Center for Digestive Health
Personalized digestive health care means relief—and getting back to doing what you love.
At the Center for Digestive Health, we bring together experts from across Middlesex Health to screen for, diagnose, treat and manage conditions from irritable bowel syndrome to pancreatitis. We prioritize privacy, comfort and support, all while providing advanced, award-winning care using state-of-the-art technology.
Chronic acid reflux, or GERD, can cause damage to your esophagus, the muscular tube that connects your mouth and your stomach.
The tissue in your esophagus is usually bright and pink. Acid damage can cause this tissue to thicken and turn red.
Although it is rare, Barrett’s Esophagus can increase your risk for esophageal cancer. It is important to monitor this condition, so that your doctor can provide treatment if you have any precancerous cells.
C. Difficile Infection
Clostridioides difficile—commonly referred to as C. difficile or C. diff—is a bacteria that can infect the large intestine, or colon.
How do you get a C. difficile infection?
C. difficile infections often develop after antibiotic use. When you take an antibiotic for another type of infection, the medication doesn’t just target your illness—it can also harm the normal flora, or good bacteria, in your intestines. Without competition, C. difficile can take over and cause diarrhea, abdominal pain, and fever.
Is there treatment for C. difficile?
Most patients with C. difficile will get better with standard treatment, which includes changing medications, as well as staying hydrated and nourished during episodes of diarrhea.
In a small percentage of patients, antibiotic treatment doesn’t work to cure C. difficile infections. In these cases, your doctor might recommend a procedure called a fecal microbiota transplant (FMT). This involves taking a stool sample from a healthy person with good, diverse gut bacteria and implanting it into the colon of a person with C. difficile.
Crohn’s disease is a type of inflammatory bowel disease (IBD). It is an illness that causes inflammation in the gastrointestinal tract (GI tract), which runs from your mouth to your anus. The most common symptoms of Crohn’s are diarrhea, abdominal pain and weight loss.
You and your provider will work together to develop a plan of care that may include medications, changes to your diet, stress reduction and other lifestyle changes, and integrative medicine. Some patients may need nutrition therapy or surgery.
Fecal incontinence is a loss of control over your bowel movements. It can significantly impact your quality of life but is a medical issue that can be managed.
Patients with fecal incontinence are supported by both our Center for Digestive Health and our Center for Continence & Pelvic Health.
Conditions of the Gallbladder
The gallbladder is a small abdominal organ that sits just below the liver. Its function is to store bile, a fluid produced by the liver to help your body digest fat. Conditions that affect the gallbladder include:
- Gallstones (Cholelithiasis)
Gallstones form when substances in bile, such as cholesterol, harden into “pebbles.” If a gallstone blocks bile from moving out of the gallbladder, you may experience nausea, vomiting, and pain. Some people may need to have their gallbladder removed. // LEARN MORE
- Inflammation (Cholecystitis)
Cholecystitis is the medical term for inflammation of the gallbladder. Inflammation can occur if gallstones block bile from moving out of the gallbladder, but it can also be the result of an infection or other issue. Many people with cholecystitis have their gallbladder removed. // LEARN MORE
- Infections & Obstruction
Gallstones are not the only reason that bile cannot be released from the gallbladder. It is possible for scarring, cysts, tumors and inflammation to block the bile duct.
Several types of physicians provide care for patients with gallbladder concerns:
- Gastroenterologists will evaluate your symptoms and provide a diagnosis. They may use tests such as ERCP. // Find a Gastroenterologist
- Surgeons: If you need to have your gallbladder removed, the procedure will be performed by one of our expert surgeons. // Find a Surgeon
Not sure where to start? Contact our Nurse Navigator
Gastroesophageal Reflux Disease (GERD)
GERD occurs when stomach acid moves upwards into your esophagus, the muscular tube that connects your mouth and stomach. Stomach acid is not meant to be in the esophagus. When this happens, you may experience uncomfortable symptoms, such as heartburn.
There are lifestyle, medical and surgical approaches to improving GERD, also known as acid reflux. Your doctor will work with you to determine the best treatment plan for your symptoms.
At Middlesex Health, we have an entire program dedicated to helping patients effectively get relief GERD and related symptoms.
Familial Adenomatous Polyposis (FAP)
FAP is a very rare genetic condition that is usually inherited from one of your parents. It is characterized by numerous polyps, or small clumps of extra cells, in the lower part of the digestive tract, such as your large intestine or rectum.
Polyps by themselves are not harmful. But in patients with FAP, it is very likely that these polyps will become cancerous during adulthood—often when people are in their 40s.
If you are at high risk for FAP because you have a close relative, such as a parent or sibling, with this condition, your doctor can perform tests and take steps to reduce your risk of colorectal cancer.
Lynch syndrome is a genetic condition that increases the risk of certain types of cancer, including colorectal cancers. People with Lynch syndrome may also have a higher risk of stomach, small intestine, liver and other cancers.
Mutations in five different genes have been found in people with Lynch syndrome. A genetic counselor can help evaluate your risk of Lynch syndrome and test for changes in these genes.
Lynch syndrome is also referred to as hereditary nonpolyposis colorectal cancer (HNPCC).
At the Middlesex Health Hereditary Risk Assessment Program patients can meet with a genetic counselor, who evaluates your risk of a genetic condition and can provide testing. If you do have a genetic condition like FAP or Lynch syndrome, our team will work with you to develop a cancer screening and monitoring plan to reduce your risk of developing colorectal or other cancers.
Cancers of the Gastrointestinal Tract
Any part of the digestive system can be affected by cancer, from the esophagus to the colon. At Middlesex Health, we have two comprehensive cancer center locations, and our oncology experts work closely with our digestive health team to ensure you get the care you need if you are facing a GI cancer diagnosis.
At the Middlesex Health Cancer Center, we provide care for the whole person—body, mind and spirit. If you are diagnosed with colorectal cancer, or another cancer of the GI tract, you will be cared for by a comprehensive team of oncologists, or cancer care specialists, and you will have access to the personalized support provided by our GI Cancer Nurse Navigator.
Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome is characterized by cramping, bloating and a change in bowel habits, such as constipation, diarrhea, or both. It is not harmful to the intestines and the cause of IBS is unknown, but there are ways to control the symptoms and improve your quality of life.
You and your doctor will work together to come up with a treatment plan that may involve avoiding certain foods, meeting with a dietitian, taking certain medications and trying integrative medicine, such as acupuncture.
Pancreatic cancer occurs when cancerous growths, or tumors, develop in the pancreas. At Middlesex Health, we are dedicated to early detection and the most effective treatments, to maximize your chance of recovery while meeting your unique needs.
Pancreatic Cancer Screening Program
Because the pancreas sits deep in your abdomen, it is not easy to feel a mass. Additionally, pancreatic cancer typically causes symptoms after the disease has metastasized, or spread to other parts of the body.
Pancreatic cancer screening can lead to early detection—which is key to effective treatment. Our digestive health and cancer care teams work together to help patients understand their risk of pancreatic cancer. For patients with increased risk, there are a number of tests available.
Risk factors for pancreatic cancer include chronic inflammation of the pancreas, diabetes, a family history of genetic conditions, smoking, having obesity and older age.
At the Middlesex Health Cancer Center, we provide care for the whole person—body, mind and spirit. If you are diagnosed with pancreatic cancer, you will be cared for by a comprehensive team of oncologists, or cancer care specialists, and you will have access to the personalized support provided by our GI Cancer Nurse Navigator.
The pancreas is an organ in your digestive system that plays two important roles: it produces fluid that contains enzymes to help with digestion of food and it produces hormones, such as insulin, that help control your blood sugar.
The pancreas can develop cysts, or pockets of fluid. Many cysts are not harmful, and many patients never have symptoms. However, in some cases, cysts can become cancerous.
Many pancreatic cysts are discovered when your doctor is doing an imaging test, such as an MRI, for other reasons. However, the most common symptoms include abdominal pain that does not go away, nausea and vomiting, weight loss, and feeling full after eating very little.
Most pancreatic cysts do not require treatment. However, there are procedures that can be done to drain or remove a cyst if necessary.
Ulcerative colitis is an inflammatory bowel disease, like Crohn's. Patients with ulcerative colitis have swelling and sores, or ulcers, in the large intestine (colon) and the rectum. There are a number of tests that doctors can use to diagnose ulcerative colitis, and there treatments available for those with severe symptoms.
More Conditions We Treat
- Celiac Disease
- Cirrhosis of the Liver
- Nonalcoholic Fatty Liver Disease
- Pancreas Divisum
- Sphincter of Oddi Dysfunction
- Ulcers & Peptic Ulcer Disease
Barrett’s ablation is a safe and effective outpatient treatment that helps prevent esophageal cancer in patients with Barrett’s esophagus.
Barrett’s ablation takes place using radiofrequency ablation (RFA). Your doctor uses advanced surgical tools to apply strong heat energy to the damaged tissue in your esophagus, destroying any pre-cancerous cells.
Barrett’s ablation can be helpful for many patients, but you and your doctor will work together to determine if it is the right treatment for you.
What is a colonoscopy?
A colonoscopy is a procedure used to look for issues or changes in the large intestine (colon) and the rectum. Colonoscopies are performed by gastroenterologists, who insert a special tool called a colonoscope into the rectum. They are used to look for causes of symptoms and to screen for colorectal cancer.
How do I know if I need a colonoscopy?
Screening colonoscopy is recommended for all adults age 50 and over to screen for colon cancer. If you need a colonoscopy for other reasons, your doctor will discuss this with you and may try other methods of relieving your symptoms first.
How can I schedule a colonoscopy? Who will I see at Middlesex Health?
You can also contact your primary care physician to ask about screening colonoscopy.
Colorectal Cancer Screening
There are several different tests that can be used to look for cancers of the colon or rectum.
- Colonoscopy: Colonoscopy is considered the “gold-standard” for colorectal cancer screening. This is because your doctor can both look for signs of cancer and remove polyps that could become cancerous in the future. In addition to regular colonoscopy, your doctor may perform a virtual colonoscopy using CT scans.
- Stool Tests: Stool tests are used to detect microscopic amounts of blood in your stool. This blood would be present because a cancer was causing small amounts of bleeding. The fecal occult blood test (FOBT), fecal immunochemical test (FIT) and stool DNA test (sDNA) are common stool tests. Patients collect a small amount of stool using a special kit provided. That kit is then sent to a lab for testing.
Your doctor will recommend the best test for you based on your age, history of colorectal polyps, family history, and other factors.
Endoscopic Mucosal Resection (EMR)
Endoscopic Mucosal Resection (EMR) is a procedure performed by gastroenterologists to prevent cancer or treat early stage cancer. The goal of EMR is to remove polyps, or small clumps of extra cells, that are either precancerous or have become cancerous.
EMR can be used for the upper GI tract (esophagus, stomach, small intestine) or the lower GI tract (colon, rectum).
Endoscopic Retrograde Cholangiopancreatography (ECRP)
ERCP is a special type of endoscopy that helps diagnose conditions of the gallbladder, pancreas, liver and bile ducts. Gastroenterologists use an endoscope, or long flexible tube with a light and camera, to locate where the bile and pancreatic ducts connect to your small intestine. The doctor then uses a catheter inside the endoscope to deliver a contrast agent, or dye, and takes x-rays of the area.
Some treatments, such as removing gallstones from the bile duct, can also be performed during ERCP.
Endoscopic ultrasound (EUS) is a minimally invasive procedure used by gastroenterologists to look for and help diagnose digestive conditions.
In this procedure, your doctor will use a tool called an endoscope, a long, thin tube with a light and camera attached, to look inside your digestive tract. During EUS, your doctor can also take a biopsy, or tissue sample, for testing.
Endoscopy is the general term for minimally invasive procedures that use a long, flexible tube with a light and camera to view the inside of the digestive tract. The tube can be inserted through the mouth, in order to view the esophagus, stomach and small intestine. It can also be inserted through the anus to view the large intestine (colon) and rectum.
Endoscopy is generally a very safe procedure and does not require any incisions. There are many different types of endoscopy, depending on what your doctor is looking for. If you are scheduled for an endoscopic procedure, your doctor will provide additional information about your specific test.
Common types of endoscopy include:
Fecal Transplant for C. difficile Infections
Fecal microbiota transplant (FMT) is a treatment for C. difficile infection that is not improving through use of antibiotics or recurs (returns) after symptoms resolve.
A Fecal Microbiota Transplant (FMT) involves taking a stool sample from a healthy person with good, diverse gut bacteria and implanting it into the colon of a person with C. difficile. When the good gut bacteria is reintroduced, the C. difficile has competition and can no longer overpopulate the intestines.
GERD - Medical & Surgical Management
Lifestyle changes, medications and surgical procedures can all be used to treat gastroesophageal reflux disease, or GERD.
Depending on the symptoms you have—and their severity—you may see a gastroenterologist or nutritionist. If steps like changing your diet, raising the head of your bed, limiting smoking and alcohol consumption, and adding a GERD medication do not help, you may be a candidate for surgery.
At Middlesex Health, our surgeons offer the most advanced procedures to treat GERD, including LINX and TIF®.
Manometry (Muscle Function Testing)
Sphincters are groups of muscles that form a ring and open/close to control the movement of substances, such as food and digestive fluid, in the digestive tract. Sphincters are a very important part of the digestive tract. The lower esophageal sphincter opens to allow food to enter the stomach and then closes to prevent stomach acid from moving up into the esophagus, causing reflux. Sphincters in the rectum and anus control bowel movements.
Manometry is used to test the function of these muscles for patients who are experiencing symptoms such as reflux, fecal incontinence, and constipation.
Anorectal manometry tests the function of the rectum and anal sphincter.
Your doctor will discuss the details of your test, which does not involve sedation or anesthesia. They will also share details about how to prepare for the test.
Esophageal manometry tests the function of the lower esophageal sphincter.
It can also be used to test the function of the esophagus. The esophagus is made of muscle. If it cannot function properly, it may not be able to move food into your stomach.
Medication & Lifestyle Changes
Many digestive health conditions can be managed very effectively without surgery or other invasive procedures. Lifestyle changes—such as adjustments to diet, exercise, sleep hygiene and alcohol consumption—can help you find relief from your symptoms.
Certain gastrointestinal disorders can also be helped by medications. You, your gastroenterologist and your other health care providers will work together to develop a plan for screening, diagnosis and treatment that is right for you.
Pancreatic Cancer Screening
Early detection of pancreatic cancer is key to effective treatment. For patients with a high risk of pancreatic cancer, there are several tests available:
- CA19-9 Blood Test: This blood test looks for the presence of certain proteins or tumor markers shed by pancreatic cancer cells. This test is not the gold standard but can provide useful information to your doctors.
- Biopsy: A small amount of tissue is removed from the pancreas. The doctor will then examine the tissue to check for abnormal and cancerous cells.
- Endoscopic Ultrasound (EUS): The use of high-frequency sound waves to create images of the lining and walls of your digestive tract, chest, pancreas, liver, and lymph nodes.
- CT Scan: The combination of a series of x-rays to create detailed images of the inside of your abdomen and pelvis.
- MRI: This test uses magnetic waves to create pictures of the inside of the abdomen.
- PET Scan: A scan of the entire body to determine if cancer has spread elsewhere in your body. PET scans can sometimes detect disease before it shows up on other imaging tests.
For patients who are diagnosed with pancreatic cancer, we offer the most advanced treatments, as well as supportive care. Patients at the Middlesex Health Cancer Center have access to nurse navigators, dietitians, social workers, integrative medicine practitioners, survivorship care and more.
Weight Loss - Medical & Surgical
At the Middlesex Health Center for Medical & Surgical Weight Loss, our priority is helping you achieve your weight loss goals. Our team of expert surgeons, nurse practitioners, dietitians and more work with each patient to provide education, medical weight loss, surgery—when appropriate—and long-term followup.
Visit our Center for Medical & Surgical Weight Loss website to access our virtual services, meet our expert providers and learn about the different treatment and support options available to you.
Managing digestive health conditions can be complex, and we take an innovative approach to providing advanced care and personalized support during screening, diagnosis, and treatment. Our Center brings together experts from across Middlesex Health—so you can be sure that even if your providers are in different offices, your care will be coordinated.
Digestive health issues can be complex. You may need to see more than one type of doctor, and it can be hard to know where to start. When you contact us, you will speak to our Nurse Navigator. This specially trained nurse can help you determine who you should see first, explain next steps, and provide education about your condition and related care after diagnosis.
Once you begin to see doctors, nurses and supportive care providers—such as physical therapists, mental health professionals, or integrative medicine practitioners—we will continue to guide you to ensure that your care is coordinated between all of your providers, even though they might not all be based in the same office. This means that you will get effective and timely support.
Depending on your concerns or diagnosis, you might see one or more providers. These could include:
- Gastroenterologists: Doctors who care for the stomach and intestines
- Surgeons: Specialists who perform complex procedures in the hospital or outpatient facility
- Dietitians: Experts in nutrition who offer counseling, education and support
- Mental Health Providers: Specialists who can help manage anxiety, obsessions and compulsions that can often affect the gastrointestinal system (GI tract)
- Physical Therapists: Providers who use biofeedback and other techniques to help manage conditions, such as fecal incontinence, associated with muscles in the pelvis
- Oncologists: Experts who care for patients with cancers of the GI tract, as well as patients with anemia
- Pulmonologists: Specialists who can assist with conditions that impact your chest and upper GI tract, such as some types of hernias, some cancers, and sarcoidosis
- Genetic Counselors: Health care professionals who have extensive training in identifying and managing genetic and inherited risk for cancer and other conditions
- Naturopathic Doctors: Board-certified providers who use natural remedies to promote healing and focus on treating the whole person—body, mind and spirit
- Integrative Medicine Practitioners: Specially trained care providers who offer acupuncture, massage and other modalities that have been shown to improve symptoms and reduce overall stress
- Compassionate Care: We understand how difficult and even painful it can be to manage digestive health conditions. Your privacy and comfort are our top priority, and every patient can expect kindness, compassion, and discretion.
- Connected Caregivers: Your providers are connected. Because your doctor, dietitian, and other Middlesex Health experts are part of our Center for Digestive Health, they can communicate often and easily to ensure that your experience is seamless. Plus, we have a nurse navigator dedicated to making sure you find the right providers and understand every aspect of your care plan.
- Complete Care: We offer a full range of services—from screening and diagnosis to treatment and long-term management.
- Mayo Clinic Care Network: Middlesex Health is Connecticut's first member of the prestigious Mayo Clinic Care Network. This means that your expert physician at Middlesex has direct access to Mayo Clinic specialists at no extra cost to you. // LEARN MORE
Middlesex Health is proud to be a Healthgrades® America's 100 Best Hospitals for Gastrointestinal CareTM in 2021.
This award builds on our history of excellence:
- Recipient of the Healthgrades® Gastrointestinal Care Excellence AwardTM for 4 Years in a Row (2018–2021)
- Five-Star Recipient for Treatment of GI Bleed for 5 Years in a Row (2017–2021)
- Five-Star Recipient for Treatment of Bowel Obstruction for 2 Years in a Row (2020-2021)
Spotlight: Our Providers & Patients
Our providers are passionate about sharing information about digestive health. Click on the links below to learn more.