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closeup photo of a microscope lenses | miscroscopyNot just for science classrooms anymore, microscopes are used in a variety of medical settings for diagnostic purposes. Microscopy has even become an integrated part of endoscopic exams routinely performed by gastroenterologists. Read on to learn more about how real-time microscopic exams have advanced the field of gastroenterology for patients and practitioners alike.

What is microscopy?

Microscopy generally refers to the use of magnifying devices in order to examine objects otherwise invisible to the naked eye. Although the first microscopes were invented more than 400 years ago, the full range of their use continues to evolve even today. The simplest microscopes resemble small telescopes with mirrors positioned between two curved lenses. With more advanced devices, such as the scanning electron microscope, smaller and smaller objects have become visible with ever greater clarity.

How is microscopy used in gastroenterology?

Endoscopy is a method routinely used in the monitoring and treatment of upper and lower gastrointestinal conditions. Standard endoscopy provides a minimally invasive means of visualizing the anatomy and tissues of the digestive tract with only slight magnification of these structures. Tissue samples taken during endoscopy are later analyzed with a microscope in order to confirm any suspected diagnoses. This diagnosis via microscopy is referred to as the histopathological diagnosis and is considered the “gold standard” for determining the presence or absence of many conditions, including those afflicting the digestive tract.

The use of microscopy has now been integrated into many endoscopic devices, allowing real-time analysis of tissues and diagnosis of conditions. Joint use of microscopic imaging in endoscopy is referred to as endomicroscopy. Some methods of endomicroscopy make use of special dyes or lights to help make diagnoses, similar to techniques that can be used in standard microscopy methods.

What are the advantages of endomicroscopy?

The greatest advantage of endomicroscopy is the ability to perform corrective procedures on tissue lesions diagnosed during endoscopy without any added discomfort to the patient. This can significantly reduce the amount of time and number of office visits required for a patient to receive the full range of treatment required for a particular condition. The reduced period of time between detection and treatment can also offer patients and physicians greater peace of mind knowing that the most appropriate treatment techniques for a specific patient’s needs were employed as quickly as possible.

In some cases, endomicroscopy is augmented by standard microscopy as this can allow for some specific diagnostic testing that is not possible in vivo during endoscopy. The capability of gastroenterologists to use both real-time and standard microscopic methods provides the practitioner with a powerful arsenal of diagnostic and therapeutic options that can be tailored to each patient’s particular condition as it is uncovered.

Who performs microscopy?

While this article is intended to be informative, it is not a substitute for professional medical advice. If you have questions or concerns regarding the diagnosis or treatment of gastrointestinal conditions using microscopy or any other methods, please contact a qualified healthcare professional near you.

Consider turning to GI North for your gastrointestinal healthcare needs. GI North uses both time-tested and cutting-edge diagnostic and therapeutic procedures to treat a wide-range of health conditions affecting the digestive tract. The GI North team is led by Drs. Cofrancesco and Quijano. For appointments in Spanish, please request Dr. Quijano.

GI North is located in Cumming, GA and also serves the surrounding areas of Alpharetta, Roswell, Canton, Suwanee, Sugar Hill, Buford, Duluth, Mountain Park, Norcross, Gainesville, Canton and Lilburn. Find out today how GI North can help you on your way to greater gastrointestinal health and wellness.

© 2017 GI North Gastroenterology Services. All Rights Reserved.

photo of beef steaks on the grill with flamesAs of late, research suggests that grilled meats or chicken could be linked to cancer. The issue is said to be connected to carcinogens, which are cancer-causing elements that may form due to grilling methods. The grilling process induces a high temperature that causes the sugars, creatine and amino acids in the meats to react by producing heterocyclic amines (HCAs). As well, polycyclic aromatic hydrocarbons (PAHs) are from the flames that are made when the fat from the meat drips onto the grill. The process of smoking of meats can also form PAHs.

Conferring to WebMD, cooking poultry, beef, pork and fish over an open flame such as grilling is known to cause compounds to form. These compounds are identified as PAHs and HCAs which form on the surface of well-done meat. Research shows that PAHs and HCAs can cause changes in DNA which may increase the chances of getting cancer. However, the studies were done on animals and in very high doses of PAH and HCA.

Although there have not been enough studies done to prove that grilling meat can cause cancer, there are precautions you can take to reduce your exposure to PAHs and HCAs.

  • The Flames – Make sure the flames have died down before you place the meat on the grill.
  • Use Lower Temperatures – Grill your meat at lower temperatures to reduce PAHs and HCAs.
  • Use Certain Herbs and Spices – rosemary is said to reduce the HCA in the end product by over 90%. Onions, garlic, honey and tart cherries are also believed to lower HCA formation on grilled meats.
  • Meat Preparation – Make sure to check food preparation methods for lowering carcinogens in well done meats.
  • The Proper Charcoal – Selecting the right charcoal is important. Some charcoal has more intense heat and flames. Coconut shell charcoal is said to produce fewer PAHs and HCAs compared to wood charcoal.
  • Marinating Meat – Research shows that marinating meat for at least 20 minutes before grilling can reduce HCA formation up to 96%.
  • Raise the Grill Rack – By raising the grill rack you reduce the amount of flames. Instead, the meat is grilled longer at a lower heat.
  • Turn the Meat Often – Frequently turn the meat over on the grill. This lowers the degree of carcinogens that can possibly form on the meat.
  • Use Gas for Grilling – Gas is recommended for grilling instead of a charcoal grill. Charcoal encourages the use of lighter fluid which causes flair-ups.
  • Lean Meat – Select lower cuts of meat and trim away all visible fat. This prevents the fat from dripping unto the grill and creating intense flame and heat.
  • Reduce Intense Flames – Lower the risk of flare-ups by placing aluminum foil on the grill. Also, puncture small holes in the foil to allow grease and fat to escape.

Grilling Meats and the Risk of Cancer

Overall, if you take precautions then the chances of getting cancer from grilled meats is pretty slim. However, if you suspect that you have cancer or you have concerns about your digestive tract, contact a specialist as soon as possible.

At GI North, gastroenterologists Dr. Simon Cofrancesco and Dr. Sergio Quijano have a combination of experience that is unmatched. Together they offer years of expertise in many specialties such as diagnosis and treatment of digestive issues and certain cancers.

GI North has a highly skilled and professional staff that is dedicated to providing exceptional personal care and service. What’s more, Dr. Sergio Quijano speaks fluent Spanish.

Contact GI North in Cumming or any of the surrounding areas in Johns Creek, Roswell, Dawsonville, Duluth, Dahlonega, Suwanee, Canton, Milton and Alpharetta.

Note: This article is not intended to replace professional medical advice. If you have any questions or concerns about stomach issues or cancer, make an appointment at GI North with Dr. Simon Cofrancesco, Dr. Sergio Quijano or an M.D. in your area.

© 2017 GI North Gastroenterology Services. All rights reserved.

medical diagram showing the effects of Clostridium Difficile | GI NorthWhile any bought of diarrhea can seem unbearable, thank your lucky stars if you have never experienced a case of C. difficile diarrhea, a.k.a. “deadly diarrhea.” Find out more about the causes and symptoms of deadly diarrhea and what you can do to prevent and cure this gastrointestinal infection.

What causes deadly diarrhea?

Clostridium Difficile, also known as C. difficile or even “C. diff.” is a gram-positive spore-forming bacteria that causes a potentially life-threatening diarrheal illness. The illness develops as a result of toxins released from the clostridium spores that cause inflammation of the intestines, or colitis. Typical symptoms of C. diff. colitis include fever and abdominal pain accompanied by 10 to 12 watery stools per day that may contain blood or pus. C. diff. diarrhea also tends to have a very strong and distinctive odor.

How do you get deadly diarrhea?

About 500,000 cases of clostridal illness and 15,000 deaths due to the infection occur in the United States each year.

One of the most important risk factors for the development of C. difficile diarrhea is the use of antibiotics. Due to the loss of competition from “friendly bacteria” in the gut that are wiped out by antibiotic use, infectious bacteria such as Clostridium difficile are able to replicate unchecked in the bowel and cause infection. Most people who develop antibiotic-associated C. difficile colitis will notice the onset of symptoms within a month after initiation of antibiotic treatment.

Exposure to people who are sick with C. difficile is another important risk factor for developing the illness. Be sure to practice good hand hygiene around anyone who is sick with C. diff. colitis. Advanced age also tends to increase the severity of Clostridium difficile infection; most people who die from C. difficile diarrhea are over the age of 65.

How do you prevent deadly diarrhea?

Disinfection of hands and surfaces that have come into contact with anyone who is sick with C. difficile diarrhea is an important step in preventing the spread of this infection.

You can also help prevent the development of C. diff. diarrhea with smart antibiotic use. Talk to your doctor about taking a probiotic along with your next antibiotic prescription to help restore your friendly gut bacteria before C. difficile can cause infection. Also ask about your healthcare facility’s approach to “antibiotic stewardship,” techniques designed to help prevent antibiotic resistance and antibiotic-associated colitis.

How is deadly diarrhea treated?

As it is caused by a bacteria, the first line treatment for C. difficile diarrhea is with antibiotics. The severity of the infection will determine if the treatment can take place as an outpatient or if hospitalization will be needed. If the digestive tract has been severely damaged by the infection, surgery may be needed for some patients suffering from C. diff. diarrhea. Patients that do not respond to antibiotic or other treatments may be offered a fecal microbiota transplant, a procedure that has been developed relatively recently but has already shown promising success rates.

While intended to be informational, this article cannot take the place of professional medical advice. If you have concerns about C. difficile or other forms of diarrhea, contact a local healthcare professional. Also consider choosing GI North for your digestive tract health needs. The GI North team, lead by Drs. Cofrancesco and Quijano, serves the Cumming, GA area as well as the surrounding areas Alpharetta, Roswell, Canton, and Suwanee. For appointments in Spanish, please ask for Dr. Quijano.

© 2017 GI North Gastroenterology Services. All rights reserved.

Gastritis is due to an inflammation of the lining of the stomach. Generally there are a large variety of symptoms. Rendering to the Mayo Clinic, symptoms include vomiting or nausea, abdominal pains, a burning pain within or above the stomach, stomach bloating, indigestion, dark stools, hiccups or constant burping. Many experts agree that the main cause of gastritis is from Helicobacter pylori (H. pylori) bacteria. However, there are certain conditions like sarcoidosis and Crohn’s disease that can also increase the risk of gastritis.

Daily Life

Your lifestyle can also make a big difference with the treatment of gastritis. In fact, according to the University of Maryland Medical Center, there are certain irritants that you should avoid completely:

  • Tobacco
  • Alcohol
  • Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and aspirin.
  • Acidic beverages like carbonated beverages, coffee (caffeinated and decaffeinated) and fruit juice that contain citric acid


When you have digestive issues it is very important to eat certain foods and beverages so that the stomach is not irritated. According to Medicine Net, there are also foods that inhibit the growth of H. pylori such as foods that contain flavonoids:

  • Kale
  • Garlic
  • Onions
  • Celery
  • Thyme
  • Parsley
  • Apples
  • Berries
  • Broccoli
  • Legumes
  • Soy products like tofu and soy milk

Eating high antioxidant foods is also helpful in lowering stomach inflammation and reducing the risk of digestive complications and disorders. High antioxidant foods include foods that are high in vitamin C and vitamin A plus flavonoids.

In addition, you should avoid foods that are high in fat because it increases inflammation in the stomach lining. As well, inflammatory foods and common allergens need to be avoided. Also, eliminate processed foods, pasteurized dairy products, all products that contain white flower like breads and pasta, fried foods, refined vegetable oils, trans fats, factory-farm meat and products with added sugar.

Other Factors

When you have gastritis there are other factors to keep in mind. For instance, you need to avoid eating heavy meals right before you go to bed. Also, many gastritis sufferers claim that eating several small meals a day instead of a few large ones greatly reduces their symptoms. Other factors that have been known to help include safe food preparation techniques, proper hygiene, reducing stress and getting rid of chewing gum because it increases gastric acid secretion.

GI North

If you suspect that you may have gastritis, it is highly recommended that you seek the advice of a professional, particularly a gastroenterologist.

At GI North, gastroenterologists Dr. Sergio Quijano and Dr. Simon Cofrancesco are well known for their knowledge and exceptional patient care. The two physicians bring numerous years of expertise to the clinic with specialties in diagnoses and treatment of digestive issues such as gastritis. Additionally, Dr. Sergio Quijano speaks fluent Spanish. Plus our highly trained and professional staff is devoted to providing the best quality in personal care and service.

For optimum convenience, GI North serves Cumming as well as the surrounding areas of Milton, Johns Creek, Alpharetta, Canton, Canton, Roswell, Suwanee, Dawsonville, Duluth and Dahlonega.

Note: This article is not meant to replace professional medical advice. If you have any questions or concerns about gastritis, make an appointment at GI North with Dr. Simon Cofrancesco, Dr. Sergio Quijano or an M.D. in your area.

© 2017 GI North Gastroenterology Services. All rights reserved.

photo of a young man holding his stomach in painThe symptoms of irritable bowel syndrome (IBS) are constipation, diarrhea, bloating, and stomach pain. Sufferers are bombarded with advice and alternate diagnoses. People say, “It’s all in your mind,” “You just need to exercise and eat right,” or “Maybe you are lactose intolerant.” The fact is—the mind does affect the symptoms. Stress makes the problem worse. Lactose intolerance is a concern for every person diagnosed with IBS, but avoiding dairy entirely does not end the suffering. Last but not least, exercise and diet are vitally important; but figuring out which foods, specifically, cause the symptoms is the tricky part.

The journey begins with diagnosis

Once the diagnosis of IBS is made, sufferers must experiment with not only food groups and beverages but additives and other eating habits as well. Making changes in the diet can definitely provide relief for the people with IBS. It’s important, however, to make sure the body’s nutritional needs are met.

Start with the basics

There is no specific, one-size-fits-all diet. Most doctors start patients with a list of very general guidelines to help begin the process of change needed to experience relief:

  • Eat meals regularly
  • Eat slowly and in a relaxed atmosphere
  • Don’t skip meals or wait too long between meals
  • Drink plenty of fluid *Limit or avoid caffeine, alcohol, carbonated drinks, milk, the artificial sweeteners sorbitol and xylitol, and fructose
  • Exercise regularly

Potential trouble spots

When IBS symptoms strike after eating, the sufferer must be aware that there is a list of foods known to cause bloating, gas, and other symptoms:

  • Cabbage
  • Onions
  • Peas and beans
  • Hot spices
  • Fried food
  • Chocolate
  • Nuts
  • Smoked food

Managing the diet is crucial to finding relief from IBS symptoms.

Non soluble fiber can be a problem

Fiber is vitally important to help with regularity. The average adult should eat 20 to 35 grams of fiber per day. While this seems simple enough, the National Digestive Diseases Information Clearinghouse estimates that most people only eat 5 to 14 grams per day (NDDIC). To the IBS patient a “fiber” is not a “fiber.” Sometimes the non-soluble fiber which adds extra bulk can be a problem. The patient must experiment to see if non-soluble fibers such as whole grain breads, cereal, pastas, nuts, tomatoes, raisins, and rice cause their symptoms to worsen. If this is true, the patient must choose soluble (dissolves in water) fibers to eat such as fruits, vegetables, and oats over non-soluble fibers.

The elimination diet allows you to experiment

The elimination diet is a helpful tool for IBS patients. Using the list of possible irritants, the patient eliminates specific foods for a specific time period to see which foods cause discomfort and worsen symptoms. The food diary allows the IBS sufferer to identify troublesome foods by charting symptoms. Patience is required to work through the list, but it is worth it to reduce suffering. Self-discipline must be exercised to limit or eliminate foods that cause diarrhea, gas, and bloating.

It is important to work with your gastroenterologist and GI North to make sure you get the nourishment your body needs. Patients find it is helpful to keep a daily food diary which includes commentary about flare-ups or other symptoms. Sharing this diary with your doctor will allow him/her to make suggestions for dietary changes based on your body’s chemistry. The doctors at GI North work with their patients to teach them how to manage IBS effectively.

If you are wondering what to eat or how to cook, your doctor will provide suggestions and there are plenty of IBS-friendly recipes on the internet. You can enjoy healthy eating which will minimize your symptoms by checking food labels, eating the right food portions, and planning ahead.

© 2017 GI North. All rights reserved.

photo of woman with stomach pain holding a glass of milk | lactose intoleranceIf you are lactose intolerant, it’s very possible that you are not getting the amount of calcium you require to keep your bones strong and healthy. Dairy products are a main source of calcium for most people. For those who cannot take in most dairy products without experiencing stomach upset, however, other healthy ways to get your required calcium intake should be investigated.

Being lactose intolerant means that your body has difficulty breaking down and digesting the sugar in milk, also known as lactose. The enzyme, lactase, is produced in the small intestine. Those who are lactose intolerant do not have enough lactase available to digest lactose, resulting in stomach upset when certain dairy products are eaten. If you’re lactose intolerant and you eat dairy containing lactose, you may experience gas, cramping, diarrhea, bloating, and even vomiting.

Alternative Dietary Sources of Calcium

If you’re avoiding foods that cause you discomfort due to being lactose intolerant, you may not be eating enough calcium-rich items that most people enjoy, such as milk, ice cream, cheeses (especially soft cheeses), sour cream, chocolate, and butter. Increase your calcium intake naturally by eating these foods that are high in calcium, but do not contain lactose:

  • Sardines
  • Soy beans
  • Tofu
  • Kale
  • Almonds
  • Greens, such as spinach, turnips, collard greens
  • Sesame seeds
  • Dried fruits (figs are high in calcium)
  • Salmon
  • Broccoli

Women need about 1,000 mg of calcium on a daily basis for bone health. If you choose to take a calcium supplement instead of upping your calcium intake with foods, consider taking calcium citrate, which the body absorbs more easily than other forms of this mineral.

Calcium Absorption

You’ll want to be sure that your body is absorbing the calcium-rich foods you’re taking in and then using it well to maintain strong bone health. Vitamin D is key to proper calcium absorption. Be sure you are taking in enough Vitamin D in your daily multivitamin. You can get your Vitamin D levels checked by your physician in north Georgia to be sure you are getting adequate supplies of this important vitamin.

GI North in Cumming, GA, has two physicians on staff, Dr. Cofrancesco and Dr. Quijano, who specialize in digestive system disturbances. Dr. Quijano is fluent in Spanish, which some patients find extremely helpful when communicating their needs. Aside from the immediate Cumming neighborhood, GI North also serves patients from surrounding areas such as Roswell, Milton, Duluth, Canton, Suwanee, Sandy Springs, Marietta, and beyond.

The offices of GI North are open five days a week in order to conveniently treat patients from all over the north Georgia area, including Dahlonega, Dawsonville, Johns Creek, Alpharetta, Milton, Suwanee, Duluth, and Canton. At GI North, you can expect the latest in advanced technological care and treatment, in addition to personalized attention from Drs. Cofrancesco and Quijano. If you suffer from lactose intolerance, require a colonoscopy, or are experiencing gastric distress, contact us at 404.446.0600 to schedule an appointment.

This article is not meant to take the place of professional medical advice. Please make an appointment with Dr. Cofrancesco or Dr. Quijano to further discuss your specific needs.

photo of a tablet with the diagnosis colon cancer on the display | GI NorthFamily medical history can be an invaluable tool in assessing one’s own risk of similar conditions. With Lynch syndrome, a condition also known as hereditary nonpolyposis colorectal cancer (HNPCC), knowing your family history is not only helpful, it may be life-saving.

Understanding Lynch syndrome

HNPCC is the most common form of hereditary colon cancer, accounting for up to 5 percent of all cases each year. This equates to around 7,500 new cases of HNPCC in the United States annually. HNPCC is caused by a mutation in one of the genes that help DNA to repair itself.

Some genetic disorders are autosomal recessive, meaning that they require two copies of a defective gene (one from each parent) in order for the disease to occur. HNPCC is an autosomal dominant disorder, meaning that inheriting the mutated gene from only one parent is enough to cause the condition to develop. This also means that, in a family with one affected parent, about one-half of the children will also be affected.

Cancer screening and HNPCC

Oftentimes, the development of colon cancer is preceded for many years by the formation of polyps. These serve as a kind of ‘red flag’ that can be detected and removed during routine or diagnostic tests such as colonoscopy. Removal of colon polyps prevents these areas of abnormal tissue from developing into cancerous lesions.

In HNPCC, polyps do not form, leaving no early warning signs to find or treat. Furthermore, colon cancer develops at a much younger age and progresses far more rapidly for people with HNPCC, making awareness of a family history of HNPCC of utmost importance for early screening and prevention. Whereas colon cancer does not tend to arise in the general population until around the age of retirement, people with HNPCC should expect to begin regular colon cancer screening exams in their 20s.

Living with Lynch syndrome

Regular cancer screening is essential to living with Lynch syndrome. People with HNPCC have a 70-80% lifetime risk of developing colon cancer. People with HNPCC who have already been diagnosed with a metastatic colon cancer, are at a significantly increased risk of developing another primary colon cancer. HNPCC also carries with it an increased risk for other forms of cancer, such as endometrial, pancreatic and stomach cancer.

With early cancer detection and treatment, people living with Lynch syndrome can expect to lead healthy and full lives. Initiation of regular colorectal and other forms of cancer screening drastically reduces the morbidity and mortality rates associated with HNPCC. Anyone with Lynch syndrome should undergo a colonoscopy every 1-2 years from the age of 20-25 years or 5 years before the first diagnosed colorectal cancer in the family, whichever is earlier. After the age of 35-40 years, colonoscopy should be performed every year.

Finding your HNPCC healthcare team

While this article is intended to be informative, it cannot take the place of professional medical advice. If you have concerns regarding your risk of HNPCC-associated health conditions, please contact a healthcare provider near you.

Consider making GI North your Lynch syndrome support team. Specialists in the diagnosis and treatment of gastrointestinal conditions, Dr. Cofrancesco and Dr. Quijano make GI North your neighborhood destination for information, treatment and support for any issue related to HNPCC or other GI disorders. For appointments in Spanish, please ask for Dr. Quijano. The GI North location makes GI health services readily accessible to the Cumming, Alpharetta, Milton, Roswell, Canton, and Suwanee, Georgia areas.

© 2017 GI North Gastroenterology Services. All rights reserved.

photo of kale salad in white bowl on wooden table | GI NorthKale is an increasingly popular vegetable that can be used in a variety of ways such as in salad, soup or steamed. As well, this hearty vegetable can be found in chips and crackers. With thorough research, studies show that kale is not a “new” food after all. In fact, has been a food served in many cultures since Roman times. And conferring too many health professionals, kale is a great superfood that is rich in vitamins and health giving properties. According to WebMD, the dark and leafy green has just 33 calories per cup and offers a plethora of benefits:

  • About 3 grams of protein
  • High in vitamins A, C, and K
  • A lot of fiber content that keeps you feeling full
  • Contains alpha-linolenic acid (an omega-3 fatty acid)
  • Rich in folate (an important nutrient for brain development)
  • Has zeaxanthin and lutein to guard against macular degeneration
  • Nearly 2.5 grams of fiber (helps with digestion and managing blood sugar)
  • High in minerals such as calcium, potassium, phosphorus, manganese and zinc

High in Digestive Fiber

Kale is very rich in fiber making it easy to digest. This healthy green can also help combat irregular bowel movements and constipation. And since it has minimal calories and high nutrition, it is a great food to add to any weight-loss diet plan. In addition, kale improves your metabolism and help hydrate the body.

Gastrointestinal Problems

Kale contains glucosinolate isothiocyanate (ITC) which fights the growth of helicobacter pylori; bacteria in the stomach lining that may cause gastric cancer. However, some researchers suggest that consuming high amounts of kale may cause gastrointestinal problems. Specialists feel this is because the vegetable contains sorbitol which is a type of sugar that is hard to digest. Some of the issues associated with the over consumption of kale include gas, diarrhea, bloating and stomach cramps.

On the contrary, Medical News Today stated that kale far surpasses spinach when it comes to nutrients. In fact, it supports healthy skin and bones plus a healthy digestion system. Not only does kale prevent constipation but it aids in regularity. So if you have difficulty digesting kale, slightly steam it instead of eating it raw. This may eliminate any digestive problems that can be caused by kale. For other concerns, contact a specialist.

GI North

If you have any questions or concerns about your digestion tract, contact GI North. We have a highly trained staff and two leading gastroenterologis, Dr. Cofrancesco and Dr. Quijano.

Affiliated with Northside Hospital Forsyth, GI North utilizes the latest diagnostic technology in the area like screening for colon cancer, colonoscopy and upper endoscopy. Open five days a week and conveniently located in the metro Atlanta communities of Georgia including Alpharetta, Canton, Dahlonega, Dawsonville, Duluth, Johns Creek, Milton and Suwanee.

Whether you suffer from digestive issues or have concerns about digestive symptoms such as stomach ulcers, abdominal pain or heartburn, the professional team at GI North can help. In fact, both Dr. Cofrancesco and Dr. Quijano are renowned for their academic achievements as well as being recipients of several prestigious medical awards. Dr. Quijano has won the American Society of Gastrointestinal Endoscopy Crystal Award for both or both Gender Research and Diversity Minority Research. Dr. Cofrancesco earned the Springfield Academic Achievement Award plus gained entrance into the Beta Beta Beta Biological Honor Society

If you suffer from any type of digestive or gastric distress, contact GI North at 404.446.0600 to schedule an appointment.

Note: This article is not intended to take the place of professional medical advice. If you have any concerns or questions about digestive issues, contact GI North or your physician.

© 2017 GI North Gastroenterology Services. All rights reserved.

medical illustration showing gallstones | GI NorthIn ancient medicine, gall (or bile), was described as one of the four humours. The apparent importance of bile led to the development of expressions like “he has a lot of gall!” to describe someone with ample self-confidence. While its actual role is slightly more humble, bile only comes to attention for most people when it causes the formation of gallstones.

The gall and its bladder

Bile is a digestive fluid produced by the liver that helps to breakdown fats and other lipids. Compounds called bile salts play a primary role in the function of bile. Bilirubin, a pigmented compound released during the natural breakdown of old red blood cells, is also found in bile and provides its distinctive yellow-green color. Bile also contains some fats and cholesterol released from the liver.

Bile is collected and concentrated in the gallbladder, a small pear-shaped pouch that sits nestled under the liver. Lipid-containing meals stimulate the release of bile from the gallbladder into the digestive tract to help ensure proper digestion.

Gallstone formation

Changes in the function of the liver or gallbladder can lead to an over-accumulation of normal bile components. Just as an excess accumulation of moisture in the air causes rain to fall, excess bile compounds can begin to clump and precipitate out of the bile as small ‘stones.’

Gallstones are described as either pigmented, because they are comprised of bilirubin, or cholesterol stones. Factors such as obesity or drugs that cause the overproduction of cholesterol by the liver increase the risk of cholesterol stone formation. Decreased activity of the gallbladder, termed hypomobility, leads to super concentrated bile, also referred to as biliary sludge, an important step toward the development of gallstones.

Symptoms of gallstones

Most often, gallstones are asymptomatic. As many as 85% of people who have gallstones do not have any symptoms. For those who have symptoms, one of the most characteristic gallstone symptoms is a sharp pain in the upper right portion of the abdomen that radiates to the back, the right shoulder or shoulder blade.

As gallstone formation progresses; the frequency, nature and severity of symptoms can evolve. In addition to the characteristic location of the abdominal pain, gallstones can be associated with nausea, vomiting, and indigestion that is often worst for several hours after high-fat meals.

Cholecystitis: a serious potential complication

If a gallstone becomes lodged in the duct connecting the gallbladder to the intestines, the resulting block of bile flow can cause inflammation or infection of the gallbladder, a condition referred to as cholecystitis that can be a medical emergency. Symptoms of cholecystitis can include worsening of gallstone symptoms, abdominal tenderness and fever.

Some patients who develop cholecystitis also develop jaundice, a yellow discoloration of the skin caused by the deposition of excess biliary bilirubin in the skin and sclera, the whites of the eyes. Restoration of the flow of bile is key to the treatment of jaundice and other symptoms of gallstone disease.

The right gallstone advice at the right time

While intended to be informative, this article cannot replace professional medical advice. If you are concerned about the potential symptoms of or treatments for gallstones, please contact GI North or a healthcare professional in your area.

Consider turning to GI North for more information on gallstone symptoms and treatments. At GI North, Dr. Simon Cofrancesco and Dr. Sergio Quijano offer comprehensive diagnostics as well as a variety of treatments for gallstones.

Dr. Simon Cofrancesco and Dr. Sergio Quijano lead the GI North team from their office in Cumming, GA and are proud to also serve the Alpharetta, Milton, Roswell, Canton, and Suwanee areas. For medical services in Spanish, please ask for Dr. Sergio Quijano.

© 2017 GI North Gastroenterology Services. All rights reserved.


Close up view of female hands holding blue ribbon for colon cancer awarenessMarch is Colon Cancer Awareness Month. Many people don’t realize that colorectal cancer is the fourth most common cancer affecting people living in the United States. It’s also the second leading cause of cancer-related fatalities.

Colonoscopy: Who Should Have One?

Colon Cancer Awareness Month exists in order to raise awareness of this highly preventable disease that can be diagnosed and cured when caught in time through colorectal cancer screenings.

The American Society of Colon and Rectal Surgeons recommends that adults begin getting colonoscopy screenings starting at age 50 or even earlier for those with a family history of colon or rectal cancer, or polyps. This procedure is done in an outpatient setting. There is some home preparation involved and very little discomfort. The important aspect of this screening is that your gastroenterologist can identify and remove potentially harmful polyps or take biopsies if necessary during the procedure, making this screening a highly therapeutic and possibly life-saving event. If nothing of any consequence is found, your next colonoscopy is usually planned for 10 years from that screening.

Symptoms That May Indicate the Need for Colon Cancer Screening

If you are not yet 50 years old and have no family history of rectal- or colon-related cancer or polyps, you should still consider contacting your Georgia gastroenterologist if you are experiencing any of the following symptoms:

  • Blood found in bowel movements or coming from rectum
  • Abdominal pain that is unexplained
  • Weight loss that is unexplained

If you are nearing the age of 50, or if you have any symptoms worrying you, such as those listed above, you may contact the team at GI North. Their two physicians, Dr. Cofrancesco and Dr. Quijano, are highly experienced gastroenterologists. Dr. Quijano speaks fluent Spanish, which is helpful for some patients for whom English is a second language. GI North accepts patients five days a week from all over the north Georgia area including Dahlonega, Dawsonville, Johns Creek, Alpharetta, Milton, Suwanee, Duluth, and Canton. Here at GI North, we take Colon Cancer Awareness Month seriously, and we encourage everyone to take advantage of our advanced technological care and treatment by scheduling your colonoscopy screening.

This article is not meant to take the place of professional medical advice. Please make an appointment to see either Dr. Quijano or Dr. Cofrancesco at your earliest convenience. We diagnose and treat all aspects and conditions that are gastroenterology-related.

© 2017 GI North Gastroenterology Services. All rights reserved.

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