Gastroenterology, weight + lifestyle management


Areas of Practice


The transoral incisionless fundoplication is a minimally invasive innovative treatment for gastroesophageal reflux disease (GERD) that is performed in the outpatient setting. The TIF procedure is performed from inside the patient’s stomach without incisions. This procedure reconstructs the gastroesophageal valve (GEV) to help restore the function as a reflux barrier using the body's natural pathway.


Gastroesophageal reflux disease (GERD) occurs when there is an imbalance between the normal defense mechanisms of the esophagus and offensive factors such as acid and other digestive juices and enzymes in the stomach. Often, the barrier between the stomach and the esophagus is impaired by weakening of the muscle (lower esophageal sphincter) or the presence of a hiatal hernia, where part of the stomach is displaced into the chest. Hiatal hernias, however, are common and not all people with a hiatal hernia have reflux.  Additional contributing factors include obesity, pregnancy, smoking, excess alcohol use and consumption of certain foods such as coffee, citrus drinks, tomato-based products, chocolate, peppermint and fatty foods.  If left untreated, GERD can lead to development of a precancerous condition called Barrett's esophagus.


Nonalcoholic fatty liver disease is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol.  The main characteristic of nonalcoholic fatty liver disease is too much fat stored in liver cells.  Nonalcoholic steatohepatitis, a potentially serious form of the disease, is marked by liver inflammation, which may progress to scarring and irreversible damage then, ultimately, to cirrhosis and liver failure.  The condition occurs in every age group and is closely linked to metabolic syndrome, which is a cluster of abnormalities including increased abdominal fat, high blood pressure and high blood levels of triglycerides, obesity and type 2 diabetes.


Colonoscopy is a common and very safe procedure that examines the lining of the lower intestinal tract called the colon or large intestine.  When used as a colon cancer prevention method, colonoscopy can find potentially precancerous growths called polyps and remove them before they turn into cancer. This explains why colonoscopy is an invaluable tool that helps your doctor answer important questions about your digestive health and prevent certain diseases like colon cancer.


EGD, often referred to as upper endoscopy, upper GI endoscopy, or panendoscopy, lets your doctor examine the lining of the upper part of your gastrointestinal tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). Your doctor will use a thin, flexible tube called an endoscope, which has its own lens and light source, and will view the images on a video monitor.


Capsule Endoscopy lets your doctor examine the lining of the middle part of your gastrointestinal tract, which includes the three portions of the small intestine (duodenum, jejunum, ileum).  This part of the bowel cannot be reached by traditional upper endoscopy or by colonoscopy. The most common reason for doing capsule endoscopy is to search for a cause of bleeding from the small intestine. It may also be useful for detecting polyps, inflammatory bowel disease (Crohn’s disease), ulcers, and tumors of the small intestine.


Bravo capsule pH system measures the acid exposure to your esophagus up to 96 hours to help assess severity of GERD. It can also evaluate various discomfort in your chest as well as atypical manifestation of gastroesophageal reflux such as frequent cough, sore throat or asthma exacerbation. A small pH capsule, the size of a pencil eraser, will be attached to the lower part of the the esophagus. A pager-sized receiver worn around the waist will capture information sent by the capsule wirelessly, recording the amount of abnormal acid exposure to the esophagus. The pH capsule naturally falls off the wall of the esophagus, usually within several days, and passes through the digestive tract.


Most people diagnosed with chronic hepatitis B infection need treatment for the rest of their lives and long-term surveillance for development of liver cancer. Treatment helps reduce the risk of liver disease and prevents you from passing the infection to others. 

Until recently, hepatitis C treatment required weekly injections and oral medications that many HCV-infected people couldn't take because of other health problems or unacceptable side effects.  That's changing. Today, chronic HCV is usually curable with oral medications taken every day for two to six months. Still, about half of people with HCV don't know they're infected, mainly because they have no symptoms, which can take decades to appear. 


According to the National Health and Nutrition Examination Survey (NHANES) data from 2007–08, the overall prevalence of overweight and obesity for adults was 68 percent (approximately 72 percent among men and 64 percent among women).  For people who are considered obese (BMI greater than or equal to 30) or those who are overweight (BMI of 25 to 29.9), it is recommended that you lose weight. Even a small weight loss (between 5 and 10 percent of your current weight) will help lower your risk of developing diseases associated with obesity.  Talk to your doctor to see whether you are at an increased risk and whether you should lose weight. Your doctor will evaluate your BMI and other risk factors for complication of obesity.  We provide long-term structured and managed weight and lifestyle management.