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Percutaneous Endoscopic Gastrotomy, or PEG, is a procedure where the physician uses a combination of an endoscope and needle to fit a patient with a feeding tube. At GI North, we routinely use PEG to help individuals who would otherwise require the more invasive laparotomy, or open abdominal procedure.

Someone who is unable to eat or drink for an extended period of time still requires nutrition. A feeding tube allows the individual to get the nutrition they need directly through a tube inserted in the stomach. Once the tube is in place, feeding is quick and problem free.

Before the procedure, you will receive a pain reliever and sedative, which will keep you comfortable and relaxed. The percutaneous endoscopic gastrotomy, or PEG, procedure begins with the physician inserting an endoscope into the stomach through the mouth. An endoscope is a thin, lighted instrument that allows the physician to determine the proper placement for the feeding tube. The physician then inserts a needle through the abdominal wall and into the stomach. The feeding tube is fed through the opening, and secured in place.

Complications from the percutaneous endoscopic gastrotomy, or PEG, procedure are rare and typically mild. Some drainage around the feeding tube and soreness in the abdominal wall is typical for a few days after the procedure. As with any surgical procedure, there is a risk of infection. There is also a risk that the tube may become blocked or leak. More serious complications include aspiration, bleeding, and inadvertent puncturing of another organ. The risks during a PEG are lower than risks from open abdominal surgery.

Anyone planning on having the PEG procedure should talk with us about any current medications they are taking. Never stop taking medications on your own, but the doctor needs to know about any prescription or over the counter medications you take on a regular basis, particularly blood thinners and anti-inflammatory medications. If you are an insulin-dependent diabetic, the doctor may need to adjust your dosage on the day of your procedure.

If you or someone you care about requires a PEG procedure, we hope you will contact us for more information and to discuss your options. At GI North, we look forward to answering any questions and concerns you may have.

© 2014 GI North Gastroenterology Services. All rights reserved.

Do you have liver disease? Contact GI-North for help.Cirrhosis is characterized by the scarring of the liver and is the final phase in chronic liver disease. It is most commonly caused by alcohol abuse or hepatitis B or C infection. Other causes of the disease is autoimmune hepatitis, bile duct disorders, medicines, and hereditary diseases. If you are unfamiliar with the disease and how to get help, here are some tips:

Symptoms of Cirrhosis

Fatigue and energy loss along with poor appetite and weight loss are common symptoms. Nausea or belly pain is also common. If small, red blood vessels that resemble spider veins appear on the skin, it could be a sign of the disease.

When the condition worsens, fluid buildup in the legs and the abdomen is common. These two conditions are also referred to as edema and ascites. Jaundice or yellowing of the skin or mucus membranes is also common. Some people have problems with thinking or confusion. If your stool is pale or clay-colored or you bruise easily, you may need to be tested for liver disease. Testicle shrinking or breast swelling is also common.

Diagnostic Tests

Doctors testing for this condition will usually administer a complete blood count, liver function test, and blood albumin levels. Computed tomography (CT) or Magnetic resonance imaging (MRI) of the abdomen may also be recommended. An ultrasound of the abdomen and an endoscopy will be taken to identify abnormalities. A biopsy can be taken to confirm any diagnosis administered.

Lifestyle Changes and Treatment Plans for Cirrhosis

Begin by limiting alcohol intake and eat a diet that’s healthy. Reduce your salt intake and get vaccinated for influenza, hepatitis A, and hepatitis B. Vaccinations for pneumococcal pneumonia is also suggested.

Water pills or diuretics are recommended to reduce fluid build up. Vitamin K will prevent excess bleeding. Medicines can also be given to prevent mental confusion. Antibiotics can also be given for infections.

Endoscopic treatments can be given for enlarged veins in the throat, and fluid can be removed from the abdomen known as paracentesis. To repair blood flow in the liver, place a transjugular intrahepatic portosystemic shunt (TIPS) in the liver. A liver transplant is the last resort for liver damage.

Get Help at GI-North

If you are diagnosed with the disease, you can join support groups to help you through the treatment. Talking with others can make the treatment bearable. Contact your health care provider if you experience any of the symptoms provided and receive the help that you need. GI North is one option to help you receive the help you need.

© 2014 GI North Gastroenterology Services. All rights reserved.

Colon Health and Diets

Platter of Vegetables and Fruits |Gastroenterologist AtlantaIn order to keep your digestive tract and colon as clean as possible, it is important for you to eat a healthy diet. Choose one of these specific ones to ensure colon health.


The Therapeutic Lifestyle Changes Diet focuses on lowering cholesterol and increasing fiber intake. Fiber moves waste through the digestive tract faster. By eating soluble fiber, plant stanols and sterols, easily found in fruits, vegetables and whole grains, you help block the absorption of cholesterol from your digestive tract. Eating this way allows you to choose your calories and meals based on your desire to lose weight or just to get healthier. Sample daily menus for TLC provide roughly 40 to 50 grams of fiber. The GI North website blog, located here, gives good suggestions on foods that are high in fiber also.

Mediterranean-style Eating

Many people who live in places bordering the Mediterranean Sea have been found to be healthier individuals. They eat a variety of fruits, vegetables, legumes, whole grains, chicken, fish, seafood and other healthy foods. Red meat and sweets are reserved for special occasions, and red wine is enjoyed on a regular basis. They couple that with regular exercise to live a healthy lifestyle. Your fat, protein and carbohydrate intakes are aligned with the government’s recommendation by eating this way. You will definitely meet or exceed the recommended 22 to 34 grams of fiber each day. Add yogurt, tofu, green leafy vegetables, salmon and other low-fat dairies to get the right amounts of calcium and vitamin D each day, both of which have been shown to lower the risk of colon cancer.


This plan has been found, according to the U.S. News and World Report, to be the healthiest overall diet. There is no need to track specific nutrients on DASH. By determining how many calories you should be eating and from where those calories come, along with cutting down on salt and fatty foods, you have created your ideal DASH plan. You calories will come from the healthy foods and will provide the right nutrients for your healthy lifestyle. You do not banish entire food groups, which helps you stay on the plan indefinitely. Plus, you get all the benefits from fiber for your colon health by eating plenty of fruits, vegetables and whole grains.

Choose one of these plans to maintain your digestive and colon health. If you have any questions pertaining to your gastrointestinal system health, simply contact GI North.

© 2014 GI North Gastroenterology Services. All rights reserved.

Picture of Bowls of Healthy Nuts | Gastroenterology AtlantaYou know the feeling. It starts with a vague fullness. It grows and grows, uncomfortably. You may feel, admit it, gassy. You may stifle a burp. Yes, you are bloated. The good news is that we at GI-North Gastroenterology Services can help you prevent these symptoms. One way is through examining your diet. Here are eight foods to watch.

1. Legumes.
It’s true. Legumes such as kidney beans, lentils and peas can cause gassiness because their sugars are difficult to digest. If you don’t want to give them up because you rely on them as a source of protein, try first taking a digestive enzyme supplement to help your system digest the meal.

2. Milk and other dairy products.
Blame the sugar, called lactose. If you are intolerant to it, you may suffer painful digestive symptoms when you consume it. Opt for lactose-free dairy products.

3. Cabbage, broccoli and asparagus.
Again, blame the sugar, which in these green vegetables is called raffinose. It can cause gassiness when it is digested. Before giving up the health benefits of these vegetables, try eating them cooked, which breaks them down a bit so they are easier to digest.

4. Some sugarless gum.
It’s not a food, but it can cause the same bloating if it has a sugar substitute called sorbitol.

5. Apples.
They can cause bloating in people with difficulty processing fruit sugar, called fructose. Try eating half an apple at a time and see if that helps. If not, you may have to give up apples.

6. Processed foods.
This time, it’s the high-sodium content that’s the culprit. It’s found in many convenience foods such as microwaveable meals, soups, sauces and salad dressings. Fresh is best.

7. Soda.
Not a shocker, is it? The carbonation expands in your gastrointestinal tract. Carbonated drinks have no nutritional value, so just skip them.

8. Too much of anything.
Think Thanksgiving dinner syndrome. You pile everything on your plate and go back for seconds, even though you are full. You pay for it later when you feel like the stuffed turkey yourself. Eating too much of anything, even healthy food, at one sitting is likely to bring on bloating and gas, not to mention too many calories, so just don’t do it.

If you’ve tried these basic tips and still suffer from intestinal discomfort, contact GI-North Gastroenterology Services. We will assess your symptoms to see if you have an underlying health condition and will get you on track to feeling better. Call us at 404-446-0600 or fill out our convenient online appointment form, by clicking here.

© 2014 GI North Gastroenterology Services. All rights reserved.

Flaxseeds with Scoop | Gastroenterologist Atlanta

Flax seeds are an excellent source of fiber and Omega 3 fatty acids.

If you are looking for a simple way to improve your digestion, then you should consider adding flaxseeds to your diet. Flax seeds come from the flax plant, which is native to the Mediterranean region. Below are some of the ways that flaxseeds can benefit your digestion:

Excellent Source Of Fiber

Flaxseed is very high in fiber. That is why it is often recommended to people who suffer from constipation. In many cases, constipation is caused or worsened by a lack of fiber in the diet. One tablespoon of flaxseeds contains 2.8 grams of fiber. Fiber helps soften your stool, which makes it easier for you to pass. It also helps increase the bulk of your stool.

Rich In Omega 3 Fatty Acids

Flaxseeds are an excellent source of omega 3 fatty acids. Most people are aware of the fact that omega 3 fatty acids can help improve heart health. However, the digestive health benefits are less known. Omega 3 fatty acids help reduce inflammation. Inflammation is the root cause of many intestinal conditions, such as Crohn’s disease and ulcerative colitis. Many people who come to GI North suffer from those problems.

Alleviate Bloating And Flatulence

Bloating and flatulence are very common and embarrassing symptoms that can sometimes be an indication of a digestive problem. A diet that is high in processed foods can worsen these symptoms by clogging up the digestive system. On the other hand, flaxseeds can help alleviate flatulence and bloating by softening the stool.

Could Reduce The Risk Of Colon Cancer

It is estimated that 102,480 people are diagnosed with colon cancer each year. It is the third most common cancer in the United States. Even though the number of people dying with colon cancer is on the decline, it still causes over 50,000 deaths per year. One of the things that can be done to reduce the risk of colon cancer is to follow a diet that is high in fiber. Because flax seeds are high in fiber, they can potentially protect against colon cancer.

Flax seeds can help improve your digestion as well as your overall health by alleviating constipation, bloating and flatulence. It is also rich in omega 3 fatty acids and can help alleviate the symptoms of inflammatory digestive disorders. Furthermore, flaxseeds can protect against colon cancer. If you want to get help with digestive issues, then you should contact GI North.

© 2013 GI North Gastroenterology Services. All rights reserved.

Various Foods that Help Prevent Colon Polyps | Gastroenterologist Atlanta

Food such as milk, yogurt, almonds, cheeses, broccoli, salmon, and avocado provide good sources of calcium.

While there are many different debilitating conditions that an individual might have to grapple with in life, colon polyps can be a uniquely challenging disease to handle. Yet by learning more about the condition and how dietary changes can ease the symptoms of the disease, you and your loved ones can continue living a productive and positive life. Here is some basic information you should know:

Polyps – A Brief Overview

Colon polyps (also referred to as colorectal polyps) are fleshy growths that occur on the lining of the rectum or colon. If they are left untreated, these polyps can evolve into colorectal cancer. Generally, colorectal polyps are classified in terms of their behavior (such as whether they are malignant or benign). Polyps can be benign (hyperplastic polyp), pre-malignant (tubular adenoma), or malignant (colorectal adenocarcinoma). They can also be classified in terms of etiology (such as whether they result from a condition such as inflammatory bowel disease).

How Diet Can Improve Your Polyp Condition

Although grappling with polyps can be a difficult thing to do, making changes to your lifestyle can decrease one’s symptoms and susceptibility to the condition. While there are many lifestyle changes you can make when dealing with colorectal polyps, changing your diet can be one of the most effective shifts. Here are some dietary improvements that can be made:

1. Get Your Calcium.

If you want to protect yourself from getting polyps or experiencing another bout with the condition, be sure to get enough calcium. Some of the great sources of calcium available include low-fat or skim milk, kale, broccoli, and canned salmon that has its bones. It also appears that adequate consumption of vitamin D can reduce one’s susceptibility to colorectal cancer given that the vitamin aids in calcium absorption. There are a wide variety of sources from which vitamin D can be obtained, such as liver, fish, egg yolks, and milk products. Vitamin D can also be obtained through exposure to the sun. If you find that you’re not drinking adequate amounts of milk or obtaining your calcium and vitamin D from other sources, consider supplementation.

2. Eat Fruits And Vegetables.

Incorporating fruits and vegetables into your diet is important because these foods are rich in fiber. When you consume foods that are high in fiber, you can decrease your susceptibility to polyp development. Additionally, fruits and vegetables contain high amounts of antioxidants that can aid in cancer prevention. According to the American Cancer Society, people should consume a minimum of five servings of vegetables and fruit each day.


At GI North, we recognize that having polyps can have an adverse effect on your personal and professional life. That’s why we’re here to help. By providing you with information regarding colon polyps and scheduling a colonoscopy for you, Dr. Cofrancesco at GI North can help you attain and maintain great health despite any physical challenges you experience.

© 2013 GI North Gastroenterology Services. All rights reserved.

Hiatal Hernia Diagram | Gastroenterologist AtlantaA hiatal hernia, also called a hiatus hernia, can be a difficult problem to live with. This condition occurs when the top portion of the stomach, the fundus, protrudes up through the hiatus, or the opening in the diaphragm. There are two main variations of hiatal hernia. One is the sliding type where the stomach tends to move up and down through the hiatus regularly. The second is the paraesophageal type. This occurs when the stomach slides up through the hiatus and twists or otherwise obstructs the esophagus. Even if these conditions aren’t causing any issues at the moment, over time, they can develop into more serious situations.

Pain and Discomfort

A hiatus hernia has the potential to cause considerable distress for its sufferers. Due to the unnatural position and location of the stomach, people with the condition may experience pain in their chest or abdomen, particularly when slouching, bending, lifting, lying down or inhaling deeply. It may also prove difficult to eat a full meal in one sitting, simply because available stomach space has been reduced. Unfortunately, this pain can easily be confused with the classic heart attack symptom, prompting many people to panic. If you experience this pain regularly and wish to identify the cause, consider making an appointment at GI North.

Acid Reflux

Acid reflux is another common symptom of a hiatus hernia. Due to the dislocation of the stomach, the lower esophageal sphincter (LES) is unable to close properly. The LES serves as the gate through which eaten food passes into the stomach, and it normally closes afterward to prevent the stomach content from going back up. However, with a hiatus hernia, this function is impaired.

Sleep Apnea

In some cases, a hiatus hernia can also cause sleep apnea. This can happen in two ways. In one, the stomach may protrude through the hiatus enough that normal sleeping respiration is hindered and disrupted. The other is when stomach acid from a malfunctioning LES causes results in inhalation of the caustic vapors, which can also disrupt normal breathing patterns. Sleep apnea is a very serious problem that is important to address. If you suffer from sleep apnea and sleep studies have failed to provide you with answers, a visit to GI North may reveal whether a hiatus hernia is involved.


If the condition becomes serious enough, or if it is aggravated, it could result in a complication known as strangulation. This happens if the stomach twists or becomes stuck in the hiatus, which may cut off the blood supply to the stomach. This is a potentially life-threatening problem that requires emergency surgery to fix.

A hiatal hernia is often a challenging condition to live with, and it can severely disrupt your everyday life. If it has been causing problems for you, you should know that it’s not something you have to endure.

© 2013 GI North Gastroenterology Services. All rights reserved.

Man Holding Stomach | Gastroenterologist AtlantaBarrett’s Esophagus is a medical condition that is a direct result of a GERD. The term GERD is also known as gastroesophageal reflux disease, which is caused by stomach acid that ends up in the esophagus due to heartburn and excessive acid indigestion.

Causes of Barrett’s Esophagus

The disorder of Barrett’s Esophagus can be described as serious alterations in the lining of the esophagus that is caused by stomach acid refluxing and scarring the esophageal tissue. Due to this scarring effect on the tissue, the esophagus no longer stretches and conforms in shape when food or liquid is ingested.

One of the main problems facing patients with Barrett’s Esophagus is the loss of elasticity to the esophagus tissue. Swallowing may become difficult due to this condition. Patients who develop this disease are also at a greater risk of developing esophageal cancer due to the harmful changes in the lining of the esophagus.


Patients may experience no direct symptoms of this disorder, yet may have been troubled with symptoms of heartburn and severe acid reflux for years prior to the onset of Barrett’s Esophagus. Dysphagia or difficulty swallowing may also occur with this condition.

Other potential symptoms that may be experienced include sore throat, hoarseness of the voice, and possibly adult-onset asthma. All of these symptoms have been found to be related to the diagnosis of Barrett’s Esophagus.

Treatment Options

The main goal of medical practitioners who treat patients with Barrett’s Esophagus is to stop any further damage to the tissue and lining of the esophagus. This would include medication therapy with prescription or non-prescription antacids, acid reducers, or proton pump inhibitors. These medications are commonly used to treat regular heartburn and GERD and typically have few side effects.

Other methods of treatment include changes in diet, weight loss, and elevating sleep position to avoid reflux at bedtime.

Surgical Treatment

Barrett’s esophagus may require surgery to stretch the esophagus when it has progressed to a point where swallowing becomes difficult. Doctors may also opt for surgery to tighten the upper stomach’s sphincter to stop excessive acid from reaching the esophagus.

Additional Information

For patients who would like to learn more about this disorder, detailed information can be found at GI North gastroenterology services or by clicking here. GI North offers medical services related to Barrett’s Esophagus and other gastrointestinal disorders.

© 2013 GI North Gastroenterology Services. All rights reserved.

Chia Seeds Arranged to Spell Chia | Gastroenterologist AtlantaChia seeds are one of the super foods that naturally work on improving digestion in your body. Many of its healing benefits are not known and are sometimes overlooked by digestive sufferers. These are five ways chia seeds helps your digestive tract get healthy again.

Add Fiber Without Adding Bulk

Increasing fiber prevents some digestive disorders, but it aggravates others. Chia seeds don’t bulk and dry in your stomach like other forms of fiber. If you are warding off a digestive disorder and have to avoid bran, wheat or psyllium husks, chia seeds can help you get the benefits of eating fiber without feeling the side effects of a clogged gut.

Reduces Inflammation While Improving Digestion

Chia helps digestive sufferers of disorders like irritable bowel syndrome, gastroparesis or gluten sensitivity. Ordinarily, you have to worry about inflammation and swelling in your stomach affecting your entire day. However, adding chia seeds to your diet reduces inflammation and soothes the stomach lining. It makes it easier for your body to digest healthy foods from a balanced diet.

Get the Same Benefits, as Fish Oil Without the Smell

This super food is high in Omega-3 fats. You get more Omega-3 from chia seeds than salmon, but it doesn’t have that fishy taste, unless that’s what you want it. Chia seeds do not have a flavor and take on the taste of the food it’s eaten with. You get all the GI health benefits of fish oil, without the fishy smell.

Heal the Stomach Lining with Chia Seeds

When mixed with water, chia forms a slippery gel similar to applesauce. Inside your body it coats the lining of your stomach and allows the villi to absorb the many antioxidants chia seeds contain. Chia is high in vitamin C, calcium and iron and several times better than blueberries for fighting free radicals.

Helps Control Your Weight

Chia seeds help you feel full even when you are eating smaller meals. Chia seeds are high in nutrients, like magnesium and boron and are high in trace minerals. You have fewer cravings to foods like chocolate or potato chips just by adding the seeds to your diet.

Another benefit of Chia Seeds is increased energy. People who simply add a sprinkle of the seeds to their morning meal have seen a noticeable difference in their energy levels. These are a few of the little-known ways chia seeds work on improving digestion naturally.

© 2013 GI North Gastroenterology Services. All rights reserved.

photo of healthy holiday meal on plateThe key to good health during the holidays is to remember that the season does not last forever. If you’re not careful, then you’ll find yourself holding onto a few extra pounds by the start of a new year. However, making a few minor adjustments to your holiday routine will keep you in tiptop shape.


An easy way to keep your diet on track is to use healthy substitutions in place of regular ingredients.

  • Substituting olive oil in place of butter will eliminate cholesterol and add good fats to a dish. In addition, using it to baked goods and dinner items will help with nutrient absorption in the intestines.
  • By incorporating herbs and spices in holiday food, you can reduce the sodium content. These ingredients will enhance the natural flavors of a dish, reduce inflammation and alleviate gas.
  • Replacing white flour with whole grain flour is a simple way to bring fiber and other nutrients into your holiday meals. Using it will keep you full and help stabilize your blood sugar level.
  • Many holiday recipes call for the use of high-fat creams. However, you can still get the same great taste by using a low-fat alternative. Ingredients such as yogurt and half-and-half will reduce the fat content without removing the protein.
  • Dishes that require copious amounts of sugar can be made healthier with the help of honey. Unlike sugar, it is unprocessed and still contains most of its natural nutrients. Honey is also lower on the glycemic index and will help maintain blood sugar levels.


The cold weather of the holiday season has many people headed towards their fireplaces instead of the gym. However, exercising during the holidays is not as difficult as it may seem.

  • A simple way to burn a few extra calories is to go shopping. While online shopping is extremely convenient, shopping at the mall can burn the average shopper an extra 1,500 calories over the course of a month.
  • Get into the spirit of fitness by incorporating games and relays during holiday parties. Games that involve running, jumping and passing will improve blood circulation and keep the digestive tract running smoothly.
  • Sitting around telling stories with family will undoubtedly give you a great workout. A good belly laugh reduces the stress hormone that increases belly fat. Likewise, laughter will help the digestive system with absorption.


A good night’s rest is often overlooked during the holiday season. However, it is essential for the body to perform at an optimal level. Those buttery, sugary treats will quickly add up and wreak havoc on the average digestive system. Getting enough sleep each night will give your digestive system the necessary time to rest and recuperate from the damage. It will also reduce your body’s cravings for excessive sugar and caffeine.

It is possible to make it through the holiday season without having to choose between good fun and good health. With a few simple adjustments, you can have the best of both worlds.

© 2013 GI North Gastroenterology Services. All rights reserved.

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