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.
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.
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 tumor of the
stomach called MALT lymphoma.
Accurate and simple tests for the detection of H. pylori infection
are available. They include blood antibody tests, urea breath tests, stool
antigen tests,
and endoscopic biopsies.
Blood tests for the presence of antibodies to H. pylori can be performed
easily and rapidly. However, blood antibodies can persist for years after
complete eradication of H. pylori with antibiotics. Therefore, blood antibody
tests may be good for diagnosing infection, but they are not good for
determining if antibiotics have successfully eradicated the bacterium.
The urea breath test (UBT) is a safe, easy, and accurate test for the presence of H. pylori
in the stomach. The breath test relies on the ability of H. pylori to break
down the naturally occurring chemical, urea, into carbon dioxide which
is absorbed from the stomach and eliminated from
the body in the breath. Ten to 20 minutes after swallowing a capsule containing
a minute amount of radioactive urea, a breath sample is collected and analyzed for radioactive
carbon dioxide. The presence of radioactive carbon dioxide in the breath (a
positive test) means that there is active infection. The test becomes negative
(there is no radioactive carbon dioxide in the breath) shortly after eradication
of the bacterium from the stomach with antibiotics. Despite the fact that
individuals having the breath test are exposed to a minute amount of
radioactivity, the breath test has been modified so that it also may be
performed with urea that is not radioactive.
Endoscopy is an accurate test for diagnosing H. pylori
as well as the inflammation and ulcers that it causes. For endoscopy, the doctor
inserts a flexible viewing tube (endoscope) through the mouth, down the
esophagus, and into the stomach and duodenum. During endoscopy, small tissue
samples (biopsies)
from the stomach lining can be removed. A biopsy specimen is placed on a
special slide containing urea (e.g., CLO test slides). If the urea is broken
down by H. pylori in the biopsy, there is a change in color around the biopsy on
the slide. This means that there is an infection with H. pylori in the
stomach.
The most recently-developed test for H. pylori is a test
in which the presence of the bacterium can be diagnosed with a sample of stool.
The test uses an antibody to H. pylori to determine if H. pylori is
present in the stool. If it is, it means that H. pylori is infecting the
stomach. Like the urea breath test, in addition to diagnosing infection with H. pylori,
the stool test can be used to determine if eradication has been effective shortly
after treatment.
Pancreatic cancer is a malignant tumor of the pancreas. Pancreatic cancer has been called a "silent" disease because early pancreatic cancer usually does not cause symptoms.
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.
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.
Rosacea is a skin disease that causes redness of the forehead, chin, and lower half of the nose. In addition to inflammation of the facial skin, symptoms include dilation of the blood vessels and pimples (acne rosacea) in the middle third of the face. Oral and topical antibiotics are treatments for rosacea. If left untreated, rhinophyma (a disfiguring nose condition) may result.
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.
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.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
"Just a spoonful of sugar... " goes the song. But what happens to that sugar once you swallow it? In fact, how is it that you are able to swallow it at all? Your digestive system performs amazing feats every day, whether you eat a double cheeseburger or a stalk of celery. Read on to learn what exactly happens to food as it makes its way through your digestive system.
What Is Digestion?
Digestion is the complex process of turning the food you eat into the energy you need to survive. The digestion process also involves creating waste to be eliminated.
The digestive tract (or gut) is a long twisting tube that starts at the mouth and ends at the anus. It is made up of a series of muscles that coordinate the movement of food and other cells that produce enzymes and hormones to aid in the breakdown of food. Along the way are three other organs that are needed for digestion: the liver, gallbladder, and the ...
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