# Orlando Gastroenterology > Worldclass Gastroenterology in Orlando, FL > Contact: vlad@mishagency.com ### Posts #### Avoiding bad breath Bad breath is a deal breaker both in business and in personal life of ours. And while breath fresheners or candies hide it, they do not cure the very problem at hand... So, most importantly, the bad breath is caused by a lack of oral hygiene. It includes sleeping with an open mouth at night. This makes mouth dry and bacterias began to flourish there and cause that smell... Bad breath has a medical name "halitosis". This kind of condition can stem from poor oral hygiene habits. It also may be a telling sign of other health problems. What you're eating can cause this disease to progress much faster. So how healthy your menu is directly correlated with any oral hygiene problems. So, how your diet and dishes choice affects the smell of your breath? Essentially, everything you're consuming begins to be broken down into parts in your mouth. As dishes are digested and absorbed into the blood system, foods eventually get carried to your lungs. Then it reveals in your breath. This is even more true in case you like foods with strong odors (such as garlic or onions). Then teeth brushing and flossing, even mouthwash and any other breath freshening liquids are redundant. They merely disguise that kind of odor temporarily. The odor will not go away completely until the foods have passed through your body completely... How damaging abundant amount of sugar is for your teeth health? John Doe Which poor oral hygiene habits lead to the bad breath? First off, ask yourself do you regularly follow basic oral hygiene routines? This, of course, includes such morning musts as brushing your teeth twice a day. Keep in mind, that each brushing should be lasting for at least 5 minutes. It's not limited to that. Teeth flossing after each eating is also strongly recommended. Because when you eat and don't follow these methods, food particles stay in your mouth. They get stuck in between the teeth, on gums and the tongue. Then it decays and absorbs there, causing various oral bacteria to flourish. All this results in a bad breath. Antibacterial mouth rinsers, instead of simple breath fresheners, may be of a big help here. It will not simply disguise the smell by replacing it with a nicer aroma. These antibacterial mouth rinsers will eventually fight off and kick out the bacteria from your mouth. As well as off the teeth, gums and tongue. To add to that you must keep an especially attentive eye on your dentures, if you have any. They are critically vulnerable towards the odor-causing bacteria. If the dentures are not cleaned properly, and even more importantly, regularly, it will get covered with invisible bacteria. This will be causing bad smells, that will be obvious to absolutely everyone around. There's also no better way to hazard you oral hygiene and health than smoking or chewing tobacco. Besides irritating the sensitive gums and making teeth yellow, this makes the bacterias prosper. It adds up to a smell too...  Are there any specific health issues that are connected to a bad breath? Such a thing as the periodontal disease may be an essential cause of the bad breath. So if smell and unpleasant taste in your mouth are a lasting issue, you'd better check with your dentist. Specifically on the matter of whether you have periodontal disease or not. Gum disease is caused by the appearance of plaque on teeth. Bacteria cause the formation of toxins to form, which irritate the gums and enamel. If such a gum disease carries on without any treatment to it provided, it can damage the gums and jawbone. Other dental causes of bad breath include poorly fitting dental appliances, yeast infections of the mouth, and denta The medical condition of the dry mouth (also called xerostomia) also can cause a bad smell. Saliva is necessary to moisten the mouth. It neutralizes acids produced by plaque and piles away the dead cells off the tongue, gums, and cheeks' insides. If not removed, these cells begin to decay and can cause bad breath. Dry mouth may be a side effect of various medications. Also salivary gland problems or breathing with your mouth open can be an additional cause. Many other general diseases and illnesses may cause bad breath. Here are some to be aware of: respiratory tract infections such as pneumonia or bronchitis, chronic sinus infections, postnasal drip, diabetes, chronic acid reflux, and liver or kidney problems. #### Burning Questions: Understanding Heartburn, Acid Reflux, and When to Take Action Heartburn and acid reflux are among the most common digestive complaints, affecting millions of people in the United States. While occasional symptoms are usually harmless, persistent reflux can signal a more serious condition that deserves attention. What Is Heartburn and Acid Reflux? Heartburn is the burning sensation you feel in your chest, typically after eating or when lying down. It occurs when stomach acid flows back into the esophagus—a condition known as gastroesophageal reflux. When this happens frequently, it may be diagnosed as Gastroesophageal Reflux Disease. Common Causes and Triggers Several lifestyle and dietary factors can contribute to reflux symptoms: Large or late-night meals Spicy, fatty, or acidic foods (e.g., citrus, tomatoes) Caffeine, alcohol, and carbonated beverages Smoking Obesity Lying down soon after eating Understanding your personal triggers is a key first step in prevention. Practical Steps to Prevent Acid Reflux Fortunately, many people can significantly reduce symptoms with simple lifestyle modifications: Eat smaller, more frequent meals instead of large portions Avoid eating within 2–3 hours of bedtime Elevate the head of your bed to prevent nighttime reflux Maintain a healthy weight, which reduces abdominal pressure Limit trigger foods and beverages Quit smoking, as it weakens the lower esophageal sphincter Over-the-counter medications such as antacids or acid reducers may also provide temporary relief, but they are not a long-term solution for frequent symptoms. When Should You See a Doctor? Occasional heartburn is common, but you should consult a physician if you experience: Symptoms more than twice a week Persistent symptoms despite medication Difficulty swallowing Chronic cough, hoarseness, or throat clearing Sleep disturbances due to reflux At Orlando Gastroenterology, P.A., we specialize in evaluating and treating reflux disorders with a personalized approach, ensuring that underlying causes are properly identified and managed. Potential Complications of Chronic Acid Reflux Ignoring chronic reflux can lead to serious complications, including: Esophagitis (inflammation of the esophagus) Strictures (narrowing due to scar tissue) Ulcers Barrett’s Esophagus, a condition where the lining of the esophagus changes and increases the risk of cancer Increased risk of Esophageal Cancer Early diagnosis and treatment can significantly reduce these risks. Red Flags You Should Never Ignore Seek immediate medical attention if you experience: Unintentional weight loss Vomiting blood or black material Black, tarry stools Severe or worsening chest pain Difficulty or pain with swallowing These symptoms may indicate a more serious underlying condition. The Bottom Line Heartburn may seem like a minor inconvenience, but persistent acid reflux is not something to ignore. With the right lifestyle changes and timely medical care, most patients can achieve excellent symptom control and avoid long-term complications. If you’re experiencing ongoing symptoms, the team at Orlando Gastroenterology, P.A. in Orlando, Florida is here to help. Our experienced providers offer comprehensive evaluation and advanced treatment options tailored to your needs—so you can get back to feeling your best. #### Checking out others? You probably think your partner is too. This general kindness quiz that was completed by more than 1,300 people. I would like to share with you the highlights of this study, along with a few surprises. Specialist is general and bariatric surgery, all minimally invasive methods. Senior general surgeon and head of bariatric surgery division. Premium private hospital, provides the highest quality medical care, individualized treatment by the country’s leading experts, and in the shortest amount of time. As the number of mobile users continues to outpace the number of desktop users, it should go without saying that designers ... Emma Doe Specialist is general and bariatric surgery, all minimally invasive methods. Senior general surgeon and head of bariatric surgery division. Specialist is general and bariatric surgery, all minimally invasive methods. Senior general surgeon and head of bariatric surgery division. Premium private hospital, provides the highest quality medical care, individualized treatment by the country’s leading experts, and in the shortest amount of time. #### Colorectal Cancer Awareness Month March is Colorectal Cancer Awareness Month, a time dedicated to increasing understanding of one of the most preventable—and treatable—forms of cancer. Despite advances in screening and treatment, colorectal cancer remains the second leading cause of cancer-related deaths in the United States. The encouraging news: with appropriate screening and lifestyle choices, many cases can be prevented or detected early when outcomes are significantly better. Why Awareness Matters Colorectal cancer often develops silently. Precancerous growths called polyps can form in the colon or rectum over several years without causing noticeable symptoms. By the time symptoms such as rectal bleeding, abdominal pain, or changes in bowel habits appear, the disease may already be advanced. This is why screening is critical. Detecting and removing polyps early can stop cancer before it starts. Who Should Be Screened? Current guidelines recommend that average-risk individuals begin screening at age 45. However, you may need earlier screening if you have: A family history of colorectal cancer or polyps A personal history of inflammatory bowel disease (Crohn’s disease or ulcerative colitis) Certain genetic syndromes At Orlando Gastroenterology, P.A., we tailor screening recommendations based on your individual risk profile to ensure optimal prevention. Colonoscopy: The Gold Standard Among available screening options, colonoscopy remains the most comprehensive and effective test. It not only detects abnormalities but also allows for immediate removal of polyps during the same procedure. Key benefits include: Direct visualization of the entire colon Ability to remove precancerous lesions Long screening intervals (typically every 10 years if normal) Our experienced physicians and advanced practice providers at Orlando Gastroenterology, P.A. in Orlando, Florida perform colonoscopies with a focus on patient comfort, safety, and high-quality outcomes. Steps You Can Take to Reduce Your Risk While screening is essential, lifestyle choices also play a major role in reducing colorectal cancer risk: 1. Eat a High-Fiber, Balanced Diet Increase intake of fruits, vegetables, and whole grains while limiting red and processed meats. 2. Stay Physically Active Regular exercise helps maintain a healthy weight and supports digestive health. 3. Maintain a Healthy Weight Obesity is a known risk factor for colorectal cancer. 4. Limit Alcohol and Avoid Tobacco Both alcohol and smoking are associated with increased cancer risk. 5. Know Your Family History Understanding your genetic risk can guide earlier and more frequent screening. Don’t Wait—Take Action This March Colorectal cancer is one of the few cancers that can be prevented through screening. Yet many individuals delay or avoid testing due to misconceptions or fear. Modern colonoscopy techniques are safe, effective, and typically well-tolerated. This March, take a proactive step for your health: If you are 45 or older, schedule your screening If you have symptoms, don’t ignore them Encourage family members and friends to get screened At Orlando Gastroenterology, P.A., we are committed to providing comprehensive, patient-centered digestive care. Our team in Orlando is here to guide you through every step—from risk assessment to screening and follow-up care. Your Health Is Worth It Raising awareness is only the first step—taking action is what saves lives. This Colorectal Cancer Awareness Month, make your health a priority. Early detection isn’t just beneficial—it can be life-saving. Schedule your colon cancer screening today with Orlando Gastroenterology, P.A., and take control of your health. #### Dry Mouth Bad breath is a deal breaker both in business and in personal life of ours. And while breath fresheners or candies hide it, they do not cure the very problem at hand... So, most importantly, the bad breath is caused by a lack of oral hygiene. It includes sleeping with an open mouth at night. This makes mouth dry and bacterias began to flourish there and cause that smell... Bad breath has a medical name "halitosis". This kind of condition can stem from poor oral hygiene habits. It also may be a telling sign of other health problems. What you're eating can cause this disease to progress much faster. So how healthy your menu is directly correlated with any oral hygiene problems. So, how your diet and dishes choice affects the smell of your breath? Essentially, everything you're consuming begins to be broken down into parts in your mouth. As dishes are digested and absorbed into the blood system, foods eventually get carried to your lungs. Then it reveals in your breath. This is even more true in case you like foods with strong odors (such as garlic or onions). Then teeth brushing and flossing, even mouthwash and any other breath freshening liquids are redundant. They merely disguise that kind of odor temporarily. The odor will not go away completely until the foods have passed through your body completely... How damaging abundant amount of sugar is for your teeth health? John Doe Which poor oral hygiene habits lead to the bad breath? First off, ask yourself do you regularly follow basic oral hygiene routines? This, of course, includes such morning musts as brushing your teeth twice a day. Keep in mind, that each brushing should be lasting for at least 5 minutes. It's not limited to that. Teeth flossing after each eating is also strongly recommended. Because when you eat and don't follow these methods, food particles stay in your mouth. They get stuck in between the teeth, on gums and the tongue. Then it decays and absorbs there, causing various oral bacteria to flourish. All this results in a bad breath. Antibacterial mouth rinsers, instead of simple breath fresheners, may be of a big help here. It will not simply disguise the smell by replacing it with a nicer aroma. These antibacterial mouth rinsers will eventually fight off and kick out the bacteria from your mouth. As well as off the teeth, gums and tongue. To add to that you must keep an especially attentive eye on your dentures, if you have any. They are critically vulnerable towards the odor-causing bacteria. If the dentures are not cleaned properly, and even more importantly, regularly, it will get covered with invisible bacteria. This will be causing bad smells, that will be obvious to absolutely everyone around. There's also no better way to hazard you oral hygiene and health than smoking or chewing tobacco. Besides irritating the sensitive gums and making teeth yellow, this makes the bacterias prosper. It adds up to a smell too...  Are there any specific health issues that are connected to a bad breath? Such a thing as the periodontal disease may be an essential cause of the bad breath. So if smell and unpleasant taste in your mouth are a lasting issue, you'd better check with your dentist. Specifically on the matter of whether you have periodontal disease or not. Gum disease is caused by the appearance of plaque on teeth. Bacteria cause the formation of toxins to form, which irritate the gums and enamel. If such a gum disease carries on without any treatment to it provided, it can damage the gums and jawbone. Other dental causes of bad breath include poorly fitting dental appliances, yeast infections of the mouth, and denta The medical condition of the dry mouth (also called xerostomia) also can cause a bad smell. Saliva is necessary to moisten the mouth. It neutralizes acids produced by plaque and piles away the dead cells off the tongue, gums, and cheeks' insides. If not removed, these cells begin to decay and can cause bad breath. Dry mouth may be a side effect of various medications. Also salivary gland problems or breathing with your mouth open can be an additional cause. Many other general diseases and illnesses may cause bad breath. Here are some to be aware of: respiratory tract infections such as pneumonia or bronchitis, chronic sinus infections, postnasal drip, diabetes, chronic acid reflux, and liver or kidney problems. #### First signs of Gum Disease Bad breath is a deal breaker both in business and in personal life of ours. And while breath fresheners or candies hide it, they do not cure the very problem at hand... So, most importantly, the bad breath is caused by a lack of oral hygiene. It includes sleeping with an open mouth at night. This makes mouth dry and bacterias began to flourish there and cause that smell... Bad breath has a medical name "halitosis". This kind of condition can stem from poor oral hygiene habits. It also may be a telling sign of other health problems. What you're eating can cause this disease to progress much faster. So how healthy your menu is directly correlated with any oral hygiene problems. So, how your diet and dishes choice affects the smell of your breath? Essentially, everything you're consuming begins to be broken down into parts in your mouth. As dishes are digested and absorbed into the blood system, foods eventually get carried to your lungs. Then it reveals in your breath. This is even more true in case you like foods with strong odors (such as garlic or onions). Then teeth brushing and flossing, even mouthwash and any other breath freshening liquids are redundant. They merely disguise that kind of odor temporarily. The odor will not go away completely until the foods have passed through your body completely... How damaging abundant amount of sugar is for your teeth health? John Doe Which poor oral hygiene habits lead to the bad breath? First off, ask yourself do you regularly follow basic oral hygiene routines? This, of course, includes such morning musts as brushing your teeth twice a day. Keep in mind, that each brushing should be lasting for at least 5 minutes. It's not limited to that. Teeth flossing after each eating is also strongly recommended. Because when you eat and don't follow these methods, food particles stay in your mouth. They get stuck in between the teeth, on gums and the tongue. Then it decays and absorbs there, causing various oral bacteria to flourish. All this results in a bad breath. Antibacterial mouth rinsers, instead of simple breath fresheners, may be of a big help here. It will not simply disguise the smell by replacing it with a nicer aroma. These antibacterial mouth rinsers will eventually fight off and kick out the bacteria from your mouth. As well as off the teeth, gums and tongue. To add to that you must keep an especially attentive eye on your dentures, if you have any. They are critically vulnerable towards the odor-causing bacteria. If the dentures are not cleaned properly, and even more importantly, regularly, it will get covered with invisible bacteria. This will be causing bad smells, that will be obvious to absolutely everyone around. There's also no better way to hazard you oral hygiene and health than smoking or chewing tobacco. Besides irritating the sensitive gums and making teeth yellow, this makes the bacterias prosper. It adds up to a smell too...  Are there any specific health issues that are connected to a bad breath? Such a thing as the periodontal disease may be an essential cause of the bad breath. So if smell and unpleasant taste in your mouth are a lasting issue, you'd better check with your dentist. Specifically on the matter of whether you have periodontal disease or not. Gum disease is caused by the appearance of plaque on teeth. Bacteria cause the formation of toxins to form, which irritate the gums and enamel. If such a gum disease carries on without any treatment to it provided, it can damage the gums and jawbone. Other dental causes of bad breath include poorly fitting dental appliances, yeast infections of the mouth, and denta The medical condition of the dry mouth (also called xerostomia) also can cause a bad smell. Saliva is necessary to moisten the mouth. It neutralizes acids produced by plaque and piles away the dead cells off the tongue, gums, and cheeks' insides. If not removed, these cells begin to decay and can cause bad breath. Dry mouth may be a side effect of various medications. Also salivary gland problems or breathing with your mouth open can be an additional cause. Many other general diseases and illnesses may cause bad breath. Here are some to be aware of: respiratory tract infections such as pneumonia or bronchitis, chronic sinus infections, postnasal drip, diabetes, chronic acid reflux, and liver or kidney problems. #### Healthy Living for Your Liver: Diet and Exercise Guidelines to Prevent Fatty Liver Disease Fatty liver disease is one of the fastest-growing health concerns in the US — and a leading cause of liver problems in adults. The good news? With the right nutrition, exercise, and medical support, it’s often preventable and even reversible. At Orlando Gastroenterology, P.A., our team of experienced gastroenterologists in Orlando helps patients take charge of their liver health through personalized care and lifestyle guidance. What Is Fatty Liver Disease? Fatty liver disease occurs when too much fat accumulates in the liver cells. It’s often linked to obesity, diabetes, high cholesterol, or lack of physical activity. Over time, this buildup can lead to liver inflammation (steatohepatitis), scarring (fibrosis), and even cirrhosis. Fortunately, early-stage fatty liver disease can be managed and sometimes reversed with consistent lifestyle changes and proper medical supervision from a fatty liver specialist in Orlando. Dietary Tips for a Healthier Liver A liver-friendly diet reduces inflammation, stabilizes blood sugar, and limits fat buildup. Here are some expert recommendations from our Orlando gastroenterologists: 1. Follow the Mediterranean diet: Focus on vegetables, fruits, legumes, nuts, whole grains, and lean proteins like fish and poultry. Use olive oil instead of butter and include omega-3–rich foods like salmon and flaxseed. 2. Cut back on sugar and refined carbs: Limit sodas, desserts, and white bread as these promote liver fat. Choose complex carbs such as oats, quinoa, and brown rice instead. 3. Choose healthy fats: Swap fried foods and red meats for heart-healthy fats from avocados, nuts, and olive oil. 4. Avoid alcohol and processed foods: Even moderate alcohol intake can worsen fatty liver disease. Processed snacks and sugary beverages also contribute to liver fat accumulation. 5. Maintain a healthy weight: If you are overweight, a slow, steady weight loss (about 1–2 pounds per week) can dramatically reduce liver fat and improve liver enzyme levels. Exercise: The Best Medicine for Your Liver Exercise helps manage and prevent fatty liver disease. Regular movement helps burn fat, improve metabolism, and enhance insulin sensitivity. • Aim for at least 150 minutes of moderate exercise per week. Brisk walking, cycling, swimming, or dancing all count — the key is consistency. • Include strength training twice a week. Building lean muscle mass helps your body process sugar and fats more efficiently. • Stay active throughout the day. Take the stairs, walk after meals, or stand up during phone calls. Every bit helps your liver function better.  Be sure to check with your doctor before starting any new exercise program to make sure it’s safe for you.   Partnering with Orlando Gastroenterology for Liver Health At Orlando Gastroenterology, P.A., we offer state-of-the-art evaluation and treatment for fatty liver disease, including FibroScan® liver stiffness testing, blood work, and tailored nutrition counseling. Our specialists focus on preventive care by helping you understand your liver health and take proactive steps toward improvement. If you’re concerned about fatty liver or want to develop a personalized plan for better digestive health, our expert gastroenterologists in Orlando are here to help. Take the first step toward a healthier liver today. 📞Call Orlando Gastroenterology, P.A. at 407-445-9225 or visit www.supergastro.com to schedule your consultation with a fatty liver specialist in Orlando, Florida.  #### Mindfulness For The Introvert Bad breath is a deal breaker both in business and in personal life of ours. And while breath fresheners or candies hide it, they do not cure the very problem at hand... So, most importantly, the bad breath is caused by a lack of oral hygiene. It includes sleeping with an open mouth at night. This makes mouth dry and bacterias began to flourish there and cause that smell... Bad breath has a medical name "halitosis". This kind of condition can stem from poor oral hygiene habits. It also may be a telling sign of other health problems. What you're eating can cause this disease to progress much faster. So how healthy your menu is directly correlated with any oral hygiene problems. So, how your diet and dishes choice affects the smell of your breath? Essentially, everything you're consuming begins to be broken down into parts in your mouth. As dishes are digested and absorbed into the blood system, foods eventually get carried to your lungs. Then it reveals in your breath. This is even more true in case you like foods with strong odors (such as garlic or onions). Then teeth brushing and flossing, even mouthwash and any other breath freshening liquids are redundant. They merely disguise that kind of odor temporarily. The odor will not go away completely until the foods have passed through your body completely... How damaging abundant amount of sugar is for your teeth health? John Doe Which poor oral hygiene habits lead to the bad breath? First off, ask yourself do you regularly follow basic oral hygiene routines? This, of course, includes such morning musts as brushing your teeth twice a day. Keep in mind, that each brushing should be lasting for at least 5 minutes. It's not limited to that. Teeth flossing after each eating is also strongly recommended. Because when you eat and don't follow these methods, food particles stay in your mouth. They get stuck in between the teeth, on gums and the tongue. Then it decays and absorbs there, causing various oral bacteria to flourish. All this results in a bad breath. Antibacterial mouth rinsers, instead of simple breath fresheners, may be of a big help here. It will not simply disguise the smell by replacing it with a nicer aroma. These antibacterial mouth rinsers will eventually fight off and kick out the bacteria from your mouth. As well as off the teeth, gums and tongue. To add to that you must keep an especially attentive eye on your dentures, if you have any. They are critically vulnerable towards the odor-causing bacteria. If the dentures are not cleaned properly, and even more importantly, regularly, it will get covered with invisible bacteria. This will be causing bad smells, that will be obvious to absolutely everyone around. There's also no better way to hazard you oral hygiene and health than smoking or chewing tobacco. Besides irritating the sensitive gums and making teeth yellow, this makes the bacterias prosper. It adds up to a smell too...  Are there any specific health issues that are connected to a bad breath? Such a thing as the periodontal disease may be an essential cause of the bad breath. So if smell and unpleasant taste in your mouth are a lasting issue, you'd better check with your dentist. Specifically on the matter of whether you have periodontal disease or not. Gum disease is caused by the appearance of plaque on teeth. Bacteria cause the formation of toxins to form, which irritate the gums and enamel. If such a gum disease carries on without any treatment to it provided, it can damage the gums and jawbone. Other dental causes of bad breath include poorly fitting dental appliances, yeast infections of the mouth, and denta The medical condition of the dry mouth (also called xerostomia) also can cause a bad smell. Saliva is necessary to moisten the mouth. It neutralizes acids produced by plaque and piles away the dead cells off the tongue, gums, and cheeks' insides. If not removed, these cells begin to decay and can cause bad breath. Dry mouth may be a side effect of various medications. Also salivary gland problems or breathing with your mouth open can be an additional cause. Many other general diseases and illnesses may cause bad breath. Here are some to be aware of: respiratory tract infections such as pneumonia or bronchitis, chronic sinus infections, postnasal drip, diabetes, chronic acid reflux, and liver or kidney problems. #### Move Your Way to Better Gut Health: Exercise Guidelines for a Healthier Digestive System When people think about gut health, diet usually gets all the attention—but physical activity plays an equally important role. Regular exercise supports digestion, balances the gut microbiome, reduces inflammation, and improves overall gastrointestinal function. At Orlando Gastroenterology, P.A., we encourage patients to view movement as a powerful, natural tool for achieving and maintaining excellent gut health. (Please be sure to consult your doctor and obtain their permission before starting on any new exercise program) How Exercise Supports Gut Health Your digestive system is highly responsive to physical activity. Regular movement helps stimulate intestinal contractions, allowing food to move efficiently through the GI tract. This reduces bloating, constipation, and discomfort. Exercise also promotes a healthier gut microbiome by increasing bacterial diversity—an important marker of good digestive and immune health. Additionally, physical activity helps regulate blood sugar, reduce visceral fat, and lower chronic inflammation, all of which are closely linked to digestive disorders such as irritable bowel syndrome (IBS), acid reflux, and fatty liver disease. Exercise Guidelines for Optimal Digestive Health 1. Aim for Consistent Moderate Activity Most adults should target at least 150 minutes of moderate-intensity exercise per week. This can include brisk walking, cycling, swimming, or using an elliptical. These activities improve circulation to the digestive organs and encourage regular bowel movements. Even short walks after meals—10 to 15 minutes—can significantly improve digestion and reduce post-meal bloating. 2. Incorporate Strength Training Strength or resistance training 2–3 times per week helps build lean muscle mass, improves metabolism, and enhances insulin sensitivity. Better metabolic health supports the gut-liver axis and reduces inflammation that can negatively affect digestion. Bodyweight exercises, resistance bands, or light weights are all effective options. 3. Add Gentle Movement for Stress Reduction Stress has a direct impact on the gut via the brain–gut connection. Chronic stress can worsen symptoms like abdominal pain, diarrhea, constipation, and reflux. Low-impact activities such as yoga, stretching, Pilates, or tai chi help calm the nervous system and support healthy digestion. Deep breathing exercises during movement can further enhance gut motility and relaxation. 4. Avoid Extreme or Overtraining Patterns While regular exercise is beneficial, excessive high-intensity training without adequate recovery can actually disrupt gut function, leading to cramping, diarrhea, or reflux. Balance is key—listen to your body and allow time for rest and recovery. Making Movement Sustainable The best exercise for gut health is the one you can maintain long term. Choose activities you enjoy, vary your routine, and focus on consistency rather than intensity. Staying active throughout the day—standing more, taking the stairs, and moving frequently—also supports digestive health. Expert Digestive Care in Orlando At Orlando Gastroenterology, P.A., we take a comprehensive approach to digestive wellness. Our board-certified gastroenterologists work closely with patients to identify GI concerns, recommend lifestyle strategies, and provide advanced diagnostic and treatment options when needed. If you’re experiencing digestive symptoms or want to proactively support your gut health, our team is here to help. Schedule your appointment today and take an active step toward better gut health. At Orlando Gastroenterology, P.A., our board-certified physicians are proud to serve patients searching for a trusted gastroenterologist near me or an experienced GI doctor in Orlando, Florida. We combine expert medical care with practical lifestyle guidance—like exercise recommendations—to help Central Florida patients achieve long-term digestive wellness. If you’re looking for a compassionate digestive health specialist in Orlando, our team is here to help. #### Stuck and Struggling? A Practical Guide to Beating Constipation and Keeping Your Gut Moving Constipation is one of the most common digestive complaints, affecting people of all ages. While occasional constipation is usually harmless, persistent symptoms can significantly impact quality of life and may signal an underlying issue that deserves attention. What is Constipation? Constipation is typically defined as having fewer than three bowel movements per week, or experiencing hard, dry stools that are difficult to pass. Many people also report straining, a feeling of incomplete evacuation, or abdominal discomfort. Common Causes Constipation often results from a combination of lifestyle and dietary factors: Low fiber intake Inadequate hydration Sedentary lifestyle Ignoring the urge to have a bowel movement Medications (such as opioids, iron supplements, certain antacids) Stress or changes in routine How to Prevent Constipation The good news is that constipation is often preventable with a few targeted measures: Increase Fiber IntakeAim for 25–35 grams of fiber daily through fruits, vegetables, whole grains, and legumes. Fiber adds bulk and helps stools pass more easily. Stay HydratedWater is essential for softening stool. Most adults should aim for at least 6–8 glasses of water daily, more if physically active. Keep MovingRegular physical activity stimulates intestinal function. Even a daily 20–30 minute walk can make a meaningful difference. Establish a RoutineTry to use the bathroom at the same time each day, especially after meals. Respond promptly to the urge to go—delaying can worsen constipation. Use Laxatives WiselyOver-the-counter remedies can help short-term, but frequent reliance should be discussed with a physician. When to See a Doctor Occasional constipation is common, but medical evaluation is important if: Symptoms persist for more than a few weeks You require frequent laxative use Constipation alternates with diarrhea There is significant discomfort or disruption to daily life Possible Consequences of Chronic Constipation Ignoring ongoing constipation can lead to complications such as: Hemorrhoids Anal fissures Rectal prolapse Fecal impaction Over time, chronic constipation can also affect appetite, energy levels, and overall well-being. Red Flags to Watch For Certain symptoms require prompt medical attention: Blood in stool Unexplained weight loss Severe abdominal pain Sudden change in bowel habits (especially after age 50) Anemia or fatigue These may indicate more serious conditions such as colorectal disease and should not be ignored. Expert Care in Orlando At Orlando Gastroenterology, P.A., we understand that digestive health is central to your overall well-being. Our experienced team provides comprehensive evaluation and personalized treatment plans for constipation and other gastrointestinal conditions. Whether your symptoms are mild or persistent, we are here to help you find lasting relief. If you are struggling with constipation or have concerns about your digestive health, don’t wait—early evaluation can prevent complications and restore comfort. Takeaway: Constipation is common, but it is not something you have to live with. With the right lifestyle changes and expert guidance when needed, you can keep your digestive system functioning smoothly. #### Teeth Grinding Bad breath is a deal breaker both in business and in personal life of ours. And while breath fresheners or candies hide it, they do not cure the very problem at hand... So, most importantly, the bad breath is caused by a lack of oral hygiene. It includes sleeping with an open mouth at night. This makes mouth dry and bacterias began to flourish there and cause that smell... Bad breath has a medical name "halitosis". This kind of condition can stem from poor oral hygiene habits. It also may be a telling sign of other health problems. What you're eating can cause this disease to progress much faster. So how healthy your menu is directly correlated with any oral hygiene problems. https://zemez.io/wordpress/ So, how your diet and dishes choice affects the smell of your breath? Essentially, everything you're consuming begins to be broken down into parts in your mouth. As dishes are digested and absorbed into the blood system, foods eventually get carried to your lungs. Then it reveals in your breath. This is even more true in case you like foods with strong odors (such as garlic or onions). Then teeth brushing and flossing, even mouthwash and any other breath freshening liquids are redundant. They merely disguise that kind of odor temporarily. The odor will not go away completely until the foods have passed through your body completely... How damaging abundant amount of sugar is for your teeth health? John Doe Which poor oral hygiene habits lead to the bad breath? First off, ask yourself do you regularly follow basic oral hygiene routines? This, of course, includes such morning musts as brushing your teeth twice a day. Keep in mind, that each brushing should be lasting for at least 5 minutes. It's not limited to that. Teeth flossing after each eating is also strongly recommended. Because when you eat and don't follow these methods, food particles stay in your mouth. They get stuck in between the teeth, on gums and the tongue. Then it decays and absorbs there, causing various oral bacteria to flourish. All this results in a bad breath. Antibacterial mouth rinsers, instead of simple breath fresheners, may be of a big help here. It will not simply disguise the smell by replacing it with a nicer aroma. These antibacterial mouth rinsers will eventually fight off and kick out the bacteria from your mouth. As well as off the teeth, gums and tongue. To add to that you must keep an especially attentive eye on your dentures, if you have any. They are critically vulnerable towards the odor-causing bacteria. If the dentures are not cleaned properly, and even more importantly, regularly, it will get covered with invisible bacteria. This will be causing bad smells, that will be obvious to absolutely everyone around. There's also no better way to hazard you oral hygiene and health than smoking or chewing tobacco. Besides irritating the sensitive gums and making teeth yellow, this makes the bacterias prosper. It adds up to a smell too...  Are there any specific health issues that are connected to a bad breath? Such a thing as the periodontal disease may be an essential cause of the bad breath. So if smell and unpleasant taste in your mouth are a lasting issue, you'd better check with your dentist. Specifically on the matter of whether you have periodontal disease or not. Gum disease is caused by the appearance of plaque on teeth. Bacteria cause the formation of toxins to form, which irritate the gums and enamel. If such a gum disease carries on without any treatment to it provided, it can damage the gums and jawbone. Other dental causes of bad breath include poorly fitting dental appliances, yeast infections of the mouth, and denta The medical condition of the dry mouth (also called xerostomia) also can cause a bad smell. Saliva is necessary to moisten the mouth. It neutralizes acids produced by plaque and piles away the dead cells off the tongue, gums, and cheeks' insides. If not removed, these cells begin to decay and can cause bad breath. Dry mouth may be a side effect of various medications. Also salivary gland problems or breathing with your mouth open can be an additional cause. Many other general diseases and illnesses may cause bad breath. Here are some to be aware of: respiratory tract infections such as pneumonia or bronchitis, chronic sinus infections, postnasal drip, diabetes, chronic acid reflux, and liver or kidney problems. #### The Hypocrisy of Antipsychiatry Specialist is general and bariatric surgery, all minimally invasive methods. Senior general surgeon and head of bariatric surgery division. Premium private hospital, provides the highest quality medical care, individualized treatment by the country’s leading experts, and in the shortest amount of time. As the number of mobile users continues to outpace the number of desktop users, it should go without saying that designers ... Emma Doe Specialist is general and bariatric surgery, all minimally invasive methods. Senior general surgeon and head of bariatric surgery division. Specialist is general and bariatric surgery, all minimally invasive methods. Senior general surgeon and head of bariatric surgery division. Premium private hospital, provides the highest quality medical care, individualized treatment by the country’s leading experts, and in the shortest amount of time. #### The Truth About Fruit: Which Fruits Are Best for Your Health? When it comes to healthy eating, fruit is often considered one of nature’s perfect foods. Packed with vitamins, minerals, antioxidants, and fiber, fruits can play a major role in supporting digestive health, heart health, weight management, and even longevity. However, not all fruit choices are equal—and fruit juice is not the same as eating whole fruit. At  Orlando Gastroenterology, P.A. in Orlando, Florida, we often counsel patients on how simple dietary changes can improve overall wellness and gut health. Understanding how to incorporate fruit wisely into your daily diet is an important step toward better long-term health. The Best Fruits to Eat The healthiest fruits are generally those that are high in fiber and relatively lower in concentrated sugar. Some excellent choices include: Berries Blueberries, strawberries, raspberries, and blackberries are nutritional powerhouses. They are rich in antioxidants that help fight inflammation and oxidative stress, both of which are associated with aging and chronic disease. Berries are also high in fiber, which supports healthy digestion and bowel regularity. Apples An apple a day may actually help keep the doctor away. Apples contain soluble fiber called pectin, which promotes healthy gut bacteria and may help lower cholesterol levels. Citrus Fruits Oranges, grapefruits, lemons, and limes are loaded with vitamin C and antioxidants. These fruits support immune health and hydration while providing beneficial fiber when eaten whole. Kiwi Kiwi is particularly beneficial for digestive health. It contains fiber and natural enzymes that may help improve digestion and reduce constipation. Avocados Although technically a fruit, avocados are unique because they are rich in healthy fats rather than sugar. They can help support heart health and promote fullness after meals. Fruits to Limit or Avoid Fruit itself is rarely “bad,” but moderation matters—especially for people with diabetes, fatty liver disease, obesity, or elevated triglycerides. Dried Fruits Raisins, dates, and dried mangoes contain concentrated sugars and calories because the water has been removed. It is very easy to overeat them. Canned Fruits in Syrup Many canned fruits are packed in heavy syrup, adding unnecessary sugar. Overly Processed Fruit Products Fruit snacks, gummies, and many “fruit bars” often contain added sugars and minimal nutritional value. Why Fruit Juice Is Not the Same as Whole Fruit Many people assume fruit juice is healthy because it comes from fruit. Unfortunately, juice removes most of the beneficial fiber while concentrating the sugar. Drinking a glass of orange juice may contain the sugar equivalent of several oranges, but without the fiber that slows sugar absorption and helps you feel full. This can lead to rapid spikes in blood sugar and increased calorie intake. Even 100% natural juice should generally be consumed sparingly. Whole fruit is almost always the healthier choice. How Much Fruit Should You Eat? For most adults, about 1.5 to 2 cups of fruit daily is a reasonable target. Variety is important. Eating different colors and types of fruits provides a broader range of nutrients and antioxidants. The key is balance: Focus on whole fruits Choose fiber-rich options Avoid excessive fruit juices Pair fruit with protein or healthy fats for better blood sugar control How Fruits Support Health and Longevity A diet rich in fruits has been associated with: Better digestive health Lower risk of heart disease Reduced inflammation Improved weight management Better blood pressure control Reduced risk of certain cancers Healthier aging and longevity The fiber in fruits also supports the gut microbiome—the trillions of beneficial bacteria living in your digestive tract that influence immunity, metabolism, and overall health. At  Orlando Gastroenterology, P.A., our team is dedicated to helping patients achieve better digestive health through prevention, education, and personalized care. If you are experiencing digestive symptoms or would like guidance on improving your nutrition and gut health, our experienced gastroenterology specialists in Orlando are here to help. Healthy eating does not have to be complicated. Sometimes, choosing the right fruits—and eating them the right way—can make a meaningful difference in your long-term health. #### Welcome to Dr. Pothamsetty’s Health and Wellness Blog As a gastroenterologist, I have seen firsthand how the choices we make every day—what we eat, how we move, how we manage stress—shape not only our digestive health, but also our overall well-being and longevity. My goal in creating this blog is to share practical, evidence-based insights that can help you live a healthier, more energetic, and longer life. Here, we will explore topics that lie at the heart of health and health span: the role of nutrition in preventing disease, how the gut influences everything from digestion to immunity to mood, and strategies to support liver health. I’ll also cover common digestive concerns, demystify medical information, and highlight lifestyle approaches that make a real difference—whether that’s choosing foods that nurture the gut microbiome, adopting habits that reduce inflammation, or learning how small, sustainable changes add up to big results. This is not about quick fixes or fad diets. It’s about empowering you with knowledge to make thoughtful choices for lifelong health. I invite you to join me on this journey—ask questions, share experiences, and explore how we can all take steps toward better living, starting today by scheduling an appointment with us. Best Regards, Dr. Pothamsetty #### Your Guide to Excellent Gut Health: Dietary Tips from Orlando Gastroenterology, P.A. A healthy gut is essential for overall wellness—affecting digestion, energy levels, immunity, mood, and even long-term disease risk. At Orlando Gastroenterology, P.A., our team of board-certified gastroenterologists is committed to helping patients throughout Central Florida build strong digestive health through evidence-based dietary choices and personalized GI care. Whether you’re seeking relief from digestive symptoms or aiming to strengthen your gut for the long run, the right nutrition can make a powerful difference. Why Gut Health Matters Your gastrointestinal system is home to trillions of bacteria, fungi, and microorganisms collectively known as the gut microbiome. These organisms play a vital role in: Breaking down food Absorbing nutrients Supporting immune function Balancing metabolism Reducing inflammation When the gut microbiome is nourished, diverse, and balanced, it promotes optimal digestive function and whole-body health. Poor diet, stress, medications, and lifestyle habits can disrupt this balance, leading to bloating, constipation, indigestion, fatigue, and even chronic disease. The good news? Gut health can be improved—and maintained—through thoughtful dietary choices. Dietary Guidelines for Excellent Gut Health 1. Eat Plenty of Fiber-Rich Foods Fiber feeds the “good” bacteria in your gut, helping them thrive. Aim to include: Fruits like apples, berries, pears Vegetables such as leafy greens, broccoli, squash Whole grains like oats, quinoa, brown rice Beans, lentils, and legumes Most adults need 25–35 grams of fiber per day, but many fall short. Slowly increase your intake to avoid bloating. 2. Add Fermented Foods for Natural Probiotics Fermented foods contain beneficial live cultures that support a diverse microbiome. Try including: Yogurt or kefir Sauerkraut Kimchi Kombucha Miso or tempeh These foods help replenish and balance healthy gut bacteria. 3. Choose Prebiotic Foods Prebiotics act as fuel for probiotics. Great prebiotic-rich options include: Garlic Onions Bananas Asparagus Chicory root Whole grains Combining prebiotics and probiotics is a powerful way to boost gut health naturally. 4. Reduce Processed Foods and Added Sugars Highly processed foods, fried items, and sugary snacks disrupt the gut microbiome and promote inflammation. Replace them with whole, unprocessed foods whenever possible. Your gut—and overall health—will thank you. 5. Stay Hydrated Water supports digestion, prevents constipation, and keeps your GI system functioning smoothly. Aim for 6–8 cups per day, or more in hot Orlando weather. 6. Limit Alcohol and Artificial Sweeteners Alcohol irritates the digestive tract and disrupts bacterial balance. Artificial sweeteners such as sucralose or aspartame may negatively affect the microbiome as well. Moderation is key. Supporting Your Gut Health with Expert GI Care At Orlando Gastroenterology, P.A., we are dedicated to helping patients achieve long-term digestive wellness. Whether you are experiencing symptoms like abdominal discomfort, irregular bowel habits, acid reflux, or simply want to optimize your gut health, our specialists offer expert diagnostic evaluations and personalized treatment plans. With advanced technology, compassionate care, and years of clinical expertise, we’re committed to helping Orlando residents feel their best—starting with a healthier gut. Take the first step toward better digestive health today. Contact Orlando Gastroenterology, P.A. to schedule a consultation with one of our trusted gastroenterologists in Orlando, Florida. ### Pages #### About About Our Practice Learn More Today- Our physicians provide comprehensive GI services delivered with compassion and understanding. We specialize in diagnosing and treating conditions, disorders, and diseases of the GI system, including the esophagus, gallbladder, liver, pancreas, stomach, and intestines.We treat patients for abdominal pain, diarrhea, Crohn’s disease, colitis, celiac disease, gastroparesis, diverticulitis, inflammatory bowel disease, acid reflux, and GERD. For a complete list, please visit our Services page.Our physicians, nurses, and staff are committed to our patients’ vigorous health. Utilizing technologically advanced diagnostic and screening tools, we seek to identify the source of every discomfort and pain so that treatment will result in our patients’ return to optimum health.Call us today to schedule an appointment: 407-445-9224. We are accepting new patients, and we take most insurance plans.See Contact Page for Practice Locations and Appointments Patient Forms New Patient Packet for Office VisitMillenia Surgery Center Forms Accepted Health Plans No Insurance? No Problem! Accepted Health Plans When you need your company to have a new website or if you venture on updating your old webpage with a new look and functionality, the choices are versatile. Assuming that you will go the easy way and choose a theme for your WordPress website.AetnaBeech StreetAnthem Blue CrossBlue Shield No Insurance? No Problem! Assuming that you will go the easy way and choose a theme for your WordPress website. When you need your company to have a new website or if you venture on updating your old webpage with a new look and functionality, the choices are versatile.CignaFirst HealthGreat West HealthcareHealth Net Elect Make a Payment Make an Appointment Orlando Gastroenterology is Orlando, Florida’s, premier gastroenterology practice. Our physicians provide comprehensive GI services delivered with compassion and understanding. We specialize in diagnosing and treating conditions, disorders, and diseases of the GI system, including the esophagus, gallbladder, liver, pancreas, stomach, and intestines.We treat patients for abdominal pain, diarrhea, Crohn’s disease, colitis, celiac disease, gastroparesis, diverticulitis, inflammatory bowel disease, acid reflux, and GERD. For a complete list, please visit our Services page.Orlando Gastroenterology physicians, nurses, and staff are committed to our patients’ vigorous health. Utilizing technologically advanced diagnostic and screening tools, we seek to identify the source of every discomfort and pain so that treatment will result in our patients’ return to optimum health.Call us today to schedule an appointment: 407-445-9224. We are accepting new patients, and we take most insurance plans.The office of Orlando Gastroenterology is at 1507 S. Hiawassee Drive, Orlando, FL 32835.  Patient Forms New Patient Packet for Office VisitMillenia Surgery Center Forms Accepted Health Plans No Insurance? No Problem! Accepted Health Plans When you need your company to have a new website or if you venture on updating your old webpage with a new look and functionality, the choices are versatile. Assuming that you will go the easy way and choose a theme for your WordPress website.AetnaBeech StreetAnthem Blue CrossBlue Shield No Insurance? No Problem! Assuming that you will go the easy way and choose a theme for your WordPress website. When you need your company to have a new website or if you venture on updating your old webpage with a new look and functionality, the choices are versatile.CignaFirst HealthGreat West HealthcareHealth Net Elect Make a Payment Make an Appointment #### Anorectal Manometry Anorectal Manometry Physician in Orlando, FL https://www.youtube.com/watch?v=XXNAKBjRjgU All You Need to Know About Anorectal Manometry for Orlando Patients Anorectal manometry is a relatively common procedure. The scientific name can sound intimidating, but this test can actually be instrumental in helping determine the root of your gastroenterology problems. But what exactly is the procedure? An anorectal manometry Orlando provider breaks down everything you need to know. What is Anorectal Manometry? You may need an anorectal manometry if you or your child is suffering from gastrointestinal issues such as:Constipation (less than 3 bowel movements per week)Incontinence (inability to control the bowels)or Hirschsprung’s Disease (which can cause intestinal blockage in children)The procedure is not a treatment – it’s a test. At Orlando Gastroenterology, our GI experts use this type of test to give you an accurate diagnosis so that we can get you started with the right treatment.It works by testing muscles and movements of the anal region, such as the neural reflexes responsible for regular bowel movements, the responsiveness and pressure of the anal sphincter muscles, and the sensations in the rectum.This is a very common procedure. It is safe, very low-risk, and takes very little time. The only potential complications are incredibly rare, but they include the possibility of perforation or bleeding of the rectum. How Should You Prepare? For at least two hours before meeting your anal manometry Orlando provider, you should refrain from eating or drinking. If you have regular medications you need to take, you must do so prior that two-hour window. If you are diabetic, you may need to adjust your medications if necessary.It is also suggested to take one or two enemas two hours prior to clean your rectum.These can easily be purchased from a local supermarket or pharmacy. What Is the Procedure Like? The test is a quick procedure which typically takes around or less than half an hour. It’s understandable to feel nervous about this type of procedure, but our compassionate physicians will walk you through it.You will have to disrobe and put on a hospital gown, which you will be given privacy to do. Once in the gown, you will be asked to lay on your left side.To begin the procedure, the doctor performing the test will insert a small, flexible tube – approximately the size of the average thermometer – into the rectum. The tube will also have a small balloon at the end.This catheter is hooked up to a small machine, which is how the pressure and necessary information will be taken down.In order to get accurate readings, the doctor will ask you to squeeze, push, and relax at different times. During each of these movements, readings are taken. The actions imitate to actions of preventing anything from coming out, or, alternatively, having a regular bowel movement.Throughout the test, the small balloon will be slightly inflated to measure the pressure and access the normal reflex pathways.When the procedure is over, you can readily drive yourself home and go about your normal daily activities. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Antonio Soto Ramos, MD Overview Dr. Antonio Soto-Ramos graduated cum laude and made the Dean’s Honors list in Universidad Central del Caribe (UCC), School of Medicine,. He completed his residency in Internal Medicine and his fellowship in Gastroenterology at VA Caribbean Healthcare System, San Juan, P.R.  He is a recipient of numerous awards and has authored many articles in various publications. Some of his skills include Consultative Gastroenterology and Hepatology, upper endoscopy, colonoscopy, video capsule endoscopy, Inflammatory Bowel Disease and Hemorrhoid Ligation. He is an excellent endoscopist and has established himself as one of the top gastroenterologists in Central Florida.He is a member of the American College of Gastroenterology, American Gastroenterology Association, American Society of Gastrointestinal Endoscopy, and American College of Physicians.Dr. Antonio Soto-Ramos is fluent in English and Spanish. He has 10+ years of experience as a Gastroenterologist. His excellent communication skills and attention to detail helps him understand every patient’s unique cultural identity and medical needs. Location Services Gastroenterology Consultation Read More Acid Reflux Treatment/Heartburn/ GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment #### Babu Mohan, MD Overview Dr. Babu Mohan completed his residency in Internal Medicine at St. Vincent Charity Medical Center, Cleveland, Ohio, and fellowship in Gastroenterology at the University of Utah.He is a recipient of numerous awards, national as well as international, and has authored more than a hundred articles in various publications. He is on the editorial board of a prestigious journal ‘Gastrointestinal Endoscopy’.Dr. Mohan is very skilled at endoscopic procedures and is committed to deliver the best possible care to his patients. Location Services Gastroenterology Consultation Read More Acid Reflux Treatment/Heartburn/ GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment #### Barrett's Esophagus Barrett’s Esophagus Treatment Provider in Orlando, FL https://www.youtube.com/watch?v=AiLrEIpnyzI What Orlando Patients Should Know About Barrett's Esophagus In a person with Barrett’s esophagus, the tissue lining of the esophagus (food pipe) slowly begins to resemble intestinal tissue. This condition occurs in people who suffer from long-term gastroesophageal reflux disease (GERD), or acid reflux. The cell change in the esophagus is produced as it tries to heal itself from the effects of digestive acids that back up from the stomach. A person with Barrett’s esophagus is at risk of developing esophageal cancer. Screenings for this kind of cancer, called adenocarcinoma, are important, as early detection increases the possibility of effective treatment. What is Barrett’s Esophagus and why is it important to treat? Barrett’s Esophagus is a condition where the normal lining of the esophagus changes, usually due to long-term acid reflux (GERD). It is considered a precancerous condition because it increases the risk of esophageal cancer.Treatment and monitoring help prevent the condition from progressing. How do medical professionals diagnose Barrett's esophagus? Medical professionals often recommend screening for people who suffer from GERD and acid reflux. The specific screening performed is an upper endoscopy, in which a camera on a small tube is inserted into the esophagus. The medical professional is able to examine the tissue of the esophagus lining and look for abnormalities. A biopsy (the collecting of tissue samples) enables a pathologist to look for dysplasia or early signs of precancerous tissue changes. Treatment for Barrett's esophagus Treatment depends on whether dysplasia is present. Common options include:No Dysplasia (mild cases)Acid-reducing medications (like PPIs)Lifestyle changes (diet, weight loss, avoiding triggers)Regular endoscopic monitoringLow-Grade DysplasiaMore frequent monitoringEndoscopic treatments such as radiofrequency ablation or cryotherapyHigh-Grade Dysplasia or Early CancerEndoscopic removal of abnormal tissueAblation therapyIn some cases, surgery Do all patients with Barrett’s need treatment? No. If there is no dysplasia, treatment may focus on controlling acid reflux and scheduling follow-up endoscopies.Endoscopic therapy is usually recommended only if dysplasia is present. How often do I need endoscopy if I have Barrett’s? Frequency depends on the severity:No Dysplasia: every 3–5 yearsLow-Grade Dysplasia: every 6–12 monthsHigh-Grade Dysplasia: much more frequent monitoring or immediate treatmentOrlando Gastroenterology will determine the specific schedule. Can treatment prevent esophageal cancer? Treatment and routine surveillance significantly reduce the risk of developing cancer, but they do not eliminate it completely.Regular follow-up is essential. What lifestyle changes can help my condition? Patients are often advised to:Avoid reflux-trigger foods (spicy, acidic, fried, caffeine, chocolate, etc.)Eat smaller mealsAvoid lying down for 2–3 hours after eatingLose weight if overweightQuit smokingLimit alcoholElevate the head of the bed at nightThese lifestyle steps help reduce acid exposure and prevent further esophageal damage. What medications are used? The most common are proton pump inhibitors (PPIs).They reduce stomach acid and help prevent progression.Some patients may also take H2 blockers or medications that improve gastric emptying. When should I seek a Barrett’s Esophagus specialist? You should see a specialist if:You were diagnosed with Barrett’s EsophagusYou have chronic GERD symptomsYou have dysplasia in your biopsyYou need endoscopic therapyYou want long-term monitoring for cancer prevention Barrett’s Esophagus is a condition where the normal lining of the esophagus changes, usually due to long-term acid reflux (GERD). It is considered a precancerous condition because it increases the risk of esophageal cancer.Treatment and monitoring help prevent the condition from progressing.Medical professionals often recommend screening for people who suffer from GERD and acid reflux. The specific screening performed is an upper endoscopy, in which a camera on a small tube is inserted into the esophagus. The medical professional is able to examine the tissue of the esophagus lining and look for abnormalities. A biopsy (the collecting of tissue samples) enables a pathologist to look for dysplasia or early signs of precancerous tissue changes.Treatment depends on whether dysplasia is present. Common options include:No Dysplasia (mild cases)Acid-reducing medications (like PPIs)Lifestyle changes (diet, weight loss, avoiding triggers)Regular endoscopic monitoringLow-Grade DysplasiaMore frequent monitoringEndoscopic treatments such as radiofrequency ablation or cryotherapyHigh-Grade Dysplasia or Early CancerEndoscopic removal of abnormal tissueAblation therapyIn some cases, surgeryNo. If there is no dysplasia, treatment may focus on controlling acid reflux and scheduling follow-up endoscopies.Endoscopic therapy is usually recommended only if dysplasia is present.Frequency depends on the severity:No Dysplasia: every 3–5 yearsLow-Grade Dysplasia: every 6–12 monthsHigh-Grade Dysplasia: much more frequent monitoring or immediate treatmentOrlando Gastroenterology will determine the specific schedule.Treatment and routine surveillance significantly reduce the risk of developing cancer, but they do not eliminate it completely.Regular follow-up is essential.Patients are often advised to:Avoid reflux-trigger foods (spicy, acidic, fried, caffeine, chocolate, etc.)Eat smaller mealsAvoid lying down for 2–3 hours after eatingLose weight if overweightQuit smokingLimit alcoholElevate the head of the bed at nightThese lifestyle steps help reduce acid exposure and prevent further esophageal damage.The most common are proton pump inhibitors (PPIs).They reduce stomach acid and help prevent progression.Some patients may also take H2 blockers or medications that improve gastric emptying.You should see a specialist if:You were diagnosed with Barrett’s EsophagusYou have chronic GERD symptomsYou have dysplasia in your biopsyYou need endoscopic therapyYou want long-term monitoring for cancer prevention Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Beth Halliburton, A.P.R.N. Overview Beth Halliburton, A.P.R.N. is a Board-Certified Advanced Registered Nurse Practitioner with special interest in Gastroenterology Location Services Gastroenterology Consultation Read More Acid Reflux Treatment/Heartburn/ GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment #### Blog 52 Ways: What Motivates Others Who Threaten A Relationship? A couple’s relationship can be threatened by others. To minimize...Read More Dec 26, 2017 Checking out others? You probably think your partner is too. This general kindness quiz that was completed by more than...Read More Dec 26, 2017 The Hypocrisy of Antipsychiatry Bad breath is a deal breaker both in business and...Read More Jul 12, 2016 Two Long-Acting Bronchodilators in a Single Metered Dose Inhaler Americans oftentimes ignore some basic, daily routines of oral hygiene,...Read More Jul 12, 2016 Load More #### Celiac Disease Celiac Disease Doctor in Orlando, FL https://www.youtube.com/watch?v=XXNAKBjRjgU Celiac Disease Celiac disease is a common genetic disorder that afflicts the small intestine portion of the digestive system. It compromises the body’s ability to absorb nutrients from food.People with Celiac disease cannot tolerate gluten, a protein substance found in wheat, barley, rye, vitamins, and some medicines. Their bodies respond to gluten by destroying the villi projections in the small intestine. These projections absorb nutrients and deposit them into the bloodstream. When the villi are destroyed or damaged, the person cannot take in important nutrients.Therefore, Celiac disease is a disease of nutrient malabsorption as well as an abnormal response of the immune system to gluten. No cure exists for the disease, but Orlando Gastroenterology physicians help patients manage symptoms. What are the symptoms of Celiac disease? Celiac symptoms vary from person to person. They are present differently in children than in adults. Symptoms in children and infants Vomiting Chronic diarrhea Constipation Weight loss Light-colored, bad-smelling stool Bloating and pain in the abdomen Irritability Failure to thrive Delayed growth Short stature Delayed puberty Enamel defects in permanent teeth Symptoms in adults Fatigue Bone/joint pain Arthritis Anemia Seizures Skipped menstrual periods Numb/tingling hands and feet Canker sores in the mouth Itchy skin rash Bone loss Depression or anxiety Infertility or troubles getting pregnant Weight loss Acid reflux Vomiting and nausea How is Celiac disease diagnosed? An Orlando Gastroenterology physician will implement several tests to diagnose Celiac disease, including blood tests, an intestinal biopsy, testing for dermatitis herpetiformis, and celiac disease screenings. Treatment of Celiac disease A gluten-free diet is the only treatment for Celiac disease. Completely avoiding gluten will stop symptoms, reverse intestinal damage, and prevent further damage. Healing begins immediately. Children may be symptom-free within three to six months; the small intestine in an adult may take up to two years to heal.Eliminating gluten from one’s diet means avoiding foods such as wheat, barley, bulgur, rye, semolina, triticale, durum, malt, farina, graham flour, einkorn, kamut, and spelt.Processed foods that may contain gluten include gravy, French fries, soups, soy sauce, sauces, candy, brown rice syrup, matzo, vegetables in sauce, bouillon, tortilla chips, potato chips, hot dogs, cold cuts, sausage, and imitation fish. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Cirrhosis Cirrhosis in Orlando, FL When preparing to see the Orlando Gastroenterology doctor, for cirrhosis, there are some things that you will need to know about certain questions to ask the doctor and what are the things that you can do to help with the cirrhosis.Here is a list of questions that you should ask when seeking help due to cirrhosis. What Does the Liver Do For the Body? Your liver is going to be important for a number of reasons. One is that it helps in the clotting of your blood by transporting oxygen to your blood with proteins in it to help it to clot. It also aids in the immune system. It helps to store excess nutrients of the body and will return some of the nutrients back to your bloodstream over time. It helps in creating bile which is needed to digest food and will help in storing of sugar. It also works to rid the body of harmful bacteria that can enter the bloodstream. It will aid in breaking down saturated fats and producing cholesterol. What Happens to the Liver When You have Cirrhosis? is is a slowly progressing disease that will take a healthy liver and replace it with scar tissue. When the liver is covered in scar tissue and starts to decrease in function. The scar tissue will cause the lack of blood and will cause the slowdown of processing all the nutrients as well as hormones, drugs and other toxins to be processed. It can also cause the slowdown of the production of the proteins as well as other substances. It is the 12th other leading cause of death according to the National Institute of Health. There are many causes of Cirrhosis of the liver including obesity as well as diabetes. There are chronic viral infections where the liver is infected such as Hepatitis B,C, and D however D is very rare. The blockage of the bile duct that will carry bile from the liver to the intestine can also cause Cirrhosis. Someone who suffers from chronic heart failure can also develop Cirrhosis due to the fluids backing up and the liver being overwhelmed with fluid. There are also certain inherited diseases that can cause or contribute to cirrhosis such as cystic fibrosis and glycogen storage diseases. Some people will develop Cirrhosis from other factors such as prescriptions and prolonged exposure to certain elements or infections.It is important to be under the care of a skilled gastroenterologist. Orlando Gastroenterology is well versed in helping patients suffering from Cirrhosis. Schedule an appointment for a friendly, sympathetic evaluation with our team of highly trained professionals. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Clermont Clinic Welcome to Your Local Digestive Health PartnerServing the Clermont community and surrounding areas, our Clermont Clinic is dedicated to providing compassionate, high-quality gastroenterology care. Whether you're bringing new symptoms to our attention or managing a chronic GI condition, our goal is to be your trusted partner in digestive health — close to home. Clermont ClinicAddress255 Citrus Tower Blvd # 207, Clermont, FL 34711 Call Clinic Directions Services Offered Gastroenterology Consultation Read More Acid Reflux Treatment / Heartburn / GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment Why Choose the Clermont Clinic Accessible & Local Serving the Clermont area so you get care without unnecessary travel. Expert GI Team Our providers specialize in digestive health and stay current with evidence-based treatments. Comprehensive Diagnostics From endoscopies to imaging to advanced testing, we have tools to uncover the root of your symptoms. Patient-Focused Care We listen. We take time. We tailor plans to your lifestyle, preferences, and needs. Seamless Coordination Need referrals, prior records, or follow-ups? We streamline the process so your care flows smoothly. Serving the Clermont area so you get care without unnecessary travel.Our providers specialize in digestive health and stay current with evidence-based treatments.From endoscopies to imaging to advanced testing, we have tools to uncover the root of your symptoms.We listen. We take time. We tailor plans to your lifestyle, preferences, and needs.Need referrals, prior records, or follow-ups? We streamline the process so your care flows smoothly. Meet Some of Our Providers Meet the Team Schedule an AppointmentWhat to Expect at Your First VisitPrepare for Your VisitBring a valid ID, your insurance card, list of medications, and any prior relevant medical or testing records.The VisitYou’ll complete check-in and basic paperwork. Your GI provider will review your medical history, symptoms, and possibly order tests (blood, imaging) or schedule procedures if needed.Personalized Care Plan & Follow-UpWe’ll explain recommended next steps, answer your questions, and schedule follow-ups or procedures as needed.Call (407) 445-9224 or use our online appointment form. #### Colon Cancer Screening Orlando, FL, Physicians Provide Colon Cancer Screening https://www.youtube.com/watch?v=XXNAKBjRjgU About Colon Cancer Screenings in Orlando A colon cancer screening usually includes two parts: a consultation with a gastroenterologist followed by a colonoscopy to look in the patient’s colon and rectum. Who should have a colonoscopy performed? Any person over the age of 50 should have a colonoscopy performed every ten years. If a person has a family history of colon cancer or polyps, he or she should have a colonoscopy every five years beginning at age 40. What are colon polyps? Colon polyps are growths of tissue inside the colon. Sometimes they lead to cancer. Usually, though, polyps are not cancerous. A colonoscopy will identify polyps while they are still small and easily treatable. What to expect in a colonoscopy The bowels must be completely empty for a successful colonoscopy, so before the procedure, patients prepare by taking certain pills or drinking a special cleansing liquid. During the procedure, patients are sedated. A technician inserts a thin colonoscope into the anus and rectum; this travels up to the large intestine. A camera in the colonoscope takes pictures of the colon; the doctor can see the images on a monitor. The colonoscope contains small instruments that can remove polyps or scrape tissue for later examination. A colonoscopy lasts approximately half an hour.Call your doctor at Orlando Gastroenterology to schedule your colonoscopy. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Colon Polyps Colon Polyps What are colon polyps? A colon polyp is a growth on the surface of the colon, also called the large intestine. Sometimes, a person can have more than one colon polyp. Colon polyps can be raised or flat.The large intestine is the long, hollow tube at the end of your digestive tract. The large intestine absorbs water from stool and changes it from a liquid to a solid. Stool is the waste that passes through the rectum and anus as a bowel movement. Are colon polyps cancerous? Some colon polyps are benign, which means they are not cancer. But some types of polyps may already be cancer or can become cancer. Flat polyps can be smaller and harder to see and are more likely to be cancer than raised polyps. Polyps can usually be removed during colonoscopy — the test used to check for colon polyps. Who gets colon polyps? Anyone can get colon polyps, but certain people are more likely to get them than others. You may have a greater chance of getting polyps if: you’re 50 years of age or older you’ve had polyps before someone in your family has had polyps someone in your family has had cancer of the large intestine, also called colon cancer you’ve had uterine or ovarian cancer before age 50 You may also be more likely to get colon polyps if you: eat a lot of fatty foods smoke drink alcohol don’t exercise weigh too much What are the symptoms of colon polyps? Most people with colon polyps do not have symptoms. Often, people don’t know they have one until the doctor finds it during a regular checkup or while testing for something else. But some people do have symptoms, such as bleeding from the anus. The anus is the opening at the end of the digestive tract where stool leaves the body. You might notice blood on your underwear or on toilet paper after you’ve had a bowel movement. constipation or diarrhea that lasts more than a week. blood in the stool. Blood can make stool look black, or it can show up as red streaks in the stool. If you have any of these symptoms, see a doctor to find out what the problem is. How does the doctor test for colon polyps? The doctor can use one or more tests to check for colon polyps. Barium enema – The doctor puts a liquid called barium into your rectum before taking x rays of your large intestine. Barium makes your intestine look white in the pictures. Polyps are dark, so they’re easy to see. Sigmoidoscopy – With this test, the doctor puts a thin, flexible tube into your rectum. The tube is called a sigmoidoscope, and it has a light in it. The doctor uses the sigmoidoscope to look at the last third of your large intestine. Colonoscopy – The doctor will give you medicine to sedate you during the colonoscopy. This test is like the sigmoidoscopy, but the doctor looks at the entire large intestine with a long, flexible tube with a camera that shows images on a TV screen. The tube has a tool that can remove polyps. The doctor usually removes polyps during colonoscopy. Computerized tomography (CT) scan – With this test, also called virtual colonoscopy, the doctor puts a thin, flexible tube into your rectum. A machine using x rays and computers creates pictures of the large intestine that can be seen on a screen.The CT scan takes less time than a colonoscopy because polyps are not removed during the test. If the CT scan shows polyps, you will need a colonoscopy so they can be removed. Stool test – The doctor will ask you to bring a stool sample in a special cup. The stool is tested in the laboratory for signs of cancer, such as DNA changes or blood. Who should get tested for colon polyps? Talk with your doctor about getting tested for colon polyps if you’re 50 years of age or older, or earlier if you have symptoms or someone in your family has had polyps or colon cancer. How are colon polyps treated? In most cases, the doctor removes colon polyps during sigmoidoscopy or colonoscopy. The polyps are then tested for cancer.If you’ve had colon polyps, the doctor will want you to get tested regularly in the future. How can I prevent colon polyps? Doctors don’t know of one sure way to prevent colon polyps. But you might be able to lower your risk of getting them if you:eat more fruits and vegetables and less fatty fooddon’t smokeavoid alcoholexercise most days of the weeklose weight if you’re overweightEating more calcium may also lower your risk of getting polyps. Some foods that are rich in calcium are milk, cheese, yogurt, and broccoli. Taking a low dose of aspirin every day might help prevent polyps. Talk with your doctor before starting any medication How can I prevent colon polyps? A colon polyp is a growth on the surface of the colon, also called the large intestine. Colon polyps can be raised or flat. Some colon polyps are benign, which means they are not cancer. Some types of polyps may already be cancer or can become cancer. Flat polyps can be smaller and harder to see and are more likely to be cancer than raised polyps. Most people with colon polyps do not have symptoms. Symptoms may include constipation or diarrhea for more than a week or blood on your underwear, on toilet paper, or in your stool. Doctors remove most colon polyps and test them for cancer. Talk with your doctor about getting tested for colon polyps if you’re 50 years of age or older, or earlier if you have symptoms or someone in your family has had polyps or colon cancer. The following information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the colon polyps entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Colonoscopy Colonoscopy in Orlando, FL https://www.youtube.com/watch?v=ntUGc-gIMWQ What is colonoscopy? Colonoscopy is a procedure used to see inside the colon and rectum. Colonoscopy can detect inflamed tissue, ulcers, and abnormal growths. The procedure is used to look for early signs of colorectal cancer and can help doctors diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus, and weight loss. What are the colon and rectum? The colon and rectum are the two main parts of the large intestine. Although the colon is only one part of the large intestine, because most of the large intestine consists of colon, the two terms are often used interchangeably. The large intestine is also sometimes called the large bowel.The colon and rectum are the two main parts of the large intestine.Digestive waste enters the colon from the small intestine as a semisolid. As waste moves toward the anus, the colon removes moisture and forms stool. The rectum is about 6 inches long and connects the colon to the anus. Stool leaves the body through the anus. Muscles and nerves in the rectum and anus control bowel movements. How to Prepare for Colonoscopy? The doctor usually provides written instructions about how to prepare for colonoscopy. The process is called a bowel prep. Generally, all solids must be emptied from the gastrointestinal tract by following a clear liquid diet for 1 to 3 days before the procedure. Patients should not drink beverages containing red or purple dye. Acceptable liquids includefat-free bouillon or brothstrained fruit juicewaterplain coffeeplain teasports drinks, such as GatoradegelatinA laxative or an enema may be required the night before colonoscopy. A laxative is medicine that loosens stool and increases bowel movements. Laxatives are usually swallowed in pill form or as a powder dissolved in water. An enema is performed by flushing water, or sometimes a mild soap solution, into the anus using a special wash bottle.Patients should inform the doctor of all medical conditions and any medications, vitamins, or supplements taken regularly, includingaspirinarthritis medicationsblood thinnersdiabetes medicationsvitamins that contain ironDriving is not permitted for 24 hours after colonoscopy to allow the sedative time to wear off. Before the appointment, patients should make plans for a ride home.How is colonoscopy performed? Examination Large of the Intestine: During colonoscopy, patients lie on their left side on an examination table. In most cases, a light sedative, and possibly pain medication, helps keep patients relaxed. Deeper sedation may be required in some cases. The doctor and medical staff monitor vital signs and attempt to make patients as comfortable as possible.During colonoscopy, patients lie on their left side on an examination table.The doctor inserts a long, flexible, lighted tube called a colonoscope, or scope, into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the large intestine to a computer screen, allowing the doctor to carefully examine the intestinal lining. The doctor may ask the patient to move periodically so the scope can be adjusted for better viewing.Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again. Bleeding and puncture of the large intestine are possible but uncommon complications of colonoscopy. Removal of Polyps and Biopsy: A doctor can remove growths, called polyps, during colonoscopy and later test them in a laboratory for signs of cancer. Polyps are common in adults and are usually harmless. However, most colorectal cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer.The doctor can also take samples from abnormal-looking tissues during colonoscopy. The procedure, called a biopsy, allows the doctor to later look at the tissue with a microscope for signs of disease.The doctor removes polyps and takes biopsy tissue using tiny tools passed through the scope. If bleeding occurs, the doctor can usually stop it with an electrical probe or special medications passed through the scope. Tissue removal and the treatments to stop bleeding are usually painless.Recovery:Colonoscopy usually takes 30 to 60 minutes. Cramping or bloating may occur during the first hour after the procedure. The sedative takes time to completely wear off. Patients may need to remain at the clinic for 1 to 2 hours after the procedure. Full recovery is expected by the next day. Discharge instructions should be carefully read and followed.Patients who develop any of these rare side effects should contact their doctor immediately:severe abdominal painfeverbloody bowel movementsdizzinessweaknessAt what age should routine colonoscopy begin?Routine colonoscopy to look for early signs of cancer should begin at age 50 for most people—earlier if there is a family history of colorectal cancer, a personal history of inflammatory bowel disease, or other risk factors. The doctor can advise patients about how often to get a colonoscopy Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Coming Soon This Site is Coming Soon 00 Days : 00 Hours : 00 Minutes : 00 Seconds Sign up to receive updates Get both our special offers and our oral health maintenance tips directly to your inbox! #### Constipation Constipation Healthcare Provider in Orlando, FL https://www.youtube.com/watch?v=zqvpN_Qcweo Orlando, Get Help for Your Constipation Constipation is difficulty passing stool and infrequent bowel movements (three or fewer bowel movements per week). Causes of Constipation Stool that moves too slowly through the intestine dries out and becomes hard, making it difficult to expel. Slow-moving stool may result from: #### Contacts Contact Us Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information MetroWest LocationSuite #1051507 S Hiawassee Rd Orlando, FL 32835 Clermont Location255 Citrus Tower Blvd # 207, Clermont, FL 34711East Orlando Location1300 N Semoran BlvdOrlando, FL 32807 Kissimmee Location 1132 Cypress Glen Circle Kissimmee, FL 34741 #### Crohn's Disease Crohn's Disease Doctor in Orlando, FL https://www.youtube.com/watch?v=XXNAKBjRjgU What About Crohn's Disease, Colitis, and IBD in Orlando Patients? Are you looking for an Orlando gastroenterology doctor who understands and treats Crohn’s Disease? Maybe you suffer from this disease and are looking for ways to treat it. Or perhaps you’ve dealt with it your whole life and want to explore new treatment options. What is Crohn's Disease? Crohn’s disease is a form of inflammatory bowel disease (IBD)--a chronic condition in which the lining of the digestive tract is severely inflamed. Inflammation may result in sores and internal bleeding. Crohn’s Disease symptoms occur in the gastrointestinal tract, anywhere between the mouth and the anus. Flare-ups of the condition lead to emergency room visits, discomfort, and complications. The cause of Crohn’s Disease is unknown, but doctors speculate that genetics and environmental issues are contributing factors. Symptoms of Crohn's Disease The most common complaint of patients who have Crohn’s Disease is extreme abdominal pain and cramping. Other symptoms include frequent diarrhea, rectal bleeding, frequent bowel movements, and fatigue. People who cope with Crohn’s disease may live relatively normal lives until a flare-up occurs. However even in day to day routines, they manage the unpredictable nature of symptoms by changing their diet, skipping meals, or avoiding going out in public. Physicians at Orlando Gastroenterology understand this disease and can provide solutions and treatments to help minimize the impact of symptoms. Ulcerative Colitis Ulcerative colitis is another form of inflammatory bowel disease (IBD). Ulcerative colitis differs from Crohn’s disease in that symptoms only occur in the large intestine, specifically in the rectum and colon. What is Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS)? IBD and IBS cause similar symptoms; however, the damage that Inflammatory Bowel Disease causes is permanent and sometimes requires surgery. IBS can generally be managed with medication. How Does a Doctor Diagnose Irritable Bowel Disease (IBD)? A doctor first conducts a physical examination of the patient and gathers medical history information. A colonoscopy or endoscopy may follow to identify signs of inflammation in the digestive tract. Tissue from abnormal areas of the lining may be biopsied. Other tests may be run, such as barium x-rays, MRIs, blood work, and examination of stool samples. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Diarrhea See a Doctor About Diarrhea in Orlando, FL https://www.youtube.com/watch?v=v6YUWNva5ks Understand Orlando Adult and Child Diarrhea Diarrhea is loose, watery stools.Acute diarrhea are a common problem that usually last one or two days and often resolve on their own without special treatment. When symptoms persist beyond two days, it may signal a more serious condition and increase the risk of dehydration. Ongoing or recurrent cases can be a feature of chronic disease. At Orlando Gastroenterology, we provide expert care to help you recover and restore your digestive health. What causes diarrhea? Acute diarrhea is usually related to a bacterial, viral, or parasitic infection. Chronic diarrhea is usually related to functional disorders such as irritable bowel syndrome or inflammatory bowel disease. A few of the more common causes of diarrhea include the following: Bacterial and viral infections Food intolerances Parasites Reaction to medicines Intestinal diseases Functional bowel disorders Eating food or drinking water contaminated with bacteria, viruses, or parasites What are the symptoms of diarrhea? Diarrhea may be accompanied by cramping, abdominal pain, bloating, nausea, or an urgent need to use the bathroom. Depending on the cause, a person may have a fever or bloody stools. Diarrhea in children Children can experience both short-term and long-lasting episodes of loose stools. If your child is affected, do not hesitate to call the doctor for advice. This condition is especially dangerous in newborns and infants, as it can cause dehydration within just a day or two.Take your child to the doctor if there is no improvement after 24 hours or if any of the following symptoms appear:Stools containing blood or pusBlack or tarry stoolA temperature above 102 degreesSigns of dehydrationMedications commonly used by adults for digestive upset can be unsafe for children and should only be given with a doctor’s guidance. Dehydration Diarrhea can cause dehydration, which means the body has lost too much fluid and too many electrolytes and can’t function properly. Dehydration is particularly dangerous in children and older adults and must be treated promptly to avoid serious health problems.Signs of dehydration include:thirstless frequent urinationdry skinfatiguelight-headednessdark-colored urineSigns of dehydration in children include:dry mouth and tongueno tears when cryingno wet diapers for 3 hours or moresunken abdomen, eyes, or cheekshigh feverlistlessness or irritabilityskin that does not flatten when pinched and releasedIf you suspect that you or your child is dehydrated, call the doctor immediately. Severe dehydration may require hospitalization. Preventing Dehydration The fluid and electrolytes lost during diarrhea need to be replaced promptly because the body cannot function without them. Electrolytes are the salts and minerals that affect the amount of water in your body, muscle activity, and other important functions.Although water is extremely important in preventing dehydration, it does not contain electrolytes. Broth and soups that contain sodium, and fruit juices, soft fruits, or vegetables that contain potassium, help restore electrolyte levels. Over-the-counter rehydration solutions are also good electrolyte sources and are especially recommended for children. When should a doctor be consulted about diarrhea? Diarrhea is not usually harmful, but it can become dangerous or signal a more serious problem. You should see the doctor if you experience any of the following:diarrhea for more than two dayssevere pain in the abdomen or rectuma fever of 102 degrees or higherblood in your stool or black, tarry stoolssigns of dehydration (see above)you’ve recently returned from a foreign country How is the cause of diarrhea diagnosed? Diagnostic tests to find the cause of diarrhea may include a physical exam, stool culture, blood tests, fasting tests, sigmoidoscopy, colonoscopy, and imaging tests. How is diarrhea treated? In most cases of diarrhea, replacing lost fluid to prevent dehydration is the only treatment necessary.Medicines that stop diarrhea may be helpful, but they are not recommended for people whose diarrhea is caused by a bacterial infection or parasite. Instead, doctors usually prescribe antibiotics as a first-line treatment.Viral infections are either treated with medication or left to run their course, depending on the severity and type of virus.The above information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the diarrhea entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Difficulty Swallowing Orlando Physicians Help with Difficulty Swallowing (Dysphagia) https://www.youtube.com/watch?v=XXNAKBjRjgU See a Trusted Dysphagia Doctor in Orlando Ulcerative colitis is a disease of the large intestine, specifically the colon and rectum. It causes inflammation and sores (ulcers) in the lining of these areas. It is an inflammatory bowel disease (IBD). Ulcerative colitis presents symptoms that are similar to other bowel disorders, including Crohn’s disease. What are the symptoms of Ulcerative colitis? A person with dysphagia has difficulty swallowing. The difficulty means that it takes more time to get down food than is usual. Dysphagia may have other symptoms as well, including: The feeling of an obstruction in the throat or chest The instinct to cough or gag while trying to swallow Pain while trying to swallow Drooling More than average amounts of saliva in the mouth Food coming back up into the throat Stomach acid coming back up; heartburn Unintentional weight loss What causes dysphagia? Dysphagia is usually the result of malfunctioning systems in the body. There are two types of dysphagia. Oropharyngeal dysphagia This form of dysphagia revolves around difficulty starting to swallow. The problem arises because the brain fails to communicate properly with the nerves of the mouth or throat. Breakdowns of this nature are seen in patients with Parkinson’s disease and multiple sclerosis (MS), or in those who have had a stroke. Esophageal dysphagia This form of dysphagia arises from a physical problem with the esophagus. Such problems include scarring, inflammation, narrowing, or blockage. The impact of these structural conditions makes a person feel like food is caught in their throat or chest. GERD (gastroesophageal reflux disease) and Barrett’s esophagus are two conditions resulting in physical problems that make it hard to swallow. Treatment for dysphagia Orlando Gastroenterology physicians prescribe different types of treatment for dysphagia. These include modifying eating habits, medication, dilation of the esophagus, and endoscopy to remove physical obstructions. See your Orlando Gastroenterology physician if you experience problems swallowing. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Digestive Tract Bleeding Orlando Doctors Help Heal Digestive Tract Bleeding https://www.youtube.com/watch?v=XXNAKBjRjgU Digestive Tract Bleeding & Blood in the Stool: What Orlando Patients Need to Know Bleeding in the digestive tract is a symptom of a condition or a disease. Most conditions that cause bleeding, such as ulcers or hemorrhoids, can be cured or controlled. Some causes of bleeding may be life-threatening. Locating the source of bleeding is important. Different conditions cause bleeding in the upper digestive tract and the lower digestive tract. What are the signs of bleeding in the digestive tract? Signs of bleeding in the upper digestive tract include: bright red blood in vomit vomit that looks like coffee grounds black or tarry stool dark blood mixed with stool stool mixed or coated with bright red blood Signs of bleeding in the lower digestive tract include: black or tarry stool dark blood mixed with stool stool mixed or coated with bright red blood Sudden, severe bleeding is called acute bleeding. If acute bleeding occurs, symptoms may include: weakness dizziness or faintness shortness of breath crampy abdominal pain diarrhea paleness A person with acute bleeding may experience a rapid pulse, dropped blood pressure, and difficulty producing urine. He or she may also go into shock. Light bleeding that continues for a long time or starts and stops is called chronic bleeding. Chronicblood loss can lead to anemia. What causes bleeding in the digestive tract? Peptic ulcers Esophageal varices--enlarged veins, located at the lower end of the esophagus, that rupture and bleed Mallory-Weiss tears in the esophagus lining Gastritis Esophagitis Benign tumors and cancer Causes of bleeding in the lower digestive tract Diverticular disease Colitis Hemorrhoids or fissures Angiodysplasia Polyps or cancer How is bleeding in the digestive tract diagnosed? The first step in diagnosing bleeding in the digestive tract is locating the site of the bleeding. The doctor will take the patient’s complete medical history and perform a physical examination. Symptoms such as changes in bowel habits, black or red stools, and pain or tenderness in the abdomen may tell the doctor which area of the digestive tract is bleeding. The doctor may need to test the stool for blood. A blood test can help determine the extent of the bleeding and whether the patient is anemic. Endoscopy is the most common method for finding the source of bleeding in the digestive tract. An endoscope is a flexible tube with a small camera on the end. The doctor inserts the endoscope through the patient’s mouth to view the esophagus, stomach, and duodenum. An endoscope can also be inserted through the rectum to view the colon. This procedure is called a colonoscopy. Enteroscopy is an examination of the small intestine. Because traditional endoscopes cannot reach the small intestine, special endoscopes are used for enteroscopy. Several other methods can help locate the source of bleeding. These include barium x-rays, radionuclide scanning, angiography, and exploratory laparotomy. How is bleeding in the digestive tract treated? Endoscopy can be used to stop bleeding in the digestive tract. A doctor can insert tools through the endoscope to: inject chemicals into the bleeding site treat the bleeding site and surrounding tissue with a heat probe, electric current, or laser close affected blood vessels with a band or clip How can bleeding be prevented? To prevent bleeding in the future, doctors can treat the conditions that cause bleeding, such as H. pylori and other infections, GERD, ulcers, hemorrhoids, polyps, and inflammatory bowel diseases. The above information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the bleeding in the digestive tract entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Direct Access Colonoscopy If you are a physician If you are a physician and wish to refer a patient for a Colonoscopy without consultation, please use the form below. Please download, complete and fax the form back to us at 407-445-6236, along with the patient demographics sheet, your last office visit note, and front/back of patient’s insurance card Download Form Here You may also call our office at 407-445-9224 If you are a patient If you are a patient, please contact your referring physician’s office and request them to complete this form and send to us.Thank you for referring your patient to the Orlando Gastroenterology, P.A., Central Florida’s Center of Excellence for Digestive Health Care. Call Us Today Contact Us Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Diverticular Disease Diverticulosis and Diverticulitis Doctor in Orlando, FL https://www.youtube.com/watch?v=XXNAKBjRjgU What are diverticulosis and diverticulitis? Many people have small pouches in the lining of the colon, or large intestine, that bulge outward through weak spots. Each pouch is called a diverticulum. Multiple pouches are called diverticula. The condition of having diverticula is called diverticulosis. Diverticula are most common in the lower portion of the large intestine. When the pouches become inflamed or infected, the condition is called diverticulitis. If blood vessels going into the pouch burst, it results in a condition called diverticular bleeding. Diverticulosis and diverticulitis together are called diverticular disease. What are the symptoms of diverticulosis and diverticulitis? Diverticulosis symptoms Most people with diverticulosis do not have any discomfort or symptoms. However, some people may experience crampy pain or discomfort in the lower abdomen, bloating, and constipation. Diverticulitis symptoms The most common symptom of diverticulitis is abdominal pain. The most common sign on examination is tenderness in the lower left side of the abdomen. Usually, the pain is severe and comes on suddenly, but it can also be mild and become worse over several days. The intensity of the pain can fluctuate. A person may experience cramping, nausea, vomiting, fever, chills, or a change in bowel habits. What are the complications of diverticulitis? Diverticulitis can lead to bleeding; infections; small tears, called perforations; or blockages in the colon. These complications always require treatment to prevent them from progressing and causing serious illness. What causes diverticular disease? Although not proven, the dominant theory is that a low-fiber diet causes diverticular disease. The disease was first noticed in the United States in the early 1900s, around the time processed foods were introduced into the American diet. Consumption of processed foods greatly reduced Americans’ fiber intake. Low fiber diets lead to constipation. Constipation or hard stool may cause people to strain when passing stool during a bowel movement. Straining may cause increased pressure in the colon, which may cause the colon lining to bulge out through weak spots in the colon wall. These bulges are diverticula. It is not clear what causes diverticula to become inflamed. The inflammation may begin when bacteria or stool are caught in the diverticula. An attack of diverticulitis can develop suddenly and without warning. How is diverticular disease diagnosed? To diagnose diverticular disease, doctors at Orlando Gastroenterology ask patients about their medical history, perform a physical exam, and may perform one or more diagnostic tests. Because most people do not have symptoms, diverticulosis is often found through tests ordered for another ailment. For example, diverticulosis is often discovered during a colonoscopy screening for cancer or to evaluate complaints. A doctor may order radiologic tests, including an abdominal ultrasound or a computerized tomography (CT) scan. How is diverticular disease treated? A high-fiber diet and pain medications help relieve symptoms in most cases of diverticulosis. Uncomplicated diverticulitis with mild symptoms usually requires the person to rest, take oral antibiotics, and be on a liquid diet for a short time.  Sometimes an attack of diverticulitis is serious enough to require a hospital stay, intravenous (IV) antibiotics, and surgery. Diverticulosis treatment Increasing the amount of fiber in the diet may reduce symptoms and prevent complications such as diverticulitis. Eating a high-fiber diet is the only requirement emphasized across medical literature. If cramps, bloating, and constipation are problems, the doctor may prescribe a short course of pain medication. However, some pain medications cause constipation. Diverticulitis treatment Treatment for diverticulitis focuses on clearing up the inflammation and infection, resting the colon, and preventing or minimizing complications. Depending on the severity of symptoms, the doctor may recommend bed rest, oral antibiotics, a pain reliever, and a liquid diet. If symptoms ease after a few days, the doctor will recommend gradually increasing the amount of high-fiber foods in the diet. Severe cases of diverticulitis with acute pain and complications may require a hospital stay. Most cases of severe diverticulitis are treated with IV antibiotics and a few days without food or drink to help the colon rest. In some cases, surgery may be necessary. The above information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the bleeding in the digestive tract entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### East Orlando Clinic Welcome to Your East Orlando Digestive Health CenterSituated in the eastern corridor of Orlando, our East Orlando Clinic brings advanced gastrointestinal care closer to home for residents in areas such as Conway, Rosemont, Goldenrod, Edgewater, and Avalon Park. Our aim is to combine clinical excellence with a warm, patient-first approach so you can receive expert GI care without traveling far. East Orlando Clinic — Orlando GastroenterologyAddress1300 N Semoran BlvdOrlando, FL 32807 Call Clinic Directions Our Services & Clinical Expertise Gastroenterology Consultation Read More Acid Reflux Treatment / Heartburn / GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment Why Our East Orlando Clinic Is the Right Choice Local Access No need to drive across town; your GI care is closer with this location. Expert GI Team Our physicians, nurse practitioners, and staff are dedicated to digestive health and remain current with the latest treatments. Modern Diagnostics & Procedures We are equipped to perform necessary testing onsite or coordinate seamlessly with our surgical centers. Patient-Centric Philosophy We strive to listen thoroughly, explain clearly, and partner with you on a customized treatment plan. Coordination & Continuity From your first visit through follow-ups, we ensure continuity of care across clinics and procedures. No need to drive across town; your GI care is closer with this location.Our physicians, nurse practitioners, and staff are dedicated to digestive health and remain current with the latest treatments.We are equipped to perform necessary testing onsite or coordinate seamlessly with our surgical centers.We strive to listen thoroughly, explain clearly, and partner with you on a customized treatment plan.From your first visit through follow-ups, we ensure continuity of care across clinics and procedures. Meet Some of Our Providers Meet the Team Schedule an AppointmentWhat to Expect on Your VisitPrepare for Your VisitBring a valid ID, insurance card, list of medications, and any previous GI test results or records.During the AppointmentAfter check-in, your provider reviews your symptoms, history, and may order labs or imaging immediately or schedule further procedures.Next Steps & Follow-UpYou’ll receive a personalized care plan, guidance for any tests or procedures, and scheduling for follow-up visits or monitoring.Call (407) 445-9224 or use our online appointment form. #### Endoscopy Endoscopy Provider in Orlando, FL https://www.youtube.com/watch?v=xmdO-rqNcls Orlando Patient, Do You Need an Endoscopy? An endoscopy is an outpatient upper gastrointestinal tract procedure that allows a doctor to see the lining of the esophagus, the stomach and upper part of the small intestine. A thin, flexible instrument called an endoscope is inserted into the mouth and moved gently into the throat, esophagus, and stomach. What happens in an endoscopy? During the endoscopy, the doctor looks for signs of ulcers, inflammation, bleeding, infection, and tumors. Tissue samples of the lining and any polyps are taken for biopsy. The bleeding of the intestine can be treated with the endoscope.Patients are lightly sedated for an endoscopy. Sedatives are usually administered through an IV in the arm. Because of the sedation, patients should plan time for recovery after the procedure as well as someone to drive them home.What an endoscopy showsAn endoscopy will reveal inflammation of the esophagus and stomach, narrowing of the throat, gastroesophageal reflux disease, ulcers, infections, cancer, blockages, and other diseases and conditions. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Eosinophilic Esophagitis Eosinophilic Esophagitis in Orlando, FL What is Eosinophilic Esophagitis? Eosinophilic Esophagitis is an immune-mediated inflammatory disorder that is often triggered in atopic individuals by food products or inhaled allergens. It is characterized by infiltration of the esophageal wall, including the epithelium, with mast cells and eosinophils. Clinically, the inflammatory response by mast cells and eosinophils within the esophagus results in symptoms of chest pain, heartburn, and dysphagia—the latter due either to peristaltic dysfunction or to mechanical narrowing of the lumen by a dense fibrotic reaction within the wall.Notably, infiltration of the esophagus by eosinophils has been shown to result from the release of eotaxin-3 and IL-4, IL-5, and IL-13 by squamous epithelial cells. This observation provides molecular targets for potential treatments for the condition. For instance, intravenous antibodies to IL-5 can reduce both blood and esophageal eosinophilia and improve the quality of life in patients with allergic or inflammatory esophagus.In 2006, a novel translational study identified the key role of eotaxin-3 in eosinophilic esophagitis. Utilizing a combination of microarray techniques, in vivo and in vitro studies, eotaxin-3 was shown to be significantly up-regulated compared to controls. Further studies showed mutation of this gene in affected patients, and basic analysis confirmed a significant role in this inflammatory process. In addition to potential molecular targets for treatment, these data add to the growing body of knowledge of the central role of the esophageal epithelium in generation of the inflammatory/ allergic cascade that ultimately translates into the clinical manifestations of the disease. What are the symptoms of Eosinophilic Esophagitis? Symptoms of allergic or inflammatory esophagus include vomiting, abdominal pain, poor growth, difficulty with swallowing, and food impaction. This condition is often misdiagnosed as GERD. Although the underlying etiology of eosinophilic esophagitis is often unidentified, foodborne and airborne allergens have been frequently implicated. What is the treatment for Eosinophilic Esophagitis? Currently, effective treatments for Eosinophilic Esophagitis are limited to steroids and diet restriction.The above information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the bleeding in the digestive tract entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### FAQs Patient Education You might have some questions….this section is for you.About your health.At Orlando Gastroenterology, we believe that treatment is only one aspect of healthcare. We’re in the practice of making sure you get healthy and stay healthy. Here, you’ll find a wealth of information on digestive health and wellness. From plain talk about gastrointestinal conditions to regimens aimed at improving internal wellness, we have your bases covered. Click on the below topics to learn more #### Fatty Liver https://www.youtube.com/watch?v=x99_E-xpfi8 Diagnosis of a Fatty Liver A diagnosis of fatty liver disease can feel overwhelming. Our team of Board-Certified Physicians develop a treatment plan that’s right for you, whether you have alcohol-related or non-alcoholic fatty liver disease. Your treatment may include lifestyle modifications, including losing weight, eating healthy, regular physical activity, quitting alcohol use and medications. Gaining control of fatty liver disease is an important step in reducing your risk of developing serious health conditions, such as liver cancer, liver failure or cirrhosis. Wherever you are on your journey, you can trust the care and compassion you’ll receive here. What Causes Non-Alcoholic Fatty Liver? Non-alcoholic fatty liver disease affects nearly 30% of Americans. Fatty liver disease can lead to end stage liver disease, cirrhosis and liver cancer. It is estimated that by the year 2030 fatty liver disease will be the leading reason for liver transplants in the United States. Orlando Gastroenterology, P.A. provides comprehensive care for patients with fatty liver disease. To schedule your appointment, please call 407-445-9224 or request an appointment online. At your visit you will undergo thorough evaluation of your medical history, physical examination and assessment of your risk factors for fatty liver disease, including your family history, your other medical conditions and your lifestyle. After a complete evaluation you will work with your physician to determine if further tests are needed, such as blood tests, radiographic studies such as an ultrasound or, in some cases, a liver biopsy. Based on the results of these investigations, we will design a treatment plan for you, including nutritional advice, lifestyle changes and, if needed, medications. After this, you will be followed closely to monitor your progress and response to treatment. Call Us Today Contact Us Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Fecal Incontinence Fecal Incontinence What is fecal incontinence? Fecal incontinence is the inability to control your bowels. When you feel the urge to have a bowel movement, you may not be able to hold it until you get to a toilet. Or stool may leak from the rectum unexpectedly, sometimes while passing gas.More than 5.5 million Americans have fecal incontinence. It affects people of all ages — children and adults. Fecal incontinence is more common in women and older adults, but it is not a normal part of aging.Loss of bowel control can be devastating. People who have fecal incontinence may feel ashamed, embarrassed, or humiliated. Some don’t want to leave the house out of fear they might have an accident in public. Most try to hide the problem as long as possible, so they withdraw from friends and family. The social isolation is unfortunate but may be reduced with treatment that improves bowel control and makes incontinence easier to manage. What causes fecal incontinence? Fecal incontinence can have several causes:constipationdamage to the anal sphincter musclesdamage to the nerves of the anal sphincter muscles or the rectumloss of storage capacity in the rectumdiarrheapelvic floor dysfunctionConstipationConstipation is one of the most common causes of fecal incontinence. Constipation causes large, hard stools to become lodged in the rectum. Watery stool can then leak out around the hardened stool. Constipation also causes the muscles of the rectum to stretch, which weakens the muscles so they can’t hold stool in the rectum long enough for a person to reach a bathroom.Muscle DamageFecal incontinence can be caused by injury to one or both of the ring-like muscles at the end of the rectum called the anal internal and external sphincters. The sphincters keep stool inside. When damaged, the muscles aren’t strong enough to do their job and stool can leak out. In women, the damage often happens when giving birth. The risk of injury is greatest if the doctor uses forceps to help deliver the baby or performs an episiotomy, which is a cut in the vaginal area to prevent it from tearing during birth. Hemorrhoid surgery can also damage the sphincters.Nerve DamageFecal incontinence can be caused by damage to the nerves that control the anal sphincters or the nerves that sense stool in the rectum. If the nerves that control the sphincters are injured, the muscles don’t work properly and incontinence can occur. If the sensory nerves are damaged, they don’t sense that stool is in the rectum so you won’t feel the need to use the bathroom until stool has leaked out. Nerve damage can be caused by childbirth, a long-term habit of straining to pass stool, stroke, physical disability due to injury, and diseases that affect the nerves such as diabetes and multiple sclerosis.Loss of Storage CapacityNormally, the rectum stretches to hold stool until you can get to a bathroom. But rectal surgery, radiation treatment, and inflammatory bowel disease can cause scarring that makes the walls of the rectum stiff and less elastic. The rectum then can’t stretch as much to hold stool and fecal incontinence results. Inflammatory bowel disease also can irritate rectal walls, making them unable to contain stool.DiarrheaDiarrhea, or loose stool, is more difficult to control than solid stool because with diarrhea the rectum fills with stool at a faster rate. Even people who don’t have fecal incontinence can leak stool when they have diarrhea.Pelvic Floor DysfunctionAbnormalities of the pelvic floor muscles and nerves can cause fecal incontinence. Examples include:impaired ability to sense stool in the rectumdecreased ability to contract muscles in the anal canal to defecatedropping down of the rectum, a condition called rectal prolapseprotrusion of the rectum through the vagina, a condition called rectocelegeneral weakness and sagging of the pelvic floorChildbirth is often the cause of pelvic floor dysfunction, and incontinence usually doesn’t appear until the mid-forties or later. How is fecal incontinence treated? Effective treatments are available for fecal incontinence and can improve or restore bowel control. The type of treatment depends on the cause and severity of fecal incontinence; it may include dietary changes, medication, bowel training, or surgery. More than one treatment may be necessary for successful control because continence is a complicated chain of events.Dietary ChangesFood affects the consistency of stool and how quickly it passes through the digestive system. If your stools are hard to control because they are watery, you may find that eating high-fiber foods adds bulk and makes stool easier to control. But people with well-formed stools may find that high-fiber foods act as a laxative and contribute to the problem. Foods and drinks that may make the problem worse are those containing caffeine — like coffee, tea, or chocolate — which relaxes the internal anal sphincter muscles.You can adjust what and how you eat to help manage fecal incontinence.Keep a food diary – List what you eat, how much you eat, and when you have an incontinent episode. After a few days, you may begin to see a pattern involving certain foods and incontinence. After you identify foods that seem to cause problems, cut back on them and see whether incontinence improves. Foods and drinks that typically cause diarrhea, and so should probably be avoided, include:drinks and foods containing caffeinecured or smoked meat such as sausage, ham, or turkeyspicy foodsalcoholic beveragesdairy products such as milk, cheese, or ice creamfruits such as apples, peaches, or pearsfatty and greasy foodssweeteners, such as sorbitol, xylitol, mannitol, and fructose, which are found in diet drinks, sugarless gum and candy, chocolate, and fruit juicesEat small meals more frequently – In some people, large meals cause bowel contractions that lead to diarrhea. You can still eat the same amount of food in a day, but space it out by eating several small meals.Eat and drink at different times – Liquid helps move food through the digestive system. So if you want to slow things down, drink something half an hour before or after meals, but not with meals.Eat the right amount of fiber – For many people, fiber makes stool soft, formed, and easier to control. Fiber is found in fruits, vegetables, and grains, like those listed below. You need to eat 20 to 30 grams of fiber a day, but add it to your diet slowly so your body can adjust. Too much fiber all at once can cause bloating, gas, or even diarrhea. Also, too much insoluble, or indigestible, fiber can contribute to diarrhea. If you find that eating more fiber makes your diarrhea worse, try cutting back to two servings each of fruits and vegetables and removing skins and seeds from your food.Eat foods that make stool bulkier – Foods that contain soluble, or digestible, fiber slow the emptying of the bowels, including bananas, rice, tapioca, bread, potatoes, applesauce, cheese, smooth peanut butter, yogurt, pasta, and oatmeal.Get plenty to drink – Drink eight 8-ounce glasses of liquid a day to help prevent dehydration and keep stool soft and formed. Water is a good choice. Avoid drinks with caffeine, alcohol, milk, or carbonation if you find they trigger diarrhea. Over time, diarrhea can keep your body from absorbing vitamins and minerals. Ask your doctor if you need a vitamin supplement. What foods have fiber? Examples of foods that have fiber include:Breads, cereals, and beansFiber½ cup of black-eyed peas, cooked4.0 grams½ cup of kidney beans, cooked5.7 grams½ cup of lima beans, cooked4.5 grams½ cup of All-Bran9.6 grams¾ cup of Total2.4 grams¾ cup of Post Bran Flakes5.3 grams1 packet of whole-grain cereal3.0 grams1 slice of whole-wheat1.7 gramsFruitsFiber1 medium apple                                     3.3 grams1 medium peach1.8 grams½ cup of raspberries4.0 grams1 medium tangerine1.9 gramsVegetables Fiber1 cup of acorn squash, raw              2.1 grams1 medium stalk of broccoli, raw3.7 grams5 brussels sprouts, raw3.5 grams1 cup of cabbage, raw2.0 grams1 medium carrot, raw1.8 grams1 cup of cauliflower, raw2.5 grams1 cup of spinach, cooked4.3 grams1 cup of zucchini, raw1.4 gramsMedicationIf diarrhea is causing your incontinence, medication may help. Sometimes doctors recommend using bulk laxatives to help people develop a more regular bowel pattern. Or the doctor may prescribe antidiarrheal medicines such as loperamide or diphenoxylate to slow down the bowel and help control the problem.Bowel TrainingBowel training helps some people relearn how to control their bowel movements. In some cases, bowel training involves strengthening muscles; in others, it means training the bowels to empty at a specific time of day.Use biofeedback – Biofeedback is a way to strengthen and coordinate the muscles and has helped some people with incontinence. Special computer equipment measures muscle contractions while you do exercises — called Kegels — to strengthen the rectum and improve rectal sensation. These exercises work muscles in the pelvic floor, including those involved in controlling stool. Computer feedback about how the muscles are working shows whether you’re doing the exercises correctly and whether the muscles are getting stronger. Whether biofeedback will work for you depends on the cause of your fecal incontinence, how severe the muscle damage is, and your ability to do the exercises.Develop a regular pattern of bowel movements – Some people — particularly those whose fecal incontinence is caused by constipation — achieve bowel control by training themselves to have bowel movements at specific times during the day, such as after every meal. The key to this approach is persistence — it may take awhile to develop a regular pattern. Try not to get frustrated or give up if it doesn’t work right away.SurgerySurgery to repair the anal sphincter may be an option for people who have not responded to dietary treatment and biofeedback and for those whose fecal incontinence is caused by injury to the pelvic floor, anal canal, or anal sphincter. People who have severe fecal incontinence that doesn’t respond to other treatments may benefit from injection of bulking agents in the anus or nerve stimulation in the lower pelvic area. A colostomy may be indicated for people with severe fecal incontinence who haven’t been helped by other procedures. This procedure involves disconnecting the colon and bringing one end through an opening in the abdomen — called a stoma — through which stool leaves the body and is collected in a pouch. The colostomy may be temporary or permanent. What to Do About Anal Discomfort The skin around the anus is delicate and sensitive. Constipation and diarrhea or contact between skin and stool can cause pain or itching. Here’s what you can do to relieve discomfort: Wash the area with water, but not soap, after a bowel movement. Soap can dry out the skin, making discomfort worse. If possible, wash in the shower with lukewarm water or use a sitz bath. Or try a no-rinse skin cleanser. Try not to use toilet paper to clean up — rubbing with dry toilet paper will only further irritate the skin. Pre-moistened, alcohol-free towelettes are a better choice. Let the area air dry after washing. If you don’t have time, gently pat yourself dry with a lint-free cloth. Use a moisture barrier cream, which is a protective cream to help prevent skin irritation from direct contact with stool. You should first clean the area well to avoid trapping bacteria that could cause further problems. However, talk with your health care professional before you try anal ointments and creams because some have ingredients that can be irritating. Your health care professional can recommend an appropriate cream or ointment. Try using non-medicated talcum powder or cornstarch to relieve anal discomfort. Wear cotton underwear and loose clothes that “breathe.” Tight clothes that block air can worsen anal problems. Change soiled underwear as soon as possible. If you use pads or disposable undergarments, make sure they have an absorbent wicking layer on top. Products with a wicking layer protect the skin by pulling stool and moisture away from the skin and into the pad How can I cope with my feelings about fecal incontinence? Because fecal incontinence can cause distress in the form of embarrassment, fear, and loneliness, taking steps to deal with it is important. Treatment can improve your life and help you feel better about yourself. If you haven’t been to a doctor yet, make an appointment. Also, consider contacting the organizations listed at the end of this fact sheet. Such groups can help you find information and support and, in some cases, referrals to doctors who specialize in treating fecal incontinence.Everyday Practical TipsTake a backpack or tote bag containing cleanup supplies and a change of clothing with you everywhere.Locate public restrooms before you need them.Use the toilet before leaving home.If you think an episode is likely, wear disposable undergarments or sanitary pads.If episodes are frequent, use oral fecal deodorants to add to your comfort level. What if my child has fecal incontinence? If your child has fecal incontinence, he or she needs to see a doctor to determine the cause and treatment. Fecal incontinence can occur in children because of a birth defect or disease, but in most cases it’s because of chronic constipation.Potty-trained children often get constipated simply because they refuse to go to the bathroom. The problem might stem from embarrassment over using a public toilet or unwillingness to stop playing and go to the bathroom. But if the child continues to hold in stool, the feces will accumulate and harden in the rectum. The child might have a stomachache and not eat much, despite being hungry. And it can be painful when he or she eventually does pass the stool, which can lead to fear of having another bowel movement.Children who are constipated may soil their underpants. Soiling happens when liquid stool from farther up in the bowel seeps past the hard stool in the rectum and leaks out. Soiling is a sign of fecal incontinence. Try to remember that your child cannot control the liquid stool and may not even know it has passed.The first step in treating the problem is passing the built-up stool. The doctor may prescribe one or more enemas or a drink that helps clean out the bowel, such as magnesium citrate, mineral oil, or polyethylene glycol.The next step is preventing future constipation. You will play a big role in this part of your child’s treatment. You may need to teach your child bowel habits, which means training your child to have regular bowel movements. Experts recommend that parents of children with poor bowel habits encourage them to sit on the toilet four times each day — after meals and at bedtime — for 5 minutes. Give rewards for bowel movements and do not punish children for incontinent episodes.Some changes in eating habits may also be necessary. Your child should eat more high-fiber foods to soften stool, avoid dairy products if they cause constipation, and drink plenty of fluids every day, including water and juices such as prune, grape, or apricot, which help prevent constipation. If necessary, the doctor may prescribe laxatives. It may take several months to break the pattern of withholding stool and constipation, and episodes may occur again in the future. The key is to pay close attention to your child’s bowel habits. Some warning signs to watch for include:pain with bowel movementshard stoolconstipationrefusal to go to the bathroomsoiled underwearsigns of holding back a bowel movement, such as squatting, crossing the legs, or rocking back and forthWhy Children Get ConstipatedThey were potty-trained too early.They refuse to have a bowel movement because of painful ones in the past, embarrassment, stubbornness, or even a dislike of public bathrooms.They are in an unfamiliar place.They are reacting to family stress such as a new sibling or their parents’ divorce.They can’t get to a bathroom when they need to go so they hold it. As the rectum fills with stool, the child may lose the urge to go and become constipated as the stool dries and hardens.The above information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the fecal incontinence entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Fibroscan Fibroscan Physician in Orlando, FL https://www.youtube.com/watch?v=XXNAKBjRjgU Trusted FibroScan Doctor in Orlando Your liver is one of the most vital organs in your body, and you need to properly care for it and monitor it. The moment something seems off, you should schedule an appointment to check your liver.If it gets to the point where a biopsy may be discussed, then you should consider FibroScan. This technology is a potential alternative to the intimidating liver biopsy, which is an invasive procedure that requires recovery time.If you’re looking for a FibroScan doctor in Orlando, look no further. At Orlando Gastroenterology, we have the knowledge and technology to perform this non-invasive diagnostic test. All About FibroScan Technology This FDA approved diagnostic ultrasound is a painless, easy, and reliable alternative to a liver biopsy. Using FibroScantesting, we can diagnose a variety of liver problems to get you on the best possible treatment plan.Seeing a FibroScan doctor in Orlando is often recommended for patients with the following conditions:Hepatitis BHepatitis CAutoimmune hepatitisGenetic liver diseases (Wilson’s disease)Alcohol-related liver diseaseCirrhosisFibroScan uses “shear waves”, which are part of an ever-improving technique called Vibration-Controlled Transient Elastography (VCTE) to measure the elasticity of the liver. As the ultrasound wave passes through your liver, it is altered by whatever scarring (or fibrosis) may be present, and these wave readings are then interpreted to get an accurate reading of the stage of the fibrosis.The shear wave analysis needs specific physical parameters to produce an accurate and reliable result in terms of the tissue stiffness, all of which are part of the Fibroscan Touch device. If the liver is stiff, it may mean more severe fibrosis. How FibroScan Can Help Other than the obvious – diagnosing liver fibrosis – what can FibroScan do for you?If you are or could be suffering from Hepatitis C, this technology can be used to check if your liver is becoming scarred, either fibrosis or even cirrhosis, your doctor and pharmacist could then potentially have the results needed to get coverage for new, stronger Hepatitis C treatments.Furthermore, the non-invasive scan means you can avoid the potential risks or complications that might accompany a biopsy. The simple scan is a much easier test and can give you the same results you need.Even better, after treatment (if necessary), the FibroScan process is easily repeatable – with no harmful effects – to monitor the liver’s recovery. This recovery may also decrease your long-term risk of cancer and can be tracked with this technology. An Overview of the Process When you come in, one of our friendly technicians will ask you to lie down and raise your right arm behind your head. From there, a water-based gel will be applied to your side, and the probe will be placed with minimal pressure.They will take ten measurements, back to back, which will measure the state of your liver as a whole, whereas a biopsy is usually focused on a small sample area.The test is a quick, 10-minute procedure, you get your results immediately, and our GI experts will interpret the results for you. No waiting around! Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Gallstones Gallstones What Are Gallstones? Gallstones are small, pebble-like substances that develop in the gallbladder. The gallbladder is a small, pear-shaped sac located below your liver in the right upper abdomen. Gallstones form when liquid stored in the gallbladder hardens into pieces of stone-like material. The liquid — called bile — helps the body digest fats. Bile is made in the liver, then stored in the gallbladder until the body needs it. The gallbladder contracts and pushes the bile into a tube — called the common bile duct — that carries it to the small intestine, where it helps with digestion.Bile contains water, cholesterol, fats, bile salts, proteins, and bilirubin — a waste product. Bile salts break up fat, and bilirubin gives bile and stool a yellowish-brown color. If the liquid bile contains too much cholesterol, bile salts, or bilirubin, it can harden into gallstones.The two types of gallstones are cholesterol stones and pigment stones. Cholesterol stones are usually yellow-green and are made primarily of hardened cholesterol. They account for about 80 percent of gallstones. Pigment stones are small, dark stones made of bilirubin. Gallstones can be as small as a grain of sand or as large as a golf ball. The gallbladder can develop just one large stone, hundreds of tiny stones, or a combination of the two.The gallbladder and the ducts that carry bile and other digestive enzymes from the liver, gallbladder, and pancreas to the small intestine are called the biliary system.Gallstones can block the normal flow of bile if they move from the gallbladder and lodge in any of the ducts that carry bile from the liver to the small intestine. The ducts include the:hepatic ducts, which carry bile out of the livercystic duct, which takes bile to and from the gallbladdercommon bile duct, which takes bile from the cystic and hepatic ducts to the small intestineBile trapped in these ducts can cause inflammation in the gallbladder, the ducts, or in rare cases, the liver. Other ducts open into the common bile duct, including the pancreatic duct, which carries digestive enzymes out of the pancreas. Sometimes gallstones passing through the common bile duct provoke inflammation in the pancreas — called gallstone pancreatitis — an extremely painful and potentially dangerous condition.If any of the bile ducts remain blocked for a significant period of time, severe damage or infection can occur in the gallbladder, liver, or pancreas. Left untreated, the condition can be fatal. Warning signs of a serious problem are fever, jaundice, and persistent pain. What Causes Gallstones? Scientists believe cholesterol stones form when bile contains too much cholesterol, too much bilirubin, or not enough bile salts, or when the gallbladder does not empty completely or often enough. The reason these imbalances occur is not known.The cause of pigment stones is not fully understood. The stones tend to develop in people who have liver cirrhosis, biliary tract infections, or hereditary blood disorders — such as sickle cell anemia — in which the liver makes too much bilirubin.The mere presence of gallstones may cause more gallstones to develop. Other factors that contribute to the formation of gallstones, particularly cholesterol stones, include:Sex – Women are twice as likely as men to develop gallstones. Excess estrogen from pregnancy, hormone replacement therapy, and birth control pills appears to increase cholesterol levels in bile and decrease gallbladder movement, which can lead to gallstones.Family history – Gallstones often run in families, pointing to a possible genetic link.Weight – A large clinical study showed that being even moderately overweight increases the risk for developing gallstones. The most likely reason is that the amount of bile salts in bile is reduced, resulting in more cholesterol. Increased cholesterol reduces gallbladder emptying. Obesity is a major risk factor for gallstones, especially in women.Diet – Diets high in fat and cholesterol and low in fiber increase the risk of gallstones due to increased cholesterol in the bile and reduced gallbladder emptying.Rapid weight loss – As the body metabolizes fat during prolonged fasting and rapid weight loss — such as “crash diets” — the liver secretes extra cholesterol into bile, which can cause gallstones. In addition, the gallbladder does not empty properly.Age – People older than age 60 are more likely to develop gallstones than younger people. As people age, the body tends to secrete more cholesterol into bile.Ethnicity – American Indians have a genetic predisposition to secrete high levels of cholesterol in bile. In fact, they have the highest rate of gallstones in the United States. The majority of American Indian men have gallstones by age 60. Among the Pima Indians of Arizona, 70 percent of women have gallstones by age 30. Mexican American men and women of all ages also have high rates of gallstones.Cholesterol-lowering drugs – Drugs that lower cholesterol levels in the blood actually increase the amount of cholesterol secreted into bile. In turn, the risk of gallstones increases.Diabetes – People with diabetes generally have high levels of fatty acids called triglycerides. These fatty acids may increase the risk of gallstones. Who is at risk for gallstones? People at risk for gallstones include:women — especially women who are pregnant, use hormone replacement therapy, or take birth control pillspeople over age 60American IndiansMexican Americansoverweight or obese men and womenpeople who fast or lose a lot of weight quicklypeople with a family history of gallstonespeople with diabetespeople who take cholesterol-lowering drugs What are the symptoms of gallstones? As gallstones move into the bile ducts and create blockage, pressure increases in the gallbladder and one or more symptoms may occur. Symptoms of blocked bile ducts are often called a gallbladder “attack” because they occur suddenly. Gallbladder attacks often follow fatty meals, and they may occur during the night. A typical attack can cause:steady pain in the right upper abdomen that increases rapidly and lasts from 30 minutes to several hourspain in the back between the shoulder bladespain under the right shoulderNotify your doctor if you think you have experienced a gallbladder attack. Although these attacks often pass as gallstones move, your gallbladder can become infected and rupture if a blockage remains.People with any of the following symptoms should see a doctor immediately:prolonged pain — more than 5 hoursnausea and vomitingfever — even low-grade — or chillsyellowish color of the skin or whites of the eyesclay-colored stoolsMany people with gallstones have no symptoms; these gallstones are called “silent stones.” They do not interfere with gallbladder, liver, or pancreas function and do not need treatment. How are gallstones diagnosed? Frequently, gallstones are discovered during tests for other health conditions. When gallstones are suspected to be the cause of symptoms, the doctor is likely to do an ultrasound exam — the most sensitive and specific test for gallstones. A handheld device, which a technician glides over the abdomen, sends sound waves toward the gallbladder. The sound waves bounce off the gallbladder, liver, and other organs, and their echoes make electrical impulses that create a picture of the gallbladder on a video monitor. If gallstones are present, the sound waves will bounce off them, too, showing their location. Other tests may also be performed. Computerized tomography (CT) scan – The CT scan is a noninvasive x ray that produces cross-section images of the body. The test may show the gallstones or complications, such as infection and rupture of the gallbladder or bile ducts. Cholescintigraphy (HIDA scan) – The patient is injected with a small amount of non-harmful radioactive material that is absorbed by the gallbladder, which is then stimulated to contract. The test is used to diagnose abnormal contraction of the gallbladder or obstruction of the bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP) – ERCP is used to locate and remove stones in the bile ducts. After lightly sedating you, the doctor inserts an endoscope — a long, flexible, lighted tube with a camera — down the throat and through the stomach and into the small intestine. The endoscope is connected to a computer and video monitor. The doctor guides the endoscope and injects a special dye that helps the bile ducts appear better on the monitor. The endoscope helps the doctor locate the affected bile duct and the gallstone. The stone is captured in a tiny basket and removed with the endoscope. Blood tests – Blood tests may be performed to look for signs of infection, obstruction, pancreatitis, or jaundice. How are gallstones treated? SurgeryIf you have gallstones without symptoms, you do not require treatment. If you are having frequent gallbladder attacks, your doctor will likely recommend you have your gallbladder removed — an operation called a cholecystectomy. Surgery to remove the gallbladder — a nonessential organ — is one of the most common surgeries performed on adults in the United States.Nearly all cholecystectomies are performed with laparoscopy. After giving you medication to sedate you, the surgeon makes several tiny incisions in the abdomen and inserts a laparoscope and a miniature video camera. The camera sends a magnified image from inside the body to a video monitor, giving the surgeon a close-up view of the organs and tissues. While watching the monitor, the surgeon uses the instruments to carefully separate the gallbladder from the liver, bile ducts, and other structures. Then the surgeon cuts the cystic duct and removes the gallbladder through one of the small incisions.Recovery after laparoscopic surgery usually involves only one night in the hospital, and normal activity can be resumed after a few days at home. Because the abdominal muscles are not cut during laparoscopic surgery, patients have less pain and fewer complications than after “open” surgery, which requires a 5- to 8-inch incision across the abdomen.If tests show the gallbladder has severe inflammation, infection, or scarring from other operations, the surgeon may perform open surgery to remove the gallbladder. In some cases, open surgery is planned; however, sometimes these problems are discovered during the laparoscopy and the surgeon must make a larger incision. Recovery from open surgery usually requires 3 to 5 days in the hospital and several weeks at home. Open surgery is necessary in about 5 percent of gallbladder operations.The most common complication in gallbladder surgery is injury to the bile ducts. An injured common bile duct can leak bile and cause a painful and potentially dangerous infection. Mild injuries can sometimes be treated nonsurgically. Major injury, however, is more serious and requires additional surgery.If gallstones are present in the bile ducts, the physician — usually a gastroenterologist — may use ERCP to locate and remove them before or during gallbladder surgery. Occasionally, a person who has had a cholecystectomy is diagnosed with a gallstone in the bile ducts weeks, months, or even years after the surgery. The ERCP procedure is usually successful in removing the stone in these cases.Because gallstone symptoms may be similar to those of a heart attack, appendicitis, ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis, and hepatitis, an accurate diagnosis is important.Non-surgical TreatmentNonsurgical approaches are used only in special situations — such as when a patient has a serious medical condition preventing surgery — and only for cholesterol stones. Stones commonly recur within 5 years in patients treated non-surgically.Oral dissolution therapy. Drugs made from bile acid are used to dissolve gallstones. The drugs ursodiol (Actigall) and chenodiol (Chenix) work best for small cholesterol stones. Months or years of treatment may be necessary before all the stones dissolve. Both drugs may cause mild diarrhea, and chenodiol may temporarily raise levels of blood cholesterol and the liver enzyme transaminase.Contact dissolution therapy. This experimental procedure involves injecting a drug directly into the gallbladder to dissolve cholesterol stones. The drug — methyl tert-butyl ether — can dissolve some stones in 1 to 3 days, but it causes irritation and some complications have been reported. The procedure is being tested in symptomatic patients with small stones. Do people need their gallbladder? Fortunately, the gallbladder is an organ people can live without. Your liver produces enough bile to digest a normal diet. Once the gallbladder is removed, bile flows out of the liver through the hepatic ducts into the common bile duct and directly into the small intestine, instead of being stored in the gallbladder. Because now the bile flows into the small intestine more often, softer and more frequent stools can occur in about 1 percent of people. These changes are usually temporary, but talk with your health care provider if they persist. Points to Remember Gallstones form when bile hardens in the gallbladder.Gallstones are more common among older adults; women; American Indians; Mexican Americans; people with diabetes; those with a family history of gallstones; people who are overweight, obese, or undergo rapid weight loss; and those taking cholesterol-lowering drugs.Gallbladder attacks often occur after eating a meal, especially one high in fat.Symptoms can mimic those of other problems, including a heart attack, so an accurate diagnosis is important.Gallstones can cause serious problems if they become trapped in the bile ducts.Laparoscopic surgery to remove the gallbladder is the most common treatment.People can live without. Your liver produces enough bile to digest a normal diet. Once the gallbladder is removed, bile flows out of the liver through the hepatic ducts into the common bile duct and directly into the small intestine, instead of being stored in the gallbladder. Because now the bile flows into the small intestine more often, softer and more frequent stools can occur in about 1 percent of people. These changes are usually temporary, but talk with your health care provider if they persist.Hope through ResearchAnimal research has helped identify several genes that may determine which people are more prone to gallstones. In spite of many well-defined risk factors for gallstones, researchers continue to look for genes that may identify susceptibility in humans. Researchers also believe that the growing global epidemic of obesity may increase rates of gallbladder disease worldwide.The above information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the gallstones entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Gas and Bloating Gas and Bloating Treatment in Orlando, FL https://www.youtube.com/watch?v=WreNHEXyMG8 What Orlando Patients Should Know About Gas and Bloating Everyone has gas. Burping and “passing gas” are normal; they are side effects of digestion. Some people believe they pass gas too often or have too much gas, but this is a rare condition. Most of the time, gas in the body is odorless. The odor of passed gas comes from sulfur made by bacteria in the large intestine. Sometimes gas causes bloating and pain. This occurs when gas is trapped in the digestive system and cannot move through the system freely. Most times, gas can be managed by dietary adjustments and over-the-counter medications. Severe gas build-up and pain may, however, be signs of celiac disease or Irritable Bowel Syndrome (IBS). What can I do about gas? Changing what you eat and drink can help prevent or reduce gas. You may want to try these strategies before making an appointment at Orlando Gastroenterology. Cut down on foods that cause gas. The amount of gas caused by certain foods varies from person to person. Keep track of what you eat and the amount of gas produced. Common gas-producing foods include: beans broccoli, cabbage, brussels sprouts, onions, artichokes, and asparagus pears, apples, and peaches whole grains such as whole wheat and bran soft drinks and fruit drinks milk and milk products such as cheese and ice cream packaged foods that contain lactose, i.e., bread, cereal, and salad dressing dietetic foods and sugar-free candy and gum Drink plenty of water. Eat clear soup. Avoid carbonated beverages and beer. Reduce the amount of air you swallow. The consistency of your stool changes You see blood in your stool You have more or less than normal bowel movements Unplanned weight loss Nausea or vomiting that recurs Constipation or diarrhea ​ Keep a diary. Write down the foods that seem to produce the most gas. Note the quantities of those foods that you consume. Keep track of the number of times you pass gas each day. If you are still troubled by gas after implementing the strategies above, see your doctor at Orlando Gastroenterology. Take your diary so that you can discuss eating habits and symptoms with the doctor. He or she may run tests to identify possible Irritable Bowel Syndrome or celiac disease. What signs are cause for concern? If you notice any of the signs below, please see one of the physicians at Orlando Gastroenterology: The consistency of your stool changes You see blood in your stool You have more or less than normal bowel movements Unplanned weight loss Nausea or vomiting that recurs Constipation or diarrhea If you experience chest pain or numbness in your hands or feet that accompanies gas, see a doctor quickly. These can be signs of heart problems. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Gastroenterology Consultation Gastroenterology Consultation in Orlando, FL https://www.youtube.com/watch?v=RDKxlh4urjc What happens in an Orlando gastroenterology consultation? A gastroenterology consultation is a sit-down meeting with your gastroenterologist (and a loved one, if you choose to bring him or her). In this meeting, you and the doctor discuss your condition—its symptoms, your prognosis, and the treatment options available to you. The purpose of the consultation is for you to receive complete information to make informed decisions about your care. When to schedule a gastroenterology consultation Usually, this type of meeting follows examinations, tests, and screenings. It also often happens before a procedure or before a new round or form of treatment. Some people will schedule a gastroenterology consultation to get a second opinion on a diagnosis or treatment recommendation that another doctor has made. Who can go to the consultation? The patient may bring another person to the consultation. It can be helpful to have a second person there to help take notes and ask questions.How is a “second opinion” consultation different from a regular consultation?A “second opinion” consultation is different from a regular consultation in that you’re discussing the conclusion of another healthcare provider about your symptoms. Usually, test results from the first doctor have been forwarded to the second doctor at your request. The second-opinion doctor may order his or her own set of tests. Upon completion of those tests, you will have a follow-up appointment with the second physician for his or her evaluation and treatment recommendation.To schedule a consultation, call our Orlando Gastroenterology office today. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Gastroesophageal Reflux Disease (GERD) Orlando, FL, Physicians Treat Gastroesophageal Reflux Disease (GERD) https://www.youtube.com/watch?v=XXNAKBjRjgU Visit a Trusted GERD Doctor in Orlando, FL Acid Reflux, also called GERD (Gastroesophageal reflux disease), is a disease of the esophagus in which stomach acid or bile enters the food pipe and irritates its lining. Symptoms include burning pain in the chest. People also refer to this condition as heartburn or acid indigestion. Reflux that happens more than twice a week is more serious than occasional heartburn and is considered GERD.For some people, GERD symptoms are a dry cough, trouble swallowing, or asthma symptoms.Many people have occasional acid reflux. Fewer people suffer from its more serious version, GERD. The disease requires that patients manage it intentionally so that the esophagus does not become permanently damaged by acid and result in a serious condition called Barrett’s esophagus.GERD is treatable by the physicians at Orlando Gastroenterology but can have long-term complications, especially if symptoms are not addressed. What causes GERD? There is a valve called the lower esophageal sphincter (the LES) that lies between the stomach and the esophagus. In some people with GERD, that valve becomes weak or damaged. It doesn’t work properly and lets acid up into the esophagus.Other possible causes of GERD include:Hiatal herniaPregnancySmokingObesity Identifying GERD If you have acid reflux regularly—a few times a month or a few times a week—you should visit a doctor. He or she can run tests such as an endoscopy to look at the lining of your esophagus. If test results show that you have GERD, your doctor will create a treatment plan to manage the disease, reduce your discomfort, and avoid long-term damage to your esophagus. GERD Treatment An Orlando Gastroenterology doctor may include lifestyle changes, medications, or surgery to treat patients with GERD. Medications may be over-the-counter antacids or prescription drugs that decrease acid production.Lifestyle changes may include:Stopping smokingWeight lossEating smaller meals more oftenWearing looser clothingAvoiding foods and drinks that make symptoms worseWaiting three hours after eating before lying downRaising the head of the bed six to eight inchesThe above information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the gastroesophageal reflux disease entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Gastroparesis Gastroparesis Treatment in Orlando, FL https://www.youtube.com/watch?v=XXNAKBjRjgU Orlando Patients, Find Help for Your Gastroparesis Gastroparesis is also called delayed gastric emptying. It is a disorder in which the stomach takes too long to empty. Usually, the stomach contracts to move food down into the small intestine for digestion. In a person with gastroparesis, the muscles of the stomach and intestines do not work normally, and food moves slowly or stops moving through the digestive tract. What Causes Gastroparesis? The most common cause of gastroparesis is diabetes. People with diabetes have high blood glucose, which, over time, can damage the vagus nerve that controls food movement through the digestive tract.Other causes of gastroparesis include:surgery on the stomach or vagus nerveviral infectionsanorexia nervosa or bulimiamedications that slow contractions in the intestinegastroesophageal reflux diseasesmooth muscle disorders, such as amyloidosis and sclerodermanervous system diseases, including abdominal migraine and Parkinson’s diseasemetabolic disorders, including hypothyroidism Many people have what is called idiopathic gastroparesis, meaning the cause is unknown and cannot be found even after medical tests. What Are The Symptoms of Gastroparesis? Signs and symptoms of gastroparesis include:heartburnpain in the upper abdomennauseavomiting of undigested food, sometimes several hours after a mealearly feeling of fullness after only a few bites of foodweight loss due to poor absorption of nutrients or low-calorie intakeabdominal bloatinghigh and low blood glucose levelslack of appetitegastroesophageal refluxspasms in the stomach area Eating solid foods, high-fiber foods such as raw fruits and vegetables, fatty foods, or drinks high in fat or carbonation may contribute to these symptoms. How is Gastroparesis Diagnosed? After performing a full physical exam and taking your medical history, your Orlando Gastroenterology doctor may order several blood tests to check blood counts and chemical and electrolyte levels.To rule out an obstruction or other conditions, the doctor may perform an upper endoscopy, ultrasound, or barium x-ray. Once other causes have been ruled out, the doctor will perform a gastric emptying test to confirm a diagnosis of gastroparesis. How is Gastroparesis Treated? Treatment of gastroparesis depends on the severity of the symptoms. In most cases, gastroparesis is chronic, so the best strategy is management of symptoms.Several medications are used to treat gastroparesis. Doctors at Orlando Gastroenterology may try different drugs or combinations to find the most effective treatment.Changing eating habits can help control gastroparesis. A doctor or dietitian may prescribe six small meals a day instead of three large ones. If less food enters the stomach at mealtimes, it may not become overly full. In more severe cases, a liquid or pureed diet may be prescribed.The doctor may recommend avoiding high-fat and high-fiber foods. Fat naturally slows digestion, and fiber is difficult to digest. Some high-fiber foods like oranges and broccoli contain material that cannot be digested.If a liquid or pureed diet does not work, surgery may be needed to insert a feeding tube that will deliver nutrients and medication into the small intestine. These products then get into the bloodstream quickly. This procedure, called a jejunostomy, is used only when gastroparesis is severe.The above information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the bleeding in the digestive tract entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Gluten Intolerance Gluten Intolerance or Sensitivity in Orlando, FL https://www.youtube.com/watch?v=XXNAKBjRjgU Orlando Doctors Identify Symptoms of Gluten Intolerance/Sensitivity People who are sensitive to or intolerant of gluten in foods experience bloating, gas, abdominal pain, diarrhea, constipation, nausea, headaches, joint pain, fatigue, and mental fog.These symptoms may also indicate celiac disease, so it is important to visit your Orlando Gastroenterology doctor. Treatment for gluten sensitivity differs from treatment for celiac disease. Is it gluten sensitivity or celiac disease? Two simple tests will distinguish whether a patient is gluten sensitive or has celiac disease. Celiac disease produces antibodies that are present in blood, stool, and saliva. Collecting and testing samples of these substances quickly show the presence or absence of celiac antibodies. If no antibodies are present, doctors usually determine that a patient is simply gluten sensitive or gluten intolerant. What causes Ulcerative colitis? Doctors don’t know what causes this disease. It may or may not be related to abnormalities of the immune system that exist in patients with the disease.At Orlando Gastroenterology, we diagnose ulcerative colitis with testing that includes a physical exam, blood tests, stool sample evaluation, colonoscopy, sigmoidoscopy, barium enemas, CT scans, and x-rays. Treatment for gluten intolerance or sensitivity The treatment for this condition is simple: eliminating gluten in one’s diet. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Hemorrhoids Orlando Doctors Can Help Your Hemorrhoids https://www.youtube.com/watch?v=9-B_J4e9-8w Orlando Men and Women, Do You Suffer from Hemorrhoids? Swollen veins in the anal canal, in the skin around the anus, and the rectum, are known as hemorrhoids. They can be painful and itchy, but in most cases, are not serious. They can be internal or external.Hemorrhoids are very common. About half of the population will develop hemorrhoids during their lifetime. Orlando Men and Women, Do You Suffer from Hemorrhoids? When there is too much pressure on the veins in the rectal area, hemorrhoids may form. Typically, the tissue inside of the rectum opening fills with blood that helps to control the movements of the bowel. If you sit on the toilet too long in the effort to expel stool, you place more pressure on the rectum, which can cause the veins to swell and develop into hemorrhoids.Diarrhea can lead to hemorrhoids as well since it places a strain on the anal canal. Pregnant women often develop hemorrhoids because of pressure on the anal region due to the weight of fluid, the baby, and pregnancy weight gain. Anal intercourse may also cause hemorrhoids. Obesity and hemorrhoids Obese or overweight people often develop hemorrhoids because their weight bears down on the rectum and anus. If you are overweight and notice bleeding when you go to the bathroom, it may be a sign of hemorrhoids. Itchiness and rectal pain may be indications also. Hemorrhoid treatment Patients may use hemorrhoidal creams and soak in warm baths to alleviate pain and itching.Orlando Gastroenterology physicians perform these treatments for more severe hemorrhoid conditions:Rubber band ligation – A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid shrivels within a few days. How are hemorrhoids prevented? Hemorrhoids may be prevented by taking the following actions:Stay hydratedGet regular exerciseKeeping stool soft and easy to passAvoid constipationAvoid straining while on the toiletEat a high-fiber dietTake a fiber supplement Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Hepatitis Hepatitis Physician in Orlando, FL https://www.youtube.com/watch?v=4J8tSuvIGNU See Orlando Gastroenterology Doctor for Hepatitis A, B, C, D, and E Hepatitis is a disease of the liver, the organ in the body that fights infection, removes harmful chemicals from the blood, helps digest food, stores nutrients and vitamins, and stores energy.Hepatitis is an infection caused by a virus. It can be acute or chronic, depending on the type of virus. There are five kinds of hepatitis: Hepatitis A, B, C, D, and E. At Orlando Gastroenterology, we understand hepatitis. We will identify what type you suffer from and establish a treatment plan to restore you to health. Hepatitis A This kind of hepatitis is the mildest form of the five. It does not cause long-term liver damage and usually disappears on its own within six months. Who gets hepatitis A? Anyone can get hepatitis A, but some people are at higher risk, including:people who travel to developing countriespeople who live with someone who has hepatitis Apeople who use illegal drugs, including non-injection drugsmen who have sex with men How can I avoid getting hepatitis A? You can avoid getting hepatitis A by getting the hepatitis A vaccine.The Hepatitis A vaccine is given through two shots. The second shot is given six to 12 months after the first shot. Both shots are needed to be fully protected from the virus. Hepatitis B This form of hepatitis can last up to six months—it can be acute but not chronic. Most people get Hepatitis B through sex or intravenous drug use. It is most often spread through bodily fluids. It can lead to complications such as liver failure or cancer if not treated. Who gets hepatitis B? Anyone can get hepatitis B, but some people are at higher risk, including:people born to a mother with hepatitis Bpeople who live with someone who has hepatitis Bpeople who have lived in countries where hepatitis B is commonpeople who are exposed to blood or bodily fluids at workpeople on hemodialysispeople who have had more than one sex partner in the last six months or have a history of sexually transmitted diseaseinjection drug usersmen who have sex with men How can I avoid getting hepatitis B? You can avoid getting hepatitis B by getting the hepatitis B vaccine, which is given in a series of three shots over several months. You need all three shots to be fully protected. Hepatitis C This form of the disease spreads through blood, not bodily fluids, so most people get Hepatitis C through intravenous drug use. Although it usually goes away by itself, in some cases it develops into chronic hepatitis and may cause damage to the liver. Who gets hepatitis C? Anyone can get hepatitis C, but some people are at higher risk, including:people born to a mother with hepatitis Cpeople who have had more than one sex partner in the last six months or have a history of sexually transmitted diseasepeople who had a blood transfusion or organ transplant before July 1992people with hemophilia who received blood products before 1987people who have used illegal injection drugs How can I avoid getting hepatitis C? do not share drug needleswear gloves if you must touch another person’s blooduse a condom during sexdo not borrow another person’s toothbrush, razor, or anything else that could have blood on itmake sure tattoos or body piercings are done with sterile toolsDo not donate blood or blood products if you have hepatitis C. Hepatitis D and E Only patients with Hepatitis B can get Hepatitis D. It is rare in the United States.Hepatitis E is rare in the United States. It is most often caused by drinking water contaminated with fecal matter. Hepatitis signs and symptoms The intensity of symptoms depends on how advanced the disease is. People with acute or chronic hepatitis may suffer from these symptoms:Appetite lossAching joints or musclesPain in the abdomenJaundice (yellowish skin and eyes)DiarrheaStools that are grayish-whiteUrine that is darkPeople with chronic forms for Hepatitis B and C may be symptom-free for years. Sometimes symptoms do not manifest until after liver damage has occurred. This can also be the case with acute forms of hepatitis. Hepatitis treatment Treatment for hepatitis depends on which form of the disease a person has. Hepatitis A treatment No medication is available to cure Hepatitis A, but this form of the disease usually goes away by itself and does not damage the liver. It can take up to six months to be disease-free. Physicians most often focus on managing nausea, fever, and other symptoms. Hepatitis B treatment Physicians focus treatment for acute Hepatitis B on managing symptoms and encouraging patients to eat properly, drink fluids, and rest. Treatment for chronic Hepatitis B may include antiviral medications and watching for signs of liver damage. Hepatitis C treatment Hepatitis C is not treated unless it becomes chronic. Chronic hepatitis C is treated with drugs that slow or stop the virus from damaging the liver.Chronic Hepatitis C is most often treated with the drug combination peginterferon and ribavirin, which attacks the hepatitis C virus. A person whose liver has already become damaged may need a liver transplant. How is hepatitis diagnosed? All forms of hepatitis are diagnosed through blood tests. A physician may also order a liver biopsy to test for liver damage.The above information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the hepatitis entries at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Hiatal Hernia Hiatal Hernia Treatment in Orlando, FL https://www.youtube.com/watch?v=XXNAKBjRjgU What About Hiatal Hernias in Orlando Patients? The hiatus is an opening through which food travels through the esophagus and into the stomach. A hiatal hernia is when part of the stomach pushes through that opening in the muscular wall. Small hiatal hernias often go unnoticed. Larger hiatal hernias are accompanied by unpleasant symptoms.These symptoms include foods or liquids coming back up into the throat after being swallowed, pain from acid flowing back up into the esophagus, chest pain, abdominal pain, heartburn, bleeding, shortness of breath, and difficulty swallowing. Treatment of hiatal hernias A simple hiatal hernia may be managed with antacids or acid-neutralizing medications.A larger hiatal hernia may require surgery to reposition the stomach and secure it so that it doesn’t migrate back through the hiatus. Laparoscopic surgery keeps this treatment from being too invasive.If you think you may have a hiatal hernia, contact the physicians at Orlando Gastroenterology today. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Home OFFER CONTACT US we now Hours Weekend one of CONTACT US Dr. Pothamsetty Doctors Orlando's Premier CONTACT US Welcome To Our Practice Dr. Babu Mohan CONTACT US Welcome To Our Practice Dr. Antonio Soto Ramos CONTACT US Welcome To Our Practice Dr. Sheryl Rosa Cruz Orlando Gastroenterology is pleased to announce we are now offering Saturday procedure times. Contact our office for more information! Board Certified Gastroenterologists in Orlando, Florida with offices located in Orlando, Clermont, Kissimmee, East-Orlando Orlando Gastroenterology is Orlando, Florida’s, premier gastroenterology practice. Our highly skilled team of GI experts are board certified and are dedicated to bringing you the best services in a caring environment. With expertise in the diagnosis and treatment of a wide array of gastrointestinal, liver and biliary tract diseases; our doctor, nurse practitioners, nurses, and courteous staff take care of patients in a state-of-the-art, beautiful outpatient surgery center located at Millenia Surgery Center.​ Our Gastroenterology Providers Sri Pothamsetty MD, AGAF Antonio Soto Ramos, MD Shams Tabrez, MD Babu Mohan, MD Sheryl Rosa Cruz, MD Stacie Kittman, APRN Kerry Dupuis, APRN Beth Halliburton, APRN Kristin Bell, APRN Morrisa Bakker, APRN Marie Wilkinson, APRN Laura Tucker, APRN Shirin Mobeen, APRN We Offer Special Procedures Fibroscan Anorectal manometry Video capsule endoscopy CRH Band ligation of hemorrhoids Our Gastroenterology Services Click on the service names to read more Gastroenterology Consultation Acid Reflux Treatment/Heartburn/ GERD Blood in Stool Colon Cancer Screening Colonoscopy Inflammatory Bowel Disease Crohn's Disease and Colitis Endoscopy Barrett's Esophagus Hemorrhoids Hepatitis Small Intestinal Bacterial Overgrowth (SIBO) Video Capsule Endoscopy (VCE) Abdominal Pain Gluten Intolerance Celiac Disease Constipation Diarrhea Gas and Bloating Gastroparesis Difficulty Swallowing Diverticular Disease Stomach and Intestine Ulcers Hiatal Hernia FibroScan testing Fatty Liver Direct Access Colonoscopy Your First GI Visit Have Questions?  Get In Touch Make an Appointment Schedule Here Make a Payment Make a Payment Everyone was attentive and professional Maritza Gonzalez Great staff friendly and attentive J Henry Starcher I am pleased with the care and environment Katy Perez Read more reviews #### Indigestion Indigestion What is indigestion? Indigestion, also called dyspepsia, describes symptoms such as early fullness during meals, uncomfortable fullness afterward, and burning or pain in the upper abdomen. Many adults experience indigestion occasionally, while others deal with it daily. What causes indigestion? Several digestive conditions trigger indigestion, including gastroesophageal reflux disease (GERD), peptic ulcers, cancer, or problems with the pancreas or bile ducts. When doctors treat the underlying issue, symptoms often improve.In some cases, no clear cause exists. This condition, known as functional dyspepsia, often occurs where the stomach meets the small intestine. Abnormal muscle movement in the stomach — either too weak or too strong — may also play a role. symptoms of indigestion People with indigestion may notice:Fullness during a meal – The person feels overly full soon after the meal starts and cannot finish the meal.Bothersome fullness after a meal – The person feels overly full after a meal — it may feel like the food is staying in the stomach too long.Epigastric pain – The epigastric area is between the lower end of the chest bone and the navel. The person may experience epigastric pain ranging from mild to severe.Epigastric burning – The person feels an unpleasant sensation of heat in the epigastric area.Other possible symptoms include nausea or bloating. These issues may stem from indigestion or other digestive problems.Heartburn is often confused with indigestion, but the two differ. Heartburn causes a burning pain in the chest when acid moves into the esophagus. Some people experience both indigestion and heartburn at the same time. Indigestion diagnosed To diagnose indigestion, the doctor asks about the person’s current symptoms and medical history and performs a physical examination. The doctor may order x rays of the stomach and small intestine. The doctor may perform blood, breath, or stool tests if the type of bacteria that causes peptic ulcer disease is suspected as the cause of indigestion. The doctor may perform an upper endoscopy. After giving a sedative to help the person become drowsy, the doctor passes an endoscope — a long, thin tube that has a light and small camera on the end — through the mouth and gently guides it down the esophagus into the stomach. The doctor can look at the esophagus and stomach with the endoscope to check for any abnormalities. The doctor may perform biopsies — removing small pieces of tissue for examination with a microscope — to look for possible damage from GERD or an infection. Because indigestion can be a sign of a more serious condition, people should see a doctor right away if they experience: the following symptoms: frequent vomiting blood in vomit weight loss or loss of appetite black tarry stools difficult or painful swallowing abdominal pain in a non-epigastric area indigestion accompanied by shortness of breath, sweating, or pain that radiates to the jaw, neck, or arm symptoms that persist for more than 2 weeks Treatment for Indigestion Some people may experience relief from symptoms of indigestion by:the following symptoms:eating several small, low-fat meals throughout the day at a slow pacerefraining from smokingabstaining from consuming coffee, carbonated beverages, and alcoholstopping use of medications that may irritate the stomach lining — such as aspirin or anti-inflammatory drugsgetting enough restfinding ways to decrease emotional and physical stress, such as relaxation therapy or yogaThe doctor may recommend over-the-counter antacids or medications that reduce acid production or help the stomach move food more quickly into the small intestine. Many of these medications can be purchased without a prescription. Nonprescription medications should only be used at the dose and for the length of time recommended on the label unless advised differently by a doctor. Informing the doctor when starting a new medication is important.Antacids, such as Alka-Seltzer, Maalox, Mylanta, Rolaids, and Riopan, are usually the first drugs recommended to relieve symptoms of indigestion. Many brands on the market use different combinations of three basic salts — magnesium, calcium, and aluminum — with hydroxide or bicarbonate ions to neutralize the acid in the stomach. Antacids, however, can have side effects. Magnesium salt can lead to diarrhea, and aluminum salt may cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects. Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can also be a supplemental source of calcium, though they may cause constipation.H2 receptor antagonists (H2RAs) include ranitidine (Zantac), cimetidine (Tagamet), famotidine (Pepcid), and nizatidine (Axid) and are available both by prescription and over-the-counter. H2RAs treat symptoms of indigestion by reducing stomach acid. They work longer than but not as quickly as antacids. Side effects of H2RAs may include headache, nausea, vomiting, constipation, diarrhea, and unusual bleeding or bruising.Proton pump inhibitors (PPIs) include omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium) and are available by prescription. Prilosec is also available in over-the-counter strength. PPIs, which are stronger than H2RAs, also treat indigestion symptoms by reducing stomach acid. PPIs are most effective in treating symptoms of indigestion in people who also have GERD. Side effects of PPIs may include back pain, aching, cough, headache, dizziness, abdominal pain, gas, nausea, vomiting, constipation, and diarrhea.Prokinetics such as metoclopramide (Reglan) may be helpful for people who have a problem with the stomach emptying too slowly. Metoclopramide also improves muscle action in the digestive tract. Prokinetics have frequent side effects that limit their usefulness, including fatigue, sleepiness, depression, anxiety, and involuntary muscle spasms or movements.If testing shows the type of bacteria that causes peptic ulcer disease, the doctor may prescribe antibiotics to treat the condition. Points to Remember the following symptoms:Indigestion, also known as dyspepsia, is a term used to describe one or more symptoms including a feeling of fullness during a meal, uncomfortable fullness after a meal, and burning or pain in the upper abdomen.Indigestion can be caused by a condition in the digestive tract such as gastroesophageal reflux disease (GERD), peptic ulcer disease, cancer, or abnormality of the pancreas or bile ducts.Sometimes a person has indigestion for which a cause cannot be found. This type of indigestion is called functional dyspepsia.Indigestion and heartburn are different conditions, but a person can have symptoms of both.The doctor may order x rays; blood, breath, and stool tests; and an upper endoscopy with biopsies to diagnose indigestion.Some people may experience relief from indigestion by making some lifestyle changes and decreasing stress.The doctor may prescribe antacids, H2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), prokinetics, or antibiotics to treat the symptoms of indigestion.Hope through ResearchThe National Institute of Diabetes and Digestive and Kidney Diseases’ Division of Digestive Diseases and Nutrition supports basic and clinical research into gastrointestinal motility disorders, including indigestion. Further research is needed in the areas ofthe following symptoms:the role of gastric hypersensitivity in indigestionthe relationship between indigestion and psychological disordersnew drug therapies for indigestionParticipants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov.The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.The above information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the indigestion entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Inflammatory Bowel Disease Orlando, FL, Doctors for Inflammatory Bowel Disease (IBD) https://www.youtube.com/watch?v=XXNAKBjRjgU Orlando Patients Should Know What IBD Is IBD most commonly affects the colon and the large intestine. It is a chronic disease of the digestive tract in which tract tissues become inflamed. The inflamed tissues develop sores (ulcers) and bleeding. Accompanying symptoms include cramps and bloating. Medical researchers generally agree that the instigator of the disease is a malfunctioning immune system. Two main types of IBD Although there are several types of IBD, ulcerative colitis and Crohn’s disease are the two most common. Ulcerative colitis and Crohn’s disease share the same symptoms, but they happen in different areas of the digestive tract. Ulcerative colitis symptoms--inflammation, sores, and bleeding--occur in the colon and rectum. Crohn’s disease symptoms can occur throughout the gastrointestinal tract, anywhere from the beginning (mouth) to the end (rectum). Treatment for inflammatory bowel disease IBD can cause permanent damage to the digestive tract, so it is important to treat it carefully. Medications and drugs help with managing disease symptoms and the malfunctioning immune system. Stress reduction can mitigate symptoms, as well. How doctors diagnose IBD Inflammatory bowel disease is usually identified through a colonoscopy or endoscopy. In these tests, tissue extracted by the colonoscope or endoscope can be examined to confirm the diagnosis. Other tests run on blood and stool samples provide additional information. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Irritable Bowel Syndrome Irritable Bowel Syndrome What is irritable bowel syndrome (IBS)? Irritable bowel syndrome is a disorder characterized most commonly by cramping, abdominal pain, bloating, constipation, and diarrhea. IBS causes a great deal of discomfort and distress, but it does not permanently harm the intestines and does not lead to a serious disease, such as cancer. Most people can control their symptoms with diet, stress management, and prescribed medications. For some people, however, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances.As many as 20 percent of the adult population, or one in five Americans, have symptoms of IBS, making it one of the most common disorders diagnosed by doctors. It occurs more often in women than in men, and it begins before the age of 35 in about 50 percent of people. What are the symptoms of IBS? Abdominal pain, bloating, and discomfort are the main symptoms of IBS. However, symptoms can vary from person to person. Some people have constipation, which means hard, difficult-to-pass, or infrequent bowel movements. Often these people report straining and cramping when trying to have a bowel movement but cannot eliminate any stool, or they are able to eliminate only a small amount.If they are able to have a bowel movement, there may be mucus in it, which is a fluid that moistens and protect passages in the digestive system. Some people with IBS experience diarrhea, which is frequent, loose, watery, stools. People with diarrhea frequently feel an urgent and uncontrollable need to have a bowel movement. Other people with IBS alternate between constipation and diarrhea. Sometimes people find that their symptoms subside for a few months and then return, while others report a constant worsening of symptoms over time. What causes IBS? Researchers have yet to discover any specific cause for IBS. One theory is that people who suffer from IBS have a colon, or large intestine, that is particularly sensitive and reactive to certain foods and stress. The immune system, which fights infection, may also be involved. Normal motility, or movement, may not be present in the colon of a person who has IBS. It can be spasmodic or can even stop working temporarily. Spasms are sudden strong muscle contractions that come and go. The lining of the colon called the epithelium, which is affected by the immune and nervous systems, regulates the flow of fluids in and out of the colon. In IBS, the epithelium appears to work properly. However, when the contents inside the colon move too quickly, the colon loses its ability to absorb fluids. The result is too much fluid in the stool. In other people, the movement inside the colon is too slow, which causes extra fluid to be absorbed. As a result, a person develops constipation. A person’s colon may respond strongly to stimuli such as certain foods or stress that would not bother most people. Recent research has reported that serotonin is linked with normal gastrointestinal (GI) functioning. Serotonin is a neurotransmitter, or chemical, that delivers messages from one part of your body to another. Ninety-five percent of the serotonin in your body is located in the GI tract, and the other 5 percent is found in the brain. Cells that line the inside of the bowel work as transporters and carry the serotonin out of the GI tract. People with IBS, however, have diminished receptor activity, causing abnormal levels of serotonin to exist in the GI tract. As a result, they experience problems with bowel movement, motility, and sensation — having more sensitive pain receptors in their GI tract. Researchers have reported that IBS may be caused by a bacterial infection in the gastrointestinal tract. Studies show that people who have had gastroenteritis sometimes develop IBS, otherwise called post-infectious IBS. Researchers have also found very mild celiac disease in some people with symptoms similar to IBS. People with celiac disease cannot digest gluten, a substance found in wheat, rye, and barley. People with celiac disease cannot eat these foods without becoming very sick because their immune system responds by damaging the small intestine. A blood test can determine whether celiac disease may be present. (For information about celiac disease, see the NIDDK’s Celiac Disease fact sheet.) How is IBS diagnosed? If you think you have IBS, seeing your doctor is the first step. IBS is generally diagnosed on the basis of a complete medical history that includes a careful description of symptoms and a physical examination.There is no specific test for IBS, although diagnostic tests may be performed to rule out other problems. These tests may include stool sample testing, blood tests, and x rays. Typically, a doctor will perform a sigmoidoscopy, or colonoscopy, which allows the doctor to look inside the colon. This is done by inserting a small, flexible tube with a camera on the end of it through the anus. The camera then transfers the images of your colon onto a large screen for the doctor to see better.If your test results are negative, the doctor may diagnose IBS based on your symptoms, including how often you have had abdominal pain or discomfort during the past year, when the pain starts and stops in relation to bowel function, and how your bowel frequency and stool consistency have changed. Many doctors refer to a list of specific symptoms that must be present to make a diagnosis of IBS.Symptoms include:Abdominal pain or discomfort for at least 12 weeks out of the previous 12 months. These 12 weeks do not have to be consecutive.The abdominal pain or discomfort has two of the following three features:It is relieved by having a bowel movement.When it starts, there is a change in how often you have a bowel movement.When it starts, there is a change in the form of the stool or the way it looks.Certain symptoms must also be present, such as:A change in frequency of bowel movementsA change in appearance of bowel movementsFeelings of uncontrollable urgency to have a bowel movementDifficulty or inability to pass stoolMucus in the stoolBloatingBleeding, fever, weight loss, and persistent severe pain are not symptoms of IBS and may indicate other problems such as inflammation, or rarely, cancer.The following have been associated with a worsening of IBS symptoms:large mealsbloating from gas in the colonmedicineswheat, rye, barley, chocolate, milk products, or alcoholdrinks with caffeine, such as coffee, tea, or colasstress, conflict, or emotional upsetsResearchers have found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can worsen IBS problems.In addition, people with IBS frequently suffer from depression and anxiety, which can worsen symptoms. Similarly, the symptoms associated with IBS can cause a person to feel depressed and anxious. What is the treatment for IBS? Unfortunately, many people suffer from IBS for a long time before seeking medical treatment. Up to 70 percent of people suffering from IBS are not receiving medical care for their symptoms. No cure has been found for IBS, but many options are available to treat the symptoms. Your doctor will give you the best treatments for your particular symptoms and encourage you to manage stress and make changes to your diet.Medications are an important part of relieving symptoms. Your doctor may suggest fiber supplements or laxatives for constipation or medicines to decrease diarrhea, such as Lomotil or loperamide (Imodium). An antispasmodic is commonly prescribed, which helps to control colon muscle spasms and reduce abdominal pain. Antidepressants may relieve some symptoms. However, both antispasmodics and antidepressants can worsen constipation, so some doctors will also prescribe medications that relax muscles in the bladder and intestines, such as Donnapine and Librax. These medications contain a mild sedative, which can be habit forming, so they need to be used under the guidance of a physician.A medication available specifically to treat IBS is alosetron hydrochloride (Lotronex). Lotronex has been reapproved with significant restrictions by the U.S. Food and Drug Administration (FDA) for women with severe IBS who have not responded to conventional therapy and whose primary symptom is diarrhea. However, even in these patients, Lotronex should be used with great caution because it can have serious side effects such as severe constipation or decreased blood flow to the colon.With any medication, even over-the-counter medications such as laxatives and fiber supplements, it is important to follow your doctor’s instructions. Some people report a worsening in abdominal bloating and gas from increased fiber intake, and laxatives can be habit forming if they are used too frequently.Medications affect people differently, and no one medication or combination of medications will work for everyone with IBS. You will need to work with your doctor to find the best combination of medicine, diet, counseling, and support to control your symptoms. How does stress affect IBS? Stress — feeling mentally or emotionally tense, troubled, angry, or overwhelmed — can stimulate colon spasms in people with IBS. The colon has many nerves that connect it to the brain. Like the heart and the lungs, the colon is partly controlled by the autonomic nervous system, which responds to stress. These nerves control the normal contractions of the colon and cause abdominal discomfort at stressful times. People often experience cramps or “butterflies” when they are nervous or upset. In people with IBS, the colon can be overly responsive to even slight conflict or stress. Stress makes the mind more aware of the sensations that arise in the colon, making the person perceive these sensations as unpleasant. Some evidence suggests that IBS is affected by the immune system, which fights infection in the body. The immune system is affected by stress. For all these reasons, stress management is an important part of treatment for IBS. Stress management options include: stress reduction (relaxation) training and relaxation therapies such as meditation counseling and support regular exercise such as walking or yoga changes to the stressful situations in your life adequate sleep What does the colon do? The colon, which is about 5 feet long, connects the small intestine to the rectum and anus. The major function of the colon is to absorb water, nutrients, and salts from the partially digested food that enters from the small intestine. Two pints of liquid matter enter the colon from the small intestine each day. Stool volume is a third of a pint. The difference between the amount of fluid entering the colon from the small intestine and the amount of stool in the colon is what the colon absorbs each day.Colon motility — the contraction of the colon muscles and the movement of its contents — is controlled by nerves, hormones, and impulses in the colon muscles. These contractions move the contents inside the colon toward the rectum. During this passage, water and nutrients are absorbed into the body, and what is left over is stool. A few times each day contractions push the stool down the colon, resulting in a bowel movement. However, if the muscles of the colon, sphincters, and pelvis do not contract in the right way, the contents inside the colon do not move correctly, resulting in abdominal pain, cramps, constipation, a sense of incomplete stool movement, or diarrhea. Can changes in diet help IBS? For many people, careful eating reduces IBS symptoms. Before changing your diet, keep a journal noting the foods that seem to cause distress. Then discuss your findings with your doctor. You may want to consult a registered dietitian who can help you make changes to your diet. For instance, if dairy products cause your symptoms to flare up, you can try eating less of those foods. You might be able to tolerate yogurt better than other dairy products because it contains bacteria that supply the enzyme needed to digest lactose, the sugar found in milk products. Dairy products are an important source of calcium and other nutrients. If you need to avoid dairy products, be sure to get adequate nutrients in the foods you substitute, or take supplements.In many cases, dietary fiber may lessen IBS symptoms, particularly constipation. However, it may not help with lowering pain or decreasing diarrhea. Whole grain breads and cereals, fruits, and vegetables are good sources of fiber. High-fiber diets keep the colon mildly distended, which may help prevent spasms. Some forms of fiber keep water in the stool, thereby preventing hard stools that are difficult to pass. Doctors usually recommend a diet with enough fiber to produce soft, painless bowel movements. High-fiber diets may cause gas and bloating, although some people report that these symptoms go away within a few weeks. (For information about diets for people with celiac disease, please see the NIDDK’s Celiac Disease fact sheet.) Increasing fiber intake by 2 to 3 grams per day will help reduce the risk of increased gas and bloating.Drinking six to eight glasses of plain water a day is important, especially if you have diarrhea. Drinking carbonated beverages, such as sodas, may result in gas and cause discomfort. Chewing gum and eating too quickly can lead to swallowing air, which also leads to gas.Large meals can cause cramping and diarrhea, so eating smaller meals more often, or eating smaller portions, may help IBS symptoms. Eating meals that are low in fat and high in carbohydrates such as pasta, rice, whole-grain breads and cereals (unless you have celiac disease), fruits, and vegetables may help.Is IBS linked to other health problems?As its name indicates, IBS is a syndrome — a combination of signs and symptoms. IBS has not been shown to lead to a serious disease, including cancer. Through the years, IBS has been called by many names, among them colitis, mucous colitis, spastic colon, or spastic bowel. However, no link has been established between IBS and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. Points to Remember IBS is a disorder that interferes with the normal functions of the colon. The symptoms are crampy abdominal pain, bloating, constipation, and diarrhea. IBS is a common disorder found more often in women than men. People with IBS have colons that are more sensitive and reactive to things that might not bother other people, such as stress, large meals, gas, medicines, certain foods, caffeine, or alcohol. IBS is diagnosed by its signs and symptoms and by the absence of other diseases. Most people can control their symptoms by taking medicines such as laxatives, antidiarrhea medicines, antispasmodics, or antidepressants; reducing stress; and changing their diet. IBS does not harm the intestines and does not lead to cancer. It is not related to Crohn’s disease or ulcerative colitis. The following information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the irritable bowel syndrome entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Kerry Dupuis, A.P.R.N. Overview Kerry Dupuis, A.P.R.N. is a Board-Certified Advanced Registered Nurse Practitioner with special interest in Gastroenterology Location Services Gastroenterology Consultation Read More Acid Reflux Treatment/Heartburn/ GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment #### Kissimmee Clinic Your Digestive Health Hub in KissimmeeServing the Kissimmee and Osceola County area, our Kissimmee Clinic brings Orlando Gastroenterology’s expertise closer to home. Whether you’re dealing with new symptoms or managing a chronic GI condition, you deserve high-quality, compassionate care — and that’s what we strive to provide in your community. Kissimmee Clinic — Orlando GastroenterologyAddress1132 Cypress Glen CircleKissimmee, FL 34741 Call Clinic Directions Our Services & Areas of Care Gastroenterology Consultation Read More Acid Reflux Treatment / Heartburn / GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment Why Choose the Kissimmee Clinic Convenient Local Access No long drives — GI care is available locally in Kissimmee. Expert Team Our gastroenterologists, advanced practice providers, and support staff focus on digestive health and maintain up-to-date, evidence-based practices. Comprehensive Diagnostics & Procedures From noninvasive testing to endoscopy, we are equipped to evaluate and treat many GI conditions. Patient-Centered Philosophy We believe in listening, explaining, and partnering with you to design the best care plan for your needs. Continuity & Coordination If procedures or imaging are needed, we help coordinate seamlessly with our network and provide follow-up support. No long drives — GI care is available locally in Kissimmee.Our gastroenterologists, advanced practice providers, and support staff focus on digestive health and maintain up-to-date, evidence-based practices.From noninvasive testing to endoscopy, we are equipped to evaluate and treat many GI conditions.We believe in listening, explaining, and partnering with you to design the best care plan for your needs.If procedures or imaging are needed, we help coordinate seamlessly with our network and provide follow-up support. Meet Some of Our Providers Meet the Team Schedule an AppointmentWhat to Expect on Your VisitBefore Your Visit Bring your ID, insurance card, list of current medications, and any prior GI-related test results or medical records. During the Appointment After check-in, your provider will review your history, symptom details, and may order diagnostics immediately or schedule necessary procedures. Next Steps & Follow-Up You’ll receive a personalized treatment plan and schedule for follow-up visits or further evaluation.Call (407) 445-9224 or use our online appointment form. #### Kristin Bell, APRN Overview Kristin Bell, A.P.R.N. is a Board-Certified Advanced Registered Nurse Practitioner with special interest in Gastroenterology Location Services Gastroenterology Consultation Read More Acid Reflux Treatment/Heartburn/ GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment #### Lactose Intolerance Lactose Intolerance in Orlando, FL What is lactose? Lactose is a sugar found in milk and milk products. The small intestine—the organ where most food digestion and nutrient absorption take place—produces an enzyme called lactase. Lactase breaks down lactose into two simpler forms of sugar: glucose and galactose. The body then absorbs these simpler sugars into the bloodstream. What is lactose intolerance? Lactose intolerance is a condition in which people have digestive symptoms—such as bloating, diarrhea, and gas—after eating or drinking milk or milk products.Lactase deficiency and lactose malabsorption may lead to lactose intolerance:Lactase deficiency. In people who have a lactase deficiency, the small intestine produces low levels of lactase and cannot digest much lactose.Lactose malabsorption. Lactase deficiency may cause lactose malabsorption. In lactose malabsorption, undigested lactose passes to the colon. The colon, part of the large intestine, absorbs water from stool and changes it from a liquid to a solid form. In the colon, bacteria break down undigested lactose and create fluid and gas. Not all people with lactase deficiency and lactose malabsorption have digestive symptoms. What Are The Symptoms of Gastroparesis? Lactose intolerance is a condition in which people have digestive symptoms—such as bloating, diarrhea, and gas—after eating or drinking milk or milk products. Lactase deficiency and lactose malabsorption may lead to lactose intolerance: Lactase deficiency. In people who have a lactase deficiency, the small intestine produces low levels of lactase and cannot digest much lactose. Lactose malabsorption. Lactase deficiency may cause lactose malabsorption. In lactose malabsorption, undigested lactose passes to the colon. The colon, part of the large intestine, absorbs water from stool and changes it from a liquid to a solid form. In the colon, bacteria break down undigested lactose and create fluid and gas. Not all people with lactase deficiency and lactose malabsorption have digestive symptoms. The Digestive Tract People have lactose intolerance when lactase deficiency and lactose malabsorption cause digestive symptoms. Most people with lactose intolerance can eat or drink some amount of lactose without having digestive symptoms. Individuals vary in the amount of lactose they can tolerate.People sometimes confuse lactose intolerance with a milk allergy. While lactose intolerance is a digestive system disorder, a milk allergy is a reaction by the body’s immune system to one or more milk proteins. An allergic reaction to milk can be life threatening even if the person eats or drinks only a small amount of milk or milk product. A milk allergy most commonly occurs in the first year of life, while lactose intolerance occurs more often during adolescence or adulthood.1Boyce JA, Assa’ad A, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. Journal of Allergy and Clinical Immunology. 2010;126(6 suppl.):S1–S58.2Suchy FJ, Brannon PM, Carpenter TO, et al. National Institutes of Health Consensus Development Conference: lactose intolerance and health. Annals of Internal Medicine. 2010;152(12):792–796. Four Types of Lactase Deficiency Four types of lactase deficiency may lead to lactose intolerance: Primary lactase deficiency, also called lactase nonpersistence, is the most common type of lactase deficiency. In people with this condition, lactase production declines over time. This decline often begins at about age 2; however, the decline may begin later. Children who have lactase deficiency may not experience symptoms of lactose intolerance until late adolescence or adulthood. Researchers have discovered that some people inherit genes from their parents that may cause a primary lactase deficiency. Secondary lactase deficiency results from injury to the small intestine. Infection, diseases, or other problems may injure the small intestine. Treating the underlying cause usually improves the lactose tolerance. Developmental lactase deficiency may occur in infants born prematurely. This condition usually lasts for only a short time after they are born. Congenital lactase deficiency is an extremely rare disorder in which the small intestine produces little or no lactase enzyme from birth. Genes inherited from parents cause this disorder. Who is more likely to have lactose intolerance? In the United States, some ethnic and racial populations are more likely to have lactose intolerance than others, including African Americans, Hispanics/Latinos, American Indians, and Asian Americans. The condition is least common among Americans of European descent. What are the symptoms of lactose intolerance? Common symptoms of lactose intolerance includeabdominal bloating, a feeling of fullness or swelling in the abdomenabdominal paindiarrheagasnauseaSymptoms occur 30 minutes to 2 hours after consuming milk or milk products. Symptoms range from mild to severe based on the amount of lactose the person ate or drank and the amount a person can tolerate. How does lactose intolerance affect health? In addition to causing unpleasant symptoms, lactose intolerance may affect people’s health if it keeps them from consuming enough essential nutrients, such as calcium and vitamin D. People with lactose intolerance may not get enough calcium if they do not eat calcium-rich foods or do not take a dietary supplement that contains calcium. Milk and milk products are major sources of calcium and other nutrients in the diet. Calcium is essential at all ages for the growth and maintenance of bones. A shortage of calcium intake in children and adults may lead to bones that are less dense and can easily fracture later in life, a condition called osteoporosis. How is lactose intolerance diagnosed? A health care provider makes a diagnosis of lactose intolerance based on medical, family, and diet history, including a review of symptoms a physical exam medical tests Medical, family, and diet history. A health care provider will take a medical, family, and diet history to help diagnose lactose intolerance. During this discussion, the health care provider will review a patient’s symptoms. However, basing a diagnosis on symptoms alone may be misleading because digestive symptoms can occur for many reasons other than lactose intolerance. For example, other conditions such as irritable bowel syndrome, celiac disease, inflammatory bowel disease, or small bowel bacterial overgrowth can cause digestive symptoms. Physical exam. A physical exam may help diagnose lactose intolerance or rule out other conditions that cause digestive symptoms. During a physical exam, a health care provider usually checks for abdominal bloating uses a stethoscope to listen to sounds within the abdomen taps on the abdomen to check for tenderness or pain A health care provider may recommend eliminating all milk and milk products from a person’s diet for a short time to see if the symptoms resolve. Symptoms that go away when a person eliminates lactose from his or her diet may confirm the diagnosis of lactose intolerance. Medical tests. A health care provider may order special tests to provide more information. Health care providers commonly use two tests to measure how well a person digests lactose: Hydrogen breath test. This test measures the amount of hydrogen in a person’s breath. Normally, only a small amount of hydrogen is detectable in the breath when a person eats or drinks and digests lactose. However, undigested lactose produces high levels of hydrogen. For this test, the patient drinks a beverage that contains a known amount of lactose. A health care provider asks the patient to breathe into a balloon-type container that measures breath hydrogen level. In most cases, a health care provider performs this test at a hospital, on an outpatient basis. Smoking and some foods and medications may affect the accuracy of the results. A health care provider will tell the patient what foods or medications to avoid before the test. Stool acidity test. Undigested lactose creates lactic acid and other fatty acids that a stool acidity test can detect in a stool sample. Health care providers sometimes use this test to check acidity in the stools of infants and young children. A child may also have glucose in his or her stool as a result of undigested lactose. The health care provider will give the child’s parent or caretaker a container for collecting the stool specimen. The parent or caretaker returns the sample to the health care provider, who sends it to a lab for analysis. How much lactose can a person with lactose intolerance have? Most people with lactose intolerance can tolerate some amount of lactose in their diet and do not need to avoid milk or milk products completely. Avoiding milk and milk products altogether may cause people to take in less calcium and vitamin D than they need. See the “Calcium and Vitamin D” section.Individuals vary in the amount of lactose they can tolerate. A variety of factors—including how much lactase the small intestine produces—can affect how much lactose an individual can tolerate. For example, one person may have severe symptoms after drinking a small amount of milk, while another person can drink a large amount without having symptoms. Other people can easily eat yogurt and hard cheeses such as cheddar and Swiss, while they are not able to eat or drink other milk products without having digestive symptoms.Research suggests that adults and adolescents with lactose malabsorption could eat or drink at least 12 grams of lactose in one sitting without symptoms or with only minor symptoms. This amount is the amount of lactose in 1 cup of milk. People with lactose malabsorption may be able to eat or drink more lactose if they eat it or drink it with meals or in small amounts throughout the day. How is lactose intolerance managed? Many people can manage the symptoms of lactose intolerance by changing their diet. Some people may only need to limit the amount of lactose they eat or drink. Others may need to avoid lactose altogether. Using lactase products can help some people manage their symptoms.For people with secondary lactase deficiency, treating the underlying cause improves lactose tolerance. In infants with developmental lactase deficiency, the ability to digest lactose improves as the infants mature. People with primary and congenital lactase deficiency cannot change their body’s ability to produce lactase.Eating, Diet, And NutritionPeople may find it helpful to talk with a health care provider or a registered dietitian about a dietary plan. A dietary plan can help people manage the symptoms of lactose intolerance and make sure they get enough nutrients. Parents, caretakers, childcare providers, and others who serve food to children with lactose intolerance should follow the dietary plan recommended by the child’s health care provider or registered dietitian.Milk and milk products. Gradually introducing small amounts of milk or milk products may help some people adapt to them with fewer symptoms. Often, people can better tolerate milk or milk products by having them with meals, such as having milk with cereal or having cheese with crackers. People with lactose intolerance are generally more likely to tolerate hard cheeses, such as cheddar or Swiss, than a glass of milk. A 1.5‑ounce serving of low-fat hard cheese has less than 1 gram of lactose, while a 1-cup serving of low-fat milk has about 11 to 13 grams of lactose.However, people with lactose intolerance are also more likely to tolerate yogurt than milk, even though yogurt and milk have similar amounts of lactose.Lactose-free and lactose-reduced milk and milk products. Lactose-free and lactose-reduced milk and milk products are available at most supermarkets and are identical nutritionally to regular milk and milk products. Manufacturers treat lactose-free milk with the lactase enzyme. This enzyme breaks down the lactose in the milk. Lactose-free milk remains fresh for about the same length of time or, if it is ultra-pasteurized, longer than regular milk. Lactose-free milk may have a slightly sweeter taste than regular milk.Lactase products. People can use lactase tablets and drops when they eat or drink milk products. The lactase enzyme digests the lactose in the food and therefore reduces the chances of developing digestive symptoms. People should check with a health care provider before using these products because some groups, such as young children and pregnant and breastfeeding women, may not be able to use them. Calcium and Vitamin D Ensuring that children and adults with lactose intolerance get enough calcium is important, especially if their intake of milk and milk products is limited. The amount of calcium a person needs to maintain good health varies by age. Table 1 illustrates recommendations for calcium intake.Table 1. Recommenced Dietary Allowance of Calcium by Age GroupAge GroupRecommended Dietary Allowance (mg/day)1–3 years700 mg4–8 years1,000 mg9–18 years1,300 mg19–50 years1,000 mg51–70 years, males1,000 mg51–70 years, females1,200 mg70+ years1,200 mg14–18 years, pregnant/breastfeeding1,300 mg19–50 years, pregnant/breastfeeding1,000 mgSource: Adapted from Dietary Reference Intakes for Calcium and Vitamin D, Institute of Medicine, National Academy of Sciences, November 2010.A U.S. Recommended Dietary Allowance for calcium has not been determined for infants. However, researchers suggest 200 mg of calcium per day for infants age 0 to 6 months and 260 mg for infants age 6 to 12 months.Many foods can provide calcium and other nutrients the body needs. Nonmilk products high in calcium include fish with soft bones, such as canned salmon and sardines, and dark green vegetables, such as spinach. Manufacturers may also add calcium to fortified breakfast cereals, fruit juices, and soy beverage—also called soy milk. Many fortified foods are also excellent sources of vitamin D and other essential nutrients, in addition to calcium.Table 2 lists foods that are good sources of dietary calcium.Table 2. Calcium Content in Common FoodsNonmilk ProductsCalcium Contentsardines, with bone, 3.75 oz.351 mgrhubarb, frozen, cooked, 1 cup348 mgsoy milk, original and vanilla, with added calcium and vitamins A and D299 mgspinach, frozen, cooked, 1 cup291 mgsalmon, canned, with bone, 3 oz.181 mgpinto beans, cooked, 1 cup79 mgbroccoli, cooked, 1 cup62 mgsoy milk, original and vanilla, unfortified, 1 cup61 mgorange, 1 medium52 mglettuce, green leaf, 1 cup13 mgtuna, white, canned, 3 oz.12 mgMilk and Milk Products yogurt, plain, skim milk, 8 oz.452 mgmilk, reduced fat, with added vitamins A and D, 1 cup293 mgSwiss cheese, 1 oz.224 mgcottage cheese, low fat, 1 cup206 mgice cream, vanilla, 1/2 cup84 mgSource:  Adapted from U.S. Department of Agriculture, Agricultural Research Service. 2013. USDA national nutrient database for standard reference, release 26.Vitamin D helps the body absorb and use calcium. Some people with lactose intolerance may not get enough vitamin D. Foods such as salmon, tuna, eggs, and liver naturally contain vitamin D. Most milk sold in the United States is fortified with vitamin D, and vitamin D is added to some nonmilk beverages, yogurts, and breakfast cereals. People’s bodies also make vitamin D when the skin is exposed to sunlight.People may find it helpful to talk with a health care provider or a registered dietitian to determine if their diet provides adequate nutrients—including calcium and vitamin D. To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements, with their health care provider. Read more at www.ods.od.nih.gov and www.nccam.nih.gov.Institute of Medicine, National Academy of Sciences. Dietary Reference Intakes for Calcium and Vitamin D. 2010. Report. What products contain lactose? Lactose is present in many food products and in some medications. Food Products Lactose is in all milk and milk products. Manufacturers also often add milk and milk products to boxed, canned, frozen, packaged, and prepared foods. People who have digestive symptoms after consuming a small quantity of lactose should be aware of the many food products that may contain even small amounts of lactose, such as bread and other baked goods waffles, pancakes, biscuits, cookies, and the mixes to make them processed breakfast foods such as doughnuts, frozen waffles and pancakes, toaster pastries, and sweet rolls processed breakfast cereals instant potatoes, soups, and breakfast drinks potato chips, corn chips, and other processed snacks processed meats such as bacon, sausage, hot dogs, and lunch meats margarine salad dressings liquid and powdered milk-based meal replacements protein powders and bars candies nondairy liquid and powdered coffee creamers nondairy whipped toppings People can check the ingredients on food labels to find possible sources of lactose in food products. If a food label includes any of the following words, the product contains lactose: milk lactose whey curds milk by-products dry milk solids nonfat dry milk powder Medications Some medications also contain lactose, including prescription medications such as birth control pills and over-the-counter medications such as products to treat stomach acid and gas. These medications most often cause symptoms in people with severe lactose intolerance. People with lactose intolerance who take medications that contain lactose should speak with their health care provider about other options. Points to Remember Lactose is a sugar found in milk and milk products. Lactose intolerance is a condition in which people have digestive symptoms—such as bloating, diarrhea, and gas—after eating or drinking milk or milk products. A health care provider makes a diagnosis of lactose intolerance based on medical, family, and diet history, including a review of symptoms; a physical exam; and medical tests. Basing a diagnosis on symptoms alone may be misleading because digestive symptoms can occur for many reasons other than lactose intolerance. Most people with lactose intolerance can tolerate some amount of lactose in their diet and do not need to avoid milk or milk products completely. However, individuals vary in the amount of lactose they can tolerate. Research suggests that adults and adolescents with lactose malabsorption could eat or drink at least 12 grams of lactose in one sitting without symptoms or with only minor symptoms. This amount is the amount of lactose in 1 cup of milk. Many people can manage the symptoms of lactose intolerance by changing their diet. Some people may only need to limit the amount of lactose they eat or drink. Others may need to avoid lactose altogether. People may find it helpful to talk with a health care provider or a registered dietitian to determine if their diet provides adequate nutrients— including calcium and vitamin D. To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements, with their health care provider. Lactose is in all milk and milk products. Manufacturers also often add milk and milk products to boxed, canned, frozen, packaged, and prepared foods. People can check the ingredients on food labels to find possible sources of lactose in food products. Hope through ResearchThe National Institute of Diabetes and Digestive and Kidney Diseases’ (NIDDK’s) Division of Digestive Diseases and Nutrition conducts and supports basic and clinical research into digestive disorders such as lactose intolerance.Clinical trials are research studies involving people. Clinical trials look at safe and effective new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. To learn more about clinical trials, why they matter, and how to participate, visit the NIH Clinical Research Trials and You website at www.nih.gov/health/clinicaltrials. For information about current studies, visit www.ClinicalTrials.gov.The following/prior information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance/index.aspx Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Locations MetroWest LocationSuite #1051507 S Hiawassee Rd Orlando, FL 32835 Learn More Clermont Location255 Citrus Tower Blvd # 207, Clermont, FL 34711 Learn More East Orlando LocationSuite #1101300 N Semoran BlvdOrlando, FL 32807 Learn More Kissimmee Location1132 Cypress Glen CircleKissimmee, FL 34741 Learn More #### Maintenance Website will be online again soon Currently it undergoes a regular health checkup. Undergoing maintenance From time to time we put our website on maintenance to check if everything works OK! Feature updates We just love to roll out new features to our website. That’s what we’re doing right now! :-) Bug fixes Even a dental care website might stumble upon some bugs. Those need to be fixed! #### MetroWest Orlando Clinic Welcome to Your Local GI Care CenterConveniently located in the heart of the MetroWest community of Orlando, our Metrowest Orlando Clinic is your go-to destination for comprehensive gastrointestinal care. Whether you're dealing with chronic issues like acid reflux or seeking preventative screening like colonoscopy, our experienced team delivers compassionate, evidence-based care close to home.MetroWest is a vibrant, master-planned community in western Orlando, surrounded by neighborhoods such as Horizons West, and positioned near major roads like Kirkman Road and S. Hiawassee Road. MetroWest Orlando ClinicAddressSuite #1051507 S. Hiawassee Rd, Ste. 105Orlando, FL 32835 Call Clinic Directions What We Treat & Services Offered Gastroenterology Consultation Read More Acid Reflux Treatment / Heartburn / GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment Why Choose Our Metrowest Clinic Board-Certified Specialists You’ll be cared for by GI physicians and APPs who are experienced in complex digestive disorders. State-of-the-Art Facilities Our clinic is equipped with modern diagnostic tools to help us arrive at accurate diagnoses quickly. Convenience & Accessibility Located within MetroWest, with easy access from surrounding neighborhoods, for streamlined care without traveling far. Patient-Centered Approach We prioritize listening, educating, and collaborating with patients to build treatment plans that fit individual needs. Insurance & Payment Options We accept a wide range of insurance plans and offer resources for patients without coverage. You’ll be cared for by GI physicians and APPs who are experienced in complex digestive disorders.Our clinic is equipped with modern diagnostic tools to help us arrive at accurate diagnoses quickly.Located within MetroWest, with easy access from surrounding neighborhoods, for streamlined care without traveling far.We prioritize listening, educating, and collaborating with patients to build treatment plans that fit individual needs.We accept a wide range of insurance plans and offer resources for patients without coverage. Meet Some of Our Providers Meet the Team Schedule an AppointmentPlan Your First VisitPrepare AheadPlease bring your identification, medical insurance card, list of current medications, and any relevant medical records or prior test results.What to ExpectOn arrival, our friendly staff will check you in and guide you through registration. During your evaluation, the provider will review your history, discuss symptoms, perform a physical exam, and recommend necessary tests (blood work, imaging, endoscopy, etc.).Follow-Up & Care PlanAfter your visit, you’ll receive a personalized treatment plan. We’ll schedule follow-ups as needed and ensure you understand all next steps.Call (407) 445-9224 or use our online appointment form. #### Non-Alcoholic Stateohepatitis Non-Alcoholic Stateohepatitis What is Non-Alcoholic Stateohepatitis? Nonalcoholic steatohepatitis or NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.NASH affects 2 to 5 percent of Americans. An additional 10 to 20 percent of Americans have fat in their liver, but no inflammation or liver damage, a condition called “fatty liver.” Although having fat in the liver is not normal, by itself it probably causes little harm or permanent damage. If fat is suspected based on blood test results or scans of the liver, this problem is called non-alcoholic fatty liver disease (NAFLD). If a liver biopsy is performed in this case, it will show that some people have NASH while others have simple fatty liver.Both NASH and NAFLD are becoming more common, possibly because of the greater number of Americans with obesity. In the past 10 years, the rate of obesity has doubled in adults and tripled in children. Obesity also contributes to diabetes and high blood cholesterol, which can further complicate the health of someone with NASH. Diabetes and high blood cholesterol are also becoming more common among Americans. What Causes Non-Alcoholic Stateohepatitis? Although NASH has become more common, its underlying cause is still not clear. It most often occurs in persons who are middle-aged and overweight or obese. Many patients with NASH have elevated blood lipids, such as cholesterol and triglycerides, and many have diabetes or pre-diabetes, but not every obese person or every patient with diabetes has NASH. Furthermore, some patients with NASH are not obese, do not have diabetes, and have normal blood cholesterol and lipids. NASH can occur without any apparent risk factor and can even occur in children. Thus, NASH is not simply obesity that affects the liver. While the underlying reason for the liver injury that causes NASH is not known, several factors are possible candidates: insulin resistance release of toxic inflammatory proteins by fat cells (cytokines) oxidative stress (deterioration of cells) inside liver cells What Are The Symptoms of Non-Alcoholic Stateohepatitis? NASH is usually a silent disease with few or no symptoms. Patients generally feel well in the early stages and only begin to have symptoms — such as fatigue, weight loss, and weakness — once the disease is more advanced or cirrhosis develops. The progression of NASH can take years, even decades. The process can stop and, in some cases, reverse on its own without specific therapy. Or NASH can slowly worsen, causing scarring or “fibrosis” to appear and accumulate in the liver. As fibrosis worsens, cirrhosis develops; the liver becomes seriously scarred, hardened, and unable to function normally. Not every person with NASH develops cirrhosis, but once serious scarring or cirrhosis is present, few treatments can halt the progression. A person with cirrhosis experiences fluid retention, muscle wasting, bleeding from the intestines, and liver failure. Liver transplantation is the only treatment for advanced cirrhosis with liver failure, and transplantation is increasingly performed in people with NASH. NASH ranks as one of the major causes of cirrhosis in America, behind hepatitis C and alcoholic liver disease. How is Non-Alcoholic Stateohepatitis Diagnosed? NASH is usually first suspected in a person who is found to have elevations in liver tests that are included in routine blood test panels, such as alanine aminotransferase (ALT) or aspartate aminotransferase (AST). When further evaluation shows no apparent reason for liver disease (such as medications, viral hepatitis, or excessive use of alcohol) and when x-rays or imaging studies of the liver show fat, NASH is suspected. The only means of proving a diagnosis of NASH and separating it from simple fatty liver is a liver biopsy. For a liver biopsy, a needle is inserted through the skin to remove a small piece of the liver. NASH is diagnosed when examination of the tissue with a microscope shows fat along with inflammation and damage to liver cells. If the tissue shows fat without inflammation and damage, simple fatty liver or NAFLD is diagnosed. An important piece of information learned from the biopsy is whether scar tissue has developed in the liver. Currently, no blood tests or scans can reliably provide this information. How is Non-Alcoholic Stateohepatitis Treated? Currently, no specific therapies for NASH exist. The most important recommendations given to persons with this disease are to:reduce their weight (if obese or overweight)follow a balanced and healthy dietincrease physical activityavoid alcoholavoid unnecessary medicationsThese are standard recommendations, but they can make a difference. They are also helpful for other conditions, such as heart disease, diabetes, and high cholesterol.A major attempt should be made to lower body weight into the healthy range. Weight loss can improve liver tests in patients with NASH and may reverse the disease to some extent. Research at present is focusing on how much weight loss improves the liver in patients with NASH and whether this improvement lasts over a period of time. People with NASH often have other medical conditions, such as diabetes, high blood pressure, or elevated cholesterol. These conditions should be treated with medication and adequately controlled; having NASH or elevated liver enzymes should not lead people to avoid treating these other conditions.Experimental approaches under evaluation in patients with NASH include antioxidants, such as vitamin E, selenium, and betaine. These medications act by reducing the oxidative stress that appears to increase inside the liver in patients with NASH. Whether these substances actually help treat the disease is not known, but the results of clinical trials should become available in the next few years.Another experimental approach to treating NASH is the use of newer anti-diabetic medications — even in persons without diabetes. Most patients with NASH have insulin resistance, meaning that the insulin normally present in the bloodstream is less effective for them in controlling blood glucose and fatty acids in the blood than it is for people who do not have NASH. The newer anti-diabetic medications make the body more sensitive to insulin and may help reduce liver injury in patients with NASH. Studies of these medications — including metformin, rosiglitazone, and pioglitazone — are being sponsored by the National Institutes of Health and should answer the question of whether these medications are beneficial in NASH. Points to Remember Non-alcoholic steatohepatitis (NASH) is fat in the liver, with inflammation and damage. NASH occurs in people who drink little or no alcohol and affects 2 to 5 percent of Americans, especially people who are middle-aged and overweight or obese. NASH can occur in children. People who have NASH may feel well and may not know that they have a liver disease. NASH can lead to cirrhosis, a condition in which the liver is permanently damaged and cannot work properly. Fatigue can occur at any stage of NASH. Weight loss and weakness may begin once the disease is advanced or cirrhosis is present. NASH may be suspected if blood tests show high levels of liver enzymes or if scans show fatty liver. NASH is diagnosed by examining a small piece of the liver taken through a needle, a procedure called biopsy. People who have NASH should reduce their weight, eat a balanced diet, engage in physical activity, and avoid alcohol and unnecessary medications. No specific therapies for NASH exist. Experimental therapies being studied include antioxidants and anti-diabetes medications. Hope through ResearchWhat is most needed in the management of NASH is more research to better understand the liver injury found in this disease. When the pathways that lead to the injury are fully known, safe and effective means can be developed to reverse these pathways and help patients with NASH. Recent breakthroughs in mapping the human genome and uncovering the individual steps by which insulin and other hormones regulate blood glucose and fat could provide the necessary clues.The National Institute of Diabetes and Digestive and Kidney Diseases funds the NASH Clinical Research Network, which comprises eight clinical centers located throughout the United States and a coordinating center at Johns Hopkins University. The NASH network researches the nature and underlying cause of NASH and conducts clinical studies on prevention and treatment. More information on the NASH Clinical Research Network and the locations of the clinical centers are available at www.jhucct.com/nash/.The following information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the Non-alcoholic Steatohepatitis entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Our Doctors Meet Our Professional Team At our clinic, you will find compassionate physicians, practitioners, helpful staff and the latest technology to help care for patients.We are excited to service the Orlando, Clermont, Metrowest and Kissimmee area. Medical Specialists Sri Pothamsetty MD, AGAF Antonio Soto Ramos, MD Shams Tabrez, MD Babu Mohan, MD Sheryl Rosa Cruz, MD Stacie Kittman, APRN Kerry Dupuis, APRN Beth Halliburton, APRN Kristin Bell, APRN Morrisa Bakker, APRN Marie Wilkinson, APRN Laura Tucker, APRN Shirin Mobeen, APRN #### Pancreatitis Pancreatitis What is pancreatitis? ​Pancreatitis is inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum — the first part of the small intestine. The pancreas secretes digestive juices, or enzymes, into the duodenum through a tube called the pancreatic duct. Pancreatic enzymes join with bile — a liquid produced in the liver and stored in the gallbladder — to digest food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body regulate the glucose it takes from food for energy.Normally, digestive enzymes secreted by the pancreas do not become active until they reach the small intestine. But when the pancreas is inflamed, the enzymes inside it attack and damage the tissues that produce them. Pancreatitis can be acute or chronic. Either form is serious and can lead to complications. In severe cases, bleeding, infection, and permanent tissue damage may occur.The gallbladder and the ducts that carry bile and other digestive enzymes from the liver, gallbladder, and pancreas to the small intestine are called the biliary system.Both forms of pancreatitis occur more often in men than women. What is acute pancreatitis? Acute pancreatitis is inflammation of the pancreas that occurs suddenly and usually resolves in a few days with treatment. Acute pancreatitis can be a life-threatening illness with severe complications. Each year, about 210,000 people in the United States are admitted to the hospital with acute pancreatitis.1 The most common cause of acute pancreatitis is the presence of gallstones — small, pebble-like substances made of hardened bile — that cause inflammation in the pancreas as they pass through the common bile duct. Chronic, heavy alcohol use is also a common cause. Acute pancreatitis can occur within hours or as long as 2 days after consuming alcohol. Other causes of acute pancreatitis include abdominal trauma, medications, infections, tumors, and genetic abnormalities of the pancreas.SymptomsAcute pancreatitis usually begins with gradual or sudden pain in the upper abdomen that sometimes extends through the back. The pain may be mild at first and feel worse after eating. But the pain is often severe and may become constant and last for several days. A person with acute pancreatitis usually looks and feels very ill and needs immediate medical attention. Other symptoms may include:a swollen and tender abdomennausea and vomitingfevera rapid pulseSevere acute pancreatitis may cause dehydration and low blood pressure. The heart, lungs, or kidneys can fail. If bleeding occurs in the pancreas, shock and even death may follow.DiagnosisWhile asking about a person’s medical history and conducting a thorough physical examination, the doctor will order a blood test to assist in the diagnosis. During acute pancreatitis, the blood contains at least three times the normal amount of amylase and lipase, digestive enzymes formed in the pancreas. Changes may also occur in other body chemicals such as glucose, calcium, magnesium, sodium, potassium, and bicarbonate. After the person’s condition improves, the levels usually return to normal.Diagnosing acute pancreatitis is often difficult because of the deep location of the pancreas.The doctor will likely order one or more of the following tests:Abdominal ultrasound – Sound waves are sent toward the pancreas through a handheld device that a technician glides over the abdomen. The sound waves bounce off the pancreas, gallbladder, liver, and other organs, and their echoes make electrical impulses that create a picture — called a sonogram — on a video monitor. If gallstones are causing inflammation, the sound waves will also bounce off them, showing their location.Computerized tomography (CT) scan – The CT scan is a noninvasive x ray that produces three-dimensional pictures of parts of the body. The person lies on a table that slides into a donut-shaped machine. The test may show gallstones and the extent of damage to the pancreas.Endoscopic ultrasound (EUS) – After spraying a solution to numb the patient’s throat, the doctor inserts an endoscope — a thin, flexible, lighted tube — down the throat, through the stomach, and into the small intestine. The doctor turns on an ultrasound attachment to the scope that produces sound waves to create visual images of the pancreas and bile ducts.Magnetic resonance cholangiopancreatography (MRCP) – MRCP uses magnetic resonance imaging, a noninvasive test that produces cross-section images of parts of the body. After being lightly sedated, the patient lies in a cylinder-like tube for the test. The technician injects dye into the patient’s veins that helps show the pancreas, gallbladder, and pancreatic and bile ducts.TreatmentTreatment for acute pancreatitis requires a few days’ stay in the hospital for intravenous (IV) fluids, antibiotics, and medication to relieve pain. The person cannot eat or drink so the pancreas can rest. If vomiting occurs, a tube may be placed through the nose and into the stomach to remove fluid and air.Unless complications arise, acute pancreatitis usually resolves in a few days. In severe cases, the person may require nasogastric feeding — a special liquid given in a long, thin tube inserted through the nose and throat and into the stomach — for several weeks while the pancreas heals.Before leaving the hospital, the person will be advised not to smoke, drink alcoholic beverages, or eat fatty meals. In some cases, the cause of the pancreatitis is clear, but in others, more tests are needed after the person is discharged and the pancreas is healed.Therapeutic Endoscopic Retrograde Cholangiopancreatography (ERCP) for Acute and Chronic PancreatitisERCP is a specialized technique used to view the pancreas, gallbladder, and bile ducts and treat complications of acute and chronic pancreatitis — gallstones, narrowing or blockage of the pancreatic duct or bile ducts, leaks in the bile ducts, and pseudocysts — accumulations of fluid and tissue debris.Soon after a person is admitted to the hospital with suspected narrowing of the pancreatic duct or bile ducts, a physician with specialized training performs ERCP.After lightly sedating the patient and giving medication to numb the throat, the doctor inserts an endoscope — a long, flexible, lighted tube with a camera — through the mouth, throat, and stomach into the small intestine. The endoscope is connected to a computer and screen. The doctor guides the endoscope and injects a special dye into the pancreatic or bile ducts that helps the pancreas, gallbladder, and bile ducts appear on the screen while x rays are taken.The following procedures can be performed using ERCP:Sphincterotomy – Using a small wire on the endoscope, the doctor finds the muscle that surrounds the pancreatic duct or bile ducts and makes a tiny cut to enlarge the duct opening. When a pseudocyst is present, the duct is drained.Gallstone removal – The endoscope is used to remove pancreatic or bile duct stones with a tiny basket. Gallstone removal is sometimes performed along with a sphincterotomy.Stent placement – Using the endoscope, the doctor places a tiny piece of plastic or metal that looks like a straw in a narrowed pancreatic or bile duct to keep it open.Balloon dilatation – Some endoscopes have a small balloon that the doctor uses to dilate, or stretch, a narrowed pancreatic or bile duct. A temporary stent may be placed for a few months to keep the duct open. People who undergo therapeutic ERCP are at slight risk for complications, including severe pancreatitis, infection, bowel perforation, or bleeding. Complications of ERCP are more common in people with acute or recurrent pancreatitis. A patient who experiences fever, trouble swallowing, or increased throat, chest, or abdominal pain after the procedure should notify a doctor immediately.ComplicationsGallstones that cause acute pancreatitis require surgical removal of the stones and the gallbladder. If the pancreatitis is mild, gallbladder removal — called cholecystectomy — may proceed while the person is in the hospital. If the pancreatitis is severe, gallstones may be removed using therapeutic endoscopic retrograde cholangiopancreatography (ERCP) — a specialized technique used to view the pancreas, gallbladder, and bile ducts and treat complications of acute and chronic pancreatitis. Cholecystectomy is delayed for a month or more to allow for full recovery. For more information, see the Gallstones fact sheet from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).If an infection develops, ERCP or surgery may be needed to drain the infected area, also called an abscess. Exploratory surgery may also be necessary to find the source of any bleeding, to rule out conditions that resemble pancreatitis, or to remove severely damaged pancreatic tissue.Pseudocysts — accumulations of fluid and tissue debris — that may develop in the pancreas can be drained using ERCP or EUS. If pseudocysts are left untreated, enzymes and toxins can enter the bloodstream and affect the heart, lungs, kidneys, or other organs.Acute pancreatitis sometimes causes kidney failure. People with kidney failure need blood-cleansing treatments called dialysis or a kidney transplant.In rare cases, acute pancreatitis can cause breathing problems. Hypoxia, a condition that occurs when body cells and tissues do not get enough oxygen, can develop. Doctors treat hypoxia by giving oxygen to the patient. Some people still experience lung failure — even with oxygen — and require a respirator for a while to help them breathe. What is chronic pancreatitis? Chronic pancreatitis is inflammation of the pancreas that does not heal or improve — it gets worse over time and leads to permanent damage. Chronic pancreatitis, like acute pancreatitis, occurs when digestive enzymes attack the pancreas and nearby tissues, causing episodes of pain. Chronic pancreatitis often develops in people who are between the ages of 30 and 40.The most common cause of chronic pancreatitis is many years of heavy alcohol use. The chronic form of pancreatitis can be triggered by one acute attack that damages the pancreatic duct. The damaged duct causes the pancreas to become inflamed. Scar tissue develops and the pancreas is slowly destroyed.Other causes of chronic pancreatitis are:hereditary disorders of the pancreascystic fibrosis — the most common inherited disorder leading to chronic pancreatitishypercalcemia — high levels of calcium in the bloodhyperlipidemia or hypertriglyceridemia — high levels of blood fatssome medicinescertain autoimmune conditionsunknown causesHereditary pancreatitis can present in a person younger than age 30, but it might not be diagnosed for several years. Episodes of abdominal pain and diarrhea lasting several days come and go over time and can progress to chronic pancreatitis. A diagnosis of hereditary pancreatitis is likely if the person has two or more family members with pancreatitis in more than one generation.SymptomsMost people with chronic pancreatitis experience upper abdominal pain, although some people have no pain at all. The pain may spread to the back, feel worse when eating or drinking, and become constant and disabling. In some cases, abdominal pain goes away as the condition worsens, most likely because the pancreas is no longer making digestive enzymes. Other symptoms include:nauseavomitingweight lossdiarrheaoily stoolsPeople with chronic pancreatitis often lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to digest food, so nutrients are not absorbed normally. Poor digestion leads to malnutrition due to excretion of fat in the stool.DiagnosisChronic pancreatitis is often confused with acute pancreatitis because the symptoms are similar. As with acute pancreatitis, the doctor will conduct a thorough medical history and physical examination. Blood tests may help the doctor know if the pancreas is still making enough digestive enzymes, but sometimes these enzymes appear normal even though the person has chronic pancreatitis.In more advanced stages of pancreatitis, when malabsorption and diabetes can occur, the doctor may order blood, urine, and stool tests to help diagnose chronic pancreatitis and monitor its progression.After ordering x rays of the abdomen, the doctor will conduct one or more of the tests used to diagnose acute pancreatitis — abdominal ultrasound, CT scan, EUS, and MRCP.TreatmentTreatment for chronic pancreatitis may require hospitalization for pain management, IV hydration, and nutritional support. Nasogastric feedings may be necessary for several weeks if the person continues to lose weight.When a normal diet is resumed, the doctor may prescribe synthetic pancreatic enzymes if the pancreas does not secrete enough of its own. The enzymes should be taken with every meal to help the person digest food and regain some weight. The next step is to plan a nutritious diet that is low in fat and includes small, frequent meals. A dietitian can assist in developing a meal plan. Drinking plenty of fluids and limiting caffeinated beverages is also important.People with chronic pancreatitis are strongly advised not to smoke or consume alcoholic beverages, even if the pancreatitis is mild or in the early stages.ComplicationsPeople with chronic pancreatitis who continue to consume large amounts of alcohol may develop sudden bouts of severe abdominal pain.As with acute pancreatitis, ERCP is used to identify and treat complications associated with chronic pancreatitis such as gallstones, pseudocysts, and narrowing or obstruction of the ducts. Chronic pancreatitis also can lead to calcification of the pancreas, which means the pancreatic tissue hardens from deposits of insoluble calcium salts. Surgery may be necessary to remove part of the pancreas.In cases involving persistent pain, surgery or other procedures are sometimes recommended to block the nerves in the abdominal area that cause pain.When pancreatic tissue is destroyed in chronic pancreatitis and the insulin-producing cells of the pancreas, called beta cells, have been damaged, diabetes may develop. People with a family history of diabetes are more likely to develop the disease. If diabetes occurs, insulin or other medicines are needed to keep blood glucose at normal levels. A health care provider works with the patient to develop a regimen of medication, diet, and frequent blood glucose monitoring. How common is pancreatitis in children? Chronic pancreatitis in children is rare. Trauma to the pancreas and hereditary pancreatitis are two known causes of childhood pancreatitis. Children with cystic fibrosis — a progressive and incurable lung disease — may be at risk of developing pancreatitis. But more often the cause of pancreatitis in children is unknown. Points to Remember Pancreatitis is inflammation of the pancreas, causing digestive enzymes to become active inside the pancreas and damage pancreatic tissue. Pancreatitis has two forms: acute and chronic. Common causes of pancreatitis are gallstones and heavy alcohol use. Sometimes the cause of pancreatitis cannot be found. Symptoms of acute pancreatitis include abdominal pain, nausea, vomiting, fever, and a rapid pulse. Treatment for acute pancreatitis includes intravenous (IV) fluids, antibiotics, and pain medications. Surgery is sometimes needed to treat complications. Acute pancreatitis can become chronic if pancreatic tissue is permanently destroyed and scarring develops. Symptoms of chronic pancreatitis include abdominal pain, nausea, vomiting, weight loss, diarrhea, and oily stools. Treatment for chronic pancreatitis may involve IV fluids; pain medication; a low-fat, nutritious diet; and enzyme supplements. Surgery may be necessary to remove part of the pancreas. The following information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the pancreatitis entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Peptic Ulcers Get Rid of Peptic Ulcers in Orlando, FL https://www.youtube.com/watch?v=XXNAKBjRjgU Peptic Ulcer (Stomach & Intestine) Relief for Orlando Patients A peptic ulcer is a sore on the lining of the stomach, esophagus (food pipe), or duodenum (the beginning of the small intestine). Peptic ulcers are common: One in 10 Americans develops an ulcer at some time in his or her life.A peptic ulcer in the stomach is also called a gastric ulcer; in the small intestine, it’s called a duodenal ulcer. The physicians at Orlando Gastroenterology will be able to identify if you have an ulcer and where it is located. What causes ulcers? One cause of peptic ulcers is a bacterial infection, and some ulcers are caused by long-term use of nonsteroidal anti-inflammatories such as aspirin and ibuprofen. In a few cases, cancerous tumors in the stomach or pancreas can cause peptic ulcers.Peptic ulcers are not caused by stress, eating spicy food, drinking alcohol, or smoking cigarettes. However, these factors can aggravate ulcers and keep them from healing well.Helicobacter pylori (H. pylori) is a type of bacteria. Researchers believe that H. pylori is responsible for most peptic ulcers. They are not certain how people contract H. pylori, but they think it may be through food or water.H.pylori weakens the protective mucous coating of the stomach and duodenum, which allows acid to get through to the sensitive lining beneath. Both the acid and the bacteria irritate the lining and cause a sore, or ulcer. What are the symptoms of an ulcer? One cause of peptic ulcers is a bacterial infection, and some ulcers are caused by long-term use of nonsteroidal anti-inflammatories such as aspirin and ibuprofen. In a few cases, cancerous tumors in the stomach or pancreas can cause peptic ulcers.Peptic ulcers are not caused by stress, eating spicy food, drinking alcohol, or smoking cigarettes. However, these factors can aggravate ulcers and keep them from healing well.Helicobacter pylori (H. pylori) is a type of bacteria. Researchers believe that H. pylori is responsible for most peptic ulcers. They are not certain how people contract H. pylori, but they think it may be through food or water.H.pylori weakens the protective mucous coating of the stomach and duodenum, which allows acid to get through to the sensitive lining beneath. Both the acid and the bacteria irritate the lining and cause a sore, or ulcer.Abdominal discomfort is the most common symptom of an ulcer. Characteristics of the discomfort include:dull, gnawing achecomes and goes for several days or weeksoccurs two to three hours after a mealoccurs in the middle of the night when the stomach is emptyis relieved by eatingis relieved by antacid medicationsOther peptic ulcer symptoms include:weight losspoor appetitebloatingburpingnauseavomiting Emergency Symptoms If you have any of these symptoms, call your doctor right away:sharp, sudden, persistent stomach painbloody or black stoolsbloody vomit or vomit that looks like coffee groundsThese could be signs of a serious problem, such as perforation, when the ulcer eats through the stomach or duodenal wall; bleeding, when acid in the ulcer breaks a blood vessel; or obstruction, when the ulcer blocks the path of food trying to leave the stomach. How is a peptic ulcer diagnosed? Diagnosing an ulcerTo see if symptoms are caused by an ulcer, an Orlando Gastroenterology doctor may do an upper gastrointestinal (GI) series or an endoscopy. An upper GI series is an x-ray of the esophagus, stomach, and duodenum.An endoscopy is an exam in which a doctor uses an endoscope, a thin, lighted tube with a tiny camera, that allows the doctor to see the lining of the esophagus, stomach, and duodenum.If an ulcer is found, the doctor will test the patient for H. pylori. This test is important because treatment for an ulcer caused by H. pylori is different from that for an ulcer caused by aspirin or ibuprofen. How are peptic ulcers treated? H.pylori peptic ulcers are treated with drugs that kill the bacteria, reduce stomach acid, and protect the stomach lining. Antibiotics are used to kill the bacteria.Treatment usually involves a combination of antibiotics, acid suppressors, and stomach protectors.Points to RememberA peptic ulcer is a sore in the lining of the stomach or duodenum.Most peptic ulcers are caused by the H. pylori bacterium. None are caused by spicy food or stress.pylori may be transmitted from person to person through close contact and exposure to vomit.A combination of antibiotics and other drugs is the most effective treatment for H. pylori peptic ulcers.The above information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the H. pylori entry at the NIDDK website. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Privacy Policy Privacy Policy: Orlando Gastroenterology, PA ("Orlando Gastroenterology, PA") operates orlandogastroenterology.com and may operate other websites. 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Your continued use of this site after any change in this Privacy Policy will constitute your acceptance of such change. #### Services Hiatal Hernia Hiatal Hernia Treatment in Orlando, FL Play Video What About Hiatal Hernias in Orlando Patients? The hiatus is an opening Read More Peptic Ulcers Get Rid of Peptic Ulcers in Orlando, FL Play Video Peptic Ulcer (Stomach & Intestine) Relief for Orlando Patients A Read More Diverticular Disease Diverticulosis and Diverticulitis Doctor in Orlando, FL Play Video What are diverticulosis and diverticulitis? Many people have small pouches in Read More Difficulty Swallowing Orlando Physicians Help with Difficulty Swallowing (Dysphagia) Play Video See a Trusted Dysphagia Doctor in Orlando Ulcerative colitis is a Read More Gastroparesis Gastroparesis Treatment in Orlando, FL Play Video Orlando Patients, Find Help for Your Gastroparesis Gastroparesis is also called delayed gastric Read More Gas and Bloating Gas and Bloating Treatment in Orlando, FL Play Video What Orlando Patients Should Know About Gas and Bloating Everyone has Read More Diarrhea See a Doctor About Diarrhea in Orlando, FL Play Video Understand Orlando Adult and Child Diarrhea Diarrhea is loose, watery Read More Constipation Constipation Healthcare Provider in Orlando, FL Play Video Orlando, Get Help for Your Constipation Constipation is difficulty passing stool and Read More Celiac Disease Celiac Disease Doctor in Orlando, FL Play Video Celiac Disease Celiac disease is a common genetic disorder that afflicts the Read More Gluten Intolerance Gluten Intolerance or Sensitivity in Orlando, FL Play Video Orlando Doctors Identify Symptoms of Gluten Intolerance/Sensitivity People who are sensitive Read More Ulcerative Colitis Ulcerative Colitis Physician in Orlando, FL Play Video Ulcerative Colitis: Manage it, Orlando Patient Ulcerative colitis is a disease of Read More Gastroenterology Consultation Gastroenterology Consultation in Orlando, FL Play Video What happens in an Orlando gastroenterology consultation? A gastroenterology consultation is a sit-down Read More Gastroesophageal Reflux Disease (GERD) Orlando, FL, Physicians Treat Gastroesophageal Reflux Disease (GERD) Play Video Visit a Trusted GERD Doctor in Orlando, FL Acid Reflux, Read More Digestive Tract Bleeding Orlando Doctors Help Heal Digestive Tract Bleeding Play Video Digestive Tract Bleeding & Blood in the Stool: What Orlando Patients Read More Colon Cancer Screening Orlando, FL, Physicians Provide Colon Cancer Screening Play Video About Colon Cancer Screenings in Orlando A colon cancer screening usually Read More Colonoscopy Colonoscopy in Orlando, FL Play Video What is colonoscopy? Colonoscopy is a procedure used to see inside the colon and Read More Inflammatory Bowel Disease Orlando, FL, Doctors for Inflammatory Bowel Disease (IBD) Play Video Orlando Patients Should Know What IBD Is IBD most commonly Read More Crohn’s Disease Crohn's Disease Doctor in Orlando, FL Play Video What About Crohn's Disease, Colitis, and IBD in Orlando Patients? Are you Read More Endoscopy Endoscopy Provider in Orlando, FL Play Video Orlando Patient, Do You Need an Endoscopy? An endoscopy is an outpatient upper Read More Barrett’s Esophagus Barrett’s Esophagus Treatment Provider in Orlando, FL Play Video What Orlando Patients Should Know About Barrett's Esophagus In a person Read More Hemorrhoids Orlando Doctors Can Help Your Hemorrhoids Play Video Orlando Men and Women, Do You Suffer from Hemorrhoids? Swollen veins in Read More Hepatitis Hepatitis Physician in Orlando, FL Play Video See Orlando Gastroenterology Doctor for Hepatitis A, B, C, D, and E Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Small Intestine Bacterial Overgrowth (SIBO) Doctor in Orlando, FL Play Video Orlando, Know Your Symptoms of SIBO Small intestine bacterial Read More Video Capsule Endoscopy (VCE) Orlando Physicians Conduct Video Capsule Endoscopy Play Video Visit an Orlando Doctor for Video Capsule Endoscopy This is a type Read More #### Shams Tabrez, M.D. Overview Dr. Shams Tabrez completed his residency in Internal Medicine at New York University and fellowship in gastroenterology and hepatology at Yale New Haven Hospital, Bridgeport, Connecticut. He is a member of several professional organizations including the American College of Gastroenterology and American Society of Gastrointestinal Endoscopy. He has over 18 years of experience in providing cutting edge GI care and endoscopic service to patients. He teaches medical student and enjoys clinical research. Location Services Gastroenterology Consultation Read More Acid Reflux Treatment/Heartburn/ GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment #### Sheryl Rosa Cruz, MD Overview Dr. Rosa-Cruz is a board-certified gastroenterologist, fluent in Spanish. She received her medical degree from Universidad de Guadalajara and brings between eleven and twenty years of practical experience to the field.Her expertise includes the clinical management of a wide variety of gastroenterological illnesses. She is also skilled in performing colonoscopies and upper GI endoscopies. Dr. Rosa is committed to delivering the best possible care to her patients, ensuring they receive the attention and treatment they need. Location Services Gastroenterology Consultation Read More Acid Reflux Treatment/Heartburn/ GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment #### Shop URL: https://orlandogastroenterology.com/shop/ #### Small Intestinal Bacterial Overgrowth (SIBO) Small Intestine Bacterial Overgrowth (SIBO) Doctor in Orlando, FL https://www.youtube.com/watch?v=XXNAKBjRjgU Orlando, Know Your Symptoms of SIBO Small intestine bacterial overgrowth, or SIBO, is a condition in which too much gut bacteria is present in the small intestine. While a certain number of bacteria are vital for the normal functioning of the digestive system, too many bacteria are not good.Symptoms of SIBO include bloating, excess gas, diarrhea, constipation, abdominal pain, nausea, cramps, and indigestion. In severe cases, excess bacteria slow or prevent nutrient absorption. The excess may also damage the tissue of the small intestine. Diagnosis of SIBO A simple test will reveal the presence of excess bacteria. After consuming a sugar solution, a patient is directed to exhale into a tube. If the exhaled air contains hydrogen and methane (byproducts of bacteria), it is an indication of SIBO. What causes Ulcerative colitis? Doctors don’t know what causes this disease. It may or may not be related to abnormalities of the immune system that exist in patients with the disease.At Orlando Gastroenterology, we diagnose ulcerative colitis with testing that includes a physical exam, blood tests, stool sample evaluation, colonoscopy, sigmoidoscopy, barium enemas, CT scans, and x-rays. How is SIBO treated? A common, effective treatment for SIBO is an antibiotic that reduces bacteria in the small intestine. Multiple courses may be necessary if the condition returns. Doctors usually look for the cause of the condition to remediate the underlying problem. Sometimes SIBO is the result of gastroparesis, celiac disease, or issues with how the digestive system is functioning. About SIBO and irritable bowel syndrome (IBS) The distinctions between SIBO and IBS are sometimes blurry because they share the same symptoms. However, SIBO has one cause (excess bacteria), and IBS can stem from an assortment of causes. Sometimes SIBO is itself the cause of IBS in a patient.SIBO is managed by an antibiotic. If SIBO is not the cause of IBS, an antibiotic may be an ineffective treatment for IBS. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Sri Pothamsetty, MD, AGAF Overview Dr. Sri Pothamsetty founded Orlando Gastroenterology, P. A. in 2002. He is a Board-Certified Gastroenterologist, and a member of the American College of Gastroenterology. Further, Dr. Pothamsetty has been awarded the fellowship of the American Gastroenterological Association. His passion for safe, comfortable and high-quality endoscopy led to the establishment of the endoscopy center at The Millenia Surgery Center, L.L.C., a state-of-the art facility operating 6 days a week including Saturdays. Dr. Pothamsetty is a recipient of Outstanding Physician Award from Surgery Partners. He is on staff at University of Central Florida College of Medicine as Assistant Professor of Internal Medicine. Location Services Gastroenterology Consultation Read More Acid Reflux Treatment / Heartburn / GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment #### Stacie Kittman, A.P.R.N. Overview Stacie Kittman, A.P.R.N. is a Board-Certified Advanced Registered Nurse Practitioner with special interest in Gastroenterology Location Services Gastroenterology Consultation Read More Acid Reflux Treatment/Heartburn/ GERD Read More Blood in Stool Read More Colon Cancer Screening Read More Colonoscopy Read More Inflammatory Bowel Disease Read More Crohn's Disease and Colitis Read More Endoscopy Read More Barrett's Esophagus Read More Hemorrhoids Read More Hepatitis Read More Small Intestinal Bacterial Overgrowth (SIBO) Read More Video Capsule Endoscopy (VCE) Read More Abdominal Pain Read More Gluten Intolerance Read More Celiac Disease Read More Constipation Read More Diarrhea Read More Gas and Bloating Read More Gastroparesis Read More Difficulty Swallowing Read More Diverticular Disease Read More Stomach and Intestine Ulcers Read More Hiatal Hernia Read More FibroScan testing Read More Make an Appointment #### Team URL: https://orlandogastroenterology.com/team/ #### Terms and Conditions Terms of Service: The following terms and conditions govern all use of the orlandogastroenterology.com website and all content, services and products available at or through the website (taken together, the Website). 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This Agreement will be binding upon and will inure to the benefit of the parties, their successors and permitted assigns. #### Test URL: https://orlandogastroenterology.com/test/ #### Testimonials Everyone was attentive and professional Maritza Gonzalez Great staff friendly and attentive Maritza Gonzalez I am pleased with the care and the environment Katy Perez Blue ribbon service. Dr. Pothamsetty and staff are the best. Despite COVID induced restrictions, my colonoscopy felt safe, comfortable and expedited with no compromise on much needed precautions. Thanks doc, and keep up the good work Mitch O’Connell Very satisfied with my experience! Joe Villano Is my first appointment and so excited for your attention MD Services Pleasant, knowledgeable physician with excellent bedside manners. Staff is friendly and helpful. The surgery center is clean, new and efficient. Felt very much at ease throughout the process of getting my colonoscopy done. Strongly recommend. Paul Sherman They treat people with a lot of respect and are very nice and have great service Lithania Thadal Staff was amazing nurse was very profesional and made me feel at ease thank you all Angel Ortiz Very attentive. organized, and care about their patients Eduarda Sader Have been receiving great care and although the appointments are telehealth, the process is very smooth. Brianna Brown I would definitely recommend Orlando Gastroenterology,best crew in Orlando Thank you guys for all the help👌🙏🤗 Engels Rosario Dr. Sharma is professional, caring and a great listener. I would highly recommend him. Kathy Horbus Had a great experience. Service was outstanding! Ann Samball Dr. Sharma is great. Very interested in what you have to say. Maryann Gilpin The staff are extremely kind, friendly and very professional. Evelyn Custodio The entire experience was great from the receptionist staff to the pre and post and Dr Mejia was amazing Charmaine Evans My appointment thru telepath went extremely well. The staff was thorough and professional in particular Jasmine followed up several times to make sure my chart and information was complete. Doctor Pothamsetty was excellent and was extremely thorough in his diagnosis. I truly felt that I was in excellent care. I highly recommend Orlando Gastroenterologist for… Tanya Yehuda Christina was great! Very friendly staff and nurses, great customer service, WM M Orland Gastrologist is excellent. They made sure my needs were met, they were kind, funny and very professional. Helen Rynkewicz Service is only as good as the people who commit to great service. Dr. Pothamsetti has been my doctor for over 10 years and will continue to be.. I trust him and his tean Fanya Jones I have visited the Millenia surgery center multiple times for a procedure and the staff there is amazing. I am always anxious before the procedure and the amount of care that they take is something I have never experienced. I want to personally thank them for making it so comfortable and easy. Specially Dr Anuj… Varadaraju Abhimanyu The staff and doctor Awsome team work and they all take care of there paients … Shavanda Wright This office is very well organized, team oriented. Jennifer and nursing department are on time with phone calls. Everybody have a nice and professional attitude. Colonoscopies are not fun, without the support of secretaries, nurses and good doctors everybody will run away from them. Maria Florence Oliverio My experience with Dr Mejia.all ways is amazing, he hes a person care ❤ a lot for his patients. Always take a time for explaining everything you want.to know..HE IS AMAZING.. Glenda Gadea Staff was extremely nice. They showed that they cared. Made me feel very comfortable before the procedures Berril Cox Orlando Gastroenterology treated me like family. They have a personable and down home fill. Thank you for your services. Joseph Jacobs I am very pleased with their service, very friendly and professional. Very informative and caring. I would recommend them 100%. VE B Amazing staff, very professional and helpful with all my questions and concerns. Dr. Sharma is ABSOLUTELY AWESOME! Joseph Walker My experiences was very positive the People’s there was very nice and polite they respected me and the procedures went well Willie Denmark I was extremely pleased with my teleconference call on August 11, 2021. The Dr. was very engaging & informative. The staff were courteous & friendly. I look forward to future visits as necessary. Sharon Salamacha The whole experience was beautiful. From the front desk, the nurses, and the doctor who performed the procedure was just professionalism through out the time I was there. One of the best places that I had visit, Paul Lindsay Being a blind individual sometimes makes it difficult to communicate with the staff and doctors but I find it quite pleasure to be a patient at Orlando Gastroenterology. The staff and my personal doctor is awesome. This a place that cares about your needs and health! Thank you! 😊 Deborah Willams Office personnel was very helpful and quick about setting up my appointments, and Dr was very thorough during our consultation answering all my concerns Ana Jimenez I was so nervous, and the staff here was incredible at getting me to relax. I had Dr. Mejia and he was very personable with a great bedside manner. Thank you to all!! L Pollman It’s always been a pleasure to be Dr Mejia’s patient, he listens y explains everything. He’s very attentive and his office staff too, they always answer and return calls. I definitely recommend Dr Mejia Ana Diaz Dr. Mejia is amazing! His team is in the same way. I really recommend him. He always has the patience to explain everything to me. Noele Troncarelli The best experience amazing sweet staff super accommodating 💕. Thank you again ❤️ Francesca Nciolas I was dying of nerves !! But inside I talked to Rachel and I felt more confident, then I met Dr. Mejias it was a very quick but informative visit. Then Vanessa and the whole team made me feel safe. Very good team!! Aleysha Tirado My experience with the Gastroenterology was great. From the receptionist, nurses and doctor everyone was professional and took very good care of Ms. Brown. Ms. Brown Thanks the entire staff! Cathy Carr Great Caring Staff. The Nurse Practitioner listened to all my concerns and answered my questions. She was patient, did not come across rushed. She followed up and sent the information she promised to send. Juanita Vinson The are al profesional! Great people and great attention. Excellent !!! Yenifer Luna Orlando Gastroenterology has been a excellent provider with a evidenced based practice for our family. We are pleased with the professionalism, courtesy, cleanliness of the office and staff and we feel confident at this time with every aspect of their service. FIVE Stars. You can feel welcomed and cared for in this office. Gene and Marilyn McFalls I had a colonoscopy by Dr. Sharma. His staff at the surgery center was very professional and kind. Vanessa, Kristie and Joselin were all attentive and considerate. I would recommend this medical team to anyone. Much better than my experience at DP Hospital! KERRY SKOVRAN I started with another office within Advent Health but communication was unbearable taking a month after consult to even hear back (despite multiple attempts on my part). Finally getting scheduled (2 months out), weeks later I received a call that the doctor would not be in that day and they needed to reschedule- 2 months… Kathleen W I saw Dr. Mejia about 6yrs ago and he left such a wonderful lasting impression, that he came to mind immediately now that I am having gastrointestinal issues again. It’s not often that you’re blessed to come across a Dr that TRULY CARES about your well being. Even the office staff is caring and efficient… Queen levy Excellent Practice! Friendly , kind and professional staff. The Doctors are excellent! Highly recommend, Dr. Mejia is my best !!! great bedside manners, very knowledgeable, good listener and communicator. His staff is very caring and professional. … Gabriel Montalvo Many thanks to Dr. Pothamsetty and his excellent team at the surgery center for taking such good care of my mother. She had multiple complex Gastro issues and they took care of her in a very professional, caring and compassionate manner. Kudos to the doc and his team Maria Gonzalez Best Doctor to have very compassionate, bedside matter over the top, great doctor over all. Really takes time and cares for his patients. Can’ t say enough about Dr. Pothamsetty MD. Good experience with his staff as well. Explains what’s going on with your health and compassionate as well. Thank you Dr Pothamsetty for all… Sandra Cormier Dr. Mejia is the best GI specialist in this town. He is very intelligent and very knowledge doctor. He goes over your result in detail and explains everything Rob Taylor Dr. Mejia and his staff is a great team. They take care off every patient like their own family member. He is very caring and great listener and explain each and every detail very nicely to their patients. Valenti Lopez Great doctor! I came here last week for my screening. He came to my room with a smiling face and talked to me and went over my results. He is a very calm and humble doctor, listens to his patients first and then explains. He very knowledgeable and he knows what he is talking about. Jessica Loard Very good doctor and staff. Everything from my consultation, scheduling of procedure and procedure itself went off seamlessly. Everything was explained to me in detail by doctor and staff, so no surprises. Smith Roy Dr. Luis Mejia is an awesome doctor, very caring and compassionate. He and his team take such good care of our family….we are very grateful Ridhi Sharma #### Timetable Timetable Pick a perfect time for your next visit! All Events Primary Health Care Emergency Dental Pediatrics Pulmonary X-Ray Cardiology Traumotology Neurology Monday Tuesday Wednesday Thursday Friday Saturday Sunday 08:00 Primary Health Care 08:00 - 11:00 Dr.Paul JohnesOffice 13, Hall A Dental 08:00 - 10:00 Dr.Paul JohnesOffice 13, Hall A Primary Health Care 08:00 - 10:00 Dr.Paul JohnesOffice 13, Hall A Primary Health Care 08:00 - 10:00 Dr.Paul JohnesOffice 13, Hall A 09:00 Pediatrics 09:00 - 11:00 Dr. Sarah ParkerOffice 81, Hall C Neurology 09:00 - 11:00 Dr.John JohnesOffice 7, Hall A Cardiology 09:00 - 11:00 Dr.John JohnesOffice 7, Hall A 10:00 Primary Health Care 10:00 - 12:00 Dr.Paul JohnesOffice 13, Hall A Traumotology 10:00 - 12:00 Dr.John JohnesOffice 7, Hall A X-Ray 10:00 - 12:00 Dr.John JohnesOffice 7, Hall A 11:00 Emergency 11:00 - 14:00 Dr.John JohnesOffice 7, Hall A Pulmonary 11:00 - 13:00 Dr.John JohnesOffice 7, Hall A Pediatrics 11:00 - 14:00 Dr. Sarah ParkerOffice 81, Hall C 12:00 Cardiology 12:00 - 15:00 Dr.John JohnesOffice 7, Hall A Dental 12:00 - 14:00 Dr.Paul JohnesOffice 13, Hall A Pulmonary 12:00 - 15:00 Dr.John JohnesOffice 7, Hall A 13:00 X-Ray 13:00 - 15:00 Dr.John JohnesOffice 7, Hall A Emergency 13:00 - 15:00 Dr.John JohnesOffice 7, Hall A Primary Health Care 13:00 - 16:00 Dr.Paul JohnesOffice 13, Hall A 14:00 Dental 14:00 - 16:00 Dr.Paul JohnesOffice 13, Hall A Neurology 14:00 - 16:00 Dr.John JohnesOffice 7, Hall A 15:00 Primary Health Care 15:00 - 17:00 Dr.Paul JohnesOffice 13, Hall A Traumotology 15:00 - 17:00 Dr.John JohnesOffice 7, Hall A Dental 15:00 - 19:00 Dr.Paul JohnesOffice 13, Hall A 16:00 Pediatrics 16:00 - 19:00 Dr. Sarah ParkerOffice 81, Hall C Emergency 16:00 - 19:00 Dr.John JohnesOffice 7, Hall A 17:00 18:00 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 08:00 Primary Health Care 08:00 - 11:00 Dr.Paul JohnesOffice 13, Hall A Primary Health Care 08:00 - 10:00 Dr.Paul JohnesOffice 13, Hall A Primary Health Care 08:00 - 10:00 Dr.Paul JohnesOffice 13, Hall A 09:00 10:00 Primary Health Care 10:00 - 12:00 Dr.Paul JohnesOffice 13, Hall A 11:00 13:00 Primary Health Care 13:00 - 16:00 Dr.Paul JohnesOffice 13, Hall A 14:00 15:00 Primary Health Care 15:00 - 17:00 Dr.Paul JohnesOffice 13, Hall A 16:00 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 11:00 Emergency 11:00 - 14:00 Dr.John JohnesOffice 7, Hall A 12:00 13:00 Emergency 13:00 - 15:00 Dr.John JohnesOffice 7, Hall A 14:00 16:00 Emergency 16:00 - 19:00 Dr.John JohnesOffice 7, Hall A 17:00 18:00 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 08:00 Dental 08:00 - 10:00 Dr.Paul JohnesOffice 13, Hall A 09:00 12:00 Dental 12:00 - 14:00 Dr.Paul JohnesOffice 13, Hall A 13:00 14:00 Dental 14:00 - 16:00 Dr.Paul JohnesOffice 13, Hall A 15:00 Dental 15:00 - 19:00 Dr.Paul JohnesOffice 13, Hall A 16:00 17:00 18:00 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 09:00 Pediatrics 09:00 - 11:00 Dr. Sarah ParkerOffice 81, Hall C 10:00 11:00 Pediatrics 11:00 - 14:00 Dr. Sarah ParkerOffice 81, Hall C 12:00 13:00 16:00 Pediatrics 16:00 - 19:00 Dr. Sarah ParkerOffice 81, Hall C 17:00 18:00 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 11:00 Pulmonary 11:00 - 13:00 Dr.John JohnesOffice 7, Hall A 12:00 Pulmonary 12:00 - 15:00 Dr.John JohnesOffice 7, Hall A 13:00 14:00 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 10:00 X-Ray 10:00 - 12:00 Dr.John JohnesOffice 7, Hall A 11:00 13:00 X-Ray 13:00 - 15:00 Dr.John JohnesOffice 7, Hall A 14:00 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 09:00 Cardiology 09:00 - 11:00 Dr.John JohnesOffice 7, Hall A 10:00 12:00 Cardiology 12:00 - 15:00 Dr.John JohnesOffice 7, Hall A 13:00 14:00 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 10:00 Traumotology 10:00 - 12:00 Dr.John JohnesOffice 7, Hall A 11:00 15:00 Traumotology 15:00 - 17:00 Dr.John JohnesOffice 7, Hall A 16:00 Monday Tuesday Wednesday Thursday Friday Saturday Sunday 09:00 Neurology 09:00 - 11:00 Dr.John JohnesOffice 7, Hall A 10:00 14:00 Neurology 14:00 - 16:00 Dr.John JohnesOffice 7, Hall A 15:00 Monday Primary Health Care 08:00 - 11:00 Dr.Paul JohnesOffice 13, Hall A Emergency 11:00 - 14:00 Dr.John JohnesOffice 7, Hall A Dental 14:00 - 16:00 Dr.Paul JohnesOffice 13, Hall A Pediatrics 16:00 - 19:00 Dr. Sarah ParkerOffice 81, Hall C Tuesday Pediatrics 09:00 - 11:00 Dr. Sarah ParkerOffice 81, Hall C Pulmonary 11:00 - 13:00 Dr.John JohnesOffice 7, Hall A X-Ray 13:00 - 15:00 Dr.John JohnesOffice 7, Hall A Primary Health Care 15:00 - 17:00 Dr.Paul JohnesOffice 13, Hall A Wednesday Dental 08:00 - 10:00 Dr.Paul JohnesOffice 13, Hall A Primary Health Care 10:00 - 12:00 Dr.Paul JohnesOffice 13, Hall A Cardiology 12:00 - 15:00 Dr.John JohnesOffice 7, Hall A Traumotology 15:00 - 17:00 Dr.John JohnesOffice 7, Hall A Thursday Primary Health Care 08:00 - 10:00 Dr.Paul JohnesOffice 13, Hall A Traumotology 10:00 - 12:00 Dr.John JohnesOffice 7, Hall A Dental 12:00 - 14:00 Dr.Paul JohnesOffice 13, Hall A Neurology 14:00 - 16:00 Dr.John JohnesOffice 7, Hall A Emergency 16:00 - 19:00 Dr.John JohnesOffice 7, Hall A Friday Primary Health Care 08:00 - 10:00 Dr.Paul JohnesOffice 13, Hall A X-Ray 10:00 - 12:00 Dr.John JohnesOffice 7, Hall A Pulmonary 12:00 - 15:00 Dr.John JohnesOffice 7, Hall A Saturday Neurology 09:00 - 11:00 Dr.John JohnesOffice 7, Hall A Pediatrics 11:00 - 14:00 Dr. Sarah ParkerOffice 81, Hall C Emergency 13:00 - 15:00 Dr.John JohnesOffice 7, Hall A Dental 15:00 - 19:00 Dr.Paul JohnesOffice 13, Hall A Sunday Cardiology 09:00 - 11:00 Dr.John JohnesOffice 7, Hall A Primary Health Care 13:00 - 16:00 Dr.Paul JohnesOffice 13, Hall A Encompassing All Accessible Exclusive Medical Treatment We offer extensive medical procedures to outbound and inbound patients. get in touch #### Transforming Orlando into a center for digestive health Our digestive doctor team is committed to providing digestive health to central Florida doctors and patients. We offer digestive health services by appointment Mon-Fri. 8am-5pm. Our main center is located in MetroWest, Orlando, FL. Call our center to schedule an appointment at our office by phone. A health care professional will respond promptly. Our center for digestive health and GI health is committed to taking care of you. We employ the latest advanced diagnostics and endoscopic therapies. Digestive health is paramount to healthy living. Our digestive health patients often choose us directly but are also sent to us by referring physicians for treatment. Make an appointment to see one of our digestive health team doctors and nurse practitioners. We offer convenient center access for digestive procedures colon cancer screening and treat common GI health concerns: Endoscopy to diagnose digestive health concerns in the upper GI tract.Colonoscopy Procedure to diagnose health concerns in lower GI regions.In-office group of nurse professionals to evaluate your GI health needs.On-site treatments at our centerWe treat heartburn, hemorrhoids, and many other GI issues. Ranging from difficulty swallowing to colon cancer screening our facility professionals are here to answer your questions. We have a group of GI specialists who have completed the highest medical degree and board certification in the field. Imagine if our area could be transformed into an area where heartburn and common GI problems are a thing of the past. Our board-certified doctors and clinical staff are here for you. Call our center today to schedule an appointment. Common Ailments we help with at our center: Ulcerative ColitisBarret's EsophagusConstipationCrohn's DiseaseVideo Capsule EndoscopyFibroscanDiarrheaDifficulty SwallowingDigestive Tract BleedingDiverticular DiseaseGas and BloatingSmall Intestinal Bacterial OvergrowthAnorectal ManometryGastroparesisGluten IntoleranceHemorrhoidsHepatitisHiatal HerniaInflammatory Bowel DiseasePeptic Ulcers See our locations for details. #### Typography Typography H1 Heading Each business niche may require a unique functionality of its own. With that notion in mind, our team of professional WordPress coders has been working day and night to roll out a definitive collection of built-in WordPress plugins, that come with each of our WordPress themes... Due to the fact that this is a WordPress theme, the process of installing it and using it is truly as easy as it gets! Read our documentation to understand how fast you can go from purchasing a JetImpex WordPress theme to actually using it as a live skin for your company’s webpage. H2 Heading Each business niche may require a unique functionality of its own. With that notion in mind, our team of professional WordPress coders has been working day and night to roll out a definitive collection of built-in WordPress plugins, that come with each of our WordPress themes... Due to the fact that this is a WordPress theme, the process of installing it and using it is truly as easy as it gets! Read our documentation to understand how fast you can go from purchasing a JetImpex WordPress theme to actually using it as a live skin for your company’s webpage. H3 Heading Each business niche may require a unique functionality of its own. With that notion in mind, our team of professional WordPress coders has been working day and night to roll out a definitive collection of built-in WordPress plugins, that come with each of our WordPress themes... Due to the fact that this is a WordPress theme, the process of installing it and using it is truly as easy as it gets! Read our documentation to understand how fast you can go from purchasing a JetImpex WordPress theme to actually using it as a live skin for your company’s webpage. H4 Heading Each business niche may require a unique functionality of its own. With that notion in mind, our team of professional WordPress coders has been working day and night to roll out a definitive collection of built-in WordPress plugins, that come with each of our WordPress themes... Due to the fact that this is a WordPress theme, the process of installing it and using it is truly as easy as it gets! Read our documentation to understand how fast you can go from purchasing a JetImpex WordPress theme to actually using it as a live skin for your company’s webpage. H5 Heading Each business niche may require a unique functionality of its own. With that notion in mind, our team of professional WordPress coders has been working day and night to roll out a definitive collection of built-in WordPress plugins, that come with each of our WordPress themes... Due to the fact that this is a WordPress theme, the process of installing it and using it is truly as easy as it gets! Read our documentation to understand how fast you can go from purchasing a JetImpex WordPress theme to actually using it as a live skin for your company’s webpage. H6 Heading Each business niche may require a unique functionality of its own. With that notion in mind, our team of professional WordPress coders has been working day and night to roll out a definitive collection of built-in WordPress plugins, that come with each of our WordPress themes... Due to the fact that this is a WordPress theme, the process of installing it and using it is truly as easy as it gets! Read our documentation to understand how fast you can go from purchasing a JetImpex WordPress theme to actually using it as a live skin for your company’s webpage. Unordered list Parallax Sections Retina Homepage Shortcode Central Ultimate Font Collection Theme Ordered list Parallax Sections Retina Homepage Shortcode Central Ultimate Font Collection Theme Blockquotes All the WordPress themes that we have here have had a vast team of professional designers sketching, working and executing the ultimate visual look for it. With such a wide range of choices at hand, we strongly advise you to stick to the WordPress Theme that is based on your business’ or a closely related field. Either way, thanks to all the diversity here you will be able to choose a Theme that can be either of a formal color scheme with some light colors in it or a more vivid one, featuring bold textures and hues! It’s perfect to display the members of your staff, team or working force. Within Bryte theme you. Adam Smith Each business niche may require a unique functionality of its own. With that notion in mind, our team of professional WordPress coders has been working day and night to roll out a definitive collection of built-in WordPress plugins, that come with each of our WordPress themes... Due to the fact that this is a WordPress theme, the process of installing it and using it is truly as easy as it gets! Read our documentation to understand how fast you can go from purchasing a JetImpex WordPress theme to actually using it as a live skin for your company’s webpage. Also, the WordPress CMS (Content Management System) allows you to easily change the content (text; multimedia; blocks; pages) of any part of your new theme! Some other styles Bold Text: Whether you found me on YouTube Italic: Whether you found me on YouTube Strike-through: Whether you found me on YouTube Link: Whether you found me on YouTube Inline Code: Whether you found me on YouTube Centre aligned image When you need your company to have a new website or if you venture on updating your old webpage with a new look and functionality, the choices are versatile. Assuming that you will go the easy way and choose a theme for your WordPress website, the overall number of characteristics that you will need to keep in mind narrows down significantly. Each business niche may require a unique functionality of its own. With that notion in mind, our team of professional WordPress coders has been working day and night to roll out a definitive collection of built-in WordPress plugins, that come with each of our WordPress themes... Left aligned image When you need your company to have a new website or if you venture on updating your old webpage with a new look and functionality, the choices are versatile. Assuming that you will go the easy way and choose a theme for your WordPress website, the overall number of characteristics that you will need to keep in mind narrows down significantly. Right aligned image When you need your company to have a new website or if you venture on updating your old webpage with a new look and functionality, the choices are versatile. Assuming that you will go the easy way and choose a theme for your WordPress website, the overall number of characteristics that you will need to keep in mind narrows down significantly. Large image When you need your company to have a new website or if you venture on updating your old webpage with a new look and functionality, the choices are versatile. Assuming that you will go the easy way and choose a theme for your WordPress website, the overall number of characteristics that you will need to keep in mind narrows down significantly. Each business niche may require a unique functionality of its own. With that notion in mind, our team of professional WordPress coders has been working day and night to roll out a definitive collection of built-in WordPress plugins, that come with each of our WordPress themes... #### Ulcerative Colitis Ulcerative Colitis Physician in Orlando, FL https://www.youtube.com/watch?v=XXNAKBjRjgU Ulcerative Colitis: Manage it, Orlando Patient Ulcerative colitis is a disease of the large intestine, specifically the colon and rectum. It causes inflammation and sores (ulcers) in the lining of these areas. It is an inflammatory bowel disease (IBD).Ulcerative colitis presents symptoms that are similar to other bowel disorders, including Crohn’s disease. What does an Ulcerative Colitis physician do? A UC physician—typically a board-certified gastroenterologist—specializes in diagnosing, treating, and managing ulcerative colitis. They help control symptoms, monitor inflammation, adjust medications, and prevent complications. What are the symptoms of Ulcerative colitis? Ulcerative colitis symptoms are predominantly abdominal pain and bloody diarrhea. Other symptoms include:FatigueLoss of appetiteAnemiaJoint painBleeding of the rectumWeight lossFailure to thrive (especially in children)Loss of body fluids When should I see a UC specialist? You should see a specialist if you experience symptoms such as:Persistent diarrheaBlood or mucus in stoolsOngoing abdominal painUnexplained weight lossFatigueA specialist can determine if UC or another condition is the cause. What causes Ulcerative colitis? Doctors don’t know what causes this disease. It may or may not be related to abnormalities of the immune system that exist in patients with the disease.At Orlando Gastroenterology, we diagnose ulcerative colitis with testing that includes a physical exam, blood tests, stool sample evaluation, colonoscopy, sigmoidoscopy, barium enemas, CT scans, and x-rays. How is ulcerative colitis diagnosed? Diagnosis usually includes:Colonoscopy with biopsies (most accurate)Stool tests to rule out infectionsBlood tests for inflammation indicators How often should I follow up with a UC specialist? During active flares: every 4–8 weeksDuring remission: every 6–12 monthsYour doctor may adjust this depending on symptoms and treatment. Do I need regular colonoscopies if I have UC? Yes. Long-term UC increases colon cancer risk. Most specialists recommend:A colonoscopy every 1–3 years once you’ve had UC for at least 8 years. Can diet help manage ulcerative colitis? Diet does not cause or cure UC, but certain foods may trigger symptoms. Many specialists recommend:A low-residue diet during flaresAvoiding foods that worsen symptoms (e.g., dairy, high-fiber foods during flares, spicy foods) Should I see a Orlando GI specialist or a general doctor for UC? A general doctor can start the conversation, but a gastroenterologist is the most qualified to diagnose and manage UC long-term. Ulcerative colitis treatment Treatment varies from person to person. Doctors may implement drug therapies, surgery, and hospitalization. A UC physician—typically a board-certified gastroenterologist—specializes in diagnosing, treating, and managing ulcerative colitis. They help control symptoms, monitor inflammation, adjust medications, and prevent complications.Ulcerative colitis symptoms are predominantly abdominal pain and bloody diarrhea. Other symptoms include:FatigueLoss of appetiteAnemiaJoint painBleeding of the rectumWeight lossFailure to thrive (especially in children)Loss of body fluidsYou should see a specialist if you experience symptoms such as:Persistent diarrheaBlood or mucus in stoolsOngoing abdominal painUnexplained weight lossFatigueA specialist can determine if UC or another condition is the cause.Doctors don’t know what causes this disease. It may or may not be related to abnormalities of the immune system that exist in patients with the disease.At Orlando Gastroenterology, we diagnose ulcerative colitis with testing that includes a physical exam, blood tests, stool sample evaluation, colonoscopy, sigmoidoscopy, barium enemas, CT scans, and x-rays.Diagnosis usually includes:Colonoscopy with biopsies (most accurate)Stool tests to rule out infectionsBlood tests for inflammation indicatorsDuring active flares: every 4–8 weeksDuring remission: every 6–12 monthsYour doctor may adjust this depending on symptoms and treatment.Yes. Long-term UC increases colon cancer risk. Most specialists recommend:A colonoscopy every 1–3 years once you’ve had UC for at least 8 years.Diet does not cause or cure UC, but certain foods may trigger symptoms. Many specialists recommend:A low-residue diet during flaresAvoiding foods that worsen symptoms (e.g., dairy, high-fiber foods during flares, spicy foods)A general doctor can start the conversation, but a gastroenterologist is the most qualified to diagnose and manage UC long-term.Treatment varies from person to person. Doctors may implement drug therapies, surgery, and hospitalization. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Video Capsule Endoscopy (VCE) Orlando Physicians Conduct Video Capsule Endoscopy https://www.youtube.com/watch?v=O5ie3P7SiA8 Visit an Orlando Doctor for Video Capsule Endoscopy This is a type of endoscopy in which a patient swallows a small capsule that contains a tiny camera. As the capsule travels through the gastrointestinal system, the camera records data and sends it to a sensor attached to a belt worn by the patient. In a day or so, the camera and capsule are expelled from the body in a bowel movement.While a traditional endoscope contains small instruments that can treat symptoms and scrape tissue for biopsy, capsule endoscopy can only collect and send data. Conditions that capsule endoscopy can identify At Orlando Gastroenterology, physicians use this diagnostic technology to identify sources of bleeding; diagnose digestive tract polyps and tumors; and identify inflammatory bowel disease, celiac disease, and other illnesses and conditions. Preparing for capsule endoscopy Preparing for capsule endoscopy is similar to preparing for traditional endoscopy. Healthcare staff instruct patients to fast overnight, take laxatives, and postpone taking regular medications.The procedure itself involves being fitted with a belt that holds a sensor and swallowing a capsule that contains the data recording device. Make a Payment Make an Appointment Name Date of Birth: Phone Number Requested Date of Appointment Time Requested Additional Information #### Viral Gastroenteritis Viral Gastroenteritis What is Viral Gastroenteritis? Viral gastroenteritis is an intestinal infection caused by several different viruses. Highly contagious, viral gastroenteritis is the second most common illness in the United States. It causes millions of cases of diarrhea each year.Anyone can get viral gastroenteritis and most people recover without any complications. However, viral gastroenteritis can be serious when people cannot drink enough fluids to replace what is lost through vomiting and diarrhea — especially infants, young children, the elderly, and people with weak immune systems. What Are The Symptoms of Viral Gastroenteritis? The main symptoms of viral gastroenteritis are watery diarrhea and vomiting. Other symptoms are headache, fever, chills, and abdominal pain. Symptoms usually appear within 4 to 48 hours after exposure to the virus and last for 1 to 2 days, though symptoms can last as long as 10 days. What Are The Causes? The viruses that cause viral gastroenteritis damage the cells in the lining of the small intestine. As a result, fluids leak from the cells into the intestine and produce watery diarrhea. Four types of viruses cause most viral gastroenteritis.Rotavirus is the leading cause among children 3 to 15 months old and the most common cause of diarrhea in children under the age of 5 years. Symptoms of rotavirus infection appear 1 to 2 days after exposure. Rotavirus typically causes vomiting and watery diarrhea for 3 to 8 days, along with fever and abdominal pain. Rotavirus can also infect adults who are in close contact with infected children, but the symptoms in adults are milder. In the United States, rotavirus infections are most common from November to April.Adenovirus occurs mainly in children under the age of 2 years. Of the 49 types of adenoviruses, one strain affects the gastrointestinal tract causing vomiting and diarrhea. Symptoms typically appear 1 week after exposure. Adenovirus infections occur year round.Caliciviruses cause infection in people of all ages. This family of viruses is divided into 4 types, the noroviruses being the most common and most responsible for infecting people. The noroviruses are usually responsible for epidemics of viral gastroenteritis and occur more frequently from October to April. Infected people experience vomiting and diarrhea, fatigue, headache, and sometimes muscle aches. The symptoms appear within 1 to 3 days of exposure.Astrovirus also infects primarily infants, young children, and the elderly. This virus is most active during the winter months. Vomiting and diarrhea appear within 1 to 3 days of exposure.Viral gastroenteritis is often mistakenly called “stomach flu,” but it is not caused by the influenza virus and it does not infect the stomach. Also, viral gastroenteritis is not caused by bacteria or parasites. For information about bacterial infections, please see the Bacteria and Foodborne Illness fact sheet from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). TransmissionViral gastroenteritis is highly contagious. The viruses are commonly transmitted by people with unwashed hands. People can get the viruses through close contact with infected individuals by sharing their food, drink, or eating utensils, or by eating food or drinking beverages that are contaminated with the virus. Noroviruses in particular, are typically spread to other people by contact with stool or vomit of infected people and through contaminated water or food — especially oysters from contaminated waters.People who no longer have symptoms may still be contagious, since the virus can be found in their stool for up to 2 weeks after they recover from their illness. Also, people can become infected without having symptoms and they can still spread the infection.Outbreaks of viral gastroenteritis can occur in households, child care settings, schools, nursing homes, cruise ships, camps, dormitories, restaurants, and other places where people gather in groups. If you suspect that you were exposed to a virus in one of these settings or by foods prepared on the premise of places such as a restaurant, deli, or bakery, you may want to contact your local health department, which tracks outbreaks. DiagnosisIf you think you have viral gastroenteritis, you may want to see your doctor. Doctors generally diagnose viral gastroenteritis based on the symptoms and a physical examination. Your doctor may ask for a stool sample to test for rotavirus or to rule out bacteria or parasites as the cause of your symptoms. No routine tests are currently available for the other types of viruses. Treatment Most cases of viral gastroenteritis resolve over time without specific treatment. Antibiotics are not effective against viral infections. The primary goal of treatment is to reduce the symptoms, and prompt treatment may be needed to prevent dehydration.Your body needs fluids to function. Dehydration is the loss of fluids from the body. Important salts or minerals, known as electrolytes, can also be lost with the fluids. Dehydration can be caused by diarrhea, vomiting, excessive urination, excessive sweating, or by not drinking enough fluids because of nausea, difficulty swallowing, or loss of appetite.In viral gastroenteritis, the combination of diarrhea and vomiting can cause dehydration. The symptoms of dehydration are:excessive thirstdry mouthlittle or no urine or dark yellow urinedecreased tearssevere weakness or lethargydizziness or lightheadednessIf you notice any of these symptoms, you should talk to your doctor. Mild dehydration can be treated by drinking liquids. Severe dehydration may require intravenous fluids and hospitalization. Untreated severe dehydration can be life threatening.Children present special concerns. Because of their smaller body size, infants and children are at greater risk of dehydration from diarrhea and vomiting. Oral rehydration solutions such as Pedialyte can replace lost fluids, minerals, and salts.The following steps may help relieve the symptoms of viral gastroenteritis:Allow your gastrointestinal tract to settle by not eating for a few hours.Sip small amounts of clear liquids or suck on ice chips if vomiting is still a problem.Give infants and children oral rehydration solutions to replace fluids and lost electrolytes.Gradually reintroduce food, starting with bland, easy-to-digest food, like toast, broth, apples, bananas, and rice.Avoid dairy products, caffeine, and alcohol until recovery is complete.Get plenty of rest.PreventionPrevention is the best way to avoid viral gastroenteritis by following the tips listed below. No vaccine is available for viral gastroenteritis with the exception of a newly released rotavirus vaccine called Rotateq. The oral vaccine for infants aged 6 to 32 weeks was approved in February 2006 by the U.S. Food and Drug Administration. Otherwise, you can avoid infection by:washing your hands thoroughly for 20 seconds after using the bathroom or changing diaperswashing your hands thoroughly for 20 seconds before eatingdisinfecting contaminated surfaces such as counter tops and baby changing stationsnot eating or drinking foods or liquids that might be contaminated Points to Remember Viral gastroenteritis is a highly contagious infection of the intestines caused by one of several viruses.Although sometimes called “stomach flu,” viral gastroenteritis is not caused by the influenza virus and does not affect the stomach.The main symptoms are watery diarrhea and vomiting.Anyone can get viral gastroenteritis through unwashed hands, close contact with an infected person, or food and beverages that contain the virus.Diagnosis is based on the symptoms and a physical examination. Currently only rotavirus can be rapidly detected in a stool test.Viral gastroenteritis has no specific treatment; antibiotics are not effective against viruses. Treatment focuses on reducing the symptoms and preventing dehydration.The symptoms of dehydration are excessive thirst, dry mouth, dark yellow urine or little or no urine, decreased tears, severe weakness or lethargy, and dizziness or lightheadedness.Infants, young children, the elderly, and people with weak immune systems have a higher risk of developing dehydration due to vomiting and diarrhea.People with viral gastroenteritis should rest, drink clear liquids, and eat easy-to-digest foods.For infants and young children, oral rehydration solutions can replace lost fluids, minerals, and salts.Avoid viral gastroenteritis by washing hands thoroughly after using the bathroom or changing diapers, disinfecting contaminated surfaces, and avoiding foods or liquids that might be contaminated. The following information comes from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services. To ensure that you’re viewing the most up-to-date information, we recommend visiting the viral gastroenteritis entry at the NIDDK website. 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