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What counts as a lower GI problem?
The lower GI tract is the second half of your digestive system: the lower small intestine, the colon (large intestine), the rectum and the anus. This is where water is absorbed, stool is formed, and waste leaves the body. Problems here usually show up as changes in your bowel habits, rectal bleeding, abdominal pain or discomfort when you go. At Digestive & Liver Center of Arkansas in Fort Smith, Dr. Ihab Herraka evaluates and treats the whole range of lower GI conditions, from colon polyps and inflammatory bowel disease to hemorrhoids and chronic constipation. Many of these conditions share symptoms, which is why an accurate diagnosis matters more than a good guess. These are common problems, and most of them respond well to treatment. The one thing that consistently makes them harder to treat is waiting. If your symptoms sit higher up instead, start from all the digestive conditions we treat.
Symptoms that should be checked out
Make an appointment if you have any of the following, especially if it has lasted more than two to four weeks.
- Bleeding from the rectum, or blood on the toilet paper, in the bowl or in the stool
- A change in your bowel habits, such as new constipation, new diarrhea, or narrower stools
- Abdominal pain, cramping or bloating that keeps returning
- Urgency, leakage or accidents you cannot control
- Ongoing itching, pain or a lump around the anus
- Unexplained weight loss, fatigue, or anemia found on bloodwork
- Waking at night because of pain or the need to have a bowel movement Seek emergency care for heavy or continuous rectal bleeding, black tarry stools, severe abdominal pain with fever, vomiting with an inability to pass stool or gas, or dizziness and fainting along with bleeding.
Lower GI conditions we treat
Each of these has its own page, written properly, with what the symptoms mean, how it is diagnosed here and what treatment involves.
- Colon polyps and colorectal cancer
- Crohn's disease
- Ulcerative colitis
- Irritable bowel syndrome (IBS)
- Diverticulosis and diverticulitis
- Chronic constipation
- Chronic diarrhea
- Hemorrhoids
- Anal fissure
- Rectal bleeding
- Bowel incontinence
How colonoscopy fits in
Colonoscopy is the central test for the lower GI tract. It lets your physician see the entire lining of the colon and rectum, remove polyps in the same visit, take biopsies, and find the source of bleeding, all in one visit at our Fort Smith endoscopy suite. Full details, including prep instructions, sedation and what to expect, are on our colonoscopy page.
Recovery and results
Most patients feel normal within a few hours of a colonoscopy, once sedation wears off and any cramping from the air used during the exam passes. Full recovery instructions, including driving restrictions, are on our colonoscopy page. Outcomes for lower GI conditions vary by diagnosis. Hemorrhoid banding usually resolves symptoms over a series of short visits, with most patients returning to normal activity the same day. Fissures typically heal over several weeks. IBS, Crohn's disease and ulcerative colitis are managed over time, with the goal of keeping you in remission and out of the hospital. Removing polyps lowers your future colorectal cancer risk, which is why keeping your follow-up interval matters.
Cost & insurance
We accept most major plans, including Medicare and both Arkansas and Oklahoma Medicaid. The full list is on our insurance page. Self-pay pricing is available for elective services. Most major plans cover a screening colonoscopy as preventive care at the recommended age. Be aware that if a polyp is found and removed, some plans process part of the claim as a diagnostic service rather than purely preventive. Our billing team will explain how your specific policy handles it before your procedure. Hemorrhoid banding is covered by most major insurance plans as well. We verify your benefits ahead of time and let you know if a referral or prior authorization is needed, so there are no surprises. If you are uninsured or have a high deductible, ask about self-pay options when you call.
Frequently asked questions
I see blood when I wipe. Is it just hemorrhoids?
It often is, but you should not assume so. Colon polyps, colorectal cancer and inflammatory bowel disease can cause bleeding that looks exactly the same. A quick evaluation either confirms hemorrhoids so they can be treated properly, or catches something else early, when it is far easier to treat.
When should I have my first colonoscopy?
At age 45 if you are at average risk. Start earlier if you have a first-degree relative with colorectal cancer or advanced polyps, a hereditary cancer syndrome, inflammatory bowel disease, or symptoms such as bleeding, anemia or a lasting change in bowel habits. If a colonoscopy is normal and you are at average risk, the next one is typically about ten years later.
Is hemorrhoid banding painful, and will I need time off?
Band placement is done above the area where pain-sensing nerves are, so the procedure itself is generally painless and no anesthesia is needed. Most patients go back to work and normal activity the same day, avoiding vigorous exercise until the next day. Read more about hemorrhoid banding.
What is the difference between IBS and inflammatory bowel disease?
IBS is a problem with how the bowel functions and how sensitive it is, and there is no visible damage, and it does not lead to cancer. Crohn's disease and ulcerative colitis are inflammatory diseases that cause visible damage to the bowel and can lead to complications. They can feel similar from the outside, which is why testing is what tells them apart.
Do I really need the full bowel prep before a colonoscopy?
Yes. Polyps can be small and flat, and even a little residue can hide one. An incomplete prep often means the exam has to be repeated. If you have had a hard time with prep before, tell us. There are different options, and we will find one that works better for you.
Do I need a referral to be seen for a lower GI problem?
Usually not. Most plans let you call and schedule with us directly. If your plan requires a referral from your primary care provider, our staff will let you know when you call and help arrange it. You can learn more about our practice on the gastroenterology page.
Talk to us about what is going on
Bowel symptoms are uncomfortable to discuss and easy to postpone, and they are also among the most treatable problems in medicine when they are looked at early. Call the Digestive & Liver Center of Arkansas Main Clinic at (479) 242-2888 to schedule with Dr. Ihab Herraka at 3416 Old Greenwood Rd, Fort Smith, AR 72903, open Monday through Friday, 8:00 to 5:00. We care for patients throughout Fort Smith, the River Valley and eastern Oklahoma.