Question 1

When should I begin colonoscopy exams?

Accepted Answer

Age 45. We used to recommend that colorectal screening examinations begin at age 50.  However, because we have seen so many cases of colorectal cancer in younger individuals over the last two decades, the national recommendation was changed to age 45 for average-risk individuals. If there are other risk factors like a family history of colon cancer or polyps, we usually begin beginning screening at age 40. If an adult has colorectal symptoms such as rectal bleeding or persistent change in bowel habits, they should tell their doctor regardless of age. Read how screening colonoscopy saved this doctor's life.

Question 2

What's the best "prep" for colonoscopy?

Accepted Answer

There are several different preparations for colonoscopy, and they are all unpleasant. From the doctor's point of view, the SUPREP prep is probably the most effective, but a little sweet. Our patients tell us that the new SUTAB pill prep seems to be the least troublesome. However, each case is different, and certain individuals require special preparation, such as those with kidney disease. These are the most common preps.

Question 3

Is colonoscopy painful?

Accepted Answer

Thankfully, no. During the examination, you will not be aware of the procedure and should not experience any pain.  Colonoscopy is a painless procedure because special anesthesia is called Monitored Anesthesia Care, or MAC. MAC anesthesia is ideally suited to a short procedure like a colonoscopy. It is quick-acting and very safe. Unlike general anesthesia, you breathe on your own and do not require a breathing tube. You feel no pain or embarrassment during the procedure. The anesthesia wears off quickly in the recovery room, and unlike many other anesthetic regimens, postoperative nausea and vomiting are rare.

Question 4

Do the new stool or blood tests prevent colon cancer?

Accepted Answer

Not really. While any screening test is better than none, you should know that there is a difference between preventing colon cancer and detecting colon cancer. Unlike most other common cancers, colon cancer starts as a small non-cancerous polyp. Screening colonoscopy is very successful at finding these polyps and removing them BEFORE they become malignant. The new blood tests and the Cologuard “little white box” you see advertised on TV are very good at finding colon cancer AFTER  you have it.  They are not so good at finding polyps before they turn to cancer. In fact, the new blood test misses 87% of polyps. Screening Colonoscopy is the only colon cancer prevention test. The others are colon cancer detection tests.

Question 5

How do I prevent heartburn at night?

Accepted Answer

If you experience heartburn at night, we suggest that you sleep on your side, left side down. Your stomach is not symmetrical. In this position, the stomach acid lies well below the opening of the esophagus, making it difficult for acid reflux to occur during the night. Of course, we also suggest elevating the head of the bed 4-6 inches. You can accomplish this with a simple wedge, which is placed on top of the mattress, or by placing blocks under the feet of the headboard. If you experience heartburn day or night on a regular basis or if it is severe or associated with difficulty swallowing, tell your doctor. This short video may help explain.

Question 6

What exactly is a hiatal hernia?

Accepted Answer

Your diaphragm is a broad, muscular sheet that separates your chest from your abdomen. To connect your esophagus (“foodpipe”) to your stomach, it must travel through the diaphragm. This opening is called the hiatus. If this opening stretches over time, your esophagus can “pull your stomach” through the hiatus and up into your chest. The part of the stomach in the chest is called a hiatal hernia.

Question 7

Are microbiome tests legit?

Accepted Answer

No. Don’t waste your money…. Currently, these tests cost hundreds of dollars and benefit the seller much more than the buyer. Common brands are VIOME, FLORE, BIOHM, and THORNE, and new ones appear monthly.

The gut microbiome refers to the trillions of microorganisms, including bacteria, viruses, fungi, and other microbes, that inhabit our digestive tract, primarily the intestines. These microorganisms play a crucial role in our overall health by aiding digestion, producing vitamins, regulating the immune system, and protecting against harmful pathogens. Various factors, including diet, environment, genetics, and lifestyle, influence the composition of the gut microbiome. A healthy, diverse microbiome is essential for maintaining digestive health, metabolic function, and even mental well-being.

Current stool tests used to analyze the gut microbiome have several limitations that make them less reliable for providing a comprehensive picture of an individual's gut health. These tests typically involve sequencing the DNA of microbes found in a stool sample to identify and quantify the various species present. While this approach offers some insights, it has significant drawbacks. Moreover, the gut microbiome is influenced by many transient factors, such as recent diet, medication use, and stress levels, which can cause significant fluctuations in microbial populations. Our understanding of the gut microbiome is still in its infancy. Scientists have identified only a fraction of the microbial species that exist, and the functions of many known microbes still need to be fully understood. This limited knowledge makes it challenging to interpret stool test results accurately and translate them into actionable health recommendations. These tests can't give you accurate recommendations concerning your diet based on the limited science in 2024.

There is hope for the future. As research advances, more comprehensive and precise methods for analyzing the gut microbiome are expected to emerge, improving our ability to assess and understand this complex ecosystem's impact on human health.

Question 8

What is a good probiotic?

Accepted Answer

Probiotic foods contain healthy bacteria that promote good digestive function. The best Probiotics do not come from pills or supplements, but rather from food, particularly fermented food:

Yogurt - Made from fermented milk and contains live cultures of probiotic bacteria. Try to avoids those with high levels of sugar.

Kefir - A fermented milk drink similar to yogurt but with a thinner consistency, containing a variety of bacteria and yeasts.

Sauerkraut - Fermented cabbage that is rich in probiotics, fiber, and vitamins. The best are refrigerated and served cold. Cooking kills the healthy bacteria.

Kimchi - A Korean dish made from fermented vegetables, typically cabbage, along with various spices and seasonings.

Miso - A Japanese seasoning produced by fermenting soybeans with salt and a type of fungus known as koji. It's often used in soups and sauces.

Pickles - Cucumbers that have been pickled in a solution of salt and water. It's important to choose those that are naturally fermented. They are refrigerated.

Kombucha - A fermented tea drink that is slightly effervescent and contains a variety of bacteria and yeast.

Cheese - Particularly aged cheeses like Gouda, mozzarella, cheddar, and Swiss which live cultures.

Question 9

How can I improve my gut health?

Accepted Answer

The most important thing you can do to improve your Gut Health is to appreciate and take better care of your gut microbiome. The gut microbiome, a community of trillions of bacteria, fungi, viruses, and other microorganisms living in your digestive tract, plays a crucial role in your overall health. This intricate ecosystem influences everything from digestion and immune function to mood and metabolism. Maintaining a healthy gut microbiome is essential for your well-being, and diet is one of the most significant factors affecting it. Here’s a detailed guide on the best diet for a healthy gut microbiome.

Understanding the Gut Microbiome
The gut microbiome acts like a virtual organ that produces essential chemicals and nutrients your body needs. A balanced microbiome supports immune function, brain health, and metabolism. Conversely, an imbalanced microbiome has been linked to various health issues, including diabetes, heart disease, and inflammatory bowel diseases.

The Importance of a Diverse Diet
Diverse Plant Intake: Aim to consume 30 different plants per week. This includes fruits, vegetables, nuts, seeds, herbs, and spices. The diversity of plant-based foods provides a range of fibers and nutrients that feed different types of beneficial microbes in your gut.
Eat the Rainbow: Incorporate colorful fruits and vegetables into your diet. These foods contain polyphenols and other beneficial compounds that support gut health by promoting a diverse microbiome.
Fermented Foods: Include a variety of fermented foods in your diet, such as yogurt, kefir, kimchi, and kombucha. These foods introduce beneficial microbes to your gut and help maintain a balanced microbiome.
Whole Grains and Fibers: Whole grains like oats, brown rice, and quinoa are rich in fiber, which is essential for gut health.      Dietary fibers act as prebiotics, feeding the beneficial bacteria in your gut.

Types of Fiber and Their Benefits
Soluble Fiber: Found in foods like oats, peas,      beans, apples, and citrus fruits, soluble fiber dissolves in water to form a gel-like substance. It helps lower cholesterol levels and regulates blood sugar.
Insoluble Fiber: This type doesn’t dissolve in      water and is found in whole grains, nuts, and vegetables. Insoluble fiber      promotes regular bowel movements and prevents constipation.
Resistant Starch: Present in legumes, green      bananas, and cooked and cooled potatoes, resistant starch acts like a      prebiotic, feeding beneficial bacteria and promoting gut health.

Potential Risks of a High-Fiber Diet
While increasing fiber intake has numerous benefits, it’s essential to do so gradually. Rapid increases in fiber can lead to bloating, gas, and other digestive discomforts. Ensure you drink plenty of water to help fiber move through your digestive system and avoid constipation.

Foods to Avoid
Ultra-processed Foods: These can harm your gut microbiome. Processed foods often contain additives and lack the nutrients necessary for a healthy microbiome.
High Sugar and Artificial Sweeteners: Excessive sugar and artificial sweeteners can negatively impact the diversity and function of your gut bacteria.

Meal Timing and Fasting
Allowing a 12-14 hour fasting period overnight can benefit gut health. Fasting gives your gut microbes time to rest and regenerate, promoting a healthier microbiome.

How about Microbiome test kits? 
 Not yet… Microbiome science is in its infancy. Despite all the TIKTOC sites selling microbiome test kits and promising personalized nutrition, we are not there yet. Most of these products benefit the seller much more than the user. Future advances in microbiome research will likely lead to personalized medical treatments, including tailored probiotics and prebiotics to enhance the effectiveness of medications and improve health outcomes.

Additional Tips for a Healthy Gut
Stay Hydrated: Drinking plenty of water helps maintain the mucosal lining of the intestines and supports the balance of good bacteria in the gut.
Get Enough Sleep: Adequate sleep supports immune function and gut health. Aim for seven to eight hours of sleep per night.
Manage Stress: Chronic stress can negatively impact your gut health. Practices like yoga, meditation, and deep breathing can help manage stress and promote a healthy gut.
Regular Exercise: Physical activity promotes the growth of beneficial microbial species and contributes to a diverse microbiome.

Conclusion
A healthy gut microbiome is vital for overall health, and diet plays a significant role in maintaining this balance. Making conscious food choices every day can significantly impact your health. For optimal gut health, embrace dietary diversity, include fermented foods, and reduce ultra-processed foods. By incorporating a diverse range of plant-based foods, whole grains, and fermented foods into your diet while avoiding ultra-processed foods and excessive sugars, you can effectively support your gut health. Adequate hydration, sleep, stress management, and regular exercise are also crucial components of a gut-healthy lifestyle.

Question 10

Why am I always so constipated?

Accepted Answer

It happens to all of us from time to time. CONSTIPATION! Constipation is a common yet often uncomfortable and disruptive digestive issue. It is defined by infrequent bowel movements, typically fewer than three times per week, or difficulty passing stools, which can be hard, dry, and painful.

What Is Constipation?
Constipation occurs when bowel movements become less frequent or difficult to pass. Normal bowel habits can vary significantly among individuals; for some, three bowel movements per week is typical, while others may have them three times a day. However, a sudden change from your usual pattern could indicate constipation.  The symptoms of constipation are often unmistakable and can include fewer than three bowel movements per week, straining during bowel movements, hard or lumpy stools, and a sensation of incomplete evacuation. Additionally, individuals may experience a feeling of blockage in the rectum or need to use manual maneuvers, such as using their fingers, to facilitate stool passage. These symptoms can vary in severity and may significantly affect an individual’s daily life and overall well-being.

Acute vs. Chronic Constipation
Based on its duration and severity, constipation can be classified as acute or chronic. Acute constipation is a short-term condition often triggered by changes in diet, routine, travel, lack of exercise, illness, or medication. It usually resolves within a few days with lifestyle modifications or over-the-counter treatments. On the other hand, chronic constipation persists for three months or longer and can significantly impact a person’s quality of life. This type often requires medical evaluation and intervention, as it may not respond to standard dietary and lifestyle changes​.

Causes of Constipation
Constipation can stem from various factors, including dietary habits, lifestyle choices, medical conditions, and medications.
Diet and Lifestyle: A common cause of constipation is a diet low in fiber. Fiber adds bulk to stool and helps it pass easily through the intestines. Fiber-rich foods include fruits, vegetables, beans, and whole grains. Inadequate fluid intake can also contribute to constipation by making stools harder and more difficult to pass. Regular physical activity helps stimulate intestinal function so that a sedentary lifestyle can slow down the digestive process. Additionally, ignoring the urge to have a bowel movement can lead to prolonged retention of stool in the colon, where it becomes drier and harder.

Medications: Certain medications are known to cause constipation as a side effect. These include opioid pain relievers, antacids containing calcium or aluminum, iron supplements, and certain antidepressants and antihypertensives. If you are taking any of these medications and experience constipation, it’s important to discuss this with your healthcare provider, who may adjust your dosage or recommend alternatives.

Medical Conditions: Various medical conditions can affect bowel function. Digestive disorders such as irritable bowel syndrome (IBS), colorectal cancer, and inflammatory bowel disease (IBD) can cause constipation. Endocrine disorders, including diabetes and hypothyroidism, can also impact bowel movements. Neurological conditions such as multiple sclerosis, Parkinson’s disease, and spinal cord injuries can interfere with the nerves that control bowel movements, leading to constipation.

Risk Factors for Chronic Constipation
Several factors can increase the risk of developing chronic constipation. These include being female, as hormonal changes during menstruation, pregnancy, and menopause can affect bowel function. Older adults are also at higher risk due to slower metabolism, reduced muscle tone, and a higher likelihood of taking multiple medications that can cause constipation. A sedentary lifestyle and mental health conditions like depression or eating disorders can further contribute to chronic constipation.

Complications of Constipation
Chronic constipation can lead to several complications if not properly managed. Straining during bowel movements can cause hemorrhoids, which are swollen veins in the anus. Persistent straining can also lead to anal fissures, small tears around the anus that cause pain and bleeding. Severe constipation can result in fecal impaction, where hard stool becomes stuck in the colon or rectum, requiring medical intervention. In rare cases, prolonged straining can cause rectal prolapse, a condition where part of the intestine protrudes from the anus.

Diagnosis and Treatment
Diagnosing constipation involves thoroughly reviewing the patient's medical history, symptoms, and lifestyle. Your doctor may also perform a physical examination, including a rectal exam, to check for blockages or abnormalities. Additional diagnostic tests, such as blood tests, abdominal X-rays, and colonoscopy, may be necessary to identify underlying causes​.

Treatment typically begins with dietary and lifestyle changes:

Increasing fiber intake through fruits, vegetables, whole grains, and legumes can help add bulk to the stool and promote regular bowel movements. OTC fiber supplements like Metamucil or Benefiber may help

Drinking plenty of fluids and engaging in regular physical activity can also improve bowel function. 
Establishing a routine for bowel movements, especially after meals, can help maintain regularity.

For those with persistent constipation, over-the-counter laxatives can provide short-term relief. These include stool softeners and osmotic or stimulant laxatives like Miralax. However, it is important to use laxatives as directed and not rely on them for long-term management.

In cases of chronic constipation, healthcare providers may prescribe prescription medications such as lubiprostone, linaclotide, or prucalopride to help stimulate bowel movements.

In very rare instances, surgery may be necessary to correct structural problems in the digestive tract, such as blockages or significant rectal prolapse. However, surgical intervention is typically considered a last resort when other treatments have failed.

Constipation is a common condition that can be effectively managed with the right approach. Understanding the causes, symptoms, and treatments can help you take proactive steps to prevent and alleviate constipation. Preventing constipation involves adopting healthy dietary and lifestyle habits. Eating a fiber-rich diet, drinking adequate fluids, and staying physically active are vital to maintaining regular bowel movements. It is also important to respond promptly to the urge to have a bowel movement and establish a regular bathroom use schedule. By making these changes, you can reduce the risk of developing constipation and improve your overall digestive health.

Question 11

Can hemorrhoids turn into cancer?

Accepted Answer

Good news! NO…Hemorrhoids are just swollen veins in a very sensitive place. They do not turn to anal or rectal cancer. That said,  you can’t assume that any rectal  bleeding is coming from hemorrhoids until an examination confirms this to be true. The worst thing you could do is ignore chronic red rectal bleeding and then find out that an anal or rectal cancer was actually the cause, and now it’s too late for a cure. If you have symptoms, tell your doctor. Never assume.

Question 12

What is the best diet for my fatty liver?

Accepted Answer

Diet for Fatty Liver Disease
Fatty liver disease is a condition characterized by the accumulation of excess fat in the liver. There are two main types: those caused by alcoholism and non-alcoholic fatty liver disease (NAFLD).  Newly termed Metabolic dysfunction-associated fatty liver disease, MAFLD is the most common liver disease affecting millions of individuals worldwide. This is important as fatty liver disease can lead to serious health complications such as cirrhosis and liver cancer. Improving liver health through diet is crucial for managing this condition.

Understanding Fatty Liver Disease
Fatty liver disease occurs when more than 5-10% of the liver's weight is composed of fat. Often, this condition presents without noticeable symptoms but can progress to more severe liver damage over time. Implementing lifestyle changes, particularly dietary adjustments, is the primary strategy for preventing and managing fatty liver disease.

The Role of Diet in Fatty Liver Disease
A healthy diet is essential in managing fatty liver disease, especially since no specific medical treatments for NAFLD exist. Dietary and lifestyle changes are the most effective ways to prevent or reverse liver damage. A diet can play a pivotal role in this management by reducing fat accumulation in the liver, improving insulin sensitivity, and combating inflammation by including specific foods.

Recommended Diet for Fatty Liver Disease
The Mediterranean diet is highly recommended for individuals with fatty liver disease. This diet is rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, making it beneficial for liver health. Here's a detailed look at the components of this diet:

Healthy Fats
Olive oil, rich in monounsaturated fats, is known to help reduce liver fat. Omega-3 fatty acids in fish, flaxseeds, and walnuts improve insulin sensitivity and reduce inflammation, making them vital for liver health.

Fruits and Vegetables
Antioxidant-rich foods like berries and leafy greens protect liver cells from damage. Fiber-rich foods, like broccoli and apples, aid in digestion and help reduce fat absorption in the liver.

Whole Grains
Whole grains like brown rice, oats, and quinoa are high in fiber and help maintain stable blood sugar levels. This reduces the liver's workload and prevents fat buildup.

Lean Proteins
Fish and seafood, rich in omega-3 fatty acids, support liver health. Plant-based proteins, such as legumes and nuts, are beneficial due to their low fat and high nutrient content, making them excellent choices for a liver-friendly diet.

Beverages
Surprisingly, coffee consumption (up to three cups a day) has been linked to a lower risk of liver disease progression. Green tea, rich in antioxidants, can help protect liver cells from damage.

Foods to Avoid
Certain foods can exacerbate fatty liver disease and should be limited or avoided to maintain liver health. These include:

Saturated Fats
Foods high in saturated fats, such as red meat and full-fat dairy, can increase fat accumulation in the liver.

Sugary Foods and Beverages
Sugary snacks and sodas, high in fructose and other sugars, can lead to insulin resistance and fat buildup in the liver.

Processed Foods
Fried foods and baked goods, often high in unhealthy fats and sugars, can worsen liver fat.

Alcohol
Excessive alcohol consumption can cause and worsen fatty liver disease, particularly in individuals with NAFLD.

Lifestyle Changes
In addition to dietary changes, certain lifestyle adjustments can significantly benefit individuals with fatty liver disease.

Weight Management
Gradual weight loss, aiming to lose 5-10% of body weight slowly, can significantly reduce liver fat and inflammation.

Regular Exercise
Aerobic exercises like walking, cycling, and swimming can help reduce liver fat. Strength training can also improve overall metabolism and liver function.

Managing Comorbid Conditions
Proper management of diabetes and cholesterol is crucial, as these conditions are risk factors for fatty liver disease.

Conclusion
Dietary and lifestyle changes are powerful tools in managing fatty liver disease. The Mediterranean diet, rich in healthy fats, lean proteins, and fiber, stands out as the most beneficial diet plan. Avoiding harmful foods, incorporating beneficial supplements, and adopting a healthy lifestyle can significantly improve liver health and prevent the progression of fatty liver disease.

Question 13

Diverticulosis - Diverticulitis. What's the difference?

Accepted Answer

Diverticulosis of the colon is a condition rather than a disease. The
inner wall of a healthy colon is strong and relatively smooth. The
colon wall affected by diverticulosis forms weak, balloon-like sacs or pouches that protrude outward like a bulge forming on a worn inner tube. Diverticula are often quite small – about the size of a pea – but can be larger. Once you get diverticula, they don’t go away. The presence of these pouches in the colon is called diverticulosis. Some people may have several small pouches on the left side of the colon, while most of the colon may be affected in others. When the pouches become inflamed or infected, it is called diverticulitis. (In medicine, the suffix “-itis” refers to inflammation or infection...like appendicitis.)

Question 14

Should I be on a gluten-free diet?

Accepted Answer

There’s a lot of buzz on TikTok around going gluten-free, with everyone from celebrities to pro athletes touting the benefits of a gluten-free diet. Gluten is a protein found in wheat, barley, and rye. Unless you have celiac disease or a diagnosed gluten sensitivity (also called gluten intolerance), there's no medical need for you to be on a gluten-free diet. Despite popular trends, there is little evidence that a gluten-free diet has health benefits for people who do not have these conditions. Some people think going gluten-free means not eating carbohydrates, but this isn’t true. Many foods containing carbs, such as rice, potatoes, and beans, don’t contain gluten.

Celiac disease
Celiac disease is straightforward. Your doctor can order blood tests, genetic tests, and intestinal biopsies that verify the diagnosis with certainty. Celiac is an autoimmune response to gluten that causes the body to attack the small intestine, causing belly pain, nausea, bloating, or diarrhea. People with celiac disease can’t tolerate gluten in any form and need to follow a gluten-free diet for the rest of their lives. Once the diagnosis is made, a lifelong, strict gluten-free diet is prescribed, and these patients do well.

Gluten Sensitivity: Is It Real?
Unfortunately, this is not so clear. No blood test, genetic test, or biopsy can confirm the diagnosis of nonceliac gluten sensitivity. Many individuals who experience symptoms of gas, bloating, and abdominal pain experiment with a period of gluten avoidance. Some do well, and others do not.

Most Gastroenterologists recognize that nonceliac gluten sensitivity does exist. However, this is a new area of study, and researchers still need to understand the condition, its risk factors, and its prevalence. While many documented cases of possible gluten sensitivity exist, more research is needed before scientists understand the causes, symptoms, and effects.

What Should You Do?
So, there is no harm in trying a gluten-free diet if you have these symptoms and feel that you may be sensitive to gluten.  Keep a food and symptom diary for at least four weeks to see if this makes a difference. There are a few downsides to a gluten-free diet:

1.    Eating out is tricky as you can’t always trust what is said on the menu.
2.    Grocery shopping for gluten-free products is definitely more expensive.
3.    Cutting out gluten can lead to nutritional deficiencies because many gluten-containing foods are good sources of fiber, vitamins, and minerals. If this is to be a long-term diet, add a daily multivitamin and non-gluten sources of fiber in fruits and vegetables to your regimen

Suppose you're considering a long-term gluten-free diet. In that case, it's important to talk to your doctor or a registered dietitian to discuss the potential benefits and risks and ensure you get all the nutrients your body needs.

Question 15

I saw a TV ad about EPI. Do I have it?

Accepted Answer

EPI (Exocrine Pancreatic Insufficiency) is when the pancreas does not produce enough enzymes to digest food properly. These enzymes break down food and absorb nutrients, including fats, proteins, and carbohydrates. Symptoms can vary but often include:

Steatorrhea: Fatty, foul-smelling stools that are difficult to flush.
Diarrhea: Frequent, loose, and watery stools.
Weight Loss: Unintentional weight loss due to poor nutrient absorption.
Bloating and Gas: Excess gas and a feeling of fullness.
Abdominal Pain: Discomfort or pain in the upper abdomen.

However, these symptoms can be associated with many different conditions. It's important to remember that a TV advertisement is not a diagnostic tool. If you are experiencing symptoms that concern you, the best action is to speak with your doctor. Consultation with a Gastroenterologist can arrange specific tests, such as stool tests, blood tests, or imaging studies, to determine if you have EPI or another condition. In most cases, the condition is permanent. However, treatment is available. The primary treatment for EPI is pancreatic enzyme replacement therapy (PERT), which involves taking enzyme supplements with meals to aid digestion.

Question 16

I have a pancreas cyst. Help!

Accepted Answer

Don’t panic. Most pancreatic cysts are benign (non-cancerous). Pancreatic cysts are fluid-filled sacs on or in the pancreas.  Most pancreatic cysts are discovered during imaging tests for other health issues, as they often cause minimal or no symptoms. However, these cysts range from benign (non-cancerous) pseudocysts to malignant (cancerous and spreading) cysts.

If a cyst is found, your doctor will recommend further tests to determine its type and whether it's precancerous or cancerous. These tests may include an endoscopic ultrasound, where a thin tube with a camera and ultrasound device is passed down your throat to your stomach and small intestine, providing images of your pancreas.  While the presence of a pancreatic cyst can be concerning, it's important to remember that they are fairly common and most cysts are not cancerous. Even those with cancerous potential can be effectively managed with regular monitoring and timely treatment. If you have been diagnosed with a pancreatic cyst, it's crucial to have regular check-ups and follow your doctor's advice. More information can be found here.

Question 17

When should I worry about trouble swallowing?

Accepted Answer

The medical term for difficulty swallowing is dysphagia. Occasional difficulty swallowing, such as when you eat too fast or don't chew your food well enough, usually isn't cause for concern. However, if you consistently have trouble swallowing, it may indicate a more severe condition like esophageal narrowing (stricture). Trouble swallowing is one of the SEVEN cancer warning symptoms,  so esophageal cancer must be ruled out. Fortunately, cancer is an uncommon reason for difficulty swallowing. If you often have difficult or painful swallowing items such as meat, bread, and clumpy rice, you need to tell your doctor. A consultation with a gastroenterologist and probably an upper endoscopy examination “scope exam” would seem to be in order. It is important to explain the underlying cause of the symptoms and to exclude serious problems. Read on...

Question 18

I had my gallbladder out…  now diarrhea!  OMG!

Accepted Answer

All abdominal surgery is a shock to your system. But, in most cases, these changes are temporary and improve within a few weeks of the operation. About 5% of individuals, however, are troubled by persistent diarrhea after their gallbladder is removed. The symptoms may vary, but most patients complain that they often experience urgency and watery diarrhea shortly after eating. The diarrhea may even force them to stop and head for the closest bathroom before they finish the meal. This is especially embarrassing when it occurs at work or when dining out with friends. Why some patients develop this side effect after gallbladder surgery, and others do not is still a mystery.  Unfortunately, there is no way to predict before surgery who will develop this problem afterward. Having this side effect does not reflect on the skill of the surgeon or how the surgery was done. It is really just bad luck. There is no cure for this problem, but treatment is available.  The mainstay of treatment is a powder called cholestyramine resin (Pronunciation: kole ESS tie ra meen). In the past, this medication was primarily marketed as a drug for patients with high blood cholesterol. It has been replaced by more effective drugs such as the statins. It is still available to help those with diarrhea after gallbladder surgery. Read more…

Question 19

Can I schedule an appointment online?

Accepted Answer

YES, we are happy to offer convenient online scheduling.

Affiliated with Three Rivers Endoscopy Center

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