Heartburn is a common problem. Many people take powerful acid-suppressing drugs like Nexium or Prilosec every day to treat gastro-esophageal reflux disease or GERD. If untreated, chronic irritation of the swallowing tube can lead to Barrett’s esophagus. Do you have to take medications forever to treat this condition? Are there better ways to heal your digestive tract?

Dr. Nicholas Shaheen has written about finding the right balance of endoscopy so that intestinal cancers are detected early enough for treatment and patients are not exposed to undue risks from overly-frequent screening. Colonoscopy is effective for detecting colon polyps before they become cancerous. Having colonoscopies at the correct interval can prevent or greatly reduce the risk of colorectal cancer. What interval is correct for you?

In the esophagus, chronic exposure to stomach acid can lead to changes doctors call Barrett’s esophagus. This is a pre-cancerous condition. How often does someone with this disorder need upper GI endoscopy to screen for esophageal cancer? Just what is the risk of esophageal cancer?

When gastroenterologists perform endoscopies and discover the beginnings of a tumor in the esophagus, they can remove it then and there. The procedure is called endoscopic mucosal resection. A new technique, ablation, to heal Barrett’s esophagus shows great promise. It may often reverse the problem indefinitely. Find out how you can deal with heartburn and how you can heal your digestive tract if you have chronic reflux.

Antibiotic treatment can frequently disrupt the balance of bacteria in the colon. The consequence may be a C diff infection that can cause severe diarrhea. The usual treatment for C diff is additional antibiotic therapy, but that isn’t always effective. The FDA has approved fecal transplants for treating C diff infections. What are they, and how do they work? What other conditions might respond to fecal transplants designed to re-establish a normal microbial balance in the digestive tract?

Nicholas J. Shaheen, MD, MPH, is the Bozymski-Heizer Distinguished Professor of Medicine at the University of North Carolina School of Medicine, and Chief of the Division of Gastroenterology and Hepatology at UNC. Dr. Shaheen is a recognized expert in esophageal diseases and endoscopy. He is author of multiple treatment guidelines for gastrointestinal illnesses. The photograph is of Dr. Shaheen. His article on “Less Is More: A Minimalist Approach to Endoscopy” was published in Gastroenterology in May 2018.

Michael Bretthauer, MD, PhD,is Professor of Medicine at the Institute of Health and Society at the University of Oslo and the Department of Transplantation Medicine in Oslo University Hospital, Oslo, Norway. He is also President of the Frontier Science Foundation in Brookline, MA. Hi article on “Fecal Microbiota Transplantation for Primary Clostridium difficile Infection” was published in the New England Journal of Medicine on June 28, 2018.

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