Services and Treatments at Advanced Digestive Care

Our physicians and practitoners treat digestive problems, from upset stomachs to colon-rectal cancer. When your digestive tract is irritated, usually due to infections, food allergies, improper absorption of food or another problem, it may cause nausea and vomiting, bloating, constipation or diarrhea. If you have any of these symptoms, our experts can help. We specialize in diagnosing and treating a wide variety of digestive disorders including swallowing problems, abdominal pain, gastrointestinal bleeding, ulcer disease, constipation, diarrhea, irritable bowel syndrome, gall stone disease, liver problems, Crohn’s disease, ulcerative colitis, colon polyps and hemorrhoids to name a few.

Gastrointestinal Evaluation

A typical gastrointestinal evaluation usually involves an interview with a physical examination, and may include specialized studies such as X-rays or other imaging studies. Endoscopic procedures involve the passage of flexible lighted instruments to visualize the inside of the digestive tract. Endoscopy allows the physician to evaluate for precancerous lesions, inflammation or sources of bleeding. During endoscopy a variety of diagnostic and therapeutic interventions can be performed including biopsies, control of bleeding, removal of precancerous lesions (e.g. polyps), injection of medications and stretching or dilation of narrowing in the GI tract.

Colon Cancer Screening

These tests are designed to detect and remove precancerous polyps and identify early cancers in order to decrease mortality from colorectal cancer. Colonoscopy with intravenous sedation is safe and comfortable for healthy individuals and prevents cancer.

Barrett’s Esophagus Ablation

A positive diagnosis generally requires observing specific endoscopic and microscopic changes. The normal squamous epithelium lining of the esophagus is replaced by metaplastic columnar epithelium. Columnar epithelium refers to a cell type that is typically found in the small intestine. The medical significance of Barrett’s esophagus is its strong association with esophageal adenocarcinoma, a particularly lethal cancer. State of the art techniques using Argon or Radio Frequency are employed by our physicians to ablate or burn Barrett’s Epithelium thereby reducing the risk of developing Cancer of Esophagus.

Swallowing Disorders

If you have a disorder of the pharynx (throat) or the Esophagus (food pipe), you may have difficulty swallowing and may also have pain while swallowing. Some people may be completely unable to swallow or may have trouble swallowing liquids, foods or saliva. This makes it hard to eat. Often, it can be difficult to take in enough calories and fluids to nourish your body. Anyone can have a swallowing disorder, but it is more likely in the elderly. Swallowing problems often happen because of conditions, including:

• Stricture or narrowing of esophagus, including those caused by gastroesophageal reflux disease (GERD).

• Motility Disorder or in-coordination of the muscles of the Esophagus.

• Systemic diseases such as Scleroderma, Diabetes or Rheumatoid arthritis.

• Nervous system disorders, such as Parkinson's disease, cerebral palsy and Stroke

• Head or spinal cord injury

• Cancer of the head, neck, or esophagus

Medicines can help some people, while others may need endoscopic treatment such as dilation or injection of BOTOX. Swallowing treatment with a speech-and swallowing pathologist can help. You may find it helpful to change your diet or gain by swallowing rehabilitation exercises or treatments. In very serious cases, people may need feeding tubes to maintain nutrition and avoid choking on food.

ERCP

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used to identify and remove stones, tumors, or bypass the narrowing in the bile ducts. The procedure is done through an endoscope. Abnormal results may indicate stones or narrowing of the ducts, presence of tumors, cancer, and cysts (abnormal cavity filled with fluid or semi-solid substances).

Liver, Pancreas & Biliary Tract Disease

Cancers of the liver, pancreas, gallbladder, bile ducts and other digestive organs are difficult diseases that require complex treatment and care plans. The Liver, Pancreas and Bile Duct disease Program at Advanced Digestive Care includes our full team of expert care givers who concentrate on these challenging cancers. We work very closely with pathologists, interventional radiologists, surgeons and your oncologists. Together, we offer every effective treatment option possible.

Esophageal Motility Study or Manometry

This is a specialized test to study the coordination or lack of activity of the esophageal muscle. It checks the pressure of the waves generated by the muscles in your food pipe. It also looks for disease that result in the sphincter muscles in esophagus relaxing too little (Achalasia) or being too weak (scleroderma). It can also diagnoses spastic conditions of the esophagus that sometimes result in chest pain and mimic heart attacks.

24 hr. PH Studies

This test can accurately measure whether or not gastroesophageal reflux disease (GERD) is present. Regarding the pH study, it identifies patients who have significant acid reflux; it helps to correlate the symptoms with acid reflux as well as the occurrence of chest pain and if the pain is related to reflux or not. It can also help to quantify if medicines being used are adequate or not. Lastly, it can also identify patients who need to undergo surgery for treatment of their reflux.

An important interrelationship exists between the two tests in that esophageal manometry can be extremely helpful in determining the correct placement for the probe that measures esophageal pH. When you need a 48-hour pH study, we know where to put the probe inside the esophagus and exactly what to look for.

Ulcer Disease

A peptic ulcer, also known as PUD or peptic ulcer disease, is an ulcer (defined as mucosal erosions equal to or larger than 0.5 cm) of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. A large proportion of the ulcers are caused by the H. pylori bacteria. Endoscopy and biopsy can thus help in not only identifying the ulcer but also in eradicating it and avoiding future recurrence.

Hemorrhoids & Anorectal conditions

A number of factors may lead to the formations of hemorrhoids including irregular bowel habits (constipation or diarrhea), exercise, gravity, nutrition (low-fiber diet), increased intra-abdominal pressure (prolonged straining), pregnancy, genetics, absence of valves within the hemorrhoidal veins, and aging. Other factors that can increase the rectal vein pressure resulting in hemorrhoids include obesity, and sitting for long periods of time. Simple endoscopic treatment with banding can cure these and avoid chronic blood loss resulting in Anemia.

Remicade and other Infusion Services

For the benefit of patients with Crohn’s Disease and Ulcerative Colitis we are able to provide Remicade (Infliximab) infusion at both office locations in a comfortable, friendly and safe environment.