Digestive health center in Richmond, Virginia
If you or a loved one find that coping with symptoms of a digestive disease is interfering with your daily life, we're here to help. The gastroenterologists at HCA Virginia Physicians are experienced in diagnosing and treating a wide range of gastrointestinal (GI) conditions. From achalasia to GI motility diseases—we create an individualized treatment plan to restore your digestive health.
To visit one of our gastroenterologists, schedule an appointment online.
Comprehensive GI care
Our highly skilled, experienced physicians and clinical colleagues at Pratt Medical Group are dedicated to providing the highest level of digestive disease healthcare in a friendly, respectful, and compassionate environment. Our centrally located office is convenient to residents throughout the Fredericksburg region with an on-site, AAAHC accredited endoscopy center.
We specialize in the diagnosis and treatment of problems affecting the entire digestive system, including the:
- Small intestine
- Bile ducts
GI conditions we treat
Our specialists treat a wide range of GI conditions, including:
- Bile duct disease
- Crohn's disease
- Gluten sensitivity (celiac sprue)
- Irritable bowel syndrome (IBS)
- Liver disease
- Pancreatic disease
- Ulcerative colitis
Achalasia is a rare disorder of the esophagus in which the muscle at the bottom of the esophagus becomes too tight. As a result, the esophagus is unable to move food down into the stomach. Patients often get a sense of food getting stuck, symptoms of heartburn and in severe cases, the inability to eat solid food. Achalasia is commonly diagnosed by esophageal manometry, an X-ray of the upper digestive system, or an upper GI endoscopy.
Achalasia typically affects adults between the ages of 30 years old and 60 years old, but does occur later. The disorder effects 10 of every 100,000 people. The use of esophageal manometry has improved the detection of the disorder. Because more people are being diagnosed with achalasia, more patients have sought treatment such as laparoscopic surgery and endoscopic myotomy.
Gastrointestinal motility diseases
Gastrointestinal (GI) motility diseases can severely impact a patient's quality of life, making daily activities unbearable through nausea, heartburn, malnutrition and even chest pain. While there are no cures, expert surgical treatment is available at Advanced Surgical Partners of Virginia.
Hiatal Hernia occurs when the upper part of the stomach bulges through an opening in the muscle that separates the chest cavity from the abdomen (the diaphragm). This is most commonly associated with increasing age, or an increase in pressure in the abdominal cavity due to obesity, coughing, vomiting, straining, etc. Diagnosis is normally confirmed by an upper GI endoscopy, and X-ray of the upper digestive system, or a computed tomography (CT) scan.
It is estimated that more than 40 percent of people have a type of hiatal hernia. People age 50 years old and older and are at an increased risk, with the incidence level increasing to about 60 percent. Hiatal hernia can be associated with severe reflux and/or heartburn, obstruction to eating and certain types of pneumonia.
Specialized gastroparesis care
Gastroparesis occurs when the stomach has difficulty emptying food. This leaves food sitting in the stomach for an extended period of time. When this happens, patients can experience a variety of symptoms, including:
- Abdominal pain
When gastroparesis is severe, these symptoms can lead to little or no food intake. This ongoing lack of nutrition can result in significant weight loss, hospitalization, dehydration and malnutrition.
At Advanced Surgical Partners of Virginia, we offer specialized gastroparesis care to help patients relieve their symptoms and heal as quickly as possible.
Diagnosis of gastroparesis
Gastroparesis is generally diagnosed after a patient experiences common associated symptoms and confirms the diagnosis with a physician-ordered diagnostic exam, such as:
- Breath testing
- Gastric emptying scans
- Upper GI endoscopy
Types of gastroparesis
There are multiple types of gastroparesis, including:
- Idiopathic gastroparesis—Idiopathic gastroparesis is the most common, however, the origin is unknown.
- Diabetic gastroparesis—Diabetic gastroparesis can affect those who have type 1 or type 2 diabetes, with obesity being a major predictor of the disease in those who have type 2 diabetes.
- Postsurgical gastroparesis—Postsurgical gastroparesis is considered a complication of routine procedures, such as those used to correct reflux, treat peptic ulcer disease (vagotomy) and promote weight loss.
In addition to the causes above, gastroparesis may be a result of:
- Crohn's disease
- Eating disorders
- Hormonal disruption diseases
- Neurological disorders (such as Parkinson's disease, stroke, multiple sclerosis or spinal injuries)
- Radiation therapy
Children are rarely affected by gastroparesis but may develop it as a result of viral infections.
There are many ways, both surgical and non-surgical, to help reduce the symptoms of gastroparesis. These include:
- Botulinum toxin injections—Botulinum toxin, commonly referred to as Botox, injected directly into the pylorus (the opening from the stomach into the small intestine) can be helpful in treating both gastric emptying and symptoms of gastroparesis.
- Dietary changes—Most patients can manage their condition with dietary changes. The most common recommended dietary change is to eat smaller, more frequent meals, and avoid high fiber and high fat foods, as they cause delays in stomach emptying.
- Medication management—When symptoms cannot be managed through dietary changes, another common treatment option is medication management.
Some patients with severe gastroparesis are not able to manage symptoms with conventional methods. When this happens, our doctors may suggest surgery.
Our doctors offer multiple kinds of surgical procedures to treat gastroparesis, including:
- Enteral feeding tube—Enteral feeding tubes are devices that are able to provide nutrition directly into the gut.
- Gastric electrical stimulation—Gastric electrical stimulation is a treatment wherein a gastric “pacemaker” is implanted in the patient.
- Pyloroplasty—Pyloroplasty is the surgical widening of the muscle in the lower part of the stomach to allow for increased emptying into the small intestine.