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ShapeFrequently Asked Questions

01. What is gastroenterology and what diseases does it deal with?

QUESTIONS FREQUENTLY ASKED BY PATIENTS IN GASTROENTEROLOGY
100 QUESTIONS 100 ANSWERS

Gastroenterology is a branch of science that studies the functioning and diseases of the digestive system. The digestive tract from the mouth to the anus, the liver, bile ducts, gallbladder, pancreas and spleen are within the scope of gastroenterology.
Gastroenterologists receive an additional subspecialty training in addition to their internal medicine major specialization training. Therefore, they are more equipped in terms of knowledge, experience and competence in their field. The problem-solving practices they receive during their training will also provide greater benefits to patients in the diagnosis and treatment of diseases.
In our country, many branches perform endoscopic procedures that are frequently applied in gastroenterology practice. The main reason for this is the low number of gastroenterology specialists in our country, the need for endoscopic procedures by a large number of patients, and the popularity of the procedures in medical practice. However, it should not be forgotten that the physicians who receive training and have legal competence for endoscopic procedures are adult and pediatric gastroenterologists and gastroenterology surgery subspecialists. Other physicians who perform endoscopic procedures in Turkey do not have a truly certified training and competence that is accepted in our country or in the world. Therefore, it would be more appropriate for the procedures to be performed by gastroenterologists and gastroenterology surgery subspecialists in adults in terms of the health of the procedure.
Endoscopic procedures are laborious procedures for the patient unless sedation is applied. In upper digestive system endoscopy, the patient may gag, and in colonoscopy, pain may prevent the procedure from being optimal. Excessive gagging may cause the procedure to be cut short or to cause errors, and pain may cause a successful colonoscopy procedure to be abandoned. Therefore, if there is no obstacle to sedation, the ideal is to perform the procedure while asleep.
An endoscopic procedure performed by an experienced and competent physician does not harm any organ of the patient.
Reflux disease is the name given to the stomach acid and food coming back up into the esophagus, causing damage and causing certain symptoms.
If left untreated, reflux disease can lead to poor quality of life, chronic cough, asthma, pneumonia, bleeding and stenosis as a result of wound formation in the esophagus, and, less commonly, esophageal cancer.
Reflux disease can be classified in several ways. We call reflux that has caused damage to the esophagus that can be seen during endoscopy as “erosive reflux”. Sometimes, despite the patient having all the complaints that suggest reflux, no damage to the esophagus can be detected during endoscopy. We call this “non-erosive reflux”. Reflux that has not caused erosion in the esophagus can be detected by measuring the acidity level in the esophagus via a catheter for 24 hours with a test called an esophageal pH meter. Reflux that has caused erosion in the esophagus is classified as Stage A, B, C, and D, from mild to severe.
Reflux disease is the name given to the stomach acid and food coming back up into the esophagus, causing damage and causing certain symptoms.
In a patient suspected of having reflux esophagitis, in addition to endoscopy, esophageal pH meter, esophageal manometer, barium esophagography, chest tomography or MRI, and cardiac angiography may be performed for diagnosis and differential diagnosis, if needed.

If advanced reflux disease is accompanied by a stomach hernia and gastric valve laxity and there is no response to drug treatment, surgical repair of the hernia or laxity may be appropriate. In addition to surgery, some new methods such as STRETTA, ARMA, ARM, GERD-X have been developed to avoid or reduce drug use, and these treatment methods can be performed on appropriate patients as determined by the physician.

 

There may be a very wide list of causes such as advanced reflux esophagitis, esophageal cancer, achalasia, lung cancer, benign masses causing stenosis in the esophagus, esophageal fungus and infections, esophageal stenosis and adhesions due to pulmonary tuberculosis or other infections, and other motor diseases that prevent the esophagus from contracting. Your doctor will evaluate which of these you may have in order of frequency and probability. However, keep in mind that there may also be a psychologically based difficulty swallowing. The first procedure to be performed is an upper digestive system endoscopy.

 

Achalasia is a disease that manifests itself with difficulty swallowing solid and liquid foods, and develops when the muscle at the lower end of the esophagus, called the gastroesophageal sphincter, cannot relax, thus blocking the passage of solid foods and liquids. Food accumulates in the esophagus and comes back towards the mouth. The esophagus has also lost its ability to contract and has widened. The first examination that should be performed is upper digestive system endoscopy. Diagnosis is confirmed with barium esophagography and esophageal manometry. The treatment method is based on the principle of relaxing this muscle in various ways or reducing the pressure by cutting it.

 

These complaints are mostly complaints that can occur in conditions we call gastritis, gastric ulcer, duodenal ulcer and functional dyspepsia. If you are young and your complaints started recently, you can start medication treatment directly after a doctor's examination without having an endoscopic examination. If you have complaints that have been going on for a long time and you are not benefiting from treatment or if you are over the age of 45 and the complaints started for the first time, it would be more appropriate to treat according to the diagnosis made after the endoscopic examination.

 

The most common cause of stomach and duodenal ulcers is inflammation caused by the bacterium H. pylori, which is located in the stomach. This bacterium causes ulcers by causing excessive acid secretion or weakening the stomach wall. In addition, some painkillers and antirheumatic drugs, excessive acidic food consumption, some drugs that irritate the stomach, genetic predisposition and excessive alcohol consumption can also pave the way for ulcer formation.

 

Fasting for 12 hours is sufficient before the endoscopic examination. You can drink some normal water (except coffee, tea, fruit juice) up to 3-4 hours before the procedure.

 

Despite fasting for the first two hours, sometimes the stomach may be found full during endoscopy. In this case, there may be a disorder in the contraction movements of the stomach (gastric paralysis) or a mass that prevents the stomach from emptying. In this case, the procedure can be continued later by fasting for a longer period or by emptying the stomach with a method deemed appropriate by the physician.

 

As long as they are performed under appropriate conditions and by experienced hands, endoscopic procedures do not cause any harm to humans, regardless of how often they are performed.

 

The stomach and digestive system mucosa have the capacity to renew themselves in a very short time. Taking a normal biopsy does not cause any harm and there is no pain due to the biopsy during and after the procedure.

 

Unless you are told otherwise, you can eat immediately after the procedure is over and the anesthesia wears off.

 

Colonoscopy is an endoscopic procedure that examines the anal canal, rectum and other colon parts of our lower digestive system organs, as well as the terminal ileum, which is the last part of the small intestine. The intestines are emptied and cleaned the day before with a method deemed appropriate by the physician, and this procedure can be performed the following day.

 

It is an endoscopic procedure in which only the rectum and sigmoid colon, the last parts of the intestine, are examined without taking any oral preparations. The procedure can be performed with only a local enema and the last 1/3 of the colon is examined.

 

Prolonged fasting or severe diarrhea cannot provide adequate cleansing for colonoscopy without preparation. The same preparation medications should be taken for adequate cleansing.

 

In those who cannot take any preparation medication, sometimes repeated enemas can provide sufficient cleansing for colonoscopy. In this case, depending on the indication for colonoscopy and the patient's condition, a decision may be made to perform a limited colonoscopy only after the enema.

 

Colonoscopy should be performed on patients of any age with anemia for which no reasonable cause can be identified, patients with rectal bleeding, newly developed and unexplained constipation, patients with changes in bowel habits, patients with diarrhea lasting longer than two months, patients with weight loss accompanied by abdominal pain, and those with intestinal wall thickening, masses, or suspicious lesions detected by other imaging methods.

 

In Turkish society, men and women over the age of 45 should undergo colonoscopy for colon cancer screening purposes, even if they have no digestive system complaints.

 

Polyps are cut and removed during colonoscopy using a method deemed appropriate by the physician and sent for pathological examination. In patients who are removed properly by an experienced physician and who do not develop any complications, the area where the polyp was removed heals quickly and the patient does not suffer any damage or feel any pain.

 

It has been scientifically proven that polyps that remain in the intestines for a long time without intervention become cancerous to a certain extent, depending on their type and the length of their stay.

 

Red bleeding from the anus can occur in conditions such as hemorrhoids, anal fissures, ulcerative colitis and rectal cancer. Sometimes in young patients, erosions and irritations in the anal canal due to acute constipation may cause temporary bleeding and then resolve on their own. If you consult your doctor, an examination and, if necessary, a colonoscopy will be performed to make the correct diagnosis.

 

Upper digestive system bleeding causes tarry, black, foul-smelling, runny stools. In addition, iron medications, bismuth-containing medications, excessive spinach and meat consumption sometimes cause black or blackish stools. If you are not taking a medication that your doctor has informed you about, and you have complaints such as weakness, palpitations, and sweating, it would be appropriate to urgently see a health institution.

 

Hemorrhoids is the name given when the superficial veins located outside and inside the anus become prominent. When it causes bleeding and pain, it is called hemorrhoidal disease. Constipation, pregnancy and other conditions that increase intra-abdominal pressure and excessive straining can cause hemorrhoids to become more prominent.

 

As the name suggests, external hemorrhoids are located on the outer periphery of the anus and can be seen with the naked eye during examination, while internal hemorrhoids can be detected by colonoscopy and finger examination of the inner area of the anus.

 

Diarrhea lasting two months or more is called chronic diarrhea. It should be examined by a specialist physician and if there is an underlying disease, this should be revealed.

 

For unknown reasons, certain types of white blood cells in our immune system perceive the surface mucosa of the large intestine as a foreign antigen and show an inflammatory reaction against it. Limited or widespread redness, edema and ulcers occur in an area on the surface of the colon.

 
Untreated ulcerative colitis can lead to adverse conditions such as bleeding, perforation and increased risk of cancer development in the long term, in addition to symptoms that impair quality of life such as abdominal pain and diarrhea.

Just like ulcerative colitis, it occurs when our immune system misses its target and attacks and damages our digestive system. If left untreated, it can lead to adverse conditions similar to ulcerative colitis, such as bleeding, perforation and increased risk of cancer development in the long term.

 
Crohn's disease can affect the entire digestive system, from the mouth to the anus.
Smoking is associated with exacerbation and treatment failure in Crohn's disease, but not in ulcerative colitis. Therefore, smoking cessation is strongly recommended as part of treatment for Crohn's disease.
Many causes can cause fatty liver disease. Hepatitis B, C, alcohol use, some medications, diabetes, high blood cholesterol and triglycerides are some of them. The most common cause of fatty liver in our country and in the world is obesity, which we call overweight. If your physician investigates the cause of your fatty liver and finds a cause, a treatment plan can be made.
Most fatty liver disease due to excess weight has a benign course. However, in some patients, this condition, which we call non-alcoholic fatty liver disease, can progress to a condition called NASH by physicians and can lead to cirrhosis. This condition should be examined and a treatment plan should be made after the diagnosis is made. It should be kept in mind that the most common cause of cryptogenic (unknown cause) cirrhosis in the world is this type of fatty liver disease called NASH.
Treatment of fatty liver disease is directed towards the cause. Excessive alcohol intake should be stopped, and hepatitis B, C should be treated if detected. If there is uncontrolled diabetes and high cholesterol-triglyceride levels, these should be controlled. The most common cause of fatty liver in the society is obesity, i.e. excess weight. Weight reduction will provide improvement in fatty liver. The use of many drugs for treatment of fatty liver has been tried but found to be useless. A drug called pioglitazone, which is also used in diabetics, has been found effective and can be used with the decision of the physician in cases deemed necessary.
The most common cause of liver enlargement is fatty liver. If there is an enlargement without fatty liver, then the degree and shape of the enlarged liver and the presence of other accompanying findings become important. Genetic diseases, lymphoma, early stage cirrhosis and heart failure are taken into consideration by the physician. However, a moderate enlargement of the liver at the slightly upper limit of normal is usually innocent and no cause can be identified. Febrile infectious diseases in childhood are thought to be the cause. Further investigations and biopsies are usually not necessary.

Chronic HBV is when you are infected with the hepatitis B virus and become immunocompromised after an acute illness.
cannot be cleared out of your body by the system and the infection is still present in your body
continue to exist and cause various problems. These situations include surrogacy and
is an active disease state. In both cases, the approach is different and must be specialized in this field.
evaluation and follow-up by a health professional is required.

 
Chronic HCV refers to the presence of the hepatitis virus with its antibody called anti-HCV and its genomic structure called HCV RNA in your body and causing various effects. In this case, you should consult a physician specialized in this field to receive appropriate treatment. Failure to follow up and treatment will have serious consequences such as cirrhosis and liver cancer.

If the gallbladder polyps are under 10 mm, they only need to be followed up, no operation is needed. Polyps of 10 mm or more are considered to have a 10% risk of carcinogenesis and it is recommended to remove the gallbladder with an operation.

 
Most gallstones are silent and are detected incidentally on ultrasound examination. Large stones cause back pain and epigastric pain, which mimics stomach pain after a meal and is called biliary colic. Large numbers of small stones and bile sludge tend to fall into the common bile duct and cause obstruction, jaundice, infection and pancreatitis. However, the behavior of a stone cannot be predicted exactly according to its size and number. For stones that have caused problems several times, the gallbladder must be removed. Large stones that do not cause any problems can be monitored with follow-up.
The absence of a gallbladder usually does not cause any problems. However, some people may experience bile gastritis, indigestion after meals and diarrhea called biliary diarrhea after the operation.
Bile is made in the liver and transported by bile ducts to the gallbladder where it is stored; the gallbladder is a storage organ for bile, not a production site. When fatty foods reach the intestine, the gallbladder contracts and discharges bile onto these foods and helps digest the fats. The bile in the gallbladder is transported to the intestine by the common bile duct. When the gallbladder is removed, the sac and its duct, the cystic duct, disappear. The main bile duct, which we call choledoch, continues to exist. The stones in this main bile duct are mostly stones that fall here from the gallbladder. However, in people who have had their gallbladder removed, stones or sludge can also form directly in the main bile duct and cause obstruction.
Infectious diseases such as liver cirrhosis and malaria and cancers that infiltrate the spleen are among the diseases that cause severe enlargement of the spleen. If there is a serious enlargement, the cause should be investigated by a physician. However, enlargements that slightly exceed the upper limit of normal are mostly innocent and no cause can be detected.
If you need to take antibiotics and you cannot avoid drinking alcohol, taking both together is a better option than taking a break from antibiotics. If this does not happen all the time and you do not have a liver problem, both will be metabolised in the liver.

While some of the pancreatic cysts are innocent, some of them have the potential to develop into pancreatic cancer. For this reason, it may be necessary not to think like simple kidney and liver cysts, and further examination and, if necessary, biopsy may be needed. For this reason, it should not be considered as simple kidney and liver cysts and further examination and biopsy may be needed if necessary.
Liver, pancreas and brain are the primary target organs. The most important risk is liver cirrhosis and pancreatic insufficiency. However, it adversely affects all systems and significantly increases the risk of cancer formation.
Anal region (rectal area) can be expressed as a part of gastroenterological examination. Hemorrhoids, anal fissure, Crohn's disease findings can be detected by examination of this region.

A gastroenterologist is authorized and experienced in performing these procedures. However, in addition to these, evaluation of the findings detected during these procedures, the procedure called ERCP to remove stones in the main bile duct, ultrasound from inside the stomach called endosonography and intervention if necessary, diagnosis and treatment of liver diseases and diagnosis and treatment of inflammatory bowel diseases are within the scope of gastroenterology.

Persistent hiccups are a symptom of diaphragmatic irritation. We have successfully treated patients who presented with this complaint and had no lung disease, and those who were diagnosed with advanced reflux esophagitis and esophageal fungus during endoscopy.
In cases of gastrointestinal disorders, the first physicians to consult may be an internal medicine specialist or a gastroenterologist. If the initial treatment did not respond sufficiently or if further examination is needed, a gastroenterologist would be a more appropriate choice.
Since gastroenterologists are also internal medicine specialists, they can also deal with and treat hypertension if they choose.
Diabetes treatment is a difficult treatment that requires long-term follow-up. Subspecialties tend to spend time on a large number of problematic patients in their field. Diabetes treatment is the primary job of internal medicine and endocrinology and metabolism specialists. Gastroenterology specialists can also organize diabetes treatment in some basic cases if they prefer.
Hemangiomas are small blood vessel clusters that are hereditary. They can develop in any organ. The sizes of liver hemangiomas vary and can range from 1-2 mm to 5-20 cm. They can be detected with imaging methods such as ultrasound, tomography and MRI. They are usually of reasonable size, do not cause any harm and do not require monitoring. Larger hemangiomas over 5 cm should be monitored periodically for the risk of bleeding, anemia and low platelets.
First-degree relatives of patients diagnosed with colon cancer should have a colonoscopy screening every 5 years, starting 10 years before the age at which the cancer was diagnosed. For example, if a father is diagnosed with colon cancer at age 40, his children should have their first screening at age 30. The mother, father and siblings should also be included in the screening.
These cases are interesting and rare. We have such a patient. He was diagnosed with stomach cancer 10 years ago and since it was in an advanced stage, he was given only chemotherapy, not surgery. There is still a tumor in his stomach now, but there is no metastasis and the patient is still living his normal life.
For those who are overweight and cannot lose weight with diet, options may include gastric balloon application and stomach reduction surgery. One of these can be chosen depending on the patient's weight and preference.
In postmenopausal women who use gastric protectors (proton pump inhibitors) for a very long time (20-30 years) and who smoke, the risk of serious osteoporosis and bone fractures increases significantly. Apart from this, the risks of using a gastric protector are negligible. Contrary to popular belief, gastric protectors do not cause a significant increase in the risk of stomach cancer.
Stomach and duodenal ulcers, cancers, biliary gastritis, infectious diseases can do this. Examination and endoscopic examination are necessary.
Intense stress can cause functional digestive disorders such as cramping pain, nausea, vomiting, bloating, gas, and diarrhea.
RLS-IBS is the name given to the presence of complaints such as abdominal pain, gas, bloating, diarrhea, and constipation lasting longer than 6 months, even though the digestive system is anatomically normal and no disease is shown in the tests.
Whether this is due to a serious illness or a functional disorder due to stress will be determined by the physician's decision after examination and tests.
MRCP is a radiological examination in which the bile ducts are evaluated with MRI. ERCP is an endoscopic method in which stones are removed from the bile ducts or obstruction is treated with endoscopic intervention.
Endosonography (EUS) is a relatively new technique in which the liver, gallbladder, bile ducts and especially the pancreas are evaluated from the upper part of the stomach and intestines with a mini ultrasound probe at the end of the endoscope.
In normal ultrasound, since the approach is from outside the abdomen, the fine details of the pancreas and bile ducts cannot be viewed and it is more difficult to take samples. With EUS, these organs can be viewed in closer detail and samples can be taken.
EUS is the first choice for detailed evaluation and sampling of the pancreas and bile ducts.
As with any endoscopic procedure, EUS has risks related to the endoscopic procedure and, if performed, to the biopsy.
If there is no obvious cause for anemia (such as excessive menstrual bleeding in a young woman), gastroscopy and colonoscopy should be performed to screen the digestive system.
Balloon enteroscopy or, if this is not possible, MR enterography can be performed to investigate the middle parts of the small intestine that cannot be seen with endoscopy and colonoscopy.
Celiac disease usually clears up completely in 6-12 months with a strict diet that avoids wheat, barley, rye, and oats. Blood tests become negative.
Liver cirrhosis is a disease that is most commonly caused by hepatitis B and C in Turkey, and alcohol in Europe, where the liver shrinks and loses its functions, and in the advanced stages, it manifests itself with fluid retention in the abdomen, edema in the legs and jaundice. In the final stages, it can lead to bleeding from enlarged veins in the esophagus and coma, leading to death.
The treatment of cirrhosis is to eliminate the cause in the early stage, to follow up and treat the symptoms we call complications in the middle stage, and to liver transplantation in the advanced stage.
Abdominal fluid accumulation, or ascites in medical terms, is a condition that can be seen in liver cirrhosis, as well as cancers, heart failure, kidney diseases and infectious diseases.
Treatment can be done according to the cause. In cirrhosis and heart failure, the use of diuretics and direct drainage of the fluid with a needle are also options.
Öncesinde uygun bir diyet yapıldıktan sonra (2-3 gün etten ve demirden fakir beslenme) verilen testte 3 kez üst üste dışkıda gizli kan pozitif çıkması sindirim sisteminin endoskopik taraması için güçlü bir endikasyondur.
According to a new study conducted in Turkey, the risk of colon cancer increases significantly in women and men in their 50s. For this reason, it is recommended that you have a digestive system screening at the age of 45, even if you have no digestive system complaints, in order to detect precursor lesions that may lead to cancer.
A need to go to the toilet between 3 times a day and once in 3 days is considered normal. More than 3 loose stools a day can be defined as diarrhea, while infrequent and hard bowel movements more than once in 3 days can be defined as constipation.
SIBO (Small Intestine Bacteria Overgrowth), an acronym for small intestinal bacterial overgrowth, refers to an increase in the number of bacteria in the small intestines and/or a change in the types of bacteria there. Nonspecific symptoms include bloating, abdominal pain, gas, nausea, indigestion, constipation, and diarrhea. Risk factors for SIBO include structural/anatomical problems, motility disorders, immune deficiency, decreased digestive secretions, aging, and various medications (repeated antibiotic use, PPIs, opioid analgesics).
It is often used in conjunction with antibiotics, probiotics, and nutritional planning for the treatment of SIBO. These antibiotics aim to suppress overgrowth in the small intestines.
Diseases that the presence of H. Pylori can cause in the digestive system include gastritis, atrophy (thinning of the stomach wall), intestinal metaplasia (cellular changes that may lead to cancer), stomach ulcer, duodenal ulcer, stomach cancer and stomach lymphoma.
Eradication of H. pylori with effective treatment cures gastritis and gastric-duodenal ulcers by 90-95%.
H. pylori, which is located under the superficial layer of the stomach, is positive in 70% of Turkish society and approximately 50% in European societies. However, this bacterium located in the stomach does not cause the same problems in everyone. It mostly gets along well with the immune system and does not cause any problems in most people like a flora bacteria. However, in some people, it causes serious problems due to incompatibility with the immune system or unexplained reasons such as the subtype of H. pylori. These are the patients who need treatment and eradication.
Eradication of H. pylori may also cause temporary or permanent improvements in upper and lower digestive system complaints (constipation, diarrhea, gas, bloating).
It can be said that H. pylori treatment does not disrupt the intestinal flora but rather repairs it.
After completing H. pylori treatment, it can be tested whether it has disappeared with a urea breath test and Hp antigen in the stool, provided that no antibiotics or PPI drugs are taken for 15 days.
The patient is first put to sleep and then endoscopy is performed to check whether the stomach is suitable for balloon application. Gastric-duodenal ulcer, cancer, advanced-stage stomach hernia and advanced-stage reflux are conditions that prevent balloon insertion. If these are not present, the balloon is lowered into the stomach through the mouth while the patient is sleeping. There, it is inflated with an appropriate volume of fluid (400-700 cc) according to the patient's condition and the procedure is completed.
The swallowable gastric balloon is applied while awake without endoscopy. Its disadvantages are that the stomach cannot be checked for suitability beforehand, it is swallowed while awake, an x-ray device is needed and it is expensive. Its advantage is that it does not require anesthesia and does not need to be removed, and it dissolves and is excreted in the feces within 4-6 months.
After the 4-5 day adaptation period following the gastric balloon application, you can walk, do sports and do pilates. It is not possible to burst the balloon by lying on it or applying pressure.
Gastric balloon application is the most innocent method for losing weight after dieting, and as long as the diet is followed and the portion size is reduced, no temporary or permanent damage to the body has been detected.
There are six-month and 12-month gastric balloons. A quality six-month balloon can remain intact in the stomach for 6-8 months. If it remains longer, there is a risk of the balloon deforming and perforating. Annual balloons are generally balloons whose volume can be adjusted and increased at different times. Their disadvantage is that they are expensive.
A 24-hour esophageal pH meter is a test performed to confirm the presence of reflux and to assess the severity of reflux. The test results can be used effectively to adapt medical therapy and decide whether endoscopic or surgical methods are necessary for the treatment of GERD.
Esophageal manometry is an examination that evaluates the strength, order and function of the contractions of the esophageal muscles during swallowing through a special catheter inserted into the esophagus. It provides qualitative and quantitative assessment of esophageal pressures, coordination and motility. Situations in which esophageal manometry should be performed: to evaluate functional diseases of the esophagus, to determine the location of the lower esophageal sphincter before pH measurement, to exclude functional diseases of the esophagus before reflux surgery. In order for esophageal manometry to be performed, the patient must have the following symptoms: difficulty swallowing (dysphagia), pain during swallowing (odynophagia), chest pain (after excluding heart pain), prolonged dry cough, burning in the esophagus and stomach.
With anorectal manometry, the symptoms and statistical values ​​of muscle functions and pressures in the anal canal are measured. The procedure is carried out by inserting a thin catheter with a small balloon at its tip into the anus. All values ​​observed during this procedure are transferred to the computer and evaluated.
In addition to achalasia, difficulty swallowing can also be seen after neurological diseases affecting the esophageal muscles, a muscle disease called scleroderma, esophageal and lung cancers, advanced-stage reflux, fungal and bacterial infections of the esophagus, benign adhesions in the esophagus, and submucosal masses.
Alcohol-related chronic pancreatitis or pancreatic insufficiency is the inability to produce sufficient amounts of enzymes as a result of chronic pancreatic damage caused by alcohol. The pancreas produces important components that help us digest proteins, fats, and carbohydrates. The most common symptoms of insufficiency are upper abdominal pain and diarrhea. As the disease becomes more chronic, patients may develop malnutrition and weight loss. If the pancreas is destroyed in the final stages of the disease, patients may develop diabetes. Treatment consists of the principle of relieving pain and replacing the missing pancreatic enzymes and other components by appropriate means.
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