Gastroenterology and Hepatology

Advanced Endoscopy at Weill Cornell Medicine

The Advanced Endoscopy program at Weill Cornell Medicine provides patients with comprehensive, compassionate, and seamless integrated care for diseases affecting the upper lower gastrointestinal system, as well as the pancreas and liver. Our team of board-certified gastroenterologists provide expert clinical care with minimally invasive techniques, as well as research, education, and patient outreach programs.

The Advanced Endoscopy program at Weill Cornell Medicine has been built upon on the principle of integrated care, focusing on prevention, screening, treatment, support, research, and education for individuals who have or are at risk for developing upper and lower gastrointestinal diseases. The program also includes a multidisciplinary collaboration with key members from many departments across the institution, including surgery and radiology.

Endoscopes — long, flexible tubes outfitted with a light and camera — have long been used to examine the digestive tract and help diagnose digestive disorders. The gastroenterologists at Weill Cornell Medicine have been on the forefront of endoscopy since it became the standard of care.

Now, advances enable physicians not only to diagnose using endoscopy, but also treat certain disorders directly. This procedure offers Weill Cornell Medicine patients another nonsurgical treatment option. These include treatment of early cancers, reflux, obesity, as well as removal of polyps.  Advanced endoscopist also use the endoscope to remove stones, treat strictures or narrowing and drain collections.

Conditions We Diagnose and Treat

Weill Cornell Medicine offers advanced endoscopy to diagnose and treat: 

●  Achalasia
●  Barrett's Esophagus
●  Colon polyps
●  Digestive Diseases and Cancers
●  Dysphasia
●  Endoscopic suturing
●  Gallbladder and Biliary Diseases
●  Gallstone
●  Gastric Outlet Obstruction
●  Gastroesophageal Reflux Disease
●  Gastrointestinal Bleeding
●  Jaundice
●  Obesity
●  Pancreatic Fluid Collections
●  Pancreatitis
●  Reflux 
●  Strictures
●  Submucosal lesions
●  Zenker's Diverticulum

What to Expect with an Advanced Endoscopy Procedure

During an advanced endoscopic procedure, physicians gently insert the scope down the patient’s throat to obtain images of a specific area.

If necessary, the scope helps physicians:

●  Open up obstructions — such as cancer tissue, inflammation, or stones
●  Drain liquid from an infected area
●  Destroy precancerous tissue

Meet Our Doctors

Our board-certified gastroenterologists are experts in advanced endoscopy and have extensive experience performing the full spectrum of procedures. Learn more about our physicians who perform endoscopic procedures.

Expert Fatty Liver Care at Weill Cornell Medicine

The liver is an organ that filters blood and removes toxins. Fatty liver is a condition in which fat deposits develop in the liver. This can cause liver inflammation and scarring, which can lead to cirrhosis and prevent the liver from functioning properly. If fatty liver progresses, patients may need a liver transplant.

The hepatologists (liver specialists) at Weill Cornell Medicine are highly trained in diagnosing and treating fatty liver, including nonalcoholic fatty liver. Our board-certified physicians offer compassionate and effective care, liver transplantation, and access to the latest clinical research. 

Fatty Liver Prevention and Screening

Fatty liver risk factors: You are more likely to develop fatty liver disease if you have: 

● Obesity
● Fat concentrated around the abdomen
● High blood sugar
● Type 2 diabetes
● High cholesterol
● High levels of triglycerides
● Polycystic ovary syndrome
● Sleep apnea
● Hormonal disorder (such as an underactive thyroid or pituitary gland)
● Current or prior heavy alcohol use

Prevention strategies: The cause of fatty liver is unknown. The best way to prevent fatty liver is to maintain good overall health:  

● Maintain a healthy weight
● Limit alcohol intake
● Eat a healthy diet
● Maintain an active lifestyle
● Control diabetes
● Take only the medications prescribed to you

Fatty liver screening: Your primary care physician can screen for fatty liver with a simple blood test to check liver enzyme levels and an ultrasound to look at the liver.

Fatty Liver Symptoms

Often, fatty liver disease does not cause symptoms. When it does, the most common signs include:  

● Fatigue
● Abdomen or belly pain
● Loss of appetite
● Nausea
● Leg swelling
● Abdomen or belly swelling
● Itching
● Yellow skin or eyes

How We Diagnose Fatty Liver  

Diagnostic tests and imaging: Fatty liver is usually diagnosed through a series of blood tests and imaging. The blood test results rule out other liver disorders, such as hepatitis B or C. To support the fatty liver diagnosis, physicians will also conduct imaging procedures, such as an ultrasound or CT scan of the liver. In some cases, your physician may recommend a liver biopsy (removing a small sample of tissue) to confirm the diagnosis of fatty liver. 

Stages: There are no stages of fatty liver, but it is important to determine if the condition has damaged the liver, as well as the extent of damage. After a fatty liver diagnosis, your physician will determine if there is any liver inflammation (steatohepatitis), scarring (fibrosis) or cirrhosis.  Physicians may use a specialized ultrasound (Fibroscan) or MRI (MR elastography) to determine the extent of damage to the liver. Occasionally, a liver biopsy is also used to examine for signs of inflammation and scarring.

Steatohepatitis, fibrosis and cirrhosis can lead to liver failure or cancer, so it is important to receive expert care from a board-certified liver specialist who can provide long-term care.

Treatment Options for Fatty Liver at Weill Cornell Medicine

Treatments: There are no medical treatments for fatty liver. Our hepatologists monitor the disease’s progression and help patients achieve their personal lifestyle goals.

The most effective way to manage fatty liver is to achieve and maintain good overall health:  

● Eat a healthy diet
● Exercise regularly
● Lower cholesterol levels
● Avoid alcohol
● Control diabetes
● Lose weight if you are overweight
● Monitor liver health by frequently visiting your hepatologist
● Get vaccinated against hepatitis A and B

The Innovative Center for Health and Nutrition in Gastroenterology (ICHANGE) was designed to create a structured approach to patients with obesity and gastrointestinal comorbidities.  The clinic is comprised of a group of gastroenterologists, hepatologists, endocrinologists, cardiologists and dieticians that see patients in a central clinic location on the same day.  The hepatologists in the clinic specialize in the diagnosis and treatment of fatty liver disease. 

Liver transplantation: In cases of extensive liver damage or failure, transplantation is the best treatment. Our highly trained surgeons use proven, minimally invasive procedures.  

After transplantation surgery, patients receive comprehensive care from a team of specialists to ensure successful recovery and long-term care.

Comprehensive Care Founded on Cutting-Edge Research 

The hepatologists at Weill Cornell Medicine unite their specialized expertise with the breadth of knowledge and support at our top-ranked hospital.

Weill Cornell Medicine patients have access to specialists in surgery, rheumatology, psychiatry, hepatology, oncology, nutrition, genetics and other fields. In addition, our patients benefit from collaborative care with:

●   The Liver Transplantation, Hepatobiliary and Pancreatic Surgery Program

Meet Our Doctors

Our board-certified hepatologists provide compassionate care based on the latest fatty liver research and clinical findings. Patients benefit from our physicians’ extensive training, targeted care, and collaboration with other specialists at our top-ranked hospital.

The key to effective disease management of acute and chronic viral hepatitis is coordinated care among specialty-trained physicians. Treatment is enforced through strict standards of practice, treatment protocols, close coordination of care with referring physicians and providing the most advanced and scientifically based approaches to the management of hepatitis. 

Hepatitis is a serious inflammation of the liver, usually due to a virus. The most prevalent of these in the United Stare are hepatitis A, B and C. Weill Cornell Medicine offers the most advanced diagnostic and treatment procedures for patients with all forms of viral hepatitis.

Treatment for hepatitis varies, depending on the type and severity of the disease:

Hepatitis A

Hepatitis A is the most common form of viral hepatitis. The disease is acquired from contaminated food or water. In healthy individuals, it causes an acute illness with fever, loss of appetite and jaundice lasting two to three weeks. Complete recovery is the rule, followed by life-long immunity to the virus. In people with pre-existing advanced liver disease, acute hepatitis A tends to be severe and can be fatal.

Hepatitis B

Acquired through exposure to the blood or secretions of an infected person, hepatitis B also can be transmitted through sexual contact. Newborns may acquire it at the time of birth from a mother with active hepatitis B. 

Adults who contract hepatitis B have an acute illness that ranges from very mild, with flu-like symptoms only, to nausea, abdominal pain and jaundice.

Most people with the condition recover and develop immunity, but 5 percent to 10 percent become persistently infected, and have the potential to infect others. For infants who are exposed at birth and do not receive treatment, the rate of chronic infection is much higher. People with long-standing active hepatitis B, spanning more than 20 years, are at risk of developing liver cancer.

Hepatitis C

Hepatitis C is usually spread through contact with infected blood. It can either be acute or become chronic and even life threatening. There is no vaccine for hepatitis C.

The acute illness is frequently very mild. However, many people fail to clear the virus, such that about 70 percent become chronically infected. An estimated 4 million Americans have hepatitis C, many of whom are unaware of their condition. As the disease progresses, the first sign may be nothing more than decreased energy. As the liver disease becomes significant, patients may experience retention of fluid, causing swelling of the ankles and increased weight, internal bleeding and confusion. 

Expert Inflammatory Bowel Disease Care at Weill Cornell Medicine

Inflammatory Bowel Disease (IBD) describes several disorders in which the digestive tract becomes chronically inflamed. These disorders can be debilitating and lead to severe complications or digestive organs damage.  IBD includes:

● Ulcerative colitis
● Crohn’s disease

The cause of IBD is unknown. One possible cause is an abnormal immune system response that causes the immune system to attack the digestive tract, which causes inflammation.

Fortunately, expert care and treatment helps IBD patients manage symptoms, lessen inflammation, prevent complications — and improve their quality of life.

Inflammatory Bowel Disease Prevention and Screening

IBD risk factors: You are more likely to develop IBD if you:

● Are younger than 30 years old
● Have a family history of IBD
● Smoke or use tobacco
● Frequently use nonsteroidal anti-inflammatory medications, including ibuprofen
● Live in an industrialized country

Prevention strategies: There is no way to prevent IBD. Physicians recommend living a healthy lifestyle and maintaining a healthy weight to promote general wellness.

Inflammatory Bowel Disease Symptoms

IBD symptoms vary from patient to patient, depending on the severity and location of the inflammation. Most patients feel sick at some times and healthy at others. The most common symptoms include: 

● Diarrhea
● Blood in stool
● Fever
● Fatigue
● Stomach pain
● Stomach cramps
● Reduced appetite
● Weight loss

How We Diagnose Inflammatory Bowel Disease

Physicians at Weill Cornell Medicine diagnose IBD by first ruling out other disorders or diseases. Then, one of the following tests may be used to confirm an IBD diagnosis:

● Blood test
● Stool test
● Endoscopic procedures, including colonoscopy or endoscopy
● Abdominal imaging tests, including x-ray, CT scan, or MRI scan

Treatment Options for Inflammatory Bowel Disease at Weill Cornell Medicine

IBD treatment aims to reduce inflammation and lessen the severity of symptoms. This helps prevent long-term complications and improve the quality of life.

It is important for IBD patients to receive frequent care from a board-certified gastroenterologist. Long term care is vital for assessing, monitoring, and preventing serious complications associated with the disease.

At Weill Cornell Medicine, our patients receive a personalized treatment plan tailored to their specific symptoms and lifestyle goals. Typically, treatment plans incorporate medications, lifestyle changes, emotional support, and — if needed — surgery. 

Medication therapy: Your physician may recommend one or more of the following medications and supplements to ease symptoms and reduce inflammation. 

● Anti-inflammatory medications
● Immune system suppressors
● Antibiotics
● Anti-diarrheal medications
● Pain relievers
● Calcium and vitamin D
● Iron supplements 

Nutritional support: There is no clear link between diet and IBD, but specific foods may aggravate IBD symptoms. At Weill Cornell Medicine, IBD patients benefit from a dedicated registered dietician nutritionist who understands the unique nutritional and dietary needs of IBD patients. 

Patients also benefit from seeking advice from our specialized nutritionists.

Stress reduction and emotional support: While stress does not cause IBD symptoms, many patients experience more severe symptoms during periods of high-stress. In addition, living with IBD can be emotionally challenging and difficult.

IBD patients may benefit from learning and implementing stress-reducing techniques, as well as seeking emotional support from other IBD patients, their personal network, and a mental health professional who understands IBD.

At Weill Cornell Medicine, IBD patients can turn to the Integrative Health and Wellbeing Program for complementary services.

Surgery: In some cases, physicians recommend surgery for IBD patients. 

● Ulcerative colitis surgery: For patients with ulcerative colitis, surgery involves removing the entire colon and rectum (proctocolectomy). In many cases, this surgery eliminates the disease.
● Crohn’s disease surgery: For patients with Crohn’s disease, surgeons can remove damaged sections of the digestive tract and reconnect the healthy sections. This surgery provides short-term relief and requires frequent monitoring.  

Comprehensive Care Founded on Cutting-Edge Research

The gastroenterologists at Weill Cornell Medicine unite their specialized expertise with the breadth of knowledge and support at our top-ranked hospital.  

Weill Cornell Medicine patients have access to specialists in surgery, rheumatology, psychiatry, hepatology, oncology, nutrition, genetics and other fields. In addition, our patients benefit from collaborative care with:

● The Jay Monahan Center for Gastrointestinal Health
● The Jill Roberts Center for Inflammatory Bowel Disease

Meet Our Doctors

Our board-certified gastroenterologists provide compassionate care based on the latest IBD research and clinical findings. Patients benefit from our gastroenterologists’ extensive training, targeted care, and collaboration with other specialists at our top-ranked hospital.

Expert Irritable Bowel Syndrome Care at Weill Cornell Medicine

Irritable Bowel Syndrome (IBS) is a common disorder in which the large intestine does not function properly. People with IBS can experience a range of symptoms including abdominal pain, constipation diarrhea or both.

IBS is a chronic, long-term condition that does not have a cure. The exact cause of IBS is not known.

Thankfully, with expert IBS care, you can improve your quality of life. Our board-certified gastroenterologists help patients diagnose IBS, identify triggers, and treat symptoms.

Irritable Bowel Syndrome Prevention and Screening

IBS risk factors: Many people experience IBS symptoms from time to time, but do not have the syndrome. You are more likely to develop IBS if you: 

● Are under the age of 50
● Are female
● Have a family history of IBS
● Have a mental health illness, such as anxiety or depression

Prevention strategies: Reducing stress and improving diet are effective ways to prevent and lessen IBS symptoms. Our leading gastroenterologists recommend that patients:

● Work with a registered dietician to help identify any food triggers
● Receive psychotherapy to help manage stress more successfully
● Learn and practice stress-reducing techniques

Irritable Bowel Syndrome Symptoms

IBS signs and symptoms vary from person to person. They also may lessen or worsen over time. The most common symptoms include:

● Abdominal pain
● Cramping
● Bloating
● Excess gas
● Constipation
● Diarrhea
● Mucus in stool
● Other persistent change in bowel movement patterns

How We Diagnose Irritable Bowel Syndrome

Diagnostic tests and imaging: [P] There is no definitive test for IBS. In fact, there is no sign of the disorder when the intestine is examined. A set of criteria can be used to diagnose IBS based upon the physician taking a careful history and performing a physical examination. Depending upon a person’s individual symptoms, some testing may need to be done to evaluate for other conditions. These tests may include:

● Blood, urine, and stool tests
● Colonoscopy
● Abdominal imaging tests, such as x-ray or ultrasound
● Food intolerance tests, such as lactose or gluten intolerance tests
● Anorectal manometry

If the testing is performed and confirm that the symptoms are not caused by another disease or disorder, your physician will then carefully discuss your symptoms and if you meet the criteria, you will be diagnosed with IBS. 

Treatment Options for Irritable Bowel Syndrome at Weill Cornell Medicine

Successful IBS treatment incorporates many different strategies — such as diet, exercise, stress reduction, and medication. At Weill Cornell Medicine, all patients receive a personalized treatment plan that addresses their unique triggers, symptoms, and lifestyle goals.

Diet: Many IBS patients greatly benefit from tracking their food intake and symptoms. This helps identify specific food that triggers symptoms. In addition to eliminating these foods, IBS patients may also be recommended to:

● Eat more high-fiber foods
● Eat smaller, more frequent meals
● Drink six to eight glasses of water per day
● Avoid foods that are known to commonly trigger IBS symptoms, including caffeine, fatty foods, dairy, alcohol, and chocolate

Our board-certified gastroenterologists collaborate with Weill Cornell Medicine registered dieticians to develop personalized dietary strategies. Patients also benefit from seeking advice from our registered egistered dieticians and specialized nutritionists.

Comprehensive Care Founded on Cutting-Edge Research

The gastroenterologists at Weill Cornell Medicine unite their specialized expertise with the breadth of knowledge and support at our top-ranked hospital.

Weill Cornell Medicine patients have access to specialists in surgery, rheumatology, psychiatry, hepatology, oncology, nutrition, genetics, and other fields. In addition, our patients benefit from collaborative care with:

● The Jay Monahan Center for Gastrointestinal Health
● The Jill Roberts Center for Inflammatory Bowel Disease

Meet Our Doctors

Our board-certified gastroenterologists provide compassionate care based on the latest research and clinical findings. Patients benefit from our gastroenterologists’ extensive training, targeted care, and collaboration with other specialists at our top-ranked hospital.

Expert Motility and Esophageal Disorders Care at Weill Cornell Medicine

Motility disorders are conditions in which the muscles and nerves in the gastrointestinal tract do not contract and tighten properly during the digestive process.

For example, dysphagia is one type of motility disorder of the esophagus (the muscular tube that connects the mouth to the stomach). Dysphagia makes swallowing difficult, preventing food and liquid from being delivered to the stomach.

The gastroenterologists at Weill Cornell Medicine are highly trained in diagnosing and treating motility disorders, including:

● Dysphagia (swallowing disorders)
● Achalasia
● Esophageal spasm disorders
● Chronic intractable constipation
● Gastroesophageal reflux disease (GERD)
● Chronic intestinal pseudo-obstruction
● Gastroparesis
● Hirshprung’s disease
● Motility disorders caused by other conditions

Motility and Esophageal Disorders Prevention and Screening

Motility and esophageal disorders risk factors: You are more likely to develop a motility disorder if you:

● Have a genetic disorder
● Suffer from an inflammatory or autoimmune disease
● Have developmental delays, autism, or an attention disorder
● Have had a serious infection

Prevention strategies: The cause of motility disorders is unknown. One prevention strategy is to try to avoid a serious infection.

At Weill Cornell Medicine, our physician-scientists are conducting research to better understand motility disorders — as well as determine the causes and innovative therapies. Our patients have direct access to cutting-edge clinical findings.

Motility and esophageal disorders screening: There is no way to screen for motility disorders, so our physicians recommend visiting a board-certified gastroenterologist as soon as you experience symptoms.

Motility and Esophageal Disorders Symptoms

Symptoms vary depending on the type of motility disorder and which organs are affected. The most common symptoms include:

● Difficulty swallowing
● Regurgitation
● Constipation
● Fecal incontinence
● Chest or stomach pain
● Heartburn
● Nausea or vomiting
● Sensation of food being stuck in throat or neck
● Anxiety
● Difficulty sleeping

How We Diagnose Motility and Esophageal Disorders

Diagnostic tests and imaging: To diagnose a motility disorder, your physician will ask questions about the symptoms and conduct a physical exam. In addition, several tests and imaging studies will help confirm the diagnosis:

● Barium swallow studies to evaluate the esophageal function and reflux
● Endoscopy or ultrasound to look directly at the affected organs
● pH study
● Manometric studies to measure the pressure in different parts of the gastrointestinal tract

Types: Once a motility disorder has been diagnosed, your physician will then determine its severity and exact type. (For example, there are three types of achalasia.) This will help determine the best treatment options to improve the quality of life.   

Treatment Options for Esophageal Disorders at Weill Cornell Medicine

Treatments: Our gastroenterologists develop a personalized treatment plan based on each patient’s specific condition and lifestyle goals. Treatment plans may include:

● Lifestyle changes, such as changes in diet and activity level
● Botulinum toxin (Botox) to reduce muscle spasms
● Surgical therapies, including:
       ○ Balloon dilation
       ○ Cecostomy to empty stool

Medication therapy: Our gastroenterologists may prescribe medications to prevent muscle spasms and alleviate symptoms. For example, laxatives may be prescribed to prevent constipation.

Comprehensive Care Founded on Cutting-Edge Research 

The gastroenterologists at Weill Cornell Medicine unite their specialized expertise with the breadth of knowledge and support at our top-ranked hospital.

Weill Cornell Medicine patients have access to specialists in surgery, rheumatology, psychiatry, hepatology, oncology, nutrition, genetics and other fields. In addition, our patients benefit from collaborative care with:

●   The Jay Monahan Center for Gastrointestinal Health

●   The Jill Roberts Center for Motility and Esophageal Disorders

Meet Our Doctors

Our board-certified gastroenterologists provide compassionate care based on the latest motility research and clinical findings. Patients benefit from our gastroenterologists’ extensive training, targeted care, and collaboration with other specialists at our top-ranked hospital.  

Nutrition at Weill Cornell Medicine

At Weill Cornell Medicine, we understand that nutrition plays an important role in maintaining a healthy digestive tract, which includes your stomach, intestines, colon, pancreas, and liver.

Improved nutrition can lead to improved digestive disease control, enhanced overall health and wellness, lessened gastrointestinal symptoms, and higher quality of life.

Our registered dieticians and physicians are highly trained in nutritional science, as well as management of digestive and liver disorders. They work closely with patients to develop personalized dietary plans to promote greater health and more active lifestyles.

Conditions Diagnosed and Treated with Nutrition Services

Our team of registered dieticians and physicians are experts in helping patients improve their nutrition and treat a variety of gastrointestinal disorders including:

● Gastrointestinal cancers (esophageal, stomach, intestinal, colon, liver, pancreatic)
● Excess weight gain or loss (including developing structured weight management plans)
● Swallowing disorders
● Eosinophilic esophagitis
● Gastroesophageal reflux disease
● Irritable bowel syndrome (IBS)
● Excessive bloating or flatulence
● Food intolerances
● Celiac disease
● Short gut syndrome
● Nutrition support: Total Enteral Nutrition (TEN) or Total Parenteral Nutrition (TPN))
● Small intestinal bacterial overgrowth (SIBO)
● Inflammatory bowel disease (Crohn’s Disease, Ulcerative Colitis)
● Fatty liver disease
● Pancreatic insufficiency

What to Expect with Nutrition Services

Weill Cornell Medicine registered dieticians work closely with patients and their physicians to understand symptoms, conditions, and lifestyle goals. They then develop personalized dietary recommendations. These may include:

● Modifying protein, sodium, or potassium intake
● Restricting total dietary cholesterol, fat, or sodium
● Addressing unique nutritional needs for development, adolescence, or pregnancy
● Changing behaviors to manage weight (to promote weight loss or gain)
● Changing eating habits or patterns to manage troublesome symptoms
● Eliminating culprit foods from the diet to manage disease

Meet Our Nutrition Providers

Our board-certified gastroenterologists and hepatologists provide expert care for a wide range of digestive and liver disorders. They collaborate closely with registered dieticians to offer personalized nutrition plans that promote wealth and a higher quality of life. Learn more about our physicians and registered dieticians. 

Patients with pancreatic diseases and disorders can find expert, compassionate care at the Pancreas Program at Weill Cornell Medicine and NewYork-Presbyterian Hospital/Weill Cornell Medical Center, where a team of specialists provide personalized treatments for cancerous and noncancerous conditions, including pancreatitis, pancreatic stones and pancreatic cysts and necrosis and pseudocysts.

In particular, we excel in early diagnosis, minimally invasive interventions, surgical services and palliative treatment that aims to relieve patients’ symptoms and improve their quality of life using cutting edge techniques.

Our approach is collaborative, with a team of physicians — specializing in surgery, advanced endoscopy, medical oncology, radiation oncology, pain management, nutrition, radiology, and pathology — working together alongside nurse practitioners, patient navigators and other medical and support professionals to deliver seamless, comprehensive care.

As part of a large academic medical center, we can also refer patients to experts who can care for other medical issues they may have, such as diabetes, heart disease, and high blood pressure.

Our multidisciplinary approach extends beyond the exam room and into the laboratory, where our physicians search for new and better ways to treat pancreatic diseases and disorders. Their research also provides patients with opportunities to participate in clinical trials, which allows patients to access therapies that may not be available anywhere else.

Education is also a large part of the Pancreas Program. As part of the Center for Advanced Digestive Care, the program regularly provides educational seminars for patients and their families. We also collaborate with the Pancreatic Cancer Action Network, which funds research and links patients and their families to support and education.

Contact us to learn more about the services we provide at Pancreas Program and to schedule an appointment with one of our experts.