Dallas-Fort Worth.

Colon Cancer

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."

Learn More

Esophageal Cancer Cáncer Esofágico

Esophageal Cancer

What is esophageal 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 about 17,990 Americans will be newly diagnosed with esophageal cancer during 2013, and about 15,210 deaths are expected.

What causes esophageal cancer?

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.

What are the different types of esophageal cancer?

There are 2 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 half of the cases.

The other type, called squamous cell carcinoma, grows in the cells that form the top layer of the inner 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.

What are the symptoms of esophageal cancer?

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 swallowing. A 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 loss. Many 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

  • Vomiting

  • Blood in stool or black-looking stools

  • Heartburn

The symptoms of esophageal cancer may resemble other medical conditions or problems. Always consult your health care provider 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.

What are the risk factors for esophageal cancer?

The following factors can put an individual at greater risk for developing esophageal cancer:

  • Age. The risk increases with age. In the U.S., most people are diagnosed at 55 years of age or older.

  • Gender. Men have more than a 3 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 is another major risk factor for esophageal cancer.

  • Acid reflux. Abnormal backward flow of stomach acid into the esophagus increases esophageal cancer risk. 

  • Barrett's esophagus. Long-term irritation from reflux, commonly known as heartburn, changes the cells at the lower end of the esophagus. This is a precancerous condition, which raises the risk of developing adenocarcinoma of the esophagus.

  • Obesity. Being very overweight increases the risk of esophageal cancer. This might be because being overweight puts you at higher risk for reflux. 

  • 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.

How is esophageal cancer diagnosed?

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 that 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 doctor to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube with a tiny video camera on the end, 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).

  • 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. 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 wall of the esophagus, stomach, and nearby lymph nodes. The endoscope is guided into the mouth and throat, then into the esophagus and the stomach. As in standard endoscopy, this allows the doctor 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 doctor to examine the lymph nodes and other structures inside the chest or abdomen with a hollow, lighted tube inserted through a small cut in the skin, and remove suspicious areas for further testing.

  • PET scan. A test that uses a radioactive glucose (sugar) dye to highlight cancer cells and create pictures of the inside of the body. The test is done much like a CT scan. First, the doctor or nurse injects a small amount of radioactive dye into your vein. Then a scanner is moved around your body and takes many pictures of your neck, chest, and abdomen. A computer puts these pictures together to show where the cancer cells are located.

Treatment for esophageal cancer

Specific treatment options for esophageal cancer will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent and location of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of this disease

  • Your opinion or preference

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.

  • Photodynamic therapy (PDT) or other laser therapies. In these treatments, an endoscope with a laser on the end is used to destroy cancer cells on or near the inner lining of the esophagus. 

Sometimes, several of these treatments may be combined to treat esophageal cancer.

Esophageal Cancer

Esophageal cancer is a malignant (cancerous) tumor of the esophagus, the muscular tube that moves food from the mouth to the stomach.

Learn More

Hepatitis C Hepatitis C

Hepatitis C

Illustration of the  anatomy of the biliary system
Click Image to Enlarge

What is hepatitis?

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.

What is hepatitis C?

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.

What causes hepatitis C?

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.

Who is at risk for 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.

What are the symptoms of hepatitis C?

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.

How is hepatitis C diagnosed?

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.

Treatment for hepatitis C

Specific treatment for hepatitis C 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 the disease

  • Your opinion or preference

At the present time, a vaccine is not available for the prevention of hepatitis C. Treatment may include biological therapy with interferon.

Hepatitis B & C

An injury to the liver characterized by the presence of inflammatory cells in the tissue of the organ.

Learn More

Irritable Bowel Syndrome (IBS)Síndrome del Intestino Irritable, su sigla en inglés es IBS

Irritable Bowel Syndrome (IBS)

Illustration of the anatomy of the digestive system, adult
Click Image to Enlarge

What is irritable bowel syndrome (IBS)?

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.

What causes irritable bowel syndrome?

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.

What are triggers for IBS?

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.

What are the symptoms of IBS?

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.

How is irritable bowel syndrome diagnosed?

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.

  • 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.

What is the treatment for IBS?

Specific treatment for IBS will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the condition

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Treatment may include:

  • 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.

What are good fiber sources?

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

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) refers to a disorder that involves abdominal pain and cramping, as well as changes in bowel movements.

Learn More

Pancreatic CancerCáncer Pancreático

Pancreatic Cancer

What is pancreatic cancer?

Pancreatic cancer is the fourth most common cause of cancer death in the U.S. Pancreatic cancer occurs when a cell in the pancreas is damaged and this malignant (cancer) cell starts to grow out of control.

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.

What are the risk factors for pancreatic cancer?

Risk factors for pancreatic cancer include:

  • Age. Most pancreatic cancer occurs in people over the age of 55.

  • Smoking. Heavy cigarette smokers are 2 or 3 times more likely than nonsmokers 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 type 2 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 whites 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 certain 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 BRCA2 gene, increase the risk of pancreatic cancer.

  • Chronic pancreatitis. Long-term inflammation of the pancreas has been linked with increased risk for pancreatic cancer.

What are the symptoms of pancreatic cancer?

The following are the other most common symptoms of pancreatic cancer. However, each person may experience symptoms differently. Symptoms may include:

  • Pain in the upper abdomen (belly) or upper back

  • Loss of appetite

  • Weight loss

  • Jaundice (yellow skin and eyes, and dark urine)

  • Indigestion

  • Nausea

  • Vomiting

  • Extreme tiredness (fatigue)

  • An enlarged abdomen from a swollen gallbladder 

  • Pale, greasy stools that float in the toilet 

The symptoms of pancreatic cancer may be a lot like those of other conditions or medical problems. Always consult your doctor for a diagnosis.

How is pancreatic cancer diagnosed?

Technician preparing patient for CT scan

In addition to a complete medical history and physical examination, diagnostic procedures for pancreatic cancer may include the following:

  • Ultrasound. 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 done using an external or internal device:

    • Transabdominal ultrasound. The technician places an ultrasound device on the abdomen to create the image of the pancreas.

    • Endoscopic ultrasound (EUS). The doctor 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 doctor 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 doctor 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 (first part of the small intestine). The doctor can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope, and a dye is injected that will allow the bile and pancreatic ducts to be seen on an X-ray.

  • Percutaneous transhepatic cholangiography (PTC). A needle is put through the skin and into the liver where the dye (contrast) is injected so that the bile duct structures can be seen by X-ray. This test is generally only done if an ERCP cannot be done. 

  • 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. For this test, a radioactive substance, usually bound to a type of sugar, is injected through a vein before the body is scanned. The radioactive sugar collects in cancer cells, which will show up on images. This test is not as specific as CT scanning, and is not used alone to diagnose pancreatic cancer. A PET scan is often done in combination with a CT scan.

Treatment for pancreatic cancer

Specific treatment for pancreatic cancer will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Location and extent of the disease

  • Type of cancer

  • Your tolerance of specific medicines, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Depending on the type and stage, pancreatic cancer may be treated with the following:

  • Surgery. This treatment may be necessary to remove the tumor, a section, or the entire pancreas and often parts of other organs. 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 gallbladder and part of the common bile duct, 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 anticancer drugs to kill cancer 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.

Pancreatic Cancer

Pancreatic cancer begins in the pancreas. The cause is unknown, but it is more common in smokers and in obese people.

Learn More

DiarrheaDiarrea

Diarrhea

Illustration of the anatomy of the digestive system, adult
Click Image to Enlarge

What is diarrhea?

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.

What causes diarrhea?

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 gallbladder

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.

What are the symptoms of diarrhea?

The following are the most common symptoms of diarrhea. However, each individual may experience symptoms differently. Symptoms may include:

  • Cramping

  • Abdominal pain

  • Bloating

  • Nausea

  • Urgent need to use the restroom

  • Fever

  • 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)

  • Fatigue

  • 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.

How is diarrhea diagnosed?

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.

  • 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.

  • Imaging tests. These tests are done to rule out structural abnormalities.

  • Fasting tests. These tests identify food intolerance or allergies.

Treatment for diarrhea

Specific treatment for diarrhea will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the condition

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Treatment usually involves replacing lost fluids, and may include antibiotics when bacterial infections are the cause.

Chronic Diarrhea

Diarrhea that lasts for more than two weeks is considered chronic. In an otherwise healthy person, chronic diarrhea can be a nuisance.

Learn More

Crohn's DiseaseEnfermedad de Crohn

Crohn's Disease

Illustration of the anatomy of the digestive system, adult
Click Image to Enlarge

What is Crohn's disease?

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.

What are the symptoms of Crohn's 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

  • Weight loss

  • Fever

  • 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.

What causes Crohn's disease?

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.

How is Crohn's disease diagnosed?

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.

Illustration demonstrating a colonoscopy
Click Image to Enlarge

What are treatments for Crohn's disease?

Specific treatment for Crohn's disease 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 the disease

  • Your opinion or preference

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.

Treatment may include:

  • 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.

Crohn's Disease

An inflammatory disease which may affect any part of the gastrointestinal tract, causing a wide variety of symptoms.

Learn More

Gastroesophageal Reflux Disease (GERD)/Heartburn

Gastroesophageal Reflux Disease (GERD)/Heartburn

Whether you want to learn about GERD symptoms, prevention or treatment, Baylor is here for you. Our system of hospitals and outpatient centers offers the experience, expertise and technology you can trust.

What is GERD?

Illustration demonstrating  gastroesophageal reflux
Click Image to Enlarge

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.

What are the symptoms of GERD?

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.

If you believe you have GERD symptoms, talk to your doctor. If you have been diagnosed with GERD, search online to find a physician, or call 1.800.4BAYLOR for digestive treatment in Dallas-Fort Worth.

What causes GERD?

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

  • Smoking

  • 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

How is GERD diagnosed?

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).

Illustration of an esophagogastroduodenoscopy procedure
Click Image to Enlarge

  • 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.

If you have been diagnosed with GERD, search online to find a physician, or call 1.800.4BAYLOR for digestive treatment in Dallas-Fort Worth.

Treatment for GERD

Specific treatment for GERD will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the condition

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

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.

We offer advanced methods of GERD treatment. Search online to find a physician, or call 1.800.4BAYLOR for digestive treatment in Dallas-Fort Worth.

Gastroesophageal (or gastric) reflux disease (GERD)

A condition in which the liquid content of the stomach backs up into the esophagus.

Learn More

Ulcerative ColitisColitis Ulcerativa

Ulcerative Colitis

Illustration of the anatomy of the digestive system, adult
Click Image to Enlarge

What is ulcerative colitis?

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.

What are the symptoms of ulcerative colitis?

The following are the most common symptoms of ulcerative colitis. However, each individual may experience symptoms differently. Symptoms may include:

  • Abdominal pain

  • Bloody diarrhea

  • Fatigue

  • Weight loss

  • Loss of appetite

  • Rectal bleeding

  • Loss of body fluids and nutrients

  • Anemia caused by severe bleeding

Sometimes, symptoms may also include:

  • Skin lesions

  • Joint pain

  • Inflammation of the eyes

  • Liver disorders

  • Osteoporosis

  • Rashes

  • Kidney stones

The symptoms of ulcerative colitis may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

What causes ulcerative colitis?

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.

How is ulcerative colitis diagnosed?

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.

Illustration of an esophagogastroduodenoscopy procedure
Click Image to Enlarge

  • Biopsy. A procedure performed to remove tissue or cells from the lining of the colon for examination under a microscope.

  • 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.

What is the treatment for ulcerative colitis?

Specific treatment for ulcerative colitis will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the condition

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

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.

Inflammatory Bowel Disease

Is a group of inflammatory conditions of the large intestine and small intestine.

Learn More

Liver Disease StatisticsEstadísticas

Liver Disease Statistics

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. About 16,000 people die of hepatitis C annually in the U.S.

  • Hepatitis B kills approximately 3,000 people in the U.S. annually, and 1.2 million people in the U.S. are infected with the virus.

Liver Disease

The term "liver disease" applies to many diseases and disorders that cause the liver to function improperly or cease functioning.

Learn More

We offer many methods of advanced digestive disease treatment. Search online to find a physician or call 1.800.4BAYLOR for digestive treatment in Dallas-Fort Worth.