Gastroenterology Treatment Options

Abdominal pain refers to any discomfort you feel in your belly region between your chest and pelvis area, and surrounded by your ribs. 

Often described as a stomach or tummy ache, the pain can come from disease or infection in any internal organ housed in your mid-region. Abdominal pain also can be caused by issues other than an underlying disease, including constipation, gas, overeating, stress or muscle strain.

Abdominal pain can be slight, moderate or severe, ranging from a dull ache to an intense stabbing. It may start slowly or come on suddenly, be constant or sporadic. Acute abdominal discomfort usually is brief and intense, while chronic abdominal pain is long-lasting, continuing for weeks, months or even years.

Achalasia is a rare disorder affecting the esophagus that occurs when esophageal nerves are damaged, preventing food and liquid from moving from your mouth to your stomach. When achalasia occurs, this muscular tube becomes paralyzed and loses the ability to squeeze food along its pathway in normal, wavelike contractions.

With achalasia, the esophageal sphincter muscle located at the end of the esophagus and entrance to the stomach doesn’t tighten properly to prevent stomach content from backing up into your esophagus. As a result, food may accumulate in the esophagus where it can be regurgitated back up into the mouth, giving a bitter taste.

Achalasia occurs most often in middle-aged or older adults. The cause is not well known. While there is no known cure for this disorder, therapies such as endoscopy, minimally invasive approaches or surgery can manage symptoms.

Acid reflux happens when stomach acid flows backward into your esophagus and irritates its lining. Also called gastrointestinal reflux, this regurgitative action can result in heartburn, a fiery sensation in your throat and chest. Heartburn can happen following a big meal or after consuming certain foods or beverages. Drinking coffee or alcohol, for example, or eating fried and fatty foods can trigger acid reflux and heartburn.

It's common to experience acid reflux sometimes and everyone has occasional heartburn. However, if it becomes chronic and more painful, acid reflux can cause serious damage if not properly treated. Those who experience acid reflux more than twice a week may be suffering from a more advanced form of reflux called GERD (gastroesophageal reflux disease).

Barrett’s esophagus is a condition in which the healthy cells lining the esophagus become damaged by continuous acid reflux or GERD. 

Repeated injury to this “food tube” connecting your mouth to your stomach may spark changes in the tissue. The lining of the esophagus thickens and turns from pink to red. Normally flat, esophageal cells change into abnormally tall, thin cells when someone is suffering from Barrett's esophagus. 

Barrett's esophagus is a precancerous condition. However, only a small percentage of people with the disease see it progress to esophageal cancer. Early detection and regular checkups are essential to monitor the condition so your physician can remove any abnormal cells before they become cancerous. 

Celiac disease is an autoimmune condition that occurs when someone has an intolerance to gluten, a protein found in wheat and other grains such as rye and barley. This disease is triggered when someone with an intolerance eats any gluten-containing food like bread, pasta, pizza or pastry.

When those with celiac disease consume gluten, their body mounts an immediate immune response that attacks and damages the lining of their small intestine. Celiac disease destroys the tiny fingerlike projections, called villi, that line the small intestine. When the villi are damaged, digestion is impaired, preventing you from getting the necessary nutrients from your food.

Celiac disease is considered a hereditary ailment and can show up at any age. It is diagnosed by a thorough medical evaluation. Left untreated, celiac disease can lead to additional serious health problems.

A colon polyp is a small growth of excess tissue that develops in the lining of the large intestine, or colon. Anyone can develop colon polyps at any age, but they are more prevalent in those over the age of 50 with a family history of colon cancer, polyps or inflammatory bowel disease. Eating a diet low in fiber and high in fat also increases your risk of developing polyps.

These polyps can develop in two shapes called pedunculated and sessile. Pedunculated polyps are tissue growths that look like tiny mushrooms because they attach to the colon lining with a long, thin stalk. Sessile polyps lie flat against the colon’s mucous membrane lining, making them harder to find. Polyps are usually painless and can be found during a colon-cancer screening called a colonoscopy. Most polyps are benign. Certain types, however, are more at risk for turning into cancer. Removal of polyps during a colonoscopy reduces the risk of developing colon cancer in the future.

Both Crohn’s disease and ulcerative colitis are types of inflammatory bowel disease (IBD) and cause inflammation to your digestive tract. While they are separate conditions, it’s easy to confuse Crohn's disease and ulcerative colitis because they have some similar symptoms, including abdominal and rectal pain. Both diseases can be painful and debilitating for those suffering from them.

The diseases differ in where they locate. Crohn’s disease causes patchy inflammation in the small intestine, while ulcerative colitis’ inflammation is confined to the lining of the colon, or large intestine. With Crohn’s disease, some parts of the intestine are inflamed while other parts remain normal. Inflammation in ulcerative colitis typically appears as a continuous blanket that spreads, often starting from the rectum.

There is no cure for either disease. However, therapies involving lifetime management can heal inflammation, cause remission and allow for a good quality of life.

Diverticulitis is the name given to inflammation or infection in the diverticula, the small pouches that can develop in the lining of your large intestine, also known as your colon.

These tiny, pebble-sized pouches can develop over time in weakened areas of the lower gastrointestinal tract. These diverticula are very common in older adults and rarely cause problems.

When the colon’s weakened wall gives way in places, the diverticula poke through the colon. Diverticulitis develops when these protruding diverticula tear, resulting in inflammation and, in some cases, infection. Bouts of severe abdominal pain, fever and nausea can occur. Mild diverticulitis responds to simple therapies, including rest, dietary changes and antibiotics. Treatment for chronic diverticulitis can include surgery.

A fistula is an abnormal opening or tunnel that develops in the wrong place as the result of an infection or surgery. People with chronic digestive problems also have a high risk of developing a fistula. There are two types of fistulas that can affect the GI tract – gastrointestinal fistulas (GIF) and anal fistulas.

A GIF, also called an intestinal fistula, refers to an abnormal opening that forms between your digestive tract and the skin or another organ in your body. This type of fistula allows gastric fluids to escape from your stomach or intestines into these other areas, causing infection. There are internal and external GIFs, depending on where the fistula leaks its fluids. Internal fistulas discharge onto other organs, while external fistulas weep through the skin.

An anal fistula is an infected tunnel that has formed between the skin and the opening at the end of the digestive tract called the anus. Anal fistulas often result from an infection in the anal gland.

The gallbladder acts as the storehouse for the digestive fluid, called bile, that’s created by your liver. Bile is stored until your body needs it to break down fat from the food you consume. Then it is released into the upper intestine to help with digestion. Gallbladder disease refers to any inflammation, blockage or infection of this small, sac-like organ located below the liver.

Several common ailments are covered under the umbrella of gallbladder disease:

• Cholecystitis results from inflammation to the gallbladder walls caused by irritation. Untreated, cholecystitis can lead to complications like a gallbladder rupture.

• Gallstones, another common ailment, form when bile in the gallbladder hardens. If those gallstones block the passageways to the small intestine, they create a more complex issue called acute cholecystitis.

• Biliary dyskinesia refers to a condition that causes a disruption to the normal “squeezing” movements necessary to empty the gallbladder into the intestine.

Gastrointestinal (GI) bleeding can be caused by a variety of issues in either the upper or lower gastrointestinal tract and is not a disease itself. Instead, the bleeding is a symptom of another disease or disorder somewhere along your digestive tract that demands your attention.

GI bleeding results from a variety of conditions ranging from hemorrhoids, diverticulitis and peptic ulcers to esophageal tears and inflammation, Crohn's disease, and digestive colon, stomach or esophagus cancers. Blood may show up in your stools or vomit as either black and tarry or bright red. Bleeding may be mild, moderate or severe. It may be benign or life-threatening.

Any digestive bleeding demands prompt diagnosis, often with advanced imaging or endoscopy. Treatments vary depending on the source of the bleeding.

Gastrointestinal (GI) cancer is an overall term that covers all the cancers that affect the organs in your digestive system. In addition to cancers of the gastrointestinal tract, this includes the rectum and anus, colon, pancreas, liver, gallbladder and biliary system, esophagus, small intestine and stomach.

Many of these GI cancers don’t show symptoms in their early stages, making them tricky to identify early, when they are most treatable. GI cancers, like colon and anal cancers, are most often discovered through routine preventive medical screenings. These screenings remain some of the most important methods of catching GI cancers early before any symptoms develop.

If they are not caught early, GI cancers can advance unnoticed until they are harder to treat. Therapies, successful treatment and quality-of-life issues depend on when GI cancers are first diagnosed.

Similar to acid reflux, gastroesophageal reflux disease (GERD) develops when the valve between your esophagus and stomach weakens. This allows stomach acid to repeatedly and frequently flow back up into your esophagus from your stomach. Chronic acidic regurgitation, or “backwash,” of digestive liquid can irritate the lining of your esophagus, resulting in pain and heartburn.

The frequent heartburn experienced with GERD can range from moderate to severe and happen multiple times per week. Some may also experience increased wheezing, coughing and problems swallowing, coupled with the constant reflux of food or liquid. While many can manage their GERD by altering their lifestyle, others may need surgery or stronger medications to reduce their symptoms. Left untreated, GERD can develop into more serious conditions.

Irritable bowel syndrome (IBS) is a common digestive disorder that affects the large intestine, or colon.

If you have IBS, you may experience cramping, abdominal pain, bloating, diarrhea and/ or constipation. While it is a chronic condition that needs to be managed long term, IBS doesn’t alter the tissue or lining of the bowel or increase your chance of colon cancer.

There is no cure for IBS and most people do not suffer severe symptoms. Side effects of IBS can be eased by managing your diet and stress levels. The small number of people who have more acute symptoms can reduce them with medication and therapy.

The liver is located just beneath your rib cage and is necessary for digesting food and removing toxins from your body. Hepatitis and cirrhosis are two common diseases with similar symptoms that can impact the liver.

Hepatitis is inflammation of the liver. It can be caused by viruses such as Epstein-Barr virus or any of the five hepatitis viruses (A, B, C, D and E). Other risk factors include drug and alcohol abuse, obesity and exposure to toxic chemicals.

Cirrhosis is a gradual and permanent scarring of the liver caused by continual inflammation of ongoing liver damage. Cirrhosis can result from chronic hepatitis, excessive alcohol use, non-alcoholic fatty liver disease (NAFL) and non-alcoholic steatohepatitis (NASH).

While the liver has the ability to repair itself, it is less likely to function properly if it builds up scar tissue. While hepatitis may be curable in some instances, cirrhosis is not.

The pancreatic and biliary tract is made up of the liver, pancreas, gallbladder and/or bile ducts. There is a wide spectrum of disorders with similar symptoms that can cause issues to the organs in the biliary system.

While good digestion depends on a robust biliary system, problems occur when any of these organs become infected or blocked. Some disorders include gallstones, acute and chronic cholecystitis, cholangitis, pancreatitis and biliary tract cancers and cysts.

In many instances, pancreatic and biliary tract diseases are severe, requiring immediate medical treatment. Often, the organ affected sustains long-term damage.

Perianal disease is inflammation at or near the anus, commonly diagnosed in individuals with Crohn’s disease. Also called perianal Crohn’s disease, this condition can appear on its own or in conjunction with other types of Crohn's disease present in your digestive system.

As another form of inflammatory bowel disease (IBD), perianal disease can manifest in many forms. These include skin tags, perianal fistulas, anal fissures, abscesses and small holes inside the anal canal.

Perianal disease can be painful and debilitating. It is a life-long chronic condition with no known cure. Left untreated, perianal disease can have a negative impact on quality of life.

The rectum makes up the lower part of your large intestine, or colon. Rectal bleeding refers to any blood that passes from your lower colon or rectum and out your body through your anus, the opening at the lower end of the digestive tract.

Rectal blood can range in color from bright red to maroon. You might first notice this blood in your stool, toilet or on your toilet paper. Rectal bleeding can be frightening but is relatively common. Some causes include hemorrhoids, constipation, ulcers, anal fissures, inflammatory bowel disease (IBD) and colorectal cancer.

If you experience rectal bleeding that is chronic, heavy or black and tarry, see a doctor. These types of bleeding may signal an underlying condition that needs treatment.

Trouble and/or pain when swallowing or trying to swallow is called dysphagia. This term is often used to describe difficulty in swallowing as either a symptom or as a distinct condition.

Dysphagia is most commonly seen in babies and older adults. Some people have trouble swallowing particular foods or drinks. Others cannot swallow at all. Still others may cough or choke when eating or drinking. Dysphagia can make it challenging for the sufferer to take in enough nutrition from the food they eat.

A wide array of possible causes can lead to dysphagia. Swallowing difficulty can happen when there are structural changes in the physical shape of your esophagus. It also can occur if there are motility or movement issues, or nerve damage affecting the muscles along your esophagus. Trouble swallowing that occurs regularly or frequently should be diagnosed by a physician to determine treatment.

Ulcers occur when excess stomach acid, bacteria or anti-inflammatory drugs damage certain areas of the digestive tract. Resulting sores develop on the lining of the stomach, the upper region of the small intestine or the lower part of the esophagus.

If they form in the stomach, these ulcers are called gastric ulcers. Duodenal ulcers develop in the upper intestine, while those found in the lower portion of your esophagus are known as esophageal ulcers. These ulcers are a common cause of upper gastrointestinal bleeding and stomach pain.

Severe, untreated ulcers can sometimes burn a hole, or perforation, through the wall in a section of the GI tract. These perforated ulcers allow food and digestive liquids to leak out. While medication often eases the pain of mild ulcers, perforated ulcers should be considered an emergency demanding immediate care.