Dr. Brian M. Kirsh, MD
Thank the whole staff for their services. Everyone was helpful and considerate. Thank you again!
 
-- Anonymous, Patient Satisfaction Survey - 2011

What We Treat

Gastroenterology is the branch of medicine that deals with conditions of the stomach and intestines. In ancient Greek gaster meant stomach and enteron referred to the intestine. Our gastroenterologists have expertise in all aspects of adult disorders of the digestive system. The following list, though not exhaustive, represents the most common problems we encounter day to day. If you need more information, please call our office at 216-593-7700 to schedule an appointment to see one of our physicians. 

Achalasia

Swallowing difficulties caused by abnormalities of the esophagus, the tube that connects the mouth to the stomach. It usually affects 1 in 100,000 people.

Signs and Symptoms

  • Difficulty swallowing liquids or solids
  • Chest pain
  • Heartburn
  • Hiccups
  • A sensation of fullness or a lump in the throat or chest
  • Weight Loss
Read more.
Autoimmune hepatitis is a disease in which the body’s natural defenses attack healthy liver cells. Autoimmune hepatitis is a condition that can lead to inflammation and scarring of the liver (cirrhosis) and eventually liver failure. Autoimmune hepatitis is typically chronic, meaning it can last for years.
 

Signs and Symptoms

  • Fatigue
  • An enlarged liver
  • Jaundice (sometimes called - Yellow Jaundice)
  • Itching
  • Skin rashes
  • Joint pain
  • Abdominal discomfort
  • Abnormal blood vessels on the skin
  • Nausea
  • Vomiting
  • Loss of appetite
  • Dark urine
  • Pale Colored Stools
Read more.
The esophagus is a tube that connects the mouth to the stomach. The esophagus has it's normal cells replaced by cells from the intestine. This is a precancerous condition caused by repetitive damage to the esophagus lining.
 

Signs and Symptoms

  • Usually no symptoms
  • Most people seek help because of heartburn, or
  • Difficulty swallowing
Read more.
When people with celiac disease eat foods containing gluten, the gluten causes damage to the lining of the small intestine. Gluten is a very common protein found in wheat, rye, barley and possibly oats. The body is then not able to absorb nutrients properly. This may lead to malnutrition.
 

Signs and Symptoms

  • Diarrhea
  • Difficulty gaining weight
  • Weight loss
  • Abdominal pain
  • Bloating 
Read more.
Scarring of the liver that occurs because of injury or long-term disease usually from alcohol, chronic hepatitis, or chronic bile duct obstruction.
 

Signs and Symptoms

  • Few or No Symptoms in Early Stages
  • Fatigue
  • Loss of Appetite
  • Reddish and blotchy palms
  • Swelling of the Legs (edema)
  • Swelling of the Abdomen (ascites)
  • Jaundice
Read more.

Colon Polyps

A colon polyp is an abnormal growth of the tissue in the large bowel (colon). There are different types of colon polyps and not all have the potential to turn into cancer.
  • Hyperplastic polyps are generally thought to be harmless. They do not become cancerous.
  • Adenomatous polyp, or adenoma, is a precancerous polyp. These polyps have the potential to turn into cancer. Removal of adenomatous polyps prevents them from becoming cancerous.

Signs and Symptoms

  • Usually there are no symptoms
  • Rectal Bleeding
Read more.

Constipation

Constipation is defined as infrequent bowel movements, hard to pass stools or straining during bowel movements that is troubling to the individual. Frequency of bowel movements among healthy people varies widely from three bowel movements each day to three bowel movements a week.
 

Signs and Symptoms

  • Passing stool fewer than 3 times per week
  • Abdominal bloating or discomfort
  • Straining frequently during bowel movements
  • A sensation of incomplete bowel movements
  • Having to apply manual pressure to have a bowel movement.
Read more.

Diarrhea

Diarrhea, is derived from the Greek word "to flow through", and is a common problem for many people. Because the range of normal stools is broad, it is not defined by the number of stools a person passes per day. In general, acute diarrhea is defined as less than 14 days in duration and chronic diarrhea is defined as more than 30 days in duration.
 

Signs and Symptoms

  • Painless watery bowel movements

Alarm Symptoms (require medical attention)

  • High Fever
  • Bloody Stools
  • Dehydration (dry mouth, dark urine, rapid pulse)
Read more.

Diffuse Esophageal Spasm

Diffuse esophageal spasm is a disorder pertaining to the contractions of the esophagus and can disrupt normal swallowing ability.
 

Signs and Symptoms

  • Sensation of Choking, Trouble Swallowing
  • Chest Discomfort
Read more.

Diverticulosis and Diverticulitis

Small pouches that bulge outward through weak spots in the colon, like an inner tube that pokes through weak places in a tire. Each pouch is called a diverticula. The condition of having diverticula is called diverticulosis. About half of all Americans age 60 to 80, and almost everyone over age 80, has diverticulosis. Diverticulitis occurs when the pouches become infected or inflamed.
 

Signs and Symptoms

  • Most people have no symptoms
  • Mild Cramping
  • Bloating
  • Constipation

Alarm Symptoms (require medical attention)

  • Abdominal Pain
  • Fever
  • Nausea
  • Vomiting
  • Chills
  • Severe Cramping
Read more.

Dyspepsia

Dyspepsia means "bad digestion" but is generally used as a label for persistent or recurring upper abdominal pain or discomfort. The term indigestion is often used synonymously with dyspepsia. The pain or discomfort is centered in the upper abdomen and is not accompanied by heartburn or regurgitation (symptoms of gastroesophageal reflux disease - GERD). Dyspepsia is very common. It affects almost one fourth of people in the United States and affects both men and women equally. Symptoms may occur regularly for months at a time, or occur intermittently with long symptom free intervals.

Signs and Symptoms

  • Bloating
  • Nausea
  • BurpingFelling of fullness soon after eating
  • Upper Abdominal Pain
  • Passing Gas
Read more.

Dysphagia

A problem swallowing foods or liquids may indicate that you have dysphagia. It is derived from the Greek dys meaning bad or disordered, and phago meaning "eat". This means it may take more time and effort to move food or liquid from your mouth to your stomach. Difficulty swallowing may also be associated with pain. In some cases you may not be able to swallow.

Signs and Symptoms

  • A feeling of chest pressure
  • Pain with swallowing
  • Choking or coughing when swallowing
  • Vomiting after eating or drinking
  • Aspirating (inhaling into the lungs) food or liquids when you swallow
  • Fatigue and unexpected weight loss
  • Frequent heartburn
Read more.

Eosinophilic Esophagitis (EE)

Eosinophilic esophagitis is one of many types of esophagitis (inflammation of the esophagus). It is not as common as reflux esophagitis, but has many of the same symptoms. It is caused by an abnormal accumulation of eosinophils in the lining of the esophagus (swallowing tube). Eosinophils are a type of blood cell that can be seen in the esophagus. In this condition they are present at an increaseed number. The reason for this increased accumulation is unknown. Often individuals with eosinophilic esophagitis have allergies (asthma, allergic rhinitis, or urticaria and food sensitivity.

Signs and Symptoms

  • Heartburn
  • Difficulty swallowing
  • Feeling that food is getting caught or stuck while swallowing
Read more.

Gastroparesis

Gastroparesis refers to a delay in emptying of stomach contents into the small intestine. This can be caused by a change in the ability of the nerves to pick up information in the stomach, or the nerves that send information to the stomach telling it to contract or empty. Another cause includes the stomach muscles not being able to contract. This loss of function can be limited to the stomach.
 

Signs and Symptoms

  • Nausea
  • Vomiting
  • Full feeling after eating only a few bites
  • Weight Loss
  • Bloating
  • Bad Breath
  • Abdominal Pain
  • Heartburn
Read more.

Foodborne Illness

Foodborne illnesses are caused by eating food or drinking beverages contaminated with bacteria, parasites, or viruses. Harmful chemicals can also cause foodborne illnesses if they have contaminated food during harvesting or processing. Most foodborne infections are undiagnosed and unreported. The Centers for Disease Control and Prevention estimates that every year about 76 million people in the United States become ill from pathogens, or disease-causing substances in food. Of these people, about 5,000 die.

Signs and Symptoms

  • Abdominal Cramps
  • Nausea
  • Vomiting
  • Watery Diarrhea
  • Bloody Diarrhea
  • Fatigue
  • Fever
Read more.

GERD (Gastroesophageal Reflux Disease)

When the valve at the end of the esophagus (tube that connects the mouth to the stomach) is too relaxed, it does not prevent stomach acid and food from backing up into the esophagus. This causes irritation and inflammation leading to that burning sensation so many people experience.

Signs and Symptoms

  • Burning sensation under the breastbone
  • Acid regurgitation into the mouth
  • Hoarse or scratchy voice
  • Coughing
  • Asthma
  • Bitter or sour taste in the mouth
  • Dental problems
  • Sinus problems
  • Difficulty swallowing
  • Narrowing of the esophagus
Read more.

Hemorrhoids

Hemorrhoids are swollen veins in the lower portion of the rectum or anus that may be internal (located inside the lower rectum) or external (under the skin around the anus).

Signs and Symptoms

  • Blood on the toilet paper or in the bowel
  • Painless bleeding
  • Itching or pain in the anal area
Read more.

Hepatic Encephalopathy

Hepatic encephalopathy is a complication of liver disease that occurs when blood flow bypasses the liver and enters into the rest of the circulation. This unfiltered blood carries high levels of ammonia which enters the brain and affects normal function. This effect on the brain is seen as an altered level of consciousness, altered intellectual function or changes in personality/behavior. Muscle and reflex abnormalities are also present. These changes can range from mild to severe and can lead to coma and death.

Signs and Symptoms

  • Poor memory
  • Confusion
  • Sleepiness
  • Irritability
  • Shaking (tremor)
Read more.

Hepatitis C

Hepatitis C is the most common blood-borne infection in the U.S. Approximately 2.7 million Americans are infected. Transmission of the virus occurs through contaminated blood through such activities as blood transfusion before 1991, intravenous drug use, occupational exposure, sexual contact, and possibly intra-nasal drug use, tattoos or body piercings.
 

Signs and Symptoms

  • Usually no symptoms and patients are surprised by the diagnosis
  • Abnormal blood tests (liver profile) during a routine visit with your doctor
  • Fatigue
  • Muscle and Joint Pain
  • Vague pain in the upper right section of the abdomen
Read more.

Hiatal Hernia

A hiatal hernia occurs when the top portion of the stomach pushes through a weakened opening in the diaphragm where the food pipe (esophagus) joins your stomach (called the hiatal opening).
 

Signs and Symptoms

  • You may never know and it is discovered after a chest x-ray
  • Heartburn
  • Chest Pain
  • Belching
  • Nausea
Read more.

Inflammatory Bowel Disease (IBD) - Adult

Inflammatory Bowel Disease (IBD) is a group of disorders that includes Ulcerative Colitis and Crohn's disease.
 

Signs and Symptoms

  • Abdominal Pain
  • Bloody Diarrhea
  • Fever
  • Weight Loss
  • Skin Lesions
  • Problems with the Eyes
  • Kidney Stones
  • Gallstones
Read more.

Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome or IBS is a condition associated with symptoms such as abdominal pain, bloating, and altered bowel function (constipation, diarrhea, or alternating pattern of constipation and diarrhea). Doctors call IBS a functional disorder. This means there is not a structural abnormality in the bowel. Instead it is a problem with the way the bowels work.
 

Signs and Symptoms

  • Abdominal Cramping
  • Loose Stools with mucous
  • Usually worse in the morning
  • Alternating pattern of constipation and diarrhea
  • Urge to move bowels and nothing happens
Read more.

Lactose and Fructose Intolerance

Lactose intolerance is the inability to digest significant amounts of lactose, the major sugar found in milk and dairy products. Fructose intolerance occurs when the body cannot readily digest fructose. Symptoms begin about 30 minutes after eating or drinking foods that contain Lactose or Fructose.
 

Signs and Symptoms

  • Nausea
  • Abdominal Cramping
  • Bloating
  • Belching
  • Passing Gas
  • Diarrhea
Read more.

Microscopic Colitis

Microscopic colitis includes collagenous colitis and lymphocytic colitis. It is characterized by chronic diarrhea caused by inflammation in the colon. They are not related to Crohns disease or Ulcerative colitis. These conditions are not life-threatening and there is no increased risk of cancer.
 

Signs and Symptoms

  • Chronic Watery Diarrhea
  • Non-Bloody Diarrhea
  • Abdominal Pain
  • Cramping
Read more.

Primary Biliary Cirrhosis

Primary biliary cirrhosis (PBC) is an inflammation of the bile ducts in the liver. This inflammation destroys these bile ducts. This can gradually damage the liver itself. 

Signs and Symptoms

  • Many times there are no symptoms
  • Abnormal liver function tests
  • Fatigue
  • Itching
  • Vitamin Deficiencies
Read more.

Primary Sclerosing Cholangitis

PSC is a chronic disease that damages the bile ducts of the liver. Inflammation and scarring cause the bile ducts to become blocked. The blockage causes bile to accumulate in the liver which may lead to scarring or damage of the liver cells.
 

Signs and Symptoms

  • Yellow Jaundice
  • Fatigue
  • Itching
Read more.

Wilson's Disease

Wilson's disease is a rare inherited disorder that causes excess copper accumulation in the body. This may lead to damage of the liver, brain, kidneys, eyes, and other organs.
 

Signs and Symptoms

  • Fatigue
  • Jaundice
  • Edema of the legs
  • Swelling of the abdomen
  • Easy bruising
  • Poor coordination
  • Changes in speech
Read more.