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SUTAB Colonoscopy Prep (Spanish)
Instrucciones: haga clic aquí
Video con instrucciones: haga clic aquí
(nota: no recomendamos tomar un desayuno sólido la mañana antes del procedimiento; solo beba líquidos claros todo el día anterior)
SUTAB Colonoscopy Prep
For instructions in Spanish, click here
Video instructions from SUTAB: click here
(note: we do not recommend eating a solid breakfast the morning before the procedure; only drink clear liquids the entire day before)
Endoscopic Ultrasound (EUS)
Endoscopic Ultrasound (EUS) is an advanced diagnostic tool used to closely examine the digestive tract, including the esophagus, stomach, and parts of the small intestine, as well as surrounding organs like the pancreas and gallbladder. While EUS is an important tool in assessing and staging certain types of cancers, it has a wide range of other applications. It's frequently used to investigate causes of abdominal pain or abnormal findings from other tests, to evaluate conditions like pancreatitis or gallstones, and to understand the extent of certain digestive diseases.
In an EUS procedure, a doctor uses an endoscope that has an ultrasound device attached. This endoscope is carefully inserted into the digestive tract through the mouth or rectum. The ultrasound component produces detailed images of the internal structures, offering more clarity than external ultrasound. EUS can also be used to collect tissue samples for biopsy, helping to diagnose various conditions accurately. The procedure is minimally invasive, usually done on an outpatient basis, and requires some preparation similar to other endoscopic exams. It's important to discuss any concerns with your healthcare provider, who will provide detailed information about preparing for the EUS, what to expect during the examination, and the follow-up process.
Esophageal pH Testing
If you have heartburn, acid reflux (GERD), non-cardiac chest pain, or issues with swallowing, your doctor may refer you for pH testing. We offer two types of esophageal pH testing: pH with impedence testing and BRAVO pH testing. Please discuss with your doctor which may be the right test for you.
24 Hour pH Test with Impedence
pH testing with impedance involves wearing a small, thin tube (catheter) that goes through your nose and into your esophagus. This catheter has sensors that measure acid and non-acid reflux by detecting any liquid and gas that comes up into your esophagus. This test is typically done over a 24-hour period, during which you can go about your usual activities. It helps doctors see if your symptoms are related to acid reflux and how often reflux happens.
BRAVO pH Test (Wireless)
The BRAVO test uses a small capsule, temporarily attached to the esophagus wall during an endoscopy. This capsule wirelessly transmits pH levels to a recording device you wear. The BRAVO test is less invasive than traditional pH testing with impedance, as there's no catheter in your nose and throat. It usually monitors your acid levels for 48 to 96 hours. This test is particularly useful for understanding long-term acid exposure and its correlation with your symptoms.
Barrett’s Esophagus Radiofrequency Ablation
Barrett's Esophagus is a condition where the lining of the esophagus changes, often due to long-term acid reflux or GERD (Gastroesophageal Reflux Disease). People with Barrett's Esophagus have a higher risk of developing esophageal cancer. That’s why monitoring and treatment, like Radiofrequency Ablation (RFA), are important. Most people with Barrett’s Esophagus don't have symptoms, but it’s usually found during tests for GERD.
RFA is a treatment used for Barrett’s Esophagus, especially when there are precancerous changes. In RFA, a doctor uses a special device that sends out radio waves (radiofrequency energy) to remove the abnormal esophagus lining. The procedure is done during an endoscopy, where a thin, flexible tube with a camera is passed down your throat. RFA is effective because it targets only the abnormal cells, leaving the healthy ones untouched. This helps reduce the risk of esophageal cancer.
Before RFA, you’ll get instructions on how to prepare, usually involving fasting for a short time. The procedure is usually quick, and you won’t feel pain because you’ll receive medication to make you comfortable. After RFA, you might have some mild side effects like a sore throat, but these usually go away quickly. Most people can return to their normal activities soon after.
If you have Barrett’s Esophagus or are experiencing long-term heartburn or acid reflux symptoms, talk to your healthcare provider. They can advise on screenings for Barrett's Esophagus and discuss whether RFA or other treatments are right for you. Regular monitoring and timely treatment are key in managing Barrett's Esophagus and preventing more serious conditions.
Covid-19 Information: Updated as of May 2022
Committed to safe, excellent care
During the Covid-19 pandemic, it is important to get the care you need—whatever they may be. Integrated Gastroenterology Consultants providers, nurses and staff are ready to provide you with exceptional care.
Our office staff follows CDC and state-recommended guidelines to keep you safe. Masks are worn by all staff and patients to keep you safe. If you are having a procedure, depending on the location of your procedure and your vaccination status, you may need COVID testing prior. We currently have a testing area on site to help you prior to your procedure.
Symptoms
To help us safely care for you, please notify us of any upper respiratory symptoms you may have, such as:
New or worsening fever
Cough
Sore throat
Runny nose/nasal congestion
Shortness of breath
Muscle aches
Inability to smell or taste
Positive responses would likely indicate a deeper discussion with the provider before proceeding.
Knowing your symptoms will help us determine the most appropriate setting in which to treat you.
Fatty Liver Disease
Nonalcoholic fatty liver disease is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of nonalcoholic fatty liver disease is too much fat stored in liver cells.
Nonalcoholic steatohepatitis, a potentially serious form of the disease, is marked by liver inflammation, which may progress to scarring and irreversible damage. This damage is similar to the damage caused by heavy alcohol use. At its most severe, nonalcoholic steatohepatitis can progress to cirrhosis and liver failure
Nonalcoholic fatty liver disease is increasingly common around the world, especially in Western nations. In the United States, it is the most common form of chronic liver disease, affecting an estimated 80 to 100 million people.
Nonalcoholic fatty liver disease occurs in every age group but especially in people in their 40s and 50s who are at high risk of heart disease because of such risk factors as obesity and type 2 diabetes. The condition is also closely linked to metabolic syndrome, which is a cluster of abnormalities including increased abdominal fat, poor ability to use the hormone insulin, high blood pressure and high blood levels of triglycerides, a type of fat.
Symptoms
Nonalcoholic fatty liver disease usually causes no signs and symptoms. When it does, they may include:
Enlarged liver
Fatigue
Pain in the upper right abdomen
Possible signs and symptoms of nonalcoholic steatohepatitis and cirrhosis (advanced scarring) include:
Abdominal swelling (ascites)
Enlarged blood vessels just beneath the skin's surface
Enlarged breasts in men
Enlarged spleen
Red palms
Yellowing of the skin and eyes (jaundice)
Causes
Experts don't know exactly why some people accumulate fat in the liver while others do not. Similarly, there is limited understanding of why some fatty livers develop inflammation that progresses to cirrhosis. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis are both linked to the following:
Overweight or obesity
Insulin resistance, in which your cells don't take up sugar in response to the hormone insulin
High blood sugar (hyperglycemia), indicating prediabetes or actual type 2 diabetes
High levels of fats, particularly triglycerides, in the blood
These combined health problems appear to promote the deposit of fat in the liver. For some people, this excess fat acts as a toxin to liver cells, causing liver inflammation and nonalcoholic steatohepatitis, which may lead to a buildup of scar tissue (fibrosis) in the liver.
Diagnosis
A diagnosis can be made using many tests including:
Plain ultrasound, which is often the initial test when liver disease is suspected.
Transient elastography, an enhanced form of ultrasound that measures the stiffness of your liver. Liver stiffness indicates fibrosis or scarring.
Liver tissue examination. If other tests are inconclusive, your doctor may recommend a procedure to remove a sample of tissue from your liver (liver biopsy). The tissue sample is examined in a laboratory to look for signs of inflammation and scarring.
If you are concerned you have fatty liver disease or have been diagnosed with fatty liver disease, contact your doctor. You can also call us at 978-459-6737 to request an appointment.
Hepatitis C
Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious liver damage. The hepatitis C virus (HCV) spreads through contaminated blood. Until recently, hepatitis C treatment required weekly injections and oral medications that many HCV-infected people couldn't take because of other health problems or unacceptable side effects. That's changing. Today, chronic HCV is usually curable with oral medications taken every day for two to six months. Still, about half of people with HCV don't know they're infected, mainly because they have no symptoms, which can take decades to appear. For that reason, the U.S. Centers for Disease Control and Prevention recommends a one-time screening blood test for everyone at increased risk of the infection. The largest group at risk includes everyone born between 1945 and 1965 — a population five times more likely to be infected than those born in other years.
Symptoms
Long-term infection with the hepatitis C virus (HCV) is known as chronic hepatitis C. Chronic hepatitis C is usually a "silent" infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease. Among these signs and symptoms are:
Bleeding easily
Bruising easily
Fatigue
Poor appetite
Yellow discoloration of the skin and eyes (jaundice)
Dark-colored urine
Itchy skin
Fluid buildup in your abdomen (ascites)
Swelling in your legs
Weight loss
Confusion, drowsiness and slurred speech (hepatic encephalopathy)
Spider-like blood vessels on your skin (spider angiomas)
Your risk of hepatitis C infection is increased if you:
Are a health care worker who has been exposed to infected blood, which may happen if an infected needle pierces your skin
Have ever injected or inhaled illicit drugs
Have HIV
Received a piercing or tattoo in an unclean environment using unsterile equipment
Received a blood transfusion or organ transplant before 1992
Received clotting factor concentrates before 1987
Received hemodialysis treatments for a long period of time
Were born to a woman with a hepatitis C infection
Were ever in prison
Were born between 1945 and 1965, the age group with the highest incidence of hepatitis C infection
Hepatitis C infection that continues over many years can cause significant complications, such as:
Scarring of the liver (cirrhosis). After 20 to 30 years of hepatitis C infection, cirrhosis may occur. Scarring in your liver makes it difficult for your liver to function.
Liver cancer. A small number of people with hepatitis C infection may develop liver cancer.
Liver failure. Advanced cirrhosis may cause your liver to stop functioning.
Diagnosis
Health officials recommend that anyone at high risk of exposure to HCV get a blood test to screen for hepatitis C infection.
Doctors typically use one or more of the following tests to assess liver damage in chronic hepatitis C.
Transient elastography. Another noninvasive test, transient elastography is a type of ultrasound that transmits vibrations into the liver and measures the speed of their dispersal through liver tissue to estimate its stiffness.
Liver biopsy. Typically done using endoscopic ultrasound guidance, this test involves inserting a thin needle through the stomach wall under anesthesia to remove a small sample of liver tissue for laboratory testing.
Treatment
Hepatitis C infection is treated with antiviral medications intended to clear the virus from your body. The goal of treatment is to have no hepatitis C virus detected in your body at least 12 weeks after you complete treatment.
If you think you are at risk of having hepatitis C, call your doctor who can test you very quickly with a simple blood test. If you have hepatitis C, call us at 978-459-6737 to request an appointment. We can talk to you about how to get rid of the virus and manage any damage you may have suffered as a result of infection.
Hepatitis B
Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For some people, hepatitis B infection becomes chronic, meaning it lasts more than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis — a condition that permanently scars of the liver.
Most adults with hepatitis B recover fully, even if their signs and symptoms are severe. Infants and children are more likely to develop a chronic (long-lasting) hepatitis B infection.
A vaccine can prevent hepatitis B, but there's no cure if you have the condition. If you're infected, taking certain precautions can help prevent spreading the virus to others.
Symptoms
Signs and symptoms of hepatitis B range from mild to severe. They usually appear about one to four months after you've been infected, although you could see them as early as two weeks post-infection. Some people, usually young children, may not have any symptoms.
Hepatitis B signs and symptoms may include:
Abdominal pain
Dark urine
Fever
Joint pain
Loss of appetite
Nausea and vomiting
Weakness and fatigue
Yellowing of your skin and the whites of your eyes (jaundice)
Hepatitis B infection is caused by the hepatitis B virus (HBV). The virus is passed from person to person through blood, semen or other body fluids. It does not spread by sneezing or coughing.
Common ways that HBV can spread are:
Sexual contact. You may get hepatitis B if you have unprotected sex with someone who is infected. The virus can pass to you if the person's blood, saliva, semen or vaginal secretions enter your body.
Sharing of needles. HBV easily spreads through needles and syringes contaminated with infected blood. Sharing IV drug paraphernalia puts you at high risk of hepatitis B.
Accidental needle sticks. Hepatitis B is a concern for health care workers and anyone else who comes in contact with human blood.
Mother to child. Pregnant women infected with HBV can pass the virus to their babies during childbirth. However, the newborn can be vaccinated to avoid getting infected in almost all cases. Talk to your doctor about being tested for hepatitis B if you are pregnant or want to become pregnant.
Having a chronic HBV infection can lead to serious complications, such as:
Scarring of the liver (cirrhosis). The inflammation associated with a hepatitis B infection can lead to extensive liver scarring (cirrhosis), which may impair the liver's ability to function.
Liver cancer. People with chronic hepatitis B infection have an increased risk of liver cancer.
Diagnosis
Your doctor will examine you and look for signs of liver damage, such as yellowing skin or belly pain. Tests that can help diagnose hepatitis B or its complications are:
Blood tests. Blood tests can detect signs of the hepatitis B virus in your body and tell your doctor whether it's acute or chronic. A simple blood test can also determine if you're immune to the condition.
Liver ultrasound. A special ultrasound called transient elastography can show the amount of liver damage.
Liver biopsy. Your doctor might remove a small sample of your liver for testing (liver biopsy) to check for liver damage. During this test, your doctor inserts a thin needle through your skin and into your liver and removes a tissue sample for laboratory analysis.
If you have been exposed or believe you have been exposed to hepatitis B, call your doctor who can test you very quickly with a simple blood test. If you have hepatitis B, call us at 978-459-6737 to request an appointment.
Autoimmune Hepatitis
Autoimmune hepatitis is liver inflammation that occurs when your body's immune system turns against liver cells. The exact cause of autoimmune hepatitis is unclear, but genetic and environmental factors appear to interact over time in triggering the disease.
Untreated autoimmune hepatitis can lead to scarring of the liver (cirrhosis) and eventually to liver failure. When diagnosed and treated early, however, autoimmune hepatitis often can be controlled with drugs that suppress the immune system.
A liver transplant may be an option when autoimmune hepatitis doesn't respond to drug treatments or when liver disease is advanced.
Symptoms
Signs and symptoms of autoimmune hepatitis can range from minor to severe and may come on suddenly. Some people have few, if any, recognized problems in the early stages of the disease, whereas others experience signs and symptoms that may include:
Fatigue
Abdominal discomfort
Yellowing of the skin and whites of the eyes (jaundice)
An enlarged liver
Abnormal blood vessels on the skin (spider angiomas)
Skin rashes
Joint pains
In women, loss of menstruation
Diagnosis
Autoimmune hepatitis can be diagnosed through a combination of lab testing as well as by performing a liver biopsy.
If you believe you have autoimmune hepatitis or you have been diagnosed with autoimmune hepatitis, contact your doctor. You can also call 978-459-6737 to request an appointment.
Cirrhosis
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. The liver carries out several necessary functions, including detoxifying harmful substances in your body, cleaning your blood and making vital nutrients.
Cirrhosis occurs in response to damage to your liver. Each time your liver is injured, it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function.
Decompensated cirrhosis is the term used to describe the development of specific complications resulting from the changes brought on by cirrhosis. Decompensated cirrhosis is life-threatening.
The liver damage done by cirrhosis generally can't be undone. But if liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed.
Symptoms
Cirrhosis often has no signs or symptoms until liver damage is extensive. When signs and symptoms do occur, they may include:
Fatigue
Bleeding easily
Bruising easily
Itchy skin
Yellow discoloration in the skin and eyes (jaundice)
Fluid accumulation in your abdomen (ascites)
Loss of appetite
Nausea
Swelling in your legs
Weight loss
Confusion, drowsiness and slurred speech (hepatic encephalopathy)
Spiderlike blood vessels on your skin
Redness in the palms of the hands
Testicular atrophy in men
Breast enlargement in men
Complications
Complications of cirrhosis can include:
High blood pressure in the veins that supply the liver (portal hypertension). Cirrhosis slows the normal flow of blood through the liver, thus increasing pressure in the vein that brings blood from the intestines and spleen to the liver.
Swelling in the legs and abdomen. Portal hypertension can cause fluid to accumulate in the legs (edema) and in the abdomen (ascites). Edema and ascites also may result from the inability of the liver to make enough of certain blood proteins, such as albumin.
Enlargement of the spleen (splenomegaly). Portal hypertension can also cause changes to the spleen. Decreased white blood cells and platelets in your blood can be a sign of cirrhosis with portal hypertension.
Bleeding. Portal hypertension can cause blood to be redirected to smaller veins, causing them to increase in size and become varices. Strained by the extra load, these smaller veins can burst, causing serious bleeding. Life-threatening bleeding most commonly occurs when veins in the lower esophagus (esophageal varices) or stomach (gastric varices) rupture. If the liver can't make enough clotting factors, this also can contribute to continued bleeding. Bacterial infections are a frequent trigger for bleeding.
Infections. If you have cirrhosis, your body may have difficulty fighting infections. Ascites can lead to spontaneous bacterial peritonitis, a serious infection.
Malnutrition. Cirrhosis may make it more difficult for your body to process nutrients, leading to weakness and weight loss.
Buildup of toxins in the brain (hepatic encephalopathy). A liver damaged by cirrhosis isn't able to clear toxins from the blood as well as a healthy liver can. These toxins can then build up in the brain and cause mental confusion and difficulty concentrating. Hepatic encephalopathy symptoms may range from fatigue and mild impairment in cognition to unresponsiveness or coma.
Jaundice. Jaundice occurs when the diseased liver doesn't remove enough bilirubin, a blood waste product, from your blood. Jaundice causes yellowing of the skin and whites of the eyes and darkening of urine.
Bone disease. Some people with cirrhosis lose bone strength and are at greater risk of fractures.
Increased risk of liver cancer. A large proportion of people who develop liver cancer that forms within the liver itself have cirrhosis.
Acute-on-chronic liver failure. Some people end up experiencing multiorgan failure. Researchers now believe this is a distinct complication in some people who have cirrhosis, but they don't fully understand its causes.
If you believe you have cirrhosis or you have been diagnosed with cirrhosis, contact your doctor. You can also call 978-459-6737 to request an appointment.
Gastroesophageal Reflux (GERD)
Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus. Many people experience acid reflux from time to time. GERD is mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week.
Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications or surgery to ease symptoms.
Symptoms
Common signs and symptoms of GERD include:
A burning sensation in your chest (heartburn), usually after eating, which might be worse at night
Chest pain
Regurgitation of food or sour liquid
Sensation of a lump in your throat
If you have nighttime acid reflux, you might also experience:
Chronic cough
Laryngitis
New or worsening asthma
Disrupted sleep
Longstanding reflux can cause many problems including Barrett’s esophagus, esophagitis, and even esophageal cancer.
Diagnosis
At Integrated Gastroenterology Consultants, we have a full complement of diagnostic tools to diagnose GERD including 24-hour pH-impedence testing, BRAVO wireless pH probe, and upper endoscopy.
Treatment
If you do have GERD, be aware that longstanding proton pump inhibitor (PPI) use – such as omeprazole, Nexium, or Prilosec – has been associated with dementia, kidney failure, pneumonia, GI infections, and more. We are one of only a few centers in Massachusetts offering endoscopic non-surgical methods for controlling reflux to minimize or even eliminate the need for anti-acid medication such as transoral incisionless fundoplication.
If you have uncontrolled GERD or wish to pursue options that may eliminate the need for medications, call us at 978-459-6737 to request an appointment.
Esophageal Cancer
Esophageal cancer is cancer that occurs in the esophagus — a long, hollow tube that runs from your throat to your stomach. Your esophagus helps move the food you swallow from the back of your throat to your stomach to be digested.
Esophageal cancer usually begins in the cells that line the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus. More men than women get esophageal cancer.
Esophageal cancer is the sixth most common cause of cancer deaths worldwide. Incidence rates vary within different geographic locations. In some regions, higher rates of esophageal cancer cases may be attributed to tobacco and alcohol use or particular nutritional habits and obesity.
Signs and symptoms of esophageal cancer include:
Difficulty swallowing (dysphagia)
Weight loss without trying
Chest pain, pressure or burning
Worsening indigestion or heartburn
Coughing or hoarseness
Early esophageal cancer typically causes no signs or symptoms.
Make an appointment with your doctor if you have any persistent signs and symptoms that worry you. You can also call us at (978) 459-6737 to request an appointment.
Diarrhea
Everyone occasionally has diarrhea — loose, watery and possibly more-frequent bowel movements.
In most cases, diarrhea lasts a couple of days. But when diarrhea lasts for weeks, it can indicate a serious disorder, such as a persistent infection, inflammatory bowel disease, or a less serious condition, such as irritable bowel syndrome.
Symptoms
Signs and symptoms associated with diarrhea may include:
Loose, watery stools
Abdominal cramps
Abdominal pain
Fever
Blood in the stool
Nausea
Urgent need to have a bowel movement
If you suffer from severe or chronic diarrhea, call your doctor. You can also call us at 978-459-6737 to request an appointment.
Hemorrhoids
Hemorrhoids (HEM-uh-roids), also called piles, are swollen veins in your anus and lower rectum, similar to varicose veins. Hemorrhoids have a number of causes, although often the cause is unknown. They may result from straining during bowel movements or from the increased pressure on these veins during pregnancy. Hemorrhoids may be located inside the rectum (internal hemorrhoids), or they may develop under the skin around the anus (external hemorrhoids).
Hemorrhoids are very common. Nearly three out of four adults will have hemorrhoids from time to time. Sometimes they don't cause symptoms but at other times they cause itching, discomfort and bleeding. Occasionally, a clot may form in a hemorrhoid (thrombosed hemorrhoid). These are not dangerous but can be extremely painful and sometimes need to be lanced and drained. Fortunately, many effective options are available to treat hemorrhoids. Many people can get relief from symptoms with home treatments and lifestyle changes.
Symptoms
Signs and symptoms of hemorrhoids may include:
Painless bleeding during bowel movements — you might notice small amounts of bright red blood on your toilet tissue or in the toilet
Itching or irritation in your anal region
Pain or discomfort
Swelling around your anus
A lump near your anus, which may be sensitive or painful (may be a thrombosed hemorrhoid)
Hemorrhoid symptoms usually depend on the location.
Don't assume rectal bleeding is due to hemorrhoids, especially if you are over 40 years old. Rectal bleeding can occur with other diseases, including colorectal cancer and anal cancer. If you have bleeding along with a marked change in bowel habits or if your stools change in color or consistency, consult your doctor. These types of stools can signal more extensive bleeding elsewhere in your digestive tract.
If you believe you suffer from hemorrhoids, call your doctor. You can also call us at 978-459-6737 to request an appointment.
Difficulty Swallowing
Difficulty swallowing (dysphagia) means it takes more time and effort to move food or liquid from your mouth to your stomach. Dysphagia may also be associated with pain. In some cases, swallowing may be impossible. Occasional difficulty swallowing, which may occur when you eat too fast or don't chew your food well enough, usually isn't cause for concern. But persistent dysphagia may indicate a serious medical condition requiring treatment.
Dysphagia can occur at any age, but it's more common in older adults. The causes of swallowing problems vary, and treatment depends on the cause. Fortunately, we have all the diagnostic and treatment tools necessary for the diagnosis and treatment of almost all diseases causing dysphagia at Integrated Gastroenterology Consultants.
Symptoms
Signs and symptoms associated with dysphagia may include:
Having pain while swallowing (odynophagia)
Being unable to swallow
Having the sensation of food getting stuck in your throat or chest or behind your breastbone (sternum)
Drooling
Being hoarse
Bringing food back up (regurgitation)
Having frequent heartburn
Having food or stomach acid back up into your throat
Unexpectedly losing weight
Coughing or gagging when swallowing
Having to cut food into smaller pieces or avoiding certain foods because of trouble swallowing
Some of the causes of esophageal dysphagia include:
Achalasia. When your lower esophageal muscle (sphincter) doesn't relax properly to let food enter your stomach, it may cause you to bring food back up into your throat. Muscles in the wall of your esophagus may be weak as well, a condition that tends to worsen over time.
Diffuse spasm. This condition produces multiple high-pressure, poorly coordinated contractions of your esophagus, usually after you swallow. Diffuse spasm affects the involuntary muscles in the walls of your lower esophagus.
Esophageal stricture. A narrowed esophagus (stricture) can trap large pieces of food. Tumors or scar tissue, often caused by gastroesophageal reflux disease (GERD), can cause narrowing.
Esophageal tumors. Difficulty swallowing tends to get progressively worse when esophageal tumors are present.
Foreign bodies. Sometimes food or another object can partially block your throat or esophagus. Older adults with dentures and people who have difficulty chewing their food may be more likely to have a piece of food become lodged in the throat or esophagus.
Esophageal ring. A thin area of narrowing in the lower esophagus can intermittently cause difficulty swallowing solid foods.
GERD. Damage to esophageal tissues from stomach acid backing up into your esophagus can lead to spasm or scarring and narrowing of your lower esophagus.
Eosinophilic esophagitis. This condition, which may be related to a food allergy, is caused by an overpopulation of cells called eosinophils in the esophagus.
Scleroderma. Development of scar-like tissue, causing stiffening and hardening of tissues, can weaken your lower esophageal sphincter, allowing acid to back up into your esophagus and cause frequent heartburn.
Radiation therapy. This cancer treatment can lead to inflammation and scarring of the esophagus.
Diagnosis
Your doctor will likely perform a physical examination and may use a variety of tests to determine the cause of your swallowing.
Tests may include:
Dynamic swallowing study. You swallow barium-coated foods of different consistencies. This test provides an image of these foods as they travel through your mouth and down your throat. The images may show problems in the coordination of your mouth and throat muscles when you swallow and determine whether food is going into your breathing tube.
A visual examination of your esophagus (endoscopy). A thin, flexible lighted instrument (endoscope) is passed down your throat so that your doctor can see your esophagus. Your doctor may also take biopsies of the esophagus to look for inflammation, eosinophilic esophagitis, narrowing or a tumor.
Esophageal muscle test (manometry). In manometry (muh-NOM-uh-tree), a small tube is inserted into your esophagus and connected to a pressure recorder to measure the muscle contractions of your esophagus as you swallow.
If you suffer from dysphagia, contact your doctor. You can also call us at 978-459-6737 to schedule a consultation.
Gastrointestinal Bleeding/Anemia
Anemia from gastrointestinal (GI) bleeding can have multiple causes. Upper GI bleeding is caused by ulcers, inflammation of the stomach lining or stomach cancer. Bleeding in the lower GI tract can be attributed to intestinal polyps, abnormal blood vessels, colorectal cancer, hemorrhoids, infectious diarrhea and inflammatory bowel disease.
The symptoms of GI bleeding.
Gastrointestinal bleeding has a number of symptoms, including blood in the stool or on toilet paper as well as stools that are black or very dark. Sometimes, slow GI bleeding can be "silent," without any noticeable change in bowel movement or stool. These people are often anemic and display pale skin color, shortness of breath and weakness.
Anemia can have serious consequences.
Losing blood means losing red blood cells, which contain the substance hemoglobin that carries life-giving oxygen. A deficiency of hemoglobin leads to a lack of sufficient oxygen to the organs and other tissues, which can have a wide range of consequences to your health. So gastrointestinal bleeding must be identified and diagnosed so it can be treated and stopped.
At Integrated Gastroenterology Consultants, our board-certified GI specialists provide comprehensive diagnosis of suspected gastrointestinal bleeding and anemia backed by years of advanced training and hands-on experience. We offer these and other diagnostic procedures:
Upper endoscopy to evaluate the esophagus, stomach & duodenum
Capsule endoscopy to diagnose problems in the small intestine
Colonoscopy to evaluate for bleeding in the lower digestive tract
We perform most scope procedures in our state-of-the-art endoscopy center, where we can get you in quickly, cater to your comfort and protect your privacy and give you the specialized, compassionate care you deserve. Call us today.
For more information or to schedule an appointment, call your doctor or call us today at 978-459-6737.