Our multi-Specialty clinic is designed to offer comprehensive care in one convenient location. Our physicians collaborate actively to provide high-quality care to patients with multiple medical conditions. In this section you will find details on some of the commonly treated conditions at the clinic and procedures we utilize.
Pulmonology

Pulmonary illnesses can impact the quality of a person's life in a great way. Difficulty breathing, snoring and fatigue limit the activities those suffering from COPD, emphysema, asthma, sleep apnea and other respiratory conditions do on a daily basis. Different tests and treatments (performed both in our office and at the hospital) help determine the cause and alleviate the symptoms of respiratory disease.

Pulmonary Procedures and Services:

    Pulmonary Function Testing

    Sleep Studies

    6-Minute Walk Test

    Bronchoscopy

    Thoracentesis

Cardiology

Our cardiologists manage a range of illnesses including (but not limited to) high blood pressure, atrial fibrillation, heart failure, congenital cardiac defects and implanted cardiac devices. In order to diagnose and treat our patients we offer a number of tests and procedures, most of which can be performed in the office. Electrocardiograms, stress tests, MUGA scans, holter monitors, ultrasounds and cardiac device monitoring allow us to better understand an individual's state of health and devise the best possible treatment plan. Our list of cardiac procedures and services includes:

Cardiology Procedures and Services:

    Electrocardiogram (EKG)

    Nuclear Stress Test

    Exercise Stress Test

    MUGA Scan

    24 Hour Holter Monitor

    Echocardiography

    Cardiac Catheterization

    Carotid Ultrasound

    Cardiac Event Monitors

    Pacemaker Monitoring

    Defibrillator Monitoring

Gastroenterology

Our GI staff consists of 4 board certified gastroenterologists, 1 nurse practitioner, and 2 physician assistants. Together we provide consultative and endoscopic services for a variety of digestive tract disorders. These include, but are not limited to, difficulty swallowing, acid reflux, gallbladder disease, liver disease, abdominal pain, diarrhea, constipation, inflammatory bowel disease, irritable bowel syndrome, treatment of hemorrhoids and fecal incontinence. Our practice is dedicated to provide the highest quality of treatment utilizing evidence-based medicine and compassionate care. We offer both endoscopy center-based and hospital-based endoscopic services to allow our patients personalized care, flexibility, and convenience. Gastrointestinal Procedures and Services: Colonoscopy Upper Endoscopy Push Enteroscopy Video Capsule Endoscopy (PillCam) Argon Plasma Coagulation Endoscopic retrograde cholangiopancreatography (ERCP) PEG Tube Placement and Removal Esophageal Manometry Esophageal Dilatation 24-Hour Impedance pH Monitoring Bacterial Overgrowth Breath Test Lactose Intolerance Breath Test Fructose Intolerance Breath Test CRH O'Regan Hemorrhoid Banding – NEW!!

Upper Endoscopy

Disease Background

An upper endoscopy (also called an EGD or EsophagoGastroDuodenoscopy) is an endoscopic procedure (also referred to as a 'test', or 'examination'), that lets your doctor examine the inside of your upper GI tract (the esophagus, the stomach, and the first part of your small intestine called the duodenum). There are many reasons why your doctor may recommend this procedure, such as to further evaluate abdominal pain, heartburn or reflux symptoms, anemia, and to look for an ulcer.

Procedure

On the day of the procedure, the Endoscopy Nurse will place an IV into your hand or arm. When it is time for your procedure, you will be brought via stretcher into the endoscopy room. You will be lying on your left side for the procedure. You will be given intravenous sedatives prior to starting your endoscopy, and so most patients are asleep during the test. The nurse will place a plastic shield ('bite block') in your mouth to protect your teeth. Most patients do not experience any pain during or after the procedure. In addition, most patients do not recall undergoing the procedure afterward. The endoscopy takes only about 10 minutes to perform.

Your doctor will carefully and safely guide a thin, flexible, fiber optic tube equipped with a light and camera, into your esophagus, then into the stomach, and all the way into the duodenum (first part of the small intestine). During the procedure, the doctor may take biopsies (small tissue samples) to obtain more information. Every biopsy is always sent to the Pathologist for examination. If a stricture (abnormal narrowing) is found during the test, your doctor may choose to dilate (stretch) the stricture to help your symptoms. In addition, if the doctor finds something bleeding during the test, he will likely cauterize the bleeding lesion in order to stop it. After the procedure, your doctor will speak to you and let you know the results of the exam. You may receive a follow-up courtesy call a few days after the procedure as well.

Possible Complications

Endoscopy is a very safe procedure. The vast majority of the time, there are no problems during the test. That being said, any procedure that a doctor performs (no matter how safe) can possibly result in unforeseen complications. The possible complications (again, all are rare) of this procedure include: bleeding, perforation (puncturing the GI tract), and adverse reaction to the IV sedation. In addition, although this procedure is the most accurate way of evaluating the upper GI tract, the doctor is not guaranteed to always find every abnormality during the test.

If you have any questions regarding the upper endoscopy, please call us at (609) 597-6513.

Preparation

Your stomach and duodenum must be empty for the procedure to be thorough and safe, so you will not be able to eat or drink anything for at least 8 hours beforehand. Also, you must arrange for someone to take you home,you will not be allowed to drive because of the sedatives. Your physician may give you other special instructions.

Colonoscopy

Disease Background

A colonoscopy is an endoscopic procedure (also referred to as a 'test', or 'examination'), that lets the physician examine the inside of your entire large intestine or colon. There are many reasons why your doctor may recommend this procedure, such as to remove polyps, find sources of bleeding, explain abnormal bowel habits, confirm diverticulosis, and examine hemorrhoids. This is the only test that enables your doctor to both find abnormalities (polyps, bleeding, cancer) AND treat them at the same time. The "virtual colonoscopy", which you may have heard of, requires you to drink the same bowel preparation, and is a diagnostic test only (a separate procedure would need to be performed to remove any polyps found during this examination).

Preparation

Your colon needs to be completely empty and free of material in order for the doctor to be able to thoroughly examine the surface of the colon and find and remove any potential polyps. Most patients feel that the preparation for the procedure is the most unpleasant part of the process. However, we will be using a newer preparation which is much more tolerable than past preparations which you may have used or heard about. The preparation that we use has the best combination of tolerability, effectiveness, and safety, out of the currently available preparations.

The day prior to the procedure, you will be allowed to have a light breakfast and then will need to be on a clear liquid diet for lunch and dinner. An instruction sheet will be given to you with all the information you will need for the preparation. The medications for the preparation are usually over the counter for your convenience. Please follow the instructions carefully and do your best to finish the entire mixture. Keeping the mixture in the refrigerator prior to drinking will make it more tolerable.

Procedure

On the day of the procedure, the Endoscopy Nurse will place an IV into your hand or arm. When it is time for your procedure, you will be brought via stretcher into the endoscopy room. You will be lying on your left side for the procedure. You will be given intravenous sedatives prior to starting your colonoscopy, and so most patients are asleep during the test. Most patients do not experience any pain during or after the procedure. In addition, most patients do not recall undergoing the procedure afterward.

The doctor will need to insufflate (gently blow open) the colon during the procedure, so you may feel some gassiness or cramping afterward. The colonoscopy takes about 20 to 30 minutes to perform. Your doctor will carefully and safely guide a thin, flexible, fiber optic tube equipped with a light and camera, throughout your colon (about 5 feet in length). During the procedure, the doctor will remove any polyps that are found using special tools made especially for this. Every polyp or biopsy (small tissue sample) is always sent to the Pathologist for examination. After the procedure, your doctor will speak to you and let you know the results of the exam. You may receive a follow-up courtesy call a few days after your procedure as well.

Possible Complications

Colonoscopy is a very safe procedure. The vast majority of the time, there are no problems during the test. That being said, any procedure that a doctor performs (no matter how safe) can possibly result in unforeseen complications. The possible complications (again, all are rare) of this procedure include: bleeding, perforation (puncturing the colon), and adverse reaction to the IV sedation. In addition, although colonoscopy has been shown to be the most accurate imaging test of the colon, the doctor is not guaranteed to always be able to complete the procedure, and is not guaranteed to always find every polyp during the test.

Video Capsule Endoscopy

Disease Background

Diseases of the small intestine are particularly difficult to diagnose because traditional diagnostic methods have limited viewing capabilities. Traditional enteroscopy is limited to viewing only the first one-third of the small intestine. Radiologic exams have a very low (3-5%) diagnostic yield. Due to these viewing limitations, the findings are often inconclusive, patients continue to suffer and remain symptomatic. Undiagnosed problems necessitate the need for repetitive tests, blood transfusions, medications and hospitalizations, which attribute to the increasing costs of patient care.

Procedure Effectiveness

Capsule Endoscopy uses a disposable miniature video camera contained in a capsule that is ingested by a patient and delivers high quality color images in a painless and noninvasive manner. It is propelled by peristalsis to naturally move through the digestive tract. It delivers approximately 50,000 high quality color images of the inside of the entire small bowel. By comparison, a push enteroscopy accesses only the first third of the small intestine.

Capsule endoscopy delivers an improved diagnostic yield as illustrated in the supporting FDA clinical trials. When compared to push enteroscopy, capsule endoscopy detected a diagnostic yield of 60%, push enteroscopy detected a diagnostic yield of 35%. Unlike radiologic imaging procedures, capsule endoscopy allows detailed (up to 0.1 millimeter resolution) visualization of the small intestine. This increases the possibility of locating and diagnosing pathologies in the small intestine that might otherwise go undetected.

Capsule Endoscopy enables us to appropriately diagnose symptomatic patients, which may lead to effective treatment, better patient management and a higher quality of patient care.

Abdominal Pain Syndrome
Acid Reflux, Heartburn, GERD
Belching, Bloating, Flatulence
Constipation and Defecation Problems
Diarrhea
Dyspepsia/Indigestion
Gallstone Pancreatitis
Hemorrhoids and Other Anal Disorders
Irritable Bowel Syndrome
Nausea and Vomiting
Peptic Ulcer Disease