Gastroenterology, Internal Medicine & Concierge V.I.P. Medicine
734 Mowry Avenue, Fremont, CA 94538
Acid Reflux - Gastroesophageal Reflux Disease (GERD)
Acid Reflux (GERD) is a more serious form of common Gastroesophageal Reflux (GER). GER is an Esophagus disease where stomach contents rise up into the Esophagus. GER is also called Acid Reflux or Acid Regurgitation. The Esophagus is the tube that carries food from the mouth to the stomach.
Barrett’s Esophagus GERD is where the lining of the Esophagus is damaged by stomach acid and changed to a lining similar to that of the stomach. Barrett's Esophagus can be treated with Radiofrequency Ablation (RFA).
A healthy colon is like a long muscular tube that squeezes food through the large intestine to the rectum.
Diverticulosis is a condition that occurs when small pouches form inside the large intestine. These pouches can cause symptoms such as cramping, bloating, constipation, diarrhea, pain and bleeding, although some people do not experience any symptoms. The pouches can become infected, causing a more serious problem called diverticulosis.
Diverticulosis is probably caused by a high fat, low fiber diet or by genetic factors. While it cannot be reversed, it can be controlled. The treatment usually consists of diet changes and or medication. In severe cases surgery may be recommended. The diagnostic tests include colonoscopy, sigmoidoscopy, and/or barium X-ray.
Hemorrhoids are veins in the anal canal or rectum that become swollen or stretched. Symptoms may include rectal bleeding, pain, burning, and itching although in many cases they do not cause any problems.
There are two types of hemorrhoids: external and internal. External are swollen veins that can be seen under the skin outside the rectum. They look like a small bulge and are the same color as the skin. Internal hemorrhoids are swollen veins inside the rectum. Hemorrhoids develop as a result of increased pressure caused by straining during bowel movements or by the increased pressure on the rectum created by the fetus during pregnancy.
About 50% of the population has them, and treatment includes eliminating constipation, increasing water and fiber intake; over the counter medications may be used to reduce swelling and eliminate symptoms.
Hemorrhoids that bleed excessively or are very painful may be treated with infrared coagulation. This treatment, performed at the Fremont Surgery Center, utilizes a laser like device to destroy the hemorrhoid. Post procedure bleeding and discomfort are minimal, and the recovery period is usually one day or less. This treatment can eliminate the need for surgical removal in many cases.
Hepatitis C is a virus known to cause inflammation and subsequent injury to the liver. It is the most common blood borne infection in the United States; an estimated 3.9 million Americans are infected. Hepatitis C is the leading indication for liver transplantation and a major cause of Cirrhosis and Hepatocellular Carcinoma (Centers for Disease Control and Prevention).
According to the Centers for Disease Control and Prevention, individuals with the following risk factors should be screened for Hepatitis C: a.) Blood transfusion or solid organ transplant before 1992, b.) Injection or intranasal drug use, c.) History of dialysis, d.) HIV infection, e.) Persistently abnormal alanine aminotransferase levels (ALT), f.) Born to a HCV positive mother.
Hepatitis C can often be present without symptoms. Many patients feel quite healthy until significant liver damage causes the liver to begin to fail. If you fall into any of the above risk categories or are concerned you may have been exposed to Hepatitis C, please talk to your doctor. Treatment is available in the form of medications including Peg Intron/Ribavirin and the Pegasys/Copegus. Dr. Sandhu specializes in the treatment of Hepatitis C.
Inflammatory Bowel Disease (IBD)
The cause of IBD is not known. Several theories are being investigated including the relationship of genetic factors, immune system factors, and the role of stress. IBD occurs most often in teen and young adults. Your own immune system. See’s your bowel as (foreign and attach) and creates ulcers. There are two main types of IBD; ulcerative colitis and Crohn’s disease.
Ulcerative colitis causes inflammation of the lining of the large intestine. The most common symptoms include diarrhea, abdominal cramps, rectal bleeding, fatigue, weight loss, and anemia. Ulcerative colitis often has periods of remission and exacerbation. It is diagnosed via colonoscopy or Barium study and can be a risk factor for the development of colon cancer.
Crohn’s disease causes inflammation of all layers of the lining of the large and/or small intestine, stomach and esophagus. Common symptoms include lower right sided abdominal pain, bloating, bloody diarrhea, weight loss, rectal bleeding, and fever. Crohn’s disease also has periods of remission and relapse. Treatment for IBD includes proper diet, medication, emotional support, and in severe cases, surgery and now remicade is now available.
Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome is a functional gastrointestinal disorder, a condition in which symptoms are due to dysfunction of the gut, not a structural problem like cancer. Nevertheless it is a real and treatable medical condition. IBS is a chronic disorder that is characterized by recurring (symptoms that come and go over time) abdominal discomfort or pain associated with an altered bowel habit, either constipation, diarrhea or both.
An ulcer is a sore that develops in the lining of the stomach or esophagus as a result of the presence of acid. The most common symptoms include burning pain in the abdomen or chest, often occurring between meals or early in the morning; nausea, indigestion, vomiting, fatigue, and bloody stool.
Ulcers can be caused by genetic factors, smoking, or chronic use of pain relievers. For many years, doctors thought ulcers were caused by factors such as stress, caffeine, alcohol, and spicy foods. It is now known that while these factors aggravate existing ulcers, they do not cause the ulcers.
Medication is often used to reduce stomach acid, allowing the ulcer to heal, however, these ulcers often return when the medication is discontinued.
For many years, it was believed that ulcers were caused by factors such as stress, caffeine, and spicy foods. Although these factors may irritate existing ulcers, they are often not the cause.
A bacteria called Helicobacter pylori (H. Pylori) has been linked to the formation of stomach ulcers. H. pylori is a common infection found in approximately 30% of the general population. It is thought to be contracted via contaminated food or water. Common symptoms include nausea, gas, bloating, and burning stomach pain, although some patients report no symptoms at all.
The National Institute of Health has classified H. pylori as a level one carcinogen. This places H. pylori in the same category as smoking with regard to its role in the development of cancer. This makes detection and treatment of this infection imperative to maintaining your good health.
Diagnosis and Treatment
H. pylori causes inflammation of the stomach lining. This weakens the stomach’s protection against acid, thus causing ulcer formation.
Ulcers and H. pylori infection are diagnosed by a procedure called an upper endoscopy, where the doctor inserts a flexible tube through the mouth to view the lining of the esophagus and stomach. A biopsy may be taken to determine the presence of bacteria.
This procedure is done in an outpatient surgery center under mild sedation. The recovery period is usually one day or less.
If bacteria is found, your doctor may prescribe a course of antibiotics along with acid suppressing medication. The antibiotics clear the infection while the acid suppression makes you feel better. By treating the bacteria with antibiotics, the ulcer is permanently cured and medication is no longer needed.
Your doctor may ask you to follow up with a simple breath test to confirm the infection has cleared. This test is done at the Fremont Surgery Center at least one month after the completion of the antibiotics. With proper treatment, most ulcers heal without complication.
S. Goney Sandhu, M.D.
Gastroenterology, Internal Medicine and
Concierge V.I.P. Medicine
Dr. Sandhu's Office
734 Mowry Avenue
Fremont, CA 94536
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© 2020 by Goney Sandhu, M.D.