Common Diseases of the Esophagus

Barrett’s Esophagus is a condition where the tissue lining the inside of the esophagus has changed as a result of persistent exposure to stomach acid. Although there is a very low chance, in the rare patient it can be the step prior to developing esophageal cancer. It is commonly found in patients suffering from longstanding gastroesophageal reflux disease (GERD), but other risk factors also include an elevated body mass index and an age over 50. Most people with Barrett’s Esophagus may have frequent heartburn or chest discomfort, but many will not have any symptoms at all. It is diagnosed with an upper endoscopy with biopsies. Treatment is individualized to the patient and can include endoscopic surveillance, medications such as a proton pump inhibitor, endoscopic ablation therapy, or surgery in uncommon cases.

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GERD occurs when stomach acid or bile is able to escape the stomach and small bowel and reflux back into the food pipe, which is also called the esophagus. The acid exposure irritates the lining of the esophagus and can lead to the development of heartburn, chest discomfort, or even difficulty laying flat at night due to burning symptoms. GERD can have many different ways that it can present itself and it may or may not be related to diet depending on your particular case. Commonly if you have acid reflux and heartburn more than twice a week, it may be a sign of GERD. Diagnosis can usually be made in consultation with your physician, but depending on your specific symptoms and history, sometimes an endoscopic evaluation or additional testing may be necessary. Treatment is generally with acid suppressive medications.

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This is a rare condition in which a special type of white blood cell, called an eosinophil, amasses in the food pipe, i.e. esophagus. This can occur as a reaction to foods, allergens, or can even occur as a result of chornic acid reflux and can lead to inflammation and ultimately injury the esophageal lining. This process can lead to having difficulty with swallowing and occasionally with having food get caught in your pipe while trying to swallow. Although we have been aware of this condition for more than 20 years, research into understanding this disease is still ongoing. At our practice we currently have a clinical trial available for interested patients.

Please visit our clinical trials page to see if you would qualify for one of our trials for this condition.

A hiatal hernia is when a part of the stomach has come above the level of the diaphragm and past the muscle that helps keep your lower part of your food pipe (esophagus) closed to prevent reflux of the stomach contents back into the esophagus. Patients with a hiatal hernia often complain heartburn, chest discomfort and some can have abdominal pain. Diagnosis is made during an upper endoscopy. Treatment is frequently with medications to help reduce acid production in the stomach. In rare cases, surgery is required.

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Often times, either due to chronic acid reflux or other conditions that cause inflammation in the food pipe (esophagus) can lead to the development of rings or webs within it. These rings and webs are actually scar tissue that can lead to developing blockages in your esophagus. Patients may have symptoms such as inability to eat, discomfort while swallowing solids or liquids, or regurgitation of food. At Great Lakes Gastroenterology, treatment is variable and individualized to the patient. It can include medications to reduce acid production in the stomach, include a periodic endoscopic evaluation for monitoring, and treatment to break up the scar tissue during the procedure.

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Esophageal varices are abnormally large veins that are found in the food pipe. They occur due to reduced or blocked blood flow to the liver. This most often occurs in patients with advanced liver disease or cirrhosis. Although generally these do not cause symptoms, sometimes they can burst due to being overfilled. This can lead to severe and life-threatening bleeding and patients can have symptoms such as vomiting of blood, have black stools (melena), and go into shock. Treatments are individualized to each patient but can include medical management in those that have not had bleeding with a type of medication called a beta blocker. We also perform endoscopic procedures to prevent bleeding or stop bleeding while it is occurring. If the liver disease is severe, then patients are referred for evaluation for a liver transplant.

Please visit our clinical trials page to see if you would qualify for one of our trials for this condition.

The esophagus is the tube that connects and moves food that is swallowed from the mouth to stomach. When patients have esophageal cancer, often they do do not notice any symptoms at all and the diagnosis is commonly made when getting a test for some other reason. In those patients that do, in fact, develop symptoms, they can include: difficulty with swallowing, especially solids and dry foods that tends to get worse over time; pain or burning in the chest; hoarse voice; unexpected weight loss. It is important to note that all of these symptoms can also occur in other conditions that are not due to cancer. When patients present with these symptoms sometimes a special xray is performed where barium is swallowed which can help outline the esophagus. The diagnostic test is an upper endoscopy with a biopsy of the tumor. Once a diagnosis of cancer is made with the biopsy results, patients are referred to an oncologist and surgeon to help determine the best route for treatment.

Please visit our clinical trials page to see if you would qualify for one of our trials for this condition.

Diseases of the Stomach

Ulcers can occur anywhere in the GI tract. Ulcers are formed when the lining of the esophagus, stomach, small intestine, or colon is damaged. They can be as small as few millimeters, but also up to several centimeters in size. Patients can have pain, discomfort, burning sensation, develop bleeding from their GI tract, or they can have no symptoms at all. The diagnosis is commonly made during an endoscopic evaluation. When an ulcer is found, our goal is to find the underlying cause for the ulcer formation. Treatment of this condition is centered on treatment of both, the ulcer itself and the reason for why it formed.

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Typically referred to has H. pylori, these are bacteria that grow in the lining of the GI tract and that are most often harmless to humans, but they are also known to cause ulcers in the stomach and small bowel. It’s a common infection that may infect more than half of our population. The infection usually occurs in childhood and currently there are no methods for prevention. These bacteria are able to penetrate through the layer of mucous that lines that stomach to protect it from the acid that the stomach produces. Once this mucous lining is destroyed, it leads to ulcer formation. In patients that do develop symptoms, most often they are abdominal pain, nausea and/or vomiting, and occasionally bleeding from the GI tract. There are many ways to diagnose this condition, including blood tests or stool tests, but the most common method is with a biopsy during an endoscopic evaluation. Treatment usually consists of a 2 week course of medications including acid suppression and antibiotics.

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Gastroparesis is a digestive disorder in which the nerves of the stomach are improperly functioning leading to abnormal or absent motility of the stomach. When the stomach is functioning normally, contractions of the stomach help to squash ingested food and then propel the crushed food into the small intestine where further digestion and absorption of nutrients occurs. In patients with gastroparesis, the stomach is unable to contract normally, and therefore cannot crush food nor propel food into the small intestine properly and so normal digestion may not occur. There are numerous causes for this condition, but one of the most common is as a result of long standing diabetes. There are many different diagnostic tests and treatments available for this condition and at Great Lakes Gastroenterology, we will work with you to help determine the best diagnostic and treatment path for you.

Please visit our clinical trials page to see if you would qualify for one of our trials for this condition.

Cancer of the stomach occurs when the cells of the lining of the stomach change into abnormal cells and start multiplying uncontrollably. This leads to the formation of a tumor and ultimately cancer. There are different types of cancer depending on the location and cells within the stomach that are involved. Some people who get stomach cancer have a condition called H. pylori infection. Infection with H. pylori sometimes causes symptoms such as belly pain, bloating, nausea, or vomiting. If it is not treated, it can lead to a type of stomach cancer. Often, patients with gastric cancer have no symptoms and the diagnosis is made when a test is being performed for some other reason. However, in patients that do develop symptoms, they can include: weight loss; abdominal pain, difficulty with swallowing, regurgitation of undigested foods, feeling full with a small amount of food, nausea, or even feeling tired and having shortness of breath. Stomach cancer can be identified by xrays, CT scans, and MRI’s, but the diagnosis is made with a tissue sample biopsy obtained during an upper endoscopy. Once a diagnosis of cancer is made with the biopsy results, patients are referred to an oncologist and surgeon to help determine the best route for treatment.

Please visit our clinical trials page to see if you would qualify for one of our trials for this condition.

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