https://www.jacksoncountygastro.com/conditions/colon-polyps-cancer daily 0.75 2021-03-16 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1612571494097-EE3Z07KYY1U4EC2NTEB1/ColonCancerScreeningButton.jpg Colon Polyps & Cancer https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1612571429660-XBU3IBIC9VNWP4QEAOZU/Colon+Polyps+%26+Cancer.jpg Colon Polyps & Cancer - Colon Polyps & Cancer Colon cancer is a major health problem in the United States. It ranks as a leading form of cancer, along with lung and breast cancer. Colon cancer is one of the most curable forms of cancer. When detected early, more than 90 percent of patients can be cured. What is a colon polyp? A polyp is a growth that occurs in the colon and other organs. These growths are shaped like a mushroom or dome-like button, and occur in the inside lining of the colon. They can be very small, or larger than a golf ball. It is important to note that colon polyps start out as benign tumors, but can develop into a malignancy. In fact, the larger the polyp, the more likely it is to contain cancer cells. In most cases, it is a polyp called an adenoma polyp that develops into colon cancer. https://www.jacksoncountygastro.com/resources/no-show-cancellation-policy daily 0.75 2021-02-06 https://www.jacksoncountygastro.com/about-us daily 0.75 2021-03-15 https://www.jacksoncountygastro.com/our-staff/gregory-m-vardakis-do daily 0.75 2022-03-11 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/2a671898-5a8e-472d-9b37-8b65fab5e99c/Dr.+V.jpg Gregory M. Vardakis, DO - First Name Last Name Tobias Keene, D.D.S. Hailing from Richmond, Virginia, Dr. Tobias Keene brings a bit of unabashed Southern hospitality to all his patients. He moved to Washington, D.C. over thirty years ago as a freshman at Ivy College. Right after graduation, he attended World University’s School of Dentistry. Before opening Keene Dental in 1994, he worked for free clinics and some of the finest practices in the District. He is part of the 123 Dental Association and stays up-to-date on the latest dental discoveries. When not striving to keep his patients happy and healthy, he’s enjoys hiking with his family in Rock Creek Park. https://www.jacksoncountygastro.com/resources/insurance-information daily 0.75 2021-02-06 https://www.jacksoncountygastro.com/resources/insurance-information/participating-and-non-participating-insurance-list daily 0.75 2021-02-06 https://www.jacksoncountygastro.com/procedures/endoscopic-ultrasound daily 0.75 2021-03-30 https://www.jacksoncountygastro.com/our-staff/farid-m-namin-md daily 0.75 2021-02-06 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1612565438553-VPHZ4HURWBVRZNGRL936/Farid_Namin_MD.jpg Farid M. Namin, MD - First Name Last Name Tobias Keene, D.D.S. Hailing from Richmond, Virginia, Dr. Tobias Keene brings a bit of unabashed Southern hospitality to all his patients. He moved to Washington, D.C. over thirty years ago as a freshman at Ivy College. Right after graduation, he attended World University’s School of Dentistry. Before opening Keene Dental in 1994, he worked for free clinics and some of the finest practices in the District. He is part of the 123 Dental Association and stays up-to-date on the latest dental discoveries. When not striving to keep his patients happy and healthy, he’s enjoys hiking with his family in Rock Creek Park. https://www.jacksoncountygastro.com/resources/frequently-asked-questions daily 0.75 2021-02-06 https://www.jacksoncountygastro.com/contact-us daily 0.75 2024-05-09 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1612821567410-UVOMYKMFCAHPJP2ANBUF/Independence_Location.png Contact https://www.jacksoncountygastro.com/all-staff daily 0.75 2024-05-09 https://www.jacksoncountygastro.com/resources/patient-forms daily 0.75 2021-02-06 https://www.jacksoncountygastro.com/conditions/barretts-esophagus daily 0.75 2021-02-06 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1612569675898-NOGALZMU1WTILWFXH8Z2/Barrett%E2%80%99s+Esophagus.jpg Barrett’s Esophagus - Barrett’s Esophagus If you have Barrett’s Esophagus, part of the lining on the esophagus near where it joins the stomach has changed. This is caused by the acid reflux that occurs with GERD (gasteroesophageal reflux disease). The change that occurs in the lining is not cancer, but can lead to cancer later on if medication for acid suppression is not taken. When you have GERD, the stomach acid is backing up into the esophagus. The esophagus is the tube that carries the food and liquid we consume from our mouths to the stomach. Acids in the stomach help break down and digest food. Normally, the sphincter muscle keeps the stomach acid from flowing back into the esophagus. If this muscle is weak, GERD may occur. The stomach is protected from its own acid by a special lining. Stomach acid normally stays out of the esophagus, so it does not need the same acid resistant lining. However, if the acid backs up during GERD, it will cause damage to the esophagus. To protect itself, the esophagus may develop a more acid resistant lining, which is called Barrett’s Esophagus. This change in lining is not normal, and if over time continues to change, it may be more likely to become cancer in the future. GERD symptoms include: Heartburn Sour tasting fluid backing up into your mouth Frequent burping or belching Symptoms that are worse after you eat, bend over, or lie down Coughing repeatedly to clear your throat Hoarseness https://www.jacksoncountygastro.com/home daily 1.0 2024-05-09 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845899350-MEHBVJQOD2MQLMFFSTSR/Diverticulosis.png Home https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615848587830-64H1DESQ6N7DZ1BZ5O3B/Diarrhea.png Home https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615848775381-9Y9IO2MWS4IV4RARQR1A/Difficulty-Swallowing.png Home https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845851148-D5IZ1IFHDNBZ25TCZ0UM/Constipation.png Home https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615847171487-NN9DCZOPXRJVSRGAE6UW/Abdominal-Pain.png Home https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615848341675-H34P5KUR9XQQ70KHYEBR/Blood-in-stool.png Home https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615849030329-NDY059Y7Y1QGL358GJKX/Gas_and_Bloating.png Home https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845719756-DI3DJ7LNFG7JW7VIGFQM/Barrett%E2%80%99s-Esophagus.png Home https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845790974-667PCVN9W0NQLM8NRYXA/Colon_Polyps_Cancer.png Home https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845959069-JB9AQO5FK6XJWKVT8OMD/GERD.png Home https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845982157-PY5PRV7JKNANCA7E9TIU/Hepatitis.png Home https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1612565438553-VPHZ4HURWBVRZNGRL936/Farid_Namin_MD.jpg https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/d937e63c-788c-4630-9c22-a33e213b36c2/Dr.+V.jpg https://www.jacksoncountygastro.com/resources/financial-policy daily 0.75 2021-02-06 https://www.jacksoncountygastro.com/procedures/lactulose-breath-test daily 0.75 2021-03-16 https://www.jacksoncountygastro.com/conditions/constipation daily 0.75 2021-02-08 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1612821146688-L7JZA5QOT6AE1953TQW6/constipation.jpg Constipation - Constipation Constipation can be defined as infrequent or hard pellet stools, or difficulty in evacuating stool. While troublesome, constipation is not usually a serious disorder. However, there may be other underlying problems causing constipation, and therefore, testing is often recommended. The function of the colon is to withdraw water from the liquid stool so that by the time it reaches the rectum, there is a soft, formed stool. If an excessive amount of water is extracted, the stool can become hard and difficult to expel. What Causes Constipation? Most often, it’s due to a lazy colon that can’t move the waste products through the colon and into the rectum. Other causes include mechanical obstruction from either benign causes (diverticulosis) or from malignant causes (colon or rectal cancer). Other conditions that can produce a sluggish, poorly contracting bowel include: pregnancy, certain drugs, thyroid hormone deficiency, and the chronic abuse of laxatives, travel and stress. How do you Treat Constipation? Determine the underlying cause, if possible. Eat regularly (don’t skip multiple meals during the day). Increase dietary fiber (whole grain breads, bran cereals, fruits/vegetables). Add a bulking agent to the diet (increase insoluble dietary fiber), if needed. Drink plenty of liquids, particularly water, during the day. Regular walking and aerobic exercise Respond to the urge to defecate Do Laxatives Help? Chronic use of laxatives, particularly stimulant laxatives is discouraged, as the bowel (colon) becomes dependent upon them to work. Examples of such laxatives include: Ex-Lax®, Ducolax®, Correctol®, Sennakot®, etc. These laxatives are harsh on the colon. Laxatives that can be used intermittently include: MiraLax®, Kristalose/Lactulose®, Golyteley® preps, etc. to get the colon to work in a correct fashion without causing bowel dependency. An occasional saline enema can be used with difficult to pass stools. Bowel Retraining Program: Do not use stimulant laxatives! Eat a diet high in roughage, such as bran cereals and leafy vegetables. Drink at least eight (8) glasses of water daily. Eat two (2) servings of fruit daily. If you cannot get enough fiber in your diet daily, take one of the fiber supplements (Citracel®, Metamucil®, Fibercon®) as prescribed to give the colon the bulk that it needs to work properly. Eat a normal breakfast. Set aside 15 minutes after breakfast to sit on the toilet, but do not strain to have a bowel movement. If you do not have a bowel movement by the third day, use an enema and repeat the above steps. https://www.jacksoncountygastro.com/conditions/gerd daily 0.75 2021-03-16 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615829778724-NCQ02I9HQ1ICX0M75VUP/GERD.jpg GERD - GERD If you feel a painful burning sensation in your chest after you eat, you may have gastroesophageal reflux disease (GERD). Heartburn is a classic symptom of GERD, but you may have other symptoms, too. After you eat, food travels from your mouth down the esophagus to your stomach. Along the way, food passes through a one-way valve called the lower esophageal sphincter (LES), which is the opening to your stomach. Normally the LES opens when you swallow, allowing food to enter the stomach, then closes quickly. With GERD, the LES does not work normally, allowing food and stomach acid to travel back, or reflux into the esophagus. Symptoms: Frequent heartburn or burping Sour tasting fluid backing up into your mouth Symptoms that get worse after you eat, bend over, or lie down Difficulty or pain when swallowing Relieve the Pressure: Eat smaller meals, even if you have to eat more often Don’t lie down right after you eat. Wait a few hours for your stomach to empty Avoid tight belts and tight fitting clothes Lose excess weight Watch Eating Habits and Avoid: Coffee, tea, carbonated drinks, alcohol and tobacco Fatty, fried or spicy foods Mint, chocolate, onions and tomatoes Any foods that seem to irritate your stomach or cause pain Raise Your Head: Reflux is more likely to strike when you’re lying flat, because stomach fluid can flow backward more easily. Try raising the head of your bed 4-6 inches by sliding blocks under the legs at the head of your bed, or a wedge under the mattress. Do not prop your head on pillows. This increases pressure on your stomach, making GERD worse. https://www.jacksoncountygastro.com/conditions/blood-in-stool daily 0.75 2021-03-29 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615850179558-Q0X68XSHIYYXKMVNFLJU/Blood-in-stool.jpg Blood in Stool - Blood in Stool How can I tell if there is blood in my stool? Blood in your stool may result from bleeding anywhere along the GI tract – from mouth to anus. Blood in the stool may cause the stool to appear sticky or black, often assuming a tar-like appearance. This is the case if the bleeding arises from the upper organs of the GI tract, like the stomach and esophagus. Other times, bleeding may cause a maroon or burgundy colored stool, or most commonly, you may notice bright red blood in the bowl, or on the tissue when cleaning yourself after a bowel movement. Bright red blood most commonly arises from the colon, rectum and anus. Is rectal bleeding important? Often rectal bleeding reflects a minor issue, but it can be very serious. It can be impossible to tell, based on the appearance of the blood, or based on how you feel. Therefore, it is important to get an evaluation if you have blood in your stool or you see blood after having a bowel movement. What causes blood in the stool? The wall of the gastrointestinal tract contains a rich supply of small blood vessels that nourish the organs and transport nutrients. Bleeding into the gastrointestinal tract occurs with the breach of the integrity of one of these vessels. Rectal bleeding can arise from numerous causes, including: Ulcerations of the GI tract Inflammation of the GI tract, as with Crohn’s Disease or colitis Anal tears (fissures) Hemorrhoidal tears Diverticulosis of the colon Aberrant blood vessels in the wall of the bowel Cancers and benign tumors of the GI tract https://www.jacksoncountygastro.com/procedures/h-pylori-breath-test daily 0.75 2021-03-16 https://www.jacksoncountygastro.com/procedures/ercp daily 0.75 2021-03-16 https://www.jacksoncountygastro.com/procedures/halo-ablation daily 0.75 2021-03-16 https://www.jacksoncountygastro.com/all-conditions daily 0.75 2021-03-16 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615847171487-NN9DCZOPXRJVSRGAE6UW/Abdominal-Pain.png All Conditions https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845790974-667PCVN9W0NQLM8NRYXA/Colon_Polyps_Cancer.png All Conditions https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845959069-JB9AQO5FK6XJWKVT8OMD/GERD.png All Conditions https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615848587830-64H1DESQ6N7DZ1BZ5O3B/Diarrhea.png All Conditions https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845899350-MEHBVJQOD2MQLMFFSTSR/Diverticulosis.png All Conditions https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845982157-PY5PRV7JKNANCA7E9TIU/Hepatitis.png All Conditions https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845851148-D5IZ1IFHDNBZ25TCZ0UM/Constipation.png All Conditions https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615848341675-H34P5KUR9XQQ70KHYEBR/Blood-in-stool.png All Conditions https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615849030329-NDY059Y7Y1QGL358GJKX/Gas_and_Bloating.png All Conditions https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615845719756-DI3DJ7LNFG7JW7VIGFQM/Barrett%E2%80%99s-Esophagus.png All Conditions https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615848775381-9Y9IO2MWS4IV4RARQR1A/Difficulty-Swallowing.png All Conditions https://www.jacksoncountygastro.com/book-an-appointment daily 0.75 2021-03-15 https://www.jacksoncountygastro.com/conditions/diarrhea daily 0.75 2021-03-16 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615850392650-5DPXR4A2R3GTR8IQZNMM/Diarrhea.jpg Diarrhea - Diarrhea What is diarrhea? Diarrhea refers to loose, frequent, watery stools and a feeling that you urgently need to make a bowel movement. Everyone has diarrhea occasionally, however when it is severe and or long-lasting it may indicate an underlying illness. The following symptoms may accompany diarrhea: Bloating in your stomach Stomach cramps Fevers Rectal bleeding Nausea or vomiting Unintended weight loss What causes diarrhea? Diarrhea can be a symptom of many different health problems, most of which are related to the gastrointestinal system. Some common causes include: Food allergies, lactose intolerance, or celiac disease Food poisoning Common prescription medications Diabetes Inflammatory bowel diseases (IBDs) like Crohn’s disease or ulcerative colitis (UC) Irritable bowel syndrome (IBS) Bacterial, viral or parasitic infection Small Intestinal Bacterial Overgrowth Microscopic colitis Overactive thyroid gland What to do if you have diarrhea? If the diarrhea is relatively mild and only lasts a day or two, you can generally manage this with over the counter remedies, hydration with electrolyte-rich fluids, and rest If diarrhea lasts longer than a couple of days, is recurrent, is severe, or occurs in association with fever, bleeding, severe pain, or signs of dehydration, then promptly seek medical attention. https://www.jacksoncountygastro.com/procedures/capsule-endoscopy-small-bowel daily 0.75 2021-03-16 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615819957783-ZM5EZ0GE017J7AK688J6/img.png Capsule Endoscopy (small bowel) https://www.jacksoncountygastro.com/conditions/gas-and-bloat daily 0.75 2021-03-15 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615851004157-HPU7MIZFAR342DMQP9RO/Gas_and_Bloating.jpg Gas / Bloat - Gas / Bloat What is gas pain and bloating? Intestinal gas is a normal byproduct of digestion, and burping or passing gas is not usually cause for concern. However, gas that does not move normally through your digestive system or increased production of gas places increased pressure on your digestive organs and causes bloating and pain. Eating difficult to digest foods will cause most people to produce excess gas. Pain associated with poor digestion can often be managed by simple dietary changes. However, severe gas and gas pain can also be a sign of conditions like celiac disease, irritable bowel syndrome (IBS) or even colon cancer. What are the signs of excess gas? You may be experiencing an excess of gas in your digestive system if you notice: Excessive burping Excessive passing gas (flatulence) Pain, cramps, or a feeling of pressure or knotting in your abdomen A feeling of over-fullness (bloating, distension) in your abdomen An observable increase in the size of your abdomen If these symptoms occur more often, chronically, or severely than normal, you should discuss the situation with your doctor. You should see a doctor promptly if your gas pains come hand-in-hand with: Blood in your stool Unintended weight loss Loss of appetite Constipation or diarrhea Persistent or recurring nausea and vomiting It’s also vital to seek help if gas is accompanied by chest pain, as this could be a sign of heart problems. https://www.jacksoncountygastro.com/conditions/diverticulosis daily 0.75 2021-03-15 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615829409764-KO8SRH6OOLSMSQ1KMWTL/Diverticulosis.jpg Diverticulosis - Diverticulosis Diverticuli are pockets, sacs or projections extending out from the colon. It occurs gradually over a long period of time and occurs at weak points in the bowel wall. The sacs develop because of the pressure exerted within the contracting colon. Most diverticula develop within the lower third of the colon, the sigmoid colon. This area represents the highest pressure zone within the colon. These balloon-like projections can make the lining of the colon become thickened and narrowed, causing some bowel problems including abdominal discomfort, diarrhea and/or constipation. Most patients, however, with diverticulosis have no symptoms whatsoever. A low fiber diet contributes to the development of these projections within the colon. Symptoms of Diverticulosis As diverticula form, few symptoms are noticeable, except for intermittent spastic discomfort in the lower portion of the abdomen. Usually, there are not any symptoms at all. When diverticulosis is far advanced, the lower colon may become very fixed, distorted and even narrowed. When this occurs, there may be thick or pellet-shaped stools, constipation and an occasional rush of diarrhea. The problem then becomes a mechanical or structural one. Complications of Diverticulosis Diverticulitis – once a sac becomes infected or inflamed, diverticulitis has occurred. The infection can be mild with only slight discomfort, or it can be quite extreme with severe pain, fever and chills. Treatment includes antibiotics and may require hospitalization if severe. Bleeding – at times, bleeding can occur from a ruptured blood vessel in diverticuli. This may produce a large amount of blood. Perforation – this is the most uncommon, but the most serious. The infection in the diverticuli have caused a hole in the colon. This requires immediate surgery. Treatment of Diverticulosis Diverticulosis cannot be cured once diagnosed, but it can be prevented from advancing if treated early. A diet high in fiber, bran and roughage is important. These foods add bulk to the stools, producing softer stools, and thus decreasing the pressure on the bowel. Fiber supplements are helpful for this. A daily fiber intake of 20 to 30 grams is recommended. Also, a daily intake of 8 glasses of water is recommended. Nuts, large seeds and popcorn may need to be avoided if indicated by your physician. Surgery may be needed to remove the diseased portion of the colon if there are recurrent episodes of diverticulitis. https://www.jacksoncountygastro.com/conditions/abdominal-pain daily 0.75 2021-03-16 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615849197701-81V5DHMZ4J3VJPV9M3FI/Abdominal+Pain.jpg Abdominal Pain - Abdominal Pain What causes abdominal pain? Abdominal pain can arise from organs of the digestive tract, or from other organs located in the pelvis and abdomen, including your kidneys, bladder, ovaries, womb and abdominal muscles. Disorders that commonly cause abdominal pain in all the digestive organs include infection, gaseous distension, ulcer formation (a break in the lining of the digestive organ), mechanical obstruction or blockage, inflammation, or perforation (where a hole occurs in the wall of an organ. Pain may also occur without an objective structural finding, due for example to a disorder of brain-gut interaction. If you experience one of the following symptoms (among others) in addition to abdominal pain, you should seek immediate medical attention: Fever Weight loss Nighttime pain interrupting sleep Pain that is steadily worsening Pain that does not resolve Vomiting, especially if you continue being unable to keep food down Dehydration An inability to make a bowel movement Painful urination Tenderness or swelling in your abdomen Blood in vomit or stool Black or tar-like stool Yellowing skin How serious is abdominal pain? In some instances, bad abdominal pain signals a serious problem. In a small minority of cases, it may be life-threatening and require an immediate operation. In the case of acute infection or blockage, for example, we may need to operative immediately in order to avoid a catastrophic organ rupture. In others, it can signal a transient and insignificant problem, such as with excess gas. Likewise, serious abdominal illness may cause bad pain, or may cause no pain at all, as with many colorectal cancers. What specific illnesses commonly cause abdominal pain? These include: Acid-related illnesses such as indigestion, ulcers or acid reflux A pulled or strained muscle in the abdominal wall Constipation or diarrhea A stomach virus Menstrual cramps Food poisoning Irritable bowel syndrome Inflammatory diseases such as Crohn’s disease and ulcerative colitis Celiac disease Gynecological diseases such as infections, endometriosis, and ruptured ovarian cysts Gallstones or kidney stones Infections such as appendicitis or diverticulitis Intestinal cancer https://www.jacksoncountygastro.com/all-resources daily 0.75 2021-03-17 https://www.jacksoncountygastro.com/procedures/colonoscopy daily 0.75 2021-03-16 https://www.jacksoncountygastro.com/procedures/remicade-infusion-therapy daily 0.75 2021-03-16 https://www.jacksoncountygastro.com/procedures/upper-endoscopy daily 0.75 2021-03-16 https://www.jacksoncountygastro.com/all-procedures daily 0.75 2021-03-30 https://www.jacksoncountygastro.com/conditions/hepatitis-c daily 0.75 2021-03-15 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615830385858-QLPVR5P30Y22TIEEHBVA/Hepatitis.jpg Hepatitis C - Hepatitis C The Liver The liver is the largest organ in the body. It is found high in the right upper abdomen, behind the ribs. It is a very complex organ and has many functions. They include: Storing energy in the form of sugar (glucose) Storing vitamins, iron and other minerals Making proteins, including blood clotting factors, to keep the body healthy and help it grow Processing worn out red blood cells Making bile, which is needed for food digestion Metabolizing or breaking down many medications and alcohol Killing germs that enter the body through the intestine The liver shoulders a heavy workload for the body and almost never complains. It even has a remarkable power to regenerate itself. Still, it should not be taken for granted. The liver is subject to illnesses, such as hepatitis C, which may lead to serious damage. What is Hepatitis? When cells in the body are injured by such things as chemicals or infection, the area that is hurt becomes inflamed. Hepatitis is inflammation of the liver, which in turn causes damage to the individual liver cells. It is most often caused by viral infection. There are different types of viral hepatitis. The most common are hepatitis A, hepatitis B and hepatitis C. Other causes of hepatitis include alcohol, certain drugs, chemicals, diseases, hereditary disorders and other infections. Hepatitis may be either acute or chronic. In acute hepatitis, the inflammation develops quickly and lasts a fairly short period of time. The patient usually recovers completely, but it can take up to several months. Occasionally, a person fails to recover fully, and the hepatitis becomes chronic. In other words, it continues at a smoldering pace. Generally, anyone with hepatitis that continues longer than six months is considered to have chronic hepatitis. Chronic hepatitis can develop over a number of years without the patient ever having acute hepatitis or even feeling sick. As the liver repairs itself, fibrous tissue develops, much like a scar forms after a cut or injury to the skin. When scarring in the liver is extensive, it is called cirrhosis. Over time, cirrhosis irreversibly damages the liver, eventually ending in liver failure. What is Hepatitis C? Hepatitis C is caused by a virus (medically abbreviated as HCV). This type of viral hepatitis is different from the others in an important way. All patients with hepatitis A and most with hepatitis B develop an acute infection, recover completely, and develop antibodies that protect them from ever getting the disease again. However, the hepatitis C virus is a “quick-change” artist. Once inside the body, it changes its form to evade discovery and attack by the immune system. Scientists have already identified many forms of HCV, and patients infected with one type are not necessarily safe from other types. Hepatitis C patients do develop antibodies, but they are not curative or protective as in hepatitis A or B. Hepatitis C antibodies may not completely rid the body of the virus. Therefore, most people infected with the HCV virus will develop chronic hepatitis. Current estimates are that 3.5 million Americans carry the virus that causes hepatitis C, and 150,000 people become infected with HCV each year. This virus is known to be spread through infected blood, blood products and needles. Prior to the late 1980’s, people were most at risk for contracting the disease through blood transfusions. However, a blood test was developed at that time to detect the virus, and the blood supply is now always tested to prevent spread of the disease in this way. Even so, there is a very slight risk for those who must receive blood products on a regular basis, such as hemophiliacs and patients on hemodialysis. Health care workers are also at risk. At this time, the people most at risk for getting hepatitis C are IV drug users who share needles. There are also a larger number of cases among east Asians. In about 40% of all cases of hepatitis C, it is unknown how the patient was infected with the virus. This situation is known as community acquired disease. Symptoms and Diagnosis Most patients with hepatitis C do not have symptoms. This is especially true early in the disease. If there are symptoms, they are usually mild and flu-like – perhaps nausea and fatigue. It can take from 2 to 26 weeks for the disease to develop, once the patient is infected with HCV. Routine blood tests will show an elevation in certain liver enzymes, especially one called the ALT. The physician can then order a specific blood test to determine if the patient has hepatitis. Chronic Hepatitis C Hepatitis C is cause for concern for two reasons. First, most common cases become chronic. Second, patients seldom become acutely ill, so it is possible for them to have the disease for some time before it is diagnosed. Later in the disease, fatigue may become increasingly severe. If cirrhosis has developed, other more serious symptoms may occur. However, the elevation in the blood ALT may not correlate with the degree of liver inflammation. In other words, a high ALT may not necessarily mean there is a serious degree of inflammation. Conversely, a low or normal blood ALT level may be present even though there is chronic liver damage. For this reason, a liver biopsy is almost always required to determine how serious the disease may be. Under local anesthesia, a slender needle is inserted into the right lower chest. A small piece of liver tissue is taken out with the needle and examined under a microscope. A biopsy can show if cirrhosis is present and how far it has progressed. It is believed that about 20% of the patients with chronic hepatitis C will develop cirrhosis, and a few of those will go on to develop liver cancer. It may take 10 to 40 years for serious liver damage to occur. Treatment Patients with hepatitis C should avoid alcohol, because it can cause additional liver damage. Some medicines can also cause liver injury. Therefore, patients should always review any medications and over-the-counter drugs with their physicians. The treatment for chronic hepatitis C is with a drug called interferon (trade name: Intron A). However, not all patients are candidates for this drug. Interferon is a synthetic form of the substance the body naturally produces to fight infections and strengthen the immune system. There are some bothersome side effects with the drug, so physicians must evaluate patients individually to decide if they are suitable for the treatment. Interferon is injected three times a week for up to six months. About half of the patients treated will respond. About half of those who respond will have a relapse after treatment is discontinued. Research continues on ways to make this treatment more effective. Additionally, newer drugs are currently being studied for use in treating hepatitis C. HCV Carriers Certain people infected with HCV have a positive HCV blood test, but a normal liver enzyme test. These individuals are often called HCV carriers, and they can pass the virus on to others. Although they appear not to be seriously ill, there is recent evidence that even these people may have chronic hepatitis. Therefore, each should be evaluated by a liver specialist. Sex and Pregnancy The risk of transmitting HCV sexually is low compared to hepatitis B and AIDS. In marriages and long-term relationships with monogamous partners, it is after the case that one person is HCV positive and the partner is HCV negative. The current medical recommendation is that in these circumstances, sexual practices need not be changed. However, when people have multiple sex partners or new partners, they should never engage in unprotected sex. It appears that in pregnancy, HCV is passed on to the fetus less than 5% of the time. It may depend on how high the mother’s blood virus level is during pregnancy. Therefore, hepatitis C infected women should always consult with their physicians before becoming pregnant. Prevention There is no vaccine currently available to protect against hepatitis C, as there is with hepatitis A and hepatitis B. People can prevent getting hepatitis C by not sharing anything that is likely to hold and transmit blood – razors, manicure tools, toothbrushes, and especially IV drug needles. Practices such as ear piercing and tattooing should be avoided in places where sterile conditions are questionable. Until all circumstances under which HCV can be transmitted have been thoroughly identified, it should be assumed that every person with hepatitis C can pass the virus on to others. Therefore everyone, especially health care workers should avoid coming in contact with blood and body fluids from infected individuals. Liver Transplantation Liver transplantation is a newer, successful form of therapy for people with a badly damaged liver. Liver transplants have become more common for people with chronic hepatitis C who develop life-threatening liver damage. However, since these patients continue to carry the virus, they will almost always re-infect their new livers. Nevertheless, with continuing treatment for the chronic infection, liver transplantation offers these patients longer life and improved quality of life. Summary Hepatitis C is a serious disease that often results in long-term complications. Many patients infected with HCV develop chronic hepatitis C. Some people become carriers of HCV without knowing it. For this reason it is important to prevent spread of the disease by lifestyle practices that avoid contact with infected blood and body fluids. Researchers are continually learning more about hepatitis C, and research into new treatments is ongoing. Chronic hepatitis C patients who are monitored frequently and follow the advice of their physicians have every reason to be hopeful about the future. https://www.jacksoncountygastro.com/procedures/hydrogen-breath-test-procedure daily 0.75 2021-03-16 https://www.jacksoncountygastro.com/conditions/difficulty-swallowing daily 0.75 2021-03-15 https://images.squarespace-cdn.com/content/v1/601a0e8d1098657d21103bc1/1615850698516-I0WMIQT9X8KPES6Q9QBD/Difficulty+Swallowing.jpg Difficulty Swallowing - Difficulty Swallowing What is dysphagia? If you have difficulty swallowing, you have the condition known as dysphagia. Dysphagia may be painful and frightening, make you need extra effort to ingest food or liquids, and cause you to lose your appetite or even avoid eating. Dysphagia – if it is recurrent – usually reflects an underlying issue with the mouth, pharynx, or esophagus. Sometimes the issue can be serious. So if you experience recurrent dysphagia you should It consult a gastroenterologist. What are the symptoms of dysphagia? In addition to difficulty swallowing, dysphagia symptoms often include: Pain, coughing or gagging while you swallow Feeling like something’s stuck in your throat or chest Excessive saliva production and drooling Feeling hoarse Heartburn Regurgitation (food or stomach acid coming back up your throat) Unexplained weight loss What causes dysphagia? Swallowing may seem to be a simple reflex, however, it’s actually a complicated process with multiple steps involving your brain, throat, and esophagus. The underlying problem may be structure (e.g. a mechanical blockage) or functional (e.g. a neuromuscular inability to propel the food downward). Two locations of dysphagia Depending on the part of the swallowing process that’s affected, you may experience oropharyngeal or esophageal dysphagia. These different types of dysphagia also have distinct causes. Oropharyngeal dysphagia is difficulty starting the act of swallowing. It usually results from an issue affecting your brain’s ability to communicate with the nerves in your mouth or throat. Causes can include neurological disorders such as Parkinson’s disease and multiple sclerosis, as well as physical conditions such as a stroke. If you have oropharyngeal dysphagia, the act of swallowing can cause you to gag, cough, or feel as if food or liquids are going down your windpipe or up your nose. Esophageal dysphagia reflects a structural or neuromuscular problem in the esophagus (your food pipe). This version of dysphagia can feel like food sticks in your throat or chest after you swallow, and “won’t go down.” Underlying structure conditions that cause this type of dysphagia include gastroesophageal reflux disease (GERD) and associated scarring or inflammation, “membranes” or abnormal esophageal tissue called “webs” or “rings,” and cancer of the stomach or esophagus. Common neuromuscular disorders include spasms or uncoordinated contractions of the esophagus, or rare disease such as achalasia or scleroderma, which cause failure of pats of the esophagus to contract or relax. How do we make the diagnosis? We obtain a careful history, and then may recommend a variety of tests, such as x-rays, endoscopy, esophageal acid measurement, or measurement of esophageal contraction. We can usually establish the diagnosis. https://www.jacksoncountygastro.com/free-language-assistance daily 0.75 2021-03-30 https://www.jacksoncountygastro.com/non-discrimination-policy daily 0.75 2021-03-30