The following is a partial listing of conditions that are regularly referred to the Advanced Endoscopy Center for treatment. Condition information provided is not for self-diagnosis or self-treatment. Diagnostic testing and physician expertise are required for diagnosing your symptoms. Check with your physician to determine what may be causing your symptoms and the treatment that is right for you.
Bile Duct Tumor
A bile duct tumor is an abnormal growth of tissue within the bile duct. A tumor may be benign (not cancerous) or malignant (cancerous). Treatments for bile duct tumors include surgical procedures and advanced ERCP procedures such as stenting.
Polyps in the colon are growths that may be benign (not cancerous) or pre-cancerous (may develop into cancer if not removed). Most colon polyps are discovered during routine screening tests such as a sigmoidoscopy or a fecal occult blood test (test for blood in the stool). Treatment for colon polyps is based on the size and the type of the polyp. Polyps that are likely to become cancerous should be removed. Some can be removed safely during a colonoscopy. Others need to be removed surgically.
The Center for Advanced Endoscopy performs a new, non-surgical technique for removing large colon polyps called endoscopic mucosal resection. This procedure also is effective in the treatment of lesions in other parts of the gastrointestinal tract such as the esophagus, stomach and duodenum.
Gallstones are hard stones that form in the gallbladder. They consist of cholesterol and other substances from bile. Gallstones range in size from barely measurable to 2.5 inches. Some of the factors that increase the risk of gallstones include being female, being over age 55, being obese, having a family history of gallstones, having multiple pregnancies, being of Native American or Mexican American descent and taking female hormones such as birth control pills or hormone replacement therapy.
Many people with gallstones do not experience any physical symptoms and do not require any medical treatment. These people have "silent" gallstones. Others feel pain in the abdomen which may be intermittent or continuous, dull or sharp, and is generally located in the upper abdomen, particularly on the right side where the gallbladder is located. If pain is accompanied by a fever, nausea and vomiting, the gallbladder may be infected. In some cases, a gallstone can block the bile duct, which is indicated by symptoms such as fever, jaundice (yellowing of the skin), dark-colored urine and light-colored stools. Gallstones in the bile duct can cause other complications such as pancreatitis. Those who require treatment usually have the gallbladder removed in a procedure called a cholecystectomy. Stones in the bile duct are best managed using ERCP.
Tests often used to diagnose gallstones include blood tests, abdominal ultrasound, hepatobiliary scan, and ERCP.
Gallstones sometimes pass into the common bile duct, causing jaundice or inflammation (cholangitis). Treatment for stones in the bile duct is based on the patient's history and the severity of his or her symptoms. Most often, treatment involves utilizing ERCP and lithotripsy.
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease is a condition in which the valve between the lower end of the esophagus and the stomach (lower esophageal sphincter, or LES) does not close properly. This causes stomach acid and juices to flow back to the upper esophagus and throat.
The symptoms of GERD include heartburn on a regular basis, a bitter or sour taste in the mouth, painful swallowing, difficulty swallowing, nausea, throat problems and respiratory problems.
Treatment for GERD usually begins with dietary changes. Foods such as chocolate, coffee, onions and peppermint may cause the LES to relax and not close tightly. Other foods can irritate the esophagus once it is affected by GERD. These include spicy foods, tomato products and citrus fruits. Acid reducers, antacids or prescription medications may be recommended, as well as simple lifestyle changes such as eating smaller meals and raising the head of the bed while sleeping.
More chronic cases of GERD may require more extensive testing and treatment. An endoscopy may be performed to look for possible complications of GERD such as swelling, bleeding or strictures in the esophagus. An endoscopy also may be used to rule out other diseases that cause symptoms similar to GERD symptoms, as well as Barretts esophagus -- a pre-malignant change in the lining of the esophagus. Other tests that may be performed include esophagus testing and an upper GI series.
Surgery to repair the LES is an option for patients with severe GERD. The Center for Advanced Endoscopy at Beth Israel Deaconess also is pioneering an exciting new endoscopic therapy for GERD patients.
Pancreatitis may be caused by excessive alcohol consumption, gallstones, some prescription drugs, or trauma to the abdomen. Sometimes its cause is never determined. People who are diagnosed with chronic pancreatitis are at higher risk for pancreas cysts and pancreas cancer.
Pancreatitis (inflammation of the pancreas) is a condition in which the digestive enzymes of the pancreas attack the pancreas, causing pain, nausea, fever, bleeding, swelling and damage to the pancreas. Pancreatitis may be acute (it goes away on its own) or chronic (it continues for weeks, months or years). Chronic pancreatitis is a serious condition that can prevent the pancreas from producing the enzymes needed by the body for digestion of food.
Pancreatitis is diagnosed by performing a physical examination, blood tests and x rays, especially CT scan and ultrasound. The doctor looks symptoms such as a rapid pulse, low blood pressure, dehydration, abnormal levels of electrolytes and minerals in the blood, and high levels of the digestive enzymes made by the pancreas (amylase and lipase).
Treatment for pancreatitis, which requires hospitalization, is based on its cause and the severity of symptoms. People with alcohol-induced pancreatitis must stop drinking. Infections that accompany pancreatitis are treated with antibiotics. Dehydration is treated with intravenous fluids. Malabsorbtion or excessive vomiting may necessitate a feeding tube. Treatment also includes managing nutritional needs and relieving pain. Beth Israel Deaconess nutritionists and pain management specialists are available to consult with all patients who are diagnosed with pancreatitis.
In severe cases, the pancreas may require drainage either by a surgical procedure or using ERCP. If pancreatitis is caused by gallstones, surgery to remove the gallbladder or ERCP to open a blocked bile duct may be needed.
To learn more about treatment for Pancreatitis, please visit our Pancreas Center.
A stricture is a portion of the esophagus, intestine, bowel or bile duct that has become narrow. Strictures can result from growth of a tumor, scarring, swelling, muscle spasm or pressure from other organs. ERCP and stenting often are used to treat strictures in the bile ducts and pancreas. Other endoscopic methods using balloons and stents are used to treat strictures in other parts of the gastrointestinal tract.