Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Modern endoscopic techniques have revolutionized the diagnosis and treatment
of diseases of the upper gastrointestinal tract (esophagus, stomach, and
duodenum) and the colon. The last remaining frontier has been the small
intestine.
The small intestine has been a difficult organ in which to make diagnoses and treat without
performing surgery. Radiologicalprocedures, specifically the upper GI series with
small bowel
follow-through, which involves following swallowed barium as it passes through
the intestine with x-ray films, have been available for diagnosis, but
these radiological procedures are time-consuming and are not accurate in
identifying small tumors and other subtle abnormalities of the small intestine. The
demand for improved capabilities in the small intestine has been less because a
minority of intestinal diseases involve the small intestine beyond the reach of
the upper gastrointestinal endoscope and the colonoscope. Nevertheless, improved
diagnostic and therapeutic capabilities in the small intestine would be very
useful, particularly in uncovering the causes of abdominal pain, diarrhea, and
anemia due to
intestinal loss of blood and diagnosing diseases that may involve only the small
intestine, for example, Crohn's disease. One of the newer technologies that
expands the diagnostic capabilities in the small intestine is capsule endoscopy
also known as wireless capsule endoscopy.
What is capsule endoscopy?
Capsule endoscopy is a technology that uses a swallowed video capsule to take photographs of the
inside of the esophagus, stomach, and small intestine. For capsule endoscopy, the
intestines are first cleared of residual food and bacterial debris with the use
of laxatives and/or purges very similar to the laxatives and purges used before
colonoscopy. A large capsule-larger than the largest pill-is swallowed by the patient. The
capsule contains one or two video chips (cameras), a light bulb, a battery, and
a radio transmitter. As the capsule travels through the esophagus, stomach,
and small intestine, it takes photographs rapidly. The photographs are
transmitted by the radio transmitter to a small receiver that is wornon the waist
ofthe patient who is undergoing the capsule endoscopy. At the end of the
procedure, approximately 24 hours later, the photographs are downloaded from the
receiver into a computer, and the images are reviewed by a physician. The
capsule is passed by the patient into the toilet and flushed away.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.
Non-Hodgkin's lymphoma is cancer of the lymphatic system, a vital part of the body's immune system. Symptoms include swollen lymph nodes, fever, night sweats, coughing, weakness, chest pain, unexplained weight loss, and abdominal pain. Treatment depends on which type of non-Hodgkin's lymphoma you have, the stage of the cancer, your age, how fast the cancer is growing, and whether you have other health problems.
Dyspepsia (indigestion) is a functional disease in which the gastrointestinal organs, primarily the stomach and first part of the small intestine, function abnormally. It is a chronic disease in which the symptoms fluctuate infrequency and intensity. Symptoms of dyspepsia include upper abdominal pain, belching, nausea, vomiting, abdominal bloating, early satiety, and abdominal distention (swelling). These symptoms are most often provoked by eating.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Anemia is a medical condition in which the red blood cell count
or hemoglobin is less than normal. The normal level of hemoglobin is generally
different in males and females. For men, anemia is typically defined as
hemoglobin level of less than 13.5 gram/100ml and in women as hemoglobin of less
than 12.0 gram/100ml. These definitions may vary slightly depending on the
source and the laboratory reference used.
What causes anemia?
Any process that can disrupt the normal life span of a red blood cell may cause anemia. Normal life span of a red blood cell is typically around 120 days. Red blood cells are made in the bone marrow.
Anemia is caused essentially through two basic pathways. Anemia is either caused:
by a decrease in production of red blood cell or hemoglobin, or
by a loss or destruction of blood.
As more common classifications of anemia (low hemoglo...
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