Frequently Asked Questions

Abdominal pain refers to discomfort or pain felt anywhere between the chest and pelvis. It can range from mild cramping or bloati​ng to sharp, severe pain. Abdominal pain may be temporary or ongoing and can originate from the stomach, intestines, liver, gallbladder, or other parts of the gastrointestinal tract.

Yes, stress can affect the digestive system by altering gut motility, increasing sensitivity, causing peptic ulcers and triggering muscle tension. Many people experience abdominal pain during periods of anxiety or emotional stress, especially if they have conditions like irritable bowel syndrome (IBS) or acid reflux.

Lower abdominal pain may be caused by constipation, gas, diarrhea, IBS, urinary tract infections, or gynecologic conditions. In some cases, it may be related to inflammation or infection in the colon or appendix or even a malignancy. Persistent or worsening pain should be evaluated by a gastroenterologist.

Abdominal pain can have many causes, including indigestion, gas, food intolerance, peptic ulcer disease, gastritis, constipation, infections, inflammation, or digestive disorders such as GERD or inflammatory bowel disease (IBD).

Gas buildup in the digestive tract can cause bloating, pressure, and cramp-like abdominal pain. Gas-related discomfort is often relieved by passing gas or having a bowel movement, but frequent symptoms may indicate an underlying digestive issue.

Abdominal pain can feel different depending on the cause. Some people experience cramping, burning, or aching sensations, while others feel sharp or stabbing pain. The location, intensity, and timing of pain can help your gastroenterologist identify the source.

Acid reflux occurs when stomach acid flows backward into the esophagus, the tube that connects your mouth to your stomach. This can cause a burning sensation in the chest, commonly known as heartburn. Occasional acid reflux is common, but frequent episodes may indicate a more persistent condition that requires medical evaluation.

Acid reflux happens when the lower esophageal sphincter (LES), a ring of muscle that acts as a valve between the esophagus and stomach, doesn’t close properly. Common triggers include certain foods, large meals, lying down soon after eating, obesity, pregnancy, smoking, and some medications. Chronic reflux is called gastroesophageal reflux disease (GERD).

Relief often begins with simple lifestyle adjustments. Avoiding trigger foods, eating smaller meals, maintaining a healthy weight, and not lying down immediately after eating can help reduce symptoms. Over-the-counter medications may also provide short-term relief. If symptoms persist, a gastroenterologist can recommend additional treatment options tailored to your needs.

Several strategies may help manage acid reflux, including elevating the head of your bed, limiting caffeine and alcohol, quitting smoking, and avoiding late-night meals. Antacids, H2 blockers,  proton pump inhibitors (PPIs) and potassium channel acid blockers (P-CABs) may be recommended based on symptom frequency and severity. Your NYGA physician can help determine the most appropriate approach for you.

Treatment depends on how often symptoms occur and how severe they are. Mild cases may improve with dietary and lifestyle changes, while more persistent reflux may require prescription medications. In some cases, additional diagnostic testing may be recommended to better understand the cause of symptoms and guide treatment. In addition, certain patients with chronic reflux may need routine screening to check for Barrett’s esophagus (a precancerous change of the esophageal lining). Men over age 50 who are overweight with reflux are at particular high risk and should be seen by a gastroenterologist to decide if an upper endoscopy to screen for Barrett’s esophagus is warrented.

The duration of acid reflux can vary. Occasional episodes may last from a few minutes to a couple of hours, particularly after eating. Chronic reflux symptoms may occur more frequently and persist without treatment. If you experience ongoing heartburn or reflux more than twice a week, it’s important to speak with a gastroenterologist for evaluation and care.

Anorectal manometry (anal probe) is a diagnostic test used to evaluate how well the muscles and nerves in your rectum and anus are functioning. These muscles are responsible for controlling bowel movements. The test helps identify conditions like chronic constipation or fecal incontinence by measuring pressure, muscle coordination, and sensation in the rectal area.

Preparation is simple. You may be asked to avoid eating or drinking for a few hours before the procedure. In most cases, your provider will also recommend using a mild enema or laxative the night before to clear the rectum. Be sure to follow your physician’s instructions carefully to ensure the most accurate results.

Yes, the procedure is performed while you are awake and relaxed. Sedation is not required because anorectal manometry is quick, minimally invasive, and painless and requires your active effort. You may feel slight pressure or fullness during the test, but most patients find it very tolerable.

Anorectal manometry is a quick, minimally invasive procedure that typically takes 20 to 30 minutes. You’ll be asked to lie comfortably on your side while a thin, flexible catheter with a small balloon at the tip is gently inserted into your rectum.
Once the catheter is in place, the doctor will:

• Measure resting pressure in the anal sphincter muscles
• Ask you to squeeze or push to assess muscle coordination
• Inflate a small balloon to evaluate sensation and reflexes

The test is not painful, though you may feel mild pressure or a brief urge to have a bowel movement. No sedation is required, and you’ll be awake and able to communicate throughout the procedure.

Anorectal manometry is a safe and well-tolerated procedure with minimal risks. It does not involve radiation or surgical instruments. After the test, you can return to normal activities immediately. Complications such as discomfort or irritation are rare and usually short-lived.

The procedure should not be painful. You may experience mild pressure or a temporary urge to have a bowel movement as the thin, flexible catheter is inserted into the rectum. The discomfort typically lasts only a few minutes, and your care team will guide you through the process to ensure comfort.

There are no special restrictions after the test; you can eat, drink, and resume your normal activities right away. If your test was part of an evaluation for chronic constipation or incontinence, your gastroenterologist may recommend further testing or treatment based on your results.

A breath test is a non-invasive diagnostic tool used to evaluate how your digestive system processes certain substances. By analyzing the gases you exhale after drinking a specific solution, the test can identify conditions such as H. pylori infection, small intestinal bacterial overgrowth (SIBO), and carbohydrate malabsorption such as lactose, sucrose and fructose intolerance.

You will need to fast for at least 2 hours prior to youourr H. pylori breath test, including sips of water.

You will need to fast for 2 hours (including water) and avoid smoking or chewing gum before your H pylori breath test. Certain medications, especially antibiotics, PPIs, or bismuth-containing products, may need to be stopped up to two weeks beforehand, as they can interfere with test accuracy. Your NYGA provider will give personalized instructions based on your medical history.

An H. pylori breath test typically takes 15 to 30 minutes from start to finish. You’ll breathe into a collection device before and after drinking the testing solution. Once complete, your gastroenterologist will review the results and discuss next steps.

Your NYGA provider will give instructions based on your history. You will need to avoid antibiotics and probiotics for 3 weeks prior to the test. You may need to stop certain motility medications or constipation/diarrhea medications, so s,peak with your provider to clarify instructions. The day prior,  you will be given dietary instructions and will need to avoid lactose and high fiber -containing foods. You may not smoke or exercise the morning of the test. You will fast overnight and do the test prior to eating. The hydrogen breath test traditionally collects breath samples over 3 hours.

Breath tests help diagnose several digestive conditions by analyzing how your body breaks down specific substances. They are commonly used to detect H. pylori infection, SIBO, and lactose or fructose intolerance. The results can guide targeted treatment, improve symptom management, and provide clarity for patients experiencing bloating, gas, abdominal pain, or unexplained digestive discomfort.

During the test, you’ll drink a solution that contains a sugar or urea compound. As your body digests it, certain bacteria or enzymes produce gases, such as hydrogen, methane, or carbon dioxide, that are measured in your breath at timed intervals. These patterns help your gastroenterologist determine whether infection, bacterial overgrowth, or malabsorption is present.

A colonoscopy is a procedure that allows a gastroenterologist to examine the inside of the colon (large intestine) using a thin, flexible tube and a camera. It is primarily used to screen for colon cancer, detect polyps, and diagnose conditions such as inflammatory bowel disease (IBD) or unexplained digestive symptoms.

A colonoscopy typically takes about 30 to 60 minutes. However, you should plan to be at the facility for at least two to three hours to allow time for check-in, preparation, and recovery from sedation.

Proper preparation is key to a successful colonoscopy. This includes adjusting your diet a few days before and taking a prescribed bowel preparation (laxative) to cleanse your colon thoroughly. Your doctor will provide additional instructions based on your medical history and needs.

Five days before your colonoscopy, you should avoid high-fiber foods such as raw vegetables, seeds, nuts, whole grains, and tough meats. These can be harder to fully clear from the colon. Your doctor may provide a detailed diet plan, typically switching to low-fiber foods and a clear liquid diet before the procedure.

A colonoscopy is not painful; most patients receive sedation to ensure comfort. Some may experience mild bloating or cramping afterward due to the air used to inflate the colon during the procedure, but this typically resolves quickly.

During a colonoscopy, a sedated patient lies on their side while a gastroenterologist inserts a thin, flexible tube (colonoscope) into the rectum. The colonoscope has a small camera that transmits images to a monitor, allowing the doctor to examine the colon for abnormalities. If polyps or suspicious tissue are found, they can be removed or biopsied. The process generally takes less than an hour, and patients recover briefly before going home.

Esophageal manometry is a specialized test that measures the strength and coordination of the muscles in your esophagus. By tracking how well your esophagus contracts and how effectively it moves food toward your stomach, the test helps diagnose motility disorders.

No sedation is used during an esophageal manometry because you need to be awake to perform a series of swallows. A thin, flexible catheter is passed through your nose and into your esophagus while you breathe normally. Although you may feel mild pressure or temporary discomfort, the procedure is well-tolerated and does not require recovery time.

The procedure typically lasts 30 to 45 minutes. This includes placing the catheter, recording swallowing movements, and removing the device. Afterward, you can return to your usual activities, eat normally, and resume your routine without restrictions.

Esophageal manometry evaluates how well your esophageal muscles contract and how effectively your lower esophageal sphincter opens and closes. It helps diagnose conditions that affect swallowing, motility, and acid reflux, including achalasia, esophageal spasm, and GERD that do not respond to medication.

Most patients describe the procedure as uncomfortable rather than painful. You may feel pressure in your nose or throat as the catheter is inserted, and you may have a slight urge to swallow or cough. These sensations usually fade within minutes, and the test itself does not cause pain or lingering discomfort.

To ensure accurate results, you’ll need to avoid eating or drinking for six hours before your appointment. Your provider may advise pausing certain medications like acid suppressants or motility drugs, which could affect esophageal function. Clear preparation instructions will be provided based on your medical history and current treatments.

A flexible sigmoidoscopy is a diagnostic procedure that utilizes a thin, flexible tube equipped with a
light and camera to inspect the lower portion of your colon (the rectum and sigmoid colon). This
procedure assists in diagnosing the causes of rectal bleeding, abdominal pain, and alterations in
bowel habits.

Yes. While it doesn’t view the entire colon, a flexible sigmoidoscopy can detect cancer and
precancerous polyps in the lower colon. If anything abnormal is found, your provider may recommend
a complete colonoscopy for a more comprehensive evaluation.

It can be done with sedation if a patient prefers, but most patients tolerate the procedure well without
requiring sedation. You may experience some pressure, cramping, or gas during the exam, but the
discomfort is typically brief and mild. Because there’s no sedation, you can return to your regular
routine right after the procedure.

You’ll need to follow a specific diet before your procedure. Typically, this includes clear liquids the day
before and nothing by mouth for a few hours before the exam. Your NYGA provider will give you
detailed instructions based on your appointment time.

Yes, but it’s usually simpler than a complete colonoscopy prep. Most patients are instructed to use an
enema the morning of the procedure to clear the lower colon. Your provider will explain precisely what
to do to ensure the best possible results.

A sigmoidoscopy is less invasive, does not always require sedation, and has a shorter preparation
time. It is often recommended for evaluating specific symptoms such as hemorrhoids or for routine
screening when full visualization of the colon is not necessary. Your gastroenterologist will assist in
determining which test is best for you.

A nonsurgical, FDA-registered treatment for internal hemorrhoids, HemWell™ uses a gentle electrical current to target the hemorrhoid tissue to promote healing and reduce inflammation. It’s an effective solution for patients experiencing rectal bleeding, itching, or discomfort from hemorrhoids.

Most patients report little to no pain during or after the HemWell™ procedure. The treatment is quick and well-tolerated. Unlike traditional hemorrhoid procedures, HemWell™ is designed to minimize discomfort both during the procedure and throughout recovery.

Yes, HemWell™ is a safe, FDA-registered procedure with a strong track record of success. It’s performed in the endoscopy center under anesthesia by trained gastroenterologists and requires no cutting, cauterizing, or suturing. Because it’s minimally invasive, the risk of complications is extremely low compared to surgical hemorrhoid treatments.

Most patients find the HemWell™ procedure to be virtually painless. Most patients can resume their day immediately following the appointment.

The number of treatments needed depends on the severity and number of hemorrhoids. While some patients see relief after just one session, others may benefit from several treatments spaced a few weeks apart. Your NYGA provider will recommend a personalized treatment plan based on your condition and response to the procedure.

One of the benefits of HemWell™ is that there’s no downtime. Most patients return to work, exercise, and regular activities immediately after the procedure. Mild symptoms such as temporary rectal pressure or slight irritation may occur but typically resolve quickly without the need for medication.

In the New York metro area, NYGA is one of the only providers offering HemWell’s breakthrough treatment for hemorrhoids. The procedure is completed in one of our three state-of-the-art endoscopy centers at Carnegie Hill Endoscopy on Lexington Avenue and E 98th, The Endoscopy Center of New York on East 93rd Street between 3rd and 2nd Ave, and Manhattan Endoscopy Center on 44th Street between Madison Ave and 5th Ave.

Infusion therapy is a method of delivering medication directly into your bloodstream through an IV. For IBD patients, this approach is used to administer biologic drugs that target inflammation more efficiently than oral medications. The infusion medications we currently offer to help manage moderate to severe Crohn’s disease and ulcerative colitis.

• Infliximab (Remicade® or biosimilars)
• Vedolizumab (Entyvio®)
• Ustekinumab (Stelara® )
• Risankizumab (Skyrizi®)
• Mirikizumab-mrkz (Omvoh®)
• Guselkumab (Tremfeya®)

Suppose you’ve been diagnosed with moderate to severe Crohn’s disease or ulcerative colitis, your gastroenterologist may explore other treatment options such as infusion or injectable therapies. These targeted approaches can help manage symptoms and inflammation, and in some cases, patients may begin with infusions and later transition to injectables.

For your convenience, we provide access to an in-office infusion suite, or we can coordinate treatment at an alternate location, such as an outpatient center or even in the comfort of your home. Our goal is to make your care as effective, comfortable, and accessible as possible.

As one of the leading IBD practices in the country, we are proud to offer expert, patient-centered care for those living with Crohn’s disease and ulcerative colitis. Infusion therapy can help reduce inflammation, promote long-term remission, and improve quality of life for patients with inflammatory bowel disease (IBD). It delivers medication directly into the bloodstream, providing fast results.

Most infusion sessions take between 30 minutes and two hours, depending on the specific medication. Patients typically relax in a comfortable setting during treatment and can return to normal activities afterward.

Your gastroenterologist will consider your symptoms, disease severity, and treatment history to determine if infusion therapy is appropriate. Routine monitoring helps ensure it remains effective and well tolerated.

Most insurance plans, including Medicare and those offered by commercial providers, provide coverage for infusion therapy. Our NYGA team can help verify your benefits and coordinate prior authorizations to minimize out-of-pocket costs.

Intestinal ultrasound is a noninvasive imaging test that uses sound waves to visualize the small and large intestines in real time. It allows gastroenterologists to assess inflammation, wall thickness, and blood flow in the bowel without radiation or invasive procedures. It’s commonly used to help diagnose and monitor inflammatory bowel disease (IBD), such as Crohn’s disease and ulcerative colitis.

The procedure is comfortable and straightforward. You’ll lie on an exam table while a water-based gel is applied to your abdomen. A handheld probe (called a transducer) is gently moved over the area to capture images of your intestines. There are no needles, no sedation, and no recovery time required.

Intestinal ultrasound is beneficial in evaluating inflammatory bowel diseases like Crohn’s disease and ulcerative colitis. It can detect bowel wall thickening, increased blood flow (a sign of inflammation), and other signs of active disease. It’s also helpful in monitoring treatment response over time and may help identify complications such as strictures or abscesses.

An intestinal ultrasound usually takes about 10 to 20 minutes to complete. It’s performed right in the office and doesn’t require special preparation or recovery time, making it a convenient option for ongoing care and disease monitoring.

Intestinal ultrasound is a safe, noninvasive, and radiation-free way to assess bowel inflammation and monitor IBD activity. It delivers real-time results, requires no sedation or prep, and can be repeated regularly, making it ideal for diagnosis and ongoing disease management.

If you have been diagnosed with Crohn’s disease or ulcerative colitis, or are experiencing ongoing symptoms like abdominal pain, diarrhea, or unexplained weight loss, an intestinal ultrasound may help evaluate your condition. Your NYGA provider will determine whether this test is appropriate based on your symptoms, diagnosis, and treatment goals.

NYGA is one of the few gastroenterology practices in the region offering intestinal ultrasound as part of our advanced IBD care. Our skilled team uses this cutting-edge technology to provide accurate, real-time assessments without sedation, radiation, or lengthy prep, all from our 5th Avenue location.

Liver elastography is a noninvasive imaging test that measures the stiffness of your liver. It’s used to assess liver health and detect signs of scarring (fibrosis), which may result from conditions such as hepatitis, fatty liver disease, or long-term alcohol use.

This test utilizes ultrasound-based technology to administer painless vibrations to your liver. The speed at which these vibrations travel through the tissue helps determine its stiffness; firmer tissue can indicate fibrosis or liver damage.

Liver elastography is a safe, noninvasive procedure that does not involve radiation, injections, or recovery time. Most patients tolerate it well, and it can be repeated over time to monitor changes in liver health.

You’ll lie comfortably on an exam table while a small probe is placed against your skin over the liver. You may feel a light tapping sensation during the test, but it isn’t painful. The procedure typically takes 10 to 15 minutes in the office.

Preparation is simple. In most cases, you’ll need to avoid eating or drinking for a few hours before your appointment. Your gastroenterologist will provide additional instructions based on your health history or other scheduled tests.

Yes. NYGA often has same-day availability across multiple locations and via telehealth. If you need to be seen today, our team will do everything possible to accommodate you.

Preparation for a same-day gastrointestinal (GI) visit is simple. Before you arrive, gather your insurance card, a valid photo ID, a list of your current medications and dosages, and any recent test results or referral paperwork. If you have a digestive issue, such as GI bleeding or severe symptoms, bring a summary of your symptoms and how long you've had them. Arriving a few minutes early and having this information ready helps your provider assess your needs quickly.

No, NYGA does not offer same-day scheduling for an endoscopy. A pre-procedure consultation with a NYGA provider may be required to review your medical history and determine whether prior authorization is required.  Also, physical preparation is required in advance to ensure the procedure is safe and effective.

NYGA welcomes both new and existing patients for same-day visits. Whether you're seeking a first-time consultation or a follow-up, you can call or text us to request a same-day appointment.

Same-day appointments fill up quickly, so it’s best to call or text NYGA as early as possible. If a same-day slot isn’t available, we can work to schedule you for the next day.

An upper endoscopy is a minimally invasive procedure that allows your doctor to view the inside of your esophagus, stomach, and the beginning of your small intestine using a thin, flexible tube equipped with a camera. It helps diagnose and sometimes treat a variety of gastrointestinal issues.

An upper endoscopy provides a clear, real-time view of the upper digestive tract. It can reveal inflammation, ulcers, tumors, bleeding, narrowing, and signs of conditions like GERD, celiac disease, or Barrett’s esophagus. Biopsies can also be taken during the procedure for further analysis.

The procedure itself usually takes between 15 and 30 minutes. However, plan to spend about 90 minutes at the facility to allow time for check-in, preparation, and post-procedure recovery. You’ll be monitored closely until you’re fully awake and ready to go home.

Yes, most patients receive light sedation through an IV to ensure a comfortable and stress-free experience. You’ll be asleep throughout the procedure and likely have little to no memory of it afterward.

Upper endoscopy is a safe and effective method for evaluating upper digestive symptoms, such as acid reflux, difficulty swallowing, or persistent nausea. It helps detect conditions early, often before symptoms become serious, and allows for in-procedure treatment of specific issues, such as bleeding or strictures, all without the need for surgery.

You’ll need to stop eating solid food 8 hours prior and stop drinking clear liquids 3 hours before your procedure to ensure your stomach is empty. Your gastroenterologist will provide you with detailed preparation instructions and inform you if any adjustments to your medications are necessary before your appointment.

A video capsule endoscopy is a minimally invasive test that allows your gastroenterologist to view the inside of your small intestine. You’ll swallow a tiny capsule, about the size of a vitamin, containing a small camera. As the capsule travels through your digestive tract, it takes images, which are transmitted to a recording device you wear during the procedure.

This test evaluates unexplained gastrointestinal symptoms, including celiac disease, chronic diarrhea, and other conditions. It can help identify issues such as polyps, ulcers, and inflammation related to Crohn’s disease and irritable bowel disease (IBD).

Your physician will give you specific instructions, but generally, you’ll need to fast for at least 12 hours before swallowing the capsule. You may also be asked to stop certain medications. The goal is to ensure your digestive tract is clear enough for the camera to capture high-quality images.

After swallowing the capsule, it naturally passes through your digestive system. The camera captures images at regular intervals and wirelessly transmits them to a recording device worn on a belt. Once completed, your gastroenterologist will review the images for signs of inflammation, bleeding, or other abnormalities.

The capsule typically takes eight and 12 hours to pass through the system. Most patients pass the capsule within a day during a normal bowel movement. You won’t feel it inside you; it usually exits the body naturally without issue.