Welcome Dr. Neal Schamberg
 

The Center for Gastrointestinal Medicine of Fairfield and Westchester, P.C is excited to welcome Neal J. Schamberg, M.D. to our practice. Dr. Schamberg grew up in Rockland County, New York. He graduated Magna cum Laude with a B.S. in Biology from Duke University in Durham, North Carolina. During his time in college, Dr. Schamberg worked in research laboratories at Harvard University and Duke University. His work at Duke University was published in the prestigious Journal of Biological Chemistry.


Dr. Schamberg graduated with an M.D. from the University of Pennsylvania School of Medicine in Philadelphia, Pennsylvania. Having graduated in the top of his class, he received the distinction of induction into the Alpha Omega Alpha Honor Society. Dr. Schamberg’s interest in gastroenterology began while in medical school. He published an article in the field with his mentor at the University of Pennsylvania. His research in a novel endoscopic therapy for gastroesophageal reflux disease (GERD) was presented at an international gastroenterology meeting in 2003. These experiences lead him to pursue a career in gastroenterology.


Dr. Schamberg completed his internship and residency in Internal Medicine at New York Presbyterian Hospital/Weill Cornell Medical Center in New York City. He subsequently began his Gastroenterology and Hepatology fellowship at New York Presbyterian Hospital/Weill Cornell Medical Center. As a fellow, Dr. Schamberg developed research interests in cystic neoplasms of the pancreas and inflammatory bowel disease (IBD) – Crohn’s Disease and Ulcerative Colitis. His research results were published at three international gastroenterology meetings. In 2008, Dr. Schamberg had the honor of presenting his research in IBD at the North American Conference for Gastroenterology Fellows in Orlando, Florida.


Dr. Schamberg has written a chapter in the only textbook on Video Capsule Endoscopy. He has published several other articles in peer reviewed journals and presented numerous abstracts at gastroenterology meetings. He was an instructor at the 2009 New York City regional course on radiofrequency ablation of Barrett’s Esophagus.


Dr. Schamberg’s clinical interests include a wide variety of gastrointestinal (GI) inflammatory, pre-malignant and malignant conditions, such as cystic neoplasms of the pancreas (pancreatic cysts), pancreaticobiliary diseases, Barrett’s Esophagus and esophageal cancer, Crohn’s disease, Ulcerative Colitis and colorectal cancer screening. Dr. Schamberg performs all general endoscopic procedures, ie. Colonoscopy, Upper GI Endoscopy, and has obtained additional training in Endoscopic Ultrasound with Fine Needle Aspiration (EUS-FNA), Endoscopic Retrograde Cholangiopancreatography (ERCP), Video Capsule Endoscopy, luminal stent placement for the palliation of GI malignancies, and ablation techniques for Barrett’s Esophagus (ie. BARRX, cryotherapy).


Dr. Schamberg is the first gastroenterologist to perform EUS-FNA at Greenwich Hospital. EUS allows for highly accurate evaluation of a wide variety of diseases of the GI tract including staging cancers of the esophagus, stomach, pancreas, and rectum. FNA is a biopsy technique performed through the endoscopic instrument that allows for a less invasive means of diagnosis, such as surgery. To learn more about Endoscopic Ultrasound click here www.medicinenet.com/endoscopic_ultrasound/article.html


The Center for Gastrointestinal Medicine of Fairfield and Westchester, P.C is thrilled with the addition of
Dr. Schamberg’s expertise into our practice and our community.

 

  
Addressing your Questions about Flat Polyps
 

Many of our patients have asked us about the significance of flat or slightly depressed polyps that are occasionally found at colonoscopy. Their concern stems from a well-publicized paper published in JAMA (the Journal of the American Medical Association) in March of 2008 by Dr. Roy Soetikno et al. of the Veterans Affairs Palo Alto Health Care System in California. In that study of 1819 male military veterans, it was determined that over 9% had flat polyps. The investigation suggested that the incidence of cancer or pre-cancerous tissue in these lesions was increased when compared to the more common raised polyps, perhaps by a factor of five. Most importantly, the study implied that such polyps are likely to be more difficult to spot than raised polyps, because they may be less distinguishable from the surrounding colon tissue. In addition, because the bowel preparation may be less than perfect in about 25% of patients, flat lesions may be more difficult to see.


The doctors at the Center for Gastrointestinal Medicine of Fairfield and Westchester have long been aware that some patients will be found to have flat or depressed polyps on colonoscopic exam and that, therefore, all colons must be very carefully screened for the presence of these lesions and polyps that have a more typical raised appearance. All polypoid growths in the bowel are removed during our examinations and evaluated by a trained pathologist. Since colorectal cancer kills over 50,000 people nationally, it is of extreme importance that patients are regularly screened for all types of polyps with malignant potential, and that they return for follow-up examinations when contacted to make a return visit.


The greatest importance of the Soetikno study lies in its reinforcement of the need for colonoscopy. It also emphasizes the importance of following the preparation guidelines, thereby affording the physician the most complete view of the bowel walls and the greatest likelihood of finding and removing even the most miniscule and difficult to see polyps. It also raises questions about the sensitivity of virtual colonoscopy, or CT colonography, a method of scanning the colon for polyps. It is likely that radiological techniques are not as sensitive as direct visualization of the bowel in differentiating flat polyps from the surrounding colon surface. In 2008, colonoscopy remains the best way to screen the colon for polyps of any size and shape

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The Center for Gastrointestinal Medicine of Westchester and Fairfield will continue to provide our patients with skillfully performed colonoscopic examinations. As always, we will be happy to answer any questions that you might have about polyps and other conditions related to the health of the gastrointestinal system.
   
 
   
   
   
   
   
 
Gastroenterology News - March 2007
 

An article published in the December 27, 2006 issue of the Journal of the American Medical Association entitled “Long-term Proton Pump Inhibitor Therapy and Risk of Hip Fracture,” has presented some interesting and potentially important observations regarding the use of such “proton pump inhibitors” (PPIs) as Prilosec, Protonix, Aciphex, Prevacid and Nexium, medications that many of our patients use to treat symptoms of acid reflux, gastritis and peptic ulcer disease.

The study, which was done in England, reviewed the cases of over 13,000 individuals over 50 years of age with hip fractures and compared them to over 135,000 patients who had not broken their hips.

These researchers found that the risk of hip fracture increased with the long-term use of these medicines, and that such an increase was observable even after one year of continuous treatment. The risk of fracture seemed to increase with the duration of treatment and the dose of medication prescribed.

While these studies need to be expanded, the findings have been explained by noting that the absorption of calcium, the most important mineral necessary for strong bones, may be reduced when the production of acid by the stomach is blocked. On the other hand, the use of these medicines may decrease the breakdown of bones. These two actions of PPIs oppose each other, but scientists are wondering whether a decreased absorption of calcium might be the main overall effect on the bones, making them more at risk of fractures.

Since more research is in progress, it is premature to tell our patients to stop taking PPIs. In many cases, such medications have proven indispensable to their health and sense of well-being. Nevertheless, as is the case with most medications, PPIs should only be taken when needed and patients should attempt to modify aspects of their lifestyle and diet that predispose to the gastrointestinal disorders that are treated by such agents.

The Center for Gastroenterology of Fairfield and Westchester will continue to keep you up to date of research that will shed more light on this subject.