Paggie Natalie

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Physicians & Surgeons, Family Medicine & General Practice, Physical Therapists, Physicians & Surgeons

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Mon - Fri:	9:00 am - 5:00 pm

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Categories: Physicians & Surgeons, Family Medicine & General Practice, Physical Therapists, Physicians & Surgeons, Physicians & Surgeons, Allergy & Immunology, Physicians & Surgeons, Dermatology, Physicians & Surgeons, Emergency Medicine, Physicians & Surgeons, Endocrinology, Diabetes & Metabolism, Physicians & Surgeons, Gastroenterology (Stomach & Intestines), Physicians & Surgeons, Gynecology, Physicians & Surgeons, Internal Medicine, Physicians & Surgeons, Otorhinolaryngology (Ear, Nose & Throat), Physicians & Surgeons, Psychiatry, Physicians & Surgeons, Surgery-General

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Phone: (925) 943-4900

Address: 365 Lennon Ln Ste 230, Walnut Creek, CA 94598

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Paggie Natalie

General Practitioners

Arthritis
Medical Weight Loss
Generally, it’s a good idea to consult a doctor if you’ve gone more than 3 days without passing stool, as this could be a sign that something is wrong with your colon. Normal bowel movements are characterized as easily passing formed stools that aren’t too hard or sharp and that have a clean color (without blood or excessively dark coloring). If you have more serious symptoms, such as severe abdominal pain, bleeding, or sudden, unexplainable weight loss, you probably do not have IBS but should contact a GI doctor immediately.
Ear Infections
Because vomiting is a symptom and not a disease itself—there are various causes. Sometimes vomiting is triggered by certain medication, especially antibiotics. Other times, headaches, ear infections, brain tumors and any conditions that cause the pressure inside your head to increase may make you vomit. Simply being sick or pregnant oftentimes makes patients nauseous as well, which results sometimes in vomiting. In gastroenterology, your GI doctor may detect any of the following conditions as the culprit of your vomiting: acute gastritis (inflammation of the stomach tissue or lining), gallbladder disease, inflammatory bowel disease, delayed gastric motility, pancreatitis, bowel obstruction or cancer.
Emergency Care
If gallstones are causing duct blockage between your liver and your gallbladder, you may feel slight pain or cramping on the right-hand side of your abdomen. This condition is specifically referred to as choledocholithiasis, and the pain patients feel is called biliary colic. Biliary colic usually goes away once the stone passes, but if it’s too big to pass through, you may need to surgically remove it. Pain associated with gallstones varies greatly from person to person—it can be sharp and sudden or constant and dull. If a blockage such as this occurs for considerable amount of time you can develop fevers or chills, which can be a sign of infection in the gallbladder or common bile duct and needs immediate evaluation in an emergency department.
Colonoscopy
A colostomy procedure is usually performed the patient has been diagnosed with severe infection or disease in their large intestine, such as colorectal cancer or perforated diverticulitis detected during colonoscopy. The colostomy procedure involves actually opening up the large intestine via intensive surgery and relocating it outside of the body, where a bag is attached for stool to drain into.
Constipation
Irritable Bowel Syndrome
Irritable bowel syndrome, or IBS, is a very common gastrointestinal (GI) disorder that affects patients of any age and sex. It is not a serious disease but the symptoms can be a burden to those who are diagnosed with it. If you notice frequent bouts of cramping, abdominal pain, bloating, gas and changes in your overall bowel routine, you may be diagnosed. Each case of irritable bowel syndrome differs, so don’t be alarmed if all your symptoms do not match up. While some patients find that IBS causes frequent diarrhea, others may find that it makes them constipated and having a bowel movement is difficult or painful. Even still, some IBS patients will experience both.
Urinary Incontinence
Urinary incontinence, commonly known as an overactive bladder, is marked by a loss of control over your own bladder. Sometimes this can mean that urine leaks from your body from time to time, but it can also mean a complete loss of bladder control which causes you to wet yourself often. Urinary incontinence can affect patients at any age but is particularly common among older patients.
Diarrhea
Fecal incontinence is similar to urinary incontinence, but involves your ability to control your bowel and pass stool properly. Fecal incontinence, also called bowel incontinence, can cause leakage of feces from your rectum suddenly or unexpectedly, or when you pass gas. In more severe cases, fecal incontinence can mean a total inability to manage of the bowel muscles, which causes patients older than toddlers to expel fecal matter at inappropriate times uncontrollably. Patients who have had surgery for hemorrhoids or rectal cancer sometimes experience fecal incontinence after their procedure.

Endometriosis
Endometriosis —women who are having trouble getting pregnant may undergo laparoscopic surgery for diagnostic purposes, to check for endometriosis or inflammation in their pelvic organs. These procedures are usually done after fertility tests suggest the presence of cysts, fibroids (tumors in the uterus), infection or abdominal adhesions (bands of tissue that form in the body and prevent organs from shifting easily around one another) may be preventing proper fertilization. Of all these conditions, endometriosis is the most physically painful, as it sometimes results in bleeding, and tissue may need to be treated with laparoscopic surgery.
Pregnancy

Internal Medicine
Gastroenterology
If you ask your very own GI related question to Gastroenterology.com, your question will be sent directly to gastroenterology specialists. These experts can then provide a completely free answer. Gastroenterology.com questions are typically answered within a few business days. However, our gastroenterologist network isn't required to answer medical questions. Therefore, there is a chance that your question may go unanswered. If your question goes unanswered, feel free to search for, and contact, a local gastro who may be able to offer an answer to your question.
Bladder Cancer
Cancer —laparoscopy can be used to check if abdominal cancers such as stomach cancer, kidney cancer, liver cancer, pancreatic cancer and gallbladder cancer have spread to other parts of the abdomen.
Urology
The causes of urinary incontinence range from prostate problems to nerve damage in your bladder muscles. Your primary doctor will be able to determine the necessary forms of treatment after a consultation about the specific cause of your case. Accordingly, incontinent patients have been treated with several different methods, which can include options such as physical exercises, external devices or medication. Surgery is available but very rarely used unless the urinary incontinence is causing infection to other health complications for the incontinent patient. Urinary incontinence is usually managed by a urology specialist.
Kidney Cancer
Colon Cancer
Liver cancer, also referred to in medical terminology as hepatocellular carcinoma, is a tumor made up of harmful cells that develops in a person’s liver. It affects more men and than women, mostly in patients older than 50. Although in the United States other related cancers such as colon cancer and pancreatic cancer are much more of a cause for concern, developing nations in Africa and Asia are quite affected by liver cancer due to the higher rates of hepatitis B and C infection in those countries.
Endoscopy
Doron Kahana, M.D. is a gastroenterologist who has been met with positive responses from both doctors and patients for his unorthodox reliance on medical nutrition, along with regular endoscopy, to treat patients with gastrointestinal disease. He recently opened a private clinic—called the Center for Digestive Health and Nutritional Excellence (CDHNE)—where patients are monitored with dietary logs and analytic dietary consultations and given recipes that encourage a regular diet of plant-based products and a high intake of pre-biotics. He also practices at Torrance Memorial Medical Center and Providence Little Company of Mary Medical center in Torrance, California.

Depression
Anxiety

Endocrinologist

Diabetes Care

Ultrasound
If the results of a gallbladder ultrasound or gallbladder scan show that a patient has gallstones or inflammation of gallbladder tissue, surgery may be necessary for treatment. Although surgery is often turned to only as a last resort, having the whole gallbladder removed is the only way to ensure effective treatment of gallbladder disease. While minor changes to one’s diet and lifestyle may temporarily relieve a patient’s symptoms—gallstones will not go away naturally. Having the entire gall bladder removed does not greatly affect the body’s ability to digest food.
MRI
Gallbladder ultrasounds are performed by radiologists, who are medical doctors that are experts in diagnosing diseases by looking at medical images such as x-ray, MRI (magnetic resonance imaging) and other scans. Sometimes, the actual technician doing the procedure will be a sonographer (an ultrasound expert), but a radiologist will always be the the one to interpret the images.
Radiology
X-rays are taken at a radiology center or a doctor’s office with access to the proper equipment. The patient will stand in front of a special machine and drink a barium solution, a semi-thick liquid designed to make the lining of the upper GI tract show up as a bright, white color on the final image. A technology called fluoroscopy (an x-ray video) allows for viewing of the liquid as it moves downward and coats the patient’s throat, stomach and intestines. If the patient moves around—which he or she may be asked to do—the liquid will visibly move around on the x-ray monitor.
X-Rays
Computed Tomography
While CT scanning is often used to scan bone structures, such as the skull or the spine, a gastroenterologist would order a CT scan to examine the chest and abdominal areas for problems relating to the body’s digestive system. Common gastroenterological (GI) organs scanned by CT include the kidneys, the liver, the pancreas, the gallbladder, the spleen, the aorta, the ovaries, the uterus and the large and small intestines.
Chemotherapy
As with most cancers, early detection is the most important step of preventing liver cancer. However, most patients don’t catch the disease until they notice severe symptoms, in which case the cancer is most likely already spreading. Treating liver cancer completely means removing the affected portion of the liver with surgery altogether. Sometimes doctors will deliver chemotherapy directly into the liver by using a device called a catheter—but, in general, this only controls the symptoms and slows down the cancer, not cures it. Unfortunately, this latter method of treatment is the only option for almost 90 percent of liver cancer patients. There is also a newer technique which uses radiofrequency ablation directly to the liver tumor, and obliterates the cancer cells directly. There are some forms of systemic chemotherapy available for liver cancer, but their effectiveness is not great. Depending on the individual case, liver cancer can be fatal within 5 months. In order to work toward prevention and ensure early detection of liver cancer, most doctors recommend that patients should avoid drinking alcohol and prevent contraction of hepatitis with vaccines if you are concerned about liver health.
Radiation Therapy
Available treatment options for stomach cancer depend on where the cancer is located in the stomach and how deep into the tissue and into other organs the malignant cells have spread. To remove the cancer completely, stomach removal surgery (gastrectomy) needs to be performed. Although chemotherapy and radiation therapy may help control a patient’s symptoms, it will probably not cure the entire cancer. Once the cancer moves past the stomach, to other organs, the chance that a cancer patient will survive decreases greatly. Contact a medical specialist if you or someone you know needs helping with stomach cancer symptoms.

Laparoscopy
Laparoscopy is a type of surgery which utilizes small cameras and mechanical devices at the end of small ports which can be inserted through tiny incisions into body cavities such as the abdomen or chest. It is a much less invasive operation than open surgery and is often preferred by doctors and patients alike. It usually is more cost efficient and causes less inconvenience for patients in terms of stress and recovery time.

Plastic Surgeons

Laparoscopic Surgery
Although open gallbladder surgery does exist, it is much more common these days to undergo a laparoscopic gallbladder removal, also known as laparoscopic cholecystectomy. Laparoscopic surgery requires a smaller incision, results in less post-procedural pain and has a reportedly quicker recovery time. The procedure is commonly performed in the United States.

Skin Cancer
Many internal biopsies are performed with minimal invasiveness for the patient. A doctor can use modern imaging technology such as CT scan or ultrasound equipment to give the doctor a view of the inside of the body while he or she guides tools inside. For patients at risk for skin cancer, doctors often perform punch biopsy using a small, rounded blade in order to extract a tiny, cylinder-shapes skin sample. Oftentimes, a GI doctor can even access internal organs such as liver by simply injecting a long needle into the patient’s back or stomach. In more serious cases when a part of the body that is hard to reach needs to be tested with biopsy, open surgery or laparoscopic surgery may be needed to obtain the tissue biopsy.
Cyst
Ulcer
Upper GI series are usually ordered in response to patients’ complaints of dysphagia (difficulty swallowing), nausea or vomiting that persists for more than 2 weeks. The idea is that growths or other abnormalities in the throat, stomach and small intestine can keep a person’s digestive system from processing food easily, either by blocking the food content’s path through the GI tract or making food digestion a painful task. For example, an ulcer (an open sore on the inside of the body) located in the esophagus may be irritated whenever a person eats, which may cause uncomfortable symptoms and worsen if the ulcer is left unattended. Patients who suffer from gastroesophageal reflux disease (also known as GERD or acid reflux disease) often undergo upper GI series, as well, so doctors can check for underlying medical causes.
Lesions
Any irregular areas found during such tests are usually referred to as lesions or masses. In some cases, growths are cancerous cells that must eventually be removed with chemotherapy or surgery if a biopsy concludes that the mass or lesion is cancer. On other cases, a negative biopsy result might conclude that the growth is benign. Biopsies can also identify infections and some autoimmune disorders. The testing of tissue samples is usually done in a laboratory by pathologist, a doctor who specializes in diagnosing patients based on microscopic examination of the collected tissue.
Rashes

Physical Therapists

Physical Therapy
Possible treatment options include physical therapy to exercise your throat muscles, therapeutic endoscopy to dilate your throat using a balloon or medications to ease the symptoms of GERD and regulate acid production in your stomach. Surgery is only necessary to remove tumors in dysphagia patients. Contact a GI doctor for a consultation if you have trouble swallowing.

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