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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 stomach. 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 stomach.

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.

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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

What is hepatitis C?

Hepatitis C is a liver disease that is caused by the hepatitis C virus. Hepatitis C is one type of hepatitis.

Hepatitis is a redness and swelling (inflammation) of the liver that sometimes causes lasting damage. The liver isn’t able to work the way it should.

Hepatitis C can be short-term (acute) or long-term (chronic):

  • Acute hepatitis C. This is a brief infection that lasts 6 months or less. It goes away because your body gets rid of the virus.
  • Chronic hepatitis C. This is a long-lasting infection that happens when your body can’t get rid of the virus. It causes long-term liver damage.

It is rare to recover from hepatitis C infection. Most people with hepatitis C have the virus for the rest of their life.

What causes hepatitis C?

Hepatitis C is caused by infection from the hepatitis C virus. Like other viruses, hepatitis C is passed from person to person. This happens when you have contact with an infected person’s blood.

You may get the virus if you:

  • Share needles used for illegal drugs.
  • Have unprotected sex with someone who has hepatitis C

 Babies may also get the disease if their mother has the hepatitis C virus.

Who is at risk for hepatitis C?

Anyone can get hepatitis C by having contact with the blood of someone who is infected with the virus.

But some people are at higher risk for the disease. They include:

  • Children born to mothers who are infected with hepatitis C
  • People who have jobs that involve contact with human blood, body fluids, or needles
  • People who have a blood-clotting disorder such as hemophilia, and received clotting factors before 1987
  • People who need dialysis treatment for kidney failure
  • People who had blood transfusions, blood products, or organ transplants before the early 1990s
  • People who take IV or intravenous drugs
  • People who have unprotected heterosexual or homosexual sex
  • People with HIV

What are the symptoms of hepatitis C?

Many people with hepatitis C don’t know they have it. In most cases people who are infected with hepatitis C may not show any symptoms for several years.

It is still possible to pass the virus to someone else if you have hepatitis C but do not have any symptoms.  

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

  • Loss of appetite
  • Extreme tiredness (fatigue)
  • Nausea and vomiting
  • Stomach pain
  • Yellowing of the skin and eyes (jaundice)
  • Fever
  • Diarrhea
  • Dark yellow urine
  • Light-colored stools
  • Muscle and joint pain

Hepatitis C symptoms may look like other health problems. Always see your healthcare provider to be sure.

How is hepatitis C diagnosed?

Your healthcare provider will give you a physical exam and ask about your past health. He or she will also do a blood test to see if you have hepatitis C.

If your provider thinks you have long-term (chronic) hepatitis C, he or she may take a small tissue sample (biopsy) from your liver with a needle. The sample is checked under a microscope to see what type of liver disease you have and how severe it is.

How is hepatitis C treated?

Hepatitis C is not treated unless it becomes a long-term or chronic infection. Then medicines are used to try to slow down or stop the virus from hurting your liver. Your symptoms will be closely watched and managed as needed.

If severe liver damage takes place, you may need a liver transplant.

There is no cure for hepatitis C.

What are the complications of hepatitis C?

Many people with hepatitis C develop chronic liver disease. You could need a liver transplant. Hepatitis C is the most common cause of liver transplants in the U.S.

Liver failure can lead to death.

The risk of liver cancer is higher in people with hepatitis C.

What can I do to prevent hepatitis C?

There is no vaccine to prevent hepatitis C. But you can protect yourself and others from getting infected by:

  • Making sure any tattoos or body piercings are done with sterile tools
  • Not sharing needles and other drug materials
  • Not sharing toothbrushes or razors
  • Not touching another person’s blood unless you wear gloves
  • Using condoms during sex

Key points about hepatitis C

  • Hepatitis C is a liver disease caused by infection from the hepatitis C virus.
  • The virus causes redness and swelling (inflammation) in your liver.
  • The virus spreads when you have contact with an infected person’s blood.
  • Anyone can get hepatitis C but some people are at higher risk.
  • You may not have any symptoms for years.
  • The risk of liver cancer is higher in people with hepatitis C.
  • There is no vaccine to prevent hepatitis C.

Next steps

Tips to help you get the most from a visit to your health care 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.

Hepatitis B & C

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

Learn More

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 CancerCáncer Pancreático

Pancreatic Cancer

What is pancreatic cancer?

Pancreatic cancer is the fourth most common cause of cancer death in the U.S. Pancreatic cancer occurs when a cell in the pancreas is damaged and this malignant (cancer) cell starts to grow out of control.

There are several types of pancreatic cancers, including the following:

  • Adenocarcinoma of the pancreas. The most common pancreatic cancer, which occurs in the lining of the pancreatic duct.

  • Adenosquamous carcinoma. A rare pancreatic cancer.

  • Squamous cell carcinoma. A rare pancreatic cancer.

What are the risk factors for pancreatic cancer?

Risk factors for pancreatic cancer include:

  • Age. Most pancreatic cancer occurs in people over the age of 55.

  • Smoking. Heavy cigarette smokers are 2 or 3 times more likely than nonsmokers to develop pancreatic cancer.

  • Obesity and physical inactivity. Pancreatic cancer is more common in people who are very overweight and in people who don't get much physical activity.

  • Diabetes. Pancreatic cancer occurs more often in people who have type 2 diabetes than in those who do not.

  • Gender. More men than women are diagnosed with pancreatic cancer.

  • Race. African-Americans are more likely than Asians, Hispanics, or whites to be diagnosed with pancreatic cancer.

  • Family history. The risk for developing pancreatic cancer is higher if a person's mother, father, or a sibling had the disease.

  • Cirrhosis of the liver. People with cirrhosis have a higher risk of pancreatic cancer.

  • Workplace exposures. Exposure to certain occupational pesticides, dyes, and chemicals used in the metal industry may increase the risk of pancreatic cancer.

  • Some genetic syndromes. Certain inherited gene mutations, such as in the BRCA2 gene, increase the risk of pancreatic cancer.

  • Chronic pancreatitis. Long-term inflammation of the pancreas has been linked with increased risk for pancreatic cancer.

What are the symptoms of pancreatic cancer?

The following are the other most common symptoms of pancreatic cancer. However, each person may experience symptoms differently. Symptoms may include:

  • Pain in the upper abdomen (belly) or upper back

  • Loss of appetite

  • Weight loss

  • Jaundice (yellow skin and eyes, and dark urine)

  • Indigestion

  • Nausea

  • Vomiting

  • Extreme tiredness (fatigue)

  • An enlarged abdomen from a swollen gallbladder 

  • Pale, greasy stools that float in the toilet 

The symptoms of pancreatic cancer may be a lot like those of other conditions or medical problems. Always consult your doctor for a diagnosis.

How is pancreatic cancer diagnosed?

Technician preparing patient for CT scan

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

  • Ultrasound. A diagnostic imaging technique that uses high-frequency sound waves to create an image of the internal organs. Ultrasounds are used to view internal organs of the abdomen such as the liver, pancreas, spleen, and kidneys and to assess blood flow through various vessels. The ultrasound may be done using an external or internal device:

    • Transabdominal ultrasound. The technician places an ultrasound device on the abdomen to create the image of the pancreas.

    • Endoscopic ultrasound (EUS). The doctor inserts an endoscope, a small, flexible tube with an ultrasound device at the tip, through the mouth and stomach, and into the small intestine. As the doctor slowly withdraws the endoscope, images of the pancreas and other organs are made. 

  • 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.

  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

  • Endoscopic retrograde cholangiopancreatography (ERCP). A procedure that allows the doctor to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. The procedure combines X-ray and the use of an endoscope, a long, flexible, lighted tube. The scope is guided through the patient's mouth and throat, then through the esophagus, stomach, and duodenum (first part of the small intestine). The doctor can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope, and a dye is injected that will allow the bile and pancreatic ducts to be seen on an X-ray.

  • Percutaneous transhepatic cholangiography (PTC). A needle is put through the skin and into the liver where the dye (contrast) is injected so that the bile duct structures can be seen by X-ray. This test is generally only done if an ERCP cannot be done. 

  • Pancreas biopsy. A procedure in which a sample of pancreatic tissue is removed (with a needle or during surgery) for examination under a microscope.

  • Special blood tests

  • Positron emission tomography (PET). A type of nuclear medicine procedure. For this test, a radioactive substance, usually bound to a type of sugar, is injected through a vein before the body is scanned. The radioactive sugar collects in cancer cells, which will show up on images. This test is not as specific as CT scanning, and is not used alone to diagnose pancreatic cancer. A PET scan is often done in combination with a CT scan.

Treatment for pancreatic cancer

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

  • Your age, overall health, and medical history

  • Location and extent of the disease

  • Type of cancer

  • Your tolerance of specific medicines, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Depending on the type and stage, pancreatic cancer may be treated with the following:

  • Surgery. This treatment may be necessary to remove the tumor, a section, or the entire pancreas and often parts of other organs. The type of surgery depends on the stage of the cancer, the location and size of the tumor, and the person's health. Types of surgery for pancreatic cancer include the following:

    • Whipple procedure. This procedure involves removal of the head of the pancreas, part of the small intestine, the gallbladder and part of the common bile duct, part of the stomach, and lymph nodes near the head of the pancreas. Most pancreatic tumors occur in the head of the pancreas, so the Whipple procedure is the most commonly performed surgical procedure for pancreatic cancer.

    • Distal pancreatectomy. If the tumor is located in the body and tail of the pancreas, both of these sections of the pancreas will be removed, along with the spleen.

    • Total pancreatectomy. The entire pancreas, part of the small intestine and stomach, the common bile duct, the spleen, the gallbladder, and some lymph nodes will be removed. This type of operation is not done often.

    • Palliative surgery. For more advanced cancers, surgery may be done not to try to cure the cancer, but to relieve problems such as a blocked bile duct.

  • 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. Radiation therapy may be given alone, or in combination with surgery and/or chemotherapy.

  • Chemotherapy. The use of anticancer drugs to kill cancer 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. Chemotherapy may be given alone, or in combination with surgery and radiation therapy.

  • Medication (to relieve or reduce pain)

Long-term prognosis for individuals with pancreatic cancer depends on the size and type of the tumor, lymph node involvement, and degree of metastases (spreading) at the time of diagnosis.

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

What is diarrhea?

Diarrhea is when your stools are loose and watery. You may also need to go to the bathroom more often.

Diarrhea is a common problem. It may last 1 or 2 days and goes away on its own.

If diarrhea lasts more than 2 days it may mean you have a more serious problem.

Diarrhea may be either:

  • Short-term (acute). Diarrhea that lasts 1 or 2 days and goes away. This may be caused by having food or water that was made unsafe by a bacterial infection. Or it may happen if you get sick from a virus.
  • Long-term (chronic). Diarrhea that lasts several weeks. This may be caused by another health problem such as irritable bowel syndrome. It can also be caused by an intestinal disease such as Crohn’s disease or celiac disease. Some infections such as parasites can cause chronic diarrhea.

What causes diarrhea?

Diarrhea may be caused by many things, including:

  • A bacterial infection
  • A virus
  • Trouble digesting certain things (food intolerance)
  • Food allergy (such as celiac disease, gluten allergy)
  • Parasites that enter the body through food or water
  • A reaction to medicines
  • An intestinal disease, such as inflammatory bowel disease
  • A problem with how your stomach and bowels work (functional bowel disorder), such as irritable bowel syndrome
  • A result of surgery on the stomach or gall bladder
  • Recent antibiotic use
  • Metabolic conditions such as thyroid problems
  • Other less common reasons such as damage from radiation treatments or tumors that make too many hormones

Many people get traveler's diarrhea. This happens when you have food or water that is not safe because of bacteria, parasites, and even food poisoning.

Severe diarrhea may mean you have a serious disease. See your healthcare provider if your symptoms don’t go away or if they keep you from doing your daily activities. It may be hard to find out what is causing your diarrhea.

What are the symptoms of diarrhea?

Each person’s symptoms may vary. Symptoms of diarrhea may include:

  • Belly (abdominal) cramps
  • Stomach pain
  • Swelling (bloating)
  • Upset stomach (nausea)
  • Urgent need to go to the bathroom
  • Fever
  • Bloody stools
  • Loss of body fluids (dehydration)
  • Leaking stool and not being able to control your bowels (incontinence)

Dehydration is a serious side effect of diarrhea. Symptoms include:

  • Feeling thirsty
  • Not urinating as often
  • Having dry skin as well as a dry mouth and nostrils (mucous membranes)
  • Feeling very tired
  • Feeling that you may pass out or faint (lightheaded)
  • Headaches
  • Fast heart rate
  • Sunken fontanelle (soft spot) on baby's head

Diarrhea symptoms may look like other health problems.  Bloody diarrhea is always a concern. Always see your doctor to be sure. Be sure to tell the doctor about any bleeding, fever, or vomiting.

How is diarrhea diagnosed?

To see if you have diarrhea, your healthcare provider will give you a physical exam and ask about your past health. You may also have lab tests to check your blood and urine.

Other tests may include:

  • Stool studies including culture and other tests. This test 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.
  • Sigmoidoscopy. This test lets your healthcare provider check the inside of part of your large intestine. It helps to tell what is causing diarrhea. A short, flexible, lighted tube (sigmoidoscope) is put into your intestine through the rectum. This tube blows air into your intestine to make it swell. This makes it easier to see inside. A biopsy can be taken 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 (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 can also treat some problems that may be found.
  • Imaging tests. These tests can see if there are any problems with the way your organs are formed (structural abnormalities).
  • Fasting tests. These tests show if you are unable to digest certain foods (food intolerance). They can also tell if certain foods bring on an immune system reaction (food allergy).
  • Blood tests. These can look for metabolic problems like thyroid disease, anemia (low blood count), evidence of low vitamin levels suggesting poor absorption, and celiac disease, among other things.

How is diarrhea treated?

Your healthcare provider will make 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

In most cases you will need to replace the fluids you have lost.

You may also need a medicine that fights infection (antibiotic) if a bacterial infection is causing your diarrhea.

Complications of diarrhea

If your diarrhea is not treated you are at risk for dehydration. Severe dehydration can lead to organ damage, shock, and fainting (loss of consciousness) or coma.

Can diarrhea be prevented?

Having good personal habits can keep you from getting diarrhea caused by bacteria or a virus. It is important to:

  • Wash your hands often
  • Use alcohol based sanitizers
  • Eat foods that have been cleaned and cooked in a safe way
  • Not take any foods or liquids that may have been infected with a bacteria or virus

When you are traveling, make sure anything you eat and drink is safe. This is even more important if you travel to developing countries.

Travel safety tips for water and other liquids include:

  • Not drinking tap water or using it to brush your teeth
  • Not using ice made from tap water
  • Not drinking milk or milk items that have not gone through a process to kill certain bacteria (pasteurization)

Travel safety tips for food include:

  • Not eating any fresh or raw fruits and vegetables unless you wash and peel them yourself
  • Making sure all meat and fish have been cooked to at least medium doneness
  • Not eating raw or rare-cooked meat or fish
  • Making sure meat and shellfish such as shrimp, crab, and scallops, are hot when served
  • Not eating food from street vendors or food trucks

Living with diarrhea

In most cases diarrhea is a short-term problem. Often it only lasts for a few days. Be sure to take plenty of liquids when you’re having a bout of diarrhea.

Some health problems can make diarrhea last longer or keep coming back. These include inflammatory bowel disease and irritable bowel syndrome. If another health problem is causing your diarrhea, follow your healthcare provider’s advice for treating that problem.

When should I call my healthcare provider?

Call your healthcare provider if:

  • You have diarrhea more often
  • You have a greater amount of diarrhea
  • You have symptoms of dehydration. You may feel thirsty, tired, or dizzy. You may also have less urine, or a dry mouth.
  • You have diarrhea with rectal bleeding or black and tarry stools, a fever, or are vomiting

Key points about diarrhea

  • Diarrhea is when your stools are loose and watery.
  • You may also need to go to the bathroom more often.
  • Short-term (acute) diarrhea lasts 1 or 2 days.
  • Long-term (chronic) diarrhea lasts several weeks.
  • Diarrhea symptoms may include belly cramps and an urgent need to go to the bathroom.
  • Loss of fluids (dehydration) is one of the more serious side effects.
  • Treatment usually involves replacing lost fluids.
  • You may need an infection-fighting medicine (antibiotic) if a bacterial infection is the cause.

Next steps

Tips to help you get the most from a visit to your health care 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.

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

What is Crohn's disease?

Crohn's disease occurs when there is redness and swelling (inflammation) and sores along your digestive tract. It is part of a group of diseases known as inflammatory bowel disease or IBD.

Crohn’s disease is a long-term, chronic illness that may come and go at different times in your life. In most cases, it affects the small intestine, most often the lower part called the ileum. In some cases it affects both the small and large intestines.

Sometimes the inflammation may be along your whole digestive tract. This includes your mouth, your food pipe (esophagus), your stomach, the first part of your small intestine or duodenum, your appendix, and your anus.

What causes Crohn's disease?

Experts don’t know what causes Crohn's disease. It may be that a virus or a bacteria affects the body's infection-fighting system (immune system). The immune system may create an abnormal inflammation reaction in the intestinal wall that does not stop.

Many people with Crohn’s disease have abnormal immune systems. But experts don’t know if immune problems cause the disease. They also don’t know if Crohn’s disease may cause immune problems. Stress does not seem to cause Crohn's disease.

Who is at risk for Crohn’s disease?

Crohn's disease may happen at any age. It most often affects people ages 15 to 35 years old. It can also happen in children or older people. It affects men and women equally.

You may be more at risk for Crohn’s disease if you:

  • Have a family history of Crohn’s disease. In most cases this is a close relative such as your father, mother, brother, sister, or child.
  • Have an Eastern European background, especially Jews of European descent
  • Are white
  • Live in a developed country, in a city, or in a northern climate
  • Smoke

What are the symptoms of Crohn's disease?

Each person’s symptoms may vary. Symptoms may include:

  • Belly or abdominal pain, often in the lower right area
  • Diarrhea, sometimes bloody
  • Rectal bleeding
  • Weight loss
  • Fever
  • Joint pain
  • A cut or tear in the anus (anal fissure)
  • Rashes

You may have no symptoms for a long time, even years. That is called being in remission. There is no way to know when remission may occur or when your symptoms will return.

The symptoms of Crohn's disease may look like other health problems. Always see your healthcare provider to be sure.

How is Crohn's disease diagnosed?

You may be checked for signs of Crohn's disease if you have had long-term or chronic:

  • Belly or abdominal pain
  • Diarrhea
  • Fever
  • Weight loss
  • Anemia, a loss of healthy red blood cells that can make you feel tired

Your healthcare provider will look at your past health and give you a physical exam.

 Other tests for Crohn's disease may include the following:

  • Blood tests. These are done to see if you have fewer healthy red blood cells (anemia) because of a loss of blood. These tests also check if you have a higher number of white blood cells. That might mean you have an inflammatory problem.
  • Stool culture. This is done to see if you have any abnormal bacteria in your digestive tract that may cause diarrhea or other problems. A small sample of your stool is collected and sent to a lab. In 2 or 3 days the test will show if you have abnormal bacteria or if you have lost blood. It will also show if an infection by a parasite or bacteria is causing your symptoms.
  • Upper endoscopy or EGD. This test looks at the inside of your food pipe or esophagus, stomach, and the top part of your small intestine, called the 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 or 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, or bleeding. A long, flexible, lighted tube called a colonoscope is used. It is put into your rectum up into the colon. This tube lets your provider see the lining of your colon and take out a tissue sample or 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 a tissue or cells from the lining of your colon to look at it under a microscope.
  • Upper GI series or barium swallow. This test looks at the organs of the top part of your digestive system. It checks your esophagus, stomach, and the first part of your small intestine, called the duodenum. You will swallow a chalky fluid called barium. Barium coats the organs so that they can be seen on an X-ray. Then X-rays are taken to check your digestive organs. 
  • Lower GI series or barium enema. This test checks your large intestine, including the colon and rectum. A thick, chalky fluid called barium is put into a tube. It is inserted into your rectum as an enema. Barium coats the organs, so they can be seen on an X-ray. An X-ray of your belly will show any narrowed areas called strictures. It will also show any blockages or other problems.
  • CT scan (CAT scan). This test uses X-ray images to create a view of the intestine. It may be done with an IV and oral contrast.
  • MRI. This test uses a magnetic field and radiofrequency energy to create a view of the abdomen, pelvis, and intestine. It may be done with IV contrast, and in some cases, rectal contrast.

How is Crohn’s disease 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
  • You have family planning goals (such as getting pregnant)
  • If your condition is expected to get worse
  • What you would like to do

There is no cure for Crohn's disease. But there are some things that can help to control it. Treatment has 3 goals:

  • Ease symptoms such as belly or abdominal pain, diarrhea, and rectal bleeding
  • Control redness or swelling (inflammation)
  • Help with getting the right nutrition

Treatment may include:                    

  • Medicine. Some medicines may help ease abdominal cramps and diarrhea. Medicines  often reduce inflammation in the colon. If you have a more serious case, you may need medicines that affect your body's infection-fighting system (immune system). These are given as pills, injections (called biologics), or combinations of both. It is very important to discuss the pros and cons of medicine with your doctor, and not to stop the medicines without their knowledge. Sometimes stopping a medicine will limit its ability to help you again in the future.
  • Diet. No special diet has been shown to help prevent or treat Crohn's disease. However, a special diet called an elemental diet can treat Crohn's disease in some situations. In some cases, symptoms are made worse by milk, alcohol, hot spices, or fiber.
  • Supplements. Your healthcare provider may suggest nutritional supplements or special high-calorie liquid formulas. These may be helpful for children who are not growing fast enough.
  • IV or intravenous feeding. In rare cases IV feeding may be used for people who need extra nutrition for a short period of time.
  • Surgery. Surgery may help Crohn’s disease, but it can’t cure it. The swelling or inflammation often returns next to the area where the intestine was removed.
In addition, if your colon is involved in the Crohn's disease, you will need colonoscopy at various intervals because of your increased risk of colon cancer.

Surgery options

Surgery may help to reduce long-term or chronic symptoms that don’t get better with therapy. Surgery may also fix some problems such as a blocked intestine, a hole or perforation, an abscess, or bleeding.

Types of surgery may include:

Draining abscesses in or near fistulas. An abscess is a collection of pus or infection. Treatment includes antibiotics and injectables such as biologics, but sometimes surgery is needed.

Bowel or intestinal resection. The diseased section of intestine is removed. The 2 healthy pieces of intestine are attached. This surgery shortens your intestines. 

Ostomy. When part of the intestine is removed, then a new way to remove stool from your body is created. The surgery to create the new opening is called an ostomy. The new opening is called a stoma. There are different types of ostomy surgery. The type of surgery that is done will depend on how much and what part of your intestines is removed. Ostomy surgery may include:
  • Ileostomy. The colon and rectum are removed and the bottom part of your small intestine (ileum) is attached to the new opening or stoma.
  • Colostomy. This surgery creates an opening in your belly or abdomen. A small part of the colon goes through this opening up to the surface of the skin. In some cases a short-term colostomy may be done. This is used when part of the colon has been removed and the rest of the colon needs to heal.
  • Ileoanal reservoir surgery. This may be done instead of a permanent ileostomy. It is done in 2 surgeries. First the colon and rectum are removed and a short-term ileostomy is performed. Then the ileostomy is closed. Part of the small intestine is used to create an internal pouch to hold stool. This pouch is attached to the anus. The muscle of the rectum is left in place, so the stool in the pouch does not leak out of the anus. People who have this surgery are able to control their bowel movements.

What are the complications of Crohn’s disease?

Crohn’s disease may cause other health problems. These may include:

  • A blocked intestine
  • A type of tunnel, called a fistula, in nearby tissues. This can get infected.
  • Rips or tears, called fissures, in your anus
  • Colon cancer, if your colon is involved with the Crohn's disease
  • Problems with your liver function
  • Gallstones
  • A lack of some nutrients, such as calories, proteins, and vitamins
  • Too few red blood cells or too little hemoglobin in your blood (anemia)
  • Bone weakness, either because bones are brittle (osteoporosis) or because bones are soft (osteomalacia)
  • A nervous system disorder where legs feel painful, called restless leg syndrome
  • Arthritis
  • Skin problems
  • Eye or mouth redness or swelling (inflammation)
Crohn's disease can also lead to a condition called malabsorption. The intestines help to digest and absorb foods. Malabsorption occurs when food is not digested well and nutrients are not absorbed into the body. This can lead to poor growth and development. Malabsorption may occur when the digestive tract is inflamed or if short bowel syndrome occurs after surgery.

Common symptoms of malabsorption include the following:

  • Loose stool, or diarrhea
  • Large amounts of fat in the stool, called steatorrhea
  • Weight loss or poor growth
  • Fluid loss or dehydration
  • Lack of vitamins and minerals

What can I do to prevent Crohn’s disease?

Experts don’t know what causes Crohn’s disease or how it can be prevented.

Living with Crohn’s disease

It’s important for you to work with your healthcare provider to manage your disease. Follow all instructions about medicines, diet, and lifestyle changes.

When should I call my healthcare provider?

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

Key points

  • Crohn's disease is when there is redness and swelling (inflammation) and sores or ulcers along your digestive tract.
  • It is a type of inflammatory bowel disease (IBD).
  • In most cases it affects the small intestine. But it may affect your whole digestive tract.
  • It is a long-term, chronic condition.
  • There is no cure. Making some diet changes may help ease symptoms.
  • Most people with Crohn's disease need to stay on long-term medication to limit the development of other medical problems in the future.  Surgery may be needed.

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.

Crohn's Disease

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

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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.

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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

Is a group of inflammatory conditions of the large intestine and small intestine.

Learn More

Liver Disease StatisticsEstadísticas

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.

Liver Disease

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.