Achalasia is a rare esophageal motility disorder in which the muscles do not contract properly and the lower esophageal sphincter does not relax during swallowing. The result is accumulation of food in the esophagus, regurgitation, chest pain, and weight loss. Diagnosis is performed using esophageal manometry and barium swallow. Treatment includes pneumatic dilation of the sphincter, Injection of a Muscle-Relaxing Agent or surgical procedures such as POEM or Heller myotomy.

Acid reducers from the family of proton pump inhibitors

PPIs are potent and effective acid reducers that act by inhibiting the proton pump in the stomach cells - the main mechanism responsible for the production of stomach acid.
As a result, there is a significant and sustained reduction in acid secretion, which enables symptom relief and healing of the upper gastrointestinal mucosa.

Medications from this class are used, among other indications, to treat the following conditions:

• Heartburn and gastroesophageal reflux (GERD)
• Esophagitis (inflammation of the esophagus)
• Stomach and duodenal ulcers
• As part of the treatment for Helicobacter pylori infection (H. pylori)
• Conditions of excessive acid secretion

Common medications from this group include:

• Omeprazole (Omeprazole)
• Esomeprazole - Nexium (Esomeprazole / Nexium)
• Pantoprazole (Pantoprazole)
• Lansoprazole (Lansoprazole)

In most cases, it is recommended to take PPI medications before meals, according to your doctor's instructions, and only for the required duration.

An anal fissure is a tear in the muscle of the anus. It is caused by chronic constipation.
It causes pain and bleeding from the anus. Treatment focuses on preventing constipation, local medication to relieve pain, or surgical intervention.

In gastric bypass surgery, the surgeon creates an artificial connection between the small gastric pouch and the small intestine. This connection point is called anastomosis. Initially, the diameter of the anastomosis is narrow (about 10-12 mm), functioning as a "brake": food is delayed in the gastric pouch, creating a rapid sense of fullness and prolonged satiety. Over the years, due to the natural pressure of food, this ring may expand to a diameter of 20-30 mm or more. When the anastomosis is wide, the "brake" disappears - food passes directly into the intestine, satiety is lost, and the weight begins to increase. The TORe procedure is intended to restore the anastomosis to its original, narrower size.

A biopsy is a medical procedure in which a small sample of tissue is taken from the body for microscopic examination in a laboratory.
The purpose of the test is to identify cellular changes, determine whether the process is inflammatory, infectious, or tumorous, and to help the physician choose the most appropriate treatment. The sample can be taken from various locations in the body – for example, from the stomach during gastroscopy, from the skin, from the liver, or from other areas – depending on the clinical suspicion.
The procedure is usually performed under local anesthesia or as part of an endoscopic examination, and it is considered safe and simple.

Bravo pH monitoring is an advanced test for monitoring esophageal acidity levels over a period of 48 to 96 hours, aimed at diagnosing gastroesophageal reflux disease (GERD). During endoscopy, a small capsule is attached to the wall of the esophagus, which transmits data wirelessly to a portable device carried by the patient.

The test enables precise monitoring of esophageal acidity during normal daily activities, including eating and sleeping, thus providing a reliable picture of the relationship between symptoms such as heartburn or chest pain and acid reflux from the stomach. The capsule detaches on its own after a few days and exits the body naturally.

The cecum - the beginning of the large intestine and the target site of the examination. Reaching the cecum indicates a complete examination ("Complete Examination").

Previously known in Hebrew as "Machalat HaKereset", it is characterized by sensitivity to gluten, the protein found in grains. It can be diagnosed at any age.
Symptoms may include abdominal pain, diarrhea, iron deficiency anemia, early calcium loss, and more. Diagnosis is established by combining a blood test (serology) and a duodenal biopsy taken during a gastroscopy.

Primary Biliary Cholangitis (PBC) - inflammation of the portal tracts and necrosis of the intrahepatic bile ducts.
PSC is a chronic cholestatic disease characterized by inflammation, obstruction, and fibrosis of the intrahepatic and extrahepatic bile ducts.

A more innovative method compared to virtual colonoscopy: the patient swallows a tiny capsule with a camera, which transmits images from the intestine. The procedure is comfortable and non-invasive, but less accurate, more expensive, and does not permit treatment.
For this reason, we do not perform this test and recommend undergoing endoscopic colonoscopy.

A polyp is a lesion of the colonic mucosa, a protrusion formed by an accumulation of cells lining the colon.
Although most polyps do not pose a medical problem, some can become malignant over time.
Anyone can develop a colon polyp, but the risk increases after the age of 50. Individuals with obesity, those who smoke, have a high-fat diet, or a family history, are at increased risk.

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Polyps develop as a result of abnormal growth of cells that make up the colonic tissue. Healthy cells grow in a regulated manner, in a process controlled by specific groups of genes.

A mutation, an abnormal growth process in one of the genes, can cause cells to grow in an uncontrolled manner.
This uncontrolled growth leads to the formation of polyps, which can develop throughout the colon.

A malignant tumor originating from the colon. May cause abdominal pain, weight loss, changes in bowel habits, or rectal bleeding. However, it may also present without any symptoms. The preferred diagnostic test is colonoscopy.

Polyps are small growths that develop into the lumen of the small intestine, colon, stomach, esophagus, and other organs. There is a wide variety of polyps, and some may even develop into cancerous tumors.

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The larger the surface area of the polyp, the more complex its removal becomes. One of the innovative methods for removing large polyps is Polypectomy by endoscopic mucosal resection, which can replace surgery in some cases. This technique uses a fluid, such as saline, injected beneath the polyp in order to lift and isolate it from the surrounding tissue.

Dr. Vosko performs polyp removal using advanced equipment, state-of-the-art knives, cutting-edge technology, optimal and high-definition visualization, and the integration of extensive experience and skill, all of which increase the likelihood of complete removal of the polyp or lesion along with improved and quicker recovery chances.

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Dr. Sergei Vosko is the head of the Endoscopic Unit at Hadassah and formerly the founder of the Department for Advanced Endoscopic Resections at Shamir Medical Center (Assaf Harofeh Hospital). Performs diagnostics, treatments, and surgeries using Advanced Endoscopy and artificial intelligence.

To schedule an examination, you can contact our customer service

Difficulty passing stool out of the intestine. This may be due to slow transit through the intestine, a problem with the anus, or secondary to medications or systemic diseases (such as Parkinson’s disease, severe diabetes, and others). Treatment is medicinal.

Constipation is a common gastroenterological problem. Constipation is defined as two or fewer bowel movements per week, or significant difficulty and effort during evacuation. In the general population, the normal frequency of bowel movements is defined as between 3-12 per week. There is a common misconception that normal bowel movement frequency is once daily. This misconception leads to excessive and sometimes even dangerous use of laxatives.

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People experiencing this often have difficulties during the passage of stool, and this process is accompanied by pain and effort. Fortunately, most cases of constipation are temporary. A minor change in lifestyle, such as increased physical activity and a diet rich in dietary fiber, will often relieve constipation.

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Complaints and signs:

Hard stool

Fewer than three bowel movements per week

Excessive straining during bowel movements

A sensation of "rectal blockage"

A feeling of incomplete evacuation after a bowel movement

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Under normal circumstances, stool is propelled through the intestine by muscle contractions. In the colon, most of the water and salt present in the stool are mixed and reabsorbed because they are essential for the body. However, when the colon absorbs excessive amounts of water or if muscle contractions are slow, the stool becomes hard and dry and moves through the intestine very slowly.
This is the main cause of constipation. Another cause of constipation is when the muscles used during bowel movements are not properly "coordinated".
This condition is called "pelvic floor dysfunction," and it causes straining during every bowel movement.

RFA - Radiofrequency Ablation is an advanced endoscopic technique for treating diseased mucosa, based on the controlled delivery of radiofrequency energy to the target area. In the context of Barretts esophagus, the goal of the treatment is the selective ablation of mucosa that has undergone precancerous changes, while preserving the healthy surrounding tissues.

The procedure is performed during endoscopy, without external incisions, and enables:

• Precise and uniform ablation of the diseased mucosa
• Reduction of the risk of progression to high-grade dysplasia or esophageal cancer
• Healing and long-term replacement of the diseased mucosa with healthy mucosa

RFA is performed at a controlled depth, so that injury is limited to the mucosal layer only, which reduces the risk of scarring or esophageal stricture. Multiple treatment sessions may sometimes be required, depending on the extent of the mucosal changes.

RFA is currently considered the leading standard of care for Barretts esophagus with dysplasia, and significantly improves prognosis and long-term safety for patients.

Submucosal Tunneling is an advanced endoscopic technique in which a controlled passage (tunnel) is created in the submucosal layer of the esophagus, between the mucosa and the muscle layer. This approach enables access to the muscle layer to perform a precise myotomy, without injuring the mucosa or making external incisions or opening the chest cavity.

The technique is performed under full direct visualization, with precise control of the direction, depth, and length of the tunnel, and allows:

• Safe and targeted access to the esophageal muscles and the lower esophageal sphincter
• Reduced risk of injury to adjacent tissues
• Preservation of the integrity of the esophageal wall
• Faster recovery compared to open or laparoscopic surgeries

Submucosal Tunneling forms the foundation for the Third Space Endoscopy technique and requires advanced endoscopic skill, significant experience, and in-depth knowledge of the anatomy of the esophageal wall.

Crohn's Disease is a chronic inflammatory condition from the family of Inflammatory Bowel Diseases (IBD), characterized by deep inflammation that may affect any part of the digestive system - from the mouth to the anus, although it most often affects the small intestine, primarily the ileum, and the colon. The inflammation in this disease penetrates all layers of the bowel wall, which distinguishes it from other inflammatory diseases. The disease is typically characterized by periods of flare-ups alternating with remission, and its common symptoms include abdominal pain, diarrhea, weight loss, fatigue, and sometimes fever or rectal bleeding.

The exact cause of the development of Crohn's Disease is unknown, but a connection has been found between genetic predisposition, abnormal immune response to the environment, and the structure of the bowel wall. Management of the disease requires medical follow-up and multidisciplinary evaluation, with the goals of treatment being reduction of inflammation, achievement of remission, maintaining quality of life, and prevention of complications. Treatment approaches include anti-inflammatory medications, immunosuppressants, biological therapies, tailored nutrition, and sometimes surgery to remove damaged segments of the bowel. The treatment decision is personalized based on the severity of symptoms and patient compliance.

Crohn's Disease cannot be completely cured at this stage, but modern treatments enable significant reduction of symptoms and substantial improvement in quality of life. Even during periods of remission, ongoing medical follow-up is required to prevent further flare-ups and to identify possible complications. It is recommended to consult with a dedicated Inflammatory Bowel Disease (IBD) team, incorporate nutritional support, and seek guidance from certified professionals to create a comprehensive management plan committed to optimal quality of life.

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A cytology brush is an accessory inserted through the endoscope's working channel. It allows the gastroenterologist to gently "brush" the mucosa of the esophagus, stomach, or bile ducts to collect cells for microscopic examination, typically when strictures or tumors are suspected.

Defecography is an X-ray examination that allows visualization of the rectum and evaluation of its function. The test can identify internal prolapse of pelvic organs and evaluates the mobility of the anus and rectum. The examination is performed during real-time bowel movements and enables the physician to assess the function of the pelvic floor muscles and rectum.

The purpose of the test is to examine cases of chronic constipation or rectal prolapse. It is performed in the presence of complaints such as fecal incontinence and anismus (excessive contraction of the anus), as well as other types of functional disorders.

Diarrhea is a medical condition characterized by the passage of loose or liquid stools with increased frequency, typically more than three times a day, and sometimes in larger volumes than usual. Diarrhea can be caused by poor nutrition, bacterial, viral, or parasitic infections, gastrointestinal inflammation, non-gastroenterological diseases, use of various medications, or psychological stress.

Pathophysiologically, diarrhea results from one or more of the following mechanisms: impaired absorption of water and electrolytes in the intestine, increased secretion of fluids into the intestinal lumen, accelerated intestinal motility, or damage to the intestinal mucosa.

Clinically, diarrhea is classified by duration:

• Acute Diarrhea: Lasts up to 14 days, usually due to infection.
• Persistent Diarrhea: Lasts between 14 and 30 days.
• Chronic Diarrhea: Lasts over 4 weeks, and is often related to inflammatory bowel diseases, functional disorders, or malabsorption issues.

Diarrhea may be accompanied by additional symptoms such as abdominal pain, bloating and gas, fever, blood or mucus in the stool, unexplained weight loss, and signs of dehydration. The clinical significance and the need for medical investigation depend on the duration of the symptom, its severity, the patient's age, and the presence of warning signs.

Diverticula are "pouches" that protrude from the wall of the colon through weak points in the colon. Each such pouch is called a diverticulum (diverticula).

About half of the population in Western countries aged 60-80, and nearly all individuals over 80, are affected by diverticulosis.

When these pouches become infected or inflamed, the condition is called diverticulitis. The incidence of diverticulitis is 10%-25% of diverticulosis cases.

It is very common in older adults in Western countries. It can cause abdominal pain and constipation. Sometimes, diverticula also lead to bleeding, inflammation, or perforation of the colon wall. Symptom management is done with medication for constipation or abdominal pain. If complications arise, surgery may be required to remove the affected section of colon containing the diverticula.

The duodenum is the upper part of the small intestine. Bile and pancreatic juices drain into it, initiating the main digestion process. In advanced endoscopy, the duodenum is a strategic area for treating biliary tract issues (ERCP), tumors, and complex polyps.

Also known as functional dyspepsia, it is a disorder of the digestive system that manifests in the upper abdomen with a range of symptoms called dyspeptic symptoms: a feeling of bloating, gas, constipation or diarrhea, early satiety and fullness regardless of meal size, belching, burning sensation, nausea, vomiting, and more.

Dysplasia is a structural and functional cellular change indicating disrupted normal development. This is a pre-cancerous condition in which the cells are not yet cancerous, but there is a significant risk of progression to malignancy if not identified and treated in time.

Dysplasia is usually classified into two main grades:

• Low Grade Dysplasia - mild to moderate cellular changes, with a relatively low risk of cancer progression.
• High Grade Dysplasia - more advanced and significant changes, with a high risk of cancer development, requiring closer monitoring and treatment.

Dysplasia is diagnosed using endoscopic examinations and biopsies, sometimes combined with advanced imaging technologies that enable early and precise detection of suspicious areas.

The purpose of surveillance and treatment of dysplasia is:

• To identify dangerous changes at an early stage
• To prevent progression to esophageal or gastric cancer
• To enable targeted endoscopic treatment, sometimes without the need for surgery

Orderly follow-up and timely treatment of dysplasia significantly improve the chances of cure and reduce the need for complex interventions in the future.

The examination is performed using a flexible instrument (endoscope) that is inserted through the mouth into the duodenum, reaching the opening of the bile and pancreatic ducts.
Through the endoscope's channel, a plastic catheter is introduced into the opening of the papilla, allowing for the injection of iodine-based contrast agent, which (under X-ray guidance) enables visualization of the bile and pancreatic ducts.

With ERCP, it is also possible to perform therapeutic procedures such as removal of stones from the bile and pancreatic ducts, dilation of strictures (obstructions), obtaining tissue samples (in cases of suspected cancer or precancerous conditions), and placing a stent to facilitate drainage of the bile and pancreas and to keep them open, for example, in situations where there is an obstruction.

The ERCP examination typically takes about 40 minutes.

The procedure is performed under sedation, which is administered intravenously prior to the examination.

After receiving sedation, a "bite block" will be placed in your mouth to keep your mouth open throughout the procedure.

The examination is performed while lying on the left side or on the abdomen. During the procedure, monitoring devices will be attached to your body to check your heart rate, blood pressure, and respiratory activity.

During the examination, the doctor inserts the instrument through the mouth and positions it at the site of the papilla, which is the opening of the bile and pancreatic ducts into the small intestine. Through the papilla, it is possible to access the bile or pancreatic ducts for treatment purposes, such as removing stones, taking a biopsy from a mass, or relieving an obstruction.

In certain cases, the patient will receive preventive antibiotics during the procedure to reduce the risk of infection.

Laparoscopic surgery is a common technique performed through small incisions in the body (5-10 millimeters), which eliminates the need for open surgery and allows for a faster recovery.

An advanced device composed of a long, thin, and flexible tube made of glass fibers, surrounded by a plastic sheath. The endoscope is about the thickness of a finger and enables visualization of the interior of the stomach or intestine and the simultaneous performance of various procedures. During an endoscopic examination, the tip of the device can be easily maneuvered within the digestive tract. In addition to careful inspection and examination, the procedure allows tissue sampling (biopsy), aspiration of bile or gastric juice, and investigation of infection presence in the digestive system.

For example, a straight endoscope is used for joint examinations, while a flexible endoscope is employed for examination of the colon.

Colonoscopy is an endoscopic examination of the colon, allowing the physician to view the inner lining of the colon using a small camera located at the tip of a flexible tube. The examination is intended to diagnose symptoms such as bleeding, abdominal pain, prolonged diarrhea or constipation, as well as to serve as a screening tool for the early detection of polyps and colon cancer. During the procedure, it is also possible to remove polyps or take tissue samples (biopsies) for microscopic examination.
The procedure is usually performed under mild sedation and is considered very safe and highly effective in preventing colon cancer through early detection and immediate treatment of findings.

EUS (endoscopic ultrasonography) combines an endoscope with an ultrasound transducer to provide a precise image of the layers of the gastrointestinal wall, the biliary system, pancreas, bile ducts and pancreas, as well as the stomach lining, duodenum, and esophagus.
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This test is used for diagnosing tumors, gallstones, pancreatic cysts, and bile duct diseases, and enables accurate fine-needle aspiration (FNA) biopsies under direct guidance.
This technique provides high-quality imaging and enables minimally invasive treatment.

Endoscopy is an umbrella term referring to examinations performed using various endoscopic devices. This examination generally involves the exploration of the upper digestive tract and is therefore sometimes referred to as gastroscopy.

However, endoscopic examinations are named after the organ being explored. For example, an examination of the lower digestive tract is called a colonoscopy and is performed using a colonoscope.

Endoscopic examinations are performed through the body's natural openings (mouth or anus).Upper digestive tract endoscopy generally involves introducing a long, flexible tube (endoscope) into the esophagus through the mouth. A tiny camera located at the tip of the device allows the physician to examine the esophagus, the stomach, and the upper part of the small intestine (the duodenum).

For detailed and enriching information on advanced procedures, we invite you to view the Advanced Endoscopy page.

A liquid preparation administered rectally to induce rapid and targeted evacuation of the bowel prior to an examination.

Eosinophilic esophagitis is a chronic inflammation of the esophageal mucosa caused by an immune-allergic reaction, in which white blood cells of the type eosinophils (Eosinophils) accumulate in the esophageal wall. This condition leads to persistent inflammation and structural changes in the tissue, which can result in narrowing of the esophagus and impaired swallowing function.

The disease frequently appears in individuals with an allergic tendency (such as asthma, allergic rhinitis, or eczema) and is considered an allergic response to certain food components or environmental factors.

Diagnosis is performed via gastroscopy and collection of biopsies from the esophageal wall, in which an increased presence of eosinophils is observed. In some cases, it is necessary to assess food sensitivities through an allergist.

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Damage to cells in the lower part of the esophagus due to exposure to stomach acids leads to changes in the esophageal tissues.
As a result, an esophageal stricture develops, leading to difficulty swallowing.

Esophagitis is an inflammation affecting the tissues of the esophagus. This inflammation often causes pain during swallowing, difficulty swallowing, and chest pain. The causes include acid reflux from the stomach into the esophagus, swallowing medications, infections, and allergies.

Reflux is a condition in which the contents of the stomach flow back from the stomach into the esophagus.
This disease, called gastroesophageal reflux disease (GERD), is a condition where chronic acid reflux becomes an ongoing problem.
As a result, the tissues of the esophagus are damaged, leading to chronic inflammation.

It is a tube measuring 20-25 cm in length, through which food passes by the action of the esophageal muscles pushing it from the throat to the stomach.
The esophagus is located behind the trachea and actually runs for part of its length in the neck, continuing downward toward the chest.

Various medical problems can arise when there is a disruption in the function of the esophagus. Among the common medical issues involving the esophagus are problems with the lower or upper esophageal sphincter. Esophageal problems also include inflammatory strictures of the esophagus, and the presence of a flat esophageal ring in the lower part of the esophagus.
Additionally, there may be disorders in the esophageal muscles affecting swallowing, tumors that interfere with swallowing, and impaired esophageal function. Destruction of the esophageal lining due to GERD (Reflux) is also a relevant issue. GERD (Gastroesophageal Reflux Disease) is a disorder in which acidic fluid from the stomach flows upward into the esophagus.
GERD can cause a sensation of heartburn in the chest, inflammation, and throat irritation. GERD damages the esophagus, creating ulcers and harming the esophageal lining. GERD is caused by issues with the lower esophageal sphincter, bacteria, hiatal hernia, and other factors.

Volume reduction without a scalpel

In conventional surgery, the surgeon cuts and removes part of the stomach. In ESG, we use the plication technique. Imagine an "accordion" or folds in fabric: we suture the inner stomach walls to each other, folding them inward.

‍The result: the stomach changes from a wide sac into a shorter, narrower tube. This folding not only limits the space for food, but also slows the stomach's motility, so that food remains inside longer and you feel full for many hours—without removing any vital organ.

Acid reflux from the stomach into the esophagus. Causes heartburn, pain when swallowing, and chronic cough.

Gastroesophageal reflux disease (GERD (Reflux), in English: GERD, Esophageal Reflux) is a disorder in which acidic content, which normally remains in the stomach, flows from the stomach up into the esophagus and causes a burn in the inner lining of the esophagus (the tube that connects the mouth to the stomach). Sometimes gastric juices can even reach the throat and the oral cavity.

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GERD (Reflux) means to flow back or to return. Gastroesophageal reflux is a condition in which what is in the stomach returns to the esophagus.

During normal digestion, the lower esophageal sphincter opens to allow food into the stomach. Afterward, it closes to prevent food and acidic gastric juices from flowing back into the esophagus. GERD (Reflux) occurs when the lower esophageal sphincter is weak or relaxes when it should not.

The upward movement of acidic content into the esophagus causes various symptoms that impair the patient's quality of life, including heartburn. Furthermore, the burn caused by the acidic content can result in long-term damage.

Gastroesophageal reflux disease is caused by a malfunction of the muscular ring between the esophagus and the stomach. This ring is called the lower esophageal sphincter.

GERD symptoms can be alleviated through dietary and lifestyle changes. However, some individuals may require medication or surgery.

Risk factors for GERD (Reflux)

More than 25% of the population in Israel suffer from heartburn at least once a month, and over 5% of adults experience heartburn daily, including many pregnant women. Recent studies show that GERD is more common in infants and children than doctors previously thought. This can cause repeated episodes of vomiting. It can also lead to coughing and other breathing problems.

Some physicians believe that hiatal hernia may weaken the lower esophageal sphincter and increase the risk of gastroesophageal reflux. A hiatal hernia occurs when the upper part of the stomach moves into the chest through a small opening in the diaphragm (the diaphragmatic hiatus). The diaphragm is the muscle that separates the abdomen from the chest.

Recent studies indicate that the opening in the diaphragm assists in supporting the lower end of the esophagus.

It is important to note that many people with a hiatal hernia do not experience heartburn or GERD (Reflux). However, a hiatal hernia may allow stomach contents to leak more easily into the esophagus.

Coughing, vomiting, straining, or sudden physical exertion may increase abdominal pressure and lead to a hiatal hernia. Many healthy people aged 50 and over have a small hiatal hernia. Although it is usually a condition of middle age, hiatal hernias can affect people of all ages.

Hiatal hernias usually do not require treatment. However, treatment may be necessary if the hernia is at risk of strangulation, or is twisted in a way that cuts off the blood supply. Treatment for the hernia may be needed if you also have severe GERD (Reflux) or inflammation.

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Several other factors can increase the likelihood of developing GERD (Reflux):

Overweight or obesity, pregnancy, delayed gastric emptying, connective tissue diseases such as rheumatoid arthritis, scleroderma, or lupus, dietary and lifestyle choices can worsen acid reflux if you already have it: smoking, certain foods and drinks, including chocolate and fatty or fried foods, coffee, and alcohol, large meals, eating before bedtime, certain medications including aspirin.

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The most common symptom of GERD (Reflux) is heartburn. This usually feels like a burning pain in the chest that starts behind your breastbone and moves upward toward your neck and throat. Many people say it feels as though food is coming back up into the mouth, leaving a sour or bitter taste.

The burning, pressure, or pain of heartburn can last up to two hours. It is often worse after eating. Lying down or bending over can also trigger heartburn. Many people feel better if they stand upright or take an antacid that neutralizes acid in the esophagus.
People sometimes mistake heartburn pain for the pain of heart disease or a heart attack, but there are differences.
Physical activity can worsen the pain in heart disease, and rest may relieve it.
Heartburn pain is less likely to be brought on by physical activity. However, you cannot always tell the difference, so seek immediate medical assistance if you experience chest pain. In addition to pain, you may also experience nausea, bad breath, breathing difficulties, difficulty swallowing, vomiting, erosion of tooth enamel, and the sensation of a lump in the throat. If you have acid reflux at night, you may also have: persistent cough, laryngitis, sudden onset or worsening of asthma, or sleep problems.

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In addition to heartburn, you may also experience:

Nausea

Bad breath

Breathing difficulties

Difficulty swallowing

Vomiting

Erosion of tooth enamel

Sensation of a lump in the throat

Persistent cough

Laryngitis

Sudden onset or worsening of asthma

Sleep problems

Gastroesophageal reflux disease (GERD), also known as reflux, is a condition affecting the lower esophageal sphincter, which is responsible for preventing stomach contents from returning to the esophagus. The severity of the disease is determined by the degree of functional impairment, the type of fluids that reflux from the stomach to the esophagus, and the neutralizing effect of saliva.

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When the digestive process is normal, as food travels down the esophagus to the stomach, the lower esophageal sphincter opens to allow food into the stomach and closes immediately afterward to prevent the contents of the stomach from flowing back up into the esophagus. Various processes in the body can cause the sphincter to weaken and relax, resulting in the return of food, with or without stomach acids or bile, from the stomach into the esophagus. These processes irritate the lining of the esophagus and lead to GERD.

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The main symptoms of GERD are GERD (Reflux) and heartburn. Both are digestive tract conditions in their own right and are commonly experienced temporarily by most people. If these symptoms occur more than twice a week or disrupt daily routine, they are often diagnosed as GERD.

A persistent state in which stomach acids reflux into the esophagus may irritate the esophageal tissues and cause them to become inflamed (esophagitis).
Chronic inflammation of the esophagus can lead to complications such as esophageal ulcer (stomach acids can severely erode the esophageal tissues and cause open sores - ulcers). These ulcers may bleed, cause pain and difficulty swallowing.

Or Barrett's esophagus - a condition in which the color and texture of the esophageal tissue change. These changes increase the risk of developing esophageal cancer. In such a case, the physician may recommend a gastroscopy.

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To diagnose whether you have GERD, the physician may recommend tests such as:

Upper gastrointestinal X-ray - sometimes referred to as a barium swallow. In this test, you drink a liquid that coats and fills the spaces within the digestive tract.
Afterwards, an X-ray of the upper digestive tract is performed. Because of the liquid you drank, the physician can see the shape of the upper digestive tract.

Gallstones are accumulations of cholesterol or other substances in the gallbladder that can block the bile ducts. This condition, called cholelithiasis, causes abdominal pain, inflammation of the gallbladder or pancreas, and even jaundice.

An interesting statistic: it is estimated that about 20% of the population has gallstones.

Diagnosis is done by ultrasound, and treatment is based on laparoscopic cholecystectomy or endoscopic removal of the stones via ERCP, depending on their location and the severity of symptoms.

The fundus is the upper part ("dome") of the stomach. In a surgical sleeve gastrectomy, it is typically completely removed. In the endoscopic technique (ESG), we avoid touching the fundus and leave it intact.

‍Why? The wall of the fundus is very thin and rich in blood vessels, and suturing it may be dangerous. Instead, we focus on narrowing the body of the stomach beneath it.
This allows us to achieve effective weight loss while maintaining maximal safety and preventing complications such as bleeding or impaired blood supply to the stomach.

Also known as "gastro", this is a field in medicine that deals with diseases of the digestive system and its organs, including the stomach, esophagus, intestines, bile ducts, and pancreas.

The meaning of the word gastroenterology is:
gastro = stomach, entero = intestines, logos = study.

Gastroenterology has made great strides and has advanced technologically, especially in relation to surgeries and advanced diagnostic methods.
Among the examinations offered at gastro clinics are colonoscopy, gastroscopy, sigmoidoscopy, and others. In the past, surgical procedures often required "opening the abdomen". Today, the majority of medical procedures are performed as minimally invasive surgeries using an endoscope.

Gases in the digestive system are manifested as belching (expulsion of gas through the mouth) or flatulence (expulsion of gas through the rectum).
Most people produce between half a liter and one and a half liters of gas each day, and release gas up to 14 times a day.

This is a normal and natural bodily phenomenon. In most cases, the emission of gas is odorless, but there are cases where an unpleasant smell is released. Additionally, the presence of gas may cause abdominal bloating and pain, and those who experience it slightly above the average amount may suffer considerably and even feel a decrease in quality of life. Proper and accurate treatment of gastrointestinal gas can greatly assist in reducing gas, abdominal bloating, and abdominal pain.

In patients fifty years and older, the possibility of colon cancer is usually also considered. This is also the case if there are prior cases of gastrointestinal cancer in the patient’s family. This matter is especially important in cases where the patient has never undergone an examination of the colon, such as sigmoidoscopy or colonoscopy (endoscopic examinations of the lower gastrointestinal tract).

This is a procedure used to visualize the esophagus, stomach, and duodenum (the first part of the small intestine). The procedure is performed by inserting an endoscope through the patient27s mouth. The endoscope is a flexible tube approximately 1 cm in diameter, equipped with a light source and a camera.

The endoscope contains working channels that allow suction, the injection of air and water, and the passage of instruments for various treatments.
The endoscope also enables, when necessary, the use of additional equipment, such as for obtaining a biopsy or removing a polyp during the procedure.

A burning sensation accompanied by burning pain in the chest area, behind the breastbone, and in the throat. At times, the burning sensation may extend to the neck and reach the mouth.
The symptoms usually appear after eating, but may also occur at night. Lying down or bending forward may worsen the symptoms.
Excess weight, pregnancy, a high-fat diet, nighttime eating, and smoking increase the risk of developing Heartburn.
In most cases, lifestyle changes will alleviate the unpleasant sensation.

Helicobacter Pylori (Helicobacter pylori) is a bacterium found in the lining of the stomach and can cause chronic inflammation of the gastric mucosa. It is present in approximately 60% of the population in Israel. In some individuals, it may lead to the development of gastric or duodenal ulcers (ulcus), and even increase the long-term risk of gastric cancer. Infection with Helicobacter Pylori usually occurs through direct contact with the saliva, oral secretions, or feces of an infected person. Therefore, it can be transmitted through sharing eating utensils, kissing, or consuming contaminated food and water.

Infection most often occurs during childhood, especially in areas with lower hygiene standards or when living in crowded conditions. Sometimes the bacterium remains in the body without symptoms for years.

Diagnosis is performed using a breath test, stool test, or biopsy during gastroscopy. Treatment involves a combination of antibiotics to eradicate the bacterium and medications to reduce stomach acidity, aiming for complete healing of the mucosa and preventing ulcer recurrence. Some studies suggest combining probiotics alongside drug therapy.

Hemorrhoids are natural blood vessels of the anus that protrude outward, usually as a result of chronic constipation. In women, it is common following pregnancies and childbirth. They generally do not cause symptoms. They may cause pain or bleeding. Treatment includes management of constipation, local medical therapy, and, in rare cases, surgical removal of hemorrhoids.

A hiatal hernia is a condition in which part of the stomach is pushed upward through the diaphragm. There is a small opening (hiatus) in the diaphragm through which the esophagus passes on its way to the stomach.

It is detected when evaluating the causes of heartburn, chest pain, or abdominal pain. Most people with a hiatal hernia do not experience symptoms and do not require treatment. If symptoms such as heartburn and acid rising from the stomach into the esophagus (reflux) recur, they can be treated with medications or surgery.

General Information

The stomach can be pushed through this opening and cause a hiatal hernia. In most cases, a small hernia does not cause problems and most people are unaware of its existence. However, a large hiatal hernia may result in food and acid flowing back into the esophagus, causing heartburn and chest pain.

Medications can relieve symptoms, but sometimes a large hiatal hernia requires surgery, especially if the hernia develops and the muscles and ligaments around the opening in the diaphragm weaken and allow part of the stomach to protrude into the chest cavity.

Irritable Bowel Syndrome (IBS) is a functional disorder of the digestive system rather than a structural organic disease. This means that imaging, endoscopy, or laboratory tests typically do not reveal a clear pathological finding, despite the presence of significant symptoms.

Patients with IBS may report a wide range of symptoms, including recurrent abdominal pain, bloating, excessive gas, diarrhea, constipation, or a combination of both, and sometimes nausea and persistent abdominal discomfort. Symptoms tend to vary in intensity and character over time and are often exacerbated after eating.

Pathophysiologically, the syndrome is linked to a disturbance in the brain-gut axis, visceral hypersensitivity, changes in intestinal motility, and sometimes alterations in the gut microbiota. In many cases, psychological factors such as stress, pressure, and anxiety have a significant impact and can trigger or worsen symptoms.

Diagnosis is based on clinical criteria after ruling out other organic diseases, especially in the absence of "red flag" warning signs such as gastrointestinal bleeding, unexplained weight loss, or anemia. Treatment includes pharmacological, dietary, and sometimes psychological interventions.

Infectious esophagitis develops when viruses (such as herpes or CMV), fungi (Candida), or bacteria infect the esophagus, most often in the context of immunosuppression. Symptoms include pain when swallowing, fever, difficulty swallowing solids and liquids, and sometimes heartburn. Diagnosis is performed by endoscopy and culture sampling, and treatment is tailored to the underlying cause: antiviral drugs, antifungal agents, or antibiotics.

This is a relatively rare type of inflammation that occurs in individuals with a weakened immune system, such as people with AIDS or cancer.

Pancreatitis is a condition in which the digestive enzymes of the pancreas are activated within the gland, leading to tissue destruction and scarring of the pancreas. The disease can be acute and resolve within days, or chronic and cause irreversible damage and even be life-threatening. The causes include gallstones, excessive alcohol consumption, high triglyceride levels, and medications. Symptoms include severe abdominal pain radiating to the back, nausea, vomiting, and elevated pancreatic enzymes in the blood. Acute treatment requires fasting, fluids, and pain management; in chronic cases, dietary modification, enzyme therapy, and sometimes surgery are required.

Gastroesophageal reflux disease (GERD) is a very common condition among the general population. Symptoms such as heartburn or regurgitation (the rise of stomach contents into the esophagus and throat) are reported in 25% of patients in developed countries each year. Although medication treatment provides a solution for a significant portion of patients, a considerable number of individuals (ranging from 10% to 40% of patients) may not achieve complete resolution of symptoms.

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Given the significant impact of symptomatic GERD (Reflux) on quality of life, along with the high costs and growing awareness of potential negative effects associated with long-term medication use.

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Now, after years of anticipation, we are proud to stand at the forefront of medical technological innovation and bring patients in Israel the groundbreaking Transoral Incisionless Fundoplication (TIF) procedure.

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TIF is a minimally invasive, endoscopic procedure, much safer compared to surgery, offers faster recovery for patients, and delivers impressive clinical outcomes.

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Multiple international studies have shown that the TIF procedure is successful in up to 99% of patients, with only 2% experiencing issues during or after the procedure, such as a tear or internal bleeding. For many patients, TIF provides significant relief from reflux symptoms and improves quality of life. Most patients (91%) also experience a reduction in hiatal hernia, and many (89%) are able to discontinue medication. Symptom relief after TIF typically lasts between eight to ten years, which is comparable to the outcomes in most surgical treatments. When reflux symptoms return.

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When comparing with Israel, this means that about 250,000 to 500,000 people are potential candidates for endoscopic TIF treatment for reflux, which can significantly improve their quality of life and help them discontinue chronic medication.

Dr. Sergei Vosko, Head of the Endoscopy Unit at Hadassah Medical Center and founder of the Department of Advanced Endoscopic Resections at Shamir Medical Center (Assaf Harofeh Hospital), performs examinations, treatments, and surgeries using Advanced Endoscopy and artificial intelligence.

To schedule an examination, please contact our customer service

Laparoscopic surgery is a minimally invasive surgical procedure performed through small incisions in the abdominal wall, using a tiny camera (laparoscope) and specialized instruments.
During the surgery, a camera is inserted that transmits a magnified image from the operative site to a screen, enabling the surgeon to carry out the procedure with high precision and minimal tissue damage.

The laparoscopic approach is now used in a variety of medical fields – including general surgery, gastroenterology, gynecology, and urology – and shortens recovery time, reduces pain and scarring, and allows a quicker return to routine compared to traditional open surgery.

Severe liver injury resulting from medication use is an acute problem that can lead to mortality. In the United States, it is the most common cause of acute liver failure, leading to approximately 600 liver transplants each year.

Metabolic conditions involving the liver that may lead to chronic liver diseases, cirrhosis, and cancer.

Myotomy is a surgical procedure aimed at the precise and controlled cutting of muscle fibers that are overactive or do not relax properly.
In the context of Achalasia, the myotomy focuses on the lower esophageal muscles and the lower esophageal sphincter (LES), which fail to open properly and prevent the free passage of food and liquids into the stomach.

During the procedure, only the muscle layer is deliberately cut, while preserving the mucosal layer, with the goal of:

• Reducing the pressure in the lower esophageal sphincter
• Improving the passage of food and liquids
• Relieving symptoms such as difficulty swallowing, sensation of blockage, and chest pain

In the POEM procedure, the myotomy is performed using an advanced endoscopic approach, through the esophageal lumen, without external incisions. This technique allows for a precise cut along a personalized length of the problematic muscle, according to the type of achalasia and patient characteristics.

The advantages of endoscopic myotomy include:

• High precision and minimal damage to adjacent tissues
• Better control over the depth and length of the cut
• Reduced risk of complications compared to open surgical approaches
• Faster recovery and improvement in quality of life

Successful myotomy requires a high level of technical skill, deep anatomical understanding, and extensive clinical experience, especially when performed as part of the POEM procedure using the Third Space Endoscopy technique.

Advanced light technology that highlights blood vessels and tissue changes, supporting accurate diagnosis of the gastrointestinal mucosa and early detection of cancer.

A simple and recommended test for diagnosing colorectal cancer. In the case of a positive Occult Blood in Stool result, this may indicate the presence of polyps, as both polyps and cancer tend to bleed.
It may take many years for a polyp to develop into cancer.
However, because a substantial amount of time can pass from the formation of a polyp until it becomes cancerous, there is an extended window that enables early detection of colorectal cancer, and in most cases, the patient will be referred for colonoscopy.

Overstitch device - "Surgical hands" without a scalpel

The Apollo Overstitch system is a technological marvel that is mounted on a standard endoscope. Prior to its development, gastroenterologists could only "cauterize" or place superficial clips that would fall off quickly.

The Overstitch enables Dr. Vosko to perform true surgical procedures through the mouth: the special needle grasps the full thickness of the stomach wall (Full Thickness) - both the mucosa and the muscle - securing strong, durable sutures that last for years.

Dr. Vosko serves as a proctor (instructor) for this device, ensuring the highest levels of precision and expertise.

Obesity is defined as the accumulation of fat in amounts greater than desired, to an extent that may cause illness or worsen an existing disease.
The most commonly used index for assessing obesity and its severity is the Body Mass Index (BMI). This index is calculated by the ratio between height and weight squared.

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General Information

However, BMI is not the whole picture. When assessing the relationship between obesity and illness, one must take into account chronic diseases, age, family history, eating habits, the type of obesity, and more.

With this index, it is possible to determine whether a person is at a normal weight, underweight, overweight, or obese.

The index is calculated as follows: weight (in kilograms) divided by height squared (in meters).

Below is the BMI value table and weight classifications:

Up to 18.5 - Underweight and at risk for malnutrition.

18.5-24.9 Normal weight and relatively low risk of diseases related to obesity.

25-29.9 Overweight.

30-34.9 - Obesity Grade I.

35-39.9 - Obesity Grade II.

40 and above - Obesity Grade III.

Therefore, overweight is a state in which the individual's BMI ranges between 25-29.9

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The recommended solution before bariatric surgery is to consult a dietitian, so that they can provide initial support through dietary changes, interpretation of blood tests, guidance on recommended foods, and advice on physical activity to promote real and long-term change.

In extreme cases, additional treatments may help and include medications, endoscopic treatment, or bariatric surgery.

Jenny Vosko, clinical dietitian, expert in gastro-nutrition and diabetes nutrition, has supported patients for over a decade after endoscopic treatments, providing them with knowledge, tools, and methods for healthy and proper eating to enhance the effect of the treatment and help sustain it over time.

To schedule a consultation, you may contact our customer service

The pancreas is a gland located between the stomach and the small intestine, which secretes enzymes that participate in the digestive process. In addition, the pancreas produces hormones such as insulin.

There are approximately 20 different types of tumors in the pancreas.
The origin of most pancreatic cancers is in the pancreatic duct; these cancers are typically classified as adenocarcinomas (cancers that arise from glandular tissue).
As the cancer grows, it may spread to adjacent organs (such as the stomach and blood vessels) or to distant organs (such as the lungs and liver).
Although pancreatic cancer is relatively uncommon, it is nonetheless the fourth most deadly cancer type.

A peptic ulcer is an open sore (ulcer) that develops on the lining of the upper digestive tract, most commonly in the stomach or the duodenum. The ulcer forms when the protective mechanisms of the lining are compromised, allowing stomach acid and digestive juices to cause localized and persistent damage.

Common causes of peptic ulcers include infection with the Helicobacter pylori bacterium, prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) such as Aspirin, Voltaren, Nurofen, and the like, and occasionally other factors such as smoking, physiological stress, and associated medical conditions.

Symptoms may include pain or a burning sensation in the upper abdomen, discomfort after eating, nausea, and sometimes complications such as bleeding. Diagnosis is typically performed via upper gastrointestinal endoscopy. Treatment is tailored to the cause of the ulcer and includes acid-reducing medications, treatment for infection if necessary, and the avoidance of aggravating factors. In most cases, proper treatment and medical follow-up lead to complete healing of the ulcer and significant symptomatic relief.

A polyp is a benign (non-cancerous) growth in the digestive system. There are several types of polyps. A polyp called an adenoma may develop into cancer.
Polyps can be found throughout the digestive tract but are more common in the colon.
Statistics show that 20-50 percent of people over the age of 50 will have colon polyps.

Rectal bleeding, also known as blood in the stool, refers to the passage of fresh, bright red blood through the anus. The amount of blood may be small or large.

In any case of bleeding in the stool, it is important to monitor the bleeding, its duration, frequency, and severity. When the bleeding is prolonged and involves significant blood loss, this may be life-threatening and you should contact your physician for evaluation and appropriate treatment.

The blood may be visible in the stool, in the toilet bowl, or on toilet paper. Mild bleeding typically appears as a few drops of fresh, red blood.

When bleeding is accompanied by pain, it often indicates that the source of the problem is at the anus.

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Symptoms include the passage from the anus of red or reddish-brown blood and blood clots.

The color of the blood in the stool depends mainly on the location of the bleeding within the digestive tract. The closer the bleeding site is to the anus, the brighter red the blood will be. Therefore, bleeding from the rectum, anus, and lower part of the colon tends to be bright red, while bleeding originating from the upper parts of the colon - the right or transverse colon - is usually darker red or brown. In upper gastrointestinal bleeding, the stool color will be brown or black.

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The common causes of this type of bleeding can be grouped as follows:

• Diseases of the anus and rectum, such as anal fissures, hemorrhoids, and ulcers.

• Rectal bleeding may be mild and result from constipation and the passage of hard stool through the anus.

• Anatomical (structural) problems - mainly the presence of "pockets" (known as diverticula or diverticulosis) in the colon, which can cause problems with blood supply to the bowel (ischemia).

• Tumors such as colorectal cancer.

• Inflammation of the bowel - for example, due to infection or radiation exposure - as well as inflammatory diseases such as Crohn's disease and ulcerative colitis.

• Following invasive procedures such as colonoscopy during which polyps were removed or a biopsy was taken.

• Abnormal superficial blood vessels in the bowel wall (angiodysplasia).

• After pelvic radiation therapy for malignancy, for example in the prostate gland.

The rectum, the terminal part of the large intestine. Inflammation in this area is called proctitis (Proctitis).

A technique that originated in Japan in the early 2000s for the endoscopic removal of early-stage stomach tumors. In the past decade, the method has also spread to Western countries and has recently become available in Israel.

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The majority of malignant tumors in the gastrointestinal tract begin as precancerous lesions that develop in the most superficial layer of the gastrointestinal wall - the mucosa. As the tumor grows, it begins to invade deeper layers of the bowel wall, and from there it may spread to nearby lymph nodes and send metastases to more distant areas of the body.

The accepted treatment for these precancerous lesions is resection through an endoscopic procedure.

The advantages of this method over other resection techniques such as EMR include the ability to remove lesions of any size in a single piece, which allows for thorough pathological examination of the specimen and accurate assessment of the risk of lymph node metastasis according to the depth of tumor invasion into the submucosa.

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All procedures involved in this method are performed under anesthesia or sedation, through an endoscope inserted via the mouth or rectum, without surgical incision.

Initially, the tumor boundaries are marked through the endoscope, and then fluid is injected beneath the tumor directly into the submucosal layer, to allow separation of the tumor from the deeper layers of the wall. After making a circumferential incision around the tumor area, Dr. Sergei Vosko will cut the submucosa with a special knife that separates the tumor from the surrounding tissues. Once the tumor has been completely removed, it will be sent for pathological laboratory examination.

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Dr. Sergei Vosko, head of the Endoscopy Unit at Hadassah Medical Center and founder of the Department of Advanced Endoscopic Resection at Shamir Medical Center (Assaf Harofeh Hospital), performs examinations, treatments, and procedures using Advanced Endoscopy and artificial intelligence.

To schedule an examination, you may contact our customer service

Medication-induced sedation administered intravenously. Unlike general anesthesia (with artificial respiration), here the patient breathes independently but is asleep and does not feel pain or anxiety.

The S-shaped section of the large intestine that connects the descending colon to the rectum. This area tends to develop diverticula (Diverticulosis) and polyps.

Sigmoidoscopy is a short colonoscopic examination that advances through the last 60 centimeters of the large intestine. The procedure is intended to diagnose and treat various diseases relevant to this region. It is performed by inserting an endoscope equipped with an advanced, high-resolution optical camera. The camera transmits images to Dr. Vosko's monitor, allowing him to closely follow the findings and guide the endoscope as needed. This examination is particularly relevant for rectal bleeding, changes in bowel habits, inflammatory bowel disease monitoring, and more.
The procedure enables the early detection of tumors. The length of the examination is relatively short and should not take more than 15 minutes.

A lesion that occurs in the stomach or duodenum.
May cause abdominal pain, bleeding, and, in rare cases, a perforation of the stomach or duodenum.
Usually caused by the bacterium Helicobacter pylori, but can also result from medications such as aspirin, as well as smoking or alcohol consumption.

Stretta treatment is an innovative and minimally invasive solution for gastroesophageal reflux disease (GERD). This unique method uses radiofrequency (RF) energy to strengthen the lower esophageal sphincter (LES), thereby significantly reducing reflux symptoms and improving patients' quality of life.

Stricture is a pathological narrowing of the gastrointestinal tract lumen, caused by thickening, scarring, or inflammation of the organ wall. The stricture reduces the normal diameter for the passage of food and liquids, and may lead to significant functional disturbances.

In the upper gastrointestinal tract, strictures may appear in the esophagus or stomach, and can result from prolonged reflux, chronic inflammation, prior endoscopic treatments or surgeries, and sometimes from tumors.

Common symptoms include:

• Difficulty or pain upon swallowing
• Sensation of food sticking
• Recurrent vomiting or regurgitation
• Weight loss

Diagnosis is usually performed by endoscopy and imaging, and treatment is tailored according to the severity and underlying cause of the stricture. In many cases, strictures can be treated endoscopically, such as with controlled dilation, thereby significantly improving the patient27s quality of life.

A cluster of cells that have begun to divide uncontrollably.

Benign tumor -  is a growth whose cells do not spread to other organs in the body - however, if they continue to grow in the original area, their growth may cause pressure on adjacent organs.

Malignant tumor - is cancerous in nature, composed of cells capable of spreading. Without treatment, it may send metastases to additional areas in the body, to nearby tissues, and destroy them.  Sometimes, cells detach from the original (primary) tumor and spread to other organs in the body through the bloodstream or lymphatic system.
When these cells reach a new area, they may continue to divide and form new masses called 'secondary tumor' or 'metastasis'.

Tumor symptoms depend on its location. For example, a tumor in the lungs may cause coughing, shortness of breath, or chest pain. Tumors in the intestine may cause weight loss, diarrhea, constipation, anemia, and blood in the stool.

Obtaining samples from suspicious tissue in the digestive tract and adjacent organs using an endoscopic technique guided by endoscopic ultrasound (EUS).

This method provides access to multiple organs in the body, allowing for assessment of malignant disease spread in order to plan surgeries and treatment approaches.

Ulcerative Colitis is a chronic inflammatory disease that belongs to the group of inflammatory bowel diseases (IBD), which is characterized by persistent inflammation of the mucosal lining of the colon only. The inflammation always involves the rectum and may spread continuously along the entire length of the colon, and in rare cases also to the terminal portion of the small intestine.

The disease causes the formation of ulcers and sores in the inner wall of the colon, and depending on the extent of inflammation, the severity of symptoms varies: abdominal pain, frequent diarrhea (sometimes with blood or pus), urgency of bowel movements, weight loss, fatigue, fever, and in some cases impaired growth in children.

The disease is characterized by periods of flare-ups and remission, and can manifest at any age but is most common between ages 15-30. The exact cause is unknown, but the hypotheses suggest a combination of genetic, environmental, and an excessive immune response against beneficial gut bacteria or foreign pathogens, leading to an uncontrolled inflammatory reaction. Ulcerative Colitis requires ongoing medication and usually also gastroenterological follow-up.

The medications are intended to suppress the inflammation and to regulate immune system activity. In severe cases and in the event of complications, surgery for partial or total removal of the colon may be required. There are currently about 21,000 people with Ulcerative Colitis in Israel, and in recent years the incidence has increased in Western countries.

Diagnostic tests include, among others, colonoscopy and blood tests, as well as a new video capsule test that enables full and non-invasive scanning of the colon to evaluate inflammation and monitor the disease.

An imaging test performed using CT that does not involve insertion of an endoscopic device through the entire colon. It enables identification of polyps or tumors, but does not allow for treatment or biopsy. Therefore, if a finding is detected, a complementary endoscopic examination is necessary.

For this reason, we do not perform this test and recommend undergoing endoscopic colonoscopy.

A weighted score calculated from the data, determining whether the reflux is pathological (disease-related) or within the normal range.