•  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


eat 5 or more servings of fruits and vegetables a day


replace red meat with chicken, fish, nuts, and legumes


take a multivitamin containing 0.4 mg of folic acid


limit alcohol to 2 drinks per day for men and 1 drink per day for women

Participate in moderate physical activity for at least 30 minutes each day


moderate activity includes brisk walking, dancing and gardening


start slowly and build up to 30 minutes per day

      Maintain a healthy weight

      Avoid smoking



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