Our Gastroenterology Blog
By Dordaneh Maleki MD, FACP
November 02, 2018
Category: GI Care

Is it constipation? Is it diarrhea? Frankly, when a patient complains to his or her physician about GI problems, the doctor has to wonder, "Is it Irritable Bowel Syndrome?" If you alternate between infrequent and too frequent bowel movements, you may need evaluation by a gastroenterologist. An expert in all things from your esophagus through your stomach and intestines, a GI doctor can uncover the reasons behind bowel issues, including IBS.

About IBS and its symptoms

Unfortunately, no one knows the real origin of Irritable Bowel Syndrome. However, it definitely is a cluster of symptoms which millions of people in the US--more women than men--suffer, before the age of 50. The International Foundation for Gastrointestinal Disorders reports that stress appears to increase symptoms; however, anxiety and a high-pressure job or life circumstance do not actually cause the condition.

Besides constipation and/or diarrhea, individuals with IBS have:

  • Bouts of gas
  • Bloating
  • Nausea
  • Pain
  • Cramps
  • Mucus in the stool
  • Fatigue
  • Intolerance to a variety of foods, including those containing gluten and lactose (dairy)
What you can do
 
Your primary care physician may refer you to a GI doctor for additional evaluation. This specialist will listen to your symptoms; so be sure to tell him or her what they are, when and how often they occur, how long they last and what, if anything, helps.
 
The doctor may order blood work, including a complete blood count to check for anemia, an indicator of bleeding in the GI tract. Also, he or she may wish to look into your intestine via colonoscopy. This common examination introduces a lighted, flexible tube through the entire length of the large intestine. It allows the doctor to visualize and take photos of the lining of the bowel and to biopsy areas as needed.
 
Treatments for IBS
 
If you are diagnosed with Irritable Bowel Syndrome, you can manage your symptoms. No, IBS cannot be cured, but rest assured that many patients live well with this GI condition. Many gastroenterologists ask individuals to eliminate suspect foods such as:
  • Alcohol
  • Dairy products
  • Chocolate
  • Caffeinated drinks
  • High fat or fried foods
On the positive side, you may gradually increase your intake of fibrous dietary choices such as:
  • Beans
  • Legumes
  • Oats
  • Bran
  • Yams
  • Whole grains
  • Barley
The doctor may recommend easy-to-take fiber supplements such as Fibercon or Metamucil which regulate the water in the bowel and normalize stools. Probiotics--natural supplements containing beneficial bacteria and yeast--are a common part of an IBS regimen.
 
Feeling better
 
If you suspect you have Irritable Bowel Syndrome, or are just not sure what's going on with your digestive health, consult a board-certified gastroenterologist. This highly-skilled doctor will get to the source of your issues, answer your questions and help you function at your best.
 
By Dordaneh Maleki MD, FACP
October 16, 2018
Category: GI Condition
Tags: Hemmorrhoids  

Wondering if you have hemorrhoids? Hemorrhoids are very common, especially among people ages 45 to 75. Hemorrhoids are inflamed and swollen veins around the anus or in the lower rectum. One of the main causes of hemorrhoids is straining when you’re trying to have a bowel movement. Other contributing factors include heredity, diarrhea, chronic constipation, pregnancy, and aging. Here's how to tell if you have hemorrhoids.

1. A lump near the anus- Although many individuals have hemorrhoids, not all experience symptoms. External hemorrhoids are felt as swelling or a hard lump near the anal area. Internal hemorrhoids protrude with bowel movements; usually, they return to the inside by themselves.

2. Painless bleeding- Hemorrhoids can cause bleeding. If you have hemorrhoids, you may see blood in the toilet bowl or on the toilet paper. Rectal bleeding is also a symptom of diverticulitis, colitis, colon polyps, and colorectal cancer. If you experience rectal bleeding, you should see a doctor. An evaluation and proper diagnosis by a gastroenterologist is important any time bleeding from the rectum lasts for more than a few days. 

3. Itching around the anus- Hemorrhoids can cause severe itching around the anus. Initial treatment of anal itching is directed toward relieving the soreness and burning. Your gastroenterologist may prescribe hydrocortisone cream, gel, foam, or ointment or rectal suppositories to treat itching.

4. Pain or discomfort- Pain is a common symptom of external hemorrhoids, especially during bowel movements or when sitting. Internal hemorrhoids are typically painless, even when they produce bleeding. When hemorrhoids are painful, it’s hard to think about anything else. Your gastroenterologist may prescribe pain medication, hydrocortisone cream or rectal suppositories to ease your pain. 

Why suffer? If you think you may have hemorrhoids, you should schedule an appointment with a gerontologist right away. The symptoms hemorrhoids cause are hard to ignore. Thankfully, there are many treatments that can provide relief.

By Dordaneh Maleki MD, FACP
September 28, 2018
Category: GI Care
Tags: Gallstones   Healthy Diet   Cancer  

Unfortunately, many of us eat the foods we crave before thinking about how it affects our digestive health. Your digestive health is directly impacted by the lifestyle you live and the foods you eat. Exercising, drinking water, and adding fiber all contribute to better digestive health. Here are five digestive problems that are caused by a poor diet.

1. GERD- GERD is a digestive disorder in which stomach acid or bile irritates the food pipe lining. Symptoms include heartburn, hoarseness, and trouble swallowing. Some foods and beverages are known to cause reflux. If you're at risk for GERD, avoid fatty foods, acidic foods, spicy foods, chocolate, and caffeinated beverages. Being overweight and obesity are also causes of GERD. 

2. Cancer- Diet can also directly affect your risk of stomach and bowel cancer. Some foods, such as processed and salt-preserved foods, and red meat can increase the risk of developing stomach and bowel cancer. While others, such as vegetables and fruits, are especially potent cancer fighters. Choosing whole-grain breads, cereals, and pastas instead of refined grains, and eating poultry, fish, or beans may also help lower your risk of stomach and bowel cancer.

3. Gallstones- Slimming down (if you're overweight) and changes to your diet may help prevent gallstones. Gallstones are hardened deposits of bile inside the gallbladder. Because cholesterol plays a role in the development of gallstones, you should avoid eating too many foods that are high in saturated fat. Eating too many foods that are high in cholesterol and fat and not enough of a high-fiber diet can increase your risk of gallstones.

4. Ulcerative Colitis- Eating a high-fat diet increases the risk of developing ulcerative colitis. Ulcerative colitis is a digestive disease that results in inflammation and ulcers in your digestive tract. Symptoms of ulcerative colitis include fatigue, rectal bleeding, anemia, diarrhea, abdominal pain, and feeling an urgent need to take a bowel movement. It's a serious disease that can cause dangerous complications if you don't get the right treatment.

5. Diverticulosis- Diverticulosis is a condition in which protruding pockets develop in the digestive tract. These pouches form when high pressure inside the large intestine pushes against weak spots in the intestinal wall. A high-fiber diet will reduce the risk of developing diverticular disease. Symptoms of diverticulitis include abdominal pain, diarrhea, constipation, bloody stools, fever, nausea, and vomiting. Diverticulitis can become serious, requiring hospital admission.

We really are what we eat! Swap those poor eating habits over for better ones. A healthy diet provides important minerals, vitamins, and nutrients to keep the body healthy. You can start making proactive changes to your diet today that can benefit your digestive health now, and throughout your entire life.

By Dordaneh Maleki MD, FACP
September 14, 2018
Category: GI Care
Tags: Gallstones  

Gallstones are a very common problem. You're at risk of developing gallstones if you're overweight or obese, female, or 40 or over. Gallstones are hardened deposits of bile inside the gallbladder. Many people with gallstones are unaware that they have them, as they produce no or little symptoms. For some people, however, gallstones can cause problems. Here are four signs and symptoms of a gallstone. 

1. Abdominal Pain

Symptoms of a gallstone may include severe abdominal pain. This pain goes and comes back repeatedly. The pain often occurs after eating and can last a few hours before it resolves. Chronic, ongoing pain that persists beyond a few hours may also occur, and may indicate a severe gallbladder problem.

2. Referred Pain

Gallstone pain can cause referred pain to the upper back and right shoulder. The pain usually comes on suddenly and may last for several hours. Prescribed painkillers are used to relieve pain associated with gallstones. You may also be given advice about eating a healthy diet to help control the pain.

3. Jaundice

Jaundice is a symptom of gallstones. Jaundice is a yellowish appearance of the whites of the eyes and skin due to high bilirubin levels. If a stone moves out of your gallbladder and one of your bile ducts and blocks the bile flow, jaundice occurs. Sometimes the gallstone passes from the bile duct on its own. If it doesn't, you may need to have gallbladder surgery.

4. Vomiting

A gallstone can cause nausea and vomiting, which may relieve some of the abdominal pressure and discomfort. Pain that occurs with appetite loss, nausea, vomiting, and a fever may suggest the presence of infection or inflammation of the gallbladder. Vomiting and diarrhea also occur with food poisoning and the flu, but the pain tends to come and go rather than be constant.

If you're experiencing the symptoms of a gallstone, you should notify your gastroenterologist right away. When a gallstone blocks your bile ducts, it can cause excruciating pain, which means you need emergency care right away.

By Dordaneh Maleki MD, FACP
August 29, 2018
Category: GI Care
Tags: Diarrhea  

Diarrhea is very common. When you have diarrhea, your bowel movements are loose and watery. In most cases, diarrhea lasts a couple of days. Chronic diarrhea is diarrhea that lasts longer than two weeks. When diarrhea lasts for weeks, it can indicate a serious disorder. Although diarrhea is usually not serious, it can become dangerous or signal a more serious problem. Read on to find out how chronic diarrhea is treated.

1. Replacing lost fluids- Chronic diarrhea is treated by replacing lost fluids and electrolytes to prevent dehydration. Adults with diarrhea should drink water, sports drinks, sodas without caffeine, or fruit juices. Fluid can also be delivered through a vein (intravenously) if the dehydration is severe. 

2. The use of medication- Your doctor may prescribe antibiotics and medications that target parasites to treat parasitic or bacterial infections. If a virus is causing your diarrhea, antibiotics won't help. Pain relief medications can help alleviate fever and pain. Your doctor may also prescribe medications to treat an underlying condition that may be causing your chronic diarrhea.

3. Treating medical conditions- How doctors treat chronic diarrhea depends on the cause. Chronic diarrhea is sometimes caused by an underlying medical condition that requires treatment. Common conditions that cause diarrhea include irritable bowel syndrome, Chrohn's disease, ulcerative colitis, inflammatory bowel disease, celiac disease, and chronic pancreatitis. 

4. The use of probiotics- Your doctor may recommend probiotics to treat diarrhea. Probiotics are good bacteria that are very similar to the bacteria that are already in your body. Probiotics reduce the growth of harmful bacteria and promote a healthy digestive system. If your gastroenterologist recommends probiotics, talk with him or her about how much probiotics you should take and for how long. 

Chronic diarrhea can affect your daily activities and make life frustrating and miserable. Don't hesitate to contact a gastroenterologist about diarrhea. A visit to the gastroenterologist will bring all the relief you need, with little hassle or expense. 

By Dordaneh Maleki MD, FACP
August 14, 2018
Category: GI Care
Tags: Constipation  

Having trouble going to the bathroom? Find out what might be to blame.

Constipation is an annoying and embarrassing problem that all of us will experience at some point. Constipation is when you are unable to have a bowel movement or you have trouble passing stools. If you are having less than three bowel movements a week then you could be dealing with constipation.

This problem isn’t usually something to worry about, as it usually resolves itself on its own. Of course, there are times in which you may want to turn to a gastroenterologist for care.

What causes constipation?

This usually happens when the stool moves too slowly through the digestive tract, making it difficult to expel. Causes of constipation include:

  • Dehydration
  • Poor diet
  • Bowel obstruction
  • Anal fissures
  • Bowel stricture (narrowing of the colon)
  • Conditions that affect the nerves of the colon or rectum (e.g. stroke; Parkinson’s disease)
  • Weak pelvic muscles
  • Hormone changes due to pregnancy, diabetes, or certain thyroid disorders

There are also certain factors that can increase your chances for chronic constipation:

  • Age (older adults are more likely to experience constipation)
  • Dehydration
  • Not getting enough fiber in your diet
  • Living a sedentary lifestyle
  • Taking certain medications (e.g. antidepressants; blood pressure medications)
  • Certain mental health disorders such as depression

How can you prevent constipation?

If you deal with constipation regularly there are some ways to help lessen the chances for this problem. Make sure that you are drinking enough water throughout the day and include a lot of fiber-rich foods in your diet such as whole grains, fruits and vegetables, and beans. Stay away from processed foods, and make sure you are staying active.

When should I see a doctor?

It’s a good idea to give your GI doctor a call if you’ve been experiencing constipation for over 3 weeks or if lifestyle modifications such as drinking more water or adding more fiber to your diet just aren’t working. It’s also important to see a specialist as soon as possible if your constipation is accompanied by pain or if you see blood on the toilet paper (this could be a sign of hemorrhoids or an anal fissure).

 

If you are experiencing chronic or severe constipation it’s a good idea to turn to a GI specialist who will help you get to the root of the problem and help get your digestive tract moving in the right direction.

By Dordaneh Maleki MD, FACP
August 01, 2018
Category: GI Care
Tags: Upper endoscopy  

This diagnostic procedure could determine the root cause of your digestive issues.

An upper endoscopy is a simple procedure in which your gastroenterologist will insert a small, flexible tube that contains a camera in the mouth and guide it carefully into the upper digestive tract (stomach and small intestines). Why is this outpatient procedure performed? Many reasons, actually. Your gastroenterologist may recommend getting this procedure if there are signs of bleeding within the upper digestive system.

An endoscopy is also a great tool for being able to detect inflammation within the digestive tract, as well as ulcers and tumors. You may benefit from an endoscopy if you are experiencing:

  • Difficulty swallowing
  • Chronic heartburn
  • Abdominal pain
  • Chest pain
  • Nausea and vomiting

An upper endoscopy is a much better and more accurate diagnostic tool for detecting growths and other abnormalities within the lining the digestive system than x-rays. Furthermore, many gastrointestinal issues can often be treated during the endoscopy. This includes the biopsy and/or removal of polyps, opening up narrowed areas of the esophagus or stomach, removing objects or obstructions within the intestinal tract or stopping a bleed.

Before your procedure, your gastroenterologist will give you detailed instructions to follow. This includes not eating or drinking anything for eight hours before your endoscopy. Patients with certain conditions such as a history of endocarditis (an infection of the heart valve) or those with artificial heart valves may need to take antibiotics beforehand to reduce their risk for an infection. Patients who take medications may still take their medication before the procedure with a little bit of water.

An endoscopy is performed under sedation so you won’t feel anything or remember the procedure. It’s important that you bring someone with you who will be able to drive you home afterwards, as sedation’s effects can last up to eight hours after. Prior to the procedure, a local anesthesia may be sprayed in the back of the throat to numb the area. You will then receive a combination or pain and sedation medication through an IV. Then the thin endoscope will be placed in the mouth and directed through the esophagus into the stomach. The procedure takes approximately 15-20 minutes.

 

If you are experiencing symptoms of bleeding, ulcers, or other issues within the digestive system, an endoscopy can be an amazing tool for determining what’s going on and what can be done to treat the problem.





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.