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You know what it feels like.
BUT do you know what it can do to you?
That burning sensation is caused by stomach acids backing up into your esophagus, the tube that carries food to your stomach. Those acids can damage delicate tissue. Sometimes the damage leads to cancer.
That's why chronic heartburn is something you can't ignore.
FIND OUT: Is it MORE than heartburn?
About New HALO Technology
To schedule an appointment,
CALL 631-727-4171
Office Located at: 36 Osprey Avenue, Riverhead, NY 11901
Read more about Dr. Mehta
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If you suffer from heartburn more than twice a week or have trouble falling asleep due to chronic acid reflux, you may have gastroesophageal reflux disease or GERD.
What is GERD
GERD (gastroesophageal reflux disorder) is a malfunction of the valve between the stomach and the esophagus (the swallowing tube that leads from the mouth to the stomach). When the valve does not close fully (or not at all) the contents of the stomach, like—acid and enzymes, leak back into the esophagus. This is called reflux. Some reflux is normal, but if symptoms occur more than twice a week a specialist in Gastroenterology should be consulted for evaluation and treatment.
Does GERD lead to cancer?
In some people, the damage and inflammation associated with acid reflux can cause genetic changes that cause the normal esophagus tissue to change into intestinal tissue. When this happens it is called Barrett's esophagus. Left untreated, Barrett's esophagus can lead to cancer of the esophagus.
There are no symptoms specific to Barrett's esophagus, other than the typical symptoms of acid reflux or GERD. It is estimated that approximately 15% of people who suffer with chronic acid reflux also have Barrett's esophagus.
GERD puts you at risk for Barrett's esophagus—a pre-cancer condition.
Read more ...
The HALO procedure uses radiofrequency ablation (RFA) delivered thru an endoscope to destroy the diseased lining of the esophagus and allow normal tissue to regenerate.
Specialists at Eastern Long Island Hospital are leaders in the treatment of Barrett's esophagus and certified to perform the HALO procedure.
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HALO Therapy
Advanced Ablation Technology for Treating Barrett's Esophagus
Treat Barrett's - Remove the Risk of Cancer
HALO therapy, a non-surgical procedure, uses radiofrequency ablation (RFA) technology specially designed to remove the Barrett's epithelium (thin layer of tightly packed cells lining the esophagus). This ablation therapy is delivered through short, well-tolerated endoscopic, which in clinical studies reduces the likelihood of cancer development 90%.
Patient Benefits:
The procedure usually requires three to four treatments for the tissue of the esophagus lining to regenerate. Ongoing management of GERD is important to support the re-growth of healthy tissue.
Questions & Answers:
How GERD Leads to Barrett's
If you have chronic acid reflux or frequent heartburn, you are at risk for a condition called Barrett's esophagus.
Barrett's esophagus is a change in the lining of the esophagus, the swallowing tube that carries foods and liquids from the mouth to the stomach. Left untreated, it can lead to cancer of the esophagus. About 3.3 million American adults have Barrett's.
Read more ...
Barrett's Esophagus Facts
Barrett's esophagus is a condition affecting the lining of the esophagus, the swallowing tube that carries foods and liquids from the mouth to the stomach. Barrett's esophagus is caused by injury to the esophagus from the chronic backwash of stomach contents (like acid and enzymes) that occurs with acid reflux. There are no symptoms specific to Barrett's esophagus, other than the typical symptoms of acid reflux (or GERD).
In some people, the damage and inflammation associated with acid reflux can cause genetic changes that cause the normal esophagus tissue to change into intestinal tissue (see image to right). When that happens, it is called Barrett's esophagus (your doctor may refer to it as intestinal metaplasia). It is estimated that 13% of the people who have chronic acid reflux also have Barrett's esophagus.
Read more ...
Barrett's and Cancer
Cancer occurs when the abnormal cells involved in Barrett's esophagus have rapid and uncontrolled growth and invade the deeper layers of your esophagus. This is called cancer of the esophagus, or esophageal adenocarcinoma (EAC). The cancer can also spread beyond the esophagus.
Patients with the first phase of Barrett's esophagus (intestinal metaplasia) have a combined risk of 1.4% per year of progressing to high-grade dysplasia or cancer ("dysplasia" refers to abnormalities of a tissue or cell that make it more cancer-like and disorganized). While rare, cancer of the esophagus is the most rapidly rising cancer in the U.S. It is often incurable because it is frequently discovered at a late stage.
Read more ...
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 COLONOSCOPY
A colonoscopy is an exam that allows a doctor to closely look at the inside of the entire colon. The doctor is looking for polyps or signs of cancer. Polyps are small growths that over time can become cancer. The doctor uses a thin (about the thickness of a finger), flexible, hollow, lighted tube that has a tiny video camera. This tube is called a colonoscope. The colonoscope is gently eased inside the colon and sends pictures to a TV screen. Small amounts of air are puffed into the colon to keep it open and allow the doctor to see clearly.
The exam itself takes about 30 minutes. Patients are usually given medicine to help them relax and sleep during the procedure.
Your doctor decides how often you need this test, usually once every 10 years, depending on your personal risk for colon cancer. It's important for people to talk with their doctor to understand their risk for colon cancer, the guidelines they should follow for testing, and whether they need to start being tested at age 50 or earlier.
GUIDELINES
American Cancer Society recommendations for colorectal cancer early detection.
People at average risk:
The American Cancer Society believes that preventing colorectal cancer (and not just finding it early) should be a major reason for getting tested. Finding and removing polyps keeps some people from getting colorectal cancer. Tests that have the best chance of finding both polyps and cancer are preferred if these tests are available to you and you are willing to have them.
Beginning at age 50, both men and women at average risk for developing colorectal cancer should have a Colonoscopy every 10 years at a minimum.
People at increased risk:
If you are at an increased or high risk of colorectal cancer, you should begin colorectal cancer screening before age 50 and/or be screened more often. The following conditions make your risk higher than average:
- A personal history of colorectal cancer or adenomatous polyps
- A personal history of inflammatory bowel disease (ulcerative colitis or Crohn's disease)
- A strong family history of colorectal cancer or polyps
- A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC)
The table below suggests screening guidelines for those with increased or high risk of colorectal cancer based on specific risk factors. Some people may have more than one risk factor. Refer to the table below and discuss these recommendations with your doctor. Based on your situation, your doctor can suggest the best screening option for you, as well as any changes in the schedule based on your individual risk.
American Cancer Society Guidelines on Screening and Surveillance
for the Early Detection of Colorectal Adenomas and Cancer in People
at Increased Risk or at High Risk
INCREASED RISK – Patients With a History of Polyps on Prior Colonoscopy
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| Risk Category |
Age to Begin
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Recommended Test(s)
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Comment
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People with small rectal hyperplastic polyps
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Same as those at average risk
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Colonoscopy, or other screening options at same intervals as for those at average risk
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Those with hyperplastic polyposis syndrome are at increased risk for adenomatous polyps and cancer and should have more intensive follow-up.
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| People with 1 or 2 small (less than 1 cm) tubular adenomas with low-grade dysplasia
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5 to 10 years after the polyps are removed
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Colonoscopy
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Time between tests should be based on other factors such as prior colonoscopy findings, family history, and patient and doctor preferences.
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| People with 3 to 10 adenomas, or a large (1 cm +) adenoma, or any adenomas with high-grade dysplasia or villous features
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3 years after the polyps are removed
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Colonoscopy
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Adenomas must have been completely removed. If colonoscopy is normal or shows only 1 or 2 small tubular adenomas with low-grade dysplasia, future colonoscopies can be done every 5 years.
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| People with more than 10 adenomas on a single exam
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Within 3 years after the polyps are removed
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Colonoscopy
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Doctor should consider possibility of genetic syndrome (such as FAP or HNPCC).
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| People with sessile adenomas that are removed in pieces
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2 to 6 months after adenoma removal
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Colonoscopy
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If entire adenoma has been removed, further testing should be based on doctor's judgment.
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INCREASED RISK – Patients With Colorectal Cancer
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| Risk Category
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Age to Begin
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Recommended Test(s)
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Comment
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| People diagnosed with colon or rectal cancer
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At time of colorectal surgery, or can be 3 to 6 months later if person doesn't have cancer spread that can't be removed
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Colonoscopy to view entire colon and remove all polyps
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If the tumor presses on the colon/rectum and prevents colonoscopy, CT colonoscopy (with IV contrast) or DCBE may be done to look at the rest of the colon.
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| People who have had colon or rectal cancer removed by surgery
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Within 1 year after cancer resection (or 1 year after colonoscopy to make sure the rest of the colon/rectum was clear)
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Colonoscopy
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If normal, repeat exam in 3 years. If normal then, repeat exam every 5 years. Time between tests may be shorter if polyps are found or there is reason to suspect HNPCC. After low anterior resection for rectal cancer, exams of the rectum may be done every 3 to 6 months for the first 2 to 3 years to look for signs of recurrence.
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INCREASED RISK – Patients With a Family History
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| Risk Category |
Age to Begin |
Recommended Test(s) |
Comment |
| Colorectal cancer or adenomatous polyps in any first-degree relative before age 60, or in 2 or more first-degree relatives at any age (if not a hereditary syndrome).
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Age 40, or 10 years before the youngest case in the immediate family, whichever is earlier
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Colonoscopy
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Every 5 years.
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| Colorectal cancer or adenomatous polyps in any first-degree relative aged 60 or older, or in at least 2 second-degree relatives at any age
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Age 40
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Same options as for those at average risk.
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Same intervals as for those at average risk.
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HIGH RISK
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| Risk Category
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Age to Begin
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Recommended Test(s)
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Comment
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| Familial adenomatous polyposis (FAP) diagnosed by genetic testing, or suspected FAP without genetic testing
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Age 10 to 12
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Yearly flexible sigmoidoscopy to look for signs of FAP; counseling to consider genetic testing if it hasn't been done
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If genetic test is positive, removal of colon (colectomy) should be considered.
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Hereditary non-polyposis colon
cancer (HNPCC), or at increased risk of HNPCC based on family history without genetic testing
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Age 20 to 25 years, or 10 years before the youngest case in the immediate family
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Colonoscopy every 1 to 2 years; counseling to consider genetic testing if it hasn't been done
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Genetic testing should be offered to first-degree relatives of people found to have HNPCC mutations by genetic tests. It should also be offered if 1 of the first 3 of the modified Bethesda criteria is met.1
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Inflammatory bowel disease:
-Chronic ulcerative colitis
-Crohn's disease
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Cancer risk begins to be significant 8 years after the onset of pancolitis (involvement of entire large intestine), or 12-15 years after the onset of left-sided colitis |
Colonoscopy every 1 to 2 years with biopsies for dysplasia
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These people are best referred to a center with experience in the surveillance and management of inflammatory bowel disease.
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PREPARATION
The preparation for colonoscopy makes you to go the bathroom a lot! The doctor will give you instructions. Read these carefully a few days ahead of time, since you may need to shop for special supplies and get laxatives from a pharmacy. If you are not sure about any of the instructions, call the doctor's office and go over them step by step with the nurse. Many people consider the bowel preparation (often called the "bowel prep") the most unpleasant part of the test. You follow a special diet the day before the exam and take very strong laxatives before the procedure. You may also need enemas to clean out the colon. The key to getting good pictures is to have the colon cleaned out.
Because colonoscopy is usually done with drugs that make you sleepy, people usually will miss a day of work. You'll need to stay close to a bathroom. You might want to schedule the exam for a Monday, so you can be at home the day before without taking that day off work.
Frequently Asked Questions about Colonoscopy
Colonoscopy is a screening exam for colorectal cancer (commonly referred to as “colon cancer”). But false information and a misplaced sense of modesty have scared some people away from these lifesaving tests. Here are some questions you might have and some answers for them:
- Will it hurt?
- Who will do the exam?
- Will I be in a private room?
- How will I feel afterward? Will I need someone to drive me home?
- What if they find something?
- Why are these tests so important?
Will it hurt?
No, this exam is not painful. For the most part, patients are given medicine to sleep through the colonoscopy, so they won't feel anything. Air is pumped into the cleaned-out colon to keep it open so that doctors can get the best pictures. While it may cause slight discomfort, it should not hurt.
Who will do the exam?
A colonoscopy is done by a doctor, usually a specialist gastroenterologist (a doctor whose specialty is the digestive tract).
Will I be in a private room?
Colonoscopy is done in a private area of the hospital outpatient department. The patient's privacy is a top concern.
How will I feel afterward? Will I need someone to drive me home?
Most people feel OK after a colonoscopy. They may feel a bit woozy from the drugs (anesthesia). They'll be watched and given fluids as they wake up. They may have some gas, which could cause mild discomfort. Because of the medicines given for the test, most facilities require that you bring someone to take you home.
What if they find something?
If a small polyp is found, your doctor will probably remove it. Over time some polyps could become cancer. If your doctor sees a large polyp, a tumor, or anything else abnormal, a biopsy will be done. For the biopsy, a small piece of tissue is taken out through the colonoscope. It is sent to a lab to be checked under a microscope for cancer or pre-cancer cells.
Why are these tests so important?
Colorectal cancer screening helps people stay well and save lives. Regular colorectal cancer testing is one of the most powerful weapons for preventing colorectal cancer. Removing polyps prevents colorectal cancer from ever starting. And cancers found in an early stage are more easily treated. Nine out of 10 people whose colon cancer is discovered early will be alive 5 years later. And many will live a normal life span.
But too often people don't get these tests. Then the cancer can grow and spread without being noticed, like a silent invader. In many cases, by the time people have any symptoms the cancer is very advanced and very hard to treat.
 ENDOSCOPY
Endoscopy (en-dahs-kuh-pee) is a medical procedure that uses tube-like instruments (called endoscopes.) These are put into the body to look inside. This procedure is different from imaging tests, like x-rays and CT scans, which can get pictures of the inside the body without putting instruments into it.
There are many different kinds of endoscopes, or "scopes." Some are hollow and allow the doctor to look right into the body. Others use fiber optics -- flexible glass or plastic fibers that transmit light. Still others have small video cameras on the end that put pictures on computer screens. Some endoscopes are stiff, while others are flexible. Endoscopes also vary in length. Each type is specially designed for looking at a certain part of the body.
Depending on the area of the body being looked at, the endoscope may be put in through an opening like the mouth, anus, or urethra (the tube that carries urine out of the bladder). In some cases, the endoscope is put in through a small cut (incision) made in the skin.
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Detection
Upper GI endoscopy can detect
- ulcers
- abnormal growths
- precancerous conditions
- bowel obstruction
- inflammation
- hiatal hernia
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Determine Cause
Upper GI endoscopy can be used to determine the cause of
- abdominal pain
- nausea
- vomiting
- swallowing difficulties
- gastric reflux
- unexplained weight loss
- anemia
- bleeding in the upper GI tract
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Upper GI endoscopy can be used to remove stuck objects, including food, and to treat conditions such as bleeding ulcers. It can also be used to biopsy tissue in the upper GI tract. During a biopsy, a small piece of tissue is removed for later examination with a microscope.
GUIDELINES
Endoscopy is used to diagnose and sometimes, treat conditions that affect the upper part of the digestive system, including the esophagus, stomach and beginning of the small intestine (duodenum).
You doctor may recommend an endoscopy procedure to:
- Investigate causes of digestive signs and symptoms. Endoscopy may help your doctor determine what's causing signs and symptoms, such as nausea, vomiting, abdominal pain, difficulty swallowing and gastrointestinal bleeding.
- Diagnose digestive diseases and conditions. You doctor may use endoscopy to collect tissue (biopsy) samples to test for diseases and conditions, such as anemia, bleeding, inflammation, diarrhea or cancers of the digestive system.
- Treat certain digestive system problems. Using special tools during endoscopy allows your doctor to treat certain problems in you digestive system, such as bleeding from the esophagus or stomach and difficulty swallowing caused by a narrow esophagus, or to remove polyps. Endoscopy can also be used to remove foreign objects lodged in your upper digestive tract.
PREPARATION
Gastrointestinal (GI) Endoscopy Preparation
- Wear clothing that is easily removed.
- Remove all dentures and eyeglasses prior to beginning an upper endoscopy. For colonoscopy, dentures can be left in.
- Stop taking any medications, such as aspirin and sucralfate (Carafate), used to treat ulcers, that could cause false readings on tests.
- People who have had cardiac valve replacement or blood vessel graft should receive antibiotics to prevent infection.
- Do not eat or drink anything for 8-10 hours before your examination to allow a valid examination of the upper GI tract and to lower the risk of vomiting.
- You will be given a topical anesthetic before the test to numb your throat to prevent gagging.
Frequently Asked Questions
How long will my endoscopic procedure take?
If you are scheduled for an "endoscopic procedure," plan to be in our center for about two hours.. Even though the test itself takes about 30 minutes, you will need extra time for registration, preoperative check-in, the test itself, and postoperative recovery. Currently, our patients' average stay is about two hours.
Will my endoscopic procedure be painful?
No. With the modern anesthetic sedatives, your examination should be comfortable.
Does a colonoscopy show if I have colon cancer?
Yes. In fact, colonoscopy is considered to be the most accurate way to determine the health of your colon. This includes checking for cancer, polyps, colitis, diverticulosis, and other less common lower digestive problems.
What should I expect during my endoscopic procedure?
After your pre-operative assessment, you will be taken to a private patient room. The licensed nurse will place on you equipment that monitors your heartbeat and blood pressure and gives you oxygen. After you have spoken with the physician, you will then be asked to roll onto your left side. The doctor will then administer the sedative into your intravenous line. The rest of the procedure is done while you are in a state called "conscious sedation." This is a pleasant semiconscious state in which you should be comfortable and be unaware of the actual procedure itself. The majority of patients sleep through the entire procedure.
I'm afraid that I will say things that I shouldn't while sedated.
This is a normal and common fear. Most individuals are afraid of losing control, giving away their secrets, or saying something embarrassing while they are asleep. While in a state of conscious sedation, it is very unusual for patients to speak.
If the doctor finds a polyp during my procedure, will he remove it?
In most cases, yes. All of our doctors are trained in the latest endoscopic techniques. Most polyps can be removed at the time of procedure.
How will I feel after my procedure?
After your procedure, you will probably have a slightly dry mouth and feel drowsy, gassy and hungry. The dry mouth and drowsiness are from the sedation. They will gradually wear off. The gassiness is from the puffs of air that are put into the digestive tract during the endoscopic procedure. This helps your doctor see inside your stomach or colon. Most of the air is removed before the procedure ends, but some of it just has to pass naturally.
Why can't I drive myself home after my test?
The sedation medication remains in your system for many hours. Your reflexes are slowed by the sedation, just as they would be if you drove with alcohol in your system. We suggest that you do not drive or perform activities that require quick reflexes for the remainder of the day. That is why you need a friend or family member to accompany you home.
Can I stop at a restaurant after my test?
We suggest that you go home and have light meal. You may still be drowsy from the sedation for several hours after the procedure. We suggest you go home, have a meal and take a nap for several hours. After about four hours, you may go out as long as you feel well and do not drive.
How soon will I be able to eat after my test?
As soon as you wake up our nurse will offer you some juice. After you go home, you can have a light breakfast or lunch. Eat whatever you feel like. Just go slow at first and use some common sense.
How soon can I return to work after my test?
Most patients are able to return to work the following morning.
How long do I have to wait for the results of my procedure?
The results of my endoscopic procedure are immediate. Your doctor will discuss the results of the procedure with you and your family or friend after you wake. We also give you a written explanation of what was found and what treatment, if any, is anticipated. You will also have an opportunity to ask questions, but your memory may be impaired by the sedation. Any biopsies or samples taken for lab analysis will not be available that day. The physician's office will contact you as soon as we obtain the results.
CONTACT
For appointment call phone (631) 727-4171
Office Location - 36 Osprey Avenue, Riverhead, NY 11901
Fax: (631) 727-3660
Read more about Dr. Mehta
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