Gastroenterology

Gastroenterology focuses on the causes, prevention, diagnosis and treatment of diseases of the digestive system. The organs of the digestive system include the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder and bile ducts.

Conditions and Symptoms

Gastroenterologists at Texoma Medical Center (TMC) evaluate the following signs and symptoms to find their root cause:

• Abdominal pain
• Acid reflux or heartburn
• Blood in vomit or stool
• Bloating or gas
• Constipation
• Diarrhea
• Difficulty swallowing
• Indigestion
• Nausea
• Vomiting

Treatments

Radiofrequency Ablation for the Treatment of Barrett's Esophagus

Barrett's Esophagus is a condition in which the lining of the esophagus is damaged by stomach acid. Those with Barrett's Esophagus have a greater risk of developing a rare type of cancer called esophageal adenocarcinoma.

Radiofrequency ablation (RFA) therapy, which uses heat from radiofrequency energy (radio waves) to remove diseased tissue, can be used to treat Barrett's Esophagus. While you are sedated, a catheter is inserted through the mouth into the esophagus. Electrodes deliver a controlled level of heat and destroy Barrett's tissue. The ability to provide a controlled amount of heat to diseased tissue is one reason this therapy has a lower rate of complications than other forms of treatment. RFA treatment is usually performed in less than 30 minutes in an outpatient setting. 

Testing for Gastrointestinal Problems

Diagnosing your symptoms is the first step to obtaining successful treatment. A TMC gastroenterologist will likely do a combination of the following: review your medical history, conduct a physical exam and order lab tests. Among the tests conducted may be:

• Colon cancer screening (colonoscopy, sigmoidoscopy)
• Lab tests that look for blood in the stool
• Imaging tests that help your physician see how your digestive system processes food and waste
• Tests that help show the strength and function of muscles in the esophagus, rectum, or anus

Colon Cancer Screening

TMC gastroenterologists screen for cancer using colonoscopy or flexible sigmoidoscopy. In both of these procedures, the physician can both screen for colon polyps and remove them. Polyps are small growths that can become cancerous over time. Removing polyps can help prevent colorectal cancer from ever starting. Cancers found in an early stage, while they are small and before they have spread, are more easily treated. Nine out of 10 people whose colon cancer is discovered early will be alive five years later according to The American Cancer Society, and many will live a normal life span and possibly never be affected by the cancer again. 

It is recommended that men and women at average risk for developing colorectal cancer begin getting screened starting at age 50. Individuals with an increased or high risk of colorectal cancer might need to start colorectal cancer screening before age 50 and/or be screened more often. Talk to your doctor about your health history and risk. 

Learn more about colorectal cancer screening guidelines >

Colonoscopy

Colonoscopy is a procedure used to look for pre-cancerous, early cancerous or cancerous lesions in the colon. During colonoscopy, the physician will look inside of the entire colon and rectum for polyps, which are small growths that can become cancerous over time. A colonoscope — a thin, flexible, hollow and lighted tube that has a tiny video camera — is gently eased into the colon while you are under anesthesia; the camera sends pictures to a monitor that is viewed by the physician. Small amounts of air are puffed into the colon to keep it open and let the physician see clearly. The exam takes about 30 minutes and is painless due to the anesthesia.

Flexible Sigmoidoscopy

Sometimes a doctor will perform sigmoidoscopy instead of a colonoscopy. In this procedure, a physician looks only at the lower part of the colon and the rectum for signs of cancer or polyps. Because the scope used is only about two feet long, the physician is able to see the entire rectum but less than half of the colon. The physician uses a thin, flexible, hollow, lighted tube that has a tiny video camera on the end called a sigmoidoscope. The sigmoidoscope is gently eased inside the colon while the patient is under anesthesia, and sends pictures to a monitor.  Small amounts of air are puffed into the colon to keep it open and let the physician see clearly.

Upper Endoscopy

To evaluate symptoms of upper abdominal pain, nausea, vomiting or difficulty swallowing, your doctor may recommend upper endoscopy, which enables the physician to examine the lining of the upper gastrointestinal (GI) tract, which includes the esophagus, stomach and duodenum. This is the best test for finding the cause of bleeding from the upper GI tract. It's also more accurate than X-ray films for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum. The physician uses a thin, flexible tube called an endoscope, which has its own lens and light source, and views the images on a video monitor.

A physician might use upper endoscopy to obtain a biopsy to distinguish between benign and malignant (cancerous) tissues. Biopsies are taken for many reasons, and your physician might order one even if he or she does not suspect cancer. For example, your physician might use a biopsy to test for Helicobacter pylori, the bacterium that causes ulcers. Upper endoscopy is also used to treat conditions of the upper gastrointestinal tract. The physician can pass instruments through the endoscope to directly treat many abnormalities — this will cause you little or no discomfort.

Endoscopic Ultrasonography

The combination of endoscopy and ultrasound, endoscopic ultrasonography (EUS), allows physicians to more closely examine tissue within and surrounding the digestive tract. EUS uses an endoscope with a small ultrasound probe at the tip, that emits sound waves. These ultrasound waves can reveal abnormalities not detectable by other tests. EUS can be used to diagnose diseases of the pancreas, bile duct and gallbladder when findings from other tests are inconclusive

Endoscopic Retrograde Cholangiopancreatography

If your doctor suspects problems or blockages with bile or pancreatic ducts, he or she may ask you to undergo endoscopic retrograde cholangiopancreatography (ERCP), which is a specialized technique used to study the bile ducts, pancreatic duct and gallbladder. Ducts are drainage routes; the drainage channels from the liver are called bile or biliary ducts. The pancreatic duct is the drainage channel from the pancreas.

During ERCP, the physician will pass an endoscope through your mouth, esophagus and stomach into the small intestine. After the physician sees the common opening to the ducts from the liver and pancreas, he or she the will pass a narrow plastic tube called a catheter through the endoscope and into the ducts. The physician will inject a dye into the pancreatic or biliary ducts and will take X-rays. This will enable him or her to visualize the problem and recommend treatment.

GI Pill Camera

Capsule endoscopy lets your physician examine the lining of the middle part of your gastrointestinal tract, which includes the three portions of the small intestine (duodenum, jejunum, ileum) with a pill sized video camera for you to swallow.This camera has its own light source and takes pictures of your small intestine that are set to a small recording device on your body. The small intestine is unable to be viewed by colonoscopy or upper endoscopy. Bleeding from the small intestine is the most common reason to do capsule endoscopy. The pill-sized capsule endoscope is swallowed and passes naturally through your digestive tract while transmitting video images to a data recorder worn on your belt for approximately eight hours. At the end of the procedure you will return to the office and the data recorder is removed so that images of your small bowel can be put on a computer screen for physician review.