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Specialty Programs

Barrett's Treatment

When it comes to your health, finding doctors with the necessary experience in treating your medical condition is most important. We use the most advanced technology for diagnosing and treating GERD, including the Bravo pH system, pH probe studies, and high resolution manometry/impedance testing. We also perform upper endoscopy enhanced with high definition technology and narrow band imaging. We utilize treatment protocols based on peer-reviewed guidelines and on our extensive experience.

Our Barrett’s esophagus treatment team is one of the busiest in the country, and we are the largest radiofrequency ablation (RFA) center in Connecticut. We are also one of a select group of centers in the country participating in the U.S. HALO patient registry, the largest cohort to date studying patient outcomes using RFA. Through collaboration with our peers on a national level, we are able to provide our patients the most up to date information and recommendations. With a success rate of over 90%, radiofrequency ablation provides enormous benefits to patients with all grades of Barrett’s esophagus using a nonsurgical, minimally invasive approach.

Our GERD and Barrett’s esophagus treatment team is available for consultation for those who wish to learn more about our comprehensive diagnostic, surveillance, and treatment programs. We particularly welcome:

  • Patients with GERD and/or Barrett’s esophagus
  • Primary care physicians who wish to refer their patients with GERD and/or Barrett’s esophagus
  • Gastroenterologists and other specialists who wish to refer their patients for a second opinion for treatment of GERD and/or Barrett’s esophagus

Feel free to contact our office for further information.


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Celiac Disease

Celiac Disease has changed over the last 20-30 years from a rare condition to one that can affects up to 1% of all Americans. Its presentation has also changed significantly, and the majority of cases have a range of symptoms ranging from anemia and peripheral neuropathy to infertility. Today fewer than 45% of adult patients have the classic presentation of weight loss and diarrhea.

At CTGI, we have physicians with special interest in Celiac Disease who facilitate the diagnosis and management of the condition, and have started a community outreach education program to inform and educate the general public about this disease.


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GI Oncology

Our GI Oncology Program offers advanced staging and minimally invasive management techniques for many patients with cancers or precancerous states in the esophagus, stomach, small intestine, colon, pancreas, bile duct, and liver.

For patients with Barrett’s Esophagus, we have been providing Radiofrequency Ablation (Barrx) with excellent success. This endoscopic procedure is over 90% successful in eradicating Barrett’s, and 5-year data demonstrate no evidence of recurrences following treatment in over 92%. We are one of the busiest and experienced centers in the Northeast and one of the top 35 in the country.

For patient with early esophageal cancer, we provide Endoscopic mucosal resection (EMR). This is an endoscopic technique that can be curative, thus preventing what would formerly have required surgical removal of a large part of the esophagus. Following successful EMR, patients in whom cancer arose in the setting of Barrett’s are enrolled in our Radiofrequency Ablation Program to eliminate the risk of future esophageal cancers. EMR can also provide cures for some patients with early gastric and rectal cancers.

Endoscopic Ultrasound (EUS) is an important tool to determine how advanced of GI cancers are (staging). We are one of the busiest and most experienced EUS centers in the country. In addition to assisting with determination of whether a GI tumor may be treated by endoscopy alone, EUS is extremely important in determining the best treatment approach when more advanced tumor stages preclude endoscopic therapy. EUS tumor staging assists surgeons and oncologists to determine if a patient’s tumor is best managed by surgical resection alone, chemotherapy and/or radiation therapy followed by resection, resection followed by chemotherapy and/or radiation therapy, or chemotherapy and/or radiation therapy without surgery. EUS findings are an important part of the discussion that regularly takes place at our multi-disciplinary (GI-Surgery-Oncology) meetings at which difficult patient problems are fully discussed and cooperative plans made. EUS staging thus maximizes benefit while minimizing risk, reduces the likelihood of a patient undergoing unsuccessful surgery, and expedites the delivery of the latest and most appropriate care. We are one of the busiest and most experienced EUS centers in the country.

We also specialize in advanced techniques to remove “difficult” pre-cancerous lesions of the stomach, duodenum, and colon.

At our center, we actively study pancreatic cystic neoplasm, a pre-cancerous condition of the pancreas. For non-surgical candidates in whom cyst fluid analysis suggests a high risk of progression to pancreatic cancer, endoscopic (EUS-guided) intra-cystic alcohol injection can be employed to assist in the destruction of such lesions.

We also routinely perform endoscopic (minimally invasive) palliation techniques for patients with complications of cancer. Abdominal pain can be improved by EUS-guided celiac plexus neurolysis (injection of alcohol into the pain-sensing nerves around a tumor) in patients with incurable cancer. This reduces the need for narcotics. Endoscopic radiofrequency ablation can be used to control rectal bleeding from radiation proctitis following treatment of prostate cancer.


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IBD

Connecticut GI provides comprehensive care of patients with Inflammatory Bowel Disease (IBD). IBD includes both Crohn’s Disease (CD) and Ulcerative Colitis (UC). We provide a full range of inpatient and outpatient services. Coordinated care and active communication is extremely important to us. We work closely with our patients, in conjunction with radiologists, surgeons, and pathologists, to develop a specialized treatment plan for our patients. We also work closely with the pediatric team at Connecticut Children’s Medical Center to foster a smooth transition to care by one of our gastroenterologists.

We meet regularly for a multidisciplinary IBD conference to review challenging cases and referrals from other gastroenterologists and institutions. Our IBD specialists welcome second opinion consultations from both gastroenterologists and patients.

Our comprehensive care center for the treatment of Crohn’s disease and Ulcerative Colitis includes two state of the art infusion centers. Our staff has over 10 years of experience infusing Infliximab in a convenient, comfortable and safe environment. We also provide instruction for the various injectable biologic medications. Our clinical research division is committed to participating in studies that will improve our understanding and treatment of IBD.

We are active in the Connecticut Chapter of the Crohn’s and Colitis Foundation of America (CCFA) and two of our physicians sit on the CCFA medical advisory committee. Contact our office for further information on evaluation and treatment of Crohn’s Disease and Ulcerative Colitis and to schedule an appointment with one of our physicians.


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Infusion Center

Connecticut GI provides infusion services for our patients with inflammatory bowel disease. Our patient volume makes us one of the busiest centers in the northeast, with extensive experience in the safe administration of these intravenous medications.

Remicade and Tysabri can be given for the long-term treatment Crohn’s disease and Ulcerative Colitis. Also, at the direction of a Rheumatologist, Remicade can also be administered for the treatment of rheumatoid arthritis or psoriasis. These medications are given by a nurse with special training and extensive experience who is dedicated to patients receiving IV infusions. There is always a physician present in the office for consultation, if needed.

CT GI is dedicated to providing a safe and comfortable environment for the ongoing delivery of important intravenous medication. We have two infusion centers: one at our office in Farmington (near the UConn Health Center) and the other at our office in Glastonbury. Infusions are given in large private areas inside the office, exclusively devoted to this use. Comfortable reclining chairs and flat screen TV’s are provided for our patients. Internet wi-fi access is also available. We are pleased to be able to offer our patients the convenience of receiving their necessary medication at the same office where they see their gastroenterologist.


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Liver Center

Connecticut GI, in partnership with Hartford Hospital, offers comprehensive evaluation and management of liver disease. Our board certified gastroenterologists and hepatologists help patients with both acute and chronic liver disease manage their illnesses and complications, and walk them through the process of organ transplantation when necessary. Examples of liver diseases cared for by our staff include hepatitis B, hepatitis C, autoimmune hepatitis, alcoholic cirrhosis, hemochromatosis, and Wilson's disease.

The liver transplant program at Hartford hospital is one of the oldest and most established programs in New England, and over 400 liver transplants have been performed here. Connecticut GI hepatologists partner with the transplant surgeons to care for patients with chronic and acute liver disease before transplant and then help them to maintain their organ health after liver transplant.

The Hepatitis C Treatment Center is a new partnership between Connecticut GI and Hartford Hospital. Connecticut GI hepatologists, physician's assistants and nurse practitioners have teamed up with Hartford Hospital in the wake of newly FDA-approved therapies for hepatitis C. Hepatitis C effects approximately 1.9 million Americans, and this infection can be cured in many. Treating hepatitis C has become more intricate with the emergence of the new antiviral therapies, and this C\center was created to optimize the care of this disease.

The Liver Tumor Center, in partnership with the Helen and Harry Gray Cancer Center, is another example of multidisciplinary care at Hartford Hospital, with collaboration between Connecticut GI physicians, interventional radiologists, hepatobiliary and transplant surgeons, radiation oncologists and medical oncologists. This unique center takes a patient-oriented approach to expedite the evaluation and management of tumors of the liver.

Please visit the Hartford Hospital Comprehensive Liver Center site at www.harthosp.org/liver.com


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Pancreaticobiliary Center

The pancreas and bile duct are areas of the body in which diseases can be severe, diagnoses difficult to make, and for which treatment may require invasive surgery. Yet Connecticut’s population need not travel to Boston, New York, or other centers for such specialized care. Connecticut GI’s Pancreatobiliary Team routinely provides relatively non-invasive endoscopic procedures (EUS and ERCP) that allow us to diagnose and manage many of these conditions. In fact, many of our patients are referred from gastroenterologists and surgeons outside our center because of the complex and advanced level of care CTGI is able to provide.

We have been providing tertiary care expertise to patients from CT, RI, MA, and NY for many years, performing over 600 EUS and 750 ERCP procedures annually. We work closely with a skilled and experienced group of surgeons and interventional radiologists, allowing for a skilled, multi-disciplinary approach. Our team of specialized gastroenterologists and technicians are on call 24/7 for emergencies and are actively involved in clinical research. Examples of diseases that we routinely care for include:

Pancreas Biliary
Acute and chronic pancreatitis Difficult to remove bile duct stones
Congenital pancreatic duct abnormalities Cholangitis (infection of bile duct)
Pancreatic cysts and tumors Previously unsuccessful ERCP
Pancreatic duct strictures Bile duct strictures and tumors
Traumatic injuries of the pancreas Traumatic bile duct injury, including bile leaks
Evaluation of unexplained epigastric pain Evaluation of right upper quadrant pain

When calling to schedule a consultation for the Pancreatobiliary Center, please indicate so to the assistant scheduling the appointment.


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Small Bowel Disease

While the small intestine has a smaller diameter compared to other parts of the digestive system, it is the longest, with a length of approximately 18 feet. This makes endoscopic evaluation using traditional techniques challenging. Radiographic imaging can be helpful in evaluating this organ, but accuracy is very limited for certain conditions.

There are, however, a variety of effective procedures developed to address this challenge. Several of our physicians have particular interest and experience in small bowel evaluation using capsule endoscopy, push enteroscopy, and deep enteroscopy via the Spirus system. Using a combination of these techniques, disorders of the small bowel such as Crohn’s disease, vascular anomalies, and certain tumors can be diagnosed and treated with greater accuracy, and less invasively than they had in the past.


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Colon Cancer Screening program

Colon cancer is the most common cancer of the digestive system. Over 140,000 cases are diagnosed, and almost 50,000 people succumb to the disease annually in the United States.

Fortunately, unlike many other cancers, effective screening tools are available that can detect colon cancer in its early stages. Typically, colon cancer begins as a polyp which evolves, or degenerates, into a cancer over a period of years. If polyps are detected and removed early, cancer can be prevented. While several colon cancer screening methods are available, colonoscopy is considered the gold standard as it goes beyond polyp detection. In most cases, polyps are removed during the procedure. In addition, when cancer itself is detected on a screening exam, it is often at an early, curable stage. It has been more than 10 years since screening colonoscopy has gained wide acceptance, and that decade has seen a steady decline in both new diagnoses of colon cancer and colon cancer deaths.

With the anesthesia provided at all of our locations, patients are comfortable and sleeping throughout the examination.

Colon cancer screening is recommended for all individuals beginning at the age of 50. Some patients, such as those with a family history of colon cancer or polyps, inflammatory bowel disease, and some hereditary conditions, may require screening earlier. The American Society for Gastroenterology recommends screening begin at age 45 for African Americans.

If colon cancer is diagnosed, surgery is usually planned, and can cure the majority of patients with early colon cancers. A multidisciplinary approach is needed for some patients, who may require radiation therapy and chemotherapy prior to and after surgery. Complex cases are often discussed at Tumor Board, where input is shared among pathologists, gastroenterologists, surgeons, and oncologists. Genetic counseling and testing is available at Hartford Hospital for families who may be at high risk of developing colon cancer.

To schedule a consultation and colon cancer screening, please contact us. In addition, upon a recommendation from a physician, Connecticut GI offers direct access colonoscopies for those who meet criteria and prefer to have a colonoscopy without a prior consultation.


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The information provided is intended to present general information and not as a definitive basis for diagnosis or treatment in any particular case. It is important that you consult your physician about your specific condition.