Questions about your digestive health? Wondering how to navigate your first appointment at SAGA? Find the answers to these and all your questions right here from San Antonio’s leading experts in digestive healthcare.
INSURANCE AND PAYMENT OPTIONS
Aetna — All Products
AmeriGroup — All Products
BCBS — All Products
Cigna –– All Products
Humana/ChoiceCare — All Products
National Healthcare Alliance
SA Military Treatment Facility
Unicare –– All Products
United Health Care (PacifiCare/Secure Horizons) — All Products
Wise Provider Network/ Innovative (Toyota Plant)
If you do not see your insurance provider listed, please contact SAGA at 210-242-0025 for more information.
Yes, credit cards, cash, and checks are accepted.
CareCredit is a credit card that is used for medical purposes at participating providers. San Antonio Gastroenterology Endoscopy Centers accepts this as a form of payment for procedures.
How do I apply for CareCredit?
Visit the CareCredit website: https://www.carecredit.com/ and click “Apply”. Under “Select a doctor or business by name,” type “San Antonio Gastroenterology Endoscopy Center.” You may also contact the business office at 210-404-2942 this option is available for procedures ONLY.
Financing is available for procedures at San Antonio Gastroenterology Endoscopy Centers through CareCredit (as listed above) or the E-Plan.
E-Plan is the SAGEC in-house monthly financing option. You may use your checking or savings account, a credit card or debit card. To enroll in E-Plan, there is a one-time service fee of $10.00. The SAGEC will assist you by setting up payment plans that fit your budget and set up automatic deductions. There are no interest charges. Approximately three days prior to the automatic draft, you will receive an email reminding you of your first auto draft. To learn more about the E-Plan options call 210-404-2942.
All co-pays, deductibles, and payments are due at the time services are rendered. These are determined by your insurance carrier. Contact your insurance provider to obtain this information.
If you are not using insurance, the full amount of your bill is due at time of service. Financing options must be arranged and approved before services are rendered. If you have questions about payment, please contact the SAGEC financial coordinator at 210-404-2942.
As the patient, you are responsible to provide SAGA/SAGEC with accurate insurance information for billing purposes prior to your procedure, as many insurances may require prior authorizations or referrals from your primary care physician that take time. If these are not obtained prior to the procedure, your procedure may not be covered by your insurance carrier. Please let us know if you anticipate a change in your insurance plan when booking your procedure.
Please read your bill very carefully. Bills for physician fees, which include office, procedures, anesthesia, and pathology will be marked with San Antonio Gastroenterology Associates (SAGA) and the account number will begin with “1”. Bills for the facility will be marked with San Antonio Gastroenterology Endoscopy Centers (SAGEC) and the account number will begin with “2”.
You may pay your bill on the Bill Pay page. If you have questions about paying your SAGEC (facility) bill, please call 210-404-2942. If you have questions about paying your SAGA (physician fees, pathology, anesthesiology) bill, please call 210-271-0606.
LOCATIONS & DIRECTIONS
PREPARATION FOR YOUR VISIT
Your insurance card(s)
Driver’s License or Photo ID
A list of your current medications
Co-pay or deductible, as determined by your insurance company
Leave valuables and jewelry at home.
Wear comfortable, loose fitting clothes.
Plan to arrive at the center one hour prior to the procedure.
You should expect a stay of two to three hours total.
Bring the name and phone number of the person (must be 18 years or older with a valid driver’s license) who will be taking you home. You will not be permitted to drive, take a taxi alone, or leave the center without an adult chaperone.
You must be 18 years old or over to have a procedure. If you are an adult who is unable to sign the consent, you must have someone with you who is authorized to sign on your behalf.
- Carefully read and review your colonoscopy prep instructions
- CONFIRM transportation the day of your procedure.You MUST have a person 18 years old or older who can sign discharge forms and take you home after the procedure is complete. Transportation MUST be CONFIRMED at check-in or your procedure will be rescheduled. Use of a taxi service or other ride share/public transport is NOT allowed WITHOUT AN ESCORT age 18 years old or over.
- Wear loose, comfortable clothing, including cotton socks which may be left on during the procedure.
- Bring your government-issued photo I.D. (driver’s license, passport, etc.)
- Do NOT wear jewelry (this includes wedding rings, earrings, and body piercings)
- NO high-heeled shoes
- Do NOT bring any valuable personal items such as cellphones, tablets, laptops, keys, or jewelry
- Bathe or shower prior to leaving your home before attending your procedure
- Do NOT apply lotion to your arms or chest before the procedure
- Continue to take any blood pressure or heart medications in the morning with only a sip of water. These are the only medications you may take the morning of the procedure.
- If you are diabetic, DO take your blood sugar level at home before attending your procedure
- If you use as inhaler, DO use it prior to arrival and bring it to the center with you
- DO bring a list of all your medications with dosage and frequency
You MUST have a person 18 years old or over who can sign discharge forms after the procedure is complete. Driver and patient escort MUST be CONFIRMED at check-in or your procedure will be rescheduled. Use of a taxi service or other ride share/public transport is NOT allowed without an escort aged18 years or older to accompany the patient.
You will not be permitted to drive, take a taxi alone, or leave the center without an adult chaperone.
Wear loose, comfortable clothing, including cotton socks which may be left on during the procedure.
Plan to arrive at the center one hour prior to the procedure.The procedure takes between 15 and 45 minutes. You should expect a stay two to three hours total.
Contact the physician’s office (visit the Physician page for contact details by physician) for questions about your office appointment, prep instructions or to reschedule/cancel an appointment. For questions about your procedure date and time, contact the endoscopy center at 210-271-0606.
CONDITIONS & SYMPTOMS
Colon cancer affects the large intestine (colon). It is the second leading cause of cancer-related deaths for both men and women. In 2014 alone, there was an estimated 50,000 deaths due to this disease.
Most colon cancers originate from adenomatous polyps. These are small, potentially-malignant, growths that develop within the lining of the large intestine.
Polyps may eventually grow into malignant tumors —or colon cancer—if neglected. Colon cancer prevention is achievable through careful inspection and removal of polyps, called a colonoscopy. Of all the tests to screen for colon cancer (stool tests, CT scan, etc.) only a colonoscopy provides the ability to remove precancerous polyps or even early colon cancer tumors.
At San Antonio Gastroenterology Associates, board-certified gastroenterologists perform this life-saving procedure. They follow the latest clinical guidelines for performing high-quality colonoscopy while assuring utmost safety and comfort for their patients during this procedure.
Persons with colon cancer may not experience any symptoms in the early stages of colon cancer. Often the symptoms may even be very subtle, depending on the location and stage of the cancer. So it is always important to consult with a gastroenterologist for any of the following symptoms:
- Blood in your stool
- Change in bowel habits or consistency of your stool
- Unexplained weight loss
- Unexplained anemia, fatigue or weakness
- Persistent abdominal pain
Patients with family members with history of colon cancer should be more vigilant. Talk to your doctor about the importance of having a colonoscopy.
Acid reflux is when acid content of the stomach flows up into the esophagus, causing symptoms such as heartburn, chronic cough, chest pain and even difficulty swallowing. Acid reflux is one of the most common GI conditions.
Diagram of esophagus, stomach, and digestive system
The stomach contains a strong acid called hydrochloric acid, to help with the digestion of food and to protect against troublesome microbes. The stomach lining is accustomed to this acidic environment, but the esophagus is not. When the esophagus is continuously exposed to acid, it can lead to reflux symptoms, damage to the esophagus or even changes in the lining of the esophagus that may even lead to cancer of the esophagus.
When acid reflux persists, this becomes a more serious condition called gastroesophageal reflux disease or GERD.
Regurgitation, the feeling of acid back flowing into your throat or mouth, is another common symptom of acid reflux. Regurgitation can produce a sour or bitter taste, and you may experience a “wet burp” or even vomit some contents of your stomach.
Stomach discomfort, including:
- Nausea that occurs after eating
- Stomach fullness or bloating
- Pain and discomfort in the upper abdomen
Acid reflux may manifest in a variety of symptoms. Talk to your doctor if you have classic symptoms of heartburn or even vague stomach discomfort that may be a sign you have acid reflux disease.
Dysphagia means difficulty swallowing. Dysphagia can have many causes, such as: a narrowed esophagus from structural problems, narrowing caused by esophageal cancer, scarring, or impacted food, as well as foreign bodies. Abnormal movement of the esophageal muscles also leads to it. Regardless of the cause, dysphagia may signal a more serious problem. If you have symptoms, you should see your gastroenterologist right away.
Barrett’s esophagus is a dangerous consequence to ignoring gastroesophageal reflux disease (GERD). In Barrett’s esophagus, normal tissue lining the esophagus is damaged to the extent of resembling the lining of the intestine. About 10 percent of people with chronic symptoms of GERD develop Barrett’s esophagus.
Surprisingly, some patients with Barrett’s esophagus often do not experience symptoms. Untreated Barrett’s esophagus may increase the risk of developing esophageal adenocarcinoma, which is a serious, potentially fatal cancer of the esophagus.
The symptoms of Barrett’s esophagus are non-specific. A diagnosis of Barrett’s esophagus is often preceded by GERD or symptoms of heartburn and acid reflux. Because there are often no specific symptoms associated with Barrett’s esophagus, it can only be diagnosed with an upper endoscopy and biopsy.
Factors that increase your risk of Barrett’s esophagus include: chronic heartburn and acid reflux. Other considerations include long-term GERD (five years or more), or GERD that necessitates routine medication. GERD patients over age 50 are also at a higher risk of Barrett’s esophagus.
At San Antonio Gastroenterology Associates, we provide the latest techniques in treating Barrett’s esophagus that have increased risk of cancer (called dysplasia). We utilize clinically-proven techniques such as radiofrequency ablation and even endoscopic mucosal resection for those Barrett’s esophagus with signs of early esophageal cancers.
A hiatal hernia arises when parts of the diaphragm muscle allow the stomach to protrude through the diaphragm. While it is not always certain why this occurs, pressure on your stomach and age-related changes in your diaphragm may contribute to the formation of a hiatal hernia.
Hiatal hernia could be caused by:
- Injury to the area
- Being born with an unusually large hiatus (opening of the diaphragm)
- Persistent and intense pressure on the encompassing muscles, that may happen when coughing, vomiting or straining during a bowel movement, or while lifting heavy objects
Irritable bowel syndrome, referred to as IBS, is a common condition that can affect all ages. Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating, gas, and irregular bowel movements such as diarrhea or constipation. IBS is a chronic condition that requires long term management.
Inflammatory bowel disease refers to chronic inflammation of the digestive tract, consisting of diseases, such as ulcerative colitis (UC), and Crohn’s disease. Symptoms of these conditions include diarrhea, pain, fatigue, and weight loss, and may be life-impairing in some severe cases. These are chronic conditions that require expertise from gastroenterologists who are experts in the management of IBD.
Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract. Crohn’s disease can affect any part of the digestive tract from the mouth to the anus. It usually involves the entire thickness of the bowel wall, and may be patchy in distribution, meaning, it can cause inflammation and damage in particular areas and leave other areas of the digestive tract unaffected. Because it affects the entire wall thickness of the bowel, it may penetrate through the bowel wall causing abnormal connections between organs called fistulas and infected fluid collections called abscesses.
Symptoms of Crohn’s disease may include.
- Persistent diarrhea
- Rectal bleeding
- Urgency of defecation or sensation of the need to have a bowel movement immediately
- Abdominal cramping and pain
- Feeling of incomplete bowel movements
General symptoms that may also be correlated with IBD:
- Lack of appetite
- Unintentional weight loss
- Night sweats
- Loss of normal menstrual cycle
The causes of Crohn’s Disease are not well understood. While diet and stress may exacerbate Crohn’s Disease, they are not known to cause the disease. Recent research suggests hereditary, genetics, and/or environmental factors contribute to Crohn’s Disease.
Crohn’s is often seen among family members. If a family member has the disease, there is a significantly increased chance of developing Crohn’s disease. Studies have demonstrated that 5% to 20% of affected people have a direct relative, such as parents, children, or siblings, with the disease.
Crohns disease is a chronic condition, hence treatment is also, in general, life-long.
Currently, there is no instant cure for Crohn’s disease or one treatment that works for everyone. Treatment for Crohn’s disease usually involves medications or, in certain cases, surgery.
The goal of medical treatment is to decrease the inflammation, to decrease signs and symptoms. It also aims to improve long-term prognosis by limiting complications. In the best case scenario, this may lead not only to symptom relief but also to long-term remission.
Ulcerative colitis, or UC, is a condition that affects the large intestine by causing inflammation and ulcers in the lining. It mainly affects the lower digestive tract. It can affect the entire colon, or only a segment of the lower digestive tract, such as the rectum. In general, the larger portion of the colon that’s affected, the worse the symptoms will be.
- Abdominal pain or cramps
- Bleeding from the rectum
Some people may also experience fever, loss of appetite, and may even lose weight. In severe cases, people may have diarrhea 10 to 20 times daily.
UC can also lead to other issues, such as joint pain, eye problems, or liver disease.
In most people, the symptoms arrive in phases. Some people do not have symptoms for months or even years, known as remission, until their next flare-up. About 5 to 10 out of 100 people with ulcerative colitis have symptoms all the time.
The disease can affect people of any age. But most people who have it are diagnosed before the age of 30. You are more likely to get ulcerative colitis if other people in your family have it.
Ulcerative colitis treatment usually involves either medications or surgery. There are several different types of medications used to treat ulcerative colitis. Which medication you take is determined by the severity of your condition. The drugs that work well vary from patient to patient, so it may take time to find a medication that helps you. Additionally, some drugs have serious side effects, you’ll need to weigh the benefits and risks of any treatment.
Hepatitis is defined by inflammation of the liver. While hepatitis is typically due to a viral infection, there are other potential causes. Medications and alcohol may also cause inflammation of the liver. Autoimmune hepatitis is a condition in which the body creates antibodies to attack liver tissue.
Those with hepatitis may not experience symptoms until there is liver damage. Normally, chronic hepatitis, such as hepatitis B and hepatitis C, does not initially show symptoms.
Indicators of chronic hepatitis are nearly undetectable because it progresses gradually.
However, signs of acute hepatitis are easier to identify, such as:
- Flu-like symptoms
- Dark-colored urine
- Pale stools
- Abdominal pain
- Loss of appetite
- Unintentional weight loss
- Yellowing of skin and eyes, or jaundice
Hepatitis A is acquired from an infection with the Hepatitis A virus, or HAV. Food or water contaminated by trace amounts of hepatitis A infected excrement is the most common cause of HAV.
Hepatitis B is an infection with the Hepatitis B virus (HBV). HBV is transmitted through direct contact with infected blood, saliva, or semen. The chance of contracting hepatitis B is increased by drug use, due to unclean needles, unprotected sex with an infected individual, or sharing a razor with a Hepatitis B infected person. The Center for Disease Control estimates that chronic hepatitis B affects 1.25 million Americans, and 350 million internationally.
Hepatitis C stems from the hepatitis C virus, also called HCV. Similar to Hepatitis B, Hepatitis C is contracted via infectious bodily fluids, most commonly through drug injection, and having unprotected sex. Hepatitis C virus is one of the most prevalent viral infections acquired by blood transfusion, with about 2.7 million people in the United States having chronic HCV.
Hepatitis D is also referred to as delta hepatitis. It is a severe liver disease as a result of the hepatitis D virus, or HDV. Hepatitis D virus is a rare case of hepatitis, obtained conjointly with hepatitis B, through infected blood transfusion. Unlike Hepatitis B, HDV rarely occurs in the United States.
Hepatitis E is derived from the hepatitis E virus, or HEV. Hepatitis E disease is water borne, normally caused by ingesting feces. HEV usually affects regions lacking proper sanitation, such as Central America, Africa, Middle East, and Asia. Alternatively, it is highly unlikely to be found in the United States.
Viral hepatitis treatment varies from case to case, influenced by type of hepatitis and stage of the infection. Hepatitis B and C have become more easily treatable in the last few years with continued research and advanced treatment options. Hepatitis should be properly assessed and treated by a gastroenterologist.
Jaundice is the yellowing of the skin and eyes due to inflammation of your liver or obstruction of the bile ducts. This conditions requires a prompt consultation with a gastroenterologist. See your doctor at the earliest onset as this sign may suggest a serious condition.
Pancreatitis is inflammation of the pancreas. The pancreas is an organ that makes digestive enzymes and insulin. It can get inflamed due to obstruction by a gallstone, medications, high triglycerides in the blood and alcohol, aside from other rare causes. Inflammation of the pancreas could either be acute, chronic or even recurrent.
Like any other organ in the body, the pancreas can develop cyst or fluid collections. There are several types of pancreatic cysts. However, some cysts can become cancerous. The detection and treatment of these precancerous cysts can help prevent their progression into pancreatic cancer. At San Antonio Gastroenterology Associates, we offer a comprehensive evaluation of the pancreas and provide a program for the surveillance of these precancerous conditions of the pancreas.
Celiac disease is a chronic autoimmune condition where the body produces antibodies to gluten. Gluten is a protein found in wheat, barley, and rye. The antibodies then attack and cause damage to the lining of the intestines causing malabsorption and the symptoms associated with celiac disease.
The symptoms for celiac disease are often subtle and varied among individuals with celiac disease. These include:
- Iron deficiency
- Pain in bones or joints
- Bone loss or osteoporosis
- Tingling numbness in hands and feet
- Erratic menstrual periods
- Skin rash
- Mouth sores
Celiac disease is hereditary, meaning that it runs in families. People with a first-degree relative with celiac disease (parent, child, sibling) have a 1 in 10 risk of developing celiac disease.
If you have celiac disease, you cannot eat any foods that contain gluten such as wheat, rye, barley, and oats. Excluding gluten from your diet usually alleviates the condition within a few days and eventually ends the symptoms of the disease. Typically, the villi recover within six months.
In order to manage symptoms, you will have to continue this diet for the rest of your life. Eating gluten can damage your intestine and restart the problem.
Some people with celiac disease have such severe damage to their intestines that a gluten-free diet will not fully resolve their symptoms. These patients may have to receive other treatments such as medications or nutrition supplements provided through their veins.
The job of the body’s immune system is to identify and destroy bacteria and viruses that cause illness. Food allergies result when the immune system falsely perceives a harmless food protein, an allergen, as a threat and attacks it. Food allergies cause your immune system to generate an abnormally large amount of antibody known as IgE. These antibodies attack the food allergens by releasing histamine and other chemicals, provoking symptoms of an allergic reaction. A gastroenterologist can perform certain diagnostic tests to help you identify which foods you may be allergic to.
Food sensitivities, also called food intolerance, differs from food allergies. Food allergies trigger the immune system, while food intolerance does not. Food intolerances are digestive problems triggered after eating certain foods, but the immune system does not react, meaning a histamine response is not prompted. Food sensitivities are difficult to diagnose and require the patient to pay careful attention to his or her diet and the foods that trigger a reaction.
Reactions related to a food intolerance are often subtle, such as gas or mood changes that occur within hours of eating a particular food or ingredient. Dietary changes—identifying and eliminating the trouble foods–are the only treatment for food sensitivities.
Diarrhea that lasts more than 4 weeks is “chronic diarrhea.” You usually need to see a gastroenterologist so she or he can perform diagnostic procedures to help find the cause and provide the appropriate treatment.
Constipation refers to infrequent bowel movements or difficulty passing bowel movements. Constipation is usually associated with painful defecation. Severe constipation occurs when one is not able to pass stool or gas, called fecal impaction. This can progress to bowel obstruction and become a serious condition.
Helicobacter pylori (H. pylori) is a type of bacteria. H. pylori can infiltrate and settle in your digestive tract, subsequently causing ulcers in the lining of your stomach or the upper part of your small intestine after many years. This infection can even lead to stomach cancer for some people.
An infection with H. pylori is not uncommon. Roughly two-thirds of the world’s population is infected with H. pylori, yet for most people, it doesn’t cause ulcers or any other symptoms. If you have an ulcer, you may feel a dull or burning pain in your belly.
There are medications that are able to eliminate the H. pylori bacteria and help ulcers heal. A board certified gastroenterologist can help with diagnosis and treatment of H. pylori infection.
Esophageal manometry is a procedure to measure the movement or function of the esophagus. This test is performed mostly in patients with swallowing problems. When the test is conducted, the lower esophageal sphincter, and the esophagus muscles are examined via esophageal manometry. This determines the esophageal sphincter’s ability to restrict backflow of gastric acid into the esophagus, as well as if the esophagus is capable of pushing food down to the stomach properly.
Individuals who have trouble swallowing or consistently experience heartburn or nausea after eating may need an esophageal manometry to determine the cause of these symptoms. An Esophageal manometry allows your gastroenterologist to determine if the esophagus is contracting and relaxing properly.
SERVICES & PROCEDURES
Capsule endoscopy allows a gastroenterologist evaluate the small intestine in detail. This procedure photographs the digestive tract with a wireless camera located within an easy to swallow, pill-sized capsule.
For the most accurate, secure inspection, gastroenterologists usually request patients to refrain from eating or drinking anything twelve hours prior to the exam. Your gastroenterologist will inform you of when to begin fasting. Before your capsule endoscopy, your gastroenterologist may require a bowel prep, or cleansing. Contact your SAGA gastroenterologist if you have questions about preparing for your capsule endoscopy procedure.
A colonoscopy is a diagnostic procedure performed by a gastroenterologist in order to assess the health of your colon, as well as check for ulcers, polyps, tumors, inflammation, or bleeding.
Endoscopic mucosal resection, also known as EMR, uses an upper endoscope and other special tools in order to cut out the abnormal looking portion of the esophagus. It is then removed because it has the potential to become esophageal cancer. This procedure is a treatment option for Barrett’s esophagus.
Endoscopic ultrasound, or EUS, uses ultrasound to capture high quality images of the lining of the upper digestive tract (esophagus, stomach, and first part of the small intestine). It also takes photos of the nearby organs such as the liver, gallbladder, pancreas, and surrounding lymph nodes.
Esophageal banding is a life-saving procedure to stop bleeding from esophageal varices. Esophageal varices are veins in the esophagus that have become wider and larger due to blockage in the flow of blood to the liver and or spleen.
Gastroenterologists use pH probe studies to diagnose, and treat chronic acid reflux by implanting a thin tube into the esophagus. Over 24 hours, the frequency or acid reflux into the esophagus can be evaluated objectively.
Radiofrequency ablation RFA uses heat produced from high energy radiofrequency waves delivered to the lining of the esophagus using a special catheter to destroy cancerous or pre-cancerous cells. The special catheter is inserted into the esophagus using an upper endoscope. This is a treatment option for the condition, Barrett’s esophagus.
During an upper endoscopy (also called an EGD, gastroscopy, or esophagogastroduodenoscopy), your gastroenterologist will use a small, bendable lighted tube, inserted through the mouth, to closely examine the lining of your esophagus, stomach, and the top portion of your intestines, known as the duodenum.
The initial cost of the Ideal Protein program is $377. This includes your first consultation, a starter gift bag, your first week of food, and two months’ worth of supplements, plus the specialized Ideal Protein salt and an Ideal Protein shaker. Weigh-ins are once a week with a nutrition consultant. Food costs vary based on selection each week and additional supplements may need to be purchased based upon your weight loss goals.
No, anyone looking to eat and live a healthy lifestyle can join the Ideal Protein program. You do not have to be a SAGA patient to join.
Call 210-242-0014 or visit the Ideal Protein page and click the “Get Started” button to submit your information to be contacted by a nutrition consultant.
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