Gastroenterology

Dealing with any kind of gastrointestinal problem can be painful, not to mention undue stress or embarrassment that keeps you from the life you love.

At Central Maine Health, we can help put your body – and mind – at ease. Our dedicated team of gastroenterologists and support staff, including registered dietitians, are skilled in treating all types of digestive problems. Whether your problem is a short-lived “stomach bug” or a chronic condition, count on our experts to help you find the right solution to help get back to feeling and living your best.

Bowel Disorders

Bowel disorders are any conditions that affect your intestines, specifically how your body digests and absorbs food. This can cause uncomfortable and often unpredictable symptoms, and, left treated, may lead to serious health complications. If you’re experiencing any persistent stomach problems — bloating, nausea, diarrhea, constipation — don’t suffer any longer. The digestive health experts at Central Maine Healthcare can identify the problem and provide the care and support you need to take control of your digestive health.

Expert Care for Lasting Relief: The GI providers at Central Maine specialize in treating all types of bowel disorders, including:

Irritable Bowel Syndrome (IBS): Found in both the large and small intestine, IBS can be difficult to spot because everyone experiences the symptoms once in a while: stomach pain, gas, bloating in the abdomen, nausea, diarrhea, constipation and vomiting. In more serious cases you might see blood in your stool, fever or weight loss. But with new national, standard criteria, we can now diagnose IBS faster and more effectively than ever:

• Abdominal pain three days a month, for the past three months;
• Change in the frequency of your bowel movements;
• Change in the consistency of your stool; and
• Symptoms improve after you have a bowel movement.

If those symptoms sound familiar, contact us for an official evaluation. In the meantime, it’s a good idea to track your bathroom habits before you see the provider, who might also ask you to take a lactose intolerance test. Treatment for IBS usually is a program of medications with a healthy eating plan.

Crohn’s Disease: Crohn’s is actually an autoimmune disease, meaning your body attacks its own healthy factors. The exact cause isn’t known, but risk factors include smoking, an unhealthy diet and being of Ashkenazi Jewish heritage. Our providers diagnose Crohn’s disease with a blood test, CT or MRI scans, endoscopy or a combination. Symptoms usually can be tamed with medications and healthy food. If your immune system has damaged any healthy tissue, the provider may recommend surgery to remove the injured area.

Crohn’s disease might cause the most discomfort of all the major bowel disorders — pain, severe diarrhea, weight loss, major fatigue, malnutrition and inflamed skin, eyes and joints, among other symptoms. That’s also because it is an autoimmune disorder as well, in which your body attacks its own healthy tissues. While there currently isn’t a cure for Crohn’s – it can be effectively managed, and the board-certified gastroenterologists are here to help. We specialize in early detection and diagnosis, and we provide a full range of treatment options to help keep symptoms in check and avoid serious complications.

Diagnosing Crohn’s Disease: A blood test is the go-to method for identifying Crohn’s disease. Your provider may also order a fecal occult blood test (“occult” in this case meaning “hidden,” not supernatural) to see if you have blood in your stool. Often those tests are combined with a colonoscopy, CT or MRI scan and/or endoscopy.

The exact cause of Crohn’s is unknown, but there are certain factors that may increase your risk. It tends to be a young person’s disease; most often found before a person’s 30th birthday. Ethnicity is involved, too; chances of getting it are higher if you are of Eastern European Ashkenazi (Jewish) descent, or if you’re an African American in the U.S. or United Kingdom. It’s also seen more frequently in cities than rural areas, so environment might be a factor as well.

Taking Control of Crohn’s: It’s common to treat Crohn’s disease with medications that relieve symptoms. Other drugs to suppress the immune system help keep it from attacking healthy tissue. Often these will be prescribed along with pain relievers, iron supplements, vitamin B-12 shots, antibiotics, and calcium/vitamin D supplements. If part of the digestive tract has been damaged, your provider might recommend surgery to remove the injured portion and reconnect the healthy sections. Changing your diet can help, too – eating smaller meals, taking in less fat, drinking plenty of water and limiting foods that could irritate your digestive tract, such as dairy, fiber, and spicy foods. We can also connect you to a registered dietitian at Central Maine Healthcare, who can help design a customized meal plan.

Celiac Disease: Another autoimmune disease, Celiac is triggered by gluten, a protein found in some grains. If you’re diagnosed with Celiac disease, you’ll need to avoid eating wheat, rye and barley, plus oats unless they’re certified to be gluten-free. (Oats don’t contain gluten but they often are processed on the same equipment as other grains and can be contaminated that way.) Think of it as an allergy: if you eat grains containing gluten, you will likely get a physical reaction like you would with any other substance to which your body is sensitive. In this case, you risk injuring the inner lining of your small intestines. Celiac disease is diagnosed with a blood test and sometimes a biopsy of your small intestine, collected with an endoscope – a thin, flexible tube with a tiny camera to allow your provider to see inside your body and remove tissue, if needed. Treatment is straightforward: you’ll be instructed to follow a strict gluten-free diet.

Intestinal obstruction: This disorder is just what the name implies: there is an obstruction of some kind in your intestines. It might be a hernia, or a blockage brought on by an injury. Whatever the cause, your intestines can’t process food or pass stool correctly. Treatment might involve a minimally invasive procedure to remove or bypass the obstruction.

Esophageal Disorders

Your esophagus is the long, hollow tube that runs downwards from your throat, carrying food to your stomach. But it’s not the simple organ you might think – dozens of disorders can be traced back to the esophagus, most with one primary symptom: difficulty swallowing. If you’re having a hard time getting your food down, or are having other symptoms related to swallowing, come see the experts at Central Maine Healthcare. Our skilled gastroenterologists can get to the source of the problem and help make eating easier and enjoyable once again. Like other disorders of the esophagus, the primary symptom is difficulty (or painful) swallowing, but the similarities end there. Other symptoms include hoarseness, weight loss and a cough that doesn’t go away. Risk factors for esophageal cancer include smoking, drinking heavily or having acid reflux – another reason for not ignoring your GERD symptoms.

GERD or Acid Reflux: There’s a small muscle at the end of your esophagus, and when the “tube” sends food to your stomach, the muscle clamps shut so the food will stay down there. But with gastroesophageal reflux disease (GERD), that muscle doesn’t close property and some of the contents can leak back up. When that happens, not only do you get that unpleasant taste in your mouth, but over time reflux can damage your esophagus. In most cases, over-the-counter antacids and other remedies, combined with a few lifestyle changes, will take care of reflux. If you’re overweight, your GI provider at Central Maine can help you get down to a healthy weight, with support from our registered dietitians and certified fitness trainers. If needed, we can also prescribe medications to reduce the acid in your stomach.

Heartburn is similar to GERD in many ways, so much so that people often mistake one for the other. With heartburn, instead of food backing up into the esophagus, stomach acid backs up, causing a slight burning sensation in your chest. It’s a common ailment among pregnant women, and also caused by eating spicy foods, or some alcohol or medications. Like GERD, it can damage your esophagus over time. Your gastroenterologist can recommend the best over-the-counter stomach acid remedies, or if necessary, prescribe medication to help relieve the problem.

Dysphagia: The best way to describe dysphagia is, “ineffective swallowing.” You just can’t get all of your food down, even if your esophagus is healthy, and you may feel that something’s stuck in your throat. Dysphagia can be caused by a stroke or some illness that affects the nerves or muscles of your esophagus. Often it’s associated with GERD and usually can be resolved with medication.

Functioning Chest Pain: This condition is different from heartburn, because you feel pain in your chest but without a burning sensation. Functioning chest pain indicates spastic contractions of your esophagus, or the nerves in your esophagus are simply more sensitive than usual. Most treatments focus on relieving the pain itself – we’ll work with you to create a personalized plan.

Hepatitis

Hepatitis in all its forms (A, B and C) is a liver disease. Each is a distinct illness – some that are mild and go away on their own, and others that can lead to serious complications if left untreated. At Central Maine Healthcare, our board-certified gastroenterologists and infectious disease specialists successfully treat people with hepatitis every day. If you’re living with any form of the disease, we’ll work with you to create a personalized treatment plan to help you manage your condition and live a full and healthy life.

Understanding Hepatitis: Central Maine Healthcare’s liver and digestive health experts provide specialized care for all forms of hepatitis:

Hepatitis A: We hear less about Hepatitis A than other varieties. Unlike B or C, Hep A is an inflammatory disease, caused by a virus. It doesn’t always bring symptoms, but when it does, they’re obvious: Jaundice (yellow eyes and skin), stomach pain, loss of appetite, nausea, fever, diarrhea and fatigue. Hepatitis A is contagious; you can get it by ingesting contaminated food, drinks or ice. A blood test provides the best diagnosis, but keep in mind, Hep A is preventable with good hygiene and a vaccine.

Hepatitis B: Hepatitis B is an infection, so it’s inherently more serious than Hep A. If it’s not treated promptly it can cause scarring of the liver (cirrhosis, which eventually renders the liver useless), liver failure and cancer. This form of hepatitis is transferred through body fluids and unprotected sex—but it usually lasts for only a few months, and once it’s treated, you’re immune for the rest of your life! You can’t mistake the symptoms: light-colored feces, fatigue that lasts for weeks and stomach distress that doesn’t stop. A blood test provides the diagnosis; with a vaccine and minor lifestyle changes (such as giving up acetaminophen), the illness usually ends. If it’s chronic, which happens in some cases, you might be given a drug called Interferon alfa to boost your immune system, or other medications.

Hepatitis C: In the past, people diagnosed with hepatitis C, an infectious disease caused by a virus, had to accept the fact that cirrhosis (scarring of the liver, still a possible complication) and eventual liver cancer and liver failure were inevitable. Now, there’s good news. Hepatitis C is more much management – and even curable – with a regimen of medications taken daily for up to six months. Hep C doesn’t always display symptoms. In fact, an estimated four million people in the U.S. have hepatitis C and don’t even know it. It’s the most common version of hepatitis, spread through contaminated blood. When symptoms do appear, they’re the kind that could indicate a number of illnesses: bruising or bleeding easily, poor appetite, itchy skin, swelling in legs, confusion, drowsiness, spidery blood vessels, dark urine or fatigue. Most people who get Hepatitis C first get what’s called “acute” Hep C, which is misleading because it’s rarely symptomatic and often doesn’t continue past that stage. But if you do notice the symptoms listed above, they almost always indicate something and could point to hepatitis, so it’s a good idea to contact one of our specialists to get the answers you need.

Ulcerative Colitis

Ulcerative colitis is a type of inflammatory bowel disease (IBD) that indicates ulcers in the digestive tract, along with inflammation of the inner linings of the large intestine, colon and rectum. These ulcers are long-lasting, so it’s important to get them taken care of when you first notice symptoms, which often develop slowly. The digestive health experts at Central Maine Healthcare specialize in diagnosing ulcerative colitis and help prevent or control the flare-ups that affect both your health and life.

Understanding Ulcerative Colitis: Symptoms of ulcerative colitis can be debilitating if they progress. They include:

• Diarrhea, often with blood or pus
• Abdominal pain and cramping
• Rectal pain and bleeding
• An urgent feeling that you need to spend time in the bathroom, but once you get there nothing happens
• Weight loss
• Fatigue
• Fever
• When ulcerative colitis happens in children, they don’t grow at a normal rate

The cause of ulcerative colitis is unclear, though evidence suggests the immune system somehow malfunctions and triggers it. We also think it probably has ties to heredity, along with diet and stress. Complications can be serious, including severe dehydration, swelling in the colon, blood clotting and more, so it’s important to seek care if you experience any of the symptoms above.

Diagnosis and Treatment: Because the symptoms of ulcerative colitis can indicate a number of illnesses, our GI specialists use on a variety of diagnostic tests to zero in on the most accurate answers, such as:

• Blood testing for anemia, to determine if the patient’s blood has enough red cells to carry oxygen to the tissues
• Stool sample exam, to rule out certain infections
• Colonoscopy
• X-rays
• CT scans to see how much of the colon might be inflamed
• MRI screening for a more detailed picture of the digestive tract

If you’re diagnosed, your Central Maine Healthcare gastroenterologist will work with you to find the best treatment to stay on top of the condition. Treating ulcerative colitis usually involves a combination of medications that perform specific tasks: you might be prescribed anti-inflammatory drugs, along with immune-system suppressants that also can help stop the inflammation. Anti-diarrhea drugs, pain relievers and iron supplements might also be part of your program. Lifestyle adjustments, including smaller meals, drinking more liquids, eating less fiber (if fiber aggravates your colon), more activity, and breathing exercises to control your stress can all be helpful. In extreme cases, your provider may recommend surgery to remove your colon if it’s been damaged.