Expert insights on digestive health, preventive care, and wellness tips from Dr. Parikh
Patient EducationAutoimmune hepatitis (AIH) is treated with medicines that calm the immune system so it stops attacking the liver. In most adults that means a steroid, either prednisone or budesonide, usually paired with azathioprine, followed by regular blood tests…
PreventionA sessile serrated polyp (SSP) is a flat, pale growth in the lining of the colon. It is a true precursor to colorectal cancer, and it is easy to miss. The good news is that it can be removed during a colonoscopy, and the way it is removed and follow…
Patient EducationBloating after meals most often comes from swallowed air, a large or high-fat meal, constipation, or trouble digesting certain foods such as lactose. Smaller meals, slower eating and a few diet changes ease it for many people. If it keeps coming bac…
PreventionIf you are 70 to 75 and at average risk, U.S. guidelines still recommend colorectal cancer screening, and colonoscopy is one way to do it. From 76 to 85, the decision becomes personal: it depends on your health, your screening history and what matte…
Patient EducationAn esophageal manometry test measures how well the muscles of your esophagus squeeze and relax when you swallow. A thin, flexible tube passes through your nose into the esophagus while you swallow small sips of water, and sensors record the pressure…
Digestive HealthA positive FIT test means the lab found blood in your stool sample. It does not mean you have cancer. It does mean you need a follow-up colonoscopy, so a doctor can look at your colon directly and find where the blood is coming from. Repeating the s…
Patient EducationA first colonoscopy is a short outpatient procedure. You are sedated, a doctor looks at the lining of your colon with a thin camera, and you go home the same day with someone driving you. The prep the day before is the part most people dread. It is …
Patient EducationBright red blood in your stool or on the toilet paper most often comes from the lower digestive tract, and the usual culprits are hemorrhoids and small tears in the anus. Those causes are common and treatable. Still, the color alone cannot tell you …
Patient EducationA change in bowel habits means your own pattern has shifted: how often you go, what your stool looks like, or how it feels to go. Most changes come from diet, travel, stress or a medication and settle within days to a couple of weeks. A change that …
Patient EducationPain in the right upper quadrant (RUQ) is felt in the upper right part of your abdomen, just under the right ribs. The most common digestive sources are the gallbladder, liver, stomach and bile ducts. Pain that is severe, comes with fever, yellow sk…
NutritionDermatitis herpetiformis (DH) is an intensely itchy, blistering skin rash caused by an immune reaction to gluten. It is the skin form of celiac disease, so a diagnosis points to the gut as well as the skin. The NIDDK describes it as a chronic manife…
Digestive HealthSIBO (small intestinal bacterial overgrowth) and IBS (irritable bowel syndrome) cause many of the same symptoms: bloating, abdominal pain, gas, diarrhea, constipation. They are not the same condition, but they can exist together, and one may be driv…
Patient EducationCeliac disease in adults can show up as bloating, diarrhea and stomach pain. It can also show up as fatigue, an itchy rash, mouth sores, tingling in the feet, or no symptoms at all. The only way to know is to be tested while you are still eating glu…
Patient EducationMost internal hemorrhoids are treated in steps. You start with fiber, fluids and changes in toilet habits. If bleeding or prolapse keeps coming back, a gastroenterologist can offer a quick office procedure such as rubber band ligation. Surgery is ke…
Patient EducationCirrhosis often causes no symptoms at first. When symptoms do appear, the most common are fatigue, poor appetite, weight loss, nausea, itchy skin, muscle weakness, yellowing of the skin and eyes, a swollen belly, easy bruising and confusion. Some sy…
Patient EducationTo prepare for a hydrogen breath test, avoid antibiotics for 4 weeks, hold laxatives and promotility drugs for 1 week if your doctor agrees, eat a low-fermentation diet the day before, fast for 8 to 12 hours, and skip smoking and hard exercise on te…
Patient EducationMany hiatal hernias cause no symptoms at all. When they do, the usual picture is heartburn, regurgitation, belching, and sometimes chest pain or trouble swallowing. These come mostly from stomach acid, air, or bile moving up into the esophagus, not …
Patient EducationThe hallmark symptom of pancreatitis is pain in the upper abdomen that often spreads to the back, usually with nausea and vomiting. In acute pancreatitis the pain can start suddenly or build over hours and last for days. In chronic pancreatitis the …
Digestive HealthAfter a colonoscopy removes an adenoma, the next exam is due in anywhere from 6 months to 10 years. The date depends on how many adenomas were found, how large they were, what the pathologist saw under the microscope, and how good the exam was. For …
Digestive HealthFor most people, colonoscopy recovery takes about one day. You rest at the facility for an hour or two while the sedation wears off, go home with a driver, take it easy for the rest of the day, and return to your normal diet and routine the next mor…
Digestive HealthThe most common trigger of an IBD flare is not the one most people suspect. Food and stress get the blame, but missed medication, NSAID painkillers, infections, antibiotics and smoking often matter more. Some flares have no identifiable cause at all…
PreventionIf you are turning 45 and average risk, it is time to start colon cancer screening. A colonoscopy is the most complete way to do it, and for most people with a normal result it is needed only once every 10 years. If you have symptoms or a family his…
Patient EducationIf you have chronic kidney disease (CKD), you can still have a colonoscopy, and you should not skip colon cancer screening because of your kidneys. What changes is the prep. The type of bowel cleanser matters a great deal: sodium phosphate products …
Digestive HealthMost people on a blood thinner can still have a colonoscopy, but the plan for your medicine has to be made before prep day, not on it. Whether you hold the drug, for how many days, and whether you need a substitute depends on three things: which ant…
Digestive HealthA positive Cologuard result does not mean you have cancer, and it does not mean the test made a mistake you can ignore. In the FDA’s data for the newer Cologuard Plus test, about 30 of every 100 positive results turn up no neoplastic finding at colo…
Digestive HealthA gluten challenge means eating gluten on purpose, under a doctor’s guidance, so that celiac blood tests and an intestinal biopsy can work. It is meant for people who have already cut gluten out. For adults, current guidance points to at least 3 gra…
Digestive HealthMost women with Crohn’s disease or ulcerative colitis can have a healthy pregnancy and a healthy baby. The biggest factor in how it goes is how well your IBD is controlled around conception and during the nine months that follow. The Crohn’s & Colit…
Digestive HealthMost published prices for a capsule endoscopy fall between about $750 and $2,500 without insurance, and the full billed charge averages $2,052. With commercial insurance, patients typically pay $300 to $1,200 out of pocket, depending on deductible a…
NutritionYes, invisible gluten cross-contact can be a concern for people with celiac disease. The FDA defines “gluten-free” as less than 20 parts per million of gluten, and your goal is to keep traces as low as you can. Start with one habit: clean surfaces w…
PreventionThe CDC recommends that every U.S. adult aged 18 and older get screened for hepatitis B at least once in their lifetime. The initial blood test should be the triple panel: HBsAg, anti-HBs, and total anti-HBc. Together, those three markers show wheth…
Patient EducationAn upper endoscopy, or EGD, is a generally safe procedure, and serious complications are rare. The main risks are bleeding, perforation, cardiopulmonary or sedation-related events, and infection or aspiration pneumonia. Most people experience only m…
Patient EducationIf you have steady, intense pain in your upper right or middle abdomen that lasts 30 minutes or longer, especially after a fatty meal, you are likely dealing with a gallbladder attack. Fever, jaundice, repeated vomiting, or fainting are red flags th…
Digestive HealthYou can often have a colonoscopy while taking blood thinners, but most anticoagulants and antiplatelet drugs need a planned, coordinated hold rather than a solo decision at home. Call your prescribing clinician and the endoscopy team as soon as your…
Patient EducationDiscomfort after hemorrhoid banding usually peaks in the first 24 hours, and most patients feel noticeably better within a week, with 75% reporting no pain at the one-week mark. The banded tissue typically sloughs off within about a week, sometimes …
Patient EducationLiver fibrosis stages range from F0, meaning no scarring, to F4, meaning cirrhosis, with each step marking more tissue damage and less flexibility in the liver. Earlier stages often improve once the underlying cause is treated, while F3 and F4 usual…
PreventionCeliac blood tests are good, not perfect: tTG-IgA testing correctly identifies most people with celiac disease and correctly clears most people without it, but duodenal biopsy remains the reference standard for confirming a diagnosis. Accuracy depen…
Digestive HealthMost people adapt within weeks to months and return to eating normally, though temporary diarrhea or bloating is common early on. Start now by eating smaller, lower-fat meals and adding fiber back gradually rather than all at once. Contact a gastroe…
Patient EducationIf your digestive symptoms started after a bout of food poisoning or a stomach virus and have not let up, you may be dealing with post-infectious IBS, a form of irritable bowel syndrome triggered by an earlier gut infection. The condition is real, r…
Patient EducationCirrhosis can lead to several serious complications, including variceal bleeding, ascites, hepatic encephalopathy, hepatorenal syndrome, infections such as spontaneous bacterial peritonitis, liver cancer, and acute-on-chronic liver failure. This gui…
Digestive HealthBleeding from hemorrhoids is usually bright red, shows up on toilet paper or in the toilet bowl, and comes from internal hemorrhoids or a small skin break rather than a deeper problem. It typically isn’t an emergency, but it does call for prompt att…
Patient EducationMost people are monitored for about 1 to 2 hours after an upper endoscopy before they’re cleared to go home, and the non-negotiable rules are simple: no driving, no alcohol, and a responsible adult has to take you home. Mild throat soreness, bloatin…
Patient EducationPerianal Crohn’s disease is Crohn’s inflammation around the anus that often forms abscesses or fistulas. If you have an abscess, you need prompt drainage, and long-term control requires coordinated medical and surgical care rather than either approa…
Patient EducationThe Bravo pH test is a minimally invasive, wireless capsule based pH monitoring procedure that measures how often stomach acid reaches the esophagus over 48 to 96 hours and helps diagnose or monitor GERD. It is used to confirm reflux, link symptoms …
NutritionIf you have pancreatitis, the priority is a low-fat eating pattern built around small, frequent meals, with complete avoidance of alcohol and smoking, and considering adjunct therapies like medical cannabis strains may be discussed in some jurisdict…
Patient EducationOptimized bismuth quadruple therapy for 14 days is now the preferred first-line treatment for H. pylori infection. Alternatives include rifabutin triple therapy, vonoprazan-based dual or triple regimens, and FDA-approved combination products such as…
Patient EducationBile reflux treatment usually starts with medications and lifestyle changes, not surgery. Ursodeoxycholic acid (UDCA) has systematic-review evidence behind it for reducing reflux episodes and improving symptoms in bile reflux gastritis, and it typic…
Digestive HealthRifaximin helps some patients with small intestinal bacterial overgrowth, but it is not a guaranteed fix. Pooled results from clinical studies put eradication rates roughly in the 59% to 71% range depending on how success is measured, with wide vari…
Patient EducationPancreatic (exocrine) insufficiency (EPI) is when your pancreas doesn’t make enough digestive enzymes, causing maldigestion of fats, proteins, and carbohydrates. It’s diagnosable through stool testing and usually manageable with pancreatic enzyme re…
Digestive HealthColon polyps fall into a few clinically distinct groups: adenomatous, serrated (including hyperplastic polyps, sessile serrated lesions, and traditional serrated adenomas), and inflammatory or hamartomatous growths. Adenomas and many sessile serrate…
Digestive HealthMost gallbladder sludge does not need treatment. It gets watched, and it often clears on its own once a trigger like pregnancy, rapid weight loss, or fasting resolves. Treatment becomes necessary when sludge causes real symptoms or complications: ur…
Patient EducationMost patients with a presumed mucinous pancreatic cyst, meaning branch-duct IPMN or MCN, need imaging surveillance if they’re fit for surgery. The typical protocol calls for MRI at 1 year, then every 2 years through year 5 if the cyst stays stable. …
Patient EducationColonic inflammatory bowel disease, meaning ulcerative colitis or Crohn’s colitis, raises colorectal cancer risk above that of the general population, with large studies citing a standardized incidence ratio near 4.3. The actual number for any one p…
Digestive HealthThe guideline-backed path to IBS constipation treatment starts small: hydration, movement, and soluble fiber like psyllium, then osmotic laxatives such as polyethylene glycol if symptoms persist. When that’s not enough, FDA-approved prescription age…
Digestive HealthPersistent diarrhea after gallbladder removal is most often bile acid diarrhea (BAD), a treatable condition caused by excess bile reaching the colon. See a gastroenterologist if it lasts more than four weeks or comes with blood in the stool, fever, …
NutritionA mild sore throat after an upper endoscopy is common and usually clears up within a few days. Start with warm-saline gargles, sips of lukewarm fluids, and soft foods, plus an over-the-counter pain reliever if needed. Call your provider right away f…
Digestive HealthIf you have watery diarrhea that hits several times a day, wakes you up at night, and doesn’t fit neatly into an IBS-D diagnosis, bile acid diarrhea is a real possibility worth ruling out. It happens when bile acids that should be reabsorbed in the …
Digestive HealthIf you choose colonoscopy as your colorectal cancer screening test, the guideline-backed baseline is once every 10 years starting at age 45, as long as your exam is normal and you’re at average risk. That interval shrinks fast once your history chan…
Digestive HealthDiet won’t cure ulcerative colitis, but evidence shows certain dietary patterns and targeted changes can reduce symptoms and support remission when used alongside medical treatment. The strongest current guidance favors Mediterranean-style, plant-fo…
Digestive HealthNon-celiac gluten sensitivity (NCGS) is a syndrome of gut and body-wide symptoms triggered by gluten-containing foods in people who test negative for celiac disease and wheat allergy. It’s a real, recognized syndrome, but it’s diagnosed only after r…
Patient EducationUnexplained weight loss with diarrhea is an alarm feature that usually calls for prompt medical evaluation, not a wait-and-see approach. Start oral rehydration right away and get evaluated urgently if you notice bloody stools, a high fever, severe a…
Digestive HealthStop eating, sit upright or curl onto your side, and apply a warm compress to your upper right abdomen. If you have no contraindications, a single dose of an NSAID like ibuprofen can take the edge off the pain while you decide next steps. Watch for …
PreventionMost people feel back to normal within a few days to two weeks after polyp removal, depending on where the polyp was and how large it was. Expect mild cramping, gas, or light spotting in the first 48 hours. The one thing to actually watch for is hea…
PreventionFor most people who genuinely need them, proton pump inhibitors remain safe and effective for long-term use, but the evidence isn’t uniform across every risk that’s been reported. The strongest, most reproducible signals involve enteric infections l…
PreventionA calprotectin test measures a protein released by white blood cells into stool, and it tells your doctor whether digestive symptoms come from active intestinal inflammation or something else entirely, like irritable bowel syndrome. It’s the front-l…
Digestive HealthChronic diarrhea is loose or watery stool lasting more than four weeks, and in resource-rich settings it most often traces back to functional disorders like IBS, inflammatory bowel disease, malabsorption, microscopic colitis, bile acid problems, or …
NutritionA low-residue diet limits fiber and other hard-to-digest food particles to roughly 10–15 grams a day, cutting stool volume and how often you go. Doctors prescribe it short-term before a colonoscopy, during an IBD flare with narrowing or obstruction,…
NutritionWhen a diverticulitis flare hits, start with clear liquids, then step down to low-fiber foods as pain and fever ease. Once you’re symptom-free, rebuild fiber gradually over one to two weeks. For the long term, aim for roughly 14 grams of fiber per 1…
Digestive HealthRaise the head of your bed about six to eight inches, stop eating at least two to three hours before lying down, and skip the alcohol and fried food at dinner. Those three moves address most nighttime acid reflux at its source. If you’re also chokin…
Patient EducationAn elevated lipase level most often points to pancreatic inflammation, but the number alone doesn’t confirm it. A wide range of nonpancreatic conditions, from kidney impairment to sepsis to certain medications, can push lipase upward without any pan…
Digestive HealthMost patients paying out of pocket for an upper endoscopy land somewhere in a few hundred to a few thousand dollars range, with a national self-pay median close to $1,341 under CPT code 43235. That’s the diagnostic version, no biopsy, standard sedat…
Patient EducationYes, GLP-1 drugs commonly cause gastrointestinal side effects, mainly nausea, vomiting, diarrhea, and constipation, and most cases are mild, temporary, and manageable. These symptoms tend to show up during dose escalation and fade once you reach a s…
Patient EducationEffective IBS diarrhea management starts with a positive diagnosis rather than months of exclusion testing, then layers in the low-FODMAP diet, basic lifestyle fixes, and, if symptoms persist, guideline-backed medications like rifaximin or loperamid…
Digestive HealthBlack stool is usually harmless, caused by iron supplements, Pepto-Bismol, or dark foods, but it can also mean digested blood from an upper GI bleed. If you’re also vomiting blood, feeling faint, or your heart is racing, go to the ER now. If the sto…
Digestive HealthPale or clay-colored stool usually means your body is producing less bile pigment or something is blocking bile from reaching your intestines. That’s a mechanical problem with your liver, gallbladder, pancreas, or bile ducts, not a food issue you ca…
PreventionMost patients should eat a low-residue, low-fiber diet the day before a colonoscopy, then switch to clear liquids once the bowel prep starts. Pair that with split-dose prep: the second dose 4 to 6 hours before your procedure, finished at least 2 hou…
NutritionThe most effective fatty liver diet is a Mediterranean-style eating pattern combined with weight loss and regular exercise, not a detox or a single “superfood.” Losing at least 5% of body weight cuts liver fat, and 7 to 10% improves inflammation. Cu…
Digestive HealthScreening colonoscopies are covered in full by most U.S. health plans and Medicare when performed by an in-network provider, with no copay, deductible, or coinsurance for the base procedure. The main exception: if the doctor finds and removes a poly…
PreventionEvery adult in the United States should get a one-time hepatitis C test, no risk factors required, and every pregnant person should be screened during each pregnancy, according to both the CDC and the USPSTF. The standard workup starts with an HCV a…
Patient EducationDysphagia in adults almost always traces back to one of four buckets: a neurologic problem disrupting the swallow reflex, a mechanical obstruction narrowing the esophagus, a motility disorder affecting how the esophagus contracts, or an inflammatory…
Digestive HealthSplit-dose bowel prep means dividing your colonoscopy prep into two doses: one the night before, one the morning of your procedure. The rule that determines whether it works is timing. Finish the second dose at least 2 hours before sedation, ideally…
Digestive HealthElevated liver enzymes mean liver cells (or occasionally muscle or other tissue) are leaking more enzyme into your bloodstream than normal. It’s a lab finding, not a diagnosis. Between 10% and 20% of adults have mildly elevated transaminases on rout…
PreventionFor most adults without alarm symptoms, a urea breath test or stool antigen test is the right first move for active H. pylori infection, and endoscopy with biopsy gets reserved for people 60 and older or anyone showing red-flag symptoms. Blood-based…
Digestive HealthA positive Cologuard result means the test detected signs associated with colorectal cancer or precancer, such as altered DNA or hidden blood in your stool. It is not a cancer diagnosis. It is a signal that something in your colon needs a closer loo…
NutritionThe essentials come down to six moves: eat a wide variety of plants and fiber, drink enough water, move your body most days, sleep well and manage stress, add fermented or prebiotic foods, and cut back on ultra-processed items. Most adults do best a…
Digestive HealthColon health comes down to a short list of habits with real evidence behind them: eat a sufficient amount of fiber daily, move your body regularly each week, limit red and processed meat and alcohol, stay hydrated, skip tobacco, and get screened sta…
PreventionMost patients with nondysplastic Barrett’s esophagus need endoscopic surveillance every 3 to 5 years; confirmed dysplasia changes that timeline dramatically. The American Gastroenterological Association and the ASGE both anchor their 2025 guidance i…
Digestive HealthA gastroparesis diet works by shrinking food particle size and cutting fat and fiber, so the stomach empties faster and nausea eases. The core prescription: small meals, multiple times a day, built around soft, low-fat, low-fiber foods. Both the AGA…
Patient EducationIf you have diabetes, the single most important move is booking your colonoscopy as the first appointment of the day, then getting written, personalized medication instructions from your gastroenterologist or endocrinologist before you start prep. E…
Digestive HealthPancreatic enzyme therapy (formally called pancreatic enzyme replacement therapy, or PERT) replaces the lipase, protease, and amylase your pancreas can no longer make in sufficient amounts, so food gets broken down and absorbed instead of passing th…
Patient EducationReflux esophagitis is inflammation and erosion of the esophageal lining caused by stomach acid, pepsin, and sometimes bile flowing backward into the esophagus. It’s the erosive form of GERD (gastroesophageal reflux disease), and it’s diagnosed on en…
Digestive HealthMount Sinai operates one of New York City’s most complete academic gastroenterology programs, with dedicated specialty centers for IBD, motility disorders, and endoscopy, plus both in-person and telemedicine access. If you need to book care now, vis…
Patient EducationFloating stools are most often caused by excess intestinal gas, not a disease. According to MedlinePlus, the two primary drivers are gas trapped in stool and fat malabsorption (steatorrhea), with gas being far more common. Gas lowers stool density e…
PreventionThe lactose breath test, formally called the hydrogen breath test (HBT), measures the hydrogen and methane you exhale after drinking a lactose solution. A rise of 20 ppm or more in exhaled hydrogen above your baseline, combined with symptoms like bl…
Patient EducationLaparoscopic fundoplication is a minimally invasive operation that wraps the upper stomach around the lower esophagus to rebuild a competent valve and stop acid from refluxing upward. It is the standard surgical treatment for GERD and is best suited…
Patient EducationThe duodenal switch (formally called biliopancreatic diversion with duodenal switch, or BPD-DS) is the most metabolically powerful bariatric operation available today, and also the most demanding one to live with long-term. Among all common weight-l…
Digestive HealthA stool test analyzes a sample of your bowel movement to detect infection, inflammation, hidden blood, or cancer-related signals in your digestive tract. If a stool-based cancer screening test comes back positive, the single most important next step…
Digestive HealthA complete IBD monitoring plan combines clinical symptom indices, blood biomarkers (CRP, CBC, albumin), fecal calprotectin, and noninvasive imaging (intestinal ultrasound or MRE) as your first-line tools, with ileocolonoscopy reserved for baseline a…
Digestive HealthIf your colonoscopy is coded as a preventive screening under the ACA, you may owe $0 out of pocket. If it gets coded as diagnostic, or if a polyp is removed and your insurer reclassifies the claim, you could face your full deductible, which can ofte…
Patient EducationAn inflamed esophagus, clinically called esophagitis, is irritation or swelling of the esophageal lining that causes pain, trouble swallowing, or both. Most cases are treatable once the underlying cause is identified, but a few presentations require…
PreventionEvery average-risk adult in the United States should start colorectal cancer screening at age 45, according to the USPSTF, the American Cancer Society, and the CDC. For most people, that means choosing between two practical paths: a colonoscopy ever…
Have questions about digestive health? Schedule a consultation with Dr. Parikh to discuss your concerns and get personalized guidance.
