At Barrie GI Associates we manage all forms of gastrointestinal and liver diseases. Below is a short list of the most common diseases we manage and the procedures that we perform.
Common GI Diseases
Barrett’s Esophagus
Patient’s with longstanding reflux can develop precancerous changes in the esophagus. Patients with Barrett’s esophagus require a gastroscope often every few years to assess for changes in the esophagus that may require treatment. All patients with Barrett’s esophagus should be on medications to treat reflux disease as these have been shown in clinical trials to reduce the risk of cancer. If your doctor finds certain precancerous changes, they may recommend therapies to treat these areas of concern.
Celiac Disease
An immune-mediated disease whereby a patient’s immune system reacts to gluten and can lead to damage to the small intestine. Common symptoms include chronic diarrhea, malabsorption, abdominal pain, and anemia (low blood counts). The mainstay of treatment includes lifelong gluten free diet. Your doctor will order annual blood work to monitor response to treatment and patients require a gastroscopy every several years to assess for complications.
Colonic Polyps
Polyps of the colon are found commonly during colonoscopy. Most of these polyps are safely removed at time of colonoscopy but some polyps which are larger may require more advanced techniques at removal. Certain polyps will turn into cancer and it is important to remove these polyps when they are found. If removal during colonoscopy is not possible, some patients will require surgery to remove the part of the bowel which is involved.
Crohn's Disease
A type of chronic inflammatory bowel disease (IBD) that can affect any part of the GI tract. Patients often present with diarrhea and abdominal pain. A colonoscopy is often required for diagnosis, and subsequently patients may be followed with radiologic imaging (CT or MRI) and stool samples. Most patients will require medications to suppress the immune system to control the disease and reduce the risk of complications including hospitalization and surgery.
Diverticulosis
A condition whereby small pockets develop in the lining of the bowel, most often in the colon. These pockets occur when the inner layer of the bowel pushes through weak spots in the outer layer. This is a common condition that increases with age and is seen in up to 60% of patients by the age of 60. Patients are often asymptomatic and never have any complications related to these diverticulum. Occasionally, patients present with bleeding from the diverticulum or infection of the diverticulum which is known as diverticulitis.
Eosinophilic Esophagitis
An chronic immune-mediated condition affecting the esophagus where patients often present with difficulty swallowing. Sometimes patients can be managed by a 6-food elimination diet to identify triggers for their symptoms. Patients often require medications to help improve symptoms and endoscopic procedures where the esophagus is gently stretched to alleviate symptoms.
Gallstones
Many patients develop gallstones that form within the gallbladder. If these stones lead to pain from the gallbladder then often patients require surgery to remove the gallbladder. Occasionally, gallstones can leave the gallbladder and become lodged in the bile ducts exiting the liver. These can cause pain, jaundice (yellowing of the skin), and sometimes serious infections or pancreatitis. Often the diagnosis is made based upon ultrasound or MRI findings and many patients will require EUS for diagnosis or ERCP for removal of these stones.
Gastroesophageal Reflux Disease (GERD)
A condition where stomach acid enters the esophagus often leading to retrosternal burning and regurgitation. Some patients experience trouble swallowing as complications of reflux. Most often, medications that suppress acid production in the stomach will alleviate symptoms but occasionally patients will require surgery to tighten the valve between the esophagus and stomach.
Irritable Bowel Syndrome (IBS)
A common condition whereby patients often complain of abdominal pain, bloating, diarrhea, or constipation. Diagnosis is often made based on classic symptoms but sometimes your doctor will order additional tests such as blood tests, x-rays, or endoscopic evaluation. Symptoms can be extremely troubling and there are many different treatments including dietary changes, probiotics, and medications which can help to alleviate symptoms.
Liver Disease
The most common causes of liver disease are alcohol, fatty liver disease, Hepatitis B and C, and autoimmune diseases. The management of liver disease varies tremendously depending on the cause. Ultimately, any cause of liver disease can lead to scarring of the liver. When the liver becomes severely scarred (i.e., cirrhotic) it can progress to liver failure which can cause jaundice (yellowing of the skin), confusion, retention of fluid in the abdomen, and life-threatening bleeding. Some patients who develop liver failure may require liver transplantation.
Pancreatic Cyst
Many patients are found incidentally to have a cyst on the pancreas when they undergo ultrasounds, CT scans, or MRI’s for other indications. Most often these cysts are benign (non-cancerous) but some can progress towards cancer or cause other complications and as such it is important to have these cysts followed closely with repeat abdominal imaging and sometimes EUS.
Pancreatic Mass
Patients may present with pain, weight loss, or jaundice (yellowing of the skin). Diagnosis if often made on ultrasound or CT scan. Since a mass can be cancerous, it is often required to obtain a tissue sample to make the diagnosis and obtain treatment. The safest and most effective way to obtain a diagnosis is using EUS. Sometimes an ERCP is also required to place a stent within the bile duct to relieve jaundice.
Small Bowel Bleeding
Some patients will have anemia (low blood counts) or signs of GI bleeding despite having a normal gastroscopy and colonoscopy. In these cases, additional imaging studies are required to evaluate the small bowel where the usual scopes cannot reach. Your doctor may order a CT scan or a PillCam (capsule endoscopy) whereby the patient swallows a pill that takes pictures of the small bowel to determine whether there are any areas of abnormal bleeding that will require a specialized procedure or surgery.
Ulcerative Colitis
A type of chronic inflammatory bowel disease (IBD) that affects only the large intestine. Patients often present with diarrhea and blood in the stools. A colonoscopy is required for diagnosis, and subsequently patients may be followed with stool samples and clinical symptoms. Patients may require surveillance colonoscopy since there is a slightly higher risk of colon cancer in these patients. Most patients will require medications, sometimes that suppress the immune system to control the disease and reduce the risk of complications including hospitalization and surgery.
Patient’s with longstanding reflux can develop precancerous changes in the esophagus. Patients with Barrett’s esophagus require a gastroscope often every few years to assess for changes in the esophagus that may require treatment. All patients with Barrett’s esophagus should be on medications to treat reflux disease as these have been shown in clinical trials to reduce the risk of cancer. If your doctor finds certain precancerous changes, they may recommend therapies to treat these areas of concern.
Celiac Disease
An immune-mediated disease whereby a patient’s immune system reacts to gluten and can lead to damage to the small intestine. Common symptoms include chronic diarrhea, malabsorption, abdominal pain, and anemia (low blood counts). The mainstay of treatment includes lifelong gluten free diet. Your doctor will order annual blood work to monitor response to treatment and patients require a gastroscopy every several years to assess for complications.
Colonic Polyps
Polyps of the colon are found commonly during colonoscopy. Most of these polyps are safely removed at time of colonoscopy but some polyps which are larger may require more advanced techniques at removal. Certain polyps will turn into cancer and it is important to remove these polyps when they are found. If removal during colonoscopy is not possible, some patients will require surgery to remove the part of the bowel which is involved.
Crohn's Disease
A type of chronic inflammatory bowel disease (IBD) that can affect any part of the GI tract. Patients often present with diarrhea and abdominal pain. A colonoscopy is often required for diagnosis, and subsequently patients may be followed with radiologic imaging (CT or MRI) and stool samples. Most patients will require medications to suppress the immune system to control the disease and reduce the risk of complications including hospitalization and surgery.
Diverticulosis
A condition whereby small pockets develop in the lining of the bowel, most often in the colon. These pockets occur when the inner layer of the bowel pushes through weak spots in the outer layer. This is a common condition that increases with age and is seen in up to 60% of patients by the age of 60. Patients are often asymptomatic and never have any complications related to these diverticulum. Occasionally, patients present with bleeding from the diverticulum or infection of the diverticulum which is known as diverticulitis.
Eosinophilic Esophagitis
An chronic immune-mediated condition affecting the esophagus where patients often present with difficulty swallowing. Sometimes patients can be managed by a 6-food elimination diet to identify triggers for their symptoms. Patients often require medications to help improve symptoms and endoscopic procedures where the esophagus is gently stretched to alleviate symptoms.
Gallstones
Many patients develop gallstones that form within the gallbladder. If these stones lead to pain from the gallbladder then often patients require surgery to remove the gallbladder. Occasionally, gallstones can leave the gallbladder and become lodged in the bile ducts exiting the liver. These can cause pain, jaundice (yellowing of the skin), and sometimes serious infections or pancreatitis. Often the diagnosis is made based upon ultrasound or MRI findings and many patients will require EUS for diagnosis or ERCP for removal of these stones.
Gastroesophageal Reflux Disease (GERD)
A condition where stomach acid enters the esophagus often leading to retrosternal burning and regurgitation. Some patients experience trouble swallowing as complications of reflux. Most often, medications that suppress acid production in the stomach will alleviate symptoms but occasionally patients will require surgery to tighten the valve between the esophagus and stomach.
Irritable Bowel Syndrome (IBS)
A common condition whereby patients often complain of abdominal pain, bloating, diarrhea, or constipation. Diagnosis is often made based on classic symptoms but sometimes your doctor will order additional tests such as blood tests, x-rays, or endoscopic evaluation. Symptoms can be extremely troubling and there are many different treatments including dietary changes, probiotics, and medications which can help to alleviate symptoms.
Liver Disease
The most common causes of liver disease are alcohol, fatty liver disease, Hepatitis B and C, and autoimmune diseases. The management of liver disease varies tremendously depending on the cause. Ultimately, any cause of liver disease can lead to scarring of the liver. When the liver becomes severely scarred (i.e., cirrhotic) it can progress to liver failure which can cause jaundice (yellowing of the skin), confusion, retention of fluid in the abdomen, and life-threatening bleeding. Some patients who develop liver failure may require liver transplantation.
Pancreatic Cyst
Many patients are found incidentally to have a cyst on the pancreas when they undergo ultrasounds, CT scans, or MRI’s for other indications. Most often these cysts are benign (non-cancerous) but some can progress towards cancer or cause other complications and as such it is important to have these cysts followed closely with repeat abdominal imaging and sometimes EUS.
Pancreatic Mass
Patients may present with pain, weight loss, or jaundice (yellowing of the skin). Diagnosis if often made on ultrasound or CT scan. Since a mass can be cancerous, it is often required to obtain a tissue sample to make the diagnosis and obtain treatment. The safest and most effective way to obtain a diagnosis is using EUS. Sometimes an ERCP is also required to place a stent within the bile duct to relieve jaundice.
Small Bowel Bleeding
Some patients will have anemia (low blood counts) or signs of GI bleeding despite having a normal gastroscopy and colonoscopy. In these cases, additional imaging studies are required to evaluate the small bowel where the usual scopes cannot reach. Your doctor may order a CT scan or a PillCam (capsule endoscopy) whereby the patient swallows a pill that takes pictures of the small bowel to determine whether there are any areas of abnormal bleeding that will require a specialized procedure or surgery.
Ulcerative Colitis
A type of chronic inflammatory bowel disease (IBD) that affects only the large intestine. Patients often present with diarrhea and blood in the stools. A colonoscopy is required for diagnosis, and subsequently patients may be followed with stool samples and clinical symptoms. Patients may require surveillance colonoscopy since there is a slightly higher risk of colon cancer in these patients. Most patients will require medications, sometimes that suppress the immune system to control the disease and reduce the risk of complications including hospitalization and surgery.
Common GI Procedures
Colonoscopy
A procedure where a flexible tube with a camera is inserted into the rectum, through the large intestine, and often into the last portion of the small intestine (terminal ileum). The procedure allows your doctor to examine the lining of the lower part of the gastrointestinal tract. During the procedure, devices may be used to take biopsies, remove polyps, or help control bleeding.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
A procedure where a flexible tube with a camera is inserted into the mouth and beyond the stomach into the small bowel to allow your doctor to gain access into the bile duct and pancreatic duct with the use of specialized devices. These devices are placed through the scope to permit therapeutic maneuvers (e.g., removal of stones, placement/removal of stents). To facilitate the procedure, the use of contrast dye along with X-rays allow for the examination of the bile duct and pancreatic duct.
Endoscopic Ultrasound (EUS)
A procedure where a flexible tube with a camera and ultrasound probe is inserted into the mouth (or the anus) to allow your doctor to examine the walls of your upper (or lower) gastrointestinal tract. The upper tract consists of the esophagus, stomach and duodenum; the lower tract consists of the rectum and colon. EUS is also used to study internal organs that lie near the gastrointestinal tract, such as the pancreas, biliary system, liver, blood vessels, and lymph nodes. A thin needle can be placed through the scope to allow your doctor to take biopsies of abnormal tissue from areas of concern.
Enteral Stenting
Sometimes patients with cancers of the esophagus, stomach, small bowel, or colon may develop blockages whereby they cannot swallow or adequately digest food. Using either a gastroscope or colonoscope, sometimes your doctor can insert a metal stent within the GI tract to relieve the obstruction. These stents are often left in permanently to help improve a patient’s quality of life.
Gastroscopy
A procedure where a flexible tube with a camera is inserted into the mouth and beyond the stomach into the small bowel to visualize the lining of the upper part of the GI tract. During the procedure, devices may be used to take biopsies, remove polyps, or control bleeding.
A procedure where a flexible tube with a camera is inserted into the rectum, through the large intestine, and often into the last portion of the small intestine (terminal ileum). The procedure allows your doctor to examine the lining of the lower part of the gastrointestinal tract. During the procedure, devices may be used to take biopsies, remove polyps, or help control bleeding.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
A procedure where a flexible tube with a camera is inserted into the mouth and beyond the stomach into the small bowel to allow your doctor to gain access into the bile duct and pancreatic duct with the use of specialized devices. These devices are placed through the scope to permit therapeutic maneuvers (e.g., removal of stones, placement/removal of stents). To facilitate the procedure, the use of contrast dye along with X-rays allow for the examination of the bile duct and pancreatic duct.
Endoscopic Ultrasound (EUS)
A procedure where a flexible tube with a camera and ultrasound probe is inserted into the mouth (or the anus) to allow your doctor to examine the walls of your upper (or lower) gastrointestinal tract. The upper tract consists of the esophagus, stomach and duodenum; the lower tract consists of the rectum and colon. EUS is also used to study internal organs that lie near the gastrointestinal tract, such as the pancreas, biliary system, liver, blood vessels, and lymph nodes. A thin needle can be placed through the scope to allow your doctor to take biopsies of abnormal tissue from areas of concern.
Enteral Stenting
Sometimes patients with cancers of the esophagus, stomach, small bowel, or colon may develop blockages whereby they cannot swallow or adequately digest food. Using either a gastroscope or colonoscope, sometimes your doctor can insert a metal stent within the GI tract to relieve the obstruction. These stents are often left in permanently to help improve a patient’s quality of life.
Gastroscopy
A procedure where a flexible tube with a camera is inserted into the mouth and beyond the stomach into the small bowel to visualize the lining of the upper part of the GI tract. During the procedure, devices may be used to take biopsies, remove polyps, or control bleeding.