Alfred E. McNair, Jr., M.D., a Board-Certified Gastroenterologist completed his medical and specialty training at Stanford University and Columbia University. Dr. McNair has been in medical practice on the Mississippi Gulf Coast since he founded the Digestive Health Center 1980. Dr. McNair sees patients in his offices in Gulfport, Biloxi, Ocean Springs and Pascagoula. Dr. McNair performs colonoscopies, esophagogastrodeudenoscopies, as well as the newest procedures, Enteryx, EndoCinch and Bravo. Dr. McNair also specialized in diseases of the liver and hepatitis illnesses. Dr. McNair takes pride in his continuing quality of care of each patient. His experience, knowledge and training provide patients with the confidence they need when selecting a Gastroenterologist.
Submitted by Scott Williams from Lucedale, MS
Q: I am a 65 year old male with a history of swallowing problems. After extensive testing over a couple of years my gastroenterologist has diagnosed me as one of the lucky? 2000 people in the USA to suffer from Agchlacia. He says my options are laproscopic surgery to cut the esophogeal sphincter or botox injections into the area. What do you think?
Answered 02/20/08 15:23:37 by Alfred McNair
A: As you are probably aware, achalasia is a disease of unknown cause in which there is loss of movement in the esophagus and a failure of sphincter relaxation. Difficulty swallowing are the primary features as well as difficulty belching, weight loss, chest pain, heartburn, sensation of lump in throat, hiccups and regurgitation. First off it is important to address that there is no definitive therapy to reverse or halt the process which causes achalasia. All current treatments are aimed at decreasing the pressure of the sphincter. Both surgical myotomy and botox injections are viewed as alternatives to dilation and as with any invasive procedures, it is best to discuss your risks and benefits with your gastroenterologist. Approximately, 50% of patients who are treated initially with a single dilation will require further therapy within 5 years. Surgical myotomy or botulinum toxin injections are generally considered in patients who have failed approximately 3 sessions of dilation. The botulinum toxin injection efficacy has ranged from 65 to 90% after one injection, lasting anywhere from three months to more than one year. Your treatment options should take into account factors such as your age, expectations and risk factors.Submitted by chris walker from farmington, michigan
Q: I have had diarrhea for nearly 8 years. This past year a gastrointerologist has been actively attempting to find the cause. I have had many tests including a bacterial overgrowth test which returned negative. He has tried strong antibiotics (two different ones) a round of steroids and i have tried Activia. Each of these "treatments" have cured the problem but only for about a two week period. After that the diarreah returns (watery and gassy). It appears that something in my system overcomes these treatments in a short time. Any suggestions?
Answered 02/18/08 16:43:52 by Alfred McNair
A: Chronic diarrhea is a result of many potential causes including but not limited to irritable bowel syndrome, inflammatory bowel disease, bacterial overgrowth, lactose intolerance or other food allergies, and nonspecific colitis. Assuming that you have undergone workup which includes a colonoscopy with biopsies, EGD, Given's capsule endoscopy to assess the small bowel, laboratory and fecal studies, it appears that the treatment regimens previously prescribed are appropriate short term for nonspecific colitis. This may be why you are experiencing relapse in symptoms versus medication resistance. Of great importance, is dicussing with your physician the diagnosis regarding the cause of your diarhea and carefully assessing any other significant medical issues such a an evaluation of your current medications and surgical history such as removal of your gallbladder. There are various tailored treatment options for particular causes of diarrhea and it is best to discuss your observations with your physician.Submitted by Anonymous from Long Beach. MS
Q: What is happening if everytime you eat lettuce, you get dirraher for several days? At this point, lettuce is the only thing this occurs with. I love salads and have not been able to eat them. It takes days of imodiom to stop the dirraher. I am a 28 year old female, no other health problems
Answered 02/18/08 16:36:35 by Alfred McNair
A: Many individuals with irritable bowel syndrome will identify with certain trigger foods. The most common categories are caffeine, carbonated beverages, insoluble fiber, alcohol and high fat foods which will act as GI irritants or stimulants. It is of great importance to undergo thorough evaluation of your diarrhea to rule out other causes such as inflammatory bowel disease and food allergies for example. This may include a thorough diet history, laboratory studies, elimination diet and often a food challenge diet. Generally, lettuce alone in moderate amounts is not considered to be a GI irritant or has been identified as being highly allergenic. The toppings and condiments typically consumed with salads, particularly those including lactose or having high fat content would more than likely be the causative factors. Monitor your toppings and carefully rinse any lettuce before consuming.Submitted by susie from No location specified
Q: my bowel was white looking and now it has a little bit of yellow color why is this
Answered 02/18/08 16:29:04 by Alfred McNair
A: Generally, stool color changes are a result of your diet. However, if your stool lacks the normal color for more than a couple of days, it is important to notify your physician and seek medical attention. Pale stools can indicate a problem with your biliary system caused by disorders such as liver, gallbladder or pancreas problems.Submitted by Anonymous from Biloxi
Q: My question is what could be a common cause for the following Symptoms: 1. Bloating feeling.. Pain in left side of abdomen 2. Constant belching...(with very foul smell) 3. Constantly expelling gas (mostly has to be forced out) 4. Current medications (mobic, flexerall, loritab 7.5 and ultracet) used to treat current Lower Back pain and shoulder injury.. 5. No diet changes in last 6-8 months... problem off and on x 6mo
Answered 02/18/08 16:22:50 by Alfred McNair
A: The changes you are experiencing with your bowel habits are likely consistent with irritable bowel syndrome with constipation. The medications used to treat your low back pain will significantly slow the transit time of your gastrointestinal tract. However, any new changes in your bowel habit should be assessed by your physician to exclude other causes such as mechanical bowel impairment like colon cancer, electrolyte or hormonal abnormalities, neuromuscular bowel impairment, inadequate fluid intake, dietary causes or diverticular disease.Submitted by pink diamond from Biloxi, MS
Q: Doctor, I have a personal gastroenterologist. She had me on zelnorm, after being diagnosed with IBS and acid reflux. The zelnorm was too strong. I have had constipation problems all my life, beginning in my VERY early childhood. No matter how many visits i had to my gastroenterologist, they never seemed to fix or prescribe anything that would help. I'm a female at the age of 22, by the way. I never am able to relieve myself fully in the restroom. I keep alot of fiber in my diet, watch my caffiene intake, and i even take supplements....nothing has worked. What do you suggest??
Answered 02/12/08 19:26:02 by Alfred McNair
A: I recommend that you see your physician for evaluation of bowel motility and further evaluation of your symptoms. There are a number of treatments for IBS that you and your physician can discuss. It may be necessary to try more than one combination of treatments, in order to find the one most beneficial to you. However, all other causes of constipation need to be explored, including bowel motility disorders and metabolic dysfunction.Submitted by Diane from Biloxi
Q: My 18 yr old son tested positive for influenza A last Dec. He lost 15 lbs in one month. Since getting the flu he continues to suffer from constant nausea, which is driving him crazy, and interferring with his college studies. The feeling is located in the upper abdomin area or mid torso. He has seen 5 doctors (1 fam,1 internist,2 gastro,1 ENT), had 2 endoscopes, multiple blood tests, MRI, Cat Scan etc. All negative. We would like to find "Dr. House" any suggestions? How can we get him into Oschners in NO? Could it be PTSS?
Answered 02/12/08 19:23:10 by Alfred McNair
A: It sounds as though your son has had quite a thorough evaluation. A referral can be made by your physician to another facility, if you and your physician feel this is warranted. I recommend that you continue symptomatic treatment for your son's symptoms to help maintain his quality of life, while further evaluation is pursued.Submitted by Anonymous from No location specified
Q: i have been diagonist with c difficle i have taken two round of vancocin. but i still have lots of stomach cramps. will this go away .does it just take time. and will it come back again
Answered 02/12/08 19:21:02 by Alfred McNair
A: Relapse is possible in patients whom are treated for c. difficile. Some risks for recurrence include: prolonged antibiotic use, hospitalization, age greater than 65, and diverticulosis. Patients with a history of relapse have a higher risk of recurrence. A reculture may be warranted to rule out drug resistance. However, other causes of abdominal pain and diarrhea should be considered, and you should follow closely with your physician.Submitted by Anonymous from No location specified
Q: I recently had an ultrasound done and was told there was something in my gall bladder..I also had a HIDA scan done and the techs could not see my gallbladder at all....My primary Doc. still has not done anything about this is this normal.....Why is my gallbladder stopped working?
Answered 02/12/08 19:17:48 by Alfred McNair
A: Failure to opacify the gallbladder during HIDA examination may be secondary to gallbladder or liver disease. Due to the limited information available to me, it is unclear as to other symptoms associated with your problem. I would recommend further evaluation. Other studies that may be useful in this circumstance are MRCP and gallbladder ultrasound with fatty meal stimulus. I encourage you to seek further evaluation by a gastroenterologist.Submitted by concerned from biloxi,ms
Q: Dr. mcnair, I have been experiencing a seriously bad case of constipation and energy loss, sleeplessness. Last week i didnt have a BM in 7 days and took laxatives and fiber to help. I took the laxatves, which took like a day and half to work. i started to get extreme cramping, sweating and lots of going sensation but no going for the 1st day. then i finally had a few BM back to back, ate very light and full of fiber for the past week, lots of water and the benefiber and still nothing again in the past three days. i get the sensation to go, but nothing and im afraid to strain because of the damage that can cause. What should i do? is there anything i should be looking for?
Answered 02/12/08 19:14:56 by Alfred McNair
A: There are many causes of constipation. A thorough evaluation by a gastroenterologist is warranted to determine the cause of constipation. This should include bowel motility evaluation. In the interrum, make note of any medications that may worsen constipation, make note of the color of your bowel movements, stool size and frequency. Also, be sure that you are eating enough fiber and calories and drinking plenty of flluids. Maintaining adequate exercise will also assist with bowel motility.Submitted by Scorpion from Karachi
Q: i am 18.i have a very smal hole 3,4 inches above my anus toward my back..i think it bleeds but there is no pain at all.i am very worried plz help.i dont want to go to the doctor.
Answered 05/08/07 19:31:55 by Alfred McNair
A: Dear Scorpion, This needs to be looked at by a physician. Your physician can do the proper evaluation and treatment.Submitted by lynn from enid, ok
Q: I feel like I am falling apart, i have insulin resistance, pcos,now i am extreamly tierd all the time even if i get enough sleep! i hurt all over, my neck & back hurt, i have tendonitis alot, just had my first throat spasam, burinig and tingling in my feet, hands, and arms, no energy,weight gain of 30lbs in 1 year,no changed eating habits(had gastric bypass 3 yrs ago)thyroid is stable with meds for years, help me!!
Answered 05/08/07 19:29:54 by Alfred McNair
A: Dear Lynn, This sounds like something that needs to be looked into in much more depth than one can do justice to over the internet. I would suggest that you make an appointment with your primary care physician. They can steer you in the right direction as to what tests, specialists, etc that you need. Thanks.Submitted by Ken from New Orleans, La.
Q: I had an endoscopy done and they found the following: erythema in the antrum and erythema in the lover third of the esophagus. What does this mean?
Answered 05/08/07 19:23:03 by Alfred McNair
A: Erythema means inflammation in those parts of the antrum and esophagus.Submitted by twin from dyt oh
Q: what is erythema in the antrum (biopsy)?????
Answered 05/08/07 19:19:18 by Alfred McNair
A: This means redness (inflammation) in the lower part of the stomach.Submitted by baldie from NEW SMYRNA, FL
Q: I've had a burning tongue with fluid backing into my throat for 2 years. Discomfort under breastbone which gets worse on empty stomach. Constant feeling of hunger. Some pain near heart occasionally at nite. Reflux begins in a.m. and gets progressively worse throughout the day. ENT recently confirmed my throat is burned. Nexium, Prevacid and Aciphex have not helped. Endoscopy with chip nearly two years ago showed no significant reflux. Had gallbladder removed without success. ENT's send me to Gastro. Gastro's sent me back to ENT's. On waiting list for Mayo 8 mos. as they see it not medically urgent. Please advise?
Answered 05/08/07 19:14:41 by Alfred McNair
A: The patients age would be helpful in this situation, but some common causes of rectal bleeding would include diverticulosis, colon cancer, polyps, colitis, angiodysplasia, and hemorrhoids. If an EGD, colonoscopy, and givens capsule have not been done, they may be warranted to evaluate the entire GI tract for a possible cause. In any case of rectal bleeding, it is important to identify specific etiology given the wide range of possible causes. I would recommend following up with a local gastroenterologist for evaluation.
