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Acid Reflux-Heartburn/GERD


Heartburn is a very common term that you hear used almost on a daily basis. An occasional episode is generally nothing to be worried about, however, many people experience heartburn regularly, even daily. Frequent heartburn can be a serious problem, and it requires medical attention. Frequent or constant heartburn is the most common symptom of gastro-esophageal reflux disease also known as (GERD).

GERD is a disease in which stomach acid or, occasionally, bile flows back (refluxes) into your food pipe (esophagus). This constant backwash of acid can irritate the lining of your esophagus, causing it to become irritated and inflamed.

Most people can manage the discomfort of heartburn with lifestyle modifications and over-the-counter medication s. But if heartburn is severe, these remedies may offer only temporary or partial relief. If you have GERD, you may need newer, more potent medications to reduce symptoms.

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Bad breath-Halitosis


Certain foods, health conditions and habits are among the causes of bad breath. In many cases, you can improve bad breath with proper dental hygiene. But, if simple self-care techniques don't solve the problem, you may want to see your dentist or doctor to rule out a more serious condition. Certain Gastrointestinal conditions can also cause bad breath. The use of mints, gum, mouthwashes and other products may help control bad breath (halitosis) but only temporarily. If you have had persistent halitosis that has not been alleviated by proper dental hygiene you should contact your physician or a Gastrointestinal specialist.

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Barrett's esophagus


Heartburn isn't always just an annoying condition that's quickly remedied by over-the-counter antacids. It can also be symptomatic of gastro-esophageal reflux disease (GERD), which is the chronic regurgitation of acid from your stomach into your lower esophagus. Long-term GERD can sometimes lead to Barrett's esophagus, a condition in which the color and composition of the cells lining your lower esophagus change because of constant exposure to stomach acid.

Barrett's esophagus is not a common condition. Only a small percentage of people with GERD develop Barrett's esophagus. If you are diagnosed with Barrett's esophagus, there is an increased risk of developing esophageal cancer, which can spread from the esophagus to the lymph nodes and other organs. Although increased, the absolute risk of esophageal cancer for someone with Barrett's esophagus is small — less than 1 percent a year.

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Bowel/Fecal Incontinence


Bowel incontinence is the inability to control your bowel movements, causing stool (feces) to leak unexpectedly from your rectum. Also called fecal incontinence, bowel incontinence can range from an occasional leakage of stool while passing gas to a complete loss of bowel control.

Common causes of fecal incontinence include constipation, diarrhea, and muscle or nerve damage. The condition may be due to a weakened anal sphincter associated with aging. Bowel incontinence can also occur as a result of childbirth. Injury to the nerves and muscles of the rectum and anus while giving birth can cause a woman to lose control of her bowel movements.

Whatever the cause, fecal incontinence can be a source of great embarrassment, it may cause you to stay at home and withdraw from your regular activities. More than 5.5 million Americans suffer from fecal incontinence. It's more common in older people and in women.

Although bringing the subject of bowel incontinence up with your doctor may be difficult, don't shy away, there are many treatments available — some of which are very simple and can improve, if not correct, incontinence.

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Burning mouth syndrome


Burning mouth syndrome (BMS) is a complex, vexing condition in which a burning pain occurs on your tongue or lips, or over widespread areas involving your whole mouth, without any obvious reason.

The disorder has long been associated with a variety of other conditions — including menopause, psychological problems, nutritional deficiencies, and disorders of the mouth, such as oral thrush and dry mouth (xerostomia). More recently, some researchers have suggested dysfunctional or damaged nerves as a possible cause. But the exact cause of burning mouth syndrome is often difficult to pin down, and pain may continue for months or years.

Treatment is highly individualized and depends on your particular symptoms and on the underlying cause or causes, if they can be identified. Most people with burning mouth syndrome can decrease their symptoms through tailored treatment plans.

Other names sometimes used for burning mouth syndrome include scalded mouth syndrome, burning tongue syndrome, burning lips syndrome, glossodynia and stomatodynia.

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Colon Cancer- Colorectal Cancer Colorectal cancer
includes cancers of both the large intestine,(the colon), as well as the lower part of your digestive system


Colon cancer is a cancer of the large intestine (colon), the lower part of your digestive system. Rectal cancer is a cancer of the last 8 to 10 inches of the colon. Together, they are often referred to as colorectal cancers, and they make up the second-leading cause of cancer-related deaths in the United States. Only lung cancer claims more lives.

Most cases of colon cancer begin as small, noncancerous (benign) clumps of cells called adenomatous polyps. Over time some of these polyps become cancerous.
Polyps may be small and produce few, if any, symptoms, so it's important to get regular screening tests to help prevent colon cancer. If signs and symptoms of cancer do appear, they may include a change in bowel habits, blood in your stool, persistent cramping, gas or abdominal pain.

Despite the relatively high number of cases and deaths, there's good news about colon cancer. Screening tests, along with a few simple changes in your diet and lifestyle, can dramatically reduce your overall risk of developing colon cancer.

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Esophageal cancer


Less well known than lung cancer, but no less serious, esophageal cancer starts in the inner layer of the esophagus, the 10-inch long tube that connects your throat and stomach. The most common symptom, which usually occurs late in the disease, is difficulty swallowing and a sensation of food sticking in your throat or chest

Not so long ago the outlook for people with esophageal cancer was bleak. But survival rates have improved, in part because close monitoring of Barrett's esophagus — a serious, pre-malignant complication of acid reflux disease — can help detect cancer early, when it's more likely to respond to treatment. Even more important is that diet and lifestyle changes can significantly reduce the chances of ever developing this type of cancer.

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Gallbladder Cancer


Gallbladder cancer and bile duct cancers are relatively rare in the United States. When they do occur, these cancers of the biliary tract seem to affect a disproportionate number of American Indians, Alaska natives and Hispanics, who may have rates five times that of Caucasians. This may be the result of a genetic predisposition to gallstones, one of the leading causes of gallbladder cancer.

Gallbladder cancer seldom produces symptoms in the early stages. In fact, early gallbladder cancer often is only discovered when the gallbladder is removed as a treatment for gallstones. Otherwise, gallbladder cancer is often quite advanced by the time it's diagnosed.

When gallbladder cancer is caught early, removing the gallbladder or part of the bile duct may eliminate all the cancerous cells.

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Stomach cancer


Cancer of the stomach - also called gastric cancer or gastric carcinoma - is a treatable disease that can often be cured when it is found early and treated
at a local stage.

Stomach cancers are classified according to what sort of tissues they start in. The most common type arises in the glandular tissue lining the stomach. These tumors are called adenocarcinomas and account for over 95 percent of all stomach tumors.

One particular form of this cell type, unusual in the U.S. but more common in Japan, is the superficial spreading adenocarcinoma that essentially replaces the lining (mucosa) of the stomach with sheets of malignant cells.

Another subtype is scirrhous carcinoma (linitis plastica), a poorly differentiated mixture of mucin-producing carcinoma cells that infiltrates the muscle wall and turns it into rigid, leatherlike scar tissue that cannot stretch or move during the normal digestive process (peristalsis).

Occasionally a cancer may develop in lymph tissue (gastric lymphoma) or from the smooth muscles of the stomach wall (leiomyosarcoma). Carcinoids and plasma-cytomas also can develop in the stomach.

The disease can spread directly through the stomach wall into adjacent organs and through the lymph system to nodes in the abdomen, the left side of the neck and the left armpit.

Metastases through the bloodstream can spread to the liver, lungs, bone and brain. Metastases are also found in the lining of the abdominal cavity (peritoneum) and around the rectum.

Symptoms of Stomach Cancer

The symptoms of stomach cancer are similar to the symptoms of a hiatal hernia or peptic ulcer, namely a vague pain aggravated by food, nausea, heartburn and indigestion. These symptoms are often thought to be due to the stress of psychosomatic illness and are treated with antacids or H-2 blockers. Unfortunately, the temporary relief this treatment brings often delays the tests that could diagnose the cancer sooner.

Loss of appetite, feelings of fullness after even a small meal, and weight loss are common - upper abdominal pain, vomiting after meals and weight loss are seen in 80 to 90 percent of cases.

anemia, weakness, gastrointestinal bleeding and vomiting of blood. Both vomiting blood and rectal bleeding are seen in peptic ulcer disease, esophageal varices varicose veins in the esophagus that grow and burst, a disease common in drinkers), and occasionally leiomyosarcomas.

Diagnosis of Stomach Cancer

Gastric cancers often seem to be benign ulcers, which are like pits in the stomach lining. Larger ulcers - more than 3/4 in. (2cm) in diameter - that have borders raised above the level of the surrounding stomach are more likely to be malignant.
Diagnosis may include the following:

  • X-rays of the upper gastrointestinal tract (UGI series) by standard and double-contrast methods

  • may find larger ulcer lesions

  • Chest X-rays

  • CT scan of the abdomen

  • Bone scan if the bone enzyme alkaline phosphatase is elevated in the serum

  • Ultrasound to help measure tumor size and predict recurrence

Endoscopy and Biopsy may involve examination of the stomach through a gastroscope inserted through the esophagus (fiberoptic endoscopy) to find ulcers and masses. It is the most definitive test for diagnosis of stomach cancer. Seventy percent of early malignant ulcers may look benign and even heal, but are usually positive on biopsy.

In this procedure, the esophagus and stomach are examined using a thin, lighted tube (gastroscope) which is passed through the mouth and esophagus to the stomach. The patient's throat is sprayed with a local anesthetic to reduce discomfort and gagging. Patients may also receive medication to relax them. Through the gastroscope, the doctor can look directly at the inside of the stomach. If an abnormal area is found, the doctor can remove some tissue through the gastroscope.

A small piece of tissue may be removed form any suspicious area for biopsy analysis by a pathologist, or a brush can be passed through the gastroscope to obtain cells in a way similar to a Pap smear. Tissue and brush biopsies can diagnose 98 percent of cases.

Treatment of Stomach Cancer

Stomach cancer is a somewhat treatable disease, with over half the patients with early stage disease being curable. Early-stage disease accounts for only 10 to 20 percent of all cases diagnosed in the U.S.. In early-stage disease over 50 percent are curable.

Five-year survival for more advanced cancers range from around 20 percent for those with regional disease to almost nil for those with distant metastases. Treatment for metastatic cancer can relieve symptoms and sometimes prolong survival, but long remissions are not common.

The ideal treatment is radical surgery, meaning that most or all of the stomach is removed (subtotal or total gastrectomy), along with the surrounding lymph nodes. Radical surgery is the only treatment that can lead to a cure, though lesser surgical procedures can play a significant role in therapy designed to relieve symptoms.

Radiation and chemotherapy are also treatment options. Neither has been shown to improve the outlook for those with advanced tumors, generally, although some patients with responsive tumors may benefit.

Questions To Ask Your Doctor About Stomach Cancer

  • What type is the tumor?

  • How developed is it (staging)?

  • Are further tests indicated?

  • What does the pathologist's report show?

  • What are treatment options?

  • Is surgery advisable?

Although the incidence of stomach cancer has declined dramatically in the United States and Western Europe in the last 50 years, the disease remains a serious problem in much of the rest of the world, where it's a leading cause of cancer death.

This global variation is almost certainly linked to two factors that play a major role in the development of stomach cancer: Infection with Helicobacter pylori (H. pylori) bacteria and the type of diet that certain cultures ingest.

Stomach cancer is more readily treated when caught early. Unfortunately, by the time it causes symptoms, the disease is often at an advanced stage and may have spread beyond the stomach. Yet there is encouraging news. You can reduce your risk of this serious cancer by making a few changes in your lifestyle.

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Liver cancer


Primary liver cancer begins in the cells of the liver itself. Although many cancers are declining in the United States, new cases of primary liver cancer are increasing and are likely to continue to increase for the next two decades.

Liver cancer also occurs as metastatic cancer, which happens when tumors from other parts of the body spread (metastasize) to the liver. In the United States, most cancer found in the liver spread there after originating elsewhere. Rather than being called liver cancer, this type of cancer in the liver is named after the organ in which it began — such as metastatic colon cancer in cancer that starts in the colon and spreads to the liver.

Because liver cancer is rarely discovered early and is difficult to control with current treatments, the prognosis is often poor. Even when treatments fail to provide much improvement, however, they often can help control pain and improve quality of life. But the most important news about primary liver cancer is that you can greatly reduce your risk by protecting yourself from hepatitis infection and cirrhosis, the leading causes of the disease.

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Oral and throat cancer


Recently, you've noticed a pale lump inside your mouth that doesn't seem to be healing. It's not like anything you've seen before. What you may have encountered is an early sign of oral or throat cancer.

The American Cancer Society estimates more than 28,000 new cases of oral and throat (oropharyngeal) cancer occur annually in the United States. Oral cancer includes cancer of the lips, mouth, tongue, gums and salivary glands. Throat cancer involves cancer of the part of the throat just behind the mouth. An estimated more than 7,000 Americans die of these cancers annually.

Periodic self-examination of your mouth is the best way to detect the early signs of oral cancer. And, when detected early, oral cancer is almost always successfully treated. Unfortunately, many oral and upper throat cancers are far advanced by the time a doctor is made aware of the situation. This is because oral and throat cancers are usually painless in their early stages.

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Pancreatic cancer


Pancreatic cancer is one of the most serious of all cancers. It develops when malignant cells form in the tissues of your pancreas — a large organ that lies horizontally behind the lower part of your stomach. Your pancreas secretes enzymes that aid digestion and hormones that help regulate the metabolism of carbohydrates.

Although pancreatic cancer accounts for just 2 percent of new cancer cases in the United States, it's the fourth leading cause of all cancer deaths. That's because pancreatic cancer spreads rapidly and is seldom detected in its early stages. Symptoms such as yellowing of the skin and whites of the eyes (jaundice), abdominal pain and unexplained weight loss may not appear until the disease is quite advanced. By that time, the cancer is likely to have spread (metastasized) to other parts of the body and surgical removal is no longer possible.

For years, little was known about pancreatic cancer. But researchers are beginning to understand the genetic basis of the disease — knowledge that may lead to new and better treatments. Just as important, you may be able to reduce your risk of pancreatic cancer with a few simple lifestyle changes.

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Oral thrush


Oral thrush is a condition in which the fungus Candida albicans grows out of control. Like most healthy people, you probably have small amounts of the fungus in your mouth and digestive tract and on your skin. You can't see the fungus and normally won't know it's there — it usually doesn't cause problems because normal bacteria (flora) in your body keep its growth in check. But when this balance is disturbed — by medications or illness — Candida can grow out of control, leading to problems such as diaper rash and vaginal yeast infections as well as oral thrush.

Oral thrush causes creamy white lesions, usually on your tongue or inner cheeks. The lesions can be painful and may bleed slightly when you scrape them or brush your teeth. Sometimes oral thrush may spread to the roof of your mouth, your gums, tonsils or the back of your throat.

Although oral thrush can affect anyone, it occurs most often in babies and toddlers, older adults, and people whose immune systems have been compromised by illness or medications. Oral thrush is a minor problem for healthy children and adults, but for those with weakened immune systems, symptoms of oral thrush may be more severe, widespread and difficult to control.

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Celiac disease


Celiac disease is a digestive condition triggered by consumption of the protein gluten, which is found in bread, pasta, cookies, pizza crust and other foods containing wheat, barley or rye. Oats may contain gluten as well. When a person with celiac disease eats foods containing gluten, an immune reaction occurs in the small intestine, resulting in damage to the surface of the small intestine and an inability to absorb certain nutrients from food.

Eventually, decreased absorption of nutrients (malabsorption) can cause vitamin deficiencies that deprive your brain, peripheral nervous system, bones, liver and other organs of vital nourishment, which can lead to other illnesses. This is especially serious in children, who need proper nutrition to develop and grow.

Also known as celiac sprue, nontropical sprue and gluten-sensitive enteropathy, celiac disease occurs in people who have a susceptibility to gluten intolerance. Some speculate that celiac disease has been around since humankind switched from a foraging diet of meat and nuts to a cultivated diet including grains such as wheat. Nonetheless, it has only been in the last 50 years that researchers have gained a better understanding of the condition and how to treat it.

No treatment can cure celiac disease. However, you can effectively manage celiac disease through changing your diet.

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A professional athlete — strong, fit and apparently in excellent health — collapses during a workout on a hot day and never recovers. The cause of death is dehydration (hypohydration), which occurs when the body doesn't have enough water to carry out its normal functions. Although stories of high-profile athletes succumbing on the playing field grab headlines, such cases are rare. On the other hand, millions of ordinary people — many of them infants and older adults — die worldwide of dehydration every year.

What's more, even mild dehydration — as little as a 1 percent to 2 percent loss of body weight — can cause symptoms such as weakness, dizziness and fatigue and may have a negative effect on long-term health. Severe dehydration, usually defined as a loss of 9 percent to 15 percent of body weight, is a life-threatening medical emergency.

In the simplest terms, dehydration occurs when you lose more water than you take in. Even a slight imbalance causes serious problems because water is essential to human life: It forms the basis for all body fluids, including blood and digestive juices; it aids in the transportation and absorption of nutrients; and it helps eliminate waste.

You can usually reverse mild to moderate dehydration by increasing your intake of fluids, but severe cases need immediate medical treatment. The safest approach is not to become dehydrated in the first place. You can do that by monitoring your fluid loss during hot weather, illness or exercise, and drinking enough liquids to replace what you lose.

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Acute diarrhea is an unpleasant digestive disorder that virtually everyone experiences at one time or another. The loose-stool consistency usually lasts a few days at most. Diarrhea often means more frequent trips to the toilet and may mean your stool is greater in volume. A few of the more common causes of loose, watery stools and abdominal cramps are infections from viruses, bacteria or parasites. Other causes include medications — particularly antibiotics — and artificial sweeteners.

Chronic diarrhea lasts much longer than acute diarrhea. It can be a sign of a serious disorder, such as inflammatory bowel disease, or it may be due to a less serious condition, such as irritable bowel syndrome.

Diarrhea may cause your bowel to lose significant amounts of water and salts. Also, chronic or recurrent diarrhea may signal a more serious underlying medical problem, such as chronic infection, inflammatory bowel disease or poor absorption of nutrients (malabsorption).

Most cases of diarrhea clear on their own without treatment. But if diarrhea persists or you become dehydrated, see your doctor.

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Traveler's Diarrhea


Montezuma's revenge, tourista and Tut's tummy are among the many nicknames given to this common ailment of travelers. Nothing can ruin a foreign vacation or business trip more quickly than loose stools and abdominal cramps. But this disorder usually isn't serious — it's just unpleasant.

A trip to a foreign country by no means guarantees gastrointestinal discomfort. But if you visit a place where the climate, social conditions or sanitary standards and practices are different from yours at home, you have an increased risk of developing diarrhea.

Each year millions of international travelers battle this illness. High-risk destinations for traveler's diarrhea include developing countries in Latin America, Africa, the Middle East and Asia. Traveling to southern Europe and a few Caribbean islands also poses some risk. However, your risk of traveler's diarrhea is generally low in northern Europe, Canada, Australia, New Zealand and the United States.

Being careful about what you eat and drink can reduce your risk.

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Difficulty swallowing


You might take swallowing for granted — you take a bite of food, chew and swallow. Most people don't think much more about it. But for some people, difficulty swallowing makes every meal a challenge.

Occasional difficulty swallowing (dysphagia) usually isn't cause for concern, and may simply occur when you eat too fast or don't chew your food well enough. But persistent difficulty swallowing may indicate a serious medical condition requiring treatment.

Difficulty swallowing may mean it take more time and effort to move food or liquid from your mouth to your stomach. Difficulty swallowing also may be associated with pain. In some cases, you may not be able to swallow at all.

Difficulty swallowing can occur at any age, but is most common in older adults. The causes of swallowing difficulties vary, and treatments depend upon the cause. In many cases, the condition can be partially or completely corrected.

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It's common for people older than age 60 to have small, bulging pouches (diverticula) in their digestive tracts — a condition known as diverticulosis. Although diverticula can form anywhere, including in your esophagus, stomach and small intestine, most occur in your large intestine. Because these pouches seldom cause any problems, you may never know you have them.

Sometimes, however, one or more pouches becomes inflamed or infected, causing severe abdominal pain, fever, nausea and a marked change in your bowel habits. When diverticula become infected, the condition is called diverticulitis. Mild cases of diverticulitis can be treated with rest, changes in your diet and antibiotics. But serious cases may require surgery to remove the diseased portion of your colon.

Fortunately, most people with diverticulosis never develop diverticulitis. Best of all, you can help prevent both types of diverticular disease by including more high-fiber foods in your diet.

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Peptic ulcer


Too much stress, too much spicy food, and you may be headed for an ulcer — or so the thinking used to go.

Peptic ulcers are open sores that develop on the inside lining of your stomach, upper small intestine or esophagus. The most common symptom of a peptic ulcer is pain.

Not long ago, the common belief was that peptic ulcers were a result of lifestyle. Doctors now know that a bacterial infection or medications — not stress or diet — cause most ulcers of the stomach and upper part of the small intestine (duodenum). Esophageal ulcers may also occur and are typically associated with the reflux of stomach acid.

Depending on their location, ulcers have different names:
Gastric ulcer. This is a peptic ulcer that occurs in your stomach.
Duodenal ulcer. This type of peptic ulcer develops in the first part of the small intestine (duodenum).
Esophageal ulcer. An esophageal ulcer is usually located in the lower section of your esophagus. It's often associated with chronic gastroesophageal reflux disease (GERD).

Peptic ulcers are common. The good news is that oftentimes successful treatment of ulcers takes just a few weeks.

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Non-ulcer dyspepsia (indigestion)


Sometimes, people see their doctors for stomach pain that they think is caused by an ulcer, but it isn't. Although you may have gnawing upper abdominal pain, diagnostic tests don't reveal an ulcer or other digestive problem — all tests come back normal. If this is so, you may have a type of indigestion called nonulcer stomach pain.

Formally, the condition is known as nonulcer dyspepsia (dis-PEP-se-uh). The term "dyspepsia" comes from the Greek roots "dys," meaning "difficult," and "peptein," which means "to digest."

Nonulcer stomach pain is a common, sometimes long-lasting (chronic) disorder of the upper gastrointestinal system, which includes your esophagus and first part of your small intestine (duodenum) as well as your stomach. The disorder can cause signs and symptoms that resemble those of a peptic ulcer, such as pain or discomfort in your upper abdomen, often accompanied by bloating, belching and nausea.

Nonulcer stomach pain occurs for no apparent reason and isn't necessarily related to a particular disease. Rather, the culprit may be a temporary problem, such as eating too quickly, overeating or dealing with a stressful event. For some people, stomach pain is a chronic condition. For many people, however, the symptoms of nonulcer stomach pain are often short-lived and preventable.

Endoscopy and Biopsy may involve examination of the stomach through a gastroscope inserted through the esophagus (fiberoptic endoscopy) to find ulcers and masses. It is the most definitive test for diagnosis of stomach cancer. Seventy percent of early malignant ulcers may look benign and even heal, but are usually positive on biopsy.

In this procedure, the esophagus and stomach are examined using a thin, lighted tube (gastroscope) which is passed through the mouth and esophagus to the stomach. The patient's throat is sprayed with a local anesthetic to reduce discomfort and gagging. Patients may also receive medication to relax them. Through the gastroscope, the doctor can look directly at the inside of the stomach. If an abnormal area is found, the doctor can remove some tissue through the gastroscope.

A small piece of tissue may be removed form any suspicious area for biopsy analysis by a pathologist, or a brush can be passed through the gastroscope to obtain cells in a way similar to a Pap smear. Tissue and brush biopsies can diagnose 98 percent of cases.

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