Study Confirms Lifesaving Value of Colonoscopy

March 23rd, 2018

A large study has confirmed what many public health experts have long believed: Colonoscopy saves lives.

The study looked at roughly 25,000 patients in the Veterans Affairs (VA) health system, where colonoscopy is widely used. The VA views it as the main screening test for patients aged 50 and older who have average odds for developing colon or rectal cancer.

Of that group, close to 20,000 patients were cancer-free between 2002 and 2008. About 5,000 were diagnosed with colorectal cancer during that time and died of the disease by 2010.

Those who died were significantly less likely to have had a colonoscopy, the study found.

A comparison of screening histories over about two decades found that “colonoscopy was associated with a 61 percent reduction in colorectal cancer mortality,” said study author Dr. Charles Kahi, a gastroenterology section chief with the Roudebush VA Medical Center in Indianapolis.

The U.S. Centers for Disease Control and Prevention recommends everyone between the ages of 50 and 75 get screened for colon cancer. Those at high risk — including those with a family history of the disease — should be tested even earlier, the CDC advises.

Screening can take several forms, including stool tests; a lower colon exam called flexible sigmoidoscopy; and even a “virtual” colonoscopy that relies on X-rays to scan the entire colon.

But many public health advocates favor a full colon exam, or colonoscopy. For the test, a patient is typically sedated and a doctor inserts a flexible, lighted tube to examine the entire colon. If found, growths called polyps can be removed during the procedure.

Between 11.5 million and 14 million Americans have a colonoscopy each year, according to the study team.

The new study focused on patients aged 50 and older who were treated at VA facilities between 1997 and 2010.

The investigators found that a colonoscopy reduced the risk of death from right-sided colorectal cancer by 46 percent and left-sided cancer by 72 percent, equaling a combined drop of 61 percent.

“These findings are important at several levels,” Kahi said.

For one, the study shows that the quality of care within the VA system — the nation’s largest — “is at least as good as other health care settings,” despite recent concerns, he suggested.

But more broadly, Kahi noted, the finding removes any doubt as to whether a colonoscopy can effectively reduce cancer deaths.

The answer, he said, “is an unequivocal ‘yes.'”

Both points were seconded by Dr. Andrew Chan, an associate professor of medicine at Harvard Medical School who reviewed the findings.

“I am not surprised,” Chan said. “The results confirm an already substantial body of data supporting that colonoscopy is associated with a substantial reduction in risk of colorectal cancer.”

The results provide reassurance that colonoscopy is an effective screening tool for patients in the massive VA health care system, he explained.

Chan added that doctors need to make colorectal cancer screening a routine part of their patients’ preventive care.

“And it is clear that we need to improve the performance of colonoscopy in the prevention of cancers that arise in the right side of the colon,” he concluded.

“This will likely require a focus on ensuring that patients undergo an optimal bowel preparation for the procedure and the physician performing the procedure does a high-quality exam with a focus on careful inspection of the entire colon,” Chan said.

The gastroenterology consultants at Bay Area Gastroenterology are experts in the management of stomach, intestine and colon disorders. For more information, contact Bay Area Gastroenterology online or by phone at 281.480.6264 to schedule an appointment

Obesity: A Growing and Dangerous Public Health Challenge

March 16th, 2018

Why Obesity?

The American College of Gastroenterology recognizes that the epidemic of obesity is a problem at the forefront of American public health concerns and considers it imperative that GI physicians engage in efforts to define new treatment options, refine existing approaches and enhance the management of associated complications. The growing epidemic of obesity is of particular relevance to gastroenterologists because of the clearly documented associations of obesity with a number of gastrointestinal disease risk factors and outcomes, including mortality rates and unfavorable risk profiles.

Why ACG and Obesity?

With a new appreciation for obesity as a disease and global well-being in mind, the American College of Gastroenterology has developed new tools to help physicians incorporate patient education on the GI risks of overweight and obesity. The College’s primary objective in encouraging an enhanced focus on nutrition, metabolism and obesity is to bring the clinical and scientific expertise of GI physicians to bear in formulating solutions to the obesity epidemic – both at the national health policy level and in terms of advancing clinical practice.

Do you know the gastrointestinal diseases that are associated with obesity?

Some of the most common, general medical diseases and risks associated with being overweight or obese include arthritis, type 2 diabetes, coronary heart disease, high blood pressure, cancer and premature death. You won’t be surprised to know that many of the common gastrointestinal diseases that are seen in individuals with a normal BMI are seen up to 2 to 3 times more commonly in individuals who are obese. Many of these gastrointestinal diseases like gastroesophageal reflux (GERD), liver disease and cancer significantly reduce the quality and longevity of your life.

Maintaining Your Gastrointestinal Health

Gastrointestinal diseases and disorders are seen more commonly in overweight and obese individuals than in normal weight individuals.

Weight loss is a recommended strategy to prevent the symptoms related to some gastrointestinal diseases such as GERD and hiatal hernia, and to decrease the risk of progression of diseases such as nonalcoholic fatty liver disease (NAFLD), recurrent colorectal adenomas and colorectal cancer.

The American College of Gastroenterology recommends that all average risk Americans age 50 and older undergo colorectal cancer screening with colonoscopy. African Americans should begin screening at age 45. Since colorectal cancer and precancerous polyps are more common in overweight and obese individuals extra efforts should be made for these individuals to have colonoscopy at the age of 50 years, if not sooner. Talk to your doctor.

If you are overweight or struggling with obesity and would like a healthier lifestyle, let Ideal Protein at Bay Area Gastroenterology help you achieve your goals.

Ideal Protein is a medically developed, scientifically based, supervised weight loss, weight management, and lifestyle counseling program for dieters.

For information about this exclusive program, please contact our wellness coach, Morgan, at 281-258-4280.



A lifetime of regular exercise slows down aging, study finds

March 9th, 2018

The researchers at King’s College London set out to assess the health of older adults who had exercised most of their adult lives to see if this could slow down aging.

The study recruited 125 amateur cyclists aged 55 to 79, 84 of which were male and 41 were female. The men had to be able to cycle 100 km in under 6.5 hours, while the women had to be able to cycle 60 km in 5.5 hours. Smokers, heavy drinkers and those with high blood pressure or other health conditions were excluded from the study.

The participants underwent a series of tests in the laboratory and were compared to a group of adults who do not partake in regular physical activity. This group consisted of 75 healthy people aged 57 to 80 and 55 healthy young adults aged 20 to 36.

The study showed that loss of muscle mass and strength did not occur in those who exercise regularly. The cyclists also did not increase their body fat or cholesterol levels with age and the men’s testosterone levels also remained high, suggesting that they may have avoided most of the male menopause.

More surprisingly, the study also revealed that the benefits of exercise extend beyond muscle as the cyclists also had an immune system that did not seem to have aged either.

An organ called the thymus, which makes immune cells called T cells, starts to shrink from the age of 20 and makes less T cells. In this study, however, the cyclists’ thymuses were making as many T cells as those of a young person.

The findings come as figures show that less than half of over 65s do enough exercise to stay healthy and more than half of those aged over 65 suffer from at least two diseases.* Professor Janet Lord, Director of the Institute of Inflammation and Ageing at the University of Birmingham, said: “Hippocrates in 400 BC said that exercise is man’s best medicine, but his message has been lost over time and we are an increasingly sedentary society.

“However, importantly, our findings debunk the assumption that aging automatically makes us more frail”.

“Our research means we now have strong evidence that encouraging people to commit to regular exercise throughout their lives is a viable solution to the problem that we are living longer but not healthier.”

Dr Niharika Arora Duggal, of the University of Birmingham, said: “We hope these findings prevent the danger that, as a society, we accept that old age and disease are normal bedfellows and that the third age of man is something to be endured and not enjoyed.”

Professor Stephen Harridge, Director of the Centre of Human & Aerospace Physiological Sciences at King’s College London, said: “The findings emphasise the fact that the cyclists do not exercise because they are healthy, but that they are healthy because they have been exercising for such a large proportion of their lives.

“Their bodies have been allowed to age optimally, free from the problems usually caused by inactivity. Remove the activity and their health would likely deteriorate.”

Norman Lazarus, Emeritus Professor at King’s College London and also a master cyclist and Dr Ross Pollock, who undertook the muscle study, both agreed that: “Most of us who exercise have nowhere near the physiological capacities of elite athletes.

“We exercise mainly to enjoy ourselves. Nearly everybody can partake in an exercise that is in keeping with their own physiological capabilities.

“Find an exercise that you enjoy in whatever environment that suits you and make a habit of physical activity. You will reap the rewards in later life by enjoying an independent and productive old age.”



Colon Cancer News

March 5th, 2018

Colon cancer refers to a form of cancer that affects the main part of the large intestine, commonly called the colon. Sometimes, colon cancer is grouped together with cancer that affects the other part of the large intestine, the rectum, and referred to as colorectal cancer.

Colon cancer is a fairly common cancer. It affects both men and women, and the risk for developing colon cancer goes up in everyone after age 50. Other risk factors for developing colon cancer include a family history of cancer or colon cancer specifically, and a history of developing colorectal polyps, or growths. People with Crohn’s disease or ulcerative colitis also have a higher colon cancer risk, as do those who smoke or eat diets high in fat and low in fiber, folate and calcium.

Screening and Prevention

The best way to detect colon cancer early and prevent the development of life-threatening cancer is to be screened for the disease. Screening is generally recommended for people 50 and older, though those at higher risk may need it earlier in life. Various tests can screen for colon cancer, including a fecal occult blood test and a digital rectal exam. However, colonoscopy and sigmoidoscopy are screening methods that can not only detect cancer at an early stage but also find and remove any precancerous polyps.

Symptoms of Colon Cancer

Colon cancer can be difficult to detect because the symptoms often overlap with other common medical conditions. When symptoms do occur, they’re usually related to the digestive tract. Common symptoms include diarrhea, constipation, bloody stools, narrower stools than usual or the feeling that your bowels are not completely empty. Colon cancer can also show itself with such symptoms as nausea, vomiting, fatigue, unexplained weight loss or gas and painful cramps.


The primary method for treating colon cancer is surgery to remove the tumor. In some cases, this procedure can be done in a minimally invasive way with a long robotic arm that enters the body to remove the tumor. Other times, open surgery is required.

Often, additional treatments are needed to kill cancer cells at the site of the tumor or in surrounding tissues. These treatments may be in the form of radiation therapy, chemotherapy or biological therapy



February 23rd, 2018

What is gastritis?

Many people — including some doctors — use “gastritis” as a fancy word for stomachache, but the term really means “inflammation of the stomach.” Most people with sore stomachs don’t have gastritis. When inflammation does set in, it can cause considerable pain and discomfort. Fortunately, gastritis is usually easy to control. You may need to make a few lifestyle changes or get a little help from your doctor, but you don’t have to put up with the pain.

What causes gastritis?

Most people with gastritis can blame a tiny germ, namely Helicobacter pylori. This bacterium, usually caught during childhood, is basically immune to stomach acid. It can survive happily in the mucus lining of the stomach for decades, often causing no trouble at all. In some people, however, the germ burrows deep into the stomach lining, causing gastritis. In many cases, a peptic ulcer may not be far behind.

Regular doses of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen are another major source of gastritis. These pills all have the potential to damage the lining of the stomach. The harm is usually minor and your stomach will probably recover within a few days. But if you take too many pills, use painkillers on a daily basis, or if your stomach doesn’t heal as quickly as it should, the lining can easily become inflamed. Like H. pylori, NSAIDs are a leading cause of ulcers.

For unknown reasons, severe injuries to other parts of the body often lead to gastritis. Emotional distress can cause gastritis by boosting the flow of acid in your stomach. Other possible causes include heavy drinking, and, rarely, illnesses such as Crohn’s disease.

Anything that irritates the stomach can make an existing case of gastritis feel much worse. The list of possible offenders includes alcohol, smoking, emotional stress, and some medications, including potassium and iron supplements.

What are the symptoms of gastritis?

Some people with gastritis don’t have any symptoms at all, even though the inflammation may show up clearly during tests such as an endoscopy (an examination in which the doctor slides a thin tube equipped with a tiny camera on one end down your throat to take a look at your stomach). Most people, however, will have some stomach pain and occasional indigestion. The pain may be burning or gnawing, and it usually gets worse on an empty stomach. Most people feel better after eating. Other symptoms may include bloating, nausea, and even vomiting.

These symptoms closely mimic the signs of a peptic ulcer. But since both conditions often respond to the same treatments, it isn’t always necessary to make the distinction unless the patient is elderly or there are worrisome symptoms such as weight loss or bleeding.

How is gastritis treated?

If you’re infected with H. pylori, you may need to take antibiotics to kill the germ. Whether you have gastritis or an ulcer, ridding yourself of the infection is often the key to long-term relief. Likewise, if you take regular doses of NSAIDs, you need to cut back or give them up completely.

Whatever the source of your gastritis, acid-reducing drugs can reduce your symptoms and give your stomach a chance to heal.

Whether you’re taking antibiotics, acid-blockers, or both, you may find it helpful to avoid certain foods while you’re healing. These include acidic foods, such as citrus fruits and juices, spicy foods, and food and drink that helps produce acid, such as chocolate and coffee (even if it’s decaffeinated.)

Reducing or eliminating your alcohol intake can help, too. Try to find some ways to reduce your stress: it can increase acid production. And if you smoke, stop. Smoking greatly increases the risk of ulcers.

If you’re taking any medications that can upset the stomach, your doctor may be able to offer an alternative. For instance, acetaminophen (Tylenol) is generally easier on the stomach than aspirin. (If you drink three or more glasses of alcohol a day, however, Tylenol can be too hard on the liver, so consult your doctor for advice.)

If your stomach pain comes back, or if it doesn’t start to fade after seven to 10 days of treatment, you may need an endoscopy to further explore the cause of your distress. Your doctor will slide a gastroscope down your throat and into your stomach. If you have an ulcer, cancer, or any other serious stomach problem, the endoscope will help the doctor find it. If you’re over 50 or show any symptoms of serious disease, your doctor will probably suggest you get an endoscopy or other tests right away.

But if your gastritis is caused by your eating or drinking habits, cigarette smoking, or other consequences of your lifestyle, you can make a few basic changes and feel much better for it.

The gastroenterology consultants at Bay Area Gastroenterology are experts in the management of stomach, intestine and colon disorders. For more information, contact Bay Area Gastroenterology online or by phone at 281.480.6264 to schedule an appointment.



Stomach Ulcers and What You Can Do About Them

February 16th, 2018

Stomach ulcers are almost always caused by one of the following:

  • an infection with the bacterium Helicobacter pylori (H. pylori)
  • long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen

Rarely, a condition known as Zollinger-Ellison syndrome can cause stomach and intestinal ulcers by increasing the body’s production of acid. This syndrome is suspected to cause less than 1 percent of all peptic ulcers.

Symptoms of stomach ulcers

A number of symptoms are associated with stomach ulcers. The severity of the symptoms depends on the severity of the ulcer.

The most common symptom is a burning sensation or pain in the middle of your abdomen between your chest and belly button. Typically, the pain will be more intense when your stomach is empty, and it can last for a few minutes to several hours.

Other common signs and symptoms of ulcers include:

  • dull pain in the stomach
  • weight loss
  • not wanting to eat because of pain
  • nausea or vomiting
  • bloating
  • feeling easily full
  • burping or acid reflux
  • heartburn (burning sensation in the chest)
  • pain that may improve when you eat, drink, or take antacids
  • anemia (symptoms can include tiredness, shortness of breath, or paler skin)
  • dark, tarry stools
  • vomit that’s bloody or looks like coffee grounds

Talk to your doctor if you have any symptoms of a stomach ulcer. Even though discomfort may be mild, ulcers can worsen if they aren’t treated. Bleeding ulcers can become life-threatening.

How are stomach ulcers diagnosed?

Diagnosis and treatment will depend on your symptoms and the severity of your ulcer. To diagnose a stomach ulcer, your doctor will review your medical history along with your symptoms and any prescription or over-the-counter medications you’re taking.

To rule out H. pylori infection, a blood, stool, or breath test may be ordered. With a breath test, you’ll be instructed to drink a clear liquid and breathe into a bag, which is then sealed. If H. pylori is present, the breath sample will contain higher-than-normal levels of carbon dioxide.

  • Barium swallow: You drink a thick white liquid (barium) that coats your upper gastrointestinal tract and helps your doctor see your stomach and small intestine on X-rays.
  • Endoscopy (EGD): A thin, lighted tube is inserted through your mouth and into the stomach and the first part of the small intestine. This test is used to look for ulcers, bleeding, and any tissue that looks abnormal.
  • Endoscopic biopsy: A piece of stomach tissue is removed so it can be analyzed in a lab.

Treating stomach ulcers

Treatment will vary depending on the cause of your ulcer. Most ulcers can be treated with a prescription from your doctor, but in rare cases, surgery may be required.

It’s important to promptly treat an ulcer. Talk to your doctor to discuss a treatment plan. If you have an actively bleeding ulcer, you’ll likely be hospitalized for intensive treatment with endoscopy and IV ulcer medications. You may also require a blood transfusion.

Other tests and procedures used to diagnose stomach ulcers include:

Nonsurgical treatment

If your stomach ulcer is the result of H. pylori, you’ll need antibiotics and drugs called proton pump inhibitors (PPI’s). PPI’s block the stomach cells that produce acid.

In addition to these treatments, your doctor may also recommend:

  • H2 receptor blockers (drugs that also block acid production)
  • stopping use of all NSAIDs
  • follow-up endoscopy
  • probiotics (useful bacteria that may have a role in killing off H. pylori)
  • bismuth supplement

Symptoms of an ulcer may subside quickly with treatment. But even if your symptoms disappear, you should continue to take any medication prescribed by your doctor. This is especially important with H. pylori infections, to make sure that all bacteria are eliminated.

Side effects of medications used to treat stomach ulcers can include:

  • nausea
  • dizziness
  • headaches
  • diarrhea
  • abdominal pain

These side effects are typically temporary. If any of these side effects cause extreme discomfort, talk to your doctor about changing your medication.

Surgical treatment

In very rare cases, a complicated stomach ulcer will require surgery. This may be the case for ulcers that:

  • continue to return
  • don’t heal
  • bleed
  • tear through the stomach
  • keep food from flowing out of the stomach into the small intestine

Surgery may include:

  • removal of the entire ulcer
  • taking tissue from another part of the intestines and patching it over the ulcer site
  • tying off a bleeding artery
  • cutting off the nerve supply to the stomach to reduce the production of stomach acid

Healthful diet

In the past, it was thought that diet could cause ulcers. We know now this isn’t true. We also know that while the foods you eat won’t cause or cure a stomach ulcer, eating a healthful diet can benefit your intestinal tract and overall health. In general, it’s a good idea to eat a diet with lots of fruits, vegetables, and fiber.

That said, it’s possible that some foods play a role in eliminating H. pylori. Foods that may help fight off H. pylori or boost the body’s own healthy bacteria include:

  • broccoli, cauliflower, cabbage, and radishes
  • leafy greens, such as spinach and kale
  • probiotic-rich foods, such as sauerkraut, miso, kombucha, yogurt (especially with lactobacillus and Sacharomyces)
  • apples
  • blueberries, raspberries, strawberries, and blackberries
  • olive oil

If you think you have a stomach ulcer, these may be good foods to add to your daily diet.

When should you call or see a doctor?

If you think you have a stomach ulcer, call your doctor. Together you can discuss your symptoms and treatment options. It’s important to get a stomach ulcer taken care of because without treatment, ulcers and H. pylori H. can cause:

  • bleeding from the ulcer site that can become life-threatening
  • penetration, which occurs when the ulcer goes through the wall of the digestive tract and into another organ, such as the pancreas
  • perforation, which occurs when the ulcer creates a hole in the wall of the digestive tract
  • obstruction (blockage) in the digestive tract, which is due to swelling of inflamed tissues
  • stomach cancer, which is up to six time more likely in people who have H. pylori  infections compared to those who don’t

Symptoms of these complications can include those listed below. If you have any of these symptoms, be sure to call you doctor right away:

  • weakness
  • trouble breathing
  • red or black vomit or stools
  • sudden, sharp pain in your abdomen that doesn’t go away

Prevention of stomach ulcers

To prevent the spread of bacteria that might cause a stomach ulcer, wash your hands with soap and water on a regular basis. Also, be sure to properly clean all of your food and to cook it thoroughly as needed.

To prevent ulcers caused by NSAIDs, stop using these medications (if possible) or limit their use. If you need to take NSAIDs, be sure to follow the recommended dosage and avoid alcohol while taking these medications. And always take these medications with food and adequate liquids.

The gastroenterology consultants at Bay Area Gastroenterology are experts in the management of stomach, intestine and colon disorders. For more information, contact Bay Area Gastroenterology online or by phone at 281.480.6264 to schedule an appointment.






Helicobacter Pylori (H. pylori) infection

February 9th, 2018

Helicobacter pylori (H. pylori) infection occurs when a type of bacteria called Helicobacter pylori (H. pylori) infects your stomach. This usually happens during childhood. A common cause of peptic ulcers, H. pylori infection may be present in more than half the people in the world.

Most people don’t realize they have H. pylori infection, because they never get sick from it. If you develop signs and symptoms of a peptic ulcer, your doctor will probably test you for H. pylori infection. If you have H. pylori infection, it can be treated with antibiotics.


Most people with H. pylori infection will never have any signs or symptoms. It’s not clear why this is, but some people may be born with more resistance to the harmful effects of H. pylori.

When signs or symptoms do occur with H. pylori infection, they may include:

  • An ache or burning pain in your abdomen
  • Abdominal pain that’s worse when your stomach is empty
  • Nausea
  • Loss of appetite
  • Frequent burping
  • Bloating
  • Unintentional weight loss

When to see a doctor

Make an appointment with your doctor if you notice any persistent signs and symptoms that worry you. Seek immediate medical help if you experience:

  • Severe or persistent abdominal pain
  • Difficulty swallowing
  • Bloody or black tarry stools
  • Bloody or black vomit or vomit that looks like coffee grounds


The exact way H. pylori infects someone is still unknown. H. pylori bacteria may be passed from person to person through direct contact with saliva, vomit or fecal matter. H. pylori may also be spread through contaminated food or water.

Risk factors

H. pylori is often contracted in childhood. Risk factors for H. pylori infection are related to living conditions in your childhood, such as:

  • Living in crowded conditions. You have a greater risk of H. pylori infection if you live in a home with many other people.
  • Living without a reliable supply of clean water. Having a reliable supply of clean, running water helps reduce the risk of H. pylori.
  • Living in a developing country. People living in developing countries, where crowded and unsanitary living conditions may be more common, have a higher risk of H. pylori infection.
  • Living with someone who has an H. pylori infection. If someone you live with has H. pylori, you’re more likely to also have H. pylori.


Complications associated with H. pylori infection include:

  • Ulcers. H. pylori can damage the protective lining of your stomach and small intestine. This can allow stomach acid to create an open sore (ulcer). About 10 percent of people with H. pylori will develop an ulcer.
  • Inflammation of the stomach lining. H. pylori infection can irritate your stomach, causing inflammation (gastritis).
  • Stomach cancer. H. pylori infection is a strong risk factor for certain types of stomach cancer.


In areas of the world where H. pylori infection and its complications are common, doctors sometimes test healthy people for H. pylori. Whether there is a benefit to treating H. pylori when you have no signs or symptoms of infection is controversial among doctors.

If you’re concerned about H. pylori infection or think you may have a high risk of stomach cancer, talk to your doctor. Together you can decide whether you may benefit from H. pylori screening.

For more information, contact Bay Area Gastroenterology online or by phone at 281.480.6264 to schedule an appointment.



Exocrine Pancreatic Insufficiency…..what are the symptoms of EPI?

February 2nd, 2018

Exocrine pancreatic insufficiency (EPI), sometimes called pancreatic insufficiency for short, is the inability to break down and digest food properly.

Symptoms of EPT can vary, but if you have one or more of these symptoms, you should talk to your doctor. Talking to your doctor is important since only your doctor can tell if your symptoms are due to EPI or another GI condition.

Frequent diarrhea:

EPI can cause problems with undigested food moving too quickly through the digestive tract.

Gas and bloating:

People with EPI cannot properly digest the food they eat, which can result in uncomfortable symptoms like gas and bloating.

Stomach pain:

The gas and bloating caused by maldigestion in people with EPI frequently result in stomach pain.

Foul-smelling, greasy stools (steatorrhea):

Steatorrhea is a type of bowel movement that is oily, floats, smells really bad, and is difficult to flush. People with EPI are not able to absorb all of the fat that they eat, so undigested fat is excreted, resulting in stools that look oily or greasy. Not all people experience this symptom.

Talk to your doctor if you notice oil droplets floating in the toilet bowl or stools that float or stick to the sides of the bowl and are hard to flush; it may be a sign of EPI.

Weight loss:

People with EPI cannot digest fats, proteins, and carbohydrates in the food they eat, which can result in weight loss.

Only your doctor can tell if your symptoms are due to EPI or another digestive condition.

The gastroenterology consultants at Bay Area Gastroenterology are experts in the management of stomach, intestine and colon disorders. For more information, contact Bay Area Gastroenterology online or by phone at 281.480.6264 to schedule an appointment.





Barrett’s esophagus

January 26th, 2018

What is Barrett’s Esophagus?

Barrett’s esophagus is a condition in which tissue that is similar to the lining of your intestine replaces the tissue lining your esophagus. Doctors call this process intestinal metaplasia.

Are people with Barrett’s esophagus more likely to develop cancer?

People with Barrett’s esophagus are more likely to develop a rare type of cancer called esophageal adenocarcinoma.

The risk of esophageal adenocarcinoma in people with Barrett’s esophagus is about 0.5 percent per year. Typically, before this cancer develops, precancerous cells appear in the Barrett’s tissue. Doctors call this condition dysplasia and classify the dysplasia as low grade or high grade.

You may have Barrett’s esophagus for many years before cancer develops.

How common is Barrett’s esophagus?

Experts are not sure how common Barrett’s esophagus is. Researchers estimate that it affects 1.6 to 6.8 percent of people.

Who is more likely to develop Barrett’s esophagus?

Men develop Barrett’s esophagus twice as often as women, and Caucasian men develop this condition more often than men of other races. The average age at diagnosis is 55. Barrett’s esophagus is uncommon in children.

What are the symptoms of Barrett’s esophagus?

While Barrett’s esophagus itself doesn’t cause symptoms, many people with Barrett’s esophagus have  gastroesophageal reflux

What causes Barrett’s esophagus?

Experts don’t know the exact cause of Barrett’s esophagus. However, some factors can increase or decrease your chance of developing Barrett’s esophagus.

What factors increase a person’s chances of developing Barrett’s esophagus?

Having GERD increases your chances of developing Barrett’s esophagus. GERD is a more serious, chronic form of gastroesophageal reflux, a condition in which stomach contents flow back up into your esophagus. Refluxed stomach acid that touches the lining of your esophagus can cause heartburn and damage the cells in your esophagus.

Between 10 and 15 percent of people with GERD develop Barrett’s esophagus.

Obesity—specifically high levels of belly fat—and smoking also increase your chances of developing Barrett’s esophagus. Some studies suggest that your genetics, or inherited genes, may play a role in whether or not you develop Barrett’s esophagus.

What factors decrease a person’s chances of developing Barrett’s esophagus?

Having a Helicobacter pylori (H. pylori) infection may decrease your chances of developing Barrett’s esophagus. Doctors are not sure how H. pylori protects against Barrett’s esophagus. While the bacteria damage your stomach and the tissue in your duodenum, some researchers believe the bacteria make your stomach contents less damaging to your esophagus if you have GERD.

Researchers have found that other factors may decrease the chance of developing Barrett’s esophagus, including:

  • frequent use of aspirin or other nonsteroidal anti-inflammatory drugs
  • a diet high in fruits, vegetables, and certain vitamins

How do doctors diagnose Barrett’s esophagus?

Doctors diagnose Barrett’s esophagus with an upper gastrointestinal (GI) endoscopy and a biopsy. Doctors may diagnose Barrett’s esophagus while performing tests to find the cause of a patient’s gastroesophageal reflux disease (GERD) symptoms.

Medical history

Your doctor will ask you to provide your medical history. Your doctor may recommend testing if you have multiple factors that increase your chances of developing Barrett’s esophagus.

Who should be screened for Barrett’s esophagus?

Your doctor may recommend screening for Barrett’s esophagus if you are a man with chronic—lasting more than 5 years—and/or frequent—happening weekly or more—symptoms of GERD and two or more risk factors for Barrett’s esophagus. These risk factors include:

  • being age 50 and older
  • being Caucasian
  • having high levels of belly fat
  • being a smoker or having smoked in the past
  • having a family history of Barrett’s esophagus or esophageal adenocarcinoma

How do doctors treat Barrett’s esophagus?

Your doctor will talk about the best treatment options for you based on your overall health, whether you have dysplasis, and its severity. Treatment options include medicines for GERD, endoscopic ablative therapies, endoscopic mucosal resection, and surgery.

Periodic surveillance endoscopy

Your doctor may use upper gastrointestinal endoscopy with a biopsy periodically to watch for signs of cancer development. Doctors call this approach surveillance.

Experts aren’t sure how often doctors should perform surveillance endoscopies. Talk with your doctor about what level of surveillance is best for you. Your doctor may recommend endoscopies more frequently if you have high-grade dysplasia rather than low-grade or no dysplasia.


If you have Barrett’s esophagus and gastroesophageal reflux disease (GERD), your doctor may treat you with acid-suppressing medicines called proton pump inhibitors (PPIs). These medicines can prevent further damage to your esophagus and, in some cases, heal existing damage.

How can your diet help prevent Barrett’s esophagus?

 Researchers have not found that diet and nutrition play an important role in causing or preventing Barrett’s esophagus.​

 If you have gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD), you can prevent or relieve your symptoms by changing your diet. Dietary changes that can help reduce your symptoms include:

  • decreasing fatty foods
  • eating small, frequent meals instead of three large meals

Avoid eating or drinking the following items that may make GER or GERD worse:

  • ​chocolate
  • coffee
  • peppermint
  • greasy or spicy foods​
  • tomatoes and tomato products
  • alcoholic drinks

For more information on Barrett’s esophagus, contact Bay Area Gastroenterology online or by phone at 281.480.6264 to schedule an appointment.




Teen Drinking Ups Risk for Liver Diseases Later

January 23rd, 2018

Men who started drinking in their teens are at increased risk for liver disease, Swedish researchers report.

“Our study showed that how much you drink in your late teens can predict the risk of developing cirrhosis later in life,” said lead investigator Dr. Hannes Hagstrom, with the Center for Digestive Diseases and Karolinska University Hospital in Stockholm.

The finding comes from an analysis of data on more than 49,000 men in Sweden who entered military service in 1969-1970, when they were 18 to 20 years old.

Over the next 39 years, 383 of the men developed cirrhosis and other types of severe liver disease. Some developed liver failure or died from liver disease.

Drinking during the late teen years was associated with an increased risk for liver disease. The association was mostly seen in young men who drank two drinks a day or more, the researchers found.

The study was published Jan. 22 in the Journal of Hepatology. The findings indicate that guidelines for safe levels of alcohol consumption by men may need to be reconsidered, the researchers said.

Current U.S. guidelines recommend no more than two drinks a day for men. The Swedish researchers said some countries recommend no more than three drinks a day for men to avoid alcoholic liver disease.

“However, what can be considered a safe cutoff in men is less clear,” Hagstrom said in a journal news release.

“If these results lead to lowering the cutoff levels for a ‘safe’ consumption of alcohol in men, and if men adhere to recommendations, we may see a reduced incidence of alcoholic liver disease in the future,” he said.

The researchers noted that their findings apply only to men.

Alcohol-related liver cirrhosis causes 493,000 deaths a year worldwide, according to the World Health Organization.