Related Illnesses

Celiac disease is a problem with digesting gluten, which is a type of protein found in wheat, rye, and barley. When a person with celiac disease eats gluten, the body’s natural defense system (immune system) damages the small intestine.

Symptoms of celiac disease can include gas, bloating, weight loss, fatigue, weakness, and vomiting. Stools may be bulky, loose, and more frequent. The damage to the intestine also makes it hard for your body to absorb vitamins, minerals, and other nutrients. This can lead to anemia, osteoporosis or both.

Untreated celiac disease can make it hard for you to get the nutrients you need. Eating a variety of healthy foods that do not have gluten can help you keep your weight up and stay strong.

The main treatment for celiac disease is to avoid eating any foods that contain gluten. Even the smallest amount of gluten is harmful and can cause symptoms in some people.

Even if you don’t have symptoms, you still need to avoid gluten to prevent damage to the intestine.

Some people with celiac disease need to avoid cow’s milk and milk products when they first begin treatment. Most people can slowly add dairy foods back into their diet as the intestine heals. But they will still need to avoid foods with gluten for the rest of their lives.

Conducting a food sensitivity test can help identify which foods could be worsening your symptoms.Fine Colonoscopy Trifold Redo-Final2

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Ulcerative colitis and Crohn’s disease are the most common types of inflammatory bowel disease.

Ulcerative colitis affects the colon and rectum. Ulcerative colitis is a disease that causes inflammation and sores (ulcers) in the lining of the large intestine, or colon. It usually affects the lower section (sigmoid colon) and the rectum. But it can affect the entire colon. In general, the more of the colon that’s affected, the worse the symptoms can be.

Ulcerative colitis can affect people of any age, but most people who have it are diagnosed before the age of 30. Experts are not sure what causes ulcerative colitis. They think it might be caused by the immune system overreacting to bacteria in the digestive tract.

Ulcerative colitis is not caused by stress, as people once thought. But if you have ulcerative colitis, stress can make it worse.

You are more likely to get ulcerative colitis if other people in your family have it.

The main symptoms are:

– Belly pain or cramps
– Bloody diarrhea or an urgent need to have a bowel movement
– Bleeding from the rectum

Some people also may have a fever, may not feel hungry, and may lose weight. In severe cases, people may have diarrhea 10 to 20 times a day.

Ulcerative colitis can also cause other problems, such as joint pain, eye problems, or liver disease. These symptoms are more common in people who have Crohn’s disease.

In most people, the symptoms come and go. Some people go for months or years without symptoms (remission). Then they will have a flare-up. About 5 to 10 out of 100 people with ulcerative colitis have symptoms all the time.

Ulcerative colitis can lead to more serious problems. It can cause scarring of the bile duct. This can lead to liver damage. In rare cases, severe disease causes the colon to swell to many times its normal size (toxic megacolon). This can be deadly and requires emergency treatment.

People who have ulcerative colitis for 8 years or longer have a greater chance of getting colon cancer.

To diagnose ulcerative colitis, Dr. Fine will ask you about your symptoms, do a physical exam, and may require that you have a number of tests. Testing can help Dr. Fine rule out other problems that can cause similar symptoms, such as Crohn’s disease, irritable bowel syndrome, or diverticulitis.

Conducting a food sensitivity test can help identify which foods could be worsening your symptoms.

What is a Colonoscopy and why do I need this procedure done?

A colonoscopy is the preferred screening method to detect for colon cancer. This procedure both finds and removes small clumps of cells on the inner lining of the colon called polyps. Not all polyps are harmful, but some can grow into colon cancer. A colonoscopy is the only screening method that not only detects cancer at its earliest stages but can also prevent it.

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Crohn’s disease is a chronic inflammation in the bowel resulting from immune system malfunction. Research indicates that in people with Crohn’s disease, the immune system, which is responsible for protecting the body from invading substances, actually mistakes some bacteria and other organisms normally found in the intestines for foreign invaders. The body then sends white blood cells into the lining of the intestines to fight these so-called invaders. This overproduction of white blood cells results in the inflammation of the intestines. Prolonged inflammation can lead to ulcerations and injury to portions of the bowel.

Studies indicate that there may be several factors that may contribute to the development of Crohn’s disease. Foreign substances in the environment may trigger the disease. Genetics may play a role, as Crohn’s disease may be inherited. However, if someone in your family has Crohn’s disease, it doesn’t mean you will definitely get it.

The most common initial symptoms of Crohn’s disease are abdominal pain, cramping, and diarrhea. Pain usually arises at or below the navel, often in the lower right portion of the abdomen. These symptoms tend to show up after meals. Other symptoms may include:

– Loss of appetite
– Rectal bleeding
– Weight loss
– Fever
– Joint pain
– Fatigue

Conducting a food sensitivity test can help identify which foods could be worsening your symptoms.

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This is a disorder characterized by the ingestion of wheat and gluten containing foods that are not autoimmune in origin resulting in abdominal pain, diarrhea, constipation and bloating. Neurological symptoms such as brain fog, fatigue, headaches and numbness of extremities may also occur. Other undesirable symptoms, that may seem unrelated such joint pain and dry eyes could also be a manifestation as well.

There are several reasons why this may occur:

1. The hybridization of wheat of genetically modified (GMO) strains have rendered the wheat more antigenic.
2. The non-digestible carbohydrate component of wheat known as the fructan is responsible for GI symptoms.
3. Glyphosate, the active ingredient in the herbicide, Roundup(R), maybe the most important causal factor. Fish exposed to glyphosate develop digestive problems that are reminiscent of celiac disease. Celiac disease is associated with imbalances in gut bacteria that can be fully explained by the known effects of glyphosate on gut bacteria.

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Irritable bowel syndrome is a common intestinal condition. Its cause is unknown and there is currently no cure. Roughly, 30% of Americans have IBS. It affects women about twice as often as men.

IBS is characterized by abdominal pain, changes in bowel movements, gassiness, nausea, cramps, bloating and other symptoms.

The cause of IBS occurs when food that is passed through the digestive system by means of peristalsis, a wave-like series of movements made by muscles in the wall of the digestive system, that normally occur AFTER meals, is occurring sporadically in unusual patterns. It may go on for extended periods of time or it may take place at a much slower pace. IBS is any condition in which the colon does not function normally.

Conducting a food sensitivity test can help identify which foods could be worsening your symptoms.

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What is EoE?

This inflammatory condition, commonly referred to as EoE, effects the walls of the esophagus because it becomes infiltrated with eosinophils. Eosinophils are a type of white blood cell associated with allergic reactions. Individuals, who acquire EoE, develop a series of narrowing rings or strictures within their esophagus that over time can seriously affect their ability to swallow. The symptoms associated with this disease are heartburn, reflux, chest pain, and swallowing difficulties.

Eosinophilic esophagitis most commonly occurs in individuals with other allergic conditions such as hay fever, allergic rhinitis, and atopic dermatitis. The exact mechanism of this illness is unknown but is felt that this illness is precipitated by an allergic reaction to foods.

What are the treatment options for EoE?

EoE is a chronic disorder that can wax and wane. Currently, there is no known cure. There are various symptom management options which need to be discussed with your Dr. Fine as each option has its pros and cons with a variable chance of success and may require one or more approaches like special diet or medication.

Dietary Treatments

Sometimes the first dietary approach adopted by patients is often to avoid the ​types of food that stick. These may not actually be the foods that cause the inflammation but may ​just be solid types of food (meat or bread) that just get stuck and as such may be of little help in treating their condition.

Elimination diets of foods ​that might trigger the symptoms or inflammation

Although a natural method, it requires careful ​avoidance of 2 to 6 or more foods and repeated (up to 7 or more) endoscopies to discover the ​true reactivity to each food, so that a long-term plan can be reached. The common foods linked to ​the condition which might be excluded include Dairy, Wheat, Eggs, Soya, Rice some fish and some ​vegetables (legumes).   During this process, careful attention to nutrition is essential as these diets can have a high success rate, but they can be difficult to adhere to in the long term.

Diagnostic options include esophagogastroduodenoscopy. EGD procedure information click here. This test allows the physician to look directly into the esophagus and inspect the lining and also take tissue samples from the upper gastrointestinal tract.

Conducting a food sensitivity test can help identify which foods could be worsening your symptoms.

Treatment for this illness includes acid blockers, topical and/or oral steroids, as well as an elimination diet.

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This disease commonly known as GERD is a condition in which acid from the stomach regurgitates back into the esophagus causing symptoms of heartburn, indigestion, coughing, chest discomfort, and hoarseness.

A test used to assist in the diagnosis of GERD includes esophagogastroduodenoscopy. This test allows the physician to look directly into the esophagus and inspect the lining and also take tissue samples from the upper gastrointestinal tract.

Conducting a food sensitivity test can help identify which foods could be worsening your symptoms.

Treatment consists of an anti-reflux diet, avoiding foods, which result in decreasing the pressure of the lower esophageal sphincter, which results in allowing acid to reflux back into the esophagus. However, there is recent evidence to suggest that other foods may have a direct injurious effect on the esophagus. Additional treatment options may include acid blockers, as well as an elimination diet.

Heartburn and Reflux diseases

The lower esophageal sphincter is located between the esophagus and stomach which
normally opens after swallowing. This allows food to pass into the stomach. This sphincter is supposed to close quickly to prevent the return of food and stomach juices from going back into the esophagus.
When the sphincter is slow or weak, the acid contents from the stomach can back up and cause gastro-esophageal reflux that produces heartburn.

Symptoms of Heartburn include:

Burning pain between the breastbone area
Burning pain or reflux symptoms that are worse when lying down or bending over
Sensation that food is coming back into the mouth, accompanied by an acid or bitter taste usually occurring after eating a meal

Foods to avoid minimizing heartburn:
Fried and fatty foods
Peppermint
Coffee
Ketchup & mustard
Tomato sauce
Aspirin and other anti- inflammatory pain relievers other than acetaminophen
Chocolate
Alcohol
Carbonated sodas
Vinegar
Citrus foods or juices

Stop smoking

Hemorrhoids are cushions of tissue containing swollen veins in the lower rectum or around the anus, they are also known as piles.

Most hemorrhoids are asymptomatic but approximately 10% have symptomatic hemorrhoids and should seek medical attention. Symptoms include itching, bleeding, and pain.

Hemorrhoids can be classified as either internal or external:

• Internal: swollen veins inside the rectum that form above an area known as the dentate line. When internal hemorrhoids become enlarged, the tissue may protrude out through the anus. The level of protrusion dictates the degree of severity.
• External: swollen veins that form below the dentate line and can often be seen and felt under the skin outside the anal canal. They often appear as small bulges.

Common signs and symptoms of hemorrhoids include:

• Prolapse: If an internal hemorrhoid causes the swollen tissue to push through the anal opening, it is considered a prolapsing hemorrhoid. This prolapsed tissue (which other symptoms associated with hemorrhoids) can sometimes reduce on its own, while other times it may need to be pushed back inside the anus manually.
• Bleeding: Only internal hemorrhoids cause bleeding. If you have an internal hemorrhoid, you may notice a small amount of bright red blood on the toilet paper, covering the stool, or inside the toilet bowl.
• Itching: Itching around the rectum is one of the most common symptoms of hemorrhoids. If you experience ongoing itching, it’s best to seek treatment, as scratching or continuous wiping of the area can lead to the worsening of symptoms.

What causes hemorrhoids?

Hemorrhoids can result from too much pressure in the rectum due to a variety of factors. Hemorrhoids are often linked to diet, constipation, diarrhea, obesity, pregnancy, childbirth, and even sitting for extended periods of time.

When to treat hemorrhoids:

If left untreated, hemorrhoids can worsen over time, requiring banding or in some instances, surgery may be required.

When should you seek medical attention?

If experiencing bleeding, itching and pain.

Conservative medical treatment includes:

High fiber diet, Epsom salt soaks and topical therapies.

If treatment is sought early, hemorrhoids can often be treated painlessly in a matter of seconds, and the chance of recurrence is reduced. Don’t wait – learn more about definitive protocols.

Anal fissures, though different in nature, share many signs, symptoms, and even causes with hemorrhoids. Many patients suffering from hemorrhoids also suffer from fissures. Those suffering from fissures have a great deal of pain.

Foods to avoid
It’s a good idea to limit foods that are low in fiber. These can worsen constipation, which can trigger piles.
Low-fiber foods to avoid include:
Dairy products. These include milk, cheese, and other varieties.
White flour. This flour has had the bran and germ removed, making it less fibrous. Products made from this type of flour include white breads, pasta, and bagels.
Red meat. Avoid this type of meat, as it takes longer to digest and may exacerbate constipation.
Processed meats. These foods, such as bologna and other cold cuts, are low in fiber and high in sodium, increasing your risk of constipation.
Fried foods. These can be hard on your digestive tract and difficult to digest.
Salty foods. They may cause bloating and make your hemorrhoids more sensitive.
You should also avoid:
Spicy foods. While not necessarily low in fiber, spicy food may increase pain and discomfort associated with hemorrhoids.
Caffeinated beverages. These beverages, especially coffee, may harden your stools and make it more painful to use the restroom.
Alcohol. Like caffeinated beverages, alcoholic drinks can dry up your stools and exacerbate the discomfort of piles.

The best way to know for sure is to come in for a consultation.

Bloating is a common complaint, the cause has to do with its relationship to eating, the timing after eating, association with diarrhea, constipation, abdominal pain, weight loss and blood in stool.

Bloating may be a symptom of some of the below diagnoses:

– Gastrointestinal Motility Disorders,

– Functional Bowel Obstruction,

– Carbohydrate Maldigestion and Malabsorption.

– Gastrointestinal strictures & tumors,

– Crohn’s,

– Celiac Disease,

– Irritable Bowel Syndrome

– Small Intestinal Bacterial Overgrowth (SIBO) .

– Certain Cancers like Ovarian, Colon and Liver

In order to treat bloating effectively, a full comprehensive evaluation is recommended.

This would include:

– Conducting a careful history and physical examination,

– Lab work as determined by Dr. Fine

– Upper and Lower Endoscopy

– Imaging

– Gastric Emptying Studies

– Abdominal Ultrasound

– CT scan

Carbohydrate Mal-digestive testing includes:

– Lactose Breath testing

– Fructose Breath testing

– Sucrose Breath testing

Additional Diagnostic testing:

– Small intestinal bacterial overgrowth testing (SIBO)

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Infusion therapy is the medical treatment of disease by way of Intravenous (IV) delivery. Treatments are now available at Fine Digestive Health making it easy and convenient for you to receive the treatment you need under the supervision of a medical doctor.
At FINE Digestive Health, our mission is to deliver the highest quality of patient care, education and wellness information.
Infusion Therapy prescribed by Dr. Fine is based on his assessment of each individual patients’ needs, medical history, physical exam and other diagnostic tests. He is committed to providing the highest standards of care while collaborating with each patient to administer the best course of treatment.

Inlet Patch

What is an esophageal inlet patch?
An inlet patch is a flat red area, often velvety in appearance, in the upper esophagus that is found incidentally on endoscopy in about one in 20 patients (5%). These lesions are usually found in the proximal 3 cm of the esophagus just below the upper esophageal sphincter and rarely cause symptoms or develop into cancer. They are also referred to as heterotopic gastric mucosa of the upper esophagus.

What causes an esophageal inlet patch?
The cause of inlet patches remains unclear. It may represent embryonic gastric tissue that did not convert to squamous tissue in the esophagus. Another theory believes that they are an acquired condition, similar to Barrett’s esophagus. However, the exact mechanisms for the formation of these lesions are currently unknown.

What are the symptoms of an esophageal inlet patch?
Inlet patches usually do not cause symptoms. Rare reports have shown these lesions to be associated with dysphagia, or trouble swallowing. This may be due to rings or webs that cause strictures in the region of the inlet patch. Other potential symptoms include globus (sense of fullness in the throat) and chronic cough due to reflux of GI contents into the lungs (laryngopharyngeal reflux).

How is an esophageal inlet patch diagnosed?
The diagnosis is made by typical visual findings in the proximal esophagus on standard endoscopy. Biopsies, while not essential, can also be obtained to further confirm the diagnosis.

What are the treatment options for an esophageal inlet patch?
Treatment is usually not needed as the lesion is usually benign and rarely causes symptoms. In patients with globus symptoms in whom eradication of the inlet patch is desired as a potential treatment, ablation of the inlet patch with multipolar electrocoagulation, argon plasma coagulation or radiofrequency ablation may be attempted.

Fine EGD Trifold Revised 7.21.2020A chronic, inflammatory bowel disease that causes inflammation in the digestive tract.
Ulcerative colitis is usually only in the innermost lining of the large intestine (colon) and rectum. Forms range from mild to severe. Having ulcerative colitis puts a patient at increased risk of developing colon cancer.
Symptoms include rectal bleeding, bloody diarrhea, abdominal cramps, and pain.
Depending upon the history and physical examination, further testing may be necessary to find the cause of colitis and may include blood tests (complete blood count, electrolytes, kidney function and inflammatory marker tests), urine and stool samples, colonoscopy, and barium enema.
Treatment of colitis depends upon the cause, and often is focused on symptom relief, supportive care, and maintaining adequate hydration and pain control. Antibiotics may be prescribed to treat infectious causes of colitis. Some bacterial infections that cause colitis resolve without any antibiotic treatment.

Hepatitis C is a virus of the liver that causes inflammation or swelling that disrupts the liver from performing it’s necessary functions:1.breaking down medicines, alcohol and other harmful chemicals and waste from the blood,2.storing nutrients and releasing them as your body needs them,
3. making important chemicals for blood clotting and healing, and bile, a liquid that digests fat.
Left untreated, this inflammation can damage your liver and cause cirrhosis. The built up scar tissue caused by cirrhosis can block blood flow and make it hard for your liver to remove toxins and help digest food. Over time you may be at risk for liver cancer.
Chronic Symptoms include: feeling tired, muscle and joint pain, tenderness around the liver,yellowing of the skin and whites of the eyes, dark yellow urine, loss of appetite,nausea or vomiting, and light-colored bowel movements.
Once diagnosed, Dr. Fine will recommend a course of treatment that is best for you.

Fine EGD Trifold Revised 7.21.2020Barrett’s esophagus is the condition in which the esophageal lining changes, becoming similar to the tissue that lines the intestine.Barrett’s esophagus is diagnosed when an upper endoscopy and a biopsy are
performed. The Barrett’s tissue has a different appearance. Barrett’s esophagus is 2 times more common in men than women. Men with a history of heartburn are more susceptible. Dr. Fine will work with you to develop a medical treatment plan to address your symptoms.

Peptic ulcers are one of the most common diseases of the digestive tract. Peptic ulcers occur when the stomach acid successfully penetrates the stomach or intestinal lining and causes sores in the lining. These sores can bleed and become painful. If untreated, these sores can eat a hole in the stomach or intestinal lining at which point surgery would be required.
Many ulcers are caused by these factors: an infection with the bacteria – H pylori, contaminated water, or the regular use of pain medications- NSAIDs- (non-steroidal anti-imflammatory drugs) these include: aspirin, ibuprofen, naproxen, ketoprofen, and celecoxib.
Dr. Fine is trained to treat these types of ulcers. Once he confirm’s the diagnosis, he will create a treatment regimen for you.

Colon cancer can usually be cured if found early, but the more the colon cancer grows, the more difficult it can be to treat.
For people with an average risk who have no symptoms, Dr. Fine as well as other gastroenterologists recommend screening tests for colon cancer every ten years, starting at age 45. People at a higher risk may benefit from earlier, more frequent screenings.
A colonoscopy is the preferred screening method. This procedure both finds and removes small clumps of cells, called polyps, on the inner lining of the colon. Overtime, if not removed or treated can grow into cancer.
Deaths from colon cancer have gone down over the past few decades because more people are getting screened.
Today, more than 60 percent of people aged 45 to 75 are regularly screened for the disease.
Doctors are detecting colon cancer more often and at an earlier stage when it’s most treatable. In fact, 90 percent of people with colon cancer live five years or more after treatment if the cancer is found and removed at any early stage.
Screening guidelines for colorectal cancer are based on your risk and factors specific to you. These include your age, personal and medical history, and genetics.
If you are age 45 or older, you are at an average risk of colon cancer if you have the following:
• no symptoms
• no personal or family history of colorectal cancer or precancerous polyps (noncancerous growths in the inside surface of the colon or rectum)
• no personal history of inflammatory bowel disease, such as ulcerative colitis or Crohn’s colitis
If you have an increased risk of colorectal cancer, discuss with your doctor if you should have earlier, more frequent screenings.
You are at an increased risk if you have one of the following:
• a personal history of colorectal cancer or precancerous polyps
• a family history of a first-degree relative (such as a parent or sibling) who had cancer or precancerous polyps in the colon or rectum before age 50, or multiple family members with colorectal cancer or polyps
• a personal history of long-standing (more than eight years) inflammatory bowel disease, such as ulcerative colitis or Crohn’s colitis
• a family history of familial adenomatous polyposis (FAP). This condition is a rare form of hereditary colon cancer. FAP can lead to the development of hundreds or thousands of polyps in the colon at an early age. If left untreated, people with FAP will almost always develop colon cancer by age 40.
a family history of Lynch syndrome (formerly known as hereditary nonpolyposis colorectal cancer). This condition is caused by mutations in specific genes. It accounts for approximately 2 to 3 percent of all colorectal cancer diagnoses.

Gastroparesis is a condition in which food stays in your stomach longer than it should.

Gastroparesis symptoms include:

Dr. Fine performs treatments and procedures in-office, in a hospital setting or in an ambulatory surgical center.

Here is a list of procedures and pamphlets for your convenience.

Dr. Fine performs Colonoscopy, EGD, Pill Cam,

and Hemorrhoid banding.

FDH Infusion Therapy

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Common foods that cause Gas