ABDOMINAL PAIN/DYSPEPSIA

The patient with Barrett’s esophagus present with signs and symptoms almost similar to those in GERD. These include:

• Frequent heartburn or dyspepsia

• Difficulty in swallowing food

• Chest pain might occur in some cases but is less frequent

• Blood in vomit or coffee-ground vomit

• In rare cases, Passage of black tarry stools

The area between our chest and pelvis is called abdomen and any discomfort or pain in this area is called abdominal pain. Many important organs reside in our abdomen including stomach, liver, gall bladder kidney, pancreas, spleen, appendix and intestines. The pain originating in any of these organs is felt as abdominal pain. The pain varies in its location and characteristics. It might be persistent or intermittent.

Dyspepsia is the feeling of discomfort in the upper abdomen and is due to stomach problems.

If left untreated, Celiac Disease can lead to following complications due to malabsorption of nutrients:

• Development of Type I diabetes

• Dermatitis herpetiformis (an itchy skin rash)

• Anemia

• Osteoporosis

• Infertility and miscarriage

• Neurological conditions like migraines and epilepsy

• Short stature

• Intestinal cancers

H. Pylori infection is caused by a bacteria called Helicobacter Pylori. It specifically infects the stomach and is a common cause of pyloric ulcers. The infection goes unnoticed in many people because they never fall seriously ill from it. It often occurs in children but can also occur in any age group. If left untreated it can cause following complications:

• Ulcer

• Inflammation of the lining of stomach

• Stomach cancer/MALT Lymphoma

• Obstruction

• Perforation

• Peritonitis

Dry, hard stools which are difficult to pass are characteristic of constipation. In constipated patients, bowel movements reduce to less than three times per week. This means that you pass stools very less often than normal.

Acute constipation resolves easily whereas chronic constipation might lead to following complications:

• Anal fissures

• Hemorrhoids

• Rectal prolapse

• Fecal impaction

The Bravo pH monitor is meant to really answer the question—“Do I have relux or something else? Should I be on this PPI?”

A small capsule, about the size of a gel cap, is temporarily attached to the wall of the esophagus during an upper endoscopy. The capsule measures pH levels in the esophagus and transmits readings by radio telecommunications to a receiver (about the size of a pager) worn on your belt or waistband. The receiver has several buttons on it that you will press to record symptoms of GERD such as heartburn (the nurse will tell you what symptoms to record). You will be asked to maintain a diary to record certain events such as when you start and stop eating and drinking, when you lie down, and when you get back up. This will be explained by the nurse.

If you are passing loose watery stools three times a day or more, then you have diarrhea. Diarrhea can be acute or chronic. Acute diarrhea resolves on its own after 2-3 days whereas chronic diarrhea continues for weeks and need proper medical attention.

Endoscopy is a procedure done for the examination of a person’s gastrointestinal tract {GIT). It is a non-surgical and non-invasive procedure.

Irritable bowel syndrome is characterized by pain or abdominal discomfort associated with abnormal bowel habits. The bowel movements may decrease or increase leading to constipation or diarrhea respectively and may alternate. This is not a life-threatening condition but it does affect one’s way of living. IBS is basically a functional disorder of the gastrointestinal tract.

IBS is sometimes referred as colitis, nervous colon, spastic colon and spastic bowel.

Hemorrhoids is a very common condition. Almost every three out of four adults experience hemorrhoids at least at one point in their life. These are dilated veins located in the walls of the rectum and lower part of anus.

GERD is a disorder of the digestive system in which the lower esophageal sphincter does not function properly. The sphincter lies between the lower end of the esophagus where it opens into the stomach. This causes the backflow of contents of the stomach into the esophagus which irritates the esophageal lining.

Most of the people try to manage the condition with over-the-counter medications. If left untreated, GERD can cause following complications:

• Barrett esophagus

• Esophageal structure

• Esophageal ulcer

The Obalon Balloon System is an FDA-approved, especially designed to promote weight loss in obese adults who have failed to show results with other traditional weight loss techniques including diet and exercise. It is a swallow able system consisting of 3 lightweight balloons which are placed in your stomach and lasts for a period of 6 months.

Rectal bleeding is also known as hematochezia. It is the passage of blood from the anus. The blood might be fresh having a bright red color, mixed with stools or in the form of clots giving the stools a dark tarry character. The tarry stools are foul smelling and difficult to flush.

Another important character apart from the color of blood is the quantity and duration of bleeding through the anus. This helps determine the severity of the condition so that prompt treatment is done.

Many patients experience no significant symptoms in the start. The types of symptoms usually depends on the site of location of cancer in colon. A patient with colon cancer can usually presents with following signs and symptoms:

• A change in your bowel habits which can cause diarrhea or constipation and lasts for more than 4 weeks

• Rectal bleeding

• Blood in your stool

• Persistent pain and discomfort in abdomen

• A feeling of incomplete evacuation if bowel

• Weakness

• fatigue

• Unexplained weight loss

Our regional director (usually an MD) ensures the accuracy of the medical language and cross-cultural adaptation throughout the project. The regional director reviews the text, determines which medical idioms should be used in the translation and addresses relevant issues.

Colonoscopy is used to examine colon and rectum and detect any abnormality there. This procedure is done commonly and is immensely helpful in identifying problems of colon and rectum such as rectal bleeding, diarrhea, abdominal pain,history of polyps, surveillance of cancer, treatment of hemorrhoids and rectal bleeding.

Hepatitis B and C are both inflammatory conditions of liver caused by viral infection. The inflammation causes serious liver damage and increases the risks of liver failure, cirrhosis or liver cancer.

Capsule endoscopy, as the name indicates, is a procedure in which endoscopy is done via a capsule. It is used to take pictures of the digestive tract, especially the 6 meter small intestine, because this area is difficult for the doctors to examine from ordinary endoscopic procedures. The conventional endoscopy is done with a flexible long tube which is passed through the throat down into the gut.

Hemorrhoids are swollen and dilated veins in the walls of lower anus and rectum. These veins are just like varicose veins. Hemorrhoids are also called piles. Hemorrhoids can be of following types:

• Internal hemorrhoids lie inside the rectum

• External Hemorrhoids lie beneath the skin around the anus

• Thrombosed Hemorrhoids result from pooled and thrombosed blood in external hemorrhoids

Gallstones are formed in the gallbladder from bile cholesterol and bilirubin. The Gallbladder is a small sac-like organ situated below the liver and stores bile. The gallstones can block bile ducts which drain bile and cause abdominal pain. The pain due to stones is called biliary colic. They usually require surgical removal. If left untreated, stones can cause following complications:

• Acute cholecystitis

• Jaundice

• Bile duct infection (cholangitis)

• Sepsis, a blood infection

• Inflammation of pancreas

• Gallbladder cancer

Abdominal Ultrasound is basically a screening method used to examine the structures present within the abdomen including organs and abdnominal aorta. This is used by clinicians to evaluate the condition of abdominal structures and to look for any pathology like abdominal aneurysms or tuberculous masses.

The different types of colitis include the following:

• Ulcerative colitis

• Ischemic colitis

• Infectious colitis

• Microscopic colitis

• Chemical colitis

• Medication caused colitis

Colon polyps are growths, cluster of cells that form on the inner lining of colon/large intestine. Most of the polyps are non-neoplastic and are not harmful but some of them might cause colon cancer over time and are called neoplastic polyps. ABOUT 1 IN 3 INDIVIDUALS HAVE POLYPS. Therefore, colon polyps require POLYPECTOMY.

Crohn’s disease is an inflammatory bowel disease which involves chronic inflammation of the gastrointestinal tract. Symptoms might be ignored initially but, if left untreated, it can cause following complications:

• Bowel obstruction

• Ulcers

• Anal fistula

• Anal fissures

• Malnutrition

Dyspepsia, otherwise known as “indigestion” or “sour stomach” generally affects the upper GI tract. It has associated symptoms of belching and bloating. Functional dyspepsia, a fairly common condition in about 1in every 4 individuals, is a term that is used to describe a condtion derived from the foods that you eat.

In capsule endoscopy, a patient is asked to swallow a capsule which is size of a vitamin pill. The capsule contains a tiny, wireless camera. As the capsule passes through the digestive tract of the patient and takes pictures of it. The pictures are then transmitted to a recorder which is tied around the waist of the patient with a belt.

In some patient hemorrhoids show very little to no symptoms while in the others it presents with milder symptoms. However, it untreated, the symptoms might become worse over time. Following signs and symptoms are observed:

• Painless bleeding during bowel movements

• Itching or irritation in your anal region in case of external hemorrhoids

• Swelling around your anus

• Pain or discomfort

• A lump near your anus which might be painful as in case of thrombosed hemorrhoids

Common symptoms of Dyspepsia include:

• Bloating in the morning

• “Feeling Heavy” after or during a meal

• Burning in the upper abdomen

The exact causes of colon cancer are still not clear.

• A damage in DNA of colon cells occur which trigger neoplastic changes and growth.

• Gene mutations

Certain hereditary gene mutations increase the risk of this cancer. These include:

• Hereditary nonpolyposis colorectal cancer (HNPCC)

• Familial adenomatous polyposis (FAP)

Other risk factors include:

• High-fat and low-fiber diet

• African-American race

• A personal history of colorectal cancer or polyps

• Inflammatory intestinal conditions

• Inherited syndromes including hereditary nonpolyposis colorectal cancer (Lynch syndrome) and familial adenomatous polyposis.

• Family history of colon cancer.

The most important cause of Barrett’s esophagus is GERD which is characterized by the reflux of gastric contents back into the esophagus. GRED causes inflammation in the walls of esophagus and hence causes damage to the lining. However, there are certain cases in which patients with Barrett’s esophagus never experienced heartburn or any other symptoms of GERD. Therefore, the exact causes of Barrett’s esophagus are unknown.

Certain risk factors include:

• Chronic heartburn and acid reflux

• Older adults

• Being a man

• Being white

• Being overweight

• Current or past smoking

• Alcohol abuse

• Activity: Follow your usual daily routineNote: Do not get the receiver wet; it is not waterproof!

• Eating: Eat your regular meals at the usual times. If you do not eat during the monitoring period, your stomach will not produce acid as usual, and the test results will not be accurate. Eat at least 2 meals a day. Eat foods that tend to increase your symptoms (without making yourself miserable). Avoid snacking. Do not suck on hard candy or lozenges and do not chew gum during the monitoring period.

• Lying down: Remain upright throughout the day. Do not lie down until you go to bed (unless napping or lying down during the day is part of your daily routine).

• Medications: Continue to follow your doctor’s advice regarding medications to avoid during the monitoring period.

• Recording symptoms: Press the appropriate button on the receiver when symptoms occur (as discussed with the nurse). Record the time you start and stop eating and drinking (anything other than plain water). Record the time you lie down (even if just resting) and when you get back up. The nurse will explain this.

• Unusual symptoms or side effects: If you think you may be experiencing any unusual symptoms or side effects, call your doctor.

You will return the receiver and diary when the monitoring period is over. The information on the receiver and diary will be downloaded to a computer and the results will be analyzed. Preliminary study data will be reviewed with you if you desire.

After completion of the study:

• Resume your normal diet and medications.

• Your doctor will discuss the results of your test with you during your next scheduled appointment.

• Normal activities – such as swallowing, eating and drinking – will cause the disposable pH capsule to detach and pass through the digestive tract in 7 to 10 days on average.

• No MRI exams (magnetic resonance imaging) should be performed for 30 days following capsule insertion.

Ultrasound is usually indicated in patients who are suspected to have an aortic aneurysm. This a sac like dilation in the wall of aorta due to the weakening of the wall. Abdominal aortic aneurysm screening is done by ultrasound in following patients who are:

• men

• between ages 65 to 75

• current or former cigarette smokers and have smoked at least 100 cigarettes

• White people

• Have a history of atherosclerosis

• Have a family history of abdominal aortic aneurysm

• High blood pressure

• Obesity

• Other possible reasons in which you might need an ultrasound examination are:

• a problem with another organ in your abdomen

• kidney stones

• tumors

• abnormal liver function

• abdominal pain

• bloating

The patient with IBS experiences following signs and symptoms:

• Diarrhea

• Constipation alternating with diarrhea

• Gas and bloating

• Abdominal cramps especially after meals and reduce after bowel movement

• Abdomen that sticks out

Stress often makes symptoms worse.

Gallstones present with the following characteristic signs and symptoms:

• Pain in the upper right abdomen, especially after eating fatty meals. The pain is usually intermittent.

• Nausea

• Vomiting

• Clay-colored stools

• Dark urine

• Stomach pain

• Burping

• Indigestion

• Diarrhea

Gallstones do not directly cause pain themselves. Instead, the blockage of bile ducts causes pain which impedes the flow off bile.Gallstones present with the following characteristic signs and symptoms:Pain in the upper right abdomen, especially after eating fatty meals. The pain is usually intermittent.nauseavomitingclay-colored stoolsdark urinestomach painburpingindigestiondiarrheaGallstones do not directly cause pain themselves. Instead, the blockage of bile ducts causes pain which impedes the flow off bile.

If you experience following signs and symptoms, you might have this disease:

• Bloating

• Gas (flatulence, farting)

• Diarrhea

• Fatigue

• Mouth Ulcers

• Joint Pain

• Heartburn, due to acid reflux

• Swollen Ankles (edema)

• Anemia

• Vitamin K Deficiency, leading to bleeding

• Fat Soluble Vitamins (vit ADEK)

• Excessive Bruising

Patients having any type of colitis, develop following common characteristic signs and symptoms:

• abdominal pain

• cramping

• bloating

• diarrhea

• bloody diarrhea

• fever

• chills

• fatigue

• malaise

• dehydration

• mouth ulcers

• joint swelling

• skin inflammation

A patient with Crohn’s disease may experience some or many of these symptoms and signs:

• Diarrhea

• Abdominal pain

• Reduced appetite

• Weight loss

• Fatigue

• Blood in your stool

• Mouth sores

• Anal fistula

• Inflammation of the liver or bile ducts

• Inflammation of skin, eyes and joints

• Delayed growth or sexual development in children

Colonoscopy is done by a long, flexible tube which has a video camera at its tip. The tube is inserted through the rectum and the camera allows the doctor to view the colon on the screen.

The main procedure follows a preparation which includes the following:

• Patient has to follow a special diet plan

• Take a laxative

• Adjustment of medications of the patient

If anyone of you experiences rectal bleeding, you might have one or more of the following underlying causes:

• Gastric Ulcer

• Peptic Ulcer

• Crohn’s disease

• Ulcerative colitis

• Anal or rectal fissures

• Hemorrhoids

• Irritable bowel syndrome

• Infections by Salmonella or E.coli

• Colon cancer

• Diverticulosis

Hemorrhoids re treated by making certain modification in the diet and lifestyle. Along with this conservative management, following endoscopic procedures are also performed in cases which do not respond to usual medications and remedies:

• Rubber band ligation of hemorrhoid

• Laser therapy/HET

• Hemorrhoid removal

Hepatitis B is caused by Hepatitis B virus HBV whereas Hepatitis C is caused by HCV. All the factors which act as sourced of transfer of virus, cause the infection. The common causes are as follows:

• Sexual contact

• Sharing of needles as in Intravenous drug users

• Accidental sticks from needles

• It can transfer from mother to child during birth (vertical transmission—mainly Hep B)

• Long periods of hemodialysis

• Tattooing with unsterile equipment

The exact cause of colon polyps is not known. However, there are a number of risk factors which increase the chances of developing colon cancer including genetic syndromes and family history.

Obalon weight loss balloon system have immense benefits when it comes to losing weight especially for those who have lost hope. The system promises of the following results.

• Proven weight loss, approximately twice as compared to that with diet and exercise

• It is a non-surgical procedure requiring no anesthesia

• Takes only 15 minutes to place the balloon

• It is FDA- approved

• Very quick, jump-start results

• Long term results

• Very convenient

• No downtime

If you have constipation, you will experience following symptoms:

• Small Caliber bowel movements

• Difficult and painful bowel movements

• Hard stools

• Belly bloating

Our project managers mobilize the medical translation team according to the regional director’s guidelines and project requirements. They also maintain ongoing communication with the client to ensure the final product is delivered on time and within budget.

H.Pylori most of the times goes unnoticed. However, the patients might experience following symptoms and signs:

• Burning sensation or pain in abdomen

• Pain becomes worse on an empty stomach

• Loss of appetite

• Anemia

• Bloating

• Nausea

• Frequent burping

• Unexplained weight loss

• Bloody/black stool

You should seek immediate medical help if you experience any of the following in addition to those mentioned above:

• Persistent and severe abdominal pain

• Blood in stools or black tarry stools

• Bloody or black vomit or coffee-ground colored vomit

Abdominal pain is usually accompanied by additional symptoms like:

• Indigestion

• Bloating

• Diarrhea

• Constipation

• Nausea

• Vomiting

• Flatulence

A patient with GERD presents with certain characteristic symptoms:

• A burning sensation in chest after meals.

• The heartburn increases at night

• Chest pain

• Regurgitation of food

• Difficulty swallowing

• Chronic cough

• Laryngitis

• Feeling of a lump in throat

It is done using an endoscope which is a flexible tube with an attached light and camera at its end. As the endoscope is passed through the digestive tract, beginning from the mouth into the esophagus and so on, the pictures of the tract become visible on a color monitor in front of the doctor. In this way doctor can check the patency and condition of the tract.

Upper GI Endoscopy is done to view the upper GIT which includes mouth, throat, esophagus, stomach and some proximal part of small intestine.

Similar procedure is done to examine colon and rectum and is called colonoscopy or sigmoidoscopy.

If you leave diarrhea unattended, it can lead to some serious complications. The two most common are dehydration which deplete your body of essential fluid and electrolyte balance and malabsorption in which your body does not absorb enough nutrients present in food.

Rubber band ligation is a minimally invasive surgical treatment if hemorrhoids. In banding, a rubber band is tied around the base off the hemorrhoids which stops the blood flow to the hemorrhoids. The ischemic hemorrhoids eventually undergo necrosis and shed off.

Barrett’s esophagus is diagnosed with the help of endoscopy which is done by passing a long flexible tube, called endoscope, down into the esophagus via the mouth and examining the esophagus and the Gastroesophageal junction

The most common cause of diarrhea is a viral infection. This has led to the use of terms "intestinal flu" and "stomach flu” for this condition.

There are many other causes of this condition including:

• Allergies to certain foods

• Bacterial infection

• Intestinal diseases (such as Crohn's disease or ulcerative colitis)

• Celiac Disease

• Certain Medications

• Hyperthyroidism

• Some cancers

• Radiation therapy

• Travelling from one place to the other “traveler’s diarrhea”

• Surgery on your digestive system

• Malabsorption syndromes

Diagnosis of colon cancer is done by:

• Complete medical history

• Physical examination

• Blood and stool examination

• Colonoscopy

There are a number of risk factors which increase the chances of gallstones in a person. The risk factors are as follows:

• High level of cholesterol in bile

• High level of bilirubin in bile

• Concentrated bile

• Obesity

• High-cholesterol and low-fiber diet

• Diabetes mellitus

• Sudden weight loss

• Family history

• Pregnancy

• High estrogen intake

The occurrence rate of gallstones is higher in women than in men.

The exact causes of Crohn’s disease are unknown however there are certain factors that can trigger the disease or act as risk factors for its development.

• Immune reaction or any infection

• Heredity

• Family history

• Cigarette smoking

• Non-steroidal anti-inflammatory drugs NSAIDS

• Dietary habits

The common causes include:

• Infections

• Loss of blood supply to the gut

• Chronic diseases

• Allergic reactions

• Inflammatory bowel diseases

• Ulcerative colitis

• Crohn's disease

• Vascular diseases leading to loss of blood supply

• All of these events trigger inflammatory responses which ultimately damage the lining of colon.

Capsule endoscopy is referred by a doctor for a patient if he presents with complaints related to GIT for which the causes are not clear. These might include the following:

• Find the cause of gastrointestinal bleeding/ane,ia

• Diagnose inflammatory bowel diseases

• Diagnose cancer

• Diagnose celiac disease

• For follow up testing of GIT after other imaging studies as X-Ray or Ultrasound

Fasting for 8-12 hours is recommended before an ultrasound exam because presence of food and water makes it difficult to do the exam and might impede in picking up of findings by the doctor.

At NYC GASTROENTEROLOGY AND NUTRITION, we use the best diagnostic techniques to make a reliable and accurate diagnosis of H. Pylori. The process involves:

• A complete medical history of the patient

• Physical examination for any bloating or tenderness

• Blood test to check for antibodies against H. Pylori

• Stool examination

• Urea breadth test

• Endoscopy

A patient is referred for colonoscopy to know the causes in following presentations:

• Abdominal pain

• Rectal bleeding

• Chronic constipation

• Chronic diarrhea

• Screening for colon cancer

• Looking for any colon polyp

We meticulously scrutinize our medical translators and editors based on their linguistic, medical and technical skills. Why? Because medical translators are hard to find, and we want to employ the best. We require our translation team to meet the minimum criteria:

• Medical and scientific degrees such as MD, PhD and BMedSc.

• Extensive linguistic experience and excellent scores on our quality assurance test.

• Native speakers of the target language with absolute command of the source language.

• In-country residency, when relevant.

• Knowledge of the specific document requirements, templates and guidelines.

The Obalon Balloons fill up your stomach giving the feeling of fullness and preventing you from eating too much. helps facilitate weight loss by taking up space in your stomach so you eat less. It works wonders if taken along with professional diet nutrition and exercise. This system modifies your dietary habits and provides long term results.

Our expert gastroenterologists at NYC make a definitive diagnosis of your condition on the basis pof following:

• medical history

• physical exam

• Blood test

• Stool test

• Endoscopy with a biopsy

• Colonoscopy

Following are the factors, basically which cause vascular stretching, which contribute in development of hemorrhoids:

• Straining during passage of stools

• Chronic constipation

• Sitting for long periods of time

• Obesity

• Anal intercourse

• Pregnancy

• Low-fiber diet

If you catch any of the following presentations of rectal bleeding, you need to consult a gastroenterologist immediately!

• Passage of only fresh blood from the anus

• Presence of fresh blood on the surface of stool

• Blood mixed with stools

• Blood in the form of clots

• Black tarry dark maroon stools which are foul smelling and difficult to flush

• Blood on toilet paper or underwear

There is a list of causes that might cause abdominal pain. The most common causes which we come across are:

• Appendicitis

• Pancreatic or gastric ulcer

• Hepatitis

• Kidney stones’

• Urinary Tract infections

• Irritable bowel syndrome

• Diverticulitis

• Gastric or duodenal ulcers

• Gastric cancer

• Colitis

• Colorectal cancer

• Pancreatitis

• Crohn’s disease

There are also certain gynecological conditions as well which act as additional causes of abdominal pain in women.

Lower esophageal sphincter only opens to allow the passage of food from esophagus into stomach. It remains closed rest of the time. When the sphincter becomes weak, it remains partially open all the time allowing the gastric contents to flow back into esophagus causing heartburn. There are certain risk factors which increase the risk for GERD development.

• Obesity

• Hiatal hernia

• Pregnancy

• Delayed stomach emptying

• Connective tissue disorders like scleroderma

Apart from risk factors, there are certain factors which aggravate the symptoms of GERD. These include:

• Smoking

• Eating large meals

• Excess coffee, spicy food

• eating late at night

• Eating too much fatty food

• Alcohol abuse

• certain medications like aspirin

Constipation is caused by a number of reasons. Some important causes include:

• Reduced water and fiber intake

• Sedentary lifestyle

• Stress

• Certain medications

• Eating disorders

• Irritable bowel syndrome

• Pregnancy

• Colon cancer

• Neurological disorders

• Hypothyroidism

Diet: Acidic foods (spicy, citrus, alcohol, caffeine); greasy and fatty foods, high FODMAP (for more check out..)

Anatomical and other Gastrointestinal disorders including GI Ulcers, Gallbladder problems (Gallstones), Celiac Sprue, Celiac Sensitivity, Pancreatitis, GERD, Stomach and Intestinal Cancers and Lymphoma, H.pylori

If you experience any of the following symptoms, the cause of which is not obvious, endoscopy is indicated.

• Nausea and vomiting

• Stomach pain

• Problem swallowing

• Unexplained weight loss

• Indigestion

• Abdominal pain

• GI bleeding

Let’s talk about both the infections individually.

HBV infection is also known as silent killer. It remains asymptomatic for years and continues to damage the liver silently. A patient with HBV infection presents with following signs and symptoms which develop after significant liver damage:

• Easy bleeding

• Easy bruising

• Poor appetite

• Fatigue

• Jaundice

• Dark-colored urine

• Itchy skin

• Ascites which is swollen and fluid filled abdomen

• Swelling in your legs

• Weight loss

• Hepatic encephalopathy which causes drowsiness, confusion and slurred speech

• Spider angiomas on skin which are spider-like blood vessels

The signs and symptoms of HBV usually appear after a period of one to four months of infection and are following:

Hepatitis B signs and symptoms may include:

• Abdominal pain

• fever

• Dark urine

• Joint pain

• Weakness and fatigue

• Loss of appetite

• Nausea and vomiting

• Jaundice

Celiac disease is predominantly an autoimmune disease which develops from an interaction between genes, eating foods with gluten and various environmental factors. Following environmental factors may also contribute:

• Infant Feeding Practices

• Gastrointestinal Infections

• Gut Bacteria

The disease might be triggered after following events:

• Surgery

• Pregnancy

• Childbirth

• Viral Infection

• Severe Emotional Stress

When the patients of celiac disease ingest food that contains gluten, their body initiates an immune reaction against it. The immune reaction damages the hair-like villi in small intestines and cause malabsorption.

Colon polyps usually are asymptomatic. Most of the times polyps are found suddenly during colonoscopy. However, there are certain cases which present with some or all of the following symptoms and signs:

• Rectal bleeding

• Change in stool color which might appear black

• Change in bowel habits usually constipation which last longer than a week

• Pain might be due to bowel obstruction

Iron deficiency anemia due to slow bleeding which might go unnoticed. This leads to development of fatigue and shortness of breath

Crohn’s disease is a chronic disease and mainstays of therapy are to decrease inflammation and keeps patients as comfortable as possible.. However, certain steps are advised to control its progression. These include:

• Diet changes

• Lifestyle modifications

• Supplementations

• Vaccination

• Corticosteroids to treat inflammation

• Immunobiologics

At NYC GASTROENTEROLOGY AND NUTRITION, we use the latest and the most reliable techniques for accurate diagnosis of the conditions such as colitis. DR OLINER WILL rule out all the other possible colon diseases and narrow down the diagnosis in following steps:

• Complete medical history of the patient

• Physical examination

• Examination of stool and blood samples

• Barium enema

• Colonoscopy

• Flexible sigmoidoscopy

The Obalon Balloon System is a relatively safe and very effective system which does not require any surgery or sedation. Only a few mild adverse effects have been reported yet which include:

• abdominal pain

• nausea

ur expert gastroenterologist at NYC Gastroenterology and Nutrition, Dr Oliner do reliable and definitive diagnosis through the following screening methods:

• Colonoscopy and biopsy

• Flexible sigmoidoscopy

• Stool-based tests

Experienced pathologists examine polyp tissues to make sure if polyp is cancerous or not.

At NYC GASTROENTEROLOGY AND NUTRITION, DR OLINER AND HIS STAFF aim at providing the best treatment to our patients to ensure a healthier and better lifestyle for them. We proceed in the following manner:

• Conservative management of the patient which includes necessary changes in diet and lifestyle

• Medications

• Diagnostic tools

At NYC, latest diagnostic techniques are used which follow a thorough medical history of the patient and a complete physical examination. The techniques include:

• Blood and stool examination

• Colonoscopy

• Endoscopy of upper gastrointestinal tract

• SIBO testing/Breath tests

Once our doctors have established the diagnosis of IBS, they make a personalized treatment regimen for their patients. The treatment regime includes:

• Changes in your diet

• Lifestyle modification

• Techniques for stress reduction

• Probiotics

• Medicines

Treatment of colon cancer is surgery. Early stage cancer is treated by following minimally-invasive surgery options:

• Removing polyps during a colonoscopy

• Endoscopic mucosal resection

• Minimally invasive surgery

The treatment options for Barrett’s esophagus depends upon the degree of dysplasia that has occurred in the patient.

• No dysplasia

• Periodic endoscopy to monitor the cells in your esophagus

• Treatment for GERD

• Low-grade dysplasia

• Endoscopic resection

• Radiofrequency ablation

• High-grade dysplasia

• Cryotherapy

• Photodynamic therapy

• Surgery

Our editors examine the translated document’s quality and localization, and resolves style and terminology issues. Editors also make sure the translation is coherent and meets requirements.

At NYC Gastroenterology and Nutrition we diagnose abdominal pain using following methods:

• Blood, urine and stool examination and analysis

• Imaging tests (Sonogram, MRI, CT scan)

• Endoscopy/Colonoscopy

Apart from examining upper GIT, endoscopy is used by gastroenterologists for various procedures like:

• Removal of a polyp or any other growth

• Removal a foreign object

• Stopping bleeding from an ulcer

The diagnosis of both types of hepatitis start with a complete medical history of the patient and then a thorough physical examination which includes looking for jaundice, wasting and so on. Further tests are done to confirm diagnosis which include:

• Blood tests

• Liver ultrasound

• Liver biopsy

Dr Oliner treats dyspepsia with the use of education, diet, nutrition, stress management and occasionally medications if necessary. Prior to treatment, a diagnosis will need to be clarified by taking a complete medical history and may also require help of diagnostic input including:

Lab work (liver markers, celiac markers, Hpylori breath testing, stool studies, Imaging (ultrasound, sometimes a CT or MRI will need to be ordered), Endoscopic evaluation (EGD/Colonoscopy).

The colonoscope used for colonoscopy can also be used for other procedures like:

• Removal of polyps from colon

• Removal of any other abnormal tissue in colon or rectum

• Obtaining tissue samples for biopsy

Following treatment plan is advised to the patients to completely eradicate the organism:

• Change in diet and lifestyle

• Medications

At NYC Gastroenterology, a professional diagnosis is made beginning from complete medical history of the patient and a thorough physical examination and proceeding to the following for a definitive diagnosis:

• Analysis of blood samples

• Intestinal endoscopy with biopsy

• Capsule endoscopy

AT NYC Gastroentrology and Nutrition, our expert specialists make a definitive and reliable diagnosis of gallstones. The diagnosis is made in the following steps:

• A complete medical history of the patient

• A thorough physical examination

• Blood tests

• Ultrasound of abdomen

• Abdominal CT Scan

Capsule endoscopy has a very few potential risks. However, there are chances that the capsule does not leave your body during normal bowel movements after a few days and gets stuck in the digestive system instead. This is most likely to occur in patients with:

• Crohn’s disease

• Tumor

• Stricture

A proposed diagnosis of GERD is made on the basis of complete medical history of the patient and his thorough physical examination.

• For a definitive diagnosis, following methods are used:

• Upper endoscopy.

• Ambulatory acid (pH) probe test

• Esophageal manometry

• X-ray of your upper digestive system

An experienced doctor can diagnose hemorrhoids by just doing a digital rectal examination or looking at it. Visual examination of hemorrhoids can be done with a

• Anoscope

• Proctoscope

• Sigmoidoscope

It is the duty of a medical practitioner to properly diagnose rectal bleeding through following methods:

• Complete medical history

• Physical examination

• Colonoscopy

• DRE

• Relevant tests

Hemorrhoids usually do not respond to the home remedies and become extremely painful and cause of discomfort. Such types of hemorrhoids give a very good response to band ligation technique.

Ultrasound examination is a painful procedure and requires only about 30 minutes to complete. A Sonographer is a specially trained technician who performs ultrasound. The exam is done in the following steps:

• You will be asked to lie on your back on an examination table

• A small amount of warm gel will be applied to your abdomen which helps prevent the formation of air bubbles between the skin and transducer.

• The transducer is pressed against the skin of your abdomen and is moved from one point to another

• The transducer sends images to a computer screen which is monitored by the sonographer.

• The sonographer monitors the blood flow in the aorta to check for any aneurysm present in its wall

The first step in the treatment of GERD involves lifestyle and diet modification. Over-the-counter medications are also used. These medications include:

• Antacids that neutralize stomach acid

• known as H-2-receptor blockers to reduce acid production

• proton pump inhibitors which reduce acid production as well as heals esophageal lining

• the ENDOSOCPY may be needed

Other procedures including surgery are also used as follows:

• Fundoplication

• Stretta

Our treatment plan is based on treating the cause of abdominal pain. We begin with a conservative management of the disease which includes modification in diet and lifestyle. This involves changing diet and weight loss. Then we proceed towards using diagnostic tools (labs, imaging, endoscopic intervention if necessary)and then medication.

Colon polyps can be removed during colonoscopy. The following options are available for removal:

• Removal with forceps or a wire loop (polypectomy)

• Surgery, if necessary

At NYC Gastroenterology, our expert gastroenterologists treat the disease in the best way possible. The regime includes following:

• Conservative management with diet and lifestyle

• Necessary medications

Our medical professionals provide expert treatment of colitis with a following regime:

• Diagnosis

• Medications for inflammation

• Antibiotics against infection

• Diet and lifestyle modification

Before any medical procedure is done, patient also has to take certain precautions. In this case, the success of the system relies on the readiness of the patient to change his lifestyle, modify his eating habits and follow a good exercise plan. Once you are willing to accept these changes, you are ready for the procedure.

Following useful precautions are advised to the patient undergoing endoscopy:

• Refrain from eating or drinking

• Sedation might refrain you from driving hence it is better to have someone drive in your place

• Proper rest is advised

• Sor throat, nausea and bloating are common experiences

Banding is an outpatient procedure and does not require patient to stay in the hospital. The procedure performed in following steps:

• General or topical anesthesia. over the rectum is given

• An anoscope is inserted into the rectum by the doctor, until it reaches the hemorrhoid. Anoscope is a small flexible tube which has a light at its end.

• A Ligator is then inserted through the anoscope which is used to ligate the base of hemorrhoids using one or two rubber bands.

The same process is repeated for other hemorrhoids

Our expert gastroenterologist follows the most effective treatment regime. It begins with a conservative management involving modifications in diet and lifestyle. Then we proceed towards medications which usually involves antibiotics and probiotics. Finally, diagnostic tools such as colonoscopy may be necessary to solve the problem

You need to take following precautions in case you’re going for capsule endoscopy:

• Fasting for at least 12 hours before procedure

• Refrain from taking other medications

• Avoid strenuous exercise

Although colonoscopy is a safe procedure, it does have certain risks and complications which a gastroenterologist cannot ignore. The possible risks include:

• Perforation of the gut wall

• Infection

• Bleeding at the site of removal of polyp

• Reaction to sedation/anesthesia

After the procedure, patient is advised proper rest. Bloating and nausea re common after colonoscopy which goes away on its own soon.

If you think that you have symptoms or signs which might indicate a need for colonoscopy, you can consult us freely

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The treatment of hemorrhoids begins with conservative management which involves changes in lifestyle and diet. Following recedes are used in case of mild hemorrhoids:

• Eat high-fiber foods.

• Use topical treatments

• Soak regularly in a warm bath or sitz bath

• Apply cold

• Take oral pain relievers

Certain medications are also used along with remedies.

Following ENDOSCOPIC procedures are performed:

• Rubber band ligation of hemorrhoid

• HET

• THERMAL ABLATION

• SCLEROTHERAPY

• Minimally invasive procedures

• Hemorrhoid removal

• Hemorrhoid stapling

There are two treatment options for gall stones:

1. Surgery known as cholecystectomy is done to remove gallstones. Your gastroenterologist might recommend to remove the gall bladder as gall stones have high recurrence rates.

2. Medications are also given to dissolve gall stones however it takes a longer time to dissolve all the stones.

The treatment regime has following components depending on the extent of damage and symptoms:

• Diet and lifestyle changes

• Antiviral medications

• Liver transplant

• Surveillance for Hepatocellular Carcinoma

Upper endoscopy is a relatively safe procedure. However, there are certain potential complications as follows:

• Perforation of the gut wall

• Infection

• Bleeding

• Reaction to sedation

• Pancreatitis as a result of ERCP

Despite being a safe procedure, banding has certain risks which a gastroenterologist can not ignore. The risks are:

• Infection

• Excessive bleeding during movements of bowel

• Fever

• Difficulty in urinating

• Recurring hemorrhoids