Gastroenterologists heal patients' most complex digestive conditions
If you are suffering from symptoms related to your digestive system, Baylor Scott & White All Saints Medical Center – Fort Worth's full range of innovative diagnostic and therapeutic gastroenterology services can help pinpoint their cause and get you started on the road to optimal digestive health.
Many of our state-of-the-art programs and diagnostic treatment options allow for shorter recovery times and above-average outcomes, especially for complex cases, all conveniently located in Fort Worth.
Our advanced clinical research and innovative approaches to provide quality results and care are what drive our mission to provide outstanding gastroenterology service to our patients and their families.
- Achalasia
- Acid reflux
- Anemia
- Barrett's esophagus
- Bile duct stones
- Cirrhosis
- Cáncer de colon
- Colon polyps
- Enfermedad de Crohn
- Diverticulitis
- Dysphagia
- Cáncer de esófago
- Fistulas
- Gallstones
- Gastric/Stomach cancer
- Gastroparesis
- GERD
- Hepatitis
- Hepatobiliary cancers
- Irritable bowel syndrome (IBS)
- Pancreas cysts
- Pancreatic cancer and pancreas tumors
- Pancreatitis
- Swallowing disorders
- Ulcerative colitis
- Ulcers
You may have achalasia if it is challenging for liquid and food to pass through your esophagus into your stomach. In achalasia, your esophagus muscles do not work properly, making it more difficult for food to pass into the stomach, which runs the risk of food becoming lodged in the esophagus.
Possible symptoms include:
- Dysphagia—feeling solid food or liquids getting stuck in the throat or chest
- Regurgitation—spitting up after drinking/eating
- Dolor de pecho
- Pérdida de peso
Frequent heartburn is often caused by gastroesophageal reflux disease (GERD). With GERD, the contents of the stomach back up into the esophagus.
Anemia happens when your body does not produce enough healthy red blood cells needed to carry the appropriate amount of oxygen throughout the body. Types of anemia vary and symptoms can be temporary or long-term.
Common symptoms of anemia are:
- Excessive tiredness
- Weakness
- Yellowish or pale skin
- Irregularity in heartbeats
- Dificultad para respirar
- Lightheadedness or dizziness
- Cold feet and hands
- Dolor de pecho
- Dolor de cabeza
Barrett’s esophagus is typically associated with those patients that have been diagnosed with GERD. Barrett's esophagus replaces the tissue lining of the esophagus with softer tissues similar to what is found in the intestines.
Bile duct stones can be a complication of gallstones. Gallstones are small masses that can form inside the gallbladder. The bile duct passes bile from the liver and gallbladder through to the intestine. Occasionally, the gallstones that are formed in the gallbladder and travel to the bile duct and become lodged, causing significant symptoms for the patient.
Common symptoms of bile duct stones include:
- Abdominal pain in the middle-upper or right-upper abdomen
- Fiebre
- Yellowing of the eyes and skin
- Loss of appetite
- Nausea and vomiting
- Light-colored stools
Cirrhosis is often irreversible scarring of the liver. This is usually the result of various problems that damage liver cells over time. Eventually, the damage becomes so severe that the normal structure of the liver is changed and it stops functioning correctly.
Colon and rectal cancer occurs when the cells in either the colon or rectum start to grow out of control. It usually begins as a polyp or growth of tissue. It is the third most common form of cancer for both men and women.
Colon polyps are small growths that occur in the rectum and lining of the colon. Having a polyp does not mean you have cancer, however, colon cancer most often does begin with polyps. The American Cancer Society recommends colon cancer screenings begin at age 45 for those with no family history.
Risk factors for colon cancer include:
- Being older than 50
- Having a family history of polyps or colorectal cancer
- Having inflammatory bowel disease, such as Crohn’s disease
- Being overweight or obese
- Smoking cigarettes
Crohn's disease is an inflammatory bowel disease (IBD), which is a chronic condition that may recur at various times over a lifetime. It usually involves the small intestine, and in some cases, both the small and large intestines are affected. Sometimes, inflammation may also affect the entire digestive tract, including the mouth, esophagus, stomach, duodenum, appendix or anus.
Diverticular disease, also called diverticulosis, is an infection in the tiny pouches that some people get in their colon. The pouches are called diverticula and can sometimes bulge out through weak spots in your colon. The pouches can become inflamed (red, swollen) or infected. Diverticulitis is when these tiny pouches in the colon get infected. About half of all Americans over age 60 will have diverticulosis.
Dysphagia is a medical condition where an individual has difficulty swallowing or passing food down the esophagus into the stomach. With this condition, it takes more effort and time to move liquid or solid food from the mouth to the stomach. In some cases, patients may have pain with swallowing or may find it difficult to pass any food down.
Nearly everyone has occasional trouble with swallowing, especially when food is not chewed correctly, or you eat a meal too fast. This is not a concern, in itself. However, if the dysphagia persists, it is best to seek medical help to get a diagnosis and treatment. While dysphagia can occur at any age, it is more common in older adults.
Esophageal cancer is when the cells in any part of the esophagus begin to abnormally grow at a fast rate. There are two types of esophageal cancer, squamous cell carcinoma and adenocarcinoma.
Fistulas can form when inflammation leads to sore or ulcers that form on the walls of the intestines. Fistulas can form in a variety of different organs and require removal. Symptoms of fistulas can include:
- Diarrhea
- Infecciones del tracto urinario
- Cloudy urine or blood in the urine
The gallbladder is a small organ under your liver that stores bile made by the liver. Gallstones are lumps of solid material that form in your gallbladder, made when the digestive juice called bile gets hard and stone-like. In some cases, gallstones block the tubes that carry bile, which can lead to a life-threatening infection of the bile ducts, pancreas or liver.
Stomach cancer is usually caused by the mucus-producing cells that line the stomach and be caused by acid reflux, smoking or obesity.
Risk factors for stomach cancer can include:
- A diet high in salty or fatty foods
- A family history of stomach cancer
- Smoking
- Long-term stomach inflammation
Gastroparesis delays the emptying of the contents of the stomach into the intestines that can cause prolonged retention of acid, liquids and food content in the stomach. Common symptoms of Gastroparesis can be vomiting, abdominal bloating, fullness, acid reflux/heartburn, weight loss and a lack of appetite. A new endoscopic procedure called G-POEM can help to treat the symptoms of Gastroparesis and improve patient's quality of life.
GERD stands for gastroesophageal reflux disease. Typically, GERD is where abnormal amounts of acid refluxed back from the stomach into the esophagus, leading to symptoms such as heartburn. One in five Americans claims to experience some type of acid reflux or GERD symptoms.
GERD can lead to symptoms such as heartburn, chest pain, difficulty swallowing, feeling like you have a lump stuck in your throat or chest, burping, regurgitated food and upper stomach pain. These symptoms are usually experienced after eating or a night time when laying flat.
Without proper treatment, complications can arise from the prolonged stomach acid, including damage to the esophagus or the development of scar tissue which can lead to an esophageal ulcer or the development of esophageal cancer.
Hepatitis is inflammation of the liver that results in liver cell damage and destruction. There are several different types of hepatitis, but the two most common are B and C.
Hepatobiliary cancers can include cancers of the liver, bile duct or gallbladder.
Irritable bowel syndrome (IBS) is an intestinal disorder that causes crampy pain, gassiness, bloating and changes in bowel habits. Because an organic cause has not been found, IBS often has been thought to be caused by emotional conflict or stress. While stress may worsen IBS symptoms, research suggests that other factors also are important.
Cysts are the build up of fluid in the pancreas that can lead to cancer. To evaluate the severity, the physician can take fluid samples from the cyst to determine the best course of treatment.
Pancreatic cancer affects the abdominal organ that helps to aid digestion and provides the hormones that helps to manage blood sugar. Typically, it is not detected until the later stages of the disease.
Pancreatic cancer symptoms can include:
- Upper abdomen pain radiating to the back
- Unintended weight loss or loss of appetite
- New onset diabetes
- Fatiga
- Blood clots
- Yellowing eyes or skin
Pancreatitis happens when the pancreas, an abdominal organ that helps to aid digestion and provides the hormones that help to manage blood sugar, becomes inflamed. Typically the result of pancreatitis is when the digestive enzymes become activated while they are still in the pancreas.
Signs and symptoms of pancreatitis can include:
- Pain in the upper abdomen
- Abdominal pain radiating into the back
- Worse abdominal pain after eating
- Fiebre
- Rapid pulse
- Nausea and vomiting
- Tenderness of the abdomen
There are some certain diseases and conditions that can lead to swallowing disorders:
- Acid reflux and tumors that reduce the esophageal passageway
- ALS (Lou Gehrig’s disease), Parkinson's disease and multiple sclerosis
- Stroke that damages digestive muscle function
- Achalasia, the loss of the ability of the esophagus to move food to the stomach and problems with the muscular valve between them failing to fully relax
Ulcerative colitis is an inflammatory bowel disease (IBD) in which the inner lining of the large intestine (colon or bowel) and rectum become inflamed. Inflammation usually begins in the rectum and lower intestine and spreads upward to the entire colon. Ulcerative colitis rarely affects the small intestine, except for the lower section.
There are two common ulcers found in the digestive system: peptic ulcers and esophageal ulcer. An esophageal ulcer is an open sore in the lining of the esophagus. A peptic ulcer is a sore on the lining of your stomach or the first part of your small intestine.
- Ablation therapy
- Colectomy
- Colonoscopia
- EndoFLIP (endolumenal functional lumen imaging probe)
- Endoluminal stenting
- Endoscopic mucosal resection (EMR)
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Endoscopic submucosal dissection (ESD)
- Endoscopic ultrasound (EUS)
- Esophageal manometry
- Esophagectomy
- Esophagogastroduodenoscopy (EGD)
- Gastric peroral endoscopic myotomy (G-POEM)
- Gastric pull-up
- Ileostomy
- Liver biopsy
- Paracentesis
- Peroral endoscopic myotomy (POEM)
- pH testing
- Whipple
Ablation therapy is a technique that can be used to remove abnormal or diseased tissue in the GI tract. There are multiple forms of ablation therapy used to treat different conditions including Barrett's esophagus and removal of small tumors.
A colectomy removes all or part of the colon or large intestine.
Colorectal cancer is extremely preventable if polyps that lead to the cancer are detected and removed in its early stages. Since there are very few symptoms associated, regular screening is essential. A colonoscopy is the best way to look for colon growths, but it is not right for everyone. Your provider can help determine the best options and frequency for your individualized situation. The American Cancer Society recommends colon cancer screenings begin at age 45 for those with no family history.
The EndoFLIP system is a balloon device that is passed transorally during an endoscopic procedure. The EndoFLIP uses impedance planimetry to measure the diameter and pressure in the esophagus at different inflation levels of the balloon. This system provides information when the esophagus is stretched and simulating a bolus to assess distensibility of the esophagus and also provides information on secondary peristalsis.
This information complements traditional testing with high-resolution manometry and barium swallows for diagnostic assessments and can be used to gauge the effect of treatments during interventions in real time during endoscopic procedures.
Endoluminal stenting is a procedure that is used to manage blockages or leaks in the gastrointestinal tract. The stents can be placed in the esophagus, stomach, small intestines and colon.
Endoscopic mucosal resection (EMR) is a minimally invasive procedure that can be used for large colon polyps. This technique injects fluid under a polyp to raise it up for proper removal.
A specialized endoscopy technique to help visualize and study the ducts (drainage tubes) of the gallbladder, bile ducts, pancreas and liver. An endoscope (a flexible thin tube that allows the physician to see inside the digestive tract) is passed through the mouth into the duodenum (the first part of the small intestine).
The opening called the major ampulla that drains both the bile and pancreatic ducts is then identified and a small catheter (narrow plastic tube) is passed through the endoscope into the ducts. Contrast material is then injected into the ducts, and X-ray images can be viewed and studied for abnormalities.
Endoscopic submucosal dissection (ESD) is a procedure that is used to remove tumors of the GI tract. This technique can remove large areas of precancerous or cancerous cells from the lining of the esophagus, stomach or colon in a single piece.
Sometimes other tests are not able to provide enough detail to diagnose diseases of the digestive tract and surrounding organs. Your provider may refer you for an endoscopic ultrasound, or EUS, to diagnose, evaluate or treat digestive tract conditions.
Using endoscopic ultrasound, physicians can now see beyond the inside surface of the digestive tract in more detail and can make highly accurate images of organs that lie next to the digestive tract such as the heart, lungs, liver, spleen, pancreas, gallbladder, bile ducts and prostate gland.
Esophageal manometry allows physicians to measure the strength and function of muscles in the esophagus and diagnose conditions that cause gastroesophageal reflux disease and swallowing disorders.
Esophagectomy is a procedure where part or all of the esophagus is reconstructed usually due to esophageal cancers.
An EGD, also known as an upper GI endoscopy, can help treat and diagnose issues in the upper gastrointestinal tract including stomach ulcers, abdominal pain, acid reflux, trouble swallowing and bleeding.
Gastric peroral endoscopic myotomy (G-POEM) is a procedure that can be used to treat gastroparesis. An endoscope is used to open the distal muscular valve of the stomach, which enables the stomach to empty contents into the intestine.
Gastric pull-ups are typically performed in follow-up to an esophagectomy and replace a section of the esophagus with reconstructed stomach tissue.
An ileostomy is a procedure that allows for intestinal waste to pass through into an external ostomy system.
Liver biopsy is a procedure in which a doctor uses a special needle to remove a small piece of liver so it can be examined with a microscope. This is done to check for signs of damage or to diagnose the cause of liver damage.
A paracentesis is a procedure to take out fluid that has collected in the belly, called ascites. The fluid is taken out using a thin needle. The fluid is sent to a lab and studied to find the cause of fluid buildup. Paracentesis also may be done to take the fluid out to relieve belly pressure or pain in people with cancer or cirrhosis of the liver.
Peroral endoscopic myotomy (POEM) is a technique that can be used to treat achalasia endoscopically rather than with surgery.
Wireless pH testing
Wireless pH testing is used to evaluate the acid exposure in your esophagus while patients continue normal activities. During an upper endoscopic procedure, the physician places a small capsule in the lower esophagus. The capsule records activity in that area for over a 48-hour period or 96-hour period and transmits acid levels to a wireless recording device, which is worn on a belt.
Catheter-based pH testing
This pH study is an outpatient, transnasal catheter-based test that measures the amount of acid exposure in the esophagus. Options include with impedance testing and with upper sensors to evaluate for evidence of laryngopharyngeal reflux (LPR). Indications include an uncertainty in diagnosis of GERD, evidence to establish a GERD or LPR diagnosis, or determine adequacy of therapy.
Options for catheter-based pH testing
- 24-hour monitoring of pH alone
- 24-hour monitoring of pH with Impedance Impedance can determine antegrade and retrograde bolus transit in the esophagus. It can be used to detect GERD not responding to PPI and to determine the contribution of acidic, weakly acidic and non-acidic reflux in the setting of symptoms
- 24-hour monitoring of pH with LPR and Impedance Upper sensors in the proximal esophagus at or just below the upper esophageal sphincter can assess evidence for reflux that may be contributing laryngopharyngeal reflux. This is particularly useful in assessing LPR and other extra-esophageal manifestations of GERD
pH testing on or off therapy
- Off-therapy testing is often recommended for patients in whom there is a low index of suspicion for reflux disease and in evaluation for an anti-reflux procedure to document the presence of acid reflux. We recommend avoidance of PPI therapy for at least seven days and H2 blocker therapy for at least two days prior to testing
- On-therapy testing is often recommended for patients with refractory reflux symptoms to evaluate adequacy of therapy
The Whipple procedure removes the head of the pancreas, the bile duct, gallbladder and part of the small intestine (duodenum) and reattaches the remaining organs to allow food to be digested.