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Just as there are women who prefer a female obstetrician/gynecologist, there are women who are uncomfortable talking about their gastroenterological issues and concerns with someone other than a female gastroenterologist. Even though most women are aware that they should be screened regularly for colorectal cancer after the age of 50, some will postpone having a colonoscopy until a female gastroenterologist can see them. If this is how you feel, this is the Center for you.

Innovative Care Unique to Suffolk County  
With colon cancer now the third-leading cause of cancer-related deaths among women, Stony Brook recognized the need to encourage more women on Long Island to feel comfortable addressing their gastroenterological health needs and concerns. The Gastrointestinal Women’s Center at Stony Brook is the first center of its kind in Suffolk County.

A Comprehensive, Multidisciplinary Approach
Women in Suffolk County and beyond have access to the Center’s team of four highly-trained, female gastroenterologists, as well as other key specialists, including advanced endoscopists, urologists, radiologists, nutritionists, and dieticians. Together, this multidisciplinary team works closely and meets frequently to discuss the needs of each patient to ensure the best care and treatment. 

Isabelle von Althen, MD, Director of the Gastrointestinal Women’s Center
Dr. von Althen is a board-certified gastroenterologist and advanced endoscopist, and specializes in women’s gastrointestinal health. She provides colon cancer screenings, colonoscopies, endoscopies, and treats gallbladder and inflammatory bowel disease in women. Dr. von Althen also has expertise in endoscopic retrograde cholangiopancreatography (ERCP).  She is an Assistant Professor of Medicine, Division of Gastroenterology and Hepatology at Stony Brook School of Medicine.

Ellen Li, MD, PhD
Dr. Li is a board-certified gastroenterologist and world-class scientist with expertise in inflammatory bowel diseases (IBD). Her specialty as a scientist is in translational research, which focuses on taking scientific discoveries and translating them into ways to help improve people’s health. In Stony Brook’s Division of Gastroenterology and Hepatology, she leads a major translational research initiative to analyze the effects of two key genes on the microscopic bacteria (microbia) that are present in the lining of the intestines and to explore how these microbia interact with the lining in the gut. Dr. Li is a Professor of Medicine and Molecular Genetics and Microbiology, Division of Gastroenterology and Hepatology at Stony Brook School of Medicine.

Ramona Rajapakse, MD, Clinical Director of the Division of Gastroenterology and Hepatology
Dr. Rajapakse is board-certified in gastroenterology and hepatology, with expertise in inflammatory bowel disease (IBD), which includes Crohn’s Disease and ulcerative colitis. She also has a special interest and advanced training in fertility issues and the combined conditions of pregnancy with IBD. Additionally, Dr. Rajapakse is an expert in colon cancer screening, gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS) and gastrointestinal bleeding. She is an Associate Professor of Clinical Medicine, Division of Gastroneterology and Hepatology at Stony Brook School of Medicine.

Gina Sam, MD, MPH, Director of the Gastrointestinal Motility Center
Dr. Sam is a board-certified gastroenterologist and motility expert. She has extensive training in esophageal manometry, pH/impedance testing, BRAVO pH testing, anorectal manometry and biofeedback. She is an Assistant Professor of Medicine, Division of Gastroenterology and Hepatology, at Stony Brook School of Medicine.

We provide advanced evaluations, diagnoses and treatment of the following gastrointestinal conditions, disorders and diseases:

• Abdominal distention (gas) is a swollen, bloated or gassy abdomen, typically caused by fibrous foods, weight gain, premenstrual syndrome (PMS), pregnancy or unconsciously swallowing air.
• Barrett’s esophagus is a precancerous condition in the lower esophagus, often due to repeated exposure to stomach acid. It is most often diagnosed in people with chronic gastroesophageal reflux disease (GERD) and is characterized by a change in the color of lining of the lower esophagus.
• Chronic constipation generally includes infrequent bowel movements (less than three times a week over several months) and may be caused by such conditions as irritable bowel syndrome (IBS) or pelvic floor dysfunction (when the muscles that surround a woman’s rectum do not function normally). Other, more serious conditions, such as colon cancer, an underactive thyroid gland, or neurological diseases such as multiple sclerosis or Parkinson’s disease may be the cause.
• Endometriosis with inflammatory bowel disease (IBD) is the combination of endometriosis, the development of the uterine-lining tissue outside the uterus, and IBD, which causes inflammation of the intestines. Because symptoms for both often include abdominal pain, and many women experience changes in their bowel habits during menstruation that can result in abdominal pain, special medical expertise is required when both of these complex disorders are present.
• Functional dyspepsia is a condition for which there is no apparent cause for chronic symptoms of indigestion or upset stomach, fullness, or bloating in the upper abdomen and further evaluation and testing is required.
• Gallbladder disease is caused when the liquid (bile) that is stored in the gallbladder that helps your body digest fat hardens. It produces a pebble-like substance called a gallstone. A gallbladder attack is caused by inflammation, which usually happens because a stone is blocking a passageway in the gallbladder. Women are twice as likely as men to suffer an attack of the gallbladder. Gallbladder disease in women generally occurs when there is excess estrogen from pregnancy, birth control pills or hormone replacement therapy.
• Gastroesophageal reflux disease (GERD) is commonly known as “acid reflux.” GERD occurs when liquid content of the stomach backs up into the esophagus and irritates the lining there. Chronic GERD symptoms can cause damage to your esophagus and may result in more serious digestive disorders like esophageal cancer, if left untreated.
• Gastroparesis is also called “delayed gastric emptying.” This condition consists of partial paralysis (paresis) of the stomach, which results in food remaining in the stomach for a longer period of time than normal. If left untreated, gastroparesis can lead to malnutrition and GERD. 
• Inflammatory bowel disease (IBD) refers to a group of diseases. The two major types are:
  • Ulcerative colitis is a disease where the lining of the large intestine (colon) becomes inflamed and develops open, painful wounds (ulcers).
  • Crohn’s Disease can be found in any part of the digestive tract and the inflammation caused can extend much deeper into the layers of the intestinal walls.

• Liver disease occurs when cells in the liver change and damaged cells are replaced by scar tissue called fibrosis. Continued damage diminishes the blood flow. Alcohol, drugs and poisons are all major contributors to liver damage and disease.
• Nausea is a queasy sensation felt in the upper stomach that is accompanied by an urge to vomit. It is common in women and most frequently caused by an upset stomach, pregnancy, a headache or from exercising after eating.
• Pelvic discomfort in women is the feeling of discomfort or pain below the navel in the lower abdomen, most frequently before or during menstruation. Possible causes include a bladder, kidney or bowel disorder or a condition involving the reproductive system.
• Pregnancy-related gastrointestinal (GI) disorders are found in some women that are unique to pregnancy, while others have chronic disorders that require special consideration during pregnancy.
  • Irritable bowel syndrome (IBS) is also known as a spastic colon, and often characterized by chronic abdominal pain, discomfort, bloating and changes in bowel habits (diarrhea or constipation). Symptoms generally worsen during the second and third trimesters of pregnancy.
  • Reflux is commonly referred to as “acid reflux” or “heartburn.” This condition affects 80 percent of pregnant women, usually during the second and third trimesters. It is characterized by a burning sensation that often extends from the bottom of the breastbone to the lower throat that is the result of hormonal and physical changes in the body.
  • Constipation is described as irregular bowel movements, which is common among pregnant women and caused by a rise in certain hormones and can also be due to worries, anxiety or a low fiber diet.   

• Premature abdominal fullness after meals is also known as “early satiety.” It describes the experience of feeling full sooner than normal after eating less than usual.
• Unintentional weight loss is an involuntary decrease in body weight that is not due to dieting or exercise. Some of the more prevalent causes in women include eating disorders, an overactive thyroid, depression, cancer, diarrhea, drug side effects and smoking.
• Vomiting is also known as “throwing up.” This term is used to describe when the contents of one’s stomach are forcefully expelled through the mouth and sometimes the nose. It is a common occurrence among women during their first trimester of pregnancy (and known as “morning sickness”). Other common causes among women include migraine headaches, viral or bacterial infections.

• Advanced endoscopy – The use of very specialized medical expertise and technically advanced tools to evaluate, diagnose and treat complex diseases and cancers of the gastrointestinal (GI) tract, which require specialized medical expertise and technically advanced tools. For more information, view the Advanced Endoscopy Center at Stony Brook. 

• Colonoscopy -- A test that enables your gastroenterologist to examine the inner lining of your large intestine (rectum and colon) as well as the lower part of your small intestine, using a thin, flexible tube called a colonoscope, which has a small video camera and light attached to it. A colonoscopy helps find ulcers, colon polyps (precancerous growths), tumors and areas of inflammation or bleeding. During a colonoscopy, tissue samples can be collected, (biopsy) and abnormal growths can be taken out. Colonoscopy is considered the gold standard method of screening for cancer or precancerous polyps in the colon or rectum.    

• Colorectal cancer screening – Involves checking for health problems in the colon and rectum before they cause symptoms. The average woman with no family history of colorectal cancer should begin screenings at age 50.  

• Endoscopy – A minimally invasive procedure involving a medical device that consists of a tube or a capsule that has a light and a video camera, which enables a physician to examine the organs and cavities of a person’s body and provide therapeutic treatment.   

• Liver disorders and diseases – Liver disease occurs when cells in the liver change and damaged cells are replaced by scar tissue called fibrosis, which over time diminishes the blood flow. Because the liver has so many vital functions, there are many types of liver diseases. Some are congenital (present at birth). Others are acquired over the years from infection, or due to alcohol or drug abuse. 

• Motility testing – A group of state-of-the-art and gold-standard motility testing techniques and therapies used to diagnose disorders that impact the movement (motility) of the muscles in the esophagus. These disorders can cause difficulty swallowing, regurgitation of food (acid reflux) and spasm type pain. For more information, view the Gastrointestinal Motility Center at Stony Brook.

• Nutrition therapy – Also known as medical nutrition therapy (MNT), it includes weight-loss programs, tips on healthy eating, and special diets such as gluten-free diets, which can improve a patient’s health and quality of life, effectively treat and manage disorders and diseases, and reduce the risk of complications. 

• Pelvic ultrasound – A diagnostic test that uses sound waves to make a picture of the organs and structures in the lower abdomen (pelvis).  

• Wireless capsule endoscopy – Also known as a “pill cam,” this non-invasive test uses a pill-size capsule that contains a camera to record images of the digestive tract and diagnoses obscure (unexplained and persistent) gastrointestinal bleeding.

What You Should Know About GERD by Gina Sam, MD, MPH

Understanding, Diagnosing and Treating Women’s Gastrointestinal Health Issues by Isabelle von Althen, MD