Expertise in Gastrointestinal Services
Floyd Memorial offers a complete range of screenings and services for people with gastrointestinal, or GI, conditions. “A healthy digestive system is something people take for granted,” said James Strobel, MD, a specialist in gastroenterology and hepatology. “But when something goes wrong, it can make you incredibly miserable very fast. As a gastroenterologist, it is extremely rewarding to be able to help people when they need it most.”
Treating the Upper and Lower GI Tracts
“One of the most common conditions I see is acid reflux, or GERD (gastroesophageal reflux disease),” said Dr. Strobel. “This occurs when acid from the stomach leaks up into the esophagus because the ring of muscles that separate the stomach from the esophagus does not close properly. An upper GI tract endoscopy procedure can help us diagnose and evaluate GERD, which may then be treated with medication or surgery.”
An upper endoscopy may also be used to examine ulcers, tumors, bleeding or narrowing of the esophagus that may be causing difficulty in swallowing. This is an outpatient procedure that involves inserting a flexible tube with a camera on the end through the mouth into the esophagus, stomach, and, if necessary, the first section of the small intestine.
“The HealthGrades ratings are something we’re very proud of. They are proof that patients can stay close to home and receive excellent GI care right here in Southern Indiana. The professionals at Floyd Memorial are well-trained, offer a comprehensive range of skills and strengths, and provide patients with the benefit of the latest equipment and techniques.”
James Strobel, MD
Board Certified Gastroenterologist and Hepatologist
Gastroenterology of Southern Indiana, PC
“Floyd Memorial brings together excellent safety protocols, best practices that are proven to provide optimal results, and a tremendous depth of experience in a wide range of surgeries and services. We’re well prepared to handle any GI problem a patient brings to us.”
Julie Hutchinson, MD, FACS
Board Certified General Surgeon
Floyd Memorial Medical Group-Surgery
The Digestive System at a Glance
Your gastrointestinal, or digestive, system breaks down the food you eat into simple chemicals. These are then absorbed into the blood and carried to the body’s cells, where they are used for energy and for building the body. The system includes many parts, each of which plays a unique and important role.
The digestive tract is a coiled, muscular tube that extends from the mouth to the anus and is sometimes called the “gut.” It is aided in its functions by the liver, which produces bile to help break down fats, the gallbladder, which stores the bile until it is needed, and the pancreas, which makes enzymes that convert carbohydrates, proteins and fats into nutrients for the body.
When you swallow, food mixed with saliva travels through the esophagus into the stomach.
In the stomach, food is mixed and churned with digestive enzymes. From the stomach it travels to the small intestine. Here, enzymes produced in the liver, pancreas and small intestine break down the food. That mixture passes through the intestine wall into the blood, which carries the nutrients throughout your body.
Excess water and undigested food pass into the large intestine, where water is absorbed into the blood.
Solid waste from the large intestine is stored in the rectum, until the muscles of the anus push it out of the body.
“We also diagnose and treat people with problems in the lower digestive tract,” explained Dr. Strobel. “These include diarrhea, constipation, diverticulitis and bleeding. One important tool for our evaluation is a lower endoscopy, in which the lower portion of the digestive tract can be visually examined.”
More Patients Are Seeking Colonoscopy Screenings
“One of the biggest changes I’ve noticed since I started practicing is the increased awareness of the importance of colon cancer screening with colonoscopy,” said Dr. Strobel. “Ten years ago, most people shied away from it. But now, people are coming to me saying they want a colonoscopy. It’s exciting to see that educational efforts have taken hold.”
Care for the Liver, Pancreas and Gallbladder
As Dr. Strobel explained, “We also see patients with gallstones and disorders such as hepatitis, a serious disease of the liver, and pancreatitis.” Pancreatitis results when the digestive enzymes produced in the pancreas become active inside the pancreas instead of flowing into the small intestine. Without prompt medical care, these enzymes can eat away at pancreatic tissue, leading to inflammation and permanent loss of pancreatic function.
Simple Advice for Better GI Health
According to Dr. Strobel, “The most important tips I can offer people for their GI health are the ones they hear over and over:
- Eat foods that are high in fiber and low in fat
- Get plenty of exercise
Most people don’t realize how much better they could feel if they did these things.”
Advanced GI Surgeries
“The GI tract affects just about everything, from the ability to swallow and absorb food, to a person’s energy level and ability to lead a normal life,” explained General Surgeon Julie Hutchinson, MD, FACS. “At Floyd Memorial, we make every effort to treat people who have these life-changing problems expediently, which sometimes involves surgery.”
Most GI Surgeries Are Minimally Invasive
According to Dr. Hutchinson, “We can do the majority of our GI surgeries using minimally invasive laparoscopic techniques, which means less post-op pain, faster recovery and minimal scarring.”
“Among the many laparoscopic GI procedures we perform,” said Dr. Hutchinson, “are cholecystectomy, or removal of the gallbladder, exploration of the common bile duct, and colon surgery for treatment of cancer, diverticulitis, and ulcerative colitis. When a patient needs repair of a hiatal hernia or surgical treatment of acid reflux, we may perform a procedure called Nissen fundoplication. This involves wrapping the upper part of the stomach around the lower end of the esophagus to aid in the closing function of the ring of muscles that prevents acid from rising up out of the stomach. The opening may also be narrowed by sutures to treat hiatal hernia, in which the upper part of the stomach slides up through the esophageal opening of the diaphragm.”
“Another procedure we often perform,” added Dr. Hutchinson, “is the stapled hemorrhoid procedure, which gives the patient relief with a less painful recovery.”
ERCP, or Endoscopic Retrograde Cholangiopancreatography, is a procedure in which a thin, flexible viewing instrument is inserted through the mouth into the digestive tract. A tiny plastic catheter is passed through an open channel of the scope into the bile duct from the gallbladder to the small intestine or into the pancreatic duct. Dye may then be injected and X-rays taken of the ducts. “The open channel also allows instruments to be passed through it in order to perform biopsies or to relieve blockage,” said Dr. Hutchinson.
Advanced Bravo™ pH Monitoring System Helps in Evaluating Acid Reflux
To monitor the acid levels in the esophagus of a patient with acid reflux and provide information that will help the physician create the most effective treatment plan, Floyd Memorial offers testing with the Bravo probe.
To begin the evaluation, a small capsule is attached to the wall of the patient’s esophagus. It measures the pH, or acid level, in the esophagus for up to 48 hours and sends that information by radio to a receiver worn on the patient’s belt. The patient also keeps a diary of symptoms by entering them into the receiver. When the study is completed, the data collected in the receiver is analyzed so the physician can make an accurate diagnosis and develop the best possible treatment plan. The disposable pH capsule usually detaches and passes out of the patient’s digestive tract within a week.
Bravo pH Monitoring System