Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
When there is
diarrhea, white blood cells in the stool suggest intestinal inflammation.
Plain X-rays of the abdomen. Plain X-rays of the abdomen also are referred to as a KUB (because they include
the kidney, ureter, and bladder). The KUB may show enlarged loops of intestines filled with copious amounts of fluid and
air when there is intestinal obstruction. Patients with a perforated ulcer may have air escape from the stomach into the
abdominal cavity. The escaped air often can be seen on a KUB on the underside of the diaphragm. Sometimes a KUB may
reveal a calcified kidney stone that has passed into the ureter and resulted in referred abdominal pain or calcifications
in the pancreas that suggests chronic pancreatitis.
ultrasoundis useful in diagnosing
gallstones, cholecystitis appendicitis, or ruptured
ovarian cysts as the cause
of the pain.
tomography (CT) of the abdomen is useful in diagnosing
pancreatitis, pancreatic cancer,
appendicitis, and diverticulitis, as well as in
diagnosing abscesses in the abdomen. Special CT scans of the abdominal blood
vessels can detect diseases of the arteries that block the flow of blood to the
Barium X-rays of the
stomach and the intestines (upper gastrointestinal series or UGI with a small bowel follow-through) can be helpful in
diagnosing ulcers, inflammation, and blockage in the intestines.
Computerized tomography (CT) of the small intestine can be helpful in diagnosing diseases in the small
bowel such as Crohn's disease.
enteroscopy, a small camera the size of a pill swallowed by the patient, can take pictures of the entire small
bowel and transmit the pictures onto a portable receiver. The small bowel images can be downloaded from the receiver onto
a computer to be inspected by a doctor later. Capsule enteroscopy can be helpful in diagnosing Crohn's disease, small
bowel tumors, and bleeding lesions not seen on x-rays or CT scans.
ultrasound (EUS) is useful for diagnosing pancreatic cancer or gallstones if the
standard ultrasound or CT or MRI scans fail to detect them.
the newest technique allows endoscopes to be passed through the mouth or anus and into the small intestine where
small intestinal causes of abdominal pain or bleeding can be diagnosed, biopsied, and treated.
Surgery. Sometimes, diagnosis requires examination of the abdominal cavity
either by laparoscopy or surgery.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 7/25/2012