Celiac Disease
Having celiac disease means a person can’t eat gluten, a protein found in wheat, rye, or barley. Gluten may also be found in some medicines. Celiac disease is hereditary, meaning it runs in families. The treatment for celiac disease is a gluten-free diet. Other names for celiac disease are celiac sprue and gluten intolerance. In people with celiac disease, the body’s immune system responds to gluten by damaging the lining of the small intestine. This lining has small finger-like growths called villi. The villi normally absorb nutrients from the foods we eat. When the villi are damaged, the body can’t get the nutrients it needs. People with celiac disease don’t always know they have it because they don’t feel sick. Or if they feel sick, they don’t know celiac disease is the cause. 

Is celiac disease serious?
Yes. Celiac disease can be very serious. Besides stomach pain, it can cause anemia, malnutrition, infertility, a certain skin rash, and other health problems. 

What are the symptoms of celiac disease?
Symptoms of celiac disease include

- gas

- diarrhea

- stomach pain

- feeling very tired

- change in mood

- weight loss

- a very itchy skin rash with blisters

- slowed growth

Most people with celiac disease have one or more symptoms, but not all have digestive problems. And some people with the disease don’t have any symptoms. Having one or more of these symptoms does not mean a person has celiac disease because many other disorders include these symptoms.

How is celiac disease diagnosed?
Celiac disease can be hard to discover because its symptoms are like many other digestive diseases. People with celiac disease can go untreated for many years.
If your doctor thinks you have celiac disease, you will probably need a blood test. You will need to follow your regular diet before and while being tested. If you don’t, the results could be wrong.

If your test results show you might have celiac disease, the doctor will perform a biopsy to make sure celiac disease is the problem. For a biopsy, the doctor takes a small piece of tissue from your small intestine. To get to your small intestine, the doctor puts a long tube into your mouth and down into your stomach. At the end of the tube are small tools for snipping out the bit of tissue needed to view with a microscope. You will take medicine before the biopsy that makes you very sleepy. It also keeps you from feeling any pain. Many people sleep through the procedure.

How is celiac disease treated?
The only treatment for celiac disease is a gluten-free diet. A dietitian can work with you to help you learn how to select gluten-free foods. A dietitian is an expert in food and healthy eating. You will learn to check labels of foods and other items for gluten. If you eliminate gluten from your diet, your small intestine will heal. If you eat gluten, or use items that contain gluten, you will harm your small intestine. The following chart lists examples of foods you can eat and foods you should stay away from if you have celiac disease. This list is not complete. A dietitian can help you learn what other foods you can and can’t eat when following a gluten-free diet.


Barrett’s Esophagus
Barrett's esophagus is a condition in which the cells of your lower esophagus become damaged, usually from repeated exposure to stomach acid. The damage causes changes to the color and composition of the esophageal cells. The lining of the esophagus is replaced by a tissue type similar to that normally found in the intestine. This is called intestinal metaplasia. 
Barrett’s esophagus may be associated with having heartburn, but it may cause no symptoms on its own. It is relatively common and most often diagnosed in people who have long-term gastroesophageal reflux disease (GERD). GERD is a chronic regurgitation of acid into the lower esophagus. Only a small percentage of people with GERD will develop Barrett's esophagus.
A diagnosis of Barrett's esophagus can be concerning because it increases the risk of developing esophageal cancer. Although the risk of esophageal cancer is small, monitoring of Barrett's esophagus focuses on periodic exams to find precancerous esophagus cells. If precancerous cells are discovered, they can be treated to prevent esophageal cancer.


Crohn’s Disease
Crohn’s Disease is an inflammatory bowel disease (IBD). It is a chronic disorder that creates inflammation of the lining of the digestive tract (also known as the GI tract). It can affect any area from the mouth to the rectum, but most commonly affects the lower part of the small intestine. The disease causes inflammation and swelling deep into the affected area, causing pain that can make the intestines empty frequently, resulting in diarrhea.
Crohn’s Disease may be difficult to diagnose because the symptoms, including abdominal pain and diarrhea, are so similar to other intestinal disorders. Bleeding from the rectum, joint pain, weight loss and skin problems are other symptoms. Crohn's disease can be both painful and debilitating, and sometimes may lead to life-threatening complications. Presently, there is no known cure for Crohn's disease. There are therapies that can greatly reduce the signs and symptoms of Crohn's disease and even bring about long-term remission. With treatment, many people with Crohn's disease are able to function well.


Diverticulosis and Diverticulitis
Diverticula are small, bulging pouches that can form anywhere in your digestive system, including your esophagus, stomach and small intestine. However, they're most commonly found in the large intestine.  
Diveticulosis or diverticular disease happens when these small pouches bulge outward through the colon. You may not know you have these pouches and they might not cause any symptoms.  The condition; however, can cause mild cramps, bloating or constipation.  Maintaining a high-fiber diet and medication to reduce colon spasm, will often relieve these symptoms.
Diverticulitis occurs when one or more diverticula in your digestive tract become inflamed or infected.  Depending on the acuteness of the symptoms, mild cases of diverticulitis can be treated with rest, changes in your diet, and antibiotics in order to prevent further complication.   Serious cases of diverticulitis can cause severe abdominal pain, usually on the left side.  If the diverticula are infected; then fever, nausea, vomiting, chills, cramping or constipation can signal immediate medical attention.   Diverticulitis can lead to bleeding or blockages or even perforation (puncture) through the bowel wall.  Serious cases of diverticulitis may require surgery.

Gastroesophageal reflux disease or “GERD” is a chronic digestive disease. When stomach acid or, occasionally, stomach content flows back into the esophagus (food pipe), the backwash irritates the lining of your esophagus and causes GERD. The contents come back up because the lower sphincter opens spontaneously or doesn’t close properly.
  This acid reflux may cause people to experience indigestion, a taste of food in the mouth, or a burning sensation in the chest, chest pain or pain in your throat. It can also cause dry cough, wheezing, trouble swallowing, hoarseness, or a sensation of a lump in your throat.
Notice: If you experience chest pain with other signs of shortness of breath, jaw or arm pain, seek immediate medical assistance; you may be experiencing a heart attack. 
Occasional acid reflux is a very common problem, but those who suffer from reflux more than twice a week may have gastroesophageal reflux disease (GERD), that can lead to serious health problems. 
What conditions can increase a risk of GERD?
Obesity, a bulging of the top of the stomach into the diaphragm (hiatal hernia), pregnancy, smoking, dry mouth, asthma, diabetes, a delayed stomach emptying, and connective tissue disorders.
What are my treatment options for GERD?
Treatment of GERD may include over the counter reflux medication, lifestyle changes that include low-acid diet, and prescription medication to block the production of acid.

If lifestyle changes and medications do not help treat your symptoms, your health care provider may suggest an Upper Endoscopy or other procedure to examine your esophagus for abnormalities.  In some cases, surgery may be warranted to treat certain conditions.
It is frequently caused by a backflow of stomach acid to the esophagus. This is commonly called heartburn or GERD (gastroesophageal reflux disease). This constant irritation may cause the tissues to become inflamed and occasionally form ulcers. It often causes swallowing difficulties and oral lesions.  
Sometimes a stricture occurs when the inflamed area heals with a scar that narrows the esophagus, resulting in causing problems with swallowing. People who have frequent heartburn, vomit excessively, have had surgery or radiation to the chest or take medications like aspirin, ibuprofen and potassium are at a higher risk of developing strictures.
Treatments for esophagitis depend on the underlying cause and the severity of tissue damage. If left untreated, esophagitis may change the structure and function of the esophagus.


Heartburn and Reflux (GERD)
Gastroesophageal reflux disease or “GERD” is a chronic digestive disease. When stomach acid or, occasionally, stomach content flows back into the esophagus (food pipe), the backwash irritates the lining of your esophagus and causes GERD. The contents come back up because the lower sphincter opens spontaneously or doesn’t close properly.
  This acid reflux may cause people to experience indigestion, a taste of food in the mouth, or a burning sensation in the chest, chest pain or pain in your throat. It can also cause dry cough, wheezing, trouble swallowing, hoarseness, or a sensation of a lump in your throat.
Notice: If you experience chest pain with other signs of shortness of breath, jaw or arm pain, seek immediate medical assistance; you may be experiencing a heart attack. 
Occasional acid reflux is a very common problem, but those who suffer from reflux more than twice a week may have gastroesophageal reflux disease (GERD), that can lead to serious health problems. 
What conditions can increase a risk of GERD?
Obesity, a bulging of the top of the stomach into the diaphragm (hiatal hernia), pregnancy, smoking, dry mouth, asthma, diabetes, a delayed stomach emptying, and connective tissue disorders.
What are my treatment options for GERD?
Treatment of GERD may include over the counter reflux medication, lifestyle changes that include low-acid diet, and prescription medication to block the production of acid.

If lifestyle changes and medications do not help treat your symptoms, your health care provider may suggest an Upper Endoscopy or other procedure to examine your esophagus for abnormalities.  In some cases, surgery may be warranted to treat certain conditions.


Helicobacter Pylori
H. pylori infection occurs when a type of bacteria called Helicobacter pylori (H. pylori) infects your stomach. This usually happens during childhood. The protective coating of the stomach and the first part of the small intestine is weakened by the bacteria, allowing digestive juices to irritate its sensitive lining.
Some carriers of H. pylori may have no symptoms. However, if a patient has an ulcer or gastritis, they may experience abdominal pain, indigestion, bloating, mild nausea, belching and regurgitation or feel very hungry one to three hours after eating.
Helicobacter Pylori (H. pylori) causes inflammation of the stomach, chronic gastritis, and ulcers in the stomach or small intestine. People with H. pylori infections may be more likely to develop cancer in the stomach, including mucosa-associated lymphoid tissue (MALT) lymphoma.  
Helicobacter pylori infection is treatable with antibiotics, proton pump inhibiters and histamine H2 blockers.  The bacteria should not return once it is eliminated from the body with the proper treatment.


Inflammatory Bowel Disease (IBD)
Inflammatory Bowel Disease (IBD) is a chronic disease.  It causes inflammation and swelling in the digestive tract. The irritation causes bleeding sores, known as ulcers, to form along the digestive tract. Symptoms include abdominal pain and cramping as well as bloody diarrhea. The two main types of IBD are ulcerative colitis and Crohn’s Disease. IBD can be painful and debilitating, and sometimes leads to life-threatening complications. 
It is not known what triggers IBD. Current thinking focuses on the immune system, heredity, age, ethnicity, family history, smoking, where you live, and the use of medicine in the past.  Stress can aggravate symptoms but like diet, they are not known to be the cause of IBD.


Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) is a common disorder.  It affects the large intestine and can cause bloating, abdominal cramping and a change in bowel habits. Some patients with IBS have constipation while others have diarrhea.  It is a chronic condition that you will need to manage lo IBS does not cause changes in the bowel tissue and does not increase your risk of colorectal cancer. Only a small number of people with irritable bowel syndrome have severe signs and symptoms.  
IBS is common and more frequently affects women than men. No one knows the exact cause of IBS.  Only a small number of people with irritable bowel syndrome have severe signs and symptoms.  Some people can control their symptoms by managing diet, lifestyle and stress. Others will need medication and counseling.


Colorectal (Colon Cancer)
Colorectal cancer is cancer that forms either in the actual colon or the rectum part of the intestine.  This cancer forms in the tissues of the colon, which is the largest part of the intestine.  Rectal cancer forms in the tissues of the rectum, the area before the anus. Either of these cancers is called colorectal cancer.
Each year about 150,000 people will be diagnosed with colon cancer, and 50,000 people will die from the disease, according to the American Cancer Society. In the United States, colon cancer is the second deadliest form of cancer. 
What are the risk factors in the prevention of colon cancer?

  • Being over age 50
  • Polyps, growths inside the colon and rectum that may become cancerous
  • A high-fat diet
  • Family or personal history of colon cancer or polyps
  • Ulcerative colitis, Crohn’s Disease or other inflammatory bowel diseases
  • Sedentary lifestyle
  • Diabetes
  • Obesity
  • Smoking
  • Alcohol
  • Growth hormone disorder
  • Radiation therapy for cancer

There are also warning signs and symptoms that can alert one to getting the proper screening.  Sometimes there are no symptoms or warning signs.  These symptoms may be caused by other benign diseases such as hemorrhoids, inflammation of the colon, or irritable bowel. If the following symptoms persist, a gastroenterologist should be consulted.

  • Abdominal pain or tenderness in the lower abdomen
  • Bloody stool, either bright red or very dark
  • Diarrhea, constipation or other changes in bowel functions
  • Intestinal obstruction
  • Narrower than normal stools
  • Unexplained anemia
  • Unexplained weight loss
  • Bloating, fullness or cramps
  • Vomiting

Where does colon cancer start?
A colon polyp is a growth of extra tissue in the lining of the bowel, colon or large intestine. While some can be cancerous, most are not. However, almost all colon cancer does begin as a polyp. Therefore, by removing polyps early the chances of it growing into colon cancer are eliminated. People with a higher risk for developing polyps are anyone over age 50, those who have had polyps previously or those who have a family history of polyps or colon cancer.
Polyps generally do not cause symptoms. If a patient does have symptoms, they can include: blood in their underwear or on toilet paper after a bowel movement, blood in stool, or constipation or diarrhea that has lasted more than a week.
Most important, however, is that not having a family history of colon cancer, or symptoms, does not protect you. In fact, 80 percent of those who are diagnosed with colon cancer have no family history or symptoms.
If polyps are removed through a colonoscopy and performed on the schedule recommended by your physician, the chances of getting colon cancer are dramatically reduced. If precancerous colon polyps are removed, the chance of the polyp turning into cancer is eliminated. If colon cancer is detected early well before symptoms occur it is more than 90 percent curable. Depending on an individual’s medical and family history, colonoscopies are typically recommended every one, three, five or 10 years.
What are my treatment options?
Treatment options for colon cancer depend on the following:

  • The stage of the cancer
  • Whether the cancer has recurred
  • The patient’s general health

The three primary treatment options available for colon cancer are surgery, chemotherapy and radiation. The surgical option, a partial colectomy, is the main treatment and includes removing the affected portion of the colon. How much of the colon is removed and whether it is done in conjunction with other treatments will depend on the location of the cancer, how deep it has penetrated the wall of the bowel and if it has spread to the lymph nodes or other parts of the body.
In surgical treatment, the part of the colon that contains the cancer, as well as portions of healthy colon on either side, will be removed to ensure no cancer is left behind. Nearby lymph nodes will be removed and tested at the same time. Usually the doctor is able to reconnect the healthy portions of the colon, but if that is not possible the patient will have a temporary or permanent colostomy bag. A colostomy bag is a device that is worn on the skin discreetly under the clothing and is attached to the remaining bowel end. Solid waste material travels into this bag which is then disposed of and replaced as needed. Sometimes, a colostomy is done temporarily to give the bowel time to heal; sometimes it becomes permanent if too much of the colon has to be removed.
If the cancer is small, early stage and localized in a polyp, it is possible it may all be removed during a colonoscopy.
If the cancer is very advanced or the patient’s health is extremely poor, surgery may be done simply to enhance comfort. This is an operation that will relieve a blockage of the colon to improve symptoms. This will not cure cancer but will relieve pain and bleeding.
Chemotherapy can be used after surgery to destroy any remaining cancer cells, and may be recommended by the doctor if the cancer has spread beyond the colon. Chemotherapy can be used in conjunction with radiation.
Radiation therapy uses powerful energy sources to kill any cancer cells that may remain after surgery or to shrink large tumors before an operation. This option is rarely used in early stages of colon cancer.

How can I prevent Colon Cancer?
Getting screened is the first step in preventing colon cancer. Regular colonoscopies should begin at age 50 for people with an average risk for developing colon cancer. For those with a family history of polyps or colon cancer, many physicians may recommend starting at age 40. Some recent studies indicate that African-Americans may need to start screening at age 45. Consult your physician if you are African-American.
Several screening options are available, including colonoscopy and flexible sigmoidoscopy. More frequent and earlier screening is recommended if you are at a high risk for colon cancer. Those with a high risk include:

  • Over age 50
  • Polyps, growths inside the colon and rectum that may become cancerous
  • A high-fat diet
  • Family or personal history of colon cancer
  • Ulcerative colitis, Crohn’s disease or other inflammatory bowel diseases
  • Sedentary lifestyle
  • Diabetes
  • Smoking
  • Alcohol
  • Growth hormone disorder
  • Radiation therapy for cancer

Lifestyle changes can also be made to reduce the risk of colon cancer. Take the following steps:

  • Add fruits, whole grains and vegetables to your diet
  • Limit saturated fat
  • Limit alcohol
  • Eat a varied diet
  • Stop smoking
  • Stay active and maintain a healthy body weight
  • Add a regular colonoscopy, as prescribed by your physician, to your health-care practices
  • Risk Factors

Ulcerative Colitis
Ulcerative colitis is an inflammatory bowel disease that causes inflammation and sores, called ulcers, in the lining of the large intestine that includes the rectum and colon. It usually occurs only through continuous stretches of the colon, unlike Crohn’s disease, which occurs anywhere in the digestive tract. The colon lining that is inflamed is injured and produce ulcers.  These ulcers may bleed and create pus. This inflammation also causes the colon to empty frequently, causing diarrhea. 
Ulcerative colitis can be debilitating and sometimes can lead to life-threatening complications. Because ulcerative colitis is a chronic condition, symptoms usually develop over time, rather than suddenly. 
Colitis can be difficult to diagnose because symptoms such as abdominal pain and diarrhea are so similar to other intestinal disorders. About half the people diagnosed with ulcerative colitis have mild symptoms. Others may suffer frequent fevers, bloody diarrhea, nausea and severe abdominal cramps. It may also cause problems such as arthritis, inflammation of the eye, liver disease, and osteoporosis. It is not known why these problems occur outside the colon, but scientists think it may be the result of inflammation triggered by the immune system. Some of these problems go away when the colitis is treated. 
There's no known cure for ulcerative colitis, but therapies are available that may dramatically reduce the signs and symptoms of ulcerative colitis and even bring about a long-term remission.