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IBS, or irritable bowel syndrome, is a very complex topic. Irritable bowel syndrome is basically divided into an irritable bowel syndrome with constipation and irritable bowel syndrome with diarrhea. In the field of irritable bowel syndrome with constipation, there have been numerous medicines that have come out in the last few years that have helped us treat and target the colon or the large intestine to help achieve better bowel movements and better control of symptoms. In the field of irritable bowel syndrome with diarrhea, we have seen that intestinal bacteria plays a major role. Our small intestine and large intestine have several bacteria. Most of them are friendly bacteria, and there’s a small portion of bacteria that is harmful. We’ve noticed that when the balance of bacteria changes in the intestines, that can lead to various problems. Irritable bowel syndrome with diarrhea may be linked to some of this bacteria. Now, we have antibiotics that selectively target to kill bad bacteria in the intestines, and that helps symptoms of diarrhea in these patients. Also, there’s been several important changes in probiotics and prebiotics. Probiotics are basically bacteria that are good to the intestine, and these are bacteria that normally reside in the intestines. They help regulate the daily function of the intestines. Prebiotics, or nutrients that the probiotic bacteria use, and by consuming prebiotics and probiotics, the normal bacterial flora and the intestines are maintained, which subsequently leads to good regulation of bowel habits and helps with irritable bowel syndrome.

The risk factors for esophageal cancer are numerous. Excessive body weight, smoking, excessive alcohol consumption and excessive use of caffeinated products all increase the risk of reflux and subsequently increase the risk of esophageal cancer. Many of these are modifiable including the diet we consume; increasing activity, which will help reduce weight; reducing the amount of alcohol; and reducing the amount of caffeinated products. This can all reduce reflux and reduce the risk of esophageal cancer. Another important risk of esophageal cancer is family history of esophageal disease, Barrett’s, or esophageal cancer. If a family member such as a parent has an esophageal cancer, your risk of esophageal cancer also increases. You should consult with your gastroenterologist to get evaluated for precancerous changes that may exist in your esophagus.

Healthy diet is very important. It is important to prevent cancers. It is important for a healthy lifestyle. It is important for overall well-being. Diets rich in vegetables and fruits. The “Mediterranean diet” has been repeatedly proven to be the most beneficial diet to prevent cancers and live a longer and healthy life. We recommend patients consume more healthy vegetables and fruits, and more grains, as well as reduce the amount of red meat consumption, which has shown in many studies to be linked to cancers of the colon and the gastrointestinal tract. Diets that are rich in ultra-processed foods like bacon and packaged meat have also been shown to increase the risk of cancers in the gastrointestinal system and should be avoided.

Endoscopic ultrasound technology is a relatively new technology that has been available over the last decade or so. It offers a window for us to reach certain organs in the body that are very difficult to reach. Examples are the gallbladder, the pancreas and the bile ducts. Many times, small precancerous lesions, tumors, gallstones or pancreas diseases can be seen and visualized very well with endoscopy ultrasound. It offers an unprecedented access to these organs that are not usually available with other techniques such has a CT scan or MRI. There are certain diseases that are only diagnosed with endoscopic ultrasound, and that has been a major breakthrough in gastroenterology. Endoscopy ultrasound also offers an access to reach some tissue in these important organs by using a small needle that can be guided under ultrasound guidance to obtain biopsies from precancerous lesions, cysts and tumors in the body.

Barrett’s esophagus is a condition where the inner lining of the cells in the esophagus changes to a different type due to constant acid reflux and acid exposure. Barrett’s esophagus is detected by a simple endoscopy procedure where a patient is put to sleep. A small, flexible scope is introduced through the mouth and the parts of the esophagus are evaluated, and biopsies are taken to be tested for Barrett’s. If Barrett’s esophagus is identified, most of the time it requires constant surveillance every one to two years, and can be monitored with medication and treatment. In some cases, the Barrett’s can progress to early changes of cancer called dysplasia. If dysplasia is detected, a simple endoscopic procedure can again be used to use radio frequency waves to burn and treat the Barrett’s and eradicate the Barrett’s before it turns into cancer. Simple endoscopic procedure is available to treat advanced cases of Barrett’s or precancerous changes in the esophagus to prevent esophageal cancer, but the key is early detection.