By Barbie Farley/reporter
NE Campus radiology students shared their knowledge of abdominal disorders at a seminar last week. The students focused on using contrast solution as a means to diagnose specific illnesses on X-ray exams.
Joan Asafu-Adjaye discussed different intestinal parasites that can cause diarrhea. She said two main types of parasites cause diarrhea, and coming into contact with these parasites is very likely.
“The parasites are everywhere,” she said.
Poor sanitation increases a person’s chance of contracting diarrhea. Asafu-Adjaye said the best way to decrease susceptibility to the disease is to practice good hygiene. Frequent hand washing, especially before and after using the restroom, is important.
“Parasites can live for two months under the nails,” she said.
She said depending on the severity, diarrhea may go away on its own or it may require medical attention.
CeCe Cutshall’s presentation focused on abdominal tuberculosis. She began by explaining just how contagious the disease can be.
“It can be spread when you talk, cough, sneeze or laugh,” she said.
She said tuberculosis infections include latent and active versions. A person with a latent infection will test positive for tuberculosis but will not have any symptoms of the disease. Latent infections can turn into active infections at any time.
“Your body will get very sick,” she said. “TB can spread to all organs of the body.”
She said if a person has TB in his/her lungs, coughs up some mucous and swallows it, it could lead to abdominal TB. Abdominal TB symptoms include weight loss and abdominal pain.
“The disease can affect anyone at any age,” she said.
Abdominal TB can be diagnosed with an X-ray and treated with antitubercular drugs for six months, surgery or chemotherapy depending on the specifics of the case, she said.
“One percent of the world’s population is newly infected each year,” she said. “In 2005, 1,577,000 people died from TB globally.”
Diane Lynd discussed Hirschsprung’s disease.
“Hirschsprung’s disease is caused by missing ganglion cells in the intestines,” she said.
She told the students ganglion cells cause muscles to contract and relax. Without those cells, the intestinal walls cannot relax and can cause obstructions in the bowels. The severity of the disease is dependent on how much of the intestines is affected. The classes are short segment, long segment and total colon.
“Total colon cases make up 3 to 8 percent of all cases,” she said.
Lynd told the group that males are four times more likely to be affected by Hirschsprung’s disease, 15 percent of Down syndrome patients have the disease and one out of every 5,000 children are born with the disease. Patients with a family history of the disease also have a 50 percent chance of having the condition.
“Forty to 60 percent of patients are diagnosed in the first month of life,” she said.
Hirschsprung’s disease can be diagnosed with enemas, X-rays, rectal biopsies, rectal manometry and surgery.
“Ninety-five percent of patients return to normal bowel habits after surgery,” she said.
Razan Saleh covered esophageal achalasia, another disease where muscles in the body cannot relax.
“Achalasia is a rare disease affecting the esophageal sphincter,” she said.
With this disease, the muscles of the esophagus do not relax and the sphincter is only able to open a small amount.
Saleh said patients with this disease have trouble swallowing. Food collects in the lower part of the esophagus causing heartburn and bad breath. While the actual cause of this disease is unknown, Saleh said heredity and infection may be linked to the onset of symptoms.
Achalasia can be very serious. Saleh said because food is collecting in the esophagus, a patient could possibly inhale food into the lungs when positioned a certain way — a condition known as aspiration pneumonia. Weight loss and ulcerations are also serious complications that can result from this disease.
Achalasia can be diagnosed with an esophagram, endoscopy and an esophageal manometry. The disease can be treated with oral medications, but because swallowing is difficult, three other options are available.
A balloon used to expand the airway can be dangerous, but it is an effective strategy to quickly open the contracted sphincter. Surgery and Botox are also other methods, depending on the health and weight of the patient.
Phuong Nguyen chose to do a case study over a relative with colon cancer. Her family has a strong history of the disease.
After Nguyen’s brother started having bowel trouble, he decided to see a doctor. He underwent two sigmoidoscopies. The doctor dismissed his condition because tests did not find a tumor.
Upon getting a second opinion, Nguyen’s brother received different news.
“He underwent a colonoscopy and found a large mass that extended four to five centimeters,” Nguyen said. “Multiple biopsies confirmed adenocarcinoma of rectum.”
Nguyen said surgery is the most common and effective treatment for the condition. Her brother underwent surgery in 2001 to have the tumor removed. He was also treated with chemotherapy and radiation.
Within two years, the disease was not evident in his body. A follow-up five years after surgery showed his colon to be free of cancer. Nguyen’s presentation included pictures of her brother’s colon before and after treatment as well as what other cases may look like.
“If it is diagnosed early, it is potentially curable in 90 percent of cases,” she said.
Leonard Kivunaga discussed Crohn’s disease with his classmates.
“This disease causes inflammation in the GI tract,” he said.
Kivunaga said the most common place for this disease to occur is the lower portion of the small intestine. It mainly affects children and females. Every 10-12 of 100 people in the United States have the disease.
Swelling in the intestine causes pain. Fever, fatigue, loss of appetite, weight loss and painful stool are symptoms of the disease.
“There is no cure for the disease,” Kivunaga said.
Treatments include anti-inflammatory drugs, nutrition therapy and in some rare cases, surgery.
Randy Sparks ended the seminar with his presentation on gastric antral vascular ectasia (GAVE), more commonly referred to as watermelon stomach.
“Watermelon stomach is caused by dilation in the blood vessels,” he said.
The dilated blood vessels create the appearance of watermelon stripes on the stomach walls.
“Not that many people have it, and it is often misdiagnosed,” he said.
He told the students fewer than 200,000 Americans are affected by the disease, which has been labeled as rare by the Office of Rare Diseases and the National Institutes of Health.
Watermelon stomach has several symptoms including brittle nails, headaches, fatigue, palpitation, anemia and many others.
Sparks said medications, surgery and endoscopic therapy are treatments of the disease. Medication and surgery are not very successful. The surgical procedure usually results in death.
“Endoscopic therapies include the argon laser, the YAG laser and the APC laser,” he said.
Laser treatment is used to burn the blood vessels to help decrease blood flow. The doctor needs to use caution while performing the procedure as the laser could burn through the stomach wall. Sparks showed a video demonstrating how the procedure is done.
He said the laser procedure requires only four to six treatments before the disease is cured.
