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.
Irritable
bowel syndrome (IBS) is a common
gastrointestinal condition. Patients with irritable bowel syndrome typically complain of abdominal
pain associated with bloating, gaseousness, and alterations in their bowel habit
(diarrhea, constipation, alternating diarrhea and constipation, or a sense of
incomplete evacuation of stool). Irritable bowel syndrome is a chronic condition. Symptoms can be
continuous or vary over months, years, or even decades. While irritable bowel
syndrome is not
life-threatening, symptoms of irritable bowel syndrome can have a major impact on a person's
quality of life and can even be
debilitating. For example, a patient with diarrhea after meals may avoid eating
out. Patients who experience bloating and abdominal pain after meals may develop
a fear of eating. In its extreme, they may even lose weight. Even flatulence can
be socially limiting.
Irritable bowel syndrome has been a frustrating condition for both physicians
and patients because it is difficult to diagnose and treat. Irritable bowel
syndrome is difficult to
diagnose because there is no test that will be abnormal. The diagnosis is made
on the basis of typical symptoms and tests that exclude OTHER diseases that
might be causing the symptoms such as ulcers, infections, tissue inflammation,
cancers, and obstruction of the intestine. Tests to rule out other conditions
include CT scans, barium x-rays,
upper gastrointestinal endoscopies, and
colonoscopies. Physicians have to rely heavily on their clinical judgment to
decide when enough testing has been done and to confidently make a diagnosis of
irritable bowel syndrome. Physicians are frustrated further by the fact that the treatment for
irritable bowel syndrome is
not helpful to many patients.
There is a striking similarity between the symptoms of
irritable bowel syndrome and SIBO. It has been theorized that SIBO may be responsible for the
symptoms of at least some patients with irritable bowel syndrome. The estimates run as high as 50% of
patients with irritable bowel syndrome. Support for the SIBO theory of IBS comes from the observation
that many patients with irritable bowel syndrome are found to have an abnormal hydrogen breath
test, and some patients with irritable bowel syndrome have improvement of their symptoms after
treatment with antibiotics, the primary treatment for SIBO.
Furthermore, it has been reported that successful treatment of symptoms with
antibiotics causes the hydrogen breath
test to revert to normal, suggesting that bacteria indeed
are causing the symptoms. Although this theory is tantalizing and there is much
anecdotal information that supports it, the rigorous scientific studies that are
necessary to prove the theory have just begun. Nevertheless, many physicians
have already begun to treat patients with irritable bowel syndrome for SIBO. The intriguing issue yet
to be elucidated is the reason why individuals who appear normal develop SIBO
and IBS. The most popular theory is that patients with irritable bowel syndrome have a subtle
abnormality in the function of their intestinal muscles that allows SIBO to
occur.
Small Intestinal Bacterial Overgrowth - Symptoms ExperiencedQuestion: Please describe the symptoms, and treatment of your small intestinal bacterial overgrowth.
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.
Gas or "intestinal gas" means different things to different people. Everyone has gas and eliminates it by belching or farting (passing it through the rectum).
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
In lactose intolerance, the digestive system cannot digest lactose (the main sugar in milk). Symptoms of lactose intolerance include diarrhea, flatulence, abdominal pain, abdominal bloating, abdominal distention, and nausea. There are several tests to diagnose lactose intolerance. Treatment is generally made with dietary changes, supplements, and adaptation to small amounts of milk.
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.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
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.
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