Celiac disease is an inherited, autoimmune disease in which the lining of the small intestine is damaged from eating gluten, which is found in wheat containing foods such as bread, pasta, cookies, pizza crust and many other foods containing barley, rye and possibly oats. When a person with Celiac disease eats gluten, the body responds by damaging the small intestine. This leads to an inability for the body to absorb essential nutrients.

If left untreated through a gluten-free diet, Celiac disease can cause anemia and stunted growth in children; loss of calcium and bone density; lactose intolerance from intestinal damage; intestinal cancers; and even disorders of the nervous system such as seizures and nerve damage.

Celiac disease is often misdiagnosed because the symptoms are common and resemble several other conditions like irritable bowel syndrome, gastric ulcers and Crohn’s disease. Those with Celiac disease may experience intermittent diarrhea, abdominal pain, bloating, upset stomach, irritability, depression, joint pain, muscle cramps or anemia. Dental and bone disorders, unexplained weight loss, or tingling of the legs and feet may also be indicators of malabsorption from Celiac disease.

Although Celiac disease can affect anyone, people with a family history of the condition are at a much greater risk. Also commonly affected are people with diabetes, Down’s syndrome, autoimmune thyroid disease and microscopic colitis.

With a gluten-free diet, people with Celiac disease can effectively manage the condition and live pain-free. It is not always easy; many foods and even some medications contain gluten. But with the growing number of gluten-free products on the market, even pizza lovers can avoid gluten. A registered dietitian who is experienced in teaching the gluten-free diet can offer advice on how to best maintain the nutritional quality of your diet and help sufferers come up with gluten-free alternatives and achieve a healthy lifestyle.

Once gluten is removed from the diet, inflammation in the small intestine subsides, and the organ will begin to repair itself. People generally begin feeling better in just a few days, though extensive damage may require some vitamin and mineral supplements to correct deficiencies.

On March 1, 2010, results of an international study out of London were released indicating scientists have identified new genetic links to Celiac disease. Their findings could speed the search for better ways to diagnose and treat Celiac disease and possibly even related autoimmune diseases like Type 1 diabetes.

If you are experiencing symptoms and suspect Celiac disease, see your doctor. The best treatment is a strictly followed gluten-free diet, but do not begin a gluten-free diet before you see a physician. If you stop eating foods that contain gluten before being tested, the test results may not be accurate.

Heartburn affects many of us. In fact the American Gastroenterological Association reports that more than 60 million Americans experience symptoms at least once each month.

The burning sensation you feel is actually stomach acid splashing up into your esophagus. A valve at the end of the esophagus, called the lower esophageal sphincter (LES), normally prevents this. But factors such as overeating, pregnancy or even stress can keep the valve from shutting properly. When that happens, stomach acid can be pushed back up into the esophagus, causing pain along with a sour or bitter taste in the mouth.

Occasional heartburn is normally nothing to worry about and can easily be treated with over-the-counter antacids. However, frequent heartburn may indicate a more serious problem. Over time, stomach acid can damage the wall of the esophagus and, if left untreated, can lead to narrowing of the esophagus, bleeding and trouble swallowing, a condition called Barrett’s esophagus, and even cancer of the esophagus. Prolonged heartburn may also indicate more serious problems such as acid reflux disease, gastroesophageal reflux disease (GERD), gastritis, hiatal hernia or peptic ulcer.

There are several lifestyle changes you can make to help avoid heartburn:

• Avoid trigger foods such as chocolate; coffee; peppermint; spicy or greasy foods; tomato products; and alcoholic beverages.
• Eat smaller , more frequent meals.
• Don’t go to bed with a full stomach. Give food 2-3 hours to digest before going to bed.
• Stop smoking or using tobacco in any form. Tobacco inhibits saliva, the natural protection for your esophagus and the nicotine in tobacco increases acid secretion and relaxes the LES.
• Shed some pounds. Losing weight can help relieve symptoms.
• Eat high-protein, low-fat meals.
• Drink plenty of water during exercise to keep from being dehydrated.
• Avoid tight clothes and belts.

If you still experience heartburn, antacids usually give fast, short-term relief. Look for antacids that contain both magnesium hydroxide and aluminum hydroxide to reduce the chance of diarrhea or constipation. If your symptoms worsen when lying down, raising the head of your bed so that your head and chest are higher than you feet may help.

If symptoms persist or occur frequently, speak to your doctor. Continuous heartburn may indicate a serious problem, and sudden chest pain may be mistaken for heartburn when it is really a sign of heart disease. Your physician may suggest prescription medication or testing such as x-rays to check for ulcers, pH tests to check for acid in the esophagus, or endoscopy to look for other conditions. Seek medical attention when the following symptoms occur:

• Difficulty or pain when swallowing
• Vomiting blood
• Black or bloody stools
• Shortness of breath
• Lightheaded or dizziness
• Neck or shoulder pain
• Heartburn more than 2-3 times per week for more than 2 weeks.

If heartburn is becoming a more frequent problem, keep a heartburn record. Track how often you experience the symptoms, what time of day and what you are eating or doing when the symptoms occur. That will help you get a clearer picture of when it is time to seek medical care and help your doctor more effectively diagnose and treat your condition.

In addition to the finest medical care, we know that cost and convenience also play a part in the quality of service you expect. We have that covered as well. Our ambulatory surgery centers (ASCs) allow us to provide personalized care in a convenient, cost-effective way. All our ASCs are state licensed, Medicare-certified and accredited by the Accreditation Association of Ambulatory Health Care (AAAHC).

Ambulatory care refers to medical care provided for patients who are not admitted overnight to a hospital. The popularity of ambulatory care has grown rapidly since the early 1980s, mainly because advances in technology have made many tests, procedures and surgeries formerly done in hospitals safe to do on an outpatient basis.

One of the major benefits to the patient is cost savings. A surgery or procedure performed in an ambulatory surgery center can cost an estimated 30 to 60 percent less than the same procedure performed in a hospital. In our state-of-the-art facilities, our board certified and specially trained physicians perform endoscopies, dilations, colonoscopies, removal of colon polyps, treatments for Barrett’s esophagus and many other endoscopic procedures.

If a procedure is needed that must be performed in a hospital, we have physicians on staff at local hospitals.

Convenience is another reason to choose an ambulatory care facility. Our three offices and ASCs are conveniently located to better serve our patients, are easy to get in and out of, and have plenty of parking. Additionally, our outpatient treatments offer the convenience of returning home after a surgery or procedure which makes the process easier on the whole family.

At Gastrointestinal Associates, our ambulatory surgery centers help us bring you the very best in health care. We provide medical excellence, convenience and cost-savings, getting you in and out and home again quickly.

The gallbladder is a storage tank for bile produced in the liver until the body needs it for digestion. Problems occur when the bile hardens into little pebble-like substances called gallstones and block the release of bile into the digestive system. Gallstones can be as big as a golf ball or as small as a grain of sand. Many people with gallstones don’t even know they are there.

When gallstones block the bile ducts, pressure increases in the gallbladder and may result in a gallbladder “attack.” An attack may follow a “fatty” meal, causing pain in the abdomen or in the back either between the shoulder blades or under the right shoulder.

Sometimes the pain subsides after an “attack” because the gallstone has moved. However, infection and rupture can still occur. People with prolonged pain; nausea and vomiting; fever or chills; yellowish coloration of the skin or eyes; or clay-colored stools should see a doctor immediately.

Over one million patients are diagnosed with gallstones each year. The good news is that the gallbladder is one organ you can live without, and surgery to remove the gallbladder is one of the most common surgeries performed on adults in the United States. It can often be done on an outpatient basis and may be performed laparoscopically, or with tiny incisions through the abdomen.

Although anyone can develop gallstones, the following tips can help prevent gallstones or their recurrence once treated.

• Don’t avoid eating or fast. Eating at least three balanced meals each day helps prevent the build-up of bile.
• Watch your diet. A diet that is high in fiber and calcium and low in saturated fats helps prevent the formation of gallstones.
• Maintain your target weight. Obesity increases your risk for gallstones, but so does rapid weight loss. Strive for an overall health plan to achieve a normal weight for your age and height.

Because gallstone symptoms may be similar to those of a heart attack, appendicitis, ulcers, irritable bowel syndrome (IBS), pancreatitis and hepatitis, an accurate diagnosis is very important. Don’t let this little problem become a big issue.

We have also posted some news highlights on YouTube.

I am finding new media is opening up incredible ways to provide information that can help keep people well – and for others to share that information with people who need it.

When a symptom appears or when medical questions arise, many people now are checking the Internet first to see if the situation warrants a physician visit. The Internet can be a useful tool in helping to point you in the right direction and a little more comfortable than asking health-related questions over the phone.

However, keep in mind that anyone can put information on the Internet. The key is to make sure the information you are getting is from a reliable source.

Before you believe what you read online, check out the source. For information on gastrointestinal health – including colonoscopies, irritable bowels, gallbladder pain, reflux and so on – you can trust what the experts at Gastrointestinal Associates have to say.

Our Facebook page is filled with information about our doctors and from our doctors, so you can read about an issue and decide if it is time to make an appointment to see us in person. We also have a lot of great information to help you prevent gastrointestinal health issues.

As the main source of nutrition for your body, your gastrointestinal tract plays a vital role in your overall health and wellness. The physicians at GIA are experts in gastrointestinal health, with the knowledge and helpful information you need to keep feeling your best. For example, did you know a fiber deficiency is a leading cause of constipation which can lead to diverticulosis? Adding a little flavorless bran to your favorite foods can help you add fiber to your diet and prevent gastrointestinal problems.

For the latest, most reliable information on gastrointestinal health, turn to Gastrointestinal Associates. Check out our Facebook page or see our recent videos on YouTube with patient testimonials and news worthy information. It’s the best place to find health information from experts who know and care.

Symptoms of IBS include diarrhea, constipation, abdominal cramps and bloating. For some people, symptoms are mild; many don’t even seek treatment for the condition. For others it can be very distressing and make it difficult to carry on normal daily activities.

Though the specific cause is unknown, many attribute the condition to stress. It is not unusual for people to respond to stress with some sort of physical reaction, often centering in the gastrointestinal system. With IBS, the muscles of the intestines don’t move as they should. And this “gut” reaction to stress can be annoying, uncomfortable and even painful.

When someone complains of these symptoms, the first thing we do is rule out other underlying causes such as Crohn’s disease, ulcerative colitis or cancers of the colon. The absence of another disease can indicate that the problem is IBS.

The most important thing to remember is that though it can be uncomfortable, it is definitely not serious and does not lead to more dangerous diseases. Even so, the symptoms should not be ignored. While there is no precise cure for IBS, a modified diet, lifestyle changes and medications can alleviate the pain and discomfort and help those with the condition lead a more normal life.

Dietary changes can be effective, especially when specific foods that provoke the symptoms are eliminated. For example, increasing dietary fiber and avoiding items that stimulate the intestines such as caffeine may stop chronic diarrhea. Lifestyle changes including regular exercise and improved sleep have also been shown to reduce anxiety and relieve symptoms.

When diet and lifestyle changes produce no improvement, there are some medications such as smooth (intestinal) muscle relaxers and low-dose antidepressants that may help relieve intestinal pain.

There is no single solution for IBS, since the condition affects each person differently. And there is no surgical remedy.

However, there’s no need to live with chronic diarrhea, constipation and pain. Consult a physician and see what you can do to help you get your intestinal tract back on track.

A total of 48 persons referred by The InterFaith Health Clinic and The Free Medical Clinic of America received free screenings from the physicians and staff of Gastrointestinal Associates and The Endoscopy Center.

I believe I speak for my fellow physicians and the staff when I say that we feel privileged to have helped make the day a success. It was gratifying to all of us to receive the hugs of support and thanks from the patients.

Our physicians and staff volunteered their time for “GIA Screening Colonoscopy Day” so that these individuals will have the same opportunity as the rest of us to avoid colon cancer, the second deadliest type of cancer.

The national health care debate has focused attention on the role of physicians and other health care professionals. I think this event is a great demonstration of the concern medical professionals have for their patients’ well-being. I recommend a day of this type to other gastrointestinal practices across the country.

We also wanted to make everyone more aware of the need for screenings to prevent colon cancer. Persons over 50 need to have the exam, and those with a history of colon cancer in their family should be screened even sooner.

Out of the 48 tested Oct. 17, a total of 25 had polyps removed and sent for testing – 16 women and nine men. Twenty-three had no polyps – 15 women and eight men. Polyps can lead to cancer, and that’s why early detection is so important.

In addition to my colleagues and staff, I want to add my thanks to event sponsors Anesthesia Associates of Knoxville, Mercy Health Partners, Premier Surgical Associates, The Endoscopy Center, GI Pathology of Memphis, Boston Scientific, Interactive Optics, the American Cancer Society and Braintree Laboratories Inc. Media sponsors were the Knoxville News Sentinel and WBIR-TV 10.

Thank you one and all.

With colon cancer ranked as the second-deadliest cancer, GIA is making free colonoscopy exams available to a group of people in the Knoxville area who are less able to afford the vital screening procedure.

We have termed it “GIA Screening Colonoscopy Day,” and practice gastroenterologists will perform the exams for about 50 persons who were referred by the InterFaith Health Clinic and the Free Medical Clinic of America.

Our physicians and staff volunteered their personal time for GIA Screening Colonoscopy Day so that these individuals will have the same opportunity as the rest of us to avoid this deadly cancer.

There is a message in this event for everyone, because early detection is the key in the battle against colon cancer.

Anyone over 50 should have a colon exam. Persons who have a history of colon cancer in their families may need to have the exam even earlier.

GIA appreciates the help of Dr. Tom Kim of the Free Medical Clinic of America and the InterFaith Health Clinic in identifying recipients and collaborating to make the day a success. We also thank Mercy Health Partners and Premier Surgical Associates, who will stand by in case additional medical facilities or surgical assistance might be needed. Other partners include the The Endoscopy Center, Anesthesia Associates of Knoxville, GI Pathology of Memphis, Boston Scientific, Interactive Optics, the American Cancer Society and Braintree Laboratories Inc., for prep kits. Media sponsors include The Knoxville News Sentinel and WBIR-TV.

I personally thank all of our co-sponsors and especially our physicians and staff who gave up their day off to help these very worthy recipients. Our hope is that everyone will see the value of screenings to prevent colon cancer.

According to the very thorough article, a profusion of Web sites, clinics and wellness spas have sprung up, claiming that colon cleansing can cure a number of ills from headaches and chronic fatigue to arthritis and cellulite.

Called hydrotherapy or “colonics,” proponents say that flushing the colon with warm water removes waste that leaks toxins into the body. A diet of processed foods, pharmaceuticals, stress and lack of exercise has clogged up our lower intestinal tracts, advocates of colonics say.

Cleansing can dramatically improve a person’s health and well-being, they add, as well as contribute to weight loss.

Gastroenterologists generally say “balderdash.”

A good friend and gastroenterologist colleague of mine, Dr. John I. Allen of Minnesota, is quoted in the Wall Street Journal article.

“I have seen a lot of colons and the notion that people have pounds of feces and evil toxins built up in there is pure fantasy,” he told the Journal.

The overwhelming majority of gastroenterologists I associate with, including my colleagues here at Gastrointestinal Associates (GIA) and those in my network of professional associations, agree with Dr. Allen.

The Wall Street Journal added: “Healthy colons are self-cleaning, they (gastroenterologists) say, and evacuating the colon via other means can do serious harm, even causing the sluggishness the cleansing purports to fix.”

Dr. Allen estimates that he has done about 20,000 colonoscopy exams. Here at GIA we have done more than 200,000. So we have a platform to speak from on healthy colons.

My main message to people considering colonics is to investigate and be wary. Right now, only Florida licenses colon hydrotherapists.

I agree with hydrotherapists and others that a healthy diet of whole grains and fruit contributes to colon health. That diet – with more fiber, less fat and higher fluid intake – can also relieve constipation.

Do colonics contribute to decreasing the risk of colon cancer? There is not enough evidence to say that.

There are certain other risks to colonics that people need to be aware of, including the possibility of infection and rectal perforation.

Hydrotherapists told the Wall Street Journal that they are “personal trainers” for the colon. My advice is to consult your physician if you think you have a problem with your colon. He or she has years of medical training and experience to diagnose and treat your condition.

EE is sometimes confused with gastroesophageal reflux disease (GERD) because the symptoms of the diseases are so similar.

EE has been detected in all ages and on every continent, except Africa. Our team here at Gastrointestinal Associates (GIA) is familiar with the latest research on EE and has experience treating the disease.

People that are most at risk for EE are white males in their late 30s. Women and children are less susceptible but still can suffer from the condition. If your family has a history of allergy conditions, you are more likely to develop the disease.

EE is perhaps caused by an allergic reaction to food, chemicals or airborne particles. White blood cells called eosinophils build up in the esophagus as a response to the allergens. This reaction causes irritation and inflammation in the throat.

Some of the symptoms linked with EE are difficulty swallowing, typical GERD symptoms like heartburn, and food sticking in the esophagus. If traditional methods of GERD treatment have failed, you should ask your doctor about EE. Children may have abdominal pain, vomiting or regurgitation, difficulty swallowing, GERD-like symptoms, or an aversion to solid foods.

Right now, we have multiple ways to detect or diagnose EE. As mentioned, EE will not respond to the high-dose acid suppression therapy commonly used to treat GERD. A study of the pH level in the esophagus can also rule out reflux.

EE is best confirmed by an esophageal biopsy, a routine procedure that allows us to measure the eosinophil count in the esophageal tissue. Another way to detect EE is through an endoscopy, which uses a camera to search for the ring-like appearance of the esophagus associated with EE. But it is possible for patients with EE to have a normal endoscopy, so endoscopy with biopsy are key to the diagnosis.

Once EE is confirmed, we offer two treatment options. Topical steroids are usually an effective way to treat EE when used over the course of six to eight weeks. The second way is esophageal dilation. Esophageal dilation refers to the passage of small, specially designed rubber tubes (dilators) down the esophagus to stretch the narrowed esophagus.

At GIA, we are confident in our ability to identify EE and provide you with minimal risk treatment. Our team of specially trained physicians is equipped to give our patients the latest and most effective care available.