Department of General & Colorectal Surgery

The Department of General & Colorectal Surgery at La Peer focuses on the diseases and conditions of the abdominal area and digestive organs. The department has a particular focus on colorectal and laparoscopic procedures. Laproscopy is a surgical technique where small incisions are made instead of one large incision. This technique has been proven to lower the risk of complications, infections, scarring, and increase the healing time.

General/Colorectal surgeons work very closely with gastroenterologists when treating your GI condition. A gastroenterologist may diagnose a condition while the general surgeon will surgically treat the condition.

Medical Conditions:

• Appendicitis
• Pancreatitis
• Crohn's Disease
• Gallstones
• Hernias
• Hemorrhoids
• Irritable Bowel Syndrome (IBS)
• Peptic Ulcer
• Ulcerative Colitis
• Colon Cancer
• Esophageal Cancer
• Fecal incontinence
• Anal warts
• Hepatitis
• Liver cirrhosis
• Inflammatory bowel disease

Procedures:

• Gallbladder removal
• Hernia repair
• Appendectomy
• Hemorrhoidectomy
• Abscess drainage

If you or someone you know has been diagnosed with one of the mentioned conditions, please email us or call La Peer at 310-360-9119 to set up a consultation.

Conditions Treated

Anal warts: Warts are small growths that appear on different parts of the body including the hands, neck, feet, chest, vagina, penis, and anus. When they appear on or around the anus, they are called anal warts. They are caused by the HPV virus. Because they are caused by a virus, there is no cure. The individual warts can be removed, but there is no way to completely eliminate them from coming back in the future. The signs of anal warts are the growths that appear, but many people can have the HPV virus without any symptoms.

Appendicitis: Appendicitis is a potentially life-threatening condition where the appendix becomes infected or inflamed. The cause of appendicitis is a blockage of the appendix. The blockage can be caused by feces or a foreign object. The symptoms of appendicitis include pain, a rigid belly, reduced appetite, swelling, nausea, vomiting, diarrhea, or constipation. Because appendicitis is typically an acute condition, the treatment for appendicitis is surgical removal of the appendicitis.

Colon Cancer: Colon cancer is when cells in the colon have mutated and become malignant cells. Colon cancer is a very slow growing cancer and the second most common cancer in the United States. If the cancer is caught at an early stage, it has a high cure rate. For many, the early stage of colon cancer does not have any symptoms. Therefore, it is very important to be screened regularly. The treatment for colon cancer may include chemotherapy or surgery.

Crohn's Disease: Crohn’s disease is a type of inflammatory bowel disease that affects mostly the intestines, but it can also affect a person anywhere from the mouth to the anus. Crohn’s disease has been linked to the autoimmune system. The immune system cannot properly differentiate foreign objects and bodily tissues, and then attacks bodily tissues like the intestines. Therefore, the intestines are chronically inflamed. The risk factors for Crohn’s disease include smoking, a family history of Crohn’s, and those of Jewish ancestry. The symptoms for Crohn’s disease include abdominal pain, bloody stools, diarrhea, constipation, loss of appetite, unintentional weight loss, fatigue, abdominal cramping, mouth ulcers, and joint pain. The treatment for Crohn’s disease include diet and lifestyle changes, stress management, medication, and surgery.

Esophageal Cancer: Esophageal cancer is cancer that has started in the esophagus. This form of cancer is actually fairly rare. Smoking and alcohol consumption, and GERD can contribute to esophageal cancer. The treatment for esophageal cancer includes surgery to remove part or all of the esophagus, chemotherapy, or radiation.

Fecal incontinence: Fecal incontinence is a condition where one loses control over the anal sphincter muscles. There are varying severity of fecal incontinence from leaking a little bit or complete loss of control. Fecal incontinence can be due to diarrhea, constipation, medical condition, injury, trauma, or surgery. The treatments for fecal incontinence depends on the cause. If the loss of control is due to diarrhea, anti-diarrheal medicine may be given. If it is caused by constipation, stool softeners or laxatives may be used along with dietary changes. Surgery may be used on certain cases, such as a rectum prolapse or damage to the sphincter during childbirth.

Gallstones: Gallstones are small deposits that form in the gallbladder. The stones can be comprised of different materials including cholesterol and billrubin. The most common form are cholesterol stones. Not everybody will be symptomatic if they have gallstones. Many times, they will experience symptoms if a duct has been blocked by gallstones. The common symptoms include abdominal pain, nausea, vomiting, fever, yellowing of the skin, and clay-colored stools. The treatment for acute gallstones will be a cholecystectomy - the removal of the gallbladder.

Hemorrhoids: Hemorrhoids occurs when blood vessels in the rectum are swollen and pushed towards the surface. The types of hemorrhoids include internal and external. External are near the rectal opening and internal are closer to the large intestines. Common symptoms of hemorrhoids are anal itching, pain, minor bleeding during bowel movements, lumps on the anus, and pain during bowel movements. There are many treatment options available for hemorrhoids - for many people, the hemorrhoids can go away on their own. Those who require medication intervention may used hemorrhoid banding or surgery. Banding is where a band is placed around the base of the blood vessel and the hemorrhoid will eventually fall off. Surgery is used for more severe cases where other treatment options have not worked.

Hepatitis: Hepatitis is the inflammation of the liver. There are different types of Hepaptitis. The most common viral forms of Hepatitis are Hepatitis A, B, and C. Each virus is contracted in different ways - Hepatitis A is contracted through food and water contaminated with feces that carry the virus. Hepatitis B and C are contracted through contact with bodily fluids or sharing intravenous needles. Viral forms of hepatitis is the leading cause of liver cancer and is responsible for the majority of liver transplants. The treatment for hepatits is dependent on the type of hepatitis. Hepatitis A will normally go away on its own. It is best to avoid alcohol and fatty foods because they put more strain on the liver during digestion. Hepatitis B and C are typically treated with antiviral medications to lower the risk of liver damage and cirrhosis. Those with severe liver damage from chronic hepatitis may need a liver transplant.

Hernias: While hernias are not usually indicative of a chronic condition, it is often important to have a hernia treated as soon as possible.  A lot of hernia cases start as small and unnoticeable breakthroughs. It may occur as soft lumps found under the skin at first. Usually, this stage does not involve any pain. However, there will be gradual increase of the pressure in the internal content against the weak wall and the lump size increases. The common signs are localized or generalized pain, and a bulge. Hernia will not heal by itself. A hernia is likely to cause complications that are risky depending on the structural solidity through which it is protruding and the nature of the protruding organ. Some abdominal hernias may occur since birth, while other types of hernias are developed at a later stage in life. There are those that include pathways created during fetal development, existing abdominal cavity opening and abdominal-wall weakness areas. A hernia can form and become worse by any condition that may increase abdominal cavity pressure. Heavy lifting, chronic lung disease, obesity, straining during urination or bowel movement, and abdominal cavity fluid can all cause hernias. There are different types of hernia's as follows:

• Abdominal wall hernia: This type of hernia is also called a ventral or epigastric hernia. This is not a very common type of hernia. This type also includes umbilical and inguinal hernias.
• Direct inguinal hernia: This type of hernia can affect both men and women. The intestinal loop makes a swelling in the inside part of the groin's fold.
• Indirect inguinal hernia: This type is possible in men only. An intestinal loop passes through the canal from where a testis goes down the scrotum during childhood years. If this hernia is ignored, it may increase in size progressively and cause the scrotum to expand.
• Umbilical hernia: Both men and women can be affected by this type of hernia. A loop in the intestine protrudes through a weak abdominal wall at the navel.

Hernia treatment can be surgical or non-surgical based on its severity. Usually, non-surgical treatments help ease the discomfort and pain that resulted from a hernia while surgical treatments are used for extreme and severe cases of hernia. Here are common non-surgical treatments for hernias:

• Henria Belts: These are lightweight belts that are made to give easiness movement during recovery. They are designed to be worn over belts with straps that can be adjusted and are lined with foam for additional comfort.
• Trusses: These come as umbilical and spring trusses. The umbilical truss is worn around the midsection while the spring truss is used around waist to act as a support.
• Hernia Briefs: These types of briefs look just like any ordinary briefs except that they are made with foam pads and spandex to give additional support.
• Bindings: Bindings for the abdomen are elastic and offer constant compression and abdominal muscles support.

Inflammatory bowel disease: An inflammatory bowel disease is a condition in which the bowel is inflamed. The exact cause of inflammatory bowel disease is unknown, but it is known that the body’s immune system is not responding correctly and attacking healthy parts of the body - namely the intestines and other parts of the digestive tract. Commonly known inflammatory bowel diseases are diverticulitis, Crohn’s disease, and ulcerative colitis. Those with an inflammatory bowel disease often experience unintentional weight loss, bloody stools, abdominal cramping, constipation, loss of appetite, nutritional deficiencies , and bloody diarrhea. The treatment for inflammatory bowel disease may include medication, lifestyle and diet changes, or surgical interventions.

Irritable Bowel Syndrome (IBS): Irritable bowel syndrome is a bowel disorder in which the function is impaired. Common symptoms are abdominal pain, bloating, gas, constipation, diarrhea, and mucus in the stool. The treatment for irritable bowel syndrome includes diet and lifestyle changes.

Liver cirrhosis: Liver cirrhosis is when the liver has been scarred or damaged and is unable to function properly. Those with liver disease often have liver cirrhosis. A leading cause of liver cirrhosis is frequent alcohol consumption.

Pancreatitis: Pancreatitis is the inflammation of the pancreas. The two common types of pancreatitis include acute and chronic pancreatitis. The symptoms of pancreatitis include abdominal pain, nausea, and vomiting. The treatment for pancreatitis depends on the type of pancreatitis.

Peptic Ulcer: Peptic ulcers are holes in the lining of the stomach. The most common causes of peptic ulcers are non-steroidal anti-inflammatory drugs, like Advil and Aleve, and a bacteria called H. pylori. The treatement for peptic ulcers depends on the cause - if the cause is H.pylori, then it can be treated with a cycle of antibiotics.

Procedures Available at La Peer

Wart removal: Those with HPV may be advised to have the warts removed for both medical and aesthetic reasons. Although HPV cannot be cured, it is believed that the removal of the warts will decrease the chance of recurrence in that particular area.

Appendectomy: An appendectomy is the removal of the appendix. The appendix is not normally removed unless it has become inflamed and causing discomfort to the patient. Appendectomies are normally performed laparoscopically, a minimally invasive technique. This technique uses small incisions to insert a light and video camera into the abdomen to allow the doctor to visualize the appendix. Additional small incisions are made to insert other necessary tools.

Gallbladder removal (cholecystectomy): There are two types of gallbladder surgery: open and laparoscopic. The open procedure is when an incision is made to remove the gallbladder. However, the majority of gallbladder removals are done laparoscopically. Laparscopic procedures are done through small incisions. The laparoscopic procedures have less risk of infection, shorter healing times, and less scarring.

Hernia repair: The surgical operation for hernia involves the replacement of hernia contents in the abdominal cavity and repair of the defect. Usually, a prosthetic material must be fitted to allow the safe repair.

Hemorrhoidectomy: Surgical treatment for hemorrhoids is only used on severe hemorrhoids. The procedure will be done under either local or spinal anesthesia. The hemorrhoid will be surgically cut off and the blood vessel will be closed off during the procedure. It is normal to experience some pain after the procedure.

If you have experienced any of the conditions or symptoms mentioned, please call La Peer Health Systems at 310-360-9119 or email us to set up a consultation with one of our General/Colorectal surgeons.

Symptoms of Gastrointestinal Problems

Gastrointestinal problems will have disorders in particular organs that include intestines, stomach, gallbladder, pancreas, liver and the leading ducts between organs. Gastrointestinal problems may cause an extensive array of symptoms and assessment of a physician is important to identify the causes of the problems.

Heartburn
Those who are experiencing heartburn that stays after modifications to dietary habits and home treatment might be having a gastrointestinal disorder. People with Gastroesophageal reflux disease (GERD) will experience constant heartburn, bad taste and indigestion. People who have gastric disorders like ulcer may have heartburn too that may come with indigestion.

Bowel Changes
People who are experiencing gastrointestinal problems can feel changes in their bowel movements. They might be having constipation and diarrhea from gastrointestinal problems like diverticulitis and hepatitis. They are also likely to experience bloody stools, light colored stools and mucus-filled tools.

Gas
People who have gastrointestinal problems may experience uncontrollable or frequent gas. Peptic ulcers, irritable bowel syndrome and celiac disease may cause excessive and painful flatulence. These people with such problems may have constant belching that may happen frequently after taking in some fibrous foods or fermented or carbonated beverages.

Pain
Those with gastrointestinal problems like diverticulitis are likely to have abdominal and stomach tenderness. Other gastrointestinal problems including Crohn's disease can cause cramping and pain during a bowel movement. People with peptic ulcers can experience frequent stomach discomfort and pain that becomes worse when they lay down.

Common Gastrointestinal Problems
There are millions of people in the world who are experiencing gastrointestinal problems that range from heartburn, indigestion, ulcer, diarrhea, gas, irritable bowel syndrome (IBS). These problems can cause discomfort and may be frustrating.

These problems affect both men and women of all ages, though they are more common in women. Acute problems can be treated easily and changes to lifestyles are usually recommended for these.

Constipation- This is described as a decrease in the volume and frequency of bowel movements. This usually comes with discomfort that passes a motion or permanent lower abdomen discomfort.

Indigestion- This problem is associated with too much stomach acid which could be a result of a huge alcohol intake or greasy and spicy meal.

Diarrhea - An increase in frequency of bowel movements and the discharge of loose watery stools. A person  with diarrhea may also have abdominal cramps and nausea.

Irritable bowel syndrome (IBS) - This is a functional bowel disorder which means that the function of the digestive tract is impaired. A person may experience abdominal bloating, pain and gas, mucus in stool. irregular bowel habits with constipation, diarrhea or both.

Ulcer- This condition is described by a small hole or erosion in the gastrointestinal tract.

Gas- The presence of gas in the digestive tract is demonstrated by abdominal pain, bloating and bleaching.

Causes of Gastrointestinal Problems
Complaints associated to digestive system usually occur in an ambulatory clinic setting. The uneasiness or discomfort can be stress or diet or psychogenic related. It is possible for such systematic disease to manifest as gastrointestinal symptoms. The majority of problems tend to overlap with organic and functional causes. The following are the major causes of gastrointestinal problems.

1. Functional Disturbances
2. Deficiency of secretory IgA
3. Deficiency of stomach acid
4. Insufficiency of pancreatic digestive enzymes
5. Microbial imbalances
6. Viral infections
7. Parasitic infections
8. Bacterial overgrowth
9. Normal flora imbalances
10. Destructive agents
11. Excessive alcohol
12. Environmental chemicals
13. Food vulnerabilities
14. Pharmaceutical agents
15. Oxidative stress

Diagnosis of Gastrointestinal Problems
Diagnosing gastrointestinal problems will vary according to the type of gastrointestinal disorder. Usually, the symptoms, medical history and physical examination of patients will be the basis of the diagnosis.

Constipation- The doctor may perform an examination to the thyroid gland and the nervous system as well as check medications to determine that such constipation is not a side effect of something else. Typically constipation cases are either diagnosed in a medical clinic or self-diagnosed.

Inflammatory Bowel Disease (IBS) - It is not easy to diagnose inflammatory bowel disease and it is usually mistaken for uncomfortable bowel syndrome. An irritable bowel syndrome does not demonstrate the inflammation that is typical to ulcerative colitis and Crohn's diseases. The diagnosis for IBS is performed according to the symptoms, physical examination and medical history of the person.

Diarrhea- Apart from asking about the medical history, performing physical examination and testing routine urine, stool and blood tests, the physician may recommend colonoscopy and sigmoidoscopy test for a case of diarrhea.

Indigestion- The physician is likely to ask about the symptoms of indigestion, any taken medication and the lifestyle of the patient. The GP may further perform other examinations like pressing gently some areas of the body to know whether or not it is painful.

Hemorrhoids- This disorder is diagnosed by performing a rectal examination. For internal hemorrhoids, a physician will insert an anoscope. The entire rectum will be examined by using a proctoscope. Sigmoidoscopy or colonoscopy can also be performed to examine the inner part of the colon and reveal other gastrointestinal bleeding causes.

Non Surgical Treatment Options for Gastrointestinal Problems
There are a number of problems that usually affect the gastrointestinal tract. A few of them are often short lived; however, they cause discomfort and usually distressing. A lot of problems that affect the gastrointestinal tract can be resolved by improving the lifestyle and following doctor's prescriptions.
Diarrhea- This disorder is treated while ensuring that dehydration will not happen again and decrease the rate of food movement through the bowel.

1. Kaolin- This is a known remedy due to its reputation. This medication is available in tablet or liquid form. Anything in the bowel that may cause diarrhea is absorbed by the kaolin.
2. Oral rehydration sachets- This must be the main treatment for diarrhea. Only these sachets replenish the salts in the body that it lost along with water during the disorder.
3. Loperamide- This functions like Morphine but it is more effective. An episode of diarrhea can usually be treated with a couple of capsules as one dose.

Constipation- The main goal of treating constipation is to make some improvements in the bowel movement. This is made possible by taking in laxatives. Laxatives come in different types.

1. Osmotic Laxatives- These functions by pulling water into the bowel which will soften the bowel content and minimize constipation.
2. Stimulant Laxatives- These medicines are helpful in leading the passing of a movement and relieve constipation. They will irritate the bowel lining and cause bowel muscle contractions.
3. Lubricating Agents- These agents line the bowel with lubricants to ease the passing of a movement.

Indigestion-Treating this disorder will vary according to its symptoms. Its treatment is aimed at removing the excess acid. Here are several ways to do this.

1. Alginates- They react with acid and come up with a rafting effect. They are available in liquid or tablet form.
2. Antacids- They contain ingredients that neutralize stomach acids

When you call Lapeer Surgery Center:(310) 360-9119 to book an appointment you are more than welcome to request to see one particular doctor, but we recommend you keep your options open in order to see a doctor that can help you the most, and at a time that best suits you.

La Peer Health Systems Center- Department of General & Colorectal Surgery

(310) 360-9119

8920 Wilshire Blvd #101
Beverly Hills, CA 90211
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