Ph. 410-730-1000

What is Lynch Syndrome?

Lynch syndrome is the most common cause of hereditary colon cancer. Lynch syndrome is caused by a genetic mutation in one of many DNA mismatch repair genes.  When there is a mutation in these genes the risk of developing cancer greatly increases.  Lynch syndrome can be diagnosed through genetic testing.  The lifetime risk of developing colorectal cancer with Lynch syndrome is estimated to be up to 75%.  The most common type of other cancers in Lynch syndrome are endometrial, ovarian, urinary, and gastric.

Due to the increased risk of colon cancer in individuals with Lynch syndrome, guidelines have been established for screening.  Individuals with Lynch syndrome should undergo colon cancer screening beginning between the ages of 20-25, or 2-5 years before the youngest age of diagnosis of colorectal cancer in a family member, whichever is earlier.  The testing should be repeated every 1-2 years.  The second most common cancer in Lynch syndrome is endometrial cancer.  Women with Lynch syndrome should have an annual pelvic exam with endometrial sampling beginning between the ages of 30-35.  Women should also undergo annual screening for ovarian cancer with transvaginal ultrasound beginning between the ages of 30-35.  Other important screenings include for urinary cancer (annual urinalysis beginning between the ages of 30-35) and gastric cancer (screening with an esophagogastroduodenoscopy (EGD) is recommended beginning between the ages of 30-35 and repeated every 2-3 years thereafter).

If you have further questions or concerns about Lynch syndrome, please contact the office at 410-730-1000.

By |October 24th, 2017|Colon Cancer, Gastrointestinal Disease|Comments Off

Understanding the difference between celiac disease, gluten sensitivity, and wheat allergy.

Celiac Disease
Celiac disease is a condition affecting both adults and children in which the body’s immune system responds abnormally to a protein called gluten, which is found in wheat, rye, barley, and many prepared foods.  Individuals with celiac disease who eat gluten experience an immune reaction which can cause damage to the lining of the small intestine.  This in turn can lead to difficulty absorbing essential nutrients such as iron and Vitamin D.  Treatment of the disease consists of avoiding gluten, which can stop and reverse the damage to the intestinal lining.  There is no other known cure for celiac disease.  Celiac disease is not a food allergy but an autoimmune disease.

The cause of celiac disease is unknown.  It tends to occur more prominently in individuals from Europe, North and South America, Australia, North Africa, the Middle East and South Asia.  It is found rarely in other parts of Asia or sub-Saharan Africa.  In the United States one out of every 133 people has celiac disease.  There is a genetic component to the disease – it occurs in 5-15% of the children and siblings of individuals already diagnosed with the disorder.  It is recommended that first degree family members be tested even if they do not have symptoms.

The symptoms of celiac disease are variable, and in some cases, may be absent.  Even if an individual has no symptoms he or she may still have the disease and it could be causing problems with nutrient absorption.  Possible symptoms of celiac disease include diarrhea, weight loss, abdominal pain, abdominal bloating, and increased intestinal gas.  Other conditions that tend to occur more commonly in people with celiac disease include weakening of the bones (osteopenia or osteoporosis), low […]

By |October 4th, 2017|Celiac Disease, Gastrointestinal Disease|Comments Off

Is it time for my colonoscopy?

Colon cancer is one of the leading causes of death in the United States, which is why early detection is so important for prevention. If you’re wondering when to make an appointment for your first colonoscopy, keep in mind that there are several factors involved.

Below are some guidelines that can help you decide when to have your first colonoscopy:

Family History: One of the main factors determining when you should get your first colonoscopy is your family history, as genetics play a role in the risk of colon cancer. If you have a family history of colon cancer, in a single first-degree relative (parent, sibling or child) or in more than one first or second degree relative (grandparent, aunt, uncle or cousin) screening should start earlier than age 50. Discuss the specific recommendations in your case with your gastroenterologist.


Race: Your race can dictate whether or not you have a higher risk of colon cancer. If you’re African American, some guidelines recommend that colorectal cancer screening begin at age 45, as you are considered to have a greater risk (although the reasons for this are currently unknown).


Age: If you don’t meet any criteria that might categorize you at an increased risk for colon cancer, schedule your first colonoscopy at the standard age of 50.

If you’re ready to schedule your first colonoscopy you can count on the medical professionals at Dr. Russell O. Schub.  As a premier practice, we offer a wide range of top-quality services and treatments. Call (410) 730-1000 today to set up an appointment. 

By |August 29th, 2017|Colon Cancer, Uncategorized|Comments Off

Gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease occurs when the acid that is normally in your stomach backs up into the esophagus.  Symptoms of acid reflux can include: burning in the chest (heartburn), burning in the throat or an acidic taste in the throat, stomach or chest pain, trouble swallowing, raspy voice or a sore throat, unexplained cough.

There are various types of medications that can help the symptoms of acid reflux including antacids, histamine blockers, and proton pump inhibitors.  You should seek evaluation by a medical provider if your symptoms are severe or last a long time and you cannot seem to control your symptoms.

Other symptom that warrant urgent medical evaluation include difficulty swallowing, unexplained weight loss, choking with eating,  vomiting blood, or bowel movements that are black.  Dr. Schub specializes in the evaluation and management of acid reflux.  If you feel that you are experiencing any of the above symptoms, please contact Dr. Schub for a consultation.

By |August 5th, 2017|Gastrointestinal Disease|Comments Off

What is anorectal manometry?

If you suffer from chronic constipation or fecal incontinence, anorectal manometry can help.   These issues are often stressful and embarrassing and can greatly impact a patient’s quality of life. Anorectal manometry testing, which is offered in our office, can help diagnose the root cause of the problem and guide potential therapies, including biofeedback. Biofeedback is a treatment technique which allows patient to “see” activity inside their body. This allows a patient to recognize and then improve certain behavior. For example, sometimes individuals with constipation have developed a “paradoxical” response when they attempt to have a bowel movement, during which they contract rather than relax the sphincter muscles when attempting a bowel movement. During a biofeedback session this behavior can be “shown” to the patient on a computer monitor and then corrected. The patient will “see” how their body responds to the normal behavior and re-learn the behavior. Biofeedback can also help patients who suffer from fecal incontinence by improving their ability to hold in stool. Anorectal manometry is painless and takes approximately 20 minutes to complete. There is minimal preparation and you can drive yourself to and from the appointment.

If you suffer from defecation problems, you are not alone. Please call our office today to schedule an evaluation by Dr. Schub so we can help.

By |July 11th, 2017|Anorectal Problems, Uncategorized|Comments Off

Can the FODMAP diet help me?

Do you often feel bloated and gassy? The FODMAP diet might help! The FODMAP diet was developed by researchers in Australia as treatment for Irritable Bowel Syndrome (IBS) symptoms.

The acronym FODMAP stands for: Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols

These are complex names for short chain carbohydrates, which can be poorly absorbed by some people. When these molecules are not well absorbed in the small intestine they pass into the large intestine where they may then be digested/fermented by bacteria. This can cause symptoms such as abdominal bloating and distension, flatulence, abdominal pain, nausea, and changes in bowel habits (diarrhea and/or constipation).

A low FODMAP diet involves eliminating high FODMAP foods from the diet for six to eight weeks, and then gradually reintroducing foods one at a time to determine how you tolerate individual foods.

Studies have shown improvement in IBS symptoms when patients follow a low FODMAP diet.

For more information, please contact the office to schedule at appointment at 410-730-1000.

What is a hiatal hernia?

A  hiatal hernia is a relatively common finding.  A hiatal hernia occurs when part of the stomach migrates up into the chest area.  The stomach is usually located below the diaphragm, a muscular layer that separates the chest and abdominal cavities.  There is an opening in the diaphragm through which the esophagus passes.  This is the same opening that the stomach pushes through when you have a hiatal hernia.  Hiatal hernias occur in two forms.  A sliding hernia occurs when the top of the stomach and the lower part of the esophagus migrate upward into the space above the diaphragm.  The orientation of the stomach does not change.  A paraesophageal hernia occurs when the top of the stomach migrates upward into the space above the diaphragm and lies alongside the esophagus.  This is a less common type of hernia, but it can be serious.  The main concern is that the stomach can twist onto itself and lead to a lack of blood flow to the area.

Hiatal hernias usually do not cause symptoms. Symptoms associated with sliding hiatal hernias tend to be similar to gastroesophageal reflux symptoms, such as heartburn and regurgitation, because the hiatal hernia can cause stomach acid to leak into the esophagus.

Paraesophageal hernias may also be asymptomatic. When they are symptomatic they tend to cause pain that comes and goes, nausea, and a feeling of fullness after eating that occurs earlier than expected.

Hiatal hernias can be seen on imaging tests, such as an xray or during an upper endoscopy, which involves a doctor putting a tube down your throat with a camera attached to the end.

The treatment for a hiatal hernia depends on the symptoms. People who experience acid reflux symptoms can […]

By |May 8th, 2017|Gastrointestinal Disease|Comments Off

What is Irritable Bowel Syndrome (IBS)?

Irritable Bowel Syndrome (IBS) is a chronic digestive disorder.  It is the most commonly diagnosed gastrointestinal illness.  The primary symptoms of IBS are abdominal pain and altered bowel habits, including constipation and/or diarrhea.

What is the cause?

The cause of IBS is currently unclear.  One theory suggests that IBS is caused by abnormal contractions of the intestine.  Another theory suggests that IBS may be triggered by a severe gastrointestinal infection, such as salmonella or camphylobacter.   A third theory suggests that the symptoms may be caused by a food sensitivity or allergy.  Other researchers believe that IBS may be caused by increased sensitivity of the intestines, which in turns causes normal amounts of gas or movement to be perceived as painful.

IBS usually begins in young adulthood, and, in the United States, is more common in women than men.

What are the symptoms?

The most common symptoms of IBS are abdominal pain associated with a change in bowel habits.  Other symptoms include bloating, gas, and belching.  The abdominal pain is usually a cramping sensation and may be located around the navel.  It can vary in intensity and may be associated with emotional stress or eating.  Having a bowel movement may relieve the pain. 

Altered bowel movements can include diarrhea, constipation, or both.  The diarrhea may be associated with urgency and a sensation of incomplete evacuation.  About 50% of individuals with IBS notice the passage of mucus.  The diarrhea of IBS usually does not occur during sleep.   The constipation of IBS may occur intermittently, or last for long periods of time.  It may also be associated with a feeling of incomplete evacuation.

How is IBS diagnosed?

IBS shares similar symptoms with other digestive diseases, including inflammatory bowel disease (such as Crohn’s disease […]

By |April 13th, 2017|Gastrointestinal Disease|Comments Off

Do I have too much bacteria in my gut?

The small bowel, also known as the small intestine, is part of the digestive system that connects the stomach with the large bowel or colon. The main purpose of the small intestine is to digest and absorb food into the body. The small bowel is divided into three parts: the duodenum (which food from the stomach empties into), the jejunum and the ileum (which empties undigested food into the large intestine or colon).

The entire gastrointestinal tract, including the small intestine, normally contains bacteria. The number of bacteria is greatest in the colon and much lower in the small intestine. The types of bacteria within the small intestine are different than the types of bacteria within the colon. Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria are present in the small intestine, and the types of bacteria found in the small intestine is more like the bacteria found in the colon.

What causes small intestinal bacterial overgrowth?

Disorders that affect one or more of the protective mechanisms can lead to SIBO. In general, SIBO can be divided into categorical causes as follows:

Functional and motility disorders — The small bowel has a mechanism for cleansing the small bowel of debris called the migrating motor complex.  This system can be disrupted at times in patients with irritable bowel syndrome, narcotic use, intestinal pseudo-obstruction, diabetes, patients with a history of radiation therapy to the abdomen, and scleroderma.

Anatomic disorders — Anatomic abnormalities can lead to SIBO by causing stasis. Anatomic disorders associated with SIBO include adhesions from previous surgery; strictures due to radiation, inflammatory bowel disease, or tumors of the small bowel; small intestinal diverticulosis; blind intestinal loops; reversed segments; and gastric bypass for the treatment of obesity.

What are […]

The dreaded colonoscopy prep. Why does it matter so much? (And how it has improved!)

Many people dread the preparation required for a colonoscopy. There are many factors involved in the performance of a high quality colonoscopy, and one of the most critical factors is the adequacy of the bowel preparation. The quality of the prep can impact the difficulty, speed, and completeness of the examination.

Dr. Schub has worked hard to improve the prep process as much as possible, with an aim towards reducing the burden on patients and helping more patients obtain a successful colonoscopy. The prep currently consists primarily of Miralax, a tasteless laxative which you will mix into a clear beverage of your choice, and four laxative pills. Since we began using this prep, we have witnessed a reduction in prep-related complaints without a reduction in the quality of the preps. It is important to read through the entire colonoscopy prep instructions well before your procedure date. That way you will know what to expect and can get any questions you may have answered in advance.

A colonoscopy can detect colon cancer before it has spread to other parts of the body. It can also find and remove polyps, growths that can develop into colon cancer. Colon and rectal cancers are the second leading cause of cancer-related deaths in the United States, making colonoscopy one of the most important screening tools we have in our fight against cancer. If you have questions about whether you are due for a colonoscopy please call the office today to discuss further with a  provider.

By |February 7th, 2017|Colon Cancer, Patient Education|Comments Off