Gastroenterology Consultants,SC: GI Related Diseases. [<<back | list all>>] ANAL FISSURE, ABSCESS, AND FISTULA An anal fissure is a small tear in the lining of the anus frequently caused by constipation. An abscess is a localized pocket of pus caused by infection from bacteria. When bacteria seep into the underlying tissues in the anal canal, an abscess may develop. A fistula is a tiny channel or tract that develops in the presence of inflammation and infection. AUTOIMMUNE HEPATITIS Hepatitis is inflammation of the liver, which in turn causes damage to individual liver cells. However it can also be caused by alcohol, certain drugs, chemicals or poisons, or other diseases. There are different kinds of antibodies, each fighting against a specific foreign substance. The immune system protects the body against outside invasion by germs. Sometimes the immune system mistakenly recognizes the body's own organs as foreign. It can develop antibodies against these organs. This can cause various illnesses, such as rheumatoid arthritis and lupus. These illnesses are called autoimmune disorders because the body is literally fighting against itself. When the immune system attacks the liver in this way it is called autoimmune hepatitis. This is not caused by a virus or bacteria and is not a contagious disease. What triggers the immune system against the liver is unknown. BARRETT'S ESOPHAGUS The cells lining the esophagus differ from those lining the stomach or intestines, mainly because they have different functions. They also have a different appearance, so it is usually easy for a physician to tell them apart when examining the esophagus and stomach. Normally there is an area at the end of the esophagus that marks the border between the cells of the esophagus and those of the stomach. Barrett's esophagus is the abnormal growth of intestinal-type cells above this border, into the esophagus. In time, the Barrett's cells may develop abnormal changes known as dysplasia . Over a period of two to five years, the dysplasia may then progress to low grade, then to high grade dysplasia, and finally cancer. This happens in only 5% of patient's with Barrett's esophagus. CIRRHOSIS The liver is a large organ that sits in the right upper abdomen, just under the right lung. The liver makes proteins, eliminates waste material from the body, produces cholesterol, stores and releases glucose energy and metabolizes many drugs used in medicine. Many types of chronic injury and heavy alcohol intake to the liver can result in scar tissue. This scarring distorts the normal structure and regrowth of liver cells. The flow of blood through the liver from the intestine is blocked and the work done by the liver, such as processing drugs or producing proteins, is hindered.   COLON POLYPS AND CANCER A polyp is a growth that occurs in the colon. These growths, or fleshy tumors, are shaped like a mushroom or a dome-like button, and occur on the inside lining of the colon. They may be as small as a tiny pea or larger than a plum. Colon polyps start out a benign tumors but in time may become malignant. The larger the polyp the more likely it is to contain cancer cells. CONSTIPATION Constipation is defined as infrequent or hard pellet stools, or difficulty in evacuating stool. Passing one or more soft, bulky stools every day is a desirable goal. Troublesome constipation is not usually a serious disorder. However there may be an underlying problem causing constipation and testing is often recommended. CROHN'S DISEASE Crohn's disease is a chronic, recurrent inflammatory disease of the intestinal tract. The intestinal tract has four major parts; the esophagus, or food tube; the stomach, where food is churned and digested; the long, small bowel, where nutrients, calories, and vitamins are absorbed; and the colon and rectum, where water is absorbed and stool is stored. The two primary sites for Crohn's disease are the ileum, which is the last portion of the small bowel (ileitis, regional enteritis), and the colon (Crohn's colitis). The condition begins as small, microscopic nests of inflammation which persist and smolder. The lining of the bowel can then become ulcerated and the bowel wall thickened. Eventually, the bowel may become narrowed. DIARRHEA Diarrhea for people in the Western World, the usual amount of water in stool each day is generally no more than 200 ml or 7oz ( 8 oz = 1 cup). When it is consistently more than this, it is called diarrhea in the medical field. DIVERTICULOSIS & DIVERTICULITIS Diverticulosis means that there are pockets or projections extending out from the colon. These occur very gradually over a long period of time. They occur at weak points in the bowel wall. Pockets develop because of the pressure exerted within by the contracting colon. Since the sigmoid colon has the highest pressure in the colon, it is here that most diverticuli occur. Because of these balloon-like projections, the sigmoid often becomes thickened and narrowed. When this happens, significant changes in the bowel function can occur, such as discomfort, diarrhea, and/or constipation.   ESOPHAGITIS AND STRICTURE A specialized muscle, known as the lower esophageal sphincter (LES), is located at the end of the esophagus. This muscle normally contracts firmly, relaxing only to allow food and liquid to pass from the esophagus into the stomach. This muscle maintains a certain pressure to keep the end of the esophagus closed, preventing stomach acid and digested food from moving back into the esophagus. The LES muscle does not always work perfectly. It can easily be overcome by a number of factors, the most common being eating a large meal. When stomach acid and digestive enzymes repeatedly reflux into the esophagus, the tissues become inflamed and ulcerated. This inflammation is known as esophagitis. When the inflammation is severe, esophageal ulcers develop and may develop into cancer over a period of time. FATTY LIVER AND STEATOHEPATITIS Fatty liver is just what its name suggests: the build up of fat in the liver cells. Although this is not a normal condition, fat in the liver usually cause no damage by itself. However on some occasions it can be a sign that other more harmful conditions are at work. Fatty liver may be associated with or may lead to inflammation of the liver. This can cause scarring and hardening of the liver. When scarring becomes extensive, it is called cirrhosis and this is a very serious condition. Steatohepatitis: Steato refers to fat. Therefore steatohepatitis is inflammation of the liver related to fat accumulation . GALLSTONES The gallbladder is a pear shaped organ that rests under the liver in the right upper abdomen. The liver produces bile, a yellow liquid needed by the intestine to help digest fat and oils. Ducts, or tubes, carry bile from the liver to gallbladder and on to the intestine. Bile is stored in the gallbladder, which contracts periodically to force the bile into the intestine. The gallbladder absorbs water from the bile, causing it to thicken. In some people, tiny crystals form from the cholesterol and pigments. These crystals grow gradually until one or even hundreds of gallstone develop. GASTRITIS Gastritis means inflammation of the stomach. It means that white blood cells move into the wall of the stomach as a response to some type of injury. Gastritis does not mean that there is an ulcer or cancer. It is simply inflammation -- either acute or chronic. GASTROESOPHAGEAL REFLUX DISEASE (GERD) Heartburn is caused by stomach acid refluxing or splashing up into the esophagus--the muscular tube that connects the throat to the stomach. Anyone who has heartburn on a regular basis should consult a physician. Constant exposure to stomach acid can irritate the lining of the esophagus and cause other medical problems including Barrett's esophagus . Serious heartburn is known as gastroesophageal reflux disease or (GERD). At the lower end of the esophagus where it enters the stomach, there is a strong muscular ring called the lower esophageal sphincter (LES). The LES should remain tightly closed, except to allow food and liquid to pass into the stomach. Reflux occurs when the LES is not working properly. It may relax for periods of time throughout the day and night, or it may be constantly too weak to function effectively. This allows the stomach's acid juices to flow into the esophagus. HEARTBURN AND REFLUX Heartburn occurs when stomach acids flows upward (regurgitates) into the esophagus. The esophagus is the tube that carries food to the stomach. People usually feel heartburn as a burning sensation or pain behind the breastbone. When the LES muscle does not completely close and stomach juices seep back into the esophagus, this is known as reflux. HELICOBACTER PYLORI This unusual name identifies a specific bacteria that can cause infection of the stomach. This infection can contribute to the development of diseases ,such as dyspepsia (heartburn, bloating and nausea), gastritis (inflammation of the stomach), and ulcers in the stomach and duodenum. HEMOCHROMATOSIS Hemochromatosis is commonly known as iron overload disease. A malfunction in the way iron is absorbed from the intestinal tract causes the body to absorb and store too much iron. Too much iron stored in the liver can damage it. HEMORRHOIDS Hemorrhoids are dilated (enlarged) veins which occur in and around the anus and rectum. They may be external or internal and slip to the outside. Hemorrhoids also may remain inside the rectum and so cannot be felt or seen. These are called internal hemorrhoids. HEPATITIS Any type of inflammation in the liver is called hepatitis. This inflammation can be caused by many different things: drugs, viruses, bacteria, heredity, fatty tissue, and other causes. HEPATITIS B Hepatitis B is caused by the hepatitis B virus. Current estimates are that over 250,000 people in the United States contract Hepatitis B ( medically abbreviated as HBV) each year. It is often spread through sexual contact, accounting for about 50% of the reported cases. It is also spread through contact with blood or body fluids from a person carrying HBV. HEPATITIS C Hepatitis C is caused by a virus (medically abbreviated as HCV). This type of viral hepatitis is different from the others in an important way. All patients with hepatitis A and most with hepatitis B develop an acute infection, recover completely and develop antibodies that protect them from ever getting the disease again. However, once HCV is inside the body it changes it form to evade discovery and attack by the immune system. HIATUS HERNIA The diaphragm is a sheet of muscle that separates the lungs from the abdomen. When a person takes a deep breath, the dome-shaped diaphragm contracts and flattens. In doing this the diaphragm pulls air into the lungs. The left diaphragm contains a small hole through which passes the tube-shaped esophagus that carries food and liquid to the stomach. Normally this hole, called a hiatus, is small and fits snugly around the esophagus. The J-shaped stomach sits below the diaphragm. In some people, the hiatus or hole in the diaphragm weakens and enlarges. It is not known why this occurs. When a portion of the stomach herniates, or moves up, into the chest cavity through this enlarged hole, a hiatus hernia is now present. IRRITABLE BOWEL SYDNROME Irritable Bowl Syndrome (IBS), also known as spastic colon, spastic colitis, mucous colitis, and nervous or functional bowel, is mostly due to abnormal physiology. Typically, through rhythmic contractions, the colon quietly propels the stool from the right side of the colon to the rectum, where it is stored until it can be evacuated. However, when IBS occurs, the colon does not contract normally. The contractions may be disorganized, exaggerated, and last for prolonged periods of time. These abnormal contractions may result in a change of bowel habits, with constipation being the most common. They also cause abdominal pain and discomfort, which will usually move around rather than remain localized in one area. Diarrhea can occur, especially after meals. Air can also accumulate behind localized contractions causing the bowl to swell. These causes bloating and abdominal distress. Although mucous is a normal secretion of the bowel, gobs of mucous in the stool may be seen. This is not, however, a serious problem.   PEPTIC ULCER DISEASE An ulcer is an open sore in the lining of the stomach or intestine, much like mouth or skin ulcers. Peptic ulcers are usually caused by acid and pepsin. Acid is produced in the stomach to help digest and break down food before it enters the small intestine. Pepsin is a digestive stomach enzyme. Ulcers which occur in the stomach are called gastric ulcers, and duodenal ulcers occur in the first portion of the intestine. It is the acid that causes the ulcers in the stomach or bowel lining. The ulcers cause a burning pain in the upper abdomen. Some patients experience intense hunger or bloating. Antacids and milk can provide temporary relief. Some patients have no pain but have black stools, which can indicate the ulcer is bleeding. Bleeding is a very serious complication of ulcers. Diagnosis can be suspected from the patient's medical history, although it should always be confirmed by an upper intestinal endoscopy or barium x-ray. Ulcers are usually rechecked weeks after the initial endoscopy for dysplasia. Dysplasia may lead to cancer. PRIMARY BILIARY CIRRHOSIS Primary Biliary Cirrhosis (PBC) is a disease of the bile ducts inside the liver. The bile ducts become inflamed. The inflammation is chronic and causes scaring that eventually blocks and destroys the bile ducts. This interferes with proper drainage of bile so there is back up into the liver and the bloodstream. Eventually the liver becomes badly damaged and scarred. This is known as cirrhosis. ULCERATIVE COLITIS Ulcerative colitis is a chronic, recurring disease of the large bowel. The large bowel dehydrates the liquid stool that enters it and stores the formed stool until a bowel movement occurs. When ulcerative colitis affects the colon, inflammation and ulcers form in the lining of the colon. The cause is unknown, but some experts believe there may be a defect in the immune system that actually injure the colon. Others say that an unidentified microorganism or germ is responsible. The disorder typically begins gradually, with crampy abdominal pain and diarrhea. Loss of appetite and weight loss occur.