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Conditions Treated 

We provide personalized, comprehensive and compassionate care for patients with all types of digestive diseases and conditions.

If you or a loved one is experiencing recurrent indigestion, heartburn, ulcers, the discomfort and or pain of irritable bowel syndrome, or other unwelcome gastrointestinal symptoms, Baylor has the expertise and technology to address the problem.

Among the digestive diseases treated at Baylor are inflammatory bowel disease, ulcer disease, acute and chronic liver disease including hepatitis C and cirrhosis, gastroesophageal reflux disease (GERD), chronic diarrhea and irritable bowel syndrome.

Barrett's EsophagusEsófago de Barrett

Barrett's Esophagus

What is Barrett's esophagus?

Barrett's esophagus is when the normal cells that line your food pipe (esophagus) turn into cells not usually found in your esophagus. The new cells take over because the lining of the esophagus has been damaged. The new, abnormal cells are called specialized columnar cells.

It is very rare that someone with this disease will get cancer of the esophagus. But having Barrett's esophagus may raise your risk of having esophageal cancer.

What causes Barrett's esophagus?

You may get Barrett's esophagus if you have frequent heartburn (gastroesophageal reflux disease or GERD, also called acid reflux disease) that lasts for many years. You may also get it if you have swelling of the esophagus (esophagitis). These health problems hurt the lining of your esophagus. This can cause the abnormal cells to take over.

If you have long-term (chronic) heartburn, you are at risk for Barrett's esophagus. You should talk with your healthcare provider.

Who is at risk for Barrett’s esophagus?

You are at greater risk of getting Barrett’s esophagus if you are:

  • Over 50 years old
  • Male
  • White
  • Obese

What are the symptoms of Barrett's esophagus?

Each person’s symptoms may vary. Some people with Barrett's esophagus have no symptoms. Others have symptoms caused by GERD including:

  • Heartburn
  • Regurgitation
  • Trouble swallowing
In some cases you may not have any symptoms. Or the signs of Barrett's esophagus may look like other health problems. Always see your healthcare provider to be sure.

How is Barrett's esophagus diagnosed?

Your healthcare provider will give you a physical exam. He or she will also do a test called an endoscopy. A long, thin tube (endoscope) is put in your mouth and gently pushed down into your esophagus.

The endoscope has a small camera and tools. Your healthcare provider uses the camera to see the lining of your esophagus. He or she will use the tools to remove a small tissue sample (a biopsy). This tissue sample will be sent to a lab. It will be checked to see if your normal cells have been taken over by abnormal cells.

If you are having trouble swallowing, your healthcare provider may also do an upper GI (gastrointestinal) barium study. This test may show if you have a narrowing (stricture) of the esophagus. This narrowing happens when the damaged lining of the esophagus gets thick and hard.

How is Barrett’s esophagus treated?

Your healthcare provider will suggest a care plan for you based on:

  • Your age, overall health, and past health
  • How serious your case is
  • How well you handle certain medicines, treatments, or therapies
  • If your condition is expected to get worse
  • What you would like to do

Treatment for Barrett's esophagus centers on acid blockers that will also treat GERD symptoms.

Barrett's esophagus is usually permanent, but in some people, it may go away.

Your healthcare provider will make a care plan for you. The plan will try to stop any more damage by keeping acid reflux out of your esophagus. Your care plan may include:

  • Medicine. You may be given medicine to reduce how much acid is made in your stomach.
  • Surgery. You may need a type of surgery called fundoplication. This will take out damaged tissue or part of the esophagus. The part of the esophagus that is left is usually joined to the stomach.
  • Dilation treatment. You may need this if you have a narrowing of the esophagus. During dilation, a tool gently stretches (dilates) the narrowed part of the esophagus. It also widens the opening of the esophagus.

Can Barrett’s esophagus be prevented?

You can help lower your risk of getting Barrett’s esophagus by:

  • Eating lots of fruits and vegetables
  • Losing weight and staying at a healthy weight

Living with Barrett’s esophagus

If you have Barrett’s esophagus, your healthcare provider will give you follow-up instructions. You may not need surgery or another treatment right away. But you should have GI studies done from time to time. These will help to see if your case has gotten worse and if you need surgery or another treatment.

When should I call my healthcare provider?

Call your healthcare provider right away if any of your early symptoms come back or get worse after you’ve had medicine, surgery, or other treatments.

Key points

  • Barrett's esophagus is when the normal cells that line your food pipe (esophagus) turn into cells not usually found in your esophagus.
  • This happens because the lining of your esophagus has been damaged.
  • You may get this if you have long-term gastroesophageal reflux disease (GERD).
  • You are at greater risk if you are white, male, obese, and over 50 years old.
  • Having Barrett's esophagus may raise your risk of getting esophageal cancer.
  • There is no cure for Barrett's esophagus.
  • Your care plan will try to stop any more damage by keeping acid reflux out of your esophagus.

Next steps

Tips to help you get the most from a visit to your healthcare provider:
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Barrett’s Esophagus

Barrett's esophagus occurs when the lining of the esophagus is damaged by stomach acid that leaks backward.

Learn More

Colorectal Cancer

Colon Cancer

Whether you want to learn about colon cancer symptoms, prevention or treatment, Baylor is here for you. Our system of hospitals and outpatient centers offers the experience, expertise and technology you can trust.

What is colon cancer?

Colon cancer is malignant cells found in the colon or rectum. The colon and the rectum are parts of the large intestine, which is part of the digestive system. Because colon cancer and rectal cancers have many features in common, they are sometimes referred to together as colorn cancer. Cancerous tumors found in the colon or rectum also may spread to other parts of the body.

Excluding skin cancers, colon cancer is the third most common cancer in both men and women. The American Cancer Society estimates that about 140,000 colon cancer cases and about 50,000 deaths from colon cancer occur each year. The number of deaths due to colon cancer has decreased, which is attributed to increased screening and polyp removal and to improvements in cancer treatment. 

What are the types of cancer in the colon and rectum?

A type of cancer called adenocarcinoma accounts for more than 95 percent of cancers in the colon and rectum and is usually what is meant by the term colorectal cancer. It is the type we focus on in this section. There are other types of cancer that can be found in the colon and rectum, but they are rare.

Here is an overview of the types of cancer in the colon and rectum:

  • Adenocarcinoma. Adenocarcinomas are tumors that start in the lining of internal organs. Adeno means gland. These tumors start in cells with glandular properties, or cells that secrete. They can form in many different organs, such as the lung or the breast. In colorectal cancer, early tumors start as small adenomatous polyps that continue to grow and can then turn into malignant tumors. The vast majority of colorectal cancers are adenocarcinomas.

  • Gastrointestinal stromal tumors (GIST). These are tumors that start in specialized cells in the wall of the digestive tract called the interstitial cells of Cajal. These tumors may be found anywhere in the digestive tract, although they rarely appear in the colon. They can be benign (noncancerous) at first, but many do turn into cancer. When this happens, they are called sarcomas. Surgery is the usual treatment if the tumor has not spread.

  • Lymphoma. A lymphoma is a cancer that typically starts in a lymph node, which is part of the immune system. However, it can also start in the colon, rectum, or other organs.

  • Carcinoids. Carcinoids are tumors that start in special hormone-producing cells in the intestine. Often they cause no symptoms at first. Surgery is the usual treatment.

  • Sarcoma. Tumors that start in blood vessels, muscle, or connective tissue in the the colon and rectum wall. 

What are the symptoms of colon cancer?

The following are the most common colon cancer symptoms. However, each individual may experience symptoms differently.

People who have any of the following symptoms should check with their doctors, especially if they are over 50 years old or have a personal or family history of the disease:

  • A change in bowel habits such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days

  • Rectal bleeding, dark stools, or blood in the stool

  • Cramping or gnawing stomach pain

  • Decreased appetite

  • Vomiting

  • Unintended weight loss

  • Weakness and fatigue

  • A feeling that you need to have a bowel movement that is not relieved by doing so 

The symptoms of colon cancer may resemble other conditions, such as infections, hemorrhoids, and inflammatory bowel disease. It is also possible to have colon cancer and not have any symptoms. Always consult your health care provider for a diagnosis.

If you have been diagnosed with colon cancer, search online to find a physician, or call 1.800.4BAYLOR for cancer treatment in Dallas-Fort Worth.

What are the risk factors for colorectal cancer?

Risk factors may include:

  • Age. Most people who have colon cancer are over age 50; however, it can occur at any age.

  • Race and ethnicity. African-Americans have the highest risk for colon cancer of all racial groups in the U.S. Jews of Eastern European descent (Ashkenazi Jews) have the highest colon cancer risk of any ethnic group in the world. 

  • Diet. Colon cancer is often associated with a diet high in red and processed meats.

  • Personal history of colorectal polyps. Benign growths on the wall of the colon or rectum are common in people over age 50, and may lead to colon cancer.

  • Personal history of colon cancer. People who have had colon cancer have an increased risk for another colon cancer.

  • Family history. People with a strong family history of colon cancer or polyps in a first-degree relative (especially in a parent or sibling before the age of 45 or in two first-degree relatives of any age) have an increased risk for colon cancer.

  • Ulcerative colitis or Crohn's disease. People who have an inflamed lining of the colon have an increased risk for colorectal cancer.

  • Inherited syndromes, such as familial adenomatous polyposis or hereditary nonpolyposis colon cancer, also known as Lynch syndrome 

  • Obesity

  • Physical inactivity

  • Heavy alcohol consumption

  • Type 2 diabetes

  • Smoking

What causes colon cancer?

The exact cause of most colon cancer is unknown, but the known risk factors listed above are the most likely causes. A small percentage of colon cancers are caused by inherited gene mutations. People with a family history of colorectal cancer may wish to consider genetic testing. The American Cancer Society suggests that anyone undergoing such tests have access to a doctor or geneticist qualified to explain the significance of these test results.

Prevention of colon cancer

Although the exact cause of colon cancer is not known, it may be possible to lower your risk of colon cancer with the following:

  • Diet, weight, and exercise. It is important to manage the risk factors you can control, such as diet, body weight, and exercise. Eating more fruits, vegetables, and whole-grain foods, and limiting red and processed meats, plus exercising appropriately, even small amounts on a regular basis, can be helpful. Avoiding excess alcohol intake may also lower your risk. 

  • Drug therapy. Some studies have shown that low doses of nonsteroidal anti-inflammatory drugs, such as aspirin, and hormone replacement therapy for postmenopausal women, may reduce the risk of colon cancer. But these drugs also have their own potentially serious risks, so it is important to discuss this with your health care provider.

  • Screenings. Perhaps most important to the prevention of colon cancer is having screening tests at appropriate ages. Screening may find some colorectal polyps that can be removed before they have a chance to become cancerous. Because some colorectal cancers cannot be prevented, finding them early is the best way to improve the chance of successful treatment, and reduce the number of deaths caused by colon cancer.

The following screening guidelines can lower the number of cases of the disease, and can also lower the death rate from colorectal cancer by detecting the disease at an earlier, more treatable stage.

Methods of screening for colon cancer

Screening methods for colon cancer, for people who do not have any symptoms or strong risk factors, include the following:

  • Fecal occult blood test (FOBT). Checks for hidden (occult) blood in the stool. It involves placing a very small amount of stool on a special card, which is then sent to a laboratory.

  • Fecal immunochemical test (FIT). A test that is similar to a FOBT, but does not require any restrictions on diet or medications prior to the test.

  • Flexible sigmoidoscopy. A diagnostic procedure that allows the doctor to examine the inside of a portion of the large intestine. A short, flexible, lighted tube with a small video camera on the end, called a sigmoidoscope, is inserted into the intestine through the rectum. The scope blows air into the intestine to inflate it and make viewing the inside easier.

  • Colonoscopy. A procedure that allows the doctor to view the entire length of the large intestine, and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the doctor to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.

  • CT colonography (virtual colonoscopy). A procedure that uses computerized tomography (CT) scans to examine the colon for polyps or masses. The images are processed by a computer to make a three-dimensional (3-D) model of the colon. Virtual colonoscopy is noninvasive, although it requires a small tube to be inserted into the rectum to pump air into the colon. If something abnormal is seen with this test, a standard colonoscopy will be needed as follow up.

Illustration demonstrating a colonoscopy, part 1
Click Image to Enlarge

Illustration demonstrating a colonoscopy, part 2

  • Barium enema with air contrast (also called a double contrast barium enema). A fluid called barium (a metallic, chemical, chalky liquid used to coat the inside of organs so that they will show up on an X-ray) is administered into the rectum to partially fill up the colon. Air is then pumped in to expand the colon and rectum. An X-ray of the abdomen is then taken and can show strictures (narrowed areas), obstructions (blockages), and other problems.

Screening guidelines for colon cancer

Colon cancer screening guidelines from the American Cancer Society for early detection include:

  • Beginning at age 50, both men and women should follow one of the examination schedules below:

    • Fecal occult blood test or fecal immunochemical test every year

    • Flexible sigmoidoscopy every five years

    • Double-contrast barium enema every five years

    • Colonoscopy every 10 years

    • CT colonography (virtual colonoscopy) every five years

  • People with any of the following colorectal cancer risk factors should begin screening procedures at an earlier age and/or be screened more often:

    • Strong family history of colorectal cancer or polyps in a first-degree relative, especially in a parent or sibling before the age of 45 or in two first-degree relatives of any age

    • Family with hereditary colorectal cancer syndromes, such as familial adenomatous polyposis and hereditary nonpolyposis colon cancer

    • Personal history of colorectal cancer or adenomatous polyps

    • Personal history of chronic inflammatory bowel disease (Crohn's disease or ulcerative colitis)

Diagnostic procedures for colon cancer

If a person has symptoms that might be caused by colon cancer, the doctor will want to get a complete medical history and do a physical examination. The doctor may also do certain tests to look for cancer. Many of these tests are the same as those done to screen for colon cancer in people without symptoms.

  • Digital rectal examination. A doctor or other health care provider inserts a gloved and lubricated finger into the rectum to feel for anything unusual or abnormal. This test can detect some cancers of the rectum, but not the colon.

  • Fecal occult blood test. This test checks for hidden (occult) blood in the stool. It involves placing a very small amount of stool on a special card, which is then sent to a laboratory.

  • Flexible sigmoidoscopy. A diagnostic procedure that allows the doctor to examine the inside of a portion of the large intestine. A short, flexible, lighted tube with a small video camera on the end, called a sigmoidoscope, is inserted into the intestine through the rectum. The scope blows air into the intestine to inflate it and make viewing the inside easier.

  • Colonoscopy. A procedure that allows the doctor to view the entire length of the large intestine. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the doctor to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.

  • Barium enema (also called double contrast barium enema). A fluid called barium (a metallic, chemical, chalky liquid used to coat the inside of organs so that they will show up on an X-ray) is administered into the rectum to partially fill up the colon. An X-ray of the abdomen is then taken that can show strictures (narrowed areas), obstructions (blockages), and other problems.

  • Biopsy. a procedure in which polyps or tissue samples are removed (during a colonoscopy or surgery) from the body for examination under a microscope to determine if cancer or other abnormal cells are present.

  • Blood count. A test to check for anemia (that can be a result of bleeding from a tumor).

  • Imaging tests. Tests, such as a CT scan, PET scan, ultrasound, or MRI of the abdomen, may be done to look for tumors or other problems. These tests may also be done if colon cancer has already been diagnosed to help determine the extent (stage) of the cancer.

What are the stages of colon cancer?

When colon cancer is diagnosed, tests will be performed to determine how much cancer is present, and if the cancer has spread from the colon or rectum to other parts of the body. This is called staging, and it is an important step toward planning a treatment program. The stages for colon cancer are as follows:

Stage 0 (Cancer in situ)

The cancer is found in the innermost lining of the colon or rectum.

Stage I (also called Dukes' A colon cancer)

The cancer has spread beyond the innermost lining of the colon or rectum to the second and third layers. The cancer has not spread to the outer wall or outside of the colon or rectum.

Stage II (also called Dukes' B colon cancer)

The cancer has spread through into the wall or outside the colon or rectum to nearby tissue. However, the lymph nodes are not involved.

Stage III (also called Dukes' C colon cancer)

The cancer has spread to nearby lymph nodes, but has not spread to other organs in the body.

Stage IV (also called Dukes' D colon cancer)

The cancer has spread to other parts of the body, such as the lungs.

Treatment for colon cancer

Specific treatment for colon cancer will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent and location of the disease

  • Results of certain lab tests 

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of this disease

  • Your opinion or preference

After the colon cancer is diagnosed and staged, your doctor will recommend a treatment plan. Treatment may include:

  • Colon surgery. Often, the primary treatment for colon cancer is an operation, in which the cancer and a length of normal tissue on either side of the cancer are removed, as well as the nearby lymph nodes.

  • Radiation therapy. Radiation therapy is the use of high-energy radiation to kill cancer cells and to shrink tumors. There are two ways to deliver radiation therapy, including the following:

    • External radiation (external beam therapy). A treatment that precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes.

    • Internal radiation (brachytherapy, implant radiation). Radiation is given inside the body as close to the cancer as possible. Radioactive material is placed next to or directly into the cancer, which limits the effects of surrounding healthy tissues. Some of the radioactive implants are called seeds or capsules.Internal radiation involves giving a higher dose of radiation in a shorter time span than with external radiation. Some internal radiation treatments stay in the body temporarily. Other internal treatments stay in the body permanently, though the radioactive substance loses its radiation within a short period of time. In some cases, both internal and external radiation therapies are used.

  • Chemotherapy. Chemotherapy is the use of anticancer drugs to treat cancerous cells. In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. The oncologist will recommend a treatment plan for each individual. Studies have shown that chemotherapy after surgery may increase the survival rate for patients with some stages of colon cancer. It can also be helpful before or after surgery for some stages of rectal cancer. Chemotherapy can also help slow the growth or relieve symptoms of advanced cancer.

  • Targeted therapy. Newer medications called targeted therapies may be used along with chemotherapy or sometimes by themselves. For example, some newer medications target proteins that are found more often on cancer cells than on normal cells. These medications have different (and often milder) side effects than standard chemotherapy medications and may help people some live longer.

If you're experiencing colon cancer symptoms, Baylor Health Care System offers personalized, comprehensive and compassionate care, with the experience, expertise and technology you can trust. Search online to find a physician, or call 1.800.4BAYLOR for cancer treatment in Dallas-Fort Worth.

Colon Cancer

Colon cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). This type is also referred to as "colorectal cancer."

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Esophageal Cancer Cáncer Esofágico

Esophageal Cancer

What is esophageal cancer?

Esophageal cancer is cancer that develops in the esophagus, the muscular tube that connects the throat to the stomach. The esophagus, located just behind the trachea, is about 10 to 13 inches in length and allows food to enter the stomach for digestion. The wall of the esophagus is made up of several layers and cancers generally start from the inner layer and grow out.

The American Cancer Society estimates that about 17,990 Americans will be newly diagnosed with esophageal cancer during 2013, and about 15,210 deaths are expected.

What causes esophageal cancer?

No one knows exactly what causes esophageal cancer. At the top of the esophagus is a muscle, called a sphincter, that releases to let food or liquid go through. The lower part of the esophagus is connected to the stomach. Another sphincter muscle is located at this connection that opens to allow the food to enter the stomach. This muscle also works to keep food and juices in the stomach from backing into the esophagus. When these juices do back up, reflux, commonly known as heartburn, occurs.

Long-term reflux can change the cells in the lower end of the esophagus. This condition is known as Barrett's esophagus. If these cells are not treated, they are at much higher risk of developing into cancer cells.

What are the different types of esophageal cancer?

There are 2 main types of esophageal cancer. The most common type, known as adenocarcinoma, develops in the glandular tissue in the lower part of the esophagus, near the opening of the stomach. It occurs in just over half of the cases.

The other type, called squamous cell carcinoma, grows in the cells that form the top layer of the inner lining of the esophagus, known as squamous cells. This type of cancer can grow anywhere along the esophagus.

Treatment for both types of esophageal cancer is similar.

What are the symptoms of esophageal cancer?

Often, there are no symptoms in the early stages of esophageal cancer. Symptoms do not appear until the disease is more advanced. The following are the most common symptoms of esophageal cancer. However, each individual may experience symptoms differently. Symptoms may include:

  • Difficult or painful swallowing. A condition known as dysphagia is the most common symptom of esophageal cancer. This gives a sensation of having food lodged in the chest, and people with dysphagia often switch to softer foods to help with swallowing.

  • Pain in the throat or back, behind the breastbone or between the shoulder blades

  • Severe weight loss. Many people with esophageal cancer lose weight unintentionally because they are not getting enough food.

  • Hoarseness or chronic cough that does not go away within two weeks

  • Vomiting

  • Blood in stool or black-looking stools

  • Heartburn

The symptoms of esophageal cancer may resemble other medical conditions or problems. Always consult your health care provider for a diagnosis.

There is no routine screening examination for esophageal cancer; however, people with Barrett's esophagus should be examined often because they are at greater risk for developing the disease.

What are the risk factors for esophageal cancer?

The following factors can put an individual at greater risk for developing esophageal cancer:

  • Age. The risk increases with age. In the U.S., most people are diagnosed at 55 years of age or older.

  • Gender. Men have more than a 3 times greater risk of developing esophageal cancer than women.

  • Tobacco use. Using any form of tobacco, but especially smoking, raises the risk of esophageal cancer. The longer tobacco is used, the greater the risk, with the greatest risk among persons who have indulged in long-term drinking with tobacco use. Scientists believe that these substances increase each other's harmful effects, making people who do both especially susceptible to developing the disease.

  • Alcohol use. Chronic or long-term heavy drinking is another major risk factor for esophageal cancer.

  • Acid reflux. Abnormal backward flow of stomach acid into the esophagus increases esophageal cancer risk. 

  • Barrett's esophagus. Long-term irritation from reflux, commonly known as heartburn, changes the cells at the lower end of the esophagus. This is a precancerous condition, which raises the risk of developing adenocarcinoma of the esophagus.

  • Obesity. Being very overweight increases the risk of esophageal cancer. This might be because being overweight puts you at higher risk for reflux. 

  • Diet. Diets low in fruits and vegetables and certain vitamins and minerals can increase risk for this disease.

  • Other irritants. Swallowing caustic irritants such as lye and other substances can burn and destroy cells in the esophagus. The scarring and damage done to the esophagus can put a person at greater risk for developing cancer many years after ingesting the substance.

  • Medical history. Certain diseases, such as achalasia, a disease in which the bottom of the esophagus does not open to release food into the stomach, and tylosis, a rare, inherited disease, increase the risk of esophageal cancer. In addition, anyone who has had other head and neck cancers has an increased chance of developing a second cancer in this area, which includes esophageal cancer.

How is esophageal cancer diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for esophageal cancer may include the following:

  • Chest X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

  • Upper GI (gastrointestinal) series (also called barium swallow). A diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an X-ray) is swallowed. X-rays are then taken to evaluate the digestive organs.

  • Esophagogastroduodenoscopy (also called EGD or upper endoscopy). A procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube with a tiny video camera on the end, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the doctor to view the inside of this area of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary).

  • Computed tomography scan (CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays. If further imaging is needed, your doctor may order a MRI or PET scan.

  • Endoscopic ultrasound. This imaging technique uses sound waves to create a computer image of the wall of the esophagus, stomach, and nearby lymph nodes. The endoscope is guided into the mouth and throat, then into the esophagus and the stomach. As in standard endoscopy, this allows the doctor to view the inside of this area of the body, as well as insert instruments to remove a sample of tissue (biopsy).

  • Thoracoscopy and laparoscopy. These methods allow the doctor to examine the lymph nodes and other structures inside the chest or abdomen with a hollow, lighted tube inserted through a small cut in the skin, and remove suspicious areas for further testing.

  • PET scan. A test that uses a radioactive glucose (sugar) dye to highlight cancer cells and create pictures of the inside of the body. The test is done much like a CT scan. First, the doctor or nurse injects a small amount of radioactive dye into your vein. Then a scanner is moved around your body and takes many pictures of your neck, chest, and abdomen. A computer puts these pictures together to show where the cancer cells are located.

Treatment for esophageal cancer

Specific treatment options for esophageal cancer will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent and location of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of this disease

  • Your opinion or preference

Treatment may include:

  • Surgery. Two types of surgery are commonly performed for esophageal cancer. In one type of surgery, part of the esophagus and nearby lymph nodes are removed, and the remaining portion of the esophagus is reconnected to the stomach. In the other surgery, part of the esophagus, nearby lymph nodes, and the top of the stomach are removed. The remaining portion of the esophagus is then reconnected to the stomach.

  • Chemotherapy. Chemotherapy uses anticancer drugs to kill cancer cells throughout the entire body.

  • Radiation therapy. Radiation therapy uses high-energy rays to kill or shrink cancer cells.

  • Photodynamic therapy (PDT) or other laser therapies. In these treatments, an endoscope with a laser on the end is used to destroy cancer cells on or near the inner lining of the esophagus. 

Sometimes, several of these treatments may be combined to treat esophageal cancer.

Esophageal Cancer

Esophageal cancer is a malignant (cancerous) tumor of the esophagus, the muscular tube that moves food from the mouth to the stomach.

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Hepatitis CHepatitis C

Hepatitis C

¿Qué es la hepatitis C?

La hepatitis C es una enfermedad del hígado causada por el virus de la hepatitis C. Este es uno de los tipos de hepatitis.

Produce enrojecimiento e hinchazón (inflamación) del hígado que a veces causa daño de largo plazo. El hígado no puede funcionar como debería.

La hepatitis C puede ser de corta duración (aguda) o de larga duración (crónica):

  • Hepatitis C aguda. Es una infección breve que dura seis meses o menos. Desaparece porque su cuerpo se libra del virus.
  • Hepatitis C crónica. Es una infección de larga duración que se presenta cuando su cuerpo no se puede librar del virus. Causa daño de larga duración y no es frecuente recuperarse de una infección de hepatitis C. La mayoría de las personas que contraen hepatitis C conservan el virus por el resto de su vida.

¿Cuáles son las causas de la hepatitis C?

La hepatitis C es causada por una infección con el virus de la hepatitis C. Como sucede con otros virus, la hepatitis C se contagia de una persona a otra. Esto ocurre cuando usted entra en contacto con la sangre de una persona infectada.

Usted puede contraer el virus si:

  • Comparte agujas usadas para consumir drogas ilegales.
  • Mantiene relaciones sexuales sin protección con una persona que tiene hepatitis C.

 Los bebés también pueden enfermarse si sus madres tienen el virus de la hepatitis C.

¿Quiénes corren el riesgo de contraer hepatitis C?

Cualquier persona se puede contagiar de hepatitis C al entrar en contacto con la sangre de una persona infectada con el virus.

Sin embargo, algunas personas tienen mayor riesgo de contraer esta enfermedad. Incluyen, por ejemplo:

  • Niños nacidos de madres que están infectadas con hepatitis C.
  • Personas que tienen trabajos que implican contacto con sangre humana, líquidos corporales o agujas.
  • Personas que tienen un trastorno de coagulación de la sangre como hemofilia y recibieron factores de la coagulación antes de 1987.
  • Personas que necesitan tratamiento de diálisis debido a insuficiencia renal.
  • Personas que se hicieron transfusiones de sangre, que recibieron productos sanguíneos (hemoderivados) trasplantes de órganos antes de comienzos de la década de 1990.
  • Personas que usan vías intravenosas (IV) o drogas intravenosas.
  • Personas que tienen relaciones sexuales heterosexuales u homosexuales sin protección.
  • Personas que tienen VIH.

¿Cuáles son los síntomas de la hepatitis C?

Muchas de las personas que presentan esta afección no lo saben. En la mayoría de los casos, las personas infectadas de hepatitis C pueden no tener síntomas por varios años.

Es posible transmitir el virus a otra persona si usted tiene hepatitis C, pero no presenta ningún síntoma.  

 Los síntomas pueden variar de una persona a otra. Algunos de los síntomas más comunes son:

  • Pérdida del apetito
  • Cansancio extremo (fatiga)
  • Náuseas y vómitos
  • Dolor de estómago
  • Coloración amarillenta en la piel y en los ojos (ictericia)
  • Fiebre
  • Diarrea
  • Orina de color amarillo oscuro
  • Heces de color claro
  • Dolor de los músculos y las articulaciones

Los síntomas de la hepatitis C pueden parecerse a los de otros problemas de salud. Consulte siempre a su proveedor de atención médica para confirmar cuál es su afección.

¿Cómo se diagnostica la hepatitis C?

Su proveedor de atención médica le hará un examen físico y le preguntará sobre sus antecedentes de salud. También le pedirá un análisis de sangre para determinar si tiene hepatitis C.

Si su proveedor cree que usted tiene hepatitis C de larga duración (crónica), es posible que le tome una muestra pequeña de tejido (biopsia) de su hígado con una aguja. Esa muestra se revisa con un microscopio para saber  qué tipo de enfermedad hepática tiene y su gravedad.

¿Cómo se trata la hepatitis C?

La hepatitis C no se trata a menos que se vuelva una infección crónica o de larga duración. En ese caso, se usan medicamentos para tratar de demorar o detener el daño que el virus le produce a su hígado.  Sus síntomas se vigilarán de cerca y se manejarán según sea necesario.

Si se produce un daño hepático grave, es posible que necesite un trasplante de hígado.

No existe una cura para la hepatitis C.

¿Cuáles son las complicaciones de la hepatitis C?

Muchas personas que tienen hepatitis C presentan enfermedad hepática crónica. Usted podría necesitar un trasplante de hígado. La hepatitis C es la causa más común para realizar trasplantes de hígado en Estados Unidos.

Insuficiencia hepática que puede llevar a la muerte.

El riesgo de cáncer de hígado es más alto en las personas que tienen hepatitis C.

¿Qué puedo hacer para prevenir la hepatitis C?

No existe una vacuna para prevenir la hepatitis C. Sin embargo, se puede proteger y proteger a los demás del contagio:

  • Asegurándose de hacerse cualquier tatuaje o perforación en el cuerpo (pirsin) con instrumentos estériles.
  • Evitando compartir agujas y otros materiales para usar drogas.
  • Evitando compartir cepillos de dientes y afeitadoras.
  • Evitando tocar la sangre de otra persona a menos que esté usando guantes.
  • Usando condones durante las relaciones sexuales.

Puntos clave sobre la hepatitis C

  • La hepatitis C es una enfermedad hepática causada por una infección con el virus de la hepatitis C.
  • El virus causa enrojecimiento e hinchazón (inflamación) en su hígado.
  • Además, se contagia cuando usted entra en contacto con la sangre de una persona infectada.
  • Cualquiera puede contraer hepatitis C, pero algunas personas tienen un riesgo más alto.
  • Es posible que usted no presente síntomas durante años.
  • El riesgo de cáncer de hígado es más alto en las personas que tienen hepatitis C.
  • No existe una vacuna para prevenir la hepatitis C.

Próximos pasos

Consejos para ayudarle a aprovechar al máximo una visita a su proveedor de atención médica:

  • Antes de su visita, escriba las preguntas que quiere hacerle.
  • Lleve a alguien con usted para que le ayude a hacer las preguntas y para que recuerde lo que el proveedor le dice.
  • En la consulta, anote los nombres de los nuevos medicamentos, tratamientos o pruebas y análisis, y toda nueva instrucción que su proveedor le dé.
  • Si tiene una cita de control, anote la fecha, la hora y el propósito de esa visita.
  • Averigüe cómo comunicarse con su proveedor si tiene preguntas.

Hepatitis B & C

An injury to the liver characterized by the presence of inflammatory cells in the tissue of the organ.

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Irritable Bowel Syndrome (IBS)Síndrome del Intestino Irritable, su sigla en inglés es IBS

Irritable Bowel Syndrome (IBS)

What is IBS?

Irritable bowel syndrome (IBS) is a disorder that affects your lower GI (gastrointestinal), which includes the small intestine, large intestine, and colon. It is diagnosed when a person has abdominal pain or spasm associated with a change in the appearance or frequency of their bowel movements. It causes:

  • Belly or abdominal cramps
  • Gas
  • Swelling or bloating
  • Changes in your bowel habits, such as diarrhea or constipation

When you have IBS your colon looks normal. But it does not work the way it should.

Health experts have not been able to find an exact physical cause for IBS. It is often thought that stress is one cause. Stress may make IBS symptoms worse.

IBS is a long-term, chronic condition. It can be painful. But it doesn’t cause lasting harm to your intestines. And it doesn’t lead to serious disease such as cancer.

There is no link between IBS and Crohn's disease, ulcerative colitis, or other inflammatory bowel diseases. However, people with inflammatory bowel disease can also have IBS.

What causes IBS?

The exact cause of IBS isn’t known. there are many possible causes of IBS, and they differ from person to person. This means that some people can have the same symptoms, but different causes of their IBS. Some experts think that if you have IBS your colon may be more sensitive than normal. That means it has a strong reaction to things that should not normally affect it.

When you have IBS, your colon muscles begin to move and tighten uncontrollably (spasm) after only mild stimulation or after normal events such as:

  • Eating
  • Swelling or bloating from gas or other material in the colon
  • Some medicines
  • Some foods

Women with IBS seem to have more symptoms during their periods. This could mean that the chemicals (reproductive hormones) released during a woman’s menstrual cycle may increase IBS symptoms.

Some things can make IBS symptoms worse. The 2 things most likely to make your IBS symptoms worse are the foods you eat and having emotional stress.

  • Diet. Eating makes your colon muscles move or contract. This normally gives you an urge to have a bowel movement 30 to 60 minutes after a meal. Having fat in your diet can cause contractions in your colon after a meal. With IBS the urge may come sooner. You may also have cramps or diarrhea.
  • Stress. If you have IBS, stress can make your colon move uncontrollably or spasm. Experts don’t fully understand why. But they believe this happens because the colon is partly controlled by the brain and spinal cord (nervous system). The nervous system controls how your body moves and reacts to things. Going for counseling or therapy and trying to reduce your stress can help to ease IBS symptoms. But this doesn’t mean that IBS is caused by a mental or emotional disorder. IBS is caused in part because of a problem with how the muscles of the colon move.

Who is at risk for IBS?

You are more likely to be at risk for IBS if you:

  • Are young. Most people first get IBS before they are 45 years old.
  • Are a woman. Women get IBS almost twice as often as men.
  • Have had recent gastroenteritis.

What are the symptoms of IBS?

Each person’s symptoms may vary. Some of the most common symptoms include:

  • Having belly or abdominal pain
  • Having painful constipation or diarrhea
  • Going back and forth between having constipation and having diarrhea
  • Having mucus in your stool

The symptoms of IBS may look like other health problems. Always see your doctor to be sure.

How is IBS diagnosed?

Your healthcare provider will look at your past health and give you a physical exam. He or she will also do lab tests to check for infection and for redness and swelling (inflammation).

There are usually no physical signs to tell for sure that you have IBS. There is also no exact test for IBS.

Your healthcare provider will do lab tests and imaging tests to make sure that you don’t have other diseases. These tests may include the following:

  • Blood tests. These are done to see if you are lacking healthy red blood cells (anemia), have an infection, or have an illness caused by inflammation or irritation.
  • Urinalysis and urine culture. These help to see if you have an infection in any part of your urinary system (urinary tract infection or UTI). This includes your kidneys, the tubes that send urine from the kidneys to the bladder (ureters), your bladder, and the urethra, where urine leaves your body.
  • Stool culture. This test checks for any abnormal bacteria or parasites in your digestive tract that may cause diarrhea and other problems. To do this, a small stool sample is taken and sent to a lab.
  • Stool testing for blood (fecal occult blood test). This test checks for hidden (occult) blood in your stool that can only be seen with a microscope. A small amount of stool is put on a special card. This is then tested in your healthcare provider’s office or sent to a lab. If blood is found, it may mean you have redness and swelling (inflammation) in your GI (gastrointestinal) tract.
  • Upper endoscopy, also called EGD (esophagogastroduodenoscopy). This test looks at  the inside or lining of your food pipe (esophagus), stomach, and the top part of your small intestine (duodenum). This test uses a thin, lighted tube, called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes into your esophagus, stomach, and duodenum. Your healthcare provider can see the inside of these organs. He or she can also take a small tissue sample (biopsy) if needed. This is sometimes done to evaluate for celiac disease.
  • Abdominal X-rays. This test makes images of your internal tissues, bones, and organs.
  • Abdominal ultrasound. If your symptoms seem like they may be coming from the liver or gallbladder area, an ultrasound can check. It can also check how blood is flowing through different blood vessels.
  • Colonoscopy. This test looks at the full length of your large intestine. It can help check for any abnormal growths, red or swollen tissue (inflammation), sores (ulcers), or bleeding. A long, flexible, lighted tube called a colonoscope is put into your rectum up into the colon. This tube lets your healthcare provider see the lining of your colon and take out a tissue sample (biopsy) to test it. He or she may also be able to treat some problems that may be found.

How is IBS treated?

Your healthcare provider will create a care plan for you based on:

  • Your age, overall health, and past health
  • How serious your case is
  • How well you handle certain medicines, treatments, or therapies
  • If your condition is expected to get worse
  • What you would like to do

Treatment for IBS may include:

  • Changes in your diet. Eating a proper diet is important if you have IBS. In some cases a high-fiber diet can reduce symptoms. Some people get symptoms from lactose and should eat lactose-free dairy products. Some people get symptoms from poorly digestible carbohydrates and fructose. Some people are intolerant  to gluten although they may not have celiac disease. Many people get symptoms from large and fatty meals. Keep a list of foods that cause you pain, and talk about this with your healthcare provider.
  • Medicines. Your healthcare provider may prescribe fiber supplements or have you take something now and then to loosen your stool (a laxative).Different medicines are used for IBS, depending on your symptoms. They include medicines to prevent constipation, diarrhea, pain and spasm.
  • Natural supplements. Some people feel better on various natural supplements called probiotics. Others get relief with peppermint oil capsules.
  • Manage stress. Hypnosis, acupuncture, cognitive therapy, yoga, regular exercise, relaxation, and other mindfulness activities can help some people with IBS.
Good fiber sources may include:

 

Foods

Moderate fiber

High fiber

Bread

Whole wheat bread, granola bread, wheat bran muffins, waffles, popcorn

 

Cereal

Whole-wheat cereals

Whole-bran cereals

Vegetables

Beets, broccoli, Brussels sprouts, cabbage, carrots, corn, green beans, green peas, acorn and butternut squash, spinach, potato with skin, avocado

 

Fruits

Apples with peel, dates, papayas, mangos, nectarines, oranges, pears, kiwis, strawberries, applesauce, raspberries, blackberries, raisins

Cooked prunes, dried figs

Meat substitutes

Peanut butter, nuts

Baked beans, black-eyed peas, garbanzo beans, lima beans, pinto beans, kidney beans, chili with beans, trail mix

What are the complications of IBS?

The diarrhea and constipation that occur with IBS can cause hemorrhoids. If you already have hemorrhoids, they may get worse.

Your quality of life may be affected by IBS, because the symptoms may limit your daily activities.

What can I do to prevent IBS?

Health experts don’t know what causes IBS. They also don’t know how to stop it from happening.

Living with IBS

IBS symptoms can affect your daily activities. It’s important to work with your health care provider to manage the disease. You may need a plan to deal with issues such as diet, work, lifestyle, and emotional or mental health.

When should I call my healthcare provider?

Call your healthcare provider right away if your symptoms get worse or if you have new symptoms.

Key points about IBS

  • IBS is a disorder that affects your lower GI tract, which includes the small intestine, large intestines, and colon.
  • It is a long-term, chronic disorder.
  • The exact cause of IBS is not known. There are probably many different causes in different people.
  • When you have IBS your colon looks normal. But it does not work the way it should.
  • The things most likely to worsen symptoms of IBS are diet and emotional stress.
  • Treatment may include changing your diet and taking medicines.

 

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) refers to a disorder that involves abdominal pain and cramping, as well as changes in bowel movements.

Learn More

Pancreatic Cancer: IntroductionCáncer Pancreático

Pancreatic Cancer: Introduction

What is cancer?

Cancer is when cells in the body change and grow out of control. Your body is made up of tiny building blocks called cells. Normal cells grow when your body needs them, and die when your body does not need them any longer.

Cancer is made up of abnormal cells that grow even though your body doesn't need them. In most cancers, the abnormal cells grow to form a lump or mass called a tumor. If cancer cells are in the body long enough, they can grow into (invade) nearby areas. They can even spread to other parts of the body (metastasis).

What is pancreatic cancer?

Pancreatic cancer is cancer that starts in your pancreas. In this cancer, normal cells in the pancreas undergo a series of changes. This can eventually lead to excess cell growth and the formation of tumors.

Understanding the pancreas

The pancreas is an organ behind the stomach and in front of the spine. It’s about 6 inches long. One end is wide and is called the head. The middle is called the body. The narrow end is called the tail. The pancreas is made up of two main types of cells.

The exocrine pancreas is made up of cells that make digestive juices. These help your body break down foods. Most pancreatic cancers start in this part of the pancreas. Pancreatic juices contain chemicals called enzymes that help you digest food. The pancreas releases these juices when during meals. The juices enter your intestine through tubes called ducts. The main pancreatic duct is at the head of the pancreas. It joins the common bile duct which comes from the liver and gallbladder. The juices from the pancreas mix with other substances from the liver and gallbladder. The merged ducts open into the first part of the small intestine (duodenum). In the duodenum, the juices help break down fats, sugars, and proteins from the food you eat.

The endocrine pancreas makes hormones that are released into the blood. They help control how your body works. The pancreatic endocrine cells are arranged in small clumps called islets of Langerhans. They make many hormones, including insulin and glucagon. These hormones help your body use and store the energy created from the food you eat. A small number of all pancreatic cancers start in endocrine cells.

What are the types of cancer in the pancreas?

Here’s an overview of the types of cancer that can start in the pancreas:

  • Adenocarcinomas. These exocrine cancers start in cells with glandular properties, or cells that secrete. The majority (more than 95%) of pancreatic cancers are adenocarcinomas. This is usually what’s meant by the term pancreatic cancer.

  • Pancreatic neuroendocrine tumors (NETs). These tumors, also known as islet cell tumors, start in endocrine cells in the pancreas. There are many types of pancreatic NETs. They can be noncancerous (benign) or cancerous (malignant).

Other types of cancer that can start in the pancreas are much less common. They include acinar cell carcinomas, adenosquamous carcinomas, and squamous cell carcinomas. They also include signet ring cell carcinomas and giant cell tumors.

How pancreatic cancer grows and spreads

Pancreatic cancer often grows within the pancreas for a long time before it causes any symptoms. If the cancer grows outside the pancreas, it often goes into the nearby bile ducts and lymph nodes in your belly (abdomen). In some cases, it spreads to other nearby areas. Pancreatic cancer may also spread to distant parts of the body. These can include your liver or lungs.

When pancreatic cancer spreads to another part of the body, it’s not considered a new cancer. For instance, if it spreads to your liver, it’s not considered liver cancer. It’s called metastatic pancreatic cancer. It’s still treated like pancreatic cancer.

Talk with your healthcare provider

If you have questions about pancreatic cancer, talk with your healthcare provider. Your healthcare provider can help you understand more about this cancer.

Pancreatic Cancer

Pancreatic cancer begins in the pancreas. The cause is unknown, but it is more common in smokers and in obese people.

Learn More

DiarrheaDiarrea

Diarrhea

¿Qué es la diarrea?

La diarrea se produce cuando las heces son sueltas y acuosas. También puede que necesite evacuar los intestinos con más frecuencia.

La diarrea es un problema común. Puede durar uno o dos días e irse por su cuenta.

Si dura más de dos días, significa que usted tiene un problema más serio.

La diarrea puede ser:

  • De corta duración (aguda). La diarrea que dura uno o dos días y se va por su cuenta. Puede deberse a haber consumido comida o agua que eran poco seguras por tener una infección bacteriana. O puede suceder si usted se enferma con un virus.
  • De larga duración (crónica). La diarrea que dura varias semanas. Esto puede deberse a otro problema de salud, como el síndrome de intestino irritable. También puede deberse a una enfermedad intestinal, como la enfermedad de Crohn o la enfermedad celíaca. Algunas infecciones, como los parásitos, pueden causar diarrea crónica.

¿Cuáles son las causas de la diarrea?

La diarrea puede deberse a muchas cosas, por ejemplo:

  • Una infección bacteriana
  • Un virus
  • Dificultades para digerir ciertas cosas (intolerancia alimentaria)
  • Alergia a ciertos alimentos (como sucede en la enfermedad celíaca, alergia al gluten)
  • Parásitos que entran a su cuerpo a través de la comida o el agua
  • Una reacción a ciertos medicamentos
  • Una enfermedad intestinal, como la enfermedad intestinal inflamatoria
  • Un problema con la forma en que su estómago y sus intestinos trabajan (trastorno funcional del intestino), por ejemplo, el síndrome de intestino irritable
  • Consecuencia de una cirugía del estómago o la vesícula biliar
  • Uso reciente de antibióticos
  • Afecciones metabólicas, como problemas tiroideos
  • Otros motivos menos comunes, como daños por radioterapia o tumores que producen demasiadas hormonas

Muchas personas tienen la diarrea del viajero. Esto sucede si consume alimentos o agua que no son seguros porque tienen bacterias, parásitos o incluso están contaminados y pueden provocarle una intoxicación por alimentos.

La diarrea muy fuerte puede significar una enfermedad grave. Consulte a su proveedor de atención médica si sus síntomas no desaparecen o si le impiden hacer sus actividades diarias. Puede ser difícil encontrar la causa de su diarrea.

¿Cuáles son los síntomas de la diarrea?

Los síntomas de cada persona pueden variar. Los síntomas de la diarrea pueden incluir:

  • Cólicos abdominales
  • Dolor de estómago
  • Inflamación (distensión)
  • Malestar estomacal (náuseas)
  • Necesidad urgente de ir al sanitario
  • Fiebre
  • Heces con sangre
  • Pérdida de líquidos corporales (deshidratación)
  • Pérdida de heces, y no poder controlar sus intestinos (incontinencia)

La deshidratación es un efecto secundario grave de la diarrea. Los síntomas incluyen:

  • Sentir sed
  • No orinar con tanta frecuencia
  • Tener la piel seca, así como la boca y los orificios de la nariz secos (las membranas mucosas)
  • Sentir mucho cansancio
  • Sentir que puede desmayarse en cualquier momento (aturdimiento)
  • Dolores de cabeza
  • Frecuencia cardíaca rápida
  • Tener hundida la fontanela o mollera (punto blando en la cabeza del bebé)

Los síntomas de la diarrea pueden parecerse a los de otros problemas de salud. Todas las diarreas con sangre son motivo de preocupación. Siempre consulte a su médico para estar seguro. Asegúrese de decirle a su médico si tuvo sangrado, fiebre o vómito.

¿Cómo se diagnostica la diarrea?

Para ver si tiene diarrea, su proveedor de atención médica le hará un examen físico y le preguntará sobre sus antecedentes de salud. También es probable que le hagan análisis de laboratorio para evaluar su sangre y su orina.

Otros exámenes pueden incluir:

  • Análisis de sus heces, incluido cultivo y otros análisis. Este examen comprueba si tiene alguna bacteria anormal en sus sistema digestivo que pueda causar diarrea u otros problemas. Para eso, le tomarán una pequeña muestra de heces que se enviará a un laboratorio.
  • Sigmoidoscopia. Esta prueba permite que su proveedor de atención médica revise la parte interior de su intestino grueso. Ayuda a ver qué está causando la diarrea. Le insertarán un tubo corto y flexible, con luz, llamado sigmoidoscopio, en el intestino a través del recto. A través de este tubo le enviarán aire hacia el intestino para inflarlo. Así, será más fácil ver en su interior. Pueden hacerle una biopsia si es necesario.
  • Colonoscopia. Este examen observa la totalidad del recorrido de su intestino grueso. Puede ayudar a revisar cualquier crecimiento anormal, tejido que esté rojo o hinchado, llagas (úlceras) o sangrado. Le insertarán un tubo largo y flexible, con luz (colonoscopio) por su recto y hasta su colon. Este tubo permite a su proveedor de atención médica ver el revestimiento de su colon y tomar una muestra de tejido (biopsia) para analizarla. También puede tratar algunos problemas que puedan encontrarse.
  • Pruebas con imágenes. Estas pruebas permiten ver si hay problemas con la manera en que están formados sus órganos (anomalías estructurales).
  • Pruebas con ayuno. Estas pruebas muestran si usted no puede digerir ciertos alimentos (intolerancia alimentaria). También pueden indicar si ciertos alimentos provocan una reacción de su sistema inmunitario (alergia alimentaria).
  • Análisis de sangre. Pueden ver si hay problemas metabólicos, tales como enfermedad de la tiroides, anemia (bajo recuento de glóbulos), pruebas de que tiene bajos niveles de vitaminas que sugieran una mala absorción, y enfermedad celíaca, entre otras cosas.

¿Cómo se trata la diarrea?

Su proveedor de atención médica preparará un plan de cuidados para usted según:

  • Su edad, su estado general de salud y su historia clínica
  • La gravedad de su caso
  • Qué tan bien maneja ciertos medicamentos, tratamientos o terapias
  • Si se espera que su afección empeore
  • Lo que a usted le gustaría hacer

En la mayoría de los casos, necesitará reponer los líquidos que perdió.

También puede que necesite un medicamento para combatir la infección (antibiótico) si su diarrea se debe a una infección bacteriana.

Complicaciones de la diarrea

Si no se trata su diarrea, corre riesgo de deshidratarse. Una deshidratación grave puede producir daños en los órganos, un estado de shock y desmayos (pérdida del conocimiento) o un coma.

¿Se puede prevenir la diarrea?

Tener buenos hábitos personales puede evitar que tenga una diarrea causada por bacterias o virus. Es importante que:

  • Se lave las manos con frecuencia.
  • Use desinfectantes con alcohol.
  • Coma alimentos que se limpiaron y se cocinaron de manera segura.
  • No consuma alimentos ni líquidos que puedan estar infectados con una bacteria o un virus.

Si viaja, asegúrese de que todo lo que coma y beba sea seguro. Esto es aún más importante si viaja a países en desarrollo.

Algunas sugerencias para cuidar la seguridad del agua y otros líquidos cuando viaje:

  • No beba agua del grifo ni la use para cepillarse los dientes.
  • No consuma hielo hecho con agua del grifo.
  • No beba leche ni productos lácteos que no hayan pasado por el proceso para matar ciertas bacterias (pasteurización).

Los consejos de seguridad para los alimentos incluyen:

  • No coma frutas y vegetales frescos o crudos a menos que los haya lavado y pelado usted mismo.
  • Asegúrese de que todas las carnes y pescados estén bien cocidos (al menos hasta un punto medio).
  • No coma carnes o pescados crudos o apenas cocidos.
  • Asegúrese de que la carne y los mariscos, como los camarones, el cangrejo y los ostiones (vieiras) estén calientes cuando se los sirven.
  • No coma alimentos de vendedores ambulantes ni de camiones de comida.

Cómo vivir con diarrea

En la mayoría de los casos, la diarrea es un problema de corta duración. Usualmente, solo dura unos pocos días. Asegúrese de tomar abundante cantidad de líquidos si tiene un episodio de diarrea.

Algunos problemas de salud pueden hacer que la diarrea dure más o que siga regresando. Por ejemplo, la enfermedad intestinal inflamatoria y el síndrome de intestino irritable. Si tiene algún otro problema de salud que está causando su diarrea, siga el consejo de su proveedor de atención médica para tratar ese problema.

¿Cuándo debo llamar a mi proveedor de atención médica?

Llame a su proveedor de atención médica si:

  • Tiene diarrea con más frecuencia.
  • Tiene más cantidad de diarrea.
  • Tiene síntomas de deshidratación. Puede sentir mucha sed, cansancio o mareo. También puede tener menos orina o la boca seca.
  • Tiene diarrea con sangrado rectal o heces negras y alquitranadas, fiebre, o vómito.

Puntos clave sobre la diarrea

  • La diarrea se produce cuando las heces son sueltas y acuosas.
  • También puede que necesite evacuar los intestinos con más frecuencia.
  • La diarrea de corta duración (aguda) dura uno o dos días.
  • La diarrea de larga duración (crónica) dura varias semanas.
  • Los síntomas de la diarrea pueden incluir cólicos abdominales y una necesidad urgente de ir al sanitario.
  • La pérdida de líquidos (deshidratación) es uno de los efectos secundarios más graves.
  • El tratamiento suele incluir reponer los líquidos perdidos.
  • Puede necesitar algún medicamento para combatir la infección (antibiótico) si la causa de su diarrea es una infección bacteriana.

Próximos pasos

Consejos para ayudarle a aprovechar al máximo una visita a su proveedor de atención médica:

  • Antes de su visita, escriba las preguntas que quiere hacerle.
  • Lleve a alguien con usted para que le ayude a hacer las preguntas y para que recuerde lo que el proveedor le dice.
  • En la consulta, anote los nombres de los nuevos medicamentos, tratamientos o pruebas y análisis, y toda nueva instrucción que su proveedor le dé.
  • Si tiene una cita de control, anote la fecha, la hora y el propósito de esa visita.
  • Averigüe cómo comunicarse con su proveedor si tiene preguntas.

Chronic Diarrhea

Diarrhea that lasts for more than two weeks is considered chronic. In an otherwise healthy person, chronic diarrhea can be a nuisance.

Learn More

Crohn's DiseaseEnfermedad de Crohn

Crohn's Disease

¿Qué es la enfermedad de Crohn?

La enfermedad de Crohn es el enrojecimiento, la hinchazón (inflamación) y el dolor en el recorrido de su tracto digestivo. Es parte de un grupo de enfermedades que se conocen como enfermedad inflamatoria de los intestinos (IBD, por sus siglas en inglés).

La enfermedad de Crohn es una afección crónica, de largo plazo, que puede aparecer y desaparecer en distintos momento de su vida. En la mayoría de los casos, afecta el intestino delgado, con mayor frecuencia la parte inferior que se llama íleon. En algunos casos, afecta tanto al intestino delgado como al grueso.

A veces la inflamación puede presentarse a lo largo de todo su tracto digestivo. Esto incluye su boca, su esófago, su estómago, la primera parte de su intestino delgado o duodeno, su apéndice y su ano.

¿Cuáles son las causas de la enfermedad de Crohn?

Los expertos no saben a qué se debe la enfermedad de Crohn. Puede suceder que un virus o una bacteria afecte el sistema del cuerpo que combate las infecciones (sistema inmunitario). Ese sistema puede provocar una reacción inflamatoria anormal en la pared intestinal que no se detiene.

Muchas personas que tienen la enfermedad de Crohn tienen sistemas inmunitarios anormales. Sin embargo, los expertos no saben si los problemas inmunitarios causan la enfermedad. Tampoco saben si la enfermedad de Crohn puede causar problemas inmunitarios. El estrés no parece causar esta afección.

¿Quiénes corren el riesgo de tener enfermedad de Crohn?

Esta enfermedad se puede presentar a cualquier edad. Afecta principalmente a las personas que tienen entre 15 y 35 años de edad. También puede aparecer en niños o personas mayores. Afecta a los hombres y a las mujeres por igual.

Es posible que tenga un riesgo mayor de tener enfermedad de Crohn si usted:

  • Tiene antecedentes familiares de enfermedad de Crohn. En la mayoría de los casos, es un pariente cercano como su padre, madre, hermano, hermana o hijo.
  • Tiene ascendencia de Europa del este, especialmente los judíos de ascendencia europea.
  • Es blanco.
  • Vive en un país desarrollado, en una ciudad o en un clima del norteño.
  • Fuma.

¿Cuáles son los síntomas de la enfermedad de Crohn?

Los síntomas pueden variar de una persona a otra y pueden incluir, por ejemplo:

  • Dolor abdominal, con frecuencia en la zona inferior derecha
  • Diarrea, a veces con sangre
  • Sangrado rectal
  • Pérdida de peso
  • Fiebre
  • Dolor en las articulaciones
  • Un corte o rajadura en el ano (fisura anal)
  • Salpullido

Es posible que no presente síntomas por un tiempo largo, incluso años. Esto se conoce como estar en remisión. No existe una manera de saber cuándo puede haber una remisión ni cuándo regresarán sus síntomas.

Los síntomas de la enfermedad de Crohn pueden parecerse a los de otros problemas de salud. Consulte siempre a su proveedor de atención médica para confirmar cuál es su afección.

¿Cómo se diagnostica la enfermedad de Crohn?

Es posible que le revisen para detectar signos de enfermedad de Crohn si usted tiene lo siguiente por un tiempo prolongado (crónico):

  • Dolor abdominal
  • Diarrea
  • Fiebre
  • Pérdida de peso
  • Anemia, que es una pérdida de glóbulos rojos saludables que puede hacerle sentir cansado

Su proveedor de atención médica le hará preguntas sobre su historia clínica (antecedentes médicos) y le hará un examen físico.

Otras pruebas relacionadas con la enfermedad de Crohn pueden ser, por ejemplo:

  • Análisis de sangre. Se hacen para saber si usted tiene una reducción de la cantidad de glóbulos rojos sanos (anemia) debida a pérdida de sangre. Estas pruebas también revisan si usted tiene una cantidad mayor de la normal de glóbulos blancos. Eso podría significar que usted tiene un problema inflamatorio.
  • Cultivo de heces. Se hace para saber si usted tiene alguna bacteria anormal en su tracto digestivo que pueda causar diarrea u otros problemas. Se recolecta una muestra pequeña de sus heces y se envía a un laboratorio. En dos o tres días, el análisis mostrará si usted tiene una bacteria anormal o si perdió sangre. También se verá si tiene una infección con un parásito o bacteria que esté causando sus síntomas.
  • Endoscopia superior (EGD).  Este examen observa el interior de su esófago, su estómago y la parte superior de su intestino delgado, que se llama duodeno. Este examen usa un tubo delgado y con luz llamado endoscopio. El tubo tiene una cámara en un extremo. Se coloca entrando por su boca y bajando por su garganta. Luego entra en su esófago, su estómago y su duodeno. Su proveedor de atención médica puede ver el interior de esos órganos. También puede tomarle una muestra pequeña de tejido (biopsia) si es necesario.
  • Colonoscopia. Este examen observa la totalidad del recorrido de su intestino grueso. Puede ayudar a revisar cualquier crecimiento anormal, tejido que esté rojo o hinchado, llagas o sangrado. Se utiliza un instrumento largo y flexible con luz llamado colonoscopio. Se coloca en su recto y se lo hace subir hasta el colon. Ese tubo permite a su proveedor ver el revestimiento de su colon y tomar una muestra de tejido o biopsia para analizarla. También es posible que trate algunos problemas que puedan encontrarse.
  • Biopsia. Su proveedor de atención médica extraerá tejido o células del revestimiento de su colon para observarlos con un microscopio.
  • Serie del tracto GI superior o prueba del trago de bario.  Esta prueba observa los órganos de la parte superior de su sistema digestivo. Revisa su esófago, su estómago y la primera parte de su intestino delgado, llamada duodeno. Usted tragará un líquido tipo tiza que se llama bario. El bario baña los órganos de modo tal que se pueden ver en una radiografía. Luego se toman radiografías para revisar sus órganos digestivos. 
  • Serie del tracto GI inferior o enema de bario. Esta prueba revisa su intestino grueso, incluso el colon y el recto. Un líquido espeso con aspecto de tiza llamado bario se coloca en un tubo.  Se inserta en su recto como un enema. El bario baña los órganos de modo tal que se pueden ver en una radiografía. Una radiografía de su abdomen mostrará cualquier zona que esté estrechada (conocida como estenosis). También mostrará si existen bloqueos u otros problemas.
  • Tomografía computarizada. La tomografía computarizada (CT o CAT, por sus siglas en inglés) usa imágenes radiográficas para crear una vista del intestino. Se puede hacer con una vía intravenosa (IV) y un medio de contraste (tintura) que se toma por boca.
  • Resonancia magnética. Esta prueba (MRI, por sus siglas en inglés) usa un campo magnético y energía de radiofrecuencia para crear una vista del abdomen, la pelvis y el intestino. Se puede hacer inyectando un medio de contraste intravenoso y, en algunos casos, con un contraste rectal.

¿Cómo se trata la enfermedad de Crohn?

Su proveedor de atención médica diseñará un plan de cuidados para usted sobre la base de:

  • Su edad, su estado general de salud y su historia clínica
  • La gravedad de su caso
  • Su manejo de ciertos medicamentos, tratamientos o terapias
  • Sus objetivos de planificación familiar (como quedar embarazada)
  • La expectativa de empeoramiento de su afección
  • Sus deseos

No existe ninguna cura para la enfermedad de Crohn. Sin embargo, existen algunas medidas que pueden ayudar a controlarla. El tratamiento tiene tres objetivos:

  • Aliviar los síntomas como el dolor abdominal, la diarrea y el sangrado rectal
  • Controlar el enrojecimiento o la hinchazón (inflamación)
  • Ayudar a nutrirse bien

El tratamiento puede incluir:                    

  • Medicamentos. Algunos medicamentos puede ayudar a aliviar los cólicos abdominales y la diarrea. Los medicamentos suelen reducir la inflamación del colon. Si el suyo es un caso más serio, es posible que necesite medicamentos que afectarán el sistema de su cuerpo para combatir infecciones (sistema inmunitario).  Esos medicamentos vienen en pastillas, inyecciones (llamadas medicamentos biológicos) o combinaciones de las dos formas de administración. Es muy importante analizar las ventajas y desventajas del medicamento con su médico, y no dejar de tomar los medicamentos sin avisarle al médico. A veces dejar un medicamento limitará la capacidad de este de ayudarle de nuevo en el futuro.
  • Dieta. No se ha demostrado que exista una dieta especial que ayude a prevenir o tratar la enfermedad de Crohn. Sin embargo, una dieta especial llamada dieta elemental puede tratar la enfermedad de Crohn en algunas situaciones. En algunos casos, los síntomas empeoran por el consumo de leche, alcohol, especias picantes o fibra.
  • Suplementos. Su proveedor de atención médica puede sugerirle que consuma suplementos nutricionales o fórmulas líquidas especiales con un contenido alto de calorías. Estas pueden ayudar a los niños que no están creciendo con la velocidad adecuada.
  • Alimentación intravenosa (IV). En casos poco frecuentes, la alimentación IV se puede usar para personas que necesitan una nutrición adicional por un período corto de tiempo.
  • Cirugía.  La cirugía puede aliviar la enfermedad de Crohn, pero no la cura. La hinchazón o inflamación generalmente regresa junto a la zona donde se quitó intestino.

Además, si su colon está comprometido por la enfermedad de Crohn, necesitará hacerse una colonoscopia con diferentes intervalos.

Opciones de cirugía

La cirugía puede ayudar a reducir los síntomas de larga duración (es decir, crónicos) que no mejoran con el tratamiento. También puede reparar algunos problemas como bloqueo del intestino, un agujero (perforación), un absceso o sangrado.

Los tipos de cirugía pueden incluir:

Limpieza de abscesos en o cerca de fístulas. Un absceso es una acumulación de pus o infección. El tratamiento incluye antibióticos y medicamentos inyectables, como los biológicos, pero a veces se necesita cirugía.

Resección de intestinos. Se quita la parte muerta del intestino. Luego se conectan las dos partes sanas del intestino. Esta es una cirugía que acorta sus intestinos. 

Ostomía. Cuando se extrae una parte del intestino, entonces se crea una forma nueva de retirar las heces de su cuerpo. La cirugía para crear la abertura nueva se llama ostomía. La abertura nueva se llama estoma. Existen diferentes tipos de cirugía de ostomía: El tipo de cirugía que se haga dependerá de qué cantidad y de qué parte de sus intestinos se quite. Una cirugía de ostomía puede incluir:

  • Ileostomía. El colon y el recto se quitan y la parte inferior de su intestino delgado (íleon) se conecta con la nueva abertura (estoma).
  • Colostomía.  Esta cirugía crea una abertura en su abdomen. Una parte pequeña del colon pasa por esta abertura y llega a la superficie de la piel. En algunos casos, es posible que se haga una colostomía de corta duración. Se usa cuando se extrajo una parte del colon y el resto del colon necesita curarse.
  • Cirugía de reservorio íleoanal. Es posible que se haga en cambio de una ileostomía permanente. Se realiza en dos operaciones. Primero se quitan el colon y el recto, y se hace una ileostomía de corta duración. Luego se cierra la ileostomía. Parte del intestino delgado se usa para crear un saco interno para contener las heces. Ese saco se conecta con el ano. El músculo del recto se deja en su lugar para que las heces del saco no se filtren al ano. Las personas que se hacen esta cirugía son capaces de controlar sus movimientos intestinales.

¿Cuáles son las complicaciones de la enfermedad de Crohn?

Esta afección puede causar otros problemas de salud, por ejemplo:

  • Un bloqueo intestinal
  • Un tipo de túnel, llamado fístula, en los tejidos cercanos (se puede infectar)
  • Roturas o rasgaduras, llamadas fisuras, en su ano
  • Cáncer de colon (si su colon está comprometido por la enfermedad de Crohn)
  • Problemas el funcionamiento de su hígado
  • Cálculos biliares
  • Falta de algunos nutrientes, por ejemplo, calorías, proteínas y vitaminas
  • Una cantidad demasiado baja de glóbulos rojos o muy poca hemoglobina en su sangre (anemia)
  • Debilidad de los huesos, ya sea porque están quebradizos (osteoporosis) o porque están blandos (osteomalacia)
  • Un trastorno del sistema nervioso por el cual las piernas resultan doloridas y que se conoce como síndrome de las piernas inquietas
  • Artritis
  • Problemas de la piel
  • Enrojecimiento o hinchazón (inflamación) de los ojos o la boca

La enfermedad de Crohn también puede conducir a una afección llamada malabsorción. Los intestinos ayudan a digerir y absorber los alimentos. La malabsorción se presenta cuando los alimentos no se digieren bien y el cuerpo no absorbe los nutrientes. Eso puede provocar un crecimiento y desarrollo deficientes. La malabsorción puede ocurrir cuando el tracto digestivo se inflama o si después de una cirugía se presenta síndrome del intestino corto.

Los síntomas comunes de malabsorción incluyen los siguientes:

  • Heces blandas o diarrea
  • Grandes cantidades de grasa en las heces, lo que se llama esteatorrea
  • Pérdida de peso o poco crecimiento
  • Pérdida de líquidos o deshidratación
  • Falta de vitaminas y minerales

¿Qué puedo hacer para prevenir la enfermedad de Crohn?

Los expertos no saben a qué se debe la enfermedad de Crohn ni cómo se puede prevenir.

Cómo vivir con la enfermedad de Crohn

Es importante que usted colabore con su proveedor de atención médica para manejar su enfermedad. Siga todas las instrucciones sobre medicamentos, dieta y cambios del estilo de vida.

¿Cuándo debo llamar a mi proveedor de atención médica?

Llámelo si sus síntomas empeoran o si aparecen síntomas nuevos.

Puntos clave

  • La enfermedad de Crohn provoca enrojecimiento, hinchazón (inflamación) y llagas o úlceras en todo el recorrido de su tracto digestivo.
  • Es un tipo de enfermedad inflamatoria intestinal (IBD, por sus siglas en inglés).
  • En la mayoría de los casos, afecta el intestino delgado. Sin embargo, puede afectar todo el tracto digestivo.
  • Es una afección de larga duración (crónica).
  • No existe cura. Hacer algunos cambios en la dieta puede ayudar a aliviar los síntomas.
  • La mayoría de las personas que tienen enfermedad de Crohn necesitan tomar medicamentos a largo plazo para limitar el desarrollo de otros problemas de salud futuros.  Es posible que se necesite una cirugía.

Próximos pasos

Consejos para ayudarle a aprovechar al máximo la visita a su proveedor de atención médica:

  • Antes de su visita, escriba las preguntas que quiere hacerle.
  • Lleve a alguien con usted para que le ayude a hacer las preguntas y para que recuerde lo que el proveedor le dice.
  • En la consulta, anote los nombres de los nuevos medicamentos, tratamientos o pruebas y análisis, y toda nueva instrucción que su proveedor le dé.
  • Si tiene una cita de control, anote la fecha, la hora y el propósito de esa visita.
  • Averigüe cómo comunicarse con su proveedor si tiene preguntas.

Crohn's Disease

An inflammatory disease which may affect any part of the gastrointestinal tract, causing a wide variety of symptoms.

Learn More

Gastroesophageal Reflux Disease (GERD)/Heartburn

Gastroesophageal Reflux Disease (GERD)/Heartburn

Whether you want to learn about GERD symptoms, prevention or treatment, Baylor is here for you. Our system of hospitals and outpatient centers offers the experience, expertise and technology you can trust.

What is GERD?

Illustration demonstrating  gastroesophageal reflux
Click Image to Enlarge

Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus.

Gastroesophageal refers to the stomach and esophagus, and reflux means to flow back or return. Gastroesophageal reflux (GER) is the return of acidic stomach juices, or food and fluids, back up into the esophagus.

What are the symptoms of GERD?

The following is the most common symptom of GERD. However, each individual may experience symptoms differently.

Heartburn, also called acid indigestion, is the most common symptom of GERD. Heartburn is described as a burning chest pain that begins behind the breastbone and moves upward to the neck and throat. It can last as long as two hours and is often worse after eating. Lying down or bending over can also result in heartburn.

Most children younger than 12 years of age, and some adults, diagnosed with GERD will experience a dry cough, asthma symptoms, or trouble swallowing, instead of heartburn. Heartburn pain is less likely to be associated with physical activity.

The symptoms of GERD may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

If you believe you have GERD symptoms, talk to your doctor. If you have been diagnosed with GERD, search online to find a physician, or call 1.800.4BAYLOR for digestive treatment in Dallas-Fort Worth.

What causes GERD?

GERD typically occurs when acid from the stomach backs up into the esophagus. The lower esophageal sphincter (LES), a muscle located at the bottom of the esophagus, opens to let food in and closes to keep it in the stomach. When this muscle relaxes too often or for too long, acid refluxes back into the esophagus, causing heartburn.

Other lifestyle contributors to GERD may include the following:

  • Being overweight

  • Overeating

  • Consuming certain foods, such as citrus,chocolate, fatty, and spicy foods

  • Caffeine

  • Alcohol

  • Smoking

  • Use of nonsteroidal anti-inflammatory (NSAIDs) drugs, such as aspirin and ibuprofen

Other conditions associated with heartburn may include the following:

  • Gastritis. This is inflammation of the stomach lining

  • Ulcer disease

How is GERD diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for GERD may include the following:

  • Upper GI (gastrointestinal) series (also called barium swallow). A diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an X-ray) is swallowed. X-rays are then taken to evaluate the digestive organs.

  • Esophagogastroduodenoscopy (also called EGD or upper endoscopy). An EGD (upper endoscopy) is a procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the doctor to view the inside of this area of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary).

Illustration of an esophagogastroduodenoscopy procedure
Click Image to Enlarge

  • Bernstein test. A test that helps to confirm that the symptoms are a result of acid in the esophagus. The test is performed by dripping a mild acid through a tube placed in the esophagus.

  • Esophageal manometry. This test helps determine the strength of the muscles in the esophagus. It is useful in evaluating gastroesophageal reflux and swallowing abnormalities. A small tube is guided into the nostril, then passed into the throat, and finally into the esophagus. The pressure the esophageal muscles produce at rest is then measured.

  • pH monitoring. This measures the acidity inside of the esophagus. It is helpful in evaluating gastroesophageal reflux disease (GERD). A thin, plastic tube is placed into a nostril, guided down the throat, and then into the esophagus. The tube stops just above the lower esophageal sphincter, which is at the connection between the esophagus and the stomach. At the end of the tube inside the esophagus is a sensor that measures pH, or acidity. The other end of the tube outside the body is connected to a monitor that records the pH levels for a 24 to 48 hour period. Normal activity is encouraged during the study, and a diary is kept of symptoms experienced, or activity that might be suspicious for reflux, such as gagging or coughing. It is also recommended to keep a record of the time, type, and amount of food eaten. The pH readings are evaluated and compared to the patient's activity for that time period.

If you have been diagnosed with GERD, search online to find a physician, or call 1.800.4BAYLOR for digestive treatment in Dallas-Fort Worth.

Treatment for GERD

Specific treatment for GERD will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the condition

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

In many cases, GERD can be relieved through diet and lifestyle changes, as directed by your doctor. Some ways to manage heartburn include the following:

  • Monitor the medications you are taking--some may irritate the lining of the stomach or esophagus.

  • Quit smoking.

  • Watch food intake and limit fried and fatty foods, peppermint, chocolate, alcohol,citrus fruit and juices, tomato products, and caffeinated drinks, such as coffee, soda pop, and energy drinks. .

  • Eat smaller portions.

  • Avoid overeating.

  • Watch consumption of alcohol.

  • Do not lie down or go to bed right after a meal. Instead, wait a couple of hours.

  • Lose weight, if necessary.

  • Elevate the head of the bed 6 inches by placing bricks or cinderblocks under the legs of the bed.

  • Take an antacid, as directed by your doctor.

  • Ask your doctor about use of over-the-counter medicines called "H2-blockers" and "protein pump inhibitors". Formerly available only by prescription, these drugs can be taken before eating to prevent heartburn from occurring. Also, promotility medications, which help to empty food from the stomach, may be prescribed by your doctor.

  • Occasionally, a surgical procedure called fundoplication may be performed to help keep the esophagus in proper position and prevent reflux.

We offer advanced methods of GERD treatment. Search online to find a physician, or call 1.800.4BAYLOR for digestive treatment in Dallas-Fort Worth.

Gastroesophageal (or gastric) reflux disease (GERD)

A condition in which the liquid content of the stomach backs up into the esophagus.

Learn More

Ulcerative ColitisColitis Ulcerativa

Ulcerative Colitis

What is ulcerative colitis?

Ulcerative colitis is part of a group of diseases called inflammatory bowel disease (IBD).

It is when the lining of your large intestine (the colon or large bowel) and your rectum become red and swollen or inflamed. In most cases the inflammation begins in your rectum and lower intestine and moves up to the whole colon.

Ulcerative colitis does not normally affect the small intestine. But it can affect the lower section of your small intestine (the ileum).

The inflammation causes diarrhea, making your colon empty itself often. As the cells on the lining of the colon die and come off, open sores or ulcers form. These ulcers may cause pus, mucus, and bleeding.

In most cases, ulcerative colitis starts when you are between the ages of 15 and 30 years old. Sometimes children and older people get it. It affects both men and women and seems to run in some families (is hereditary).

Ulcerative colitis is a long-term, chronic disease. There may be times when your symptoms go away and you are in remission for months or even years. But the symptoms will come back.

If only your rectum is affected, your risk of colon cancer is not higher than normal. Your risk is higher than normal if the disease affects part of your colon, and greatest if it affects your whole colon.

In rare cases, when severe problems occur, ulcerative colitis can lead to death.

What causes ulcerative colitis?

Experts don’t know what causes ulcerative colitis.

It may be that a virus or a bacteria affects the body's infection-fighting system (immune system). The immune system may create abnormal redness and swelling (inflammation) in the intestinal wall that does not go away.

Many people with ulcerative colitis have abnormal immune systems. But experts don’t know if immune problems cause the disease. They also don’t know if ulcerative colitis may cause immune problems.

Having stress or being sensitive to some foods does not seem to cause ulcerative colitis.

Right now there is no cure, except for surgery to remove the colon.

Who is at risk for ulcerative colitis?

Some things may make you at higher risk for ulcerative colitis. These include your:

  • Age. The disease most often starts when you are between the ages of 15 and 30 years old.
  • Family history. Having a family member or close blood relative with ulcerative colitis raises your risk of getting the disease.
  • Race and ethnicity. It occurs more often in whites and people of Jewish background

What are the symptoms of ulcerative colitis?

Each person’s symptoms may vary. The most common symptoms include:

  • Belly or abdominal pain
  • Bloody diarrhea
  • Extreme tiredness (fatigue)
  • Weight loss
  • Loss of appetite
  • Rectal bleeding
  • Loss of body fluids and nutrients
  • Loss of blood (anemia) caused by severe bleeding

In some cases, symptoms may also include:

  • Skin sores
  • Joint pain
  • Redness and swelling (inflammation) of the eyes
  • Liver disorders
  • Weak and brittle bones (osteoporosis)
  • Rashes
  • Kidney stones

The symptoms of ulcerative colitis may look like other health problems. Always see your healthcare provider to be sure.

How is ulcerative colitis diagnosed?

Your healthcare provider will give you a physical exam and do some blood tests. The blood tests will check your red blood cells and white blood cells. If your red blood cell count is low, this is a sign of anemia. If your white blood cell count is high, this is a sign of redness and swelling (inflammation).

Other tests for ulcerative colitis include:

  • Stool culture. Checks for any abnormal bacteria in your digestive tract that may cause diarrhea and other problems. To do this, a small stool sample is taken and sent to a lab. In 2 or 3 days, the test will show if abnormal bacteria, bleeding, or infection are ­present.
  • Upper endoscopy, also called EGD (esophagogastroduodenoscopy). This test looks at the inside or lining of your food pipe (esophagus), stomach, and the top part of your small intestine (duodenum). This test uses a thin, lighted tube, called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes into your esophagus, stomach, and duodenum. Your healthcare provider can see the inside of these organs. He or she can also take a small tissue sample (biopsy) if needed.
  • Colonoscopy. This test looks at the full length of your large intestine. It can help check for any abnormal growths, tissue that is red or swollen, sores (ulcers), or bleeding. A long, flexible, lighted tube called a colonoscope is put into your rectum up into the colon. This tube lets your healthcare provider see your colon lining and take out a tissue sample (biopsy) to test it. He or she may also be able to treat some problems that may be found.
  • Biopsy. Your healthcare provider will take out a tissue sample or cells from the lining of your colon. This will be checked under a microscope.
  • Lower GI (gastrointestinal) series, also called barium enema. This is an X-ray exam of your rectum, the large intestine, and the lower part of your small intestine (the ileum). You will be given a metallic fluid called barium. Barium coats the organs so they can be seen on an X-ray. The barium is put into a tube and inserted into your rectum as an enema. An X-ray of your belly will show if you have any narrowed areas (strictures), blockages, or other problems.

How is ulcerative colitis treated?

Your healthcare provider will create a care plan for you based on:

  • Your age, overall health, and past health
  • How serious your case is
  • How well you handle certain medicines, treatments, or therapies
  • If your condition is expected to get worse
  • Your intended family plans, such as getting pregnant
  • What you would like to do

There is no special diet for ulcerative colitis. But you may be able to manage mild symptoms by not eating foods that seem to upset your intestines.

Medical treatment may include:

  • Medicines. Medicines that reduce redness and swelling (inflammation) in your colon may help to ease your belly or abdominal cramps. More serious cases may need steroids, medicines that fight bacteria (antibiotics), or medicines that affect your infection-fighting system (immune system). Steroids are not a good choice for long-term management. Therefore, your healthcare provider will discuss medicines for long-term control. This may include pills, injections, or a combination. In addition, placing a medicine into the rectum (foam, enema, or suppository) can be very helpful in controlling your symptoms.
  • Hospitalization. This may be needed if you have severe symptoms. The goal will be to give you the nutrients you need, stop diarrhea, and replace lost blood, fluids, and electrolytes (minerals).You may need a special diet, IV (intravenous) feedings, medicines, or sometimes surgery.
  • Surgery. Most people don’t need surgery. But some people do need surgery to remove their colon. That might happen if you have heavy bleeding, are very weak after being ill for a long time, have a hole (perforation) in your colon, or are at risk for cancer. You may also need surgery if medical treatment fails or if the side effects of steroids and other medicines become harmful.

There are several types of surgery, including the following:

  • Proctocolectomy with ileostomy. This is the most common surgery. It is done when other medical treatment does not help. Your entire colon and your rectum are removed. A small opening (stoma) is made in your belly or abdominal wall. The bottom part of your small intestine (the ileum) is attached to the new opening. Your stool will come out of this opening. It will collect in a drainage bag that will be attached to you.
  • Ileoanal anastomosis. Your whole colon and the diseased lining of your rectum are removed. The outer muscles of your rectum stay in place. The bottom part of your small intestine (the ileum) is attached to the opening of your anus. A pouch is made out of the ileum. The pouch holds stool. This lets you pass stool through your anus in the normal way. You will still have fairly normal bowel movements. But your bowel movements may happen more often. They may also be more watery than normal.

If your colon remains inside, you will need a colonoscopy at various intervals because of your increased risk of colon cancer.

What are the complications of ulcerative colitis?

Ulcerative colitis is a long-term, chronic condition. It can lead to problems over time, including:

  • Loss of appetite, leading to weight loss
  • Lack of energy (fatigue)
  • Severe bleeding (hemorrhage)
  • Hole or tear (perforation) in the colon
  • Infection of the colon
  • Severe fluid loss (dehydration)
  • Joint pain
  • Eye problems
  • Kidney stones
  • Weak, brittle bones (osteoporosis)
  • Colon cancer, if ulcerative colitis affects much of or the whole colon over a long period of time

In rare cases, when severe problems occur, ulcerative colitis can lead to death.

Can ulcerative colitis be prevented?

Experts don’t know what causes ulcerative colitis. They also don’t know how to stop the disease from happening.

When should I call my healthcare provider?

Call your healthcare provider right away if:

  • Your symptoms come back after they have gone away
  • Your symptoms worsen
  • You have new symptoms

Key points

  • Ulcerative colitis is when the lining of your large intestine and your rectum become red and swollen or inflamed.
  • It is part of a group of diseases called inflammatory bowel disease (IBD).
  • It affects men and women equally and seems to run in some families (is hereditary).
  • It is a long-term, chronic disease.
  • Experts don’t know what causes it.
  • While medicines can't cure it, they can control symptoms in most cases.

 

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Inflammatory Bowel Disease

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Liver Disease Statistics

The following are the latest statistics available from the Centers for Disease Control and Prevention and the American Liver Foundation:

  • Cirrhosis and other chronic liver diseases are common disease-related causes of death in the U.S. Approximately 31,000 people in the U.S. die each year from cirrhosis.

  • The vast majority of cases of cirrhosis could be prevented by eliminating chronic alcohol abuse.

  • Approximately 2.7 to 3.9 million people in the U.S. are chronically infected with the hepatitis C virus. About 16,000 people die of hepatitis C annually in the U.S.

  • Hepatitis B kills approximately 3,000 people in the U.S. annually, and 1.2 million people in the U.S. are infected with the virus.

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The term "liver disease" applies to many diseases and disorders that cause the liver to function improperly or cease functioning.

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We offer many methods of advanced digestive disease treatment. Search online to find a physician or call 1.800.4BAYLOR for digestive treatment in Dallas-Fort Worth.