Esophagogastroduodenoscopy (EGD). EGD is a
technique used to look inside the esophagus, stomach,
and duodenum. It uses an endoscope to investigate
swallowing difficulties, nausea, vomiting, reflux,
bleeding, indigestion, abdominal pain, or chest pain.
Flexible sigmoidoscopy. Technique that allows to
look at the inside of the large intestine from the
rectum through the last part of the colon, called the
sigmoid colon. It is used to investigate diarrhea,
abdominal pain, or constipation.
Stool tests. Collection of stool to identify microor-
ganisms that may be infecting the intestine. Stools
are examined under a microscope or analyzed for the
substances they contain. For example, normal stool
contains almost no fat. But, in certain types of diges-
tive diseases, fat is not completely absorbed and
remains in the stool.
Swallowing test. In this procedure, the patient is
asked to drink a solution of barium before the X-
ray examination of the upper digestive tract (esoph-
agus, stomach, and small intestine).
TreatmentThe treatment of digestive diseases varies depend-
ing on the condition being treated. Almost all treat-
ment seeks the relief of symptoms and combine
changes in eating habits with medications specific to
the disease. In serious cases, surgical procedures are
used, which can involve the complete removal of the
affected organ.
Gastroesophageal reflux disease GORD. Treatment
may involve lifestyle changes, such as avoiding alco-
hol, loosing weight and eating smaller meals. Ant-
acid medication, such as Alka-Seltzer, Maalox,
Mylanta, Pepto-Bismol, Rolaids, and Riopan, can
also relieve heartburn. Other drugs, such as foaming
agents (Gaviscon), work by covering the stomach
contents with foam to prevent reflux. H2 blockers,
such as cimetidine (Tagamet HB), famotidine (Pep-
cid AC), nizatidine (Axid AR), and ranitidine (Zan-
tac 75), can also reduce acid production. Proton
pump inhibitors such as omeprazole (Prilosec), lan-
soprazole (Prevacid), pantoprazole (Protonix), rabe-
prazole (Aciphex), and esomeprazole (Nexium) are
now considered more efficient. Surgery is an option
when medications do not work. A standard surgical
treatment is fundoplication which wraps the upper
part of the stomach around the LES to strengthen it
and prevent acid reflux.
Gastroparesis. When related to diabetes, treatment
seeks to control the blood sugar levels with insulin
and oral medications, such as metoclopramide
(Reglan) to stimulate stomach muscle contractions
which helps empty food. In severe cases, intravenous
feeding may be required to bypass the stomach
entirely. This is achieved by inserting a jejunostomy
tube through the skin of the abdomen into the small
intestine. The procedure allows nutrients and medi-
cation to be delivered directly into the small intestine.
Peptic ulcer. Ulcers caused byHelicobacter pyloriare
treated with drugs to kill the bacteria, reduce stom-
ach acid, and protect the stomach lining. Antibiotics
are usually prescribed. The acid-suppressing drugs
commonly used are H2 blockers and proton pump
inhibitors. Medications such as bismuth subsalicy-
late are also used as protectors in the case of stomach
ulcers. Surgery may also be required, such as a vagot-
omy, a procedure that cuts parts of the vagus nerve
that transmits messages from the brain to the stom-
ach. This interrupts messages to produce acid, hence
reducing acid secretion.
Budd-Chiari syndrome. Treatment usually involves
sodium restriction, diuretics to control the accumu-
lation of fluid in the abdominal cavity (ascites), and
prescription of anticoagulants such as heparin and
warfarin. Surgical shunts that divert blood flow
around the obstruction or the liver may be required.
In very serious cases, liver transplantation is the only
effective treatment.
Cholecystitis. If acute, treatment may require hospi-
talization to reduce stimulation to the gallbladder.
Antibiotics are usually prescribed to fight the infec-
tion as well as acid-suppressing medications. In some
cases, the gallbladder may be surgically removed
(cholecystectomy).
Cirrhosis. Treatment depends on the cause of the cir-
rhosis and on the complications that may be present.
Alcoholic cirrhosis is first treated by completely
abstaining from alcohol. Hepatitis-related cirrhosis is
treated with medications specific to the different types
of hepatitis, such as interferon for viral hepatitis and
corticosteroids for autoimmune hepatitis. Treatment
also includes medications to help remove fluid from
the body. When complications cannot be controlled or
when the liver becomes so damaged that it can no
longer function, a liver transplant is required.
Hepatitis. Hepatitis A is treated by bed rest and
medications to relieve symptoms such as fever, nau-
sea and diarrhea if any. Hepatitis B is treated with a
course of interferon injections, usually for some
months. Additionally, drugs such as lamivudine
and dipivoxil are prescribed for a period of one
year. Over time, hepatitis B may cause the liver to
stop functioning and require a liver transplant. As
for hepatitis C, it is treated with peginterferon,Digestive diseases