Issue 3 Stories

Gut Check Time: Finding Relief for Gastrointestinal Issues

Problems with the digestive, or gastrointestinal (GI), tract can cause uncomfortable—sometimes embarrassing—symptoms such as gas, bloating, stomach pain, cramping, diarrhea and constipation. When serious or frequent enough, such symptoms can even be disruptive to life, causing missed workdays or interfering with everyday activities.

While these sensitive medical issues aren’t always easy to talk about—even to a physician—it is possible to find relief. Sentara Martha Jefferson’s gastroenterology team focuses extensively on managing disorders of the digestive tract, including the esophagus, stomach, liver, and small and large intestines, and can help you find the most effective treatments to bring you relief.

Why Are Stomach and Digestive Issues So Common?

While GI issues are certainly quite common, that doesn’t mean they’re “normal.” In many cases, these problems may be the result of a busy, hectic lifestyle, which can cause stress, anxiety, decreased appetite and poor eating habits. In addition, the Western diet, which tends to be high in sugar, fat and salt, can contribute to obesity and increase incidences of digestive problems.

“Gastrointestinal issues often are caused by cultural issues,” says Sentara Martha Jefferson interventional gastroenterologist Alan Brijbassie, MD. “A stressful lifestyle can result in an increase in digestive acid in the stomach, with an associated decrease in how much the stomach contracts. Along with that, when people are busy rushing here and there, they often skip meals or don’t eat meals on time. These factors can all cause digestive problems that can lead to GI diseases.”

GI problems also may go along with chronic diseases such as diabetes, as well as with taking medications such as nonsteroidal anti-inflammatory drugs.

Some of the most common GI disorders include:

•     Gastroesophageal reflux disease (GERD), also known as acid reflux or heartburn. The American College of Gastroenterology (ACG) estimates that more than 60 million Americans experience heartburn on a daily basis. GERD occurs when the muscle at the base of the esophagus doesn’t function properly, allowing stomach acid to flow back into the esophagus and causing chronic irritation to the esophagus lining. People who have the condition may feel a burning sensation in the throat or chest, have difficulty swallowing, or experience a feeling of having a lump in the throat. While most people experience heartburn occasionally, you should see a doctor if it occurs at least two to three times per week. Left untreated, GERD can lead to serious conditions, including narrowing of the esophagus, bleeding or a precancerous condition called Barrett’s syndrome that affects the lining of the esophagus. Potential treatments may include taking over-the-counter medications and avoiding foods that can trigger heartburn, such as chocolate, peppermint, tomatoes and citrus fruits.

•     Indigestion/dyspepsia. Many adults experience upset stomach from time to time, with symptoms including a feeling of fullness, even before finishing a meal; nausea; or a burning sensation in the stomach. The cause may be as simple as overeating or anxiety—or it may indicate a more severe condition like ulcers, pancreatitis (inflammation of the pancreas), gallstones or Celiac disease.

•     Peptic ulcers. Caused by stomach acid, these open sores develop in the lining of the stomach or the duodenum, the upper section of the small intestine. They may be caused by an infection or by regular, prolonged use of certain medications, including ibuprofen or naproxen sodium. While most people with ulcers experience no noticeable symptoms, upper abdominal pain is common. The biggest concern with ulcers is bleeding, which potentially can be life-threatening.

•     Gall bladder disorders. The gall bladder is the small sac located under the liver that stores bile, a substance that aids in the digestion of fats in the small intestine. The formation of gallstones—tiny particles made up of cholesterol, bile and calcium—in the gall bladder can cause serious problems such as cholecystitis, the inflammation of the gall bladder lining. These stones also may block the duct leading to the small intestines, which can result in serious complications like jaundice and pancreatitis.

•     Irritable bowel syndrome (IBS). This common disorder affects the function of the bowels, causing complications such as constipation and diarrhea, along with cramping, bloating and abdominal pain. The ACG estimates that while 10-15 percent of American adults have IBS symptoms, only 5-7 percent have been diagnosed. And while IBS isn’t a life-threatening condition, it can dramatically affect quality of life. Two severe forms of IBS, Crohn’s disease and ulcerative colitis, can increase a person’s risk of cancer if left untreated.

Colonoscopies Save Lives

Screening colonoscopies can help prevent colorectal cancer by detecting precancerous lesions called polyps. The procedure, usually performed under mild sedation, is done by inserting a colonoscope—a long, thin, lighted tube equipped with a camera—into the intestines through the rectum. This allows the doctor to view the inside wall of the colon and remove any polyps that may be discovered.

Due to the discomfort of preparing for the procedure, which involves drinking a laxative that causes diarrhea and cleanses the colon—as well as the inconvenience of the procedure itself—many people would prefer to avoid colonoscopy screenings. However, the screening is the best way to prevent colorectal cancer, or to detect it in the earliest stages, increasing the chances for a positive outcome. The American Cancer Society recommends screening colonoscopies for all adults beginning at age 50. Patients who have a higher risk, due to family history of colon cancer or genetic predisposition, may start screenings earlier, at the recommendation of their physician.

When Should I See a Doctor?

Be sure to see a gastroenterologist if stomach or digestive problems are affecting your daily life, and consult a doctor immediately if you have any of the following serious symptoms:

•     Unexplained weight loss

•     Dark urine

•     Blood in the stool

•     Abdominal pain that is not associated with known causes

A Wide Range of Treatment Options

Many GI disorders can be improved with lifestyle changes, such as improved eating and exercise habits. Medication also may be needed to manage some conditions. When symptoms persist or escalate, however, it may be time for further testing.

Dr. Brijbassie, who joined the Sentara Martha Jefferson medical staff in 2016, brings expertise in interventional endoscopy and advanced interventional care for patients with diseases of the hepatobiliary system, which comprises the liver, gall bladder and bile ducts. He also offers nonsurgical removal of lesions in the digestive tract, from the esophagus to the rectum, as well as a wide range of other procedures, including endoscopic retrograde cholangio-pancreatography, endoscopic ultrasound with fine-needle aspiration, tumor staging and stent placement to relieve blockages.

“My services can be thought of as a bridge between general gastroenterology and surgery,” says Dr. Brijbassie, noting that most of his patients are referred by general gastroenterologists for advanced interventional care. “On occasion I am able to offer procedures that potentially can help patients avoid surgery. On the other hand, if they do need surgery, I work closely with our surgeons in a collaborative setting to provide the best care for our patients.”

For those who may be experiencing GI issues, Dr. Brijbassie and the gastroenterology team at Sentara Martha Jefferson bring a wealth of expertise and resources to provide the most effective treatments.

“When patients come to Sentara Martha Jefferson, they can rest assured that they will receive an accurate diagnosis and advanced interventional care,” he adds. “They will also have access to a top-notch team of gastrointestinal surgeons to help treat advanced digestive problems or any GI issues related to cancer. We have a wonderful medical staff and the most advanced equipment to provide excellent care for patients with severe digestive concerns.”

Meet Alan Brijbassie

For Alan Brijbassie, MD, the field of interventional gastroenterology offers an exciting way to combine critical thinking with hands-on problem solving.

“I was drawn to internal medicine because I like to read about and better understand the human body and its complexities,” says Dr. Brijbassie, a native of Trinidad, who practices with Sentara Martha Jefferson Medical and Surgical Associates.

A graduate of the University of the West Indies, Dr. Brijbassie completed a residency in internal medicine at the Virginia Tech Carilion School of Medicine and Research Institute and a fellowship in gastroenterology at the U.Va. Health System. He worked as an interventional gastroenterologist at the Virginia Tech Carilion School of Medicine and Research from June 2013 until this past summer, when he joined Sentara Martha Jefferson Hospital.

Most of Dr. Brijbassie’s patients have cancers of the digestive tract, and he feels humbled to be able to provide advanced therapeutic care to potentially alter the quality of their lives.

“It’s such a joy to see these patients, who have been very sick, able to spend more time with their families,” he says. “It’s so rewarding to be able to help improve their lives.”

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