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. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Upper
endoscopy is a procedure that enables the examiner (usually a
gastroenterologist) to examine the esophagus (swallowing tube),
stomach, and duodenum (first portion of small bowel) using a thin, flexible tube
through which the lining of the esophagus, stomach, and duodenum can be viewed
using a TV monitor.
How do I prepare for endoscopy?
To accomplish a safe and complete examination, the stomach should be
empty. The patient will most likely be asked to have nothing to eat or drink
for six hours or more prior to the procedure.
Prior to scheduling
the procedure, the patient should inform his or her physician of any medications
they are currently taking,
any allergies, and all of their health problems. This information will
remind the doctor whether the patient may need antibiotics prior to the
procedure, what potential medications should not be used during the exam
because of the patient's allergies, and will provide the individual scheduling
the procedure an
opportunity to instruct the patient whether any of the medications they are
taking should be
held or adjusted prior to the endoscopy.
Knowledge whether the patient has
any major health problems, such as heart or lung diseases, will alert
the examiner of possible need for special attention during the
procedure.
Why have you been scheduled for an
endoscopy?
Upper endoscopy usually is performed to evaluate possible problems with the
esophagus, stomach or duodenum, and evaluate symptoms such as upper
abdominal pain, nausea or
vomiting,
difficulty in swallowing, intestinal
bleeding anemia,
etc.. Upper endoscopy is more accurate than X-ray for detecting inflammation or
smaller abnormalities such as ulcers or tumors within the reach of the
instrument. Its other major advantage over X-ray is the ability to
perform biopsies (obtain small pieces of tissue) or cytology
(obtain some cells with a fine brush) for microscopic examination to
determine the nature of the abnormality and whether the abnormality is benign or malignant
(cancerous).
Biopsies are taken for many reasons and may not
mean that cancer is suspected. Upper endoscopy also can be used to treat
many conditions within its reach. The endoscope's channels permit
passage of accessory instruments enabling the examiner to treat many
of the conditions such as stretching areas of narrowing (strictures), removal of benign growths such as polyps, accidentally
swallowed objects, or treating upper gastrointestinal bleeding as seen
in ulcers tears of the lining. These capabilities have markedly
reduced the need for transfusions or surgery.
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.
Rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Rectal bleeding may be moderate to severe and most bleeding comes from the colon, rectum, or anus. Common causes include anal fissures, hemorrhoids, diverticulitis, and more.
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid
contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are heartburn,
regurgitation, and nausea. Effective treatment is available for most patients with GERD.
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.
A hiatal hernia is an anatomical abnormality in which part of the stomach protrudes through the diaphragm and up into the chest. Causes of hiatal hernia are a larger than normal esophageal hiatus. There are two types of hiatal hernias, sliding, or para-esophageal. When symptoms of hiatal hernia appear, they are similar to GERD symptoms. Hiatal hernia treatment is generally surgery.
Though the cause of stomach cancer is unknown, risk factors for stomach cancer include diet, H. pylori infection, smoking age, gastritis, stomach surgery, family history, and pernicious anemia. Symptoms include stomach discomfort, feeling full after a small meal, nausea and vomiting, and weight loss. Treatment depends upon staging and may involve surgery, radiation therapy, or chemotherapy.
Thrush is an infection of the mouth caused by the candida fungus. Symptoms of Thrush include pain or difficulty swallowing, a feeling that food gets stuck in the throat, and fever.
The term oral cancer includes cancer of the mouth (oral cavity) and the back of the mouth (oropharynx). Red and white patches inside the mouth, bleeding, loose teeth, pain upon swallowing, a lump in the neck, earache, and a sore on your lip or in your mouth that won't heal are all symptoms of oral cancer. Treatment for oral cancer depends upon the staging of the disease and usually involves surgery, radiation therapy, or chemotherapy.
IBS (irritable bowel syndrome) is a common gastrointestinal disorder involving abnormal gut contractions (motility) characterized by abdominal pain,
bloating, mucous in stools, and irregular bowel habits with alternating diarrhea
and constipation, symptoms that tend to be chronic and to wax and wane over the
years. Treatment options include medication and lifestyle changes such as diet, exercise, and stress management to control symptoms. Also called spastic colitis, mucus colitis, nervous colon syndrome.
Esophageal cancer is a disease in which malignant cells form in the esophagus. Risk factors of cancer of the esophagus include smoking, heavy alcohol use, Barrett's esophagus, being male and being over age 60. Severe weight loss, vomiting, hoarseness, coughing up blood, painful swallowing, and pain in the throat or back are symptoms. Treatment depends upon the size, location and staging of the cancer and the health of the patient.
Helicobacter pylori (H. pylori) is a bacterium that causes chronic inflammation (gastritis) of the inner lining of the stomach in humans. This bacteria also is the most common cause of ulcers worldwide.
Celiac disease is a result of an immune reaction to gluten, a protein found in wheat or related grains and present in many foods that we eat. Celiac disease causes impaired absorption and digestion of nutrients through the small intestine. Signs and symptoms of celiac disease include malabsorbption (diarrhea, foul smelling gas, bloating, and increased amounts of fat in the stool) and malnutrition (weight loss, edema, anemia, bruising easily, neuropathy, and infertility). Treatment for celiac disease is a gluten free diet, and at times if necessary, medications
Internal bleeding occurs when an artery or vein is damaged and blood to escapes the circulatory system and collects inside the body. Internal bleeding can be caused by a variety of situations such as blunt trauma, deceleration trauma, medications, fractures, and spontaneous bleeding. Treatment of internal bleeding depends on the cause of the bleeding.
A peptic ulcer is an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related to Helicobacter pylori bacteria in the stomach, use of anti-inflammatory medications, and cigarette smoking.
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.
Eosinophilic esophagitis is an inflammation of the esophagus. Eosinophilic esophagitis has many causes including acid reflux, heartburn, viruses, medications that become stuck in the esophagus, allergy, asthma, hay fever, allergic rhinitis, and atopic dermatitis. Eosinophilic esophagitis symptoms include difficulty swallowing food, abdominal pain, chest pain, and heartburn.
Anal cancer, cancer located at the end of the large intestine, has symptoms that include anal or rectal bleeding, anal pain or pressure, anal discharge or itching, a change in bowel movements, and/or a lump in the anal region. Treatment for anal cancer may involve radiation, chemotherapy, or surgery and depends upon the stage of the cancer, its location, whether cancer is eradicated after the first treatment, and whether the patient has HIV.
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
Esophagitis is caused by an infection or irritation of the esophagus. Infections that cause esophagitis include candida yeast infection of the esophagus as well as herpes.
Gastritis is an inflammation of the stomach lining. Causes of gastritis include drinking too much alcohol, medications such as NSAIDs, ibuprofen, aspirin, H. pylori infection, severe infections, burns, anemia, and autoimmune disorders. Gastritis is diagnosed with endoscopy, blood tests, or stool tests. Treatment depends upon the cause of gastritis.
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD refers to the reflux of acidic fluid from the stomach into the esophagus (the swallowing tube), and is classically associated with heartburn.
Achalasia is a disease of the esophagus that mainly affects young adults. Abnormal function of nerves and muscles of the esophagus causes difficulty swallowing and sometimes chest pain.
A carcinoid tumor is a tumor that develops from enterochromaffin cells. The important characteristic of carcinoid tumors that sets them apart from other gastrointestinal tract tumors, is their potential to cause the carcinoid syndrome. Local symptoms may include abdominal pain, intestinal bleeding, and intestinal obstruction. However, often symptoms of the carcinoid syndrome can be more devastating than the local symptoms. There are many options for the treatment of carcinoid tumors and carcinoid syndrome.
Gastroparesis is a medical condition in which the muscle of the stomach is paralyzed by a disease of either the stomach muscle itself or the nerves controlling the muscle. As a consequence, food and secretions do not empty normally from the stomach. Gastroparesis symptoms are nausea and vomiting; abdominal bloating, and pain can result.
Salivary gland cancer is cancer that affects the parotid glands, sublingual glands, or the submandibular glands. Risk factors include older age, radiation therapy treatment to head or neck, and being exposed to certain substances at work. Signs include fluid draining from the ear, pain, numbness, weakness, trouble swallowing, and a lump. Treatment depends upon the stage of the cancer and usually involves surgery, radiation therapy, chemotherapy, or radiosensitizers.
Head and neck cancer is cancer of the oral cavity, salivary glands, paranasal sinuses and nasal cavity, pharynx, larynx, or lymph nodes in the upper part of the neck. These cancers account for 3% to 5% of cancers in the U.S. Tobacco and alcohol use are important risk factors. Treatment may involve surgery, radiation therapy, and/or chemotherapy.
Schatzki (Schatzki's) ring, is a narrow ring of tissue located just above the junction of the esophagus and stomach. The cause of Schatzki ring is not clearly known, however, some doctors believe they are caused by long term acid reflux. The symptoms of a Schatzki ring is primarily poorly chewed food that stays in chunks becoming stuck in the esophagus. Diagnosis of Schatzki's ring is barium x-ray or endoscopy. Treatment is generally a procedure to stretch or fracture the rings.
Helicobacter pylori (H. pylori) is
a bacterium
that causes chronic inflammation of
the inner lining of the
stomach (gastritis) in humans. This bacterium also is the most
common cause of ulcers worldwide. H. pylori infection is most likely acquired by
ingesting contaminated food and water and through person to person contact. In
the United States, 30% of the adult population is infected. (50% of infected
persons are infected by the age of 60.) The infection is more common in crowded living conditions with poor
sanitation. In countries with poor sanitation, 90% of the adult population
can be infected. Infected individuals usually carry the infection
indefinitely unless they are treated with medications to eradicate the
bacterium. One out of every six patients with H. pylori infection will
develop ulcers of the duodenum or stomach. H. pylori also
is associated with stomach cancer and a rare type of lymphocytic tu...
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