Dr. Peter Anthony Derosa, MD

An individual with anemia will have the following symptoms: shortness of breath, weakness, dizziness, cold hands or feet, paleness, and irritability. Anemia is diagnosed when blood tests show low counts for hemoglobin, which is the protein responsible for carrying oxygen to different tissues throughout the body.

Treatments for anemia are dependent on the kind of anemia an individual has. For example, iron supplementation may correct iron deficiency anemia. For anemia caused by chronic kidney failure, chemotherapy treatments, and HIV/AIDS, a group of medications called erythropoiesis-stimulating agents may be prescribed.

Enteroscopies may be used alone or in combination with other procedures. For example, if a doctor suspects malignancy (cancer) in the small bowel, she may use an enteroscope to take a sample of tissue from the small bowel and have it examined in a laboratory. If there is a blockage in the small intestine that cannot be surgically removed, an enteroscopy-guided stent placement may help relieve some of the symptoms associated with the obstruction. Enteroscopes may also be used to treat intestinal bleeding and remove abnormal growths like tumors and polyps, as well as foreign objects that might have found their way into the small bowel.

There are several ways to perform an enteroscopy:

• Push enteroscopy involves the use of a long tube with a camera, called an enteroscope. Depending on the location of the problem, the enteroscope is either passed through the mouth or rectum. This technique is often used to detect and stop bleeding in the upper small intestine.
• Balloon enteroscopy uses scopes that have tiny balloons at the tip. The balloons inflate and deflate to help make the passage of the scope into the small bowel easier. This method is used when there is a need to access and treat certain parts of the small intestine that push enteroscopy cannot reach.
• Capsule enteroscopy involves swallowing a capsule with a tiny camera inside it. As the capsule travels through the small intestine, the camera records and sends images that are then downloaded and analyzed by the doctor. The capsule eventually leaves the body during bowel movement. If the doctor needs to visualize the entire small intestine, capsule enteroscopy is the only option. The only drawback to this technique is that it cannot be combined with any treatment.

Enteroscopy is typically performed at the doctor's office and takes about 20 to 30 minutes, but may take longer if combined with another procedure. Patients may have a sore throat for a few hours if the scope was inserted through the mouth. Normal activities may be resumed about 24 hours following enteroscopy.

Today, most gallbladder surgeries are done laparoscopically. Four tiny incisions are made in the abdomen, and small tools are inserted through these tiny incisions to perform the surgery. Because the incisions are much smaller, recovery time is much faster with this type of surgery. Patients are usually discharged from the hospital the same day. Sometimes, open surgery is used to remove a gallbladder. In this type of surgery, a cut about six inches long is made in the upper right abdomen. After the gallbladder is removed, it is sutured or stapled closed. With open surgery, patients usually stay in the hospital for two to three days to recover before they are discharged.

Gallbladder removal, like any surgery, carries some risks, such as bleeding, infection, or the development of blood clots. Doctors will tell patients how to minimize their risk for complications. After surgery, patients are advised to avoid strenuous activity for several days. They should not soak in a bath until their sutures or staples have been removed. Patients should wash hands before touching the area around the incision. It will take a couple of days until patients feel like themselves again and a few weeks until their scar has healed and faded.