University of Pennsylvania Health System

Penn Gastroenterology Q&As

Wednesday, February 29, 2012

How Long Will I Feel Pain After A Gallstone Attack?

Question:
I recently suffered a gallstone attack. My symptoms were intense pain under my right rib cage, diarrhea and chills. My ultrasound indicated gallstones were not blocking my ducts, but they were traveling and causing intense pain.

My blood work showed an elevated white blood cell count. My gallbladder is not diseased or inflamed. My pain has dramatically improved; however, I am still tender and sore. It has been three days since my attack and I was wondering when I will feel better?

Answer:
After a gallstone attack it is normal to be sore for a few days, but if the soreness lasts for more than a week it is probably wise to see a doctor again. David A. Ingis, MD, FACG, is a Penn gastroenterologist who can evaluate your condition.

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

Tuesday, February 28, 2012

Should High Levels Of B12 Be A Cause For Concern?

Question:
I recently had my yearly complete blood count that showed a level of 195 for B12. All other readings were normal. My doctor sent me to a stomach specialist and I am still awaiting test results. Other than some irritable bowel symptoms when I was young, I have had no other stomach problems. Is this something to worry about? People often mention stomach cancer when I mention low B12.

Answer:
To ease your mind from the start, a low B12 level is not typically an indicator of stomach cancer. Some possible causes are the following:

Further testing is necessary to narrow down the cause of your B12 deficiency. David A. Ingis, MD, FACG, is a Penn gastroenterologist who can evaluate your condition.

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

Monday, February 27, 2012

Should I Worry About Having A Lemon-Sized Hiatal Hernia?

Question:
I was recently told I had a hiatal hernia the size of a lemon. I was told not to be concerned until it gets to be the size of a grapefruit. Is this true?

Answer:
A hiatal hernia occurs when part of your stomach presses upwards into your diaphragm — a sheet of muscle across the bottom of the rib cage through which the esophagus passes. When you swallow, food moves through the esophagus into the stomach for digestion.

The larger the hiatal hernia is, the greater the chance that the hernia will impede food and acid from traveling through the esophagus. This can cause reflux and chest pain. It may be helpful to get a second opinion in regards to whether your hernia requires immediate treatment or not.

If you would like to schedule an appointment with a Penn gastroenterologist, Sanford L. Herold, MD, can consult with you and recommend next steps.

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

Thursday, February 23, 2012

Does Anyone At Penn Medicine Specialize In Treating Parasitic Infections?

Question:
A year ago, I went to southeast Asia. I believe that I have a parasitic infection as a result of that trip. I have various symptoms, but no one knows what to look for or how to find it. Does anyone at Penn specialize in finding and treating parasites?

Answer:
David Ingis, MD is a Penn gastroenterologist who can evaluate your symptoms and recommend a treatment plan.

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

Wednesday, February 22, 2012

What Can I Do To Alleviate Loud Noises During Digestion?

Question:
I have growling and gurgling in my upper and lower abdomen that does not correlate with a specific action or food. I was diagnosed with celiac disease in 2008, but it turned out to be a misdiagnosis. I eat healthy and take care of myself, but I am never completely free of this problem.

Answer:
Stomach noises like gurgling and growling are typically signs of normal digestion. They can occur before, during or after meals. When the body is hungry, the stomach and intestines begin to contract and release acids and digestive fluids into the digestive system, which causes the noises. The thought, sight or smell of food is enough to trigger the digestive system to act. Sometimes excessive stomach noises can be a sign of irritable bowel syndrome (IBS), but IBS is usually accompanied by other symptoms like bloating, cramping or diarrhea.

To schedule an appointment with Dr. David Ingis, MD, a Penn gastroenterologist who can determine the cause of your symptoms, please call 800-789-PENN (7366) or you can also request an appointment online.

Tuesday, February 21, 2012

What Treatment Options Exist For Divertiulitis?

Question:
My mom is concerned about the following symptoms: lower back and stomach pain, gas, constipation, mucus and blood in her stool. She has diverticulitis, but the pain and symptoms are not going away with medication.

Answer:
Diverticulitis occurs when diverticula – small, bulging pouches in the digestive tract that are common in adults over age 40 – become infected or inflamed. Mild diverticulitis can be treated with diet changes, rest and antibiotics. More severe cases may require surgery to either remove the diseased part of the colon or to drain the abscess formed by the infection. Since the pain has sustained over time, I recommend seeing a gastroenterologist.

To schedule an appointment with David Ingis, MD, a Penn gastroenterologist who can advise you, please call 800-789-PENN (7366) or request an appointment online.

What Does Nausea And Irregular Bowel Movements Mean For A Patient With Acid Reflux?

Question:
I have acid reflux and woke up this morning with nausea and the feeling of moving my bowels, but I could not go. Should I be concerned?
Answer:
Acid reflux or gastroesophageal reflux disease (GERD) happens when the stomach's contents leak back – or reflux – into the esophagus causing irritation it. It can includea burning in the chest or throat, called heartburn. Constipation, having three or fewer bowel movements a week, and nausea are common symptoms and in most cases, last a short time. If the nausea persists or if your bowel habits change significantly, check with your doctor.

To set up a consultation with a Penn gastroenterologist, please call 800-789-PENN (7366) or request an appointment online.

Monday, February 20, 2012

Need A Diagnosis For Constant Vomiting And Diarrhea?

Question:
I have been having pain on my right side for about a month that is especially painful at night. In the morning I vomit bile and have diarrhea. I have gone to my primary physician and had blood work done, which comes back normal. I had a laparoscopy done, but now they are sending me to get an MRI. I was given a prescription for Nexium®, but I've had no improvement. The doctors seem baffled. Do you have any ideas?

Answer:
Right-sided abdominal pain, vomiting and diarrhea can independently indicate a variety of conditions, such as gallstones or gastroesophageal reflux disease (GERD), among others.

To schedule an appointment with Dr. David Ingis, MD, a Penn gastroenterologist who can evaluate your symptoms, please call 800-789-PENN (7366) or request an appointment online.

What Are The Symptoms Of GERD?

Question:
I have had frequent heartburn and gas for years. A couple times a year, I have extreme discomfort in my chest. I feel it from the top of my throat to the bottom of my sternum. It feels like a balloon is inflated in my chest and sometimes I get a bit of foam in my mouth. It doesn't hurt when I eat, drink or cough. It seems to subside when I finally get to sleep - but not long after waking up, it comes back. I took Prilosec OTC® with no relief, but Prevacid® does help. I'm not so sure it's GERD, as I don't have any burning. Do you think this could be GERD or something else?

Answer:
If you have heartburn more than twice a week, you may have GERD (gastroesophageal reflux disease). Prevacid® (lansoprazole) is a medication used to treat ulcers and GERD. It is best to be examined by a gastroenterologist. The long-term effects of GERD can cause Barrett's esophagus, esophageal ulcers or strictures. Whether or not it is GERD, a Penn GI physician can diagnose the problem.

To schedule an appointment with a Penn gastroenterologist who can evaluate your condition and recommend the best course of treatment, please call 800-789-PENN (7366) or you can also request an appointment online.

Friday, February 17, 2012

Need A Diagnosis For Constant Stomach Pain.

Question:
I am 38 years old. Three months ago I started having severe stomach pains on my right side. I had a colonoscopy during which my doctor found seven polyps, but he said everything looked good. I was concerned about IBS, but he said I didn't have it. I ruled out gastroenterology problems until I had a laparoscopy done two weeks ago and scar tissue was found on my small and large intestine.

 
I was told by this doctor he didn't know why I have scarring since I've never had GI surgery. I am still in a lot of pain on my right side, but my doctor wants me to give it time to heal and see if the pain goes away. What could this be? And is it normal to still have this much pain?

 
Answer:
There are a number of different problems that can cause pain on your right side, but if you are experiencing severe abdominal pain you should seek prompt medical attention. Some of the pain you're having now may resolve itself once your abdomen is completely healed from the laparoscopy.

 
Keeping track of your symptoms will help your doctor form a diagnosis:
  • When do you have pain?
  • Exactly where is the pain is located?
  • What type of pain (such as aching, stabbing, throbbing or cramping)?
  • How long does the pain lasts?
  • What triggers the pain? What helps relieve the pain?
  • How does the pain impact your life (such as limiting activities or missing work)?

Kashyap Panganamamula, MD is a Penn gastroenterologist who can evaluate your condition and recommend the best treatment.

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

Thursday, February 16, 2012

Are There Physicians at Penn Medicine who Specialize in Distached Intestines?

Question:
I have been diagnosed with a floater. My organs are not attached to my abdominal wall. So my intestines float and get twisted up. I would like to know what specialist or who is experienced in this situation to seek medical care.

Answer:
I recommend you schedule an appointment with a Penn gastroenterologist who can evaluate your condition.

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

Monday, February 13, 2012

Does Penn Medicine Have A Back-Up Scope In Case One Malfunctions?

Question:
Does your facility have a back-up scope in case the first one malfunctions?

Answer:
Yes, all of our facilities have multiple endoscopes on hand.

Friday, February 10, 2012

What Can I Do To Alleviate Flatulence?

Question:
For the past week, every afternoon for about two or three hours I get bad gas. Also, my intestines are very noisy. Then it goes away and starts up again the next afternoon.

 
Answer:
Flatulence — commonly known as gas — accompanied by noisy intestines can indicate a number of causes. These include swallowing air while eating, lactose intolerance, irritable bowel syndrome, malabsorption or simply eating foods that are difficult for your body to digest.

 
Here are some simple ways to improve your problem by adjusting your daily habits:
  • Eat more slowly
  • Chew your food thoroughly
  • Avoid chewing gum
  • Relax while you eat
  • Avoid beans, cabbage, and carbonated beverages
  • Walk for 10 to 15 minutes after eating
  • Drink peppermint or chamomile tea after a meal
  • Try Beano® if you eat a high-fiber diet
If these tips do not improve your symptoms, it may mean there is an underlying problem.

 

To schedule an appointment with a Penn gastroenterologist, please call 800-789-PENN (7366) or request an appointment online.

Wednesday, February 8, 2012

Need A Diagnosis For Blood In Stool

Question:
I made a dish that included pimiento in its ingredients. I had that for dinner along with homemade cheesecake with strawberries. I went to use the bathroom and noticed there were some red objects in my stool. I've had some rectal bleeding before. I do know that I have external hemorrhoids — which I've been told is the cause. I have become increasingly concerned about the possibility of colorectal cancer.

 
I am a 26 year-old healthy female. I examined the red objects and thought them to be pimiento or possibly strawberries. Four days later I used the bathroom and once again saw this red "thing." It seemed to be the same as what I saw before. Could it be blood? Is it normal to see things you've eaten days ago in your stool?

 
Answer:
There are many possible reasons for blood appearing in stool. Some are harmless and temporary, while others may signal a more serious condition. Anytime you find blood in your stool, it is best to see a healthcare provider. In addition to blood in the stool, hemorrhoids can cause:
  • Anal itching
  • Anal ache or pain, especially while sitting
  • Pain during bowel movements
  • One or more hard, tender lumps near the anus
A Penn gastroenterologist can evaluate you and determine if your symptoms are a result of hemorrhoids or indicate a more serious problem.

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

Monday, February 6, 2012

Can Menstrual Cycles Exacerbate IBS?

Question:
I was diagnosed with IBS-C spasmodic colon last year. Each month following my menstrual cycle, I have extreme pain, spasms and burning sensations in my abdomen for the next two to three weeks. I take over 800 mg of ibuprofen to cope. I am pain free for about a week and then the cycle starts all over. I'm 44 years old and I have two small fibroid cysts on my right ovary. Could my menstrual cycle be causing my IBS to flare up and cause me this additional pain for weeks at a time? What can I do?

Answer:
IBS-C or irritable bowel syndrome with constipation is a common intestinal disorder. The typically smooth and regular contractions of muscles in the intestines are replaced by irregular and sometimes painful contractions. Many women report that their symptoms worsen around and during the time of their menstrual period. It is believed to be the result of heightened hormone activity, but the exact reason is unknown. Geoffrey Spencer, MD, is a Penn gastroenterologist who specializes in irritable bowel syndrome.

To schedule an appointment with Dr. Spencer, please call 800-789-PENN (7366) or request an appointment online.

Thursday, February 2, 2012

Is There A Permanent Feeding Tube To The Large Bowel?

Question:
Is there a permanent feeding tube to the large bowel for persons not able to have the tube in their stomach?

Answer:
Yes, a feeding tube can also insert into the small bowel. Gregory Ginsberg, MD is a national expert on this procedure.

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

Wednesday, February 1, 2012

Should High Levels Of (AST) And (GSP) Be A Cause For Concern?

Question:
I am an asymptomatic 40 year-old male. However, a recent physical blood test showed an aspartate aminotransferase (AST) in the mid 80s and glycosylated serum protein (GSP) near 270. All other numbers were within normal ranges. (ALP near 60, ALT near 30, CGT near 15, TBIL 0.5mg/dL, total protein 7.5, albumin just under 5.0 and ALB/GLO of 1.8) Are these results worthy of seeing a gastroenterologist, and what, if any, concerns could there be?

Answer:
Elevated aspartate aminotransferase (AST) and galactose single point (GSP) levels involve enzymes of the liver and can sometimes be an indication of a more serious problem. There are too many potential scenarios to list here, but I recommend getting further testing done. Karen Krok, MD, is a Penn hepatologist – a doctor who specializes in liver disease. She sees patients at the Perelman Center for Advanced Medicine at the Hospital of the University of Pennsylvania.

You can schedule an appointment by calling 800-789-PENN (7366) or you can also request an appointment online.