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.
Standard upper gastrointestinal endoscopes (120 cm flexible tubes with a
light and camera on their tips) are capable of reaching only a foot or so past
the stomach into the small intestine. If abnormalities are located within this
area, these endoscopes have working channels through which surgical instruments
can be passed so that diagnostic and therapeutic procedures such as biopsy and
electrocautery can be done.
Many abnormalities of the small bowel, however, lie
further along the small intestine beyond the reach of the standard upper
gastrointestinal endoscopes. Sometimes a
colonoscope, similar to the upper
gastrointestinal endoscope but 180 cm in length, can be used to reach a little
further into the small intestine, but the additional reach of colonoscopes is
limited.
It is not the length of the endoscope that is the most important
problem in reaching further into the small intestine. The problem is that the
path of the endoscope through the stomach and duodenum is twisty and the
endoscopes curl in the stomach. In addition, the small intestine is not fixed in
place, and this makes advancement of the endoscopes even more difficult.
What is push endoscopy?
Push endoscopy (also referred to as push enteroscopy) is a procedure that allows diagnosis and treatment of
diseases in the upper small intestine. Push endoscopy reaches further into the
small intestine than the standard upper
gastrointestinal endoscopy (also known
as esophagogastroduodenoscopy, EGD).
Endoscopes for push endoscopy are similar
in length to colonoscopes, approximately 200cm and have working channels for
diagnostic and therapeutic procedures. After the endoscope is passed into the
duodenum, a more rigid overtube is passed over the endoscope to straighten its
path. With the overtube in place, the endoscope then can be advanced without
coiling in the stomach.
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.
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.
Crohn's disease (also spelled Crohn disease) is a chronic inflammatory disease of the intestines. It
primarily causes ulcerations (breaks in the lining) of the small and large
intestines, but can affect the digestive system anywhere from the mouth to the
anus. It is named after the physician who described the disease in 1932. It also
is called granulomatous enteritis or colitis, regional enteritis, ileitis, or
terminal ileitis.
Crohn's disease is related closely to another chronic inflammatory condition that involves only the colon called
ulcerative colitis. Together, Crohn's disease and ulcerative colitis are frequently referred to as
inflammatory bowel disease (IBD). Ulcerative colitis and Crohn's disease have no medical cure. Once the diseases begin, they tend to fluctuate between periods of inactivity (remission) and activity (relapse).
Inflammatory bowel disease affects approximately 500,000 to two million peop...
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