University of Pennsylvania Health System

Penn Gastroenterology Q&As

Monday, February 28, 2011

What Should I Do To Alleviate Irregular Bowel Movements?

Question:
I have been having irregular bowel movements for the past few weeks along with some sporadic abdominal cramps and frequent, smelly gas. When I do have a bowel movement, it is soft, sticky and hard to eliminate. I haven't changed my diet and I am not taking any medication.

I was diagnosed with GERD four years ago but stopped taking Nexium® five months ago. I am trying to manage it by watching what I eat and using antacids. I've also gained about 10-12 pounds in the past three months. Help!

Answer:
Trouble with irregular bowel movements can usually be easily remedied by increasing the amount of fiber you consume in your diet, drinking more fluids, and increasing your activity level. Because of your history, I suggest you discuss your case with a Penn gastroenterologist.

Please call 800-789-PENN (7366) or request an appointment online.

What Are The Treatment Options For GERD?

Question:
I am a 27 year-old man having a burning sensation in my upper abdomen and throat for several months. It is becoming increasingly difficult to catch my breath and I feel as if there is a lump in the lower part of my throat. I was being treated for gastroesophageal reflux disease (GERD) with 40 mg of Protonix® twice a day which eliminated most symptoms prior to the start of the burning sensation.

An endoscopy revealed gastritis and esophagitis. A small bowel series revealed a slightly prominent small bowel loop in the upper left quadrant and feces throughout the colon. What treatments are available?

Answer:
Gastroesophageal reflux disease (GERD) occurs when a muscle at the end of the esophagus does not close properly. This allows stomach contents to leak back – or reflux – into the esophagus and irritate it. The long-term effects of GERD can lead to Barrett's esophagus, a disorder in which the lining of the esophagus becomes damaged.

Normally, a combination of medications is used to treat GERD, and it is possible that other medications may yield better results. Anti-reflux operations may help patients who have persistent symptoms despite medical treatment. There are also new therapies that can be performed through an endoscope.

Gary Falk, MD is a Penn gastroenterologist who would be happy to consult with you and recommend the best course of treatment for controlling your symptoms.

To make an appointment, please call 800-789-PENN (7366) or request an appointment online.

Would You Recommend Allergy Testing For Patients With Eosinophilic Esophagitis?

Question:
I have been diagnosed with eosinophilic esophagitis (EE) and had 93 eosinophils with high power magnification. At my doctor's recommendation, I ordered an allergy kit online and had my local lab do the blood draw. I was tested for several hundred substances. My current GI doctor does not want to handle my case and referred me elsewhere. No one else seems interested in these results and I wondered what your thoughts are on this comprehensive panel?

Answer:
Eosinophilic esophagitis is an allergic inflammatory response that results in a large number of eosinophils and inflammation in the esophagus, which can lead to more serious problems over time. Once a diagnosis of eosinophilic esophagitis is made, it is standard procedure to perform allergy testing like your doctor recommended. Dietary restrictions based on the results of the testing become a major part of treatment for eosinophilic esophagitis along with topical corticosteroids. Many people respond well to dietary restrictions, so it is important to follow up with a gastroenterologist who can recommend a treatment plan using your results.

Gary Falk, MD is a Penn gastroenterologist who treats eosinophilic esophagitis. To make an appointment, please call 800-789-PENN (7366) or request an appointment online.

What Are The Treatment Options For Severe Abdominal Pain?

Question:

I have experienced right-side upper-abdominal burning and pain on and off for the past 14 months. An ultrasound and endoscopy were performed with no findings, and a DISIDA scan (EF of 35 percent). My gastroenterologist said none of the tests had any significant results or answers. I am again in daily pain with burning and tenderness in the area. Please let me know how I can find some answers and relief.



Answer:

Gastroesophageal reflux disease (GERD) can cause a burning sensation as well as pain in the upper abdomen. GERD is a condition in which acid from your stomach backs up into your esophagus and irritates the lining. Try taking an over-the-counter acid reflux medication like Prevacid® to see if this helps decrease the pain and burning. You can also try adjusting your diet by eating less fried food, chocolate, alcohol, caffeine, garlic and a variety of other things. If your symptoms do not improve, you may want to see another doctor for a second opinion.



Gary Falk, MD, is a renowned gastroenterologist in Barrett's esophagus and medical and surgical therapy joining Penn in January 2010 who can evaluate your case and recommend a course of treatment. To make an appointment, please call 800-789-PENN (7366) or request an appointment online.

Friday, February 25, 2011

How Do I Shrink Or Remove Gallstones?

Question:
I have gallstones and my doctor recommended surgery. I don't have pain often, maybe once a month or every 8-10 weeks. It's usually a sharp pain and only lasts about 5-10 minutes. I would like to try alternatives other than surgery to either shrink the stones or remove them. Any suggestions?

Answer:
Gallstones are hard, pebble-like deposits that form inside the gallbladder. Gallstones may be as small as a grain of sand or as large as a golf ball. Pain experienced from gallstones varies greatly from person to person, and treatment is important regardless of pain experienced in order to prevent further complications such as gallbladder cancer. Surgical removal of gallstones, like your physician suggested, is a common treatment. Medication is the most common alternative treatment option. Chenodeoxycholic acids (CDCA) or ursodeoxycholic acid (UDCA) can be used to dissolve gallstones, but results are often not seen for up to two years. Gallstones can return after the regimen of medication stops.

I recommend consulting with a Penn gastroenterologist to determine the best course of treatment for your condition. George S. Ahtaridis, MD, provides general consultations and would be happy to meet with you. To make an appointment, please call 800-789-PENN (7366) or request an appointment online.