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                            What is heartburn? 
                             
                            Heartburn is a burning sensation behind the breastbone 
                            which results from the reflux (back flow) of acid 
                            and other stomach contents from the stomach into the 
                            esophagus (swallowing tube). Normally, acid should 
                            remain in the stomach when a meal is eaten. Heartburn 
                            arises when the "valve" (called the lower 
                            esophageal sphincter) between the esophagus and the 
                            stomach relaxes abnormally.   
                           •  
                            How can I control my heartburn?   
                               
                          The 
                            control of heartburn varies greatly among individuals. 
                            If heartburn is mild and occurs only intermittently, 
                            it is important for each person to determine what 
                            precipitated it. For example, if heartburn occurs 
                            only when eating late at night, one should avoid eating 
                            within three hours of going to bed. In addition, if 
                            heartburn occurs only after eating certain foods or 
                            after consuming large quantities of coffee, these 
                            foods should be avoided. 
                          •  
                            Is heartburn serious?   
                             
                            Although heartburn is merely a nuisance in the vast 
                            majority of individuals, it can also be a warning 
                            sign that more serious problems may be occurring. 
                            If you are over age 40 and are having heartburn or 
                            "indigestion" for the first time it is imperative 
                            that you see a physician as soon as possible. Many 
                            persons who are experiencing angina (decreased blood 
                            flow to the heart) may experience what they consider 
                            heartburn or indigestion. The possibility of angina 
                            or a heart attack must be excluded. If you know you 
                            have heartburn that has been occurring for a long 
                            period of time, an evaluation by a gastroenterologist 
                            is important. While the vast majority of individuals 
                            have only symptoms, acid refluxing into the esophagus 
                            may also damage the esophagus, leading to inflammation 
                            or esophagitis. Esophagitis can progress to more serious 
                            problems, including (in the most extreme cases) the 
                            development of cancer of the esophagus. While this 
                            is relatively uncommon, certain individuals are at 
                            a high risk for the development of severe complications. 
                            The most important factors include the duration of 
                            heartburn (how many years) and the severity of the 
                            symptoms. In addition, during the past several years, 
                            it has been determined that the reflux of acid into 
                            the esophagus can also lead to or worsen asthma, chronic 
                            cough, hoarseness, and even erosion of the teeth. 
                            Finally, the reflux of acid into the esophagus can 
                            cause chest pain indistinguishable from the chest 
                            pain of a heart attack or angina. If you are having 
                            any of these symptoms, it is imperative that you seek 
                            medical attention as soon as possible.  
                             
                             
                              •  What 
                            causes ulcers?     
                             
                          In 
                            the past fifteen years, it has been determined that 
                            ulcers are most commonly caused by infection with 
                            a bacterium called Helicobacter pylori (H. pylori). 
                            It resides in the stomach and causes an inflammation 
                            of the stomach (gastritis). Although a very large 
                            number of individuals, particulary those over the 
                            age of fifty, are infected with this germ, in most 
                            individuals is does not cause any harm or any symptoms. 
                            In only a small proportion, less than five percent, 
                            will ulcers develop. Currently, it is recommended 
                            that antibiotics be used to treat this infection if 
                            it is associated with a proven peptic ulcer. In addition 
                            to H. pylori, one of the most common causes of ulcers 
                            is the use of aspirin and a class of drugs called 
                            nonsteroidal anti-inflammatory drugs (NSAIDs). These 
                            latter drugs include prescription medication, such 
                            as Motrin‘ and Naprosyn‘, as well as over-the-counter 
                            medications such as Advil‘ and Aleve‘. Tylenol‘ and 
                            other forms of acetaminophen do not cause ulcers, 
                            but their use in very large doses, or in combination 
                            with alcohol, can lead to liver damage. It is also 
                            important to realize that certain medications that 
                            one can purchase without prescription, such as Alka-Seltzer‘, 
                            Goody Powder‘ and Standback‘, also contain aspirin 
                            and can lead to serious damage to the stomach. Finally, 
                            a significant proportion of individuals develop ulcers 
                            without infection with H. pylori or without consuming 
                            NSAIDs. If you are experiencing pain in the center 
                            of the abdomen below the rib cage, it is advisable 
                            to see a gastroenterologist to determine whether or 
                            not you do have an ulcer    
                             
                             
                              •  What 
                            is Irritable bowel syndrome?   
                             
                            Irritable bowel syndrome (IBS) is a common disorder 
                            of the intestine that leads to crampy pain, gas, bloating, 
                            and changes in bowel habits. Some people with IBS 
                            have constipation, others have diarrhea, and some 
                            people experience both. Sometimes a person with IBS 
                            has the urge to move the bowels but cannot do so. 
                            The cause of IBS is unknown and while there is no 
                            cure, effective treatment is available. 
                             
                              •  What 
                            is endoscopy?     
                             
                          Endoscopy 
                            refers to procedures that visualize the gastrointestinal 
                            tract utilizing high definition video equipment. 
                             It is an endoscopic procedure that visualizes 
                            the esophagus, stomach, and the first portion of the 
                            intestine. Upper endoscopy (also known as an upper 
                            GI endoscopy, or EGD) is a procedure that enables 
                            your physician to examine the lining of the upper 
                            part of your gastrointestinal tract, i.e. the esophagus, 
                            stomach, and duodenum (first portion of the small 
                            intestine) using a thin flexible tube with its own 
                            lens and light source. Upper endoscopy is usually 
                            performed to evaluate symptoms of persistent upper 
                            abdominal pain, nausea, vomiting, or difficulty swallowing. 
                            It is also the best test for finding the cause of 
                            bleeding from the upper gastrointestinal tract, way 
                            to find the bacteria which cause ulcers.  
                             
                             
                              •  Is endoscopy 
                            dangerous?      
                          Endoscopy 
                            in general is very safe. The majority of endoscopic 
                            procedures are performed in an outpatient setting. 
                            Patients can be discharged home after the procedure 
                            is completed. As with any medical procedure, there 
                            are some small risks associated with endoscopy. 
                              
                             
                              •  What 
                            is a polyp and does it do any harm?   
                               
                          A 
                            polyp is a growth often occurring in the large intestine 
                            (colon). Polyps rarely cause symptoms. Some polyps 
                            are precancerous (adenomas) meaning that if not removed 
                            they could develop slowly in to a cancer. Gastroenterologists 
                            can perform a procedure called colonoscopy to detect 
                            polyps of the large intestine and remove them preventing 
                            cancer of the colon.     
                             
                              •  What 
                            is yellow jaundice?     
                             
                          This 
                            is a yellow discoloration of the skin. It can be best 
                            recognized in the eyes and under the tongue. Sometimes 
                            it is accompanied by dark urine. In almost all instances 
                            is it caused by a liver condition that must be evaluated 
                            by a physician. If you do have jaundice, see your 
                            doctor immediately.   
                             
                              •  I saw 
                            blood on my stool; what should I do?   
                               
                          You 
                            need to consult your doctor first. Blood in the stool 
                            warrants an endoscopic examination of the large intestine 
                            (colon) to identify a possible source of the bleeding 
                            even if you suspect hemorrhoids. If you bleed a lot 
                            you must go to the nearest ER for immediate evaluation. 
                              
                             
                              •  Why do 
                            I have trouble s wallowing?  
                               
                          There 
                            are many reasons why swallowing is impaired usually 
                            related to the esophagus (swallowing tube) such as 
                            acid reflux or cancer. You must see a gastroenterologist 
                            in consultation to rapidly identify the reason of 
                            your problem   
                           
                              •  What 
                            is Pancreatitis?     
                             
                          Pancreatitis 
                            is a rare disease in which the pancreas becomes inflamed. 
                            Damage to the gland occurs when digestive enzymes 
                            are activated and begin attacking the pancreas. In 
                            severe cases, there may be bleeding into the gland, 
                            serious tissue damage, infection, and cysts. Enzymes 
                            and toxins may enter the bloodstream and seriously 
                            injure organs, such as the heart, lungs, and kidney. 
                            There are two forms of pancreatitis. The acute form 
                            occurs suddenly and may be a severe, life-threatening 
                            illness with many complications. Usually, the patient 
                            recovers completely. If injury to the pancreas continues, 
                            such as when a patient persists in drinking alcohol, 
                            a chronic form of the disease may develop, bringing 
                            severe pain and reduced functioning of the pancreas 
                            that affects digestion and causes weight loss. 
                              
                             
                              •  Who should 
                            be screened for colorectal cancer?   
                             
                            Anyone over the age of 50, regardless of gender or 
                            race/ethnicity, is at increased risk of colorectal 
                            cancer and warrants screening. Individuals with a 
                            family history of colorectal cancer or polyps are 
                            at an even higher risk and warrant screening at an 
                            even younger age. Screening should begin around age 
                            40 if only one first-degree relative (parent, sibling 
                            or child) had either cancer or polyps, and as early 
                            as 25 if multiple first-degree relatives were affected. 
                            Patients with a personal history of colorectal polyps, 
                            cancer or inflammatory bowel disease (ulcerative colitis 
                            or Crohn’s disease) are also at high risk and warrant 
                            periodic colonoscopy   
                             
                              •  Can I 
                            reduce my risk of getting colorectal cancer? 
                                 
                             
                            Eat a healthy diet   
                             
                          
                             
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                                 eat 
                                  5 or more servings of fruits and vegetables 
                                  a day    | 
                             
                             
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                                 replace 
                                  red meat with chicken, fish, nuts, and legumes 
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                                 take 
                                  a multivitamin containing 0.4 mg of folic acid 
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                                 limit 
                                  alcohol to 2 drinks per day for men and 1 drink 
                                  per day for women    | 
                             
                             
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                                  Participate in moderate physical activity for 
                                  at least 30 minutes each day   | 
                             
                             
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                                 moderate 
                                  activity includes brisk walking, dancing and 
                                  gardening    | 
                             
                             
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                                 start 
                                  slowly and build up to 30 minutes per day 
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                                  Maintain a healthy weight    | 
                             
                             
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                                  Avoid smoking    | 
                             
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