Jerry asks:
My wife has a GI problem and we are having a hard time getting a diagnosis. She is allergic to contrast dye so we are looking at the MRCP test. She has appointment at Penn in June. Do you use the MRCP test?

Anil Rustgi, MD responds:
Abdominal magnetic resonance imaging (MRI) is sometimes used as a diagnostic test alternative for patients who have iodine-related allergic reactions. An abdominal MRI provides detailed pictures of the belly area from many different views.

MRCP (magnetic resonance cholangiopancreatography) is a type of MRI that provides a view of the bile ducts, pancreatic duct and gallbladder. Your wife's Penn gastroenterologist will work with you to determine what testing is most appropriate for her condition.

DJ asks:
I have read that the double-balloon endoscopy gives doctors greater ability to diagnose and treat GI disorders. Does Penn use the double-balloon endoscopy?

Anil Rustgi, MD responds:
Yes, Penn Gastroenterology uses the double-balloon endoscopy (DBE). A technique similar to an upper endoscopy and colonoscopy, DBE has the added benefit of inserting a scope down through the mouth or up from the colon. Two balloons help anchor the scope to the intestine as it inches along – allowing it to travel a greater distance. DBE allows us to visualize most, if not all of the small intestine and assists with intervention as well.

Annie asks:
What tests should be done when one has a high serotonin level? Is a gastroenterologist the right specialist to be consulted?

Anil Rustgi, MD responds:
The serum serotonin blood test – used to measure the serotonin level in the body – can fluctuate, but may indicate a carcinoid tumor. Additional blood and/or urine tests are used to diagnose this condition. Carcinoid tumors are rare, but if left untreated, can lead to carcinoid syndrome – a form of cancer. Carcinoid tumors usually develop in the gastrointestinal tract, but can also develop in the lungs and in very rare cases, the ovaries.

A Penn gastroenterologist can evaluate your condition and risk factors for carcinoid tumors. As with all potential cancers, early diagnosis is important. To schedule an appointment, please call 800.789.PENN (7366) or you can also request an appointment online.

Randy asks:
Are any Penn physicians familiar with using stents to widen a stricture in the esophagus? I have been told by my doctors that it would be risky to use the balloon dilation in my case because the tissue has been radiated and chance of perforation to the esophagus would be high.

I had radiation from tonsil cancer and a neck dissection about eight years ago. The stricture is approximately 8 - 10 mm wide and I eat mostly creamed soups - it takes about an hour for each meal and I feel like I may choke at least once a day.

What risks would be involved trying to dilate with a stent and do you think the risks would outweigh the benefits for me? I am now in remission and would like to better my quality of life.

Anil Rustgi, MD responds:
An esophageal stricture – or narrowing of the esophagus – can be caused by several conditions, including radiation treatment. Esophageal dilation is a procedure that stretches a narrowed area of the esophagus. Various techniques are used for this procedure and advances in stent technology and balloon dilation provide new options for treatment.

A Penn gastroenterologist can evaluate your condition and recommend the best treatment, as well as advise you of the risks involved. To make an appointment, please call 800.789.PENN (7366) or you can also request an appointment online.