Speciality Programs

Colon Cancer Prevention

Gastroenterology Associates are experts in screening for colorectal cancer.  Their up-to-date knowledge and skills, along with access to the latest technology serve their patients well.  It is important to ask your primary care physician about routine colon cancer screenings or if you prefer, contact our office for assistance in determining if you are at risk.

Colorectal cancer is the third most common cancer in the world. There are few factors that increase the risk of colon cancer:

  • Family history of colon cancer: if an individual has an immediate family member or several extended family members with colon cancer, especially if the cancer occurred when the patient was less than 55 years of age.
  • Personal history of colon cancer or polyps: patients with history of adenomatous polyps that occurred prior to age 60 years are at increased risk for developing colorectal cancer.
  • History of radiation therapy for cancer: Radiation therapy directed to the abdomen to treat another previous cancer can increase the chance of colon cancer.
  • Aging: 90 percent of colorectal cancers occur in people older than 50 years of age.   This is why it is extremely important that everyone reaching the age of 50 begin routine colon cancer screening.  Risk increases with age.
  • Race: African-Americans have been shown to be at a higher risk for colon cancer.
  • Lifestyle factors: high fat diet, low fiber diet, sedentary lifestyle, smoking, alcohol and obesity are other factors that can increase the chance of colon cancer.
  • Familial Adenomatous Polyposis (FAP): it is inherited condition that presents with a polyp in the colon. Almost 100 percent of patients develop colon cancer (usually by the age of 50). These patients need to start colonoscopy screening very early (before age of 25).
  • Hereditary Nonpolyposis Colorectal Cancer (HNPCC): This is a condition whereby at least 3 members of family in 2 generations have been diagnosed with colon cancer, and one of them was diagnosed before the age of 50.  Usually there is high incidence of ovarian and endometrial cancer in these patients as well.
  • Inflammatory Bowel Disease (IBD): chronic Ulcerative colitis and Crohn’s disease patients have a higher risk for developing colon cancer. Any patient with IBD should discuss having more frequent colonoscopy testing with their physician as this is recommended.

There are factors that decrease the risk of colon cancer:

  • Aspirin and related medications in this group (called NSAID) may decrease the chance of developing colon cancer.
  • Calcium: Studies have shown that people with a higher calcium intake have a lower chance of developing colon cancer.

Fortunately colon cancer is preventable. A person without a self and/or family history of colon cancer should begin to schedule regular screening colonoscopies at age 50. Usually the first manifestation or introduction to colon cancer is a polyp.  A polyp is small clump of cells that forms the lining of colon.

Colon cancer can cause a variety of symptoms, some of which are:

Bright colored blood in the stool or rectal bleeding, thin caliber stool, continual constipation or diarrhea (changes in bowel habits), unintentional weight loss, frequent discomfort in the lower abdomen, bloating that does not improve with treatment, anemia, weakness and fatigue.

There are different colon cancer screening tests:

  • Colonoscopy: it is the most accurate and available method. It allows the physician to look at all parts of colon and exam it directly.
  • Sigmoidoscopy: It is similar to colonoscopy, but only the rectum and the lower part of colon will be visualized. A colonoscopy covers the entire colon and is a more reliable test for colon cancer. A sigmoidoscopy is helpful when the location of a tumor or polyp is in the rectum or in the lower portion of the colon.
  • Fecal Occult Blood Test (FOBT):  a microscopic amount of blood is released into the stool with most colon cancers. A stool test can detect this blood. A yearly FOBT is recommended for those 50 years old and older.  Although it does not replace the colonoscopy, it is good tool for a brief evaluation. Blood detection in the stool is not a definitive test for colon cancer. Other culprits can be hemorrhoids, ulcers, polyps and/or inflammatory bowel disease.

Our center utilizes a multidisciplinary team approach to your healthcare, which means that patients benefit from the combined expertise of physicians who have the knowledge, perspective and experience to address all aspects of your complete gastroenterological care including colorectal cancer screening.

We offer the most advanced diagnostic techniques and treatments for a wide variety of gastroenterological conditions.  We also offer a full range of diagnostic procedures, as well as medical, surgical and minimally invasive treatment options to meet the individual needs of patients with gastroenterological conditions of any kind.  Contact us if you are experiencing gastrointestinal issues that have not yet been addressed by our physicians.

Irritable Bowel Syndrome
Irritable bowel picture

As many as one in five Americans have IBS symptoms making it one of the most common disorders diagnosed by doctors. It occurs more often in women than in men.  It can be extremely frustrating and at times a debilitating condition that interferes with normal daily life, including job performance and social life.

Unfortunately, for many diagnosed with IBS, there is also a sense of frustration in regards to how they are perceived and treated by their physician.  Many feel that because IBS conditions are so varied, they are often not taken seriously. Patients can feel that only basic symptoms are treated, without regard to their overall gastrointestinal health.

At Gastroenterology Associates, we consider IBS a condition that needs to be properly diagnosed and treated. More serious causes need to be considered to either be treated or ruled out.  Our physicians work with IBS patients individually to develop a treatment plan that is tailored to their diagnosis, rather than a general one-size fits all treatment.  Our physicians want the patient to play an active role in the diagnosis and treatment. We will work with our patients to make sure the treatment plan is working.  Our physicians can be accessed via email if serious concerns arise or symptoms change and need to be addressed.

Learn more about IBS below:

IBS or irritable bowel syndrome is a combination of abdominal cramping, bloating or a change in bowel movements (diarrhea, constipation). IBS affects the intestines, and the symptoms are uncomfortable. Patients may have diarrhea (IBS-D), constipation (IBS-C) or a combination of both diarrhea and constipation. It can be debilitating and even hinder routine, daily tasks.  IBS is a functional problem and is not the result of a germ or bacteria. IBS does not cause intestinal bleeding, bowel obstruction or cancer.

IBS can be affected by diet, lifestyle, hormones and stress.  Unfortunately, many patients are often misdiagnosed or labeled with a psychiatric condition.

Diagnosing IBS is based on ruling out other possibilities, therefore there are a few tests that have to done before properly diagnosing someone with IBS. Testing may include blood work, diagnostic studies, urine testing, stool testing, colonoscopy and endoscopy.

Treatment of IBS is based on different factors: age, severity of IBS and tolerance of the patient. Some patients get relief or reduce their symptoms by slowly adding more fiber into their diet. Some patients may experience relief with medications. There are many ways to help improve the symptoms for those with IBS.

Our physicians are two of the best in this field. They are the experienced and up-to-date.  They spend time with you and carefully listen to your concerns. You are treated like a family member to our facility and not just a patient. Our doctors have seen many IBS patients and are helpful and accurate in their treatment strategies. Each patient’s case has a different approach and plan. We have highly flexible strategies for treating IBS.

This is the reason that so many from across the country and world travel to GABH for treatment.

Unfortunately, many patients with IBS are often told that there is an underlying psychiatric cause. We pride ourselves on properly diagnosing patients, without mislabeling conditions. We promise to guide you to the point where you can live a life that is not controlled by your gastrointestinal system, but controlled by you. We know that IBS can be affect your life, although it is generally not a life threatening condition.

Our center utilizes a multidisciplinary team approach to your healthcare, which means that patients benefit from the combined expertise of physicians who have the knowledge, perspective and experience to address all aspects of your complete gastroenterological care.

We offer the most advanced diagnostic techniques and treatments for a wide variety of gastroenterological conditions.  We also offer a full range of diagnostic procedures, as well as medical, surgical and minimally invasive treatment options to meet the individual needs of patients with gastroenterological conditions of any kind.  Contact us if you are experiencing gastrointestinal issues that have not yet been addressed by our physicians.

Fatty Liver
fattyliver

The liver is a unique and critical organ in our body.  It is imperative that a patient diagnosed with Fatty Liver receive specialized and patient specific care in treating this disorder.  Gastroenterologists of Beverly Hills utilizes a multidisciplinary team approach to treating Fatty Liver, which means that patients benefit from the combined expertise of physicians and dietitians who have the knowledge, perspective and experience to address all aspects of your complete care.

We offer the most advanced diagnostic techniques and treatments for fatty liver and have a specialized program that can be tailored to meet each patient’s specific needs.  We work together with our patients as a team to make sure we understand their full health status in order to treat their Fatty Liver disorder individually.  A “one-size fits all” treatment protocol is not a proper approach.  We fully investigate factual clinical trial based treatments, and continually gather information in order to know the latest and best care available to our patients.

If you have been diagnosed with fatty liver, we can provide a multidisciplinary approach to your care. Our physicians are available by email if questions arise during your treatment and care.   We arrange same day appointments when necessary.

About Fatty Liver:

The blood coming from the digestive system first goes to liver, where the liver picks up food elements and changes them to absorbable particles so that the cells can take them from the blood and use them.  Also the liver can change the extra food elements to storage particles. Another important function of the liver is to detoxify chemicals and metabolize medications. The liver is an important organ that makes proteins and clotting factors.

Fatty liver is the definition of accumulation of fat in liver tissue. It is classified into two groups: benign or simple and nonalcoholic fatty liver disease (NAFLD).  Accumulation of large amounts of fat can interact with normal liver function and can cause symptoms like: fatigue, weight loss, skin color change (yellow color), spider like blood vessels, itching and at critical levels can cause liver failure. Liver failure is better known by the word: “Cirrhosis”. The sooner you take care of your condition, the more likely you can have a successful treatment course.

Many people with nonalcoholic fatty liver disease live without any problems, but some of them can develop symptoms. There are some factors that increase the chances of developing fatty liver: high cholesterol, obesity, metabolic syndrome, sleep apnea and diabetes mellitus type 2.

Controlling the above factors can help to prevent and sometimes cure NAFLD.

Maintain a healthy weight, keep blood sugar levels within normal range, avoid alcohol and unnecessary medications (especially over the counter), follow a healthy diet, exercise regularly, and see a liver specialist. We have an onsite registered dietician to help manage your cholesterol, weight and blood pressure.

In our facility the dietitian helps you to lower your cholesterol, lose weight and control your blood sugar. You will have access to weekly or monthly support group meetings that give you motivation, new ways to approach difficulties and also meet others that are going through these lifestyle changes as well. Gastroenterology Associates not only gets you on the path to a healthier you, but we are with you every step of the way.

We not only show you the road to health, but we walk with you through this pathway to the end.

Gastroenterology Associates also offers a full range of diagnostic procedures, as well as medical, surgical and minimally invasive treatment options to meet the individual needs of patients with gastroenterological conditions of any kind.  Contact us if you are experiencing gastrointestinal issues that have not yet been addressed by our physicians.

Liver Disease Program

If you have been diagnosed with liver disease, it should be taken very seriously by you and your gastroenterologist.  Unfortunately, liver disease can be a cause of morbidity and mortality.  It affects people of all ages, but most liver disease is diagnosed between the ages of 40 and 60 years.  Most recently, liver disease has benefited from extensive medical research, resulting in major improvements in the survival and quality-of-life of patients.

In treating liver disease, our center utilizes a multidisciplinary team approach, which means that patients benefit from the combined expertise of physicians who have the knowledge, perspective and experience to address all aspects of your complete care.

We offer the most advanced diagnostic techniques and treatments for a wide range of liver diseases such as hepatitis (viral or autoimmune), primary biliary cirrhosis, primary sclerosing cholangitis, hemochromatosis, Wilson’s disease, Alpha-1 antitrypsin deficiency.

If our liver disease patients were to experience a complication or have any concerns while under our care, they should contact us immediately. Our physicians are available at all times by email/phone if serious concerns arise.

Hepatitis

Hepatitis can be viral, autoimmune or drug induced. Viral hepatitis can be caused by hepatitis A, B, C, D, E, G virus.

Hepatitis A and E are transmitted by contaminated food and water. They are ingested orally and the patients do not usually have symptoms for several weeks. The hepatitis A and E virus infection never causes cirrhosis or liver cancer.

Hepatitis B, C and D are transmitted from mother to child, sexual contact, blood transfusion, needle stick injuries and needle sharing. Hepatitis B and C may lead to chronic liver disease, cirrhosis and liver cancer. Hepatitis C is one of the main causes for liver transplant in the United States. Usually patients with hepatitis B or C have a variety of symptoms such as, jaundice, dark urine, fatigue, malaise, weight loss and light colored stool. Blood tests are used to first diagnose hepatitis. It is very important for patients diagnosed with hepatitis to manage their condition, as unmanaged hepatitis may lead to liver cancer.

You can prevent Hepatitis B by getting vaccinated. Unfortunately there is no vaccine for hepatitis C at this time.

Hepatitis G was diagnosed in few patients but until now no clinical disease has been reported. Hepatitis G was once diagnosed but there is no knowledge that at this time that there are any cases of Hepatitis G exist.

Patients with liver disease require an expert multidisciplinary team to understand the condition to achieve the best outcome. At GABH, our efforts are to slow, stop and treat the illness in order to achieve the best prognosis. Our doctors will provide the most up to date therapies for their patients to treat their condition.

Our skilled doctors are specialists in taking care of patients with a variety of liver diseases such as, Hepatitis (A, B, C, D), autoimmune hepatitis, hemochromatosis, primary biliary cirrhosis, hepatic encephalopathy, portal hypertension, liver tumors and cancer, unexplained elevations in liver enzymes, congenital liver disease and end stage liver disease.

Due to the nature of liver disease, some patients need other types of medical care such as a nutritionist, dietitian, or social worker.  Gastroenterology Associates of Beverly Hills is part of a multi-disciplinary team, and can offer all these needs for our patients within our office.

We know living with liver disease is a challenge.  Our team is trained and dedicated to manage and cure liver disease in the best possible way.

Consistent communication is one of the most important keys in hepatitis management. Our physicians will sit with the patient and listen to concerns and answer any questions regarding this issue.

We offer the most advanced diagnostic techniques and treatments for a wide variety of gastroenterological conditions.  We also offer a full range of diagnostic procedures, as well as medical, surgical and minimally invasive treatment options to meet the individual needs of patients with gastroenterological conditions of any kind.  Contact us if you are experiencing gastrointestinal issues that have not yet been addressed by our physicians.

Esophageal Disorders Program
esophagus

The team at Gastroenterology Associates understands the concerns and apprehension patients experience in regards to being diagnosed with esophageal disease.  We will take the extra steps necessary to make sure the patient is on board as a team member in the diagnosis and treatment of esophageal disease.  Our center utilizes a multidisciplinary team approach to your healthcare, which means that patients benefit from the combined expertise of physicians who have the knowledge, perspective and experience to address all aspects of your complete gastroenterological care when treating esophageal disease.

We offer the most advanced diagnostic techniques and treatments, and are affiliated with the best AAAHC accredited Ambulatory Health Care Centers in the Los Angeles area, all of which, give our patients the discreet personalized care they deserve.

We believe our patients deserve the best. An AAAHC certificate of accreditation signifies the highest level of accreditation. AAAHC, an independent, not-for-profit organization that has closely examined our affiliated facilities and procedure practices.

Our Gastroenterologists never rush an appointment, and take the extra time to thoroughly discuss your esophageal disease and any other medical concerns.  They will sit with you and personally review the results of any testing performed.  Our doctors want to make sure you completely understand the results, and, if necessary, any medical recommendations for further medical care or follow-up.  The doctors are available via email to patients as well if any immediate concern or heath situation arises.

Below is some information on esophageal disease:

Esophagus is the tube that transfers food from mouth to stomach.

There are a wide range of esophageal disorders: Rings, Webs, Achalasia, Scleroderma, Diffuse Esophageal Spasm, Esophagitis, Barrett’s Esophagus, Plumer –Vinson Syndrome, Zenker diverticulum, Esophageal cancer, GERD, Hiatal Hernia…

Here is a small review of above conditions:

Esophagitis

Any inflammation in esophagus is called esophagitis. Patients can complain of dysphagia (difficulty in swallowing), odynophagia (painful swallowing). It is divided to several categories based on the causative agent.

Candida esophagitis is the type that is caused by Candida, which is a type of fungus. This will usually occur in patients who have a decreased immune system response that is not strong, which is known as immunocompromised.

Another type of esophagitis is called eosinophilic esophagitis, also known as allergic esophagitis. This type is often misdiagnosed due to its inconspicuous nature. The rate of misdiagnosis for this type is high and generally requires multiple esophageal biopsies to confirm the diagnosis.

There is a type of esophagitis called pill-induced esophagitis that is a result of taking medications, such as iron sulfate, vitamin C, potassium chloride, among others. It is simply managed by taking medications with a full glass of water and remaining upright for 30 minutes after taking the medication.

Esophageal diverticulum

Diverticulum is an out pouching of the lumen due to weakness in the wall in that location. It can cause a problem because the food can stay there and cause bad breath and difficulty in swallowing. The patient may feel the need to clear their throat and may cause regurgitation of undigested food.

Rings

Rings are thin, smooth prominence of esophageal tissue that causes tightness in the food pathway in the esophagus. The rings can be located in any part of esophagus and patients generally complain of dysphagia, or difficulty swallowing. There is a condition that has a combination of esophageal rings and iron deficiency anemia. This condition is called Plummer-Vinson syndrome and usually occurs in middle-aged women.

When a patient has a symptomatic ring, it is advised to treat the affected area with dilation. It is a simple procedure and can be done during an upper endoscopy.

Barrett’s esophagus

The changing in the tissue structure at the lower part of esophagus is called Barrett’s esophagus and usually happens in the junction of the esophagus to the stomach, due to acid reflux. The tissue structure of the esophagus is not as resistant as the stomach tissue is to acid. Patients who have acid reflux may have stomach acid that comes up to the esophagus and damages the tissue. This change of tissue is the reason that Barrett’s esophagus is known as a pre-cancerous condition. Therefore, it is very important to take care of the condition as soon as possible. Diagnosis and management is done by upper endoscopy.

GERD

Acid reflux or heartburn is one of the most common complaints for gastroenterological patients. Patients usually feel a burning sensation in their chest or upper abdomen. These complaints are more severe with spicy foods, citrus foods and greasy foods. Vomiting is not always a symptom, but nausea can be associated with acid reflux. Hoarseness, cough, metallic-like taste and sore throat are other symptoms that may occur. Pain is usually in upper middle abdomen or in the sub-sternal area.

Lifestyle modifications are one of the basic treatments for GERD. Avoid eating food late at night, tobacco, alcohol, caffeine, chocolate and spicy food. It is recommended to elevate the head of bed for 6-8 inches.

Usually an anti-acid medication will be prescribed for patients with GERD symptoms. It has to be taken in the morning 30 minutes before breakfast. There are many different kind of anti-acid medication that your physician can recommend for you.

Achalasia

It presents with progressive difficulty swallowing both solid foods and liquids. Patients can regurgitate the food a few hours after eating. There is no relationship between achalasia and alcohol or tobacco consumption, which is generally the opposite of esophageal cancer. A diagnosis is made by radiologic imaging, although endoscopy can be diagnostic and therapeutic.

We offer the most advanced diagnostic techniques and treatments for a wide variety of gastroenterological conditions.  We also offer a full range of diagnostic procedures, as well as medical, surgical and minimally invasive treatment options to meet the individual needs of patients with gastroenterological conditions of any kind.  Contact us if you are experiencing gastrointestinal issues that have not yet been addressed by our physicians.

Weight Loss with Obalon Balloon System

The Obalon Balloon System is the FIRST and ONLY swallowable, FDA-approved balloon treatment option for weight loss.  The lightweight balloons occupy space in the stomach so people eat less, which makes weight loss easier.  The non-surgical treatment lasts 6-months and is coupled with a professionally supervised nutrition and exercise program.  Contact our office for complete and further information on the Obalon Balloon System!

How does the Obalon Balloon System work?

The Obalon Balloon System helps facilitate weight loss by taking up space in their stomach so people east less.  During treatment people receive professional nutrition and exercise support to help make the lifestyle changes that facilitate weight loss. The Obalon Balloon System provides support to help change eating habits and keep the weight off for the long-term.

What commitment is required?

The Obalon Balloon System can assist with weight loss efforts, but weight loss success is also dependent on people’s readiness to develop new lifestyle skills. The degree of long-term weight loss will depend on their ability to modify their lifestyle and maintain this behavior after the balloons are removed. It is important that you discuss their willingness to accept this commitment before treating them with the Obalon Balloon System.

What weight loss results can be expected?

In a large clinical study, the Obalon Balloon System was shown to help adults have clinically meaningful weight loss. When used with a diet and exercise program people lost on average 15 pounds and up to 50 pounds. An average of 89.5% of the total weight loss was maintained at 1 year.

How long is the treatment?

The Obalon Balloon treatment is a 6-month treatment. People usually have a second balloon 1 month after the first balloon and a third balloon 2 months after the second balloon. All balloons will be taken out 6 months after the first balloon capsule was swallowed.

What are the potential side effects of the Obalon Balloon System?

The Obalon Balloon System is a safe, effective, FDA-approved, non-surgical weight loss system.  In the clinical trial, the majority of adverse events were reported as mild and consisted of abdominal pain and nausea which typically resolve within two weeks. (serious side effects were less than 0.3%). You can find this information and a complete list of contradictions warnings and precautions by clicking here.

 

c 2016 Obalon Therapeutics Inc. LIT-7500-0037-01. November 2016.