Diplomat of the American Board of Internal Medicine and Gastroenterology, Gastrointestinal Diseases, Colonoscopy, and Endoscopy
Kailash C. Singhvi, M.D.
Gastroenterology
Rectal Bledding
Rectal bleeding is a very common problem affecting people. Any type or quantity of blood that one notices coming from the rectal area is considered rectal bleeding, whether it is or is not associated with a bowel movement. The most common cause for rectal bleeding is hemorrhoids, which can either occur around the anus (external hemorrhoids) or inside the rectum just above the anus (internal hemorrhoids). Another cause of rectal bleeding is an anal fissure, which is a tear in the skin lining the anus. Typically, bleeding from this is associated with pain particularly during defecation.

While hemorrhoids and anal fissures are common and benign causes of rectal bleeding, it is important for one not to presume his or her rectal bleeding is due to these conditions. Tumors, polyps, or diverticuli in the rectum or colon can cause rectal bleeding. Inflammation of the rectum (proctitis) or colon(colitis) are other causes. Whenever one sees blood arising from the rectal area, one should consult with his or her physician. The physician may recommend further testing such a flexible sigmoidoscopy and colonoscopy to identify the cause of the rectal bleeding.

RADIOFREQUENCY ABLATION

Barrett’s esophagus is a condition where part of the lining of the esophagus undergoes a change from one cell type (squamous cell) to another (columnar cell). This change is a result of chronic injury to the esophagus from gastroesophageal reflux disease (GERD). Patients with Barrett’s esophagus have an increased risk of developing esophageal cancer. The progression to esophageal cancer typically occurs by some cells in the barrett’s segment becoming more abnormal and atypical, which is called “dysplasia” in medical terms. Patients with this condition usually have their esophagus surveyed every few years to see if they are developing any signs of dysplasia.

Traditionally, the only way to remove the dysplasia before it turned into cancer was by surgery, where the patient would have either a part or the whole esophagus removed. Now Monmouth Gastroenterology is pleased to offer a new technique where both the dysplasia and the barrett’s esophagus can be treated without the need for surgery.

The technique is radiofrequency ablation. Through using a device either mounted on a balloon or the tip of the endoscope, heat energy is applied to the barrett’s segment. The procedure is done in the setting of an outpatient upper endoscopy, usually taking between 30 to 60 minutes. More than one treatment may be required to eradicate the dysplasia and barrett’s tissue. Complications from this procedure include mucosal laceration, esophageal perforation, infection, bleeding, and stricture formation. The overall complication rate is well under 1%.

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