CT Scans

What is a CT scan?

Computed tomography (CT) is a type of medical imaging test that uses special x-ray equipment to make detailed pictures of the inside of your body.

A CT scan produces cross-sectional pictures, which are like slices of the body. These images show the size and structure of organs, bones, and other tissues. CT images can also be combined to create 3-dimensional (3D) views.

Health care providers use CT scans to diagnose, treat, and monitor many health conditions.

Your provider may suggest a CT scan for many reasons, including:

• Fractures (broken bones)
• Cancer
• Tumors or masses
• Blood clots
• Signs of heart disease
• Spinal conditions
• Lung disease

CT scans may also be used to find the best place to perform a biopsy or help guide certain treatments. They may also be used to check for internal bleeding or injury after trauma or to evaluate the brain for certain conditions.

You may be asked not to eat or drink for a few hours before the scan. Ask your provider if there are any special instructions to follow.

For some CT scans, you may receive a contrast material. Contrast helps certain parts of the body show up more clearly on the images. Depending on what area is being examined, contrast material might be given as:

• A liquid to swallow
• A shot (injection)
• An enema (placed into the rectum)

CT scans use ionizing radiation at levels higher than a standard x-ray, but the amount is kept as low as possible. Always tell your provider if you are pregnant or think you may be pregnant.

You may be asked to change clothes and remove jewelry or other items that could interfere with the scan.

During the scan, you lie still on a table. The table slowly passes through the center of a large donut-shaped machine. The x-ray tube rotates around your body to create images.

You may hear whirring sounds during the scan. You may be asked to hold your breath for short periods. The test is painless.

The scan usually takes a few minutes, but some may last up to 30 minutes, depending on the area being scanned.

Most people can return to normal activities right away. If you were given a contrast material, drinking fluids can help your body clear it.

A specialist called a radiologist reviews the images and shares the results with your provider.

NIH: National Cancer Institute

E. coli Infections

E. coli is the name of a type of bacteria that lives in your intestines. Most types of E. coli are harmless. However, some types can make you sick and cause diarrhea. One type causes travelers' diarrhea. The worst type of E. coli causes bloody diarrhea, and can sometimes cause kidney failure and even death. These problems are most likely to occur in children and in adults with weak immune systems.

You can get E. coli infections by eating foods containing the bacteria. Symptoms of infection include:

• Nausea or vomiting
• Severe abdominal cramps
• Watery or very bloody diarrhea
• Fatigue
• Fever

To help avoid food poisoning and prevent infection, handle food safely. Cook meat well, wash fruits and vegetables before eating or cooking them, and avoid unpasteurized milk and juices. You can also get the infection by swallowing water in a swimming pool contaminated with human waste.

Most cases of E. coli infection get better without treatment in 5 to 10 days.

Endoscopy

Endoscopy is a procedure that lets your doctor look inside your body. It uses an instrument called an endoscope, or scope for short. Scopes have a tiny camera attached to a long, thin tube. The doctor moves it through a body passageway or opening to see inside an organ. Sometimes scopes are used for surgery, such as for removing polyps from the colon.

There are many different kinds of endoscopy. Here are the names of some of them and where they look.:

• Arthroscopy: joints
• Bronchoscopy: lungs
• Colonoscopy and sigmoidoscopy: large intestine
• Cystoscopy and ureteroscopy: urinary system
• Laparoscopy: abdomen or pelvis
• Upper gastrointestinal endoscopy: esophagus and stomach

Eosinophilic Esophagitis

What is eosinophilic esophagitis (EoE)?

Eosinophilic esophagitis (EoE) is a chronic disease of the esophagus. Your esophagus is the muscular tube that carries food and liquids from your mouth to the stomach. If you have EoE, white blood cells called eosinophils build up in your esophagus. This causes damage and inflammation, which can cause pain, trouble swallowing, and food getting stuck in your throat.

EoE is rare. But because it is a newly recognized disease, it is being diagnosed more often. Some people who think that they have reflux (GERD) may actually have EoE.

Researchers are not certain about the exact cause of EoE. They think that it is an immune system/allergic reaction to foods or to substances in your environment, such as dust mites, animal dander, pollen, and molds. Certain genes may also play a role in EoE.

EoE can affect anyone, but it is more common in people who:

• Are male
• Have other allergic diseases, such as hay fever, eczema, asthma and food allergies
• Have family members with EoE

The most common symptoms of EoE can depend on your age.

In infants and toddlers::

• Feeding problems
• Vomiting
• Poor weight gain and growth
• Reflux that does not get better with medicines

In older children::

• Vomiting
• Abdominal pain
• Trouble swallowing, especially with solid foods
• Reflux that does not get better with medicines
• Poor appetite

In adults::

• Trouble swallowing, especially with solid foods
• Food getting stuck in the esophagus
• Reflux that does not get better with medicines
• Heartburn
• Chest pain

To find out if you have EoE, your doctor will likely:

• Ask about your symptoms and medical history. Since other conditions can have the same symptoms of EoE, it is important for your doctor to take a thorough history.
• Do an upper gastrointestinal (GI) endoscopy. An endoscope is a long, flexible tube with a light and camera at the end of it. Your doctor will run the endoscope down your esophagus and look at it. Some signs that you might have EoE include white spots, rings, narrowing, and inflammation in the esophagus. However, not everyone with EoE has those signs, and sometimes they can be signs of a different esophagus disorder.
• Do a biopsy. During the endoscopy, the doctor will take small tissue samples from your esophagus. The samples will be checked for a high number of eosinophils. This is the only way to make a diagnosis of EoE.
• Do other tests as needed. You may have blood tests to check for other conditions. If you do have EoE, you may have blood or other types of tests to check for specific allergies.

There is no cure for EoE. Treatments can manage your symptoms and prevent further damage. The two main types of treatments are medicines and diet.

Medicines used to treat EoE are:

• Steroids, which can help control inflammation. These are usually topical steroids, which you swallow either from an inhaler or as a liquid. Sometimes doctors prescribe oral steroids (pills) to treat people who have serious swallowing problems or weight loss.
• Acid suppressors such as proton pump inhibitors (PPIs), which may help with reflux symptoms and decrease inflammation.
• Monoclonal antibodies, which can reduce inflammation and may help with swallowing. They can be used in adults and children over age 12.

Dietary changes for EoE include:

• Elimination diet. If you are on an elimination diet, you stop eating and drinking certain foods and beverages for several weeks. If you are feeling better, you add the foods back to your diet one at a time. You have repeat endoscopies to see whether or not you are tolerating those foods. There are different types of elimination diets:
• With one type, you first have an allergy test. Then you stop eating and drinking the foods you are allergic to.
• For another type, you eliminate foods and drinks that commonly cause allergies, such as dairy products, egg, wheat, soy, peanuts, tree nuts and fish/shellfish.
• Elemental diet. With this diet, you stop eating and drinking all proteins. Instead, you drink an amino acid formula. Some people who do not like the taste of the formula use a feeding tube instead. If your symptoms and inflammation go away completely, you may be able to try adding foods back one at a time, to see whether you can tolerate them.

Which treatment your doctor suggests depends on different factors, including your age. Some people may use more than one kind of treatment. Researchers are still trying to understand EoE and how best to treat it.

If your treatment is not working well enough and you have narrowing of the esophagus, you may need dilation. This is a procedure to stretch the esophagus. This makes it easier for you to swallow.

Esophageal Cancer

The esophagus is a hollow tube that carries food and liquids from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. Later, you may have symptoms such as:

• Painful or difficult swallowing
• Weight loss
• A hoarse voice or cough that doesn't go away

You're at greater risk for getting esophageal cancer if you smoke, drink heavily, or have acid reflux. Your risk also goes up as you age

Your doctor uses imaging tests and a biopsy to diagnose esophageal cancer. Treatments include surgery, radiation, and chemotherapy. You might also need nutritional support, since the cancer or treatment may make it hard to swallow.

NIH: National Cancer Institute