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.

What causes eosinophilic esophagitis (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.

Who is at risk for eosinophilic esophagitis(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

What are the symptoms of eosinophilic esophagitis (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

How is eosinophilic esophagitis (EoE) diagnosed?

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.

What are the treatments for eosinophilic esophagitis (EoE)?

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

Exercise and Physical Fitness

What are the basics of exercise and physical fitness?

Exercise is anything that gets your body moving. Regular exercise is one of the best things you can do for your health. It has many benefits, including improving your overall health and fitness, and reducing your risk for many chronic (long-term) diseases.

Every physical fitness routine is built on a few simple ideas. These include:

• Make exercise a habit, as your body adapts to the type of activity you do most often. Regular practice will help you improve.
• Build up your activity level slowly to help you continue to get stronger, faster, or more flexible without pushing too hard all at once.
• Challenge yourself by lifting slightly heavier weights, adding a few more minutes to your walk, or increasing your pace.
• Mix up your workouts to keep things interesting and help prevent injuries or burnout.
• Show up regularly, even for short sessions, to help you continue to make progress.

What are the different types of exercise?

There are many different types of exercise. Before you start, check with your health care provider, especially if you have trouble moving, balancing, or worry that exercise might not be safe for you.

A few main types of exercise include:

• Aerobic exercises such as walking, running, or swimming are sometimes referred to as cardio. This is short for cardiovascular exercise. These exercises increase your breathing and heart rate. They keep your heart, lungs, and circulatory system healthy and improve your overall fitness.
• Strength, or resistance training, exercises use weights, resistance bands, or your own body weight to build stronger muscles.
• Balance exercises, such as tai chi or standing on one leg, improve your stability and coordination. They may make it easier for you to walk on uneven surfaces and help prevent falls.
• Flexibility exercises, such as stretching or yoga, help your joints move more easily and improve your posture.

Most people benefit from a combination of these types of exercises. Your provider can help you choose the best type or amount of activity for you based on your fitness level and health.

How can I fit exercise into my day?

Fitting regular exercise into your daily schedule may seem difficult at first. But you can start slowly and break your exercise time into chunks. Even small amounts of exercise can be helpful. You can work your way up to doing the recommended amount of exercise.How much exercise you needdepends on your age and health.

To get started, you don't need fancy equipment, but having the right tools can make it easier and more fun. There are a variety of places where you can exercise and create a routine that fits your lifestyle. This includes:

• At home. Dumbbells, kettlebells, a mat, or resistance bands are versatile and affordable options for strength training and stretching. A treadmill, a stationary bike, or a workout video are a few options for indoor cardio.
• A fitness center, gym, or health club. These places offer equipment, classes, and sometimes personal trainers for guidance and support. Ask if you can try the center before you join, and if staff are available to show you how to use the exercise equipment.
• Outdoors. Try riding a bike, walking your dog, or exploring local parks and trails. Dress for the weather and protect yourself from the sun. If safety is a concern, choose a well-lit neighborhood, a busy park, or even an indoor shopping mall for your walk.

Include activities that strengthen all parts of your body, especially your core, which are the muscles in your abdomen (belly), back, and hips. A strong core helps with balanceand stability and can lower your risk ofback injuries.

If youhaven't exercised in a while, start slowly and talk to your provider if you have health concerns. If you don't feel right, or have any pain, extremeshortness of breath, ordizziness, stop exercising and seek help right away.

How can I stay motivated?

Even with the best intentions, it's easy to fall off track. Here are some ways to keep going:

• Choose activities you enjoy. It's easier to make exercise a regular part of your life if you have fun doing it.
• Exercise safely. Use the proper equipment to preventinjuries, listen to your body, and don't overdo it.
• Give yourself goals. Your goals should be challenging, but realistic. It may be helpful to reward yourself when you reach them. The rewards could be something big, like new workout gear, or something smaller, such as a new water bottle or movie tickets.
• Mix it up. Try a new class, playlist, Podcast, or outdoor route when things get stale.
• Find an accountability partner. Exercise with a friend, join a group challenge, or check in with an online community.
• Use wearable technology. A pedometer or an app like a fitness tracker on your phone or other device can help you track your progress.

Exercise for Older Adults

Exercise and physical activity are good for just about everyone, including older adults. There are four main types and each type is different. Doing them all will give you more benefits.:

• Endurance, or aerobic, activities increase your breathing and heart rate. Brisk walking or jogging, dancing, swimming, and biking are examples.
• Strength exercises make your muscles stronger. Lifting weights or using a resistance band can build strength.
• Balance exercises help prevent falls
• Flexibility exercises stretch your muscles and can help your body stay limber

If you have not been active, you can start slowly and work up to your goal. How much exercise you need depends on your age and health. Check with your health care provider on what is right for you.

NIH: National Institute on Aging