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Gastroenterology Q & A

Below are our archive of questions and answers in Gastroenterology.

Question 5/8/2002: Three years ago I had pancreatitis. After recovering, I had my gallbladder removed. Since this time I have experienced the same kind of pain and discomfort that I felt when having a "gallbladder attach". I have had this checked out with my gastroenterologist and was told my pancreas is fine. Have you dealt with this occurrence in other patients and should I have other tests run?
Answer: It is possible for some people to have gallstones in the common bile duct even after having a cholecystectomy. Transient elevation of the bilirubin or other liver tests may be seen along with pain, nausea, and jaundice. An abdominal ultrasound may suggest this problem as well as an abdominal CT scan. If suspected, ERCP is the test of choice to demonstrate the stone and dilate the bile duct or even on occasion, remove the stone. NEA Clinic - (870) 935-4150 (for appointment)

Question 4/20/2002: Does the NEA Clinic plan to get another Gastroenterologist so that Dr. Hightower will again be able to see patients at Regional Hospital? Regional is our PPO and Dr. Hightower is our Gastro PPO and being retired and on a fixed income seeing a non PPO Dr or going to a non-PPO hospital puts a strain on our budget. Thank you.
Answer: Yes! After a long search we are pleased to say that in September of this year Dr. Brad Moore will be joining NEA Clinic as a Gastroenterologist. He will be serving Regional Medical Center of NEA as well as SBMC. Dr. Moore is finishing his Fellowship at the University of South Carolina Medical Center in Charleston.
NEA Clinic - (870) 935-4150 (for appointment)

Question 4/20/2002: What causes gallstones? Does diet pay into getting them?
Answer: Gallstones come from cholesterol and bile mixing to form a small crystal that grows into a stone. There is a strong hereditary factor involved in the formation of gallstones. High cholesterol may be an independent risk factor as well.
NEA Clinic - (870) 935-4150 (for appointment)

Question 4/16/2002: I'm actually having 2 problems and am wondering if they are related. Recently, I have found that every thing I eat gives me gas and heartburn. I have bouts of diarrhea, nausea, vomiting and loss of appetite. A few weeks ago, my stomach began to cramp and swelled up so that I looked about 6 months pregnant. Also have symptoms of heart attack? What is it and are they related?
Answer: It sounds like you have Gastroesophageal reflux disorder (GERD) and irritable bowel syndrome as well (IBS). This is actually not too uncommon to see in this part of the country. To treat GERD one needs to avoid highly seasoned foods carbonated beverages, chocolate, and caffeine. Try to not eat late at night and avoid overeating. PPI, proton pump inhibitors may decrease acid secretion and result in relief. On the other hand, IBS is a condition associated with motility problems of the bowel. The anatomy of the bowel is normal in this condition. The problem is bowel spasm. Often we have to give medications to relax the bowel, whenever the symptoms arise. You need to see your family doctor to discuss the situation you have in more detail.
NEA Clinic - (870) 935-4150 (for appointment)

Question 4/9/2002: I had a lower GI series about 11 months ago. The ONLY thing they found was internal hemorrhoids. Can anything be done for this, other then surgery?
Answer: Hemorrhoids are varicose veins; therefore anything that decreases veins will do the same for hemorrhoids. Things that help include weight loss, more fiber in the diet, being off your feet more, and topical agents such as Anusol HC cream or suppositories.
NEA Clinic - (870) 935-4150 (for appointment)

Question 3/16/2002: I've had to use a fleet suppository for several years to initiate bowel movement. How do I get back to having a spontaneous initiate bowel movement?
Answer: First you must be sure that there is no obstruction in the lower colon. Therefore, you need to have a full colonoscopy. If there is no blockage, then a bulk laxative may be your solution. This will provide more water to the lower colon region.
NEA Clinic
(870) 935-4150 (for appointment)

Question 3/13/2002: When I eat, my bowels move 4 to 5 times or more usually after lunch, with a lot of gas. I have had gall bladder surgery. I had it before, but am more now.
Answer: It is difficult to say without an exam. However, many people after having gall bladder surgery suffer with this malady. For most of them the problem is a rush of bile salts in response to the meal. Since there is no gall- bladder, there is basically a tidal- wave of the bile material that sucks water into the colon and therefore, diarrhea results. The best way to see if this is the problem is to take a bile salt binder before your meal, and see if you can stop the process. If this works, then you have the diagnosis. Try two tablespoons of amphogel or basalgel before meals. If this doesn’t work, see your doctor.
NEA Clinic
(870) 935-4150 (for appointment)

Question 2/6/2002: I had a baby in March of 2001; at this time I got a blockage in the transverse colon. I experienced severe pain for several days. I was told that the blockage was caused during my surgery and that it had fallen asleep because of the medications used. Well it has now been 10 months, and for the entire ten-month period I have had constant diarrhea, and terrible cramps. I was wondering if the problem I discussed earlier could still be affecting me or could it be something else more severe?
Answer: If you are continuing to have diarrhea after an ileus, after the delivery, this should not be happening without some other reason. You probably need to see a gastroenterologist and be considered for colonoscopy to be sure that you don’t have inflammatory bowel disease. It may just be irritable bowel syndrome, but you almost have to view the colon to make sure that you do not have a more serious condition. The treatment of these two conditions is completely different.
NEA Clinic (870) 935-4150 (for appointment)

Question 2/4/2002: I need some information on Cirrhosis of the liver in 4th stage. It is for a friend. Her husband has been diagnosed with this condition and she is trying to get all the info about it.
Answer: Cirrhosis by definition means that the liver has become scarred because of inflammation or infection. Therefore, as the veins pass through the liver the pressure is increased causing dilated veins (portal hypertension). This increases the risk of bleeding from the esophagus and rectum. This increased pressure also causes fluid to accumulate in the peritoneal cavity (ascites). The liver makes important clotting factors, so as the function of the liver declines, bleeding becomes more likely. As the liver function declines the blood ammonia level increases and hepatic conra occurs. The continuing failure of the liver ultimately causes kidney (renal) failure or hepato-renal syndrome. This usually results in death with failure of both the liver and kidneys. Depending on the cause of liver injury and the stage of cirrhosis, different medications may be tried to slow the complications. Sometimes liver transplants may be quite successful. See a Gastroenterologist for more details. NEA Clinic (870) 935-4150 (for appointment)

Question 1/30/2002: My husband had an EGD, 2 months ago and was then put on Prevacid 30 mg. He took them for a month with no problems and went without taking the medication for almost 2 weeks and the symptoms returned. I called the doctor and he renewed the script and started taking them again. Since then he has had diarrhea, for 11 days. I know this is a side effect of Prevacid, what else should we looking for. He is losing weight and tired most of the time. I am beginning to get very concerned.
Answer: First you need to know the diagnosis at the time of the EGD. Was there an ulcer, or Gastroesophageal reflux, or gastritis? This would tell you the next step. Was there any evidence of H. Pylori infection? Sometimes the Prevacid may cause diarrhea as you know, and therefore, all that is needed is a change of medications. Discuss this more with your gastroenterologist.
NEA Clinic (870) 935-4150 (for appointment)

Question 1/24/2002: My son is 28 & has been to the ER in Paragould twice with severe back and stomach pain. He was diagnosed with Acid Reflux -of which he has no symptoms. He has had an EGD and gall bladder series tests, which show nothing wrong. He is taking Aciphex, which was prescribed when they thought he might have an ulcer. Can Acid Reflux cause this much pain? What should he do now?
Answer: If the EGD test is completely normal, he does not have Gastroesophageal reflux disease. He may have irritable bowel disease or some other not yet diagnosed disorder. He needs to have another physician evaluation.
NEA Clinic (870) 935-4150 (for appointment)

Question 1/18/2002: I have been diagnosed with hemorrhoids and was given a Rx for Proctofoam. But before I was given the Rx I would have intense burning after each bowel movement. Now that I've been using the medication, I still burn. I have also had my gallbladder removed back before Christmas. Previous to that I never had problems. I have been taking fiber. What do I do now?
Answer: Hemorrhoids are varicose veins in the rectal canal. There are external and internal hemorrhoids present. The lining of the rectal mucosa has some nerve endings, which are quite sensitive. Proctofoam is a helpful agent to decrease the inflammation and swelling. The fiber will increase the water in the lower bowel, thus decreasing the chance of further irritation. There are some over the counter _caine_ agents that may decrease the pain as you recover. Warm baths may also be helpful. The gallbladder surgery may have nothing at all to do with the hemorrhoids. However, on occasion having the gallbladder removed, may cause more frequent diarrhea.
NEA Clinic (870) 935-4150 (for appointment)

Question 1/7/2002: I began having heartburns or burps several times a day. If I bend a lot its continuous. I also have a lump in the top middle part of my chest or maybe tightness. I cannot lie on my back and breathe comfortably, so I lay on my side. Could this all be related. I did not pass a breathing test at work. They ask if I had asthma? Should I see a specialist or just a MD?
Answer: Your symptoms sound like you have Gastroesophageal reflux. This condition is often accompanied by a hiatal hernia, but that is not necessary in order to have GERD. The obvious treatment is weight loss and anti-reflux procedures. Those include avoidance of overeating, not reclining for at least thirty minutes after eating, and avoidance of foods such as chocolate, spicy foods, alcohol, caffeine, and carbonated drinks. If those efforts are not successful, then you may need antacids after eating, or histamine blockers such as Pepcid or Zantac, or if severe your doctor may prescribe a proton pump inhibitor such a Prilosec. As far as your breathing is concerned, that may be related for chronic reflux may cause interstitial lung disease, or this may be an unrelated condition. It sounds like you need to see your family doctor with these problems.
NEA Clinic (870) 935-4150 (for appointment)

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