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Conditions

Barrett's Esophagus

This is condition where the lining of your lower esophagus changes into a precancerous lining due to reflux. It is twice as common in men compared to women. About 5-10% of patients with GERD get Barrett’s esophagus.

Various risk factors for Barrett’s esophagus are:

  • Caucasian race
  • Male sex
  • Reflux ( lot of patients never complain of reflux)
  • Obesity
  • Smoking
  • Genetic factors

Barrett’s is easily diagnosed with Endoscopy. Your gastroenterologist will examine the esophagus carefully and take tissue biopsies which are then sent to the Pathologist for analysis to diagnose Barrett’s esophagus. Barrett’s esophagus carries a risk of Esophageal cancer (adenocarcinoma) in the long run hence it is very important to have a careful and long term follow up with a Gastroenterologist.

Celiac Disease

Celiac disease is a lifelong autoimmune condition where body’s immune system attacks the small intestine and causes destruction of the lining thereby resulting in malabsorption of nutrients. There is an immune response against a protein called Gluten that is found in wheat, rye and barley. Typical symptoms include weight loss, diarrhea, belly cramps, bloating, skin rash, anemia, fatigue and et cetera
Celiac disease needs to be distinguished from Gluten sensitivity, Gluten allergy and Wheat allergy. The diagnosis is made by specialized blood tests and endoscopic testing. Celiac disease carries a risk of small bowel lymphoma over long term hence requires careful frequent monitoring by a Gastroenterologist.

Cirrhosis

The liver is one of the most important organs in your body and is located below your right rib cage. The functions of the liver include: Converting food into energy, Cleaning out your body by metabolizing medications and removing alcohol and poisons from your system, and making bile to help you digest food.

Cirrhosis occurs when liver is permanently injured & scarred by chronic conditions and disease such as alcohol use, chronic viral hepatitis B or C, Nonalcoholic fatty liver disease (NASH/NAFLD), Hemochromatosis, Autoimmune Hepatitis, Medications, et cetera. The scar tissue that forms in cirrhosis harms the structure of the liver, blocking the flow of blood through the organ.

There are multiple ways to manage advanced cirrhosis:

  • Treat the underlying disease.
  • Avoid ALL alcohol ( ZERO Alcohol should be the goal)
  • Practice good diet nutrition such as 2 gram sodium diet
  • Work closely with a doctor
  • Anticipate and treat complications such as bleeding, memory loss, confusion, encephalopathy, sleep issues, swelling of the feet & abdomen

Symptoms of Cirrhosis:

  • Extreme Fatigue
  • Weakness
  • Loss of appetite
  • Water build up in the legs (edema) or belly (ascites).
  • Easy skin bruising or bleeding from gums/nose
  • For females, absence of menses
  • For men, loss of sex drive or tender, enlarged breasts called gynecomastia
Probiotics & Gut Flora

There is a bidirectional signal flow and cross talk between your gut and your brain. According to a recent article probiotics may hold the key for deeper understanding and hopefully treatment of mood disorders.

Changes in “Gut Flora” have been linked to mood disorders and depression.

Per a recent study, healthy people who drank probiotic milk had much improved mood and increased activity in the “emotional centers” of their brain. Individuals who received certain probiotics had much less incidence of psychological distress or depressed mood compared to those who did not take probiotics. There was also a beneficial effect on levels of stress hormone cortisol in people consuming certain probiotics.

I believe that future research will further clarify the relationship between probiotics and mood disorders.

All diseases begin in the gut. When Hippocrates said these words thousands of years ago, he was right on point. Humans have about 100 trillion microbes in their gut, which help to digest complex food molecules, maintain a healthy & functioning gut environment, extract energy from foods and produce nutrients such as Vitamin K and folic acid. There is more microbial genetic material in the human body compared to that contained in cells of the human body. These microbes begin entering the gut at birth and stay there forever. Currently, many researchers are looking to the human gut and the microbes within it to help answer some difficult questions about health and disease.

More and more evidence is pouring in to indicate that these microbes are not silent but in fact, they play a big role in converting the human body’s digestive system into a “bioreactor,” or a place where lots of metabolic, immune system and inflammation triggers are either generated or suppressed. In fact, roughly 70% of your body’s immune system exists within your gut, and these microbes “talk” to your immune system; they are always at work, 24/7… no days off, no sick leave. As you get older, and with exposure to certain foods, tobacco, alcohol, medicines, toxins, stresses, pathogens etc., these resident microbes may experience an imbalance which may cause abdominal symptoms such as bloating, diarrhea, constipation, change in bowel habits, excess gas and pain.

The take-away? Your food and lifestyle choices affect the balance of microbes in your gut and, consequently, your overall health. That’s why it’s very important to eat well and practice a balanced lifestyle.

Clostridium Difficile Infection

Also known as C. difficile for short, this is a very aggressive intestinal bug that results from over use of antibiotics. Each year, this bacterial infection affects roughly 500,000 people in the U.S and sends almost 350,000 to the hospital for treatment. In extreme cases, C. difficile infection can be fatal, with estimates of C. diff-associated death ranging from 14,000 to 30,000 annually.

The symptoms of Clostridium difficile (C. diff) infection are:

  • Watery diarrhea (very liquid stool) three or more times a day for more than two days.
  • Belly pain, cramping
  • Nausea with or without vomiting
  • Poor appetite

In more serious cases, symptoms may be:

  • Severe Watery diarrhea
  • Severe belly pain and cramping
  • Severe Dehydration.
  • Fever and sepsis
  • Weight loss
  • Septic Shock that may need emergent surgery

Treatment:

  • Antibiotics
  • Stool Transplant: If you get diarrhea within a few days of being admitted to or released from a hospital or health care facility or within two months of taking an antibiotic, and you have had three or more bouts of diarrhea in 24 hours, C. diff may be the culprit  Talk to your doctor right away.
Colon Polyps & Colorectal Cancer

Colorectal cancer (also known as colon cancer) is cancer of the colon and/or rectum and occurs when a growth in the lining of the colon or rectum becomes cancerous.

The colon also known as the large intestine is a vital organ in your body’s digestive system.

Colon is a long, thick tube that:

  • Absorbs in water and minerals from digested food.
  • Stores undigested solid waste.
  • Most colorectal cancers come from precancerous polyps — adenomatous polyps or serrated polyps — that form over a number of years (five to 10) to become a cancer.

A polyp is a mushroom-like or flat growth on the inside wall of the colon or rectum. Polyps grow slowly over many years.

Not all colon polyps have the same risk of turning into colon cancer. Precancerous polyps (called adenomas) could become cancerous; other types of polyps (hyperplastic, inflammatory) do not.

 PREVENTION IS BETTER THAN CURE… BE PROACTIVE, GET CHECKED FOR COLON POLYPS

If caught early before any symptoms arise, surgery can cure colorectal cancer. Finding colorectal cancer early leads to easier treatments and higher survival rates.

Constipation

Constipation is defined as harder stool consistency, the presence of pellets, straining or feelings of incomplete evacuation, and a feeling of “want to, but can’t.” As a ground rule, constipation should be suspected if more than three days pass between bowel movements or if there is difficulty or pain when passing a hardened stool.

Millions of people suffer from constipation. Most people have constipation at some point, as it is a normal issue. Most of the time, it can be helped through diet, drinking more water, exercise and over-the-counter (OTC) medications. If you are feeling constipated, try those first.

Sometimes, constipation persists then you should talk to your doctor about your constipation when:

  • Your symptoms last longer than three weeks.
  • You have bad belly pain when you pass stool.
  • You notice that your stools are consistently thinner.
  • You notice that your rectal bleeding (blood on the toilet paper) does not go away or comes back often.
  • You see blood in your stool, particularly if it is mixed with stool.
  • Your stools are turning black
  • You are found to have anemia, caused by blood loss in stool
  • Along with other abdominal symptoms, you start losing weight without trying to
  • Your symptoms are getting bad and you don’t feel well

When you talk to your doctor, tell them about all medications, even Over the Counter drugs, you are taking, as they could be a cause of constipation.

Your doctor may run more tests or procedures.

Diverticulitis

Diverticulosis is a condition in which pockets (or diverticula) occur in the wall of the colon. When these pockets become infected or inflamed, it is called diverticulitis. Acute diverticulitis is a painful, relatively sudden condition that can usually be treated with antibiotics without surgery. Some patients do end up needing surgery in the long run.

Symptoms of diverticulitis

  • Abdominal pain and soreness
  • Fever, chills, nausea, vomiting
  • Change in bowel habits, such as diarrhea (loose stool) or constipation (hard stool or trouble passing stool).

Talk to your Gastroenterologist if you think you have diverticulitis.

Dyspepsia

Dyspepsia, also known as indigestion, can have many symptoms, including fullness during a meal, painful fullness after a meal, or pain in the upper abdomen. Indigestion is not the same as heartburn or reflux. Gallstones & Pancreatic disorders can present as dyspepsia or indigestion.

Eosinophilic Esophagitis

This condition presents as Trouble swallowing, choking and gagging on food. It is an immune system disease where white blood cells enter the esophagus tissue making swallowing difficult.

Treatment of this condition may include eflux medications, Elimination diet (avoiding trigger foods) and endoscopy to check esophagus for injury.

Fatty Liver

Nonalcoholic fatty liver disease (NAFLD) is a broad term for a range of liver conditions affecting people who drink little to no alcohol. As implied by the name, the main characteristic of the nonalcoholic fatty liver disease is too much fat stored in liver cells.

NAFLD tends to run in families and is more likely to occur in those who are middle-aged and overweight or obese. Other causes include Medications, Viral hepatitis, autoimmune or inherited liver disease, quick weight loss, malnutrition.

Nonalcoholic steatohepatitis is a potentially serious form of the disease and is evident by liver inflammation, which may progress to scarring and irreversible damage. This liver damage is similar to the damage caused by substantial alcohol use. In the most severe cases, nonalcoholic steatohepatitis can lead to liver failure and cirrhosis.

In the United States, Nonalcoholic fatty liver disease it is the most common form of chronic liver disease, affecting an estimated 80 to 100 million people. The disease is increasingly common around the world, especially in Western nations.

Nonalcoholic fatty liver disease can occur at any age, but people in their 40s and 50s who are at high risk of heart disease because of such risk factors as obesity and type 2 diabetes have a higher risk. The disease is also closely linked to metabolic syndrome, which is characterized by abnormalities including increased abdominal fat, poor ability to process the hormone insulin, high blood pressure and high blood levels of triglycerides.

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Gallstones
Gallstone disease is a common medical problem, affecting well over 25 million people. Nearly 1 million new cases of gallstone disease are diagnosed every year in this USA approximately 250,000 require treatment.

Symptoms

  • Pain after eating
  • Heartburn, fullness after eating
  • Nausea
  • Vomiting
  • Pain may come and go over many months or years
  • GERD

Gastroesophageal reflux disease is a condition where stomach contents reflux into the esophagus causing symptoms.

Symptoms of GERD or Reflux

  • Heartburn
  • Chest pain
  • Heaviness in the pit of the stomach
  • Choking
  • Night time cough
  • Worsening of asthma in some cases
  • Sore throat that won’t go away
  • Hoarseness of voice
  • Nausea
  • Vomiting
  • Pain on swallowing
  • Excess Burping

Long term untreated GERD can cause esophageal injury called Esophagitis or scar tissue formation in the esophagus. Rarely, it can also raise the risk for Esophageal adenocarcinoma, a type of esophageal cancer.

Please call your Dr. Sharma to make an appointment if you or your family members are suffering from any of the above symptoms.

Hemorrhoids
Hemorrhoids occur when veins around the anus swell up and congest with blood and become painful.

Symptoms of Hemorrhoids

  • Blood in stools
  • Pain and pressure in the rectum and anus area
  • Blood on toilet paper
  • Itching around the anus

Hepatitis C
Hepatitis C is an infection of the liver that causes inflammation and scarring of the liver that may cause liver cirrhosis and more complications such as bleeding, swelling of legs and belly, bruisability, liver cancer and more.

Symptoms:

  • Fatigue
  • Joint pains
  • Skin rashes
  • Bruises
  • Jaundice
  • Nausea
  • Vomiting

Inflammatory Bowel Disease (Crohn's Disease, Ulcerative Colitis)
This is a condition where your immune system attacks the lining of the gastrointestinal symptoms. This condition is genetic and the risk is higher if you have family members with similar diseases.

Symptoms

  • Abdominal pain
  • Blood in stools
  • Weight loss
  • Diarrhea
  • Bloating
  • Fatigue
  • Joint pains
  • Skin rashes
  • Vision abnormalities
  • Back pain
  • Jaundice
  • Liver test abnormalities
  • Malnutrition
  • Anal fissures

Treatment includes steroids, pills like Asacol, Pentasa, Lialda and immunosuppressive agents such as Immuran, Mercaptopurine, Remicade, Humira, Entyvio, Stelara and et cetera.

PLEASE schedule an appointment with Dr. Sharma today if you have any of the above symptoms and have a concern for IBD.