It is common to experience a little heartburn after eating spicy foods or drinking alcohol. It may feel like chest pain or burning after eating, a sour taste in the back of the throat or hoarseness.  But suffering daily, long-lasting or frequent heartburn symptoms should not be ignored and may indicate a more serious condition.As many as 15 million Americans suffer from daily heartburn, or gastroesophageal reflux disease (GERD). This chronic but treatable condition refers to irritation and damage to the lining of the esophagus from prolonged exposure to stomach acid. This damage occurs because of a weakening of the valve that separates the esophagus from the stomach which allows acid to leak up into the esophagus.Typical treatments for GERD may include medication to reduce stomach acid and simple lifestyle changes to help reduce the reflux symptoms – such as avoiding trigger foods, decreasing portion sizes, losing weight, quitting smoking, elevating the head of the bed, and not eating before bedtime.

For certain patients who have had chronic acid reflux, an upper endoscopy may be recommended to assess the severity and to uncover any pre-cancerous changes. If GERD is left untreated or unmonitored for a long period of time, it can result in a condition called Barrett’s esophagus which can progress to cancer.

Barrett’s esophagus is a disorder in which the inflamed, acid-damaged cells in the lining of the lower esophagus change to resemble those found in the stomach. As a result of this transformation, Barrett’s patients have an increased risk of esophageal cancer.

At Atlanta Gastroenterology Associates, many of our physicians are specially trained in the treatment of GERD and Barrett’s esophagus. If you’ve noticed that your heartburn symptoms are frequent, severe, longstanding, or getting worse, schedule an appointment with us today.


Celiac disease is an autoimmune disorder in which the small intestine is hypersensitive to gluten – a protein commonly found in wheat, rye, and barley. Gluten is typically found in foods such as bread, pasta, pizza, pastries, and cereal. Consuming these foods causes damage to the lining of the intestine. This leads to difficulty absorbing nutrients from food. While there are only 40,000 known cases of celiac disease in the United States, it’s estimated that this digestive disorder affects more than two million Americans – including adults, adolescents, and children. People who have a first-degree relative with celiac disease have a 1 in 10 risk of developing it. Other high-risk groups include those who have Down syndrome, type 1 diabetes, autoimmune thyroid disease, and juvenile chronic arthritis.

Signs & Symptoms

Celiac disease can be difficult to diagnose because it affects people differently. Some develop celiac disease as children, while others later as adults. The ‘classic’ symptoms of celiac disease include:

  • Abdominal Pain and Bloating
  • Vomiting
  • Chronic Diarrhea
  • Weight Loss or Failure to Thrive
  • Pale, Foul-smelling, or Fatty Stool

Some of the less typical, non-gastrointestinal manifestations may include:

  • Arthritis / Joint Pain
  • Osteopenia / Osteoporosis
  • Dental Enamel Defects
  • Delayed Growth and Puberty
  • Dermatitis Herpetiformis (itchy skin rash)
  • Fatigue
  • Depression or Anxiety
  • Irritability and Behavioral Issues
  • Seizures or Migraines
  • Iron Deficiency Anemia
  • Missed Menstrual Periods
  • Infertility or Recurrent Miscarriage

Recent research has demonstrated that only a third of adult patients diagnosed with celiac disease experience diarrhea. In fact, the most common sign of celiac disease in adults is iron deficiency anemia that does not respond to iron therapy.

Detection & Treatment

If you are experiencing these symptoms or have additional risk factors, you should be evaluated for celiac disease by a gastroenterologist. It is advised to see a doctor first before cutting out gluten from the diet, which will help make diagnostic testing more accurate. Highly sensitive and specific tests can be useful screening tools. If celiac disease is suspected, an upper endoscopy with small intestinal biopsies is recommended to confirm the diagnosis. Once confirmed, living a lifelong gluten-free diet is the only known treatment available at this time. Guidance from your physician or a registered dietitian can be quite helpful in maintaining a balanced, nutritious diet.

Valley Gastroenterology & Endoscopy offers comprehensive nutrition counseling at many of our offices.  We have helped many people suffering from celiac disease achieve and maintain a healthy and happy gluten-free lifestyle.


We hope you and your loved ones are staying healthy and safe during this time.

We continue to monitor the prevalence of COVID-19 in our local communities.

Steps We’re Taking for You:


  • Virtual Appointments – We encourage all our patients to continue to take advantage of virtual or telehealth appointment options when appropriate. Using secure video chat technology, this allows you to both see and hear your physician and consult with them face-to-face from the comfort of your home. First time referrals do require a face to visit initial visit.
  • Masks – Following the CDC recommendations, we ask all patients and staff to wear masks while in our facilities. You are welcome to bring your own, or if you don’t have a mask, one will be provided upon arrival.
  • Visit Experience – At your next visit, you will be asked a set of COVID-19 screening questions and your temperature will be checked before you are taken back to an exam room. In addition, any non-essential guests may be asked to wait in the car until your appointment is complete.

As always, the safety of both you and our team is our highest priority. If you have any questions, please don’t hesitate to call our office at 740 633 4765.


Valued Patients,

Rest assured, we are actively monitoring the novel coronavirus (COVID-19) outbreak, and taking every precaution to keep our patients, physicians, and employees safe while in our facilities.

We are closely following the prevention recommendations from the Centers for Disease Control (CDC) and Ohio and West Virginia Department of Public Health (DPH). As the circumstances with COVID-19 are constantly evolving, we will make any appropriate changes and communicate updates as needed.

We ask that all patients and their guests who have a fever, symptoms of a respiratory infection (cough, runny nose, sore throat), or have been exposed to a person with coronavirus, flu, or any other communicable disease to please reschedule their appointments and procedures. In addition, if you or a family member have traveled out of the country within the past 14 days, please notify our offices before coming in. Our team is available and eager to assist.

If you are experiencing any of the symptoms associated with COVID-19 (fatigue, cough, fever, shortness of breath), call your primary healthcare provider who can make recommendations as to whether you should self-treat at home, visit their office, or go to the emergency department. If you are experiencing severe symptoms, such as difficulty breathing, call 9-1-1 immediately.

Please keep in mind that the best way to prevent the spread of any infectious disease, including COVID-19, is through simple everyday practices such as:

Diligent handwashing with soap and water
Staying home when sick and avoiding contact with those who are sick
Frequently cleaning commonly used surfaces, such as doorknobs, light switches, tabletops, etc.
Avoiding touching your eyes, nose, and mouth with unwashed hands
Always covering a cough or sneeze with a tissue or arm sleeve

For immediate updates on the COVID-19 situation, we recommend visiting the CDC at

Again, we want to assure you that your team at Valley  Gastroenterology & Endoscopy is taking the recommended steps as our number one priority will always be maintaining the well-being of our patients and our community.

We thank you for your cooperation and understanding.


  • Cologuard is a stool test that looks for traces of blood and 11 distinct DNA biomarkers, and its only approved use is screening average-risk adults between 50 and 75. So if you have any personal history of colon cancer, colon polyps or conditions like inflammatory bowel disease, iron deficiency anemia, bleeding hemorrhoids or a family history of colon or rectal cancers or polyps, this test isn’t intended for you.
  • A 2014 study of 10,000 people that compared Cologuard® with the FIT (Fecal Immunochemical Test) stool test resulted in a significant number of false negatives – 1 out of every 13 patients. While the study, published in the New England Journal of Medicine, did suggest that Cologuard® was more effective than the FIT test, Cologuard® still missed more than 30 percent of polyps that would soon be cancer. This means there was a lost opportunity to stop someone from getting colon cancer by removing pre-cancerous polyps during a colonoscopy.
  • Cologuard® – like other stool-DNA-based tests – can detect most colon cancers or advanced polyps, but it cannot identify precancerous lesions in their early stages. On the other hand, a screening colonoscopy candetect those early lesions and prevent cancer by removing precancerous polyps – all in one procedure.
  • Under the Affordable Care Act (ACA), colon cancer screenings are considered preventive care and the cost of the test is covered by insurance. But what if your Cologuard® test comes back with a positive result? A colon cancer screening will still be necessary and it won’t be considered preventive anymore, which could result in unexpected out-of-pocket expenses.

While there is a place for Cologuard® in colon cancer screening, those situations are limited to a few instances:

  • It may be a good alternative for patients on blood thinners or those with serious medical conditions.
  • It may be an alternative way to reach patients in very rural areas where screening compliance is already low.

While any test that reduces barriers to getting screened should be considered, it’s important to remember that a colonoscopy is still the gold standard for preventing cancer by detecting early lesions and removing pre-cancerous polyps.

Talk to your gastroenterologist or primary care physician about the best screening test for you.


Valley Endoscopy Receives National Accreditation and Recognition

Valley Endoscopy Center has been accreditated by the Accreditation Association for Ambulatory Health Care (AAAHC). Accreditation distinguishes Valley Endoscopy from many other outpatient facilities by providing the highest quality of care to its patients as determined by an independent, external process of evaluation. Valley Endoscopy is the only facility of its kind in the Ohio Valley that is AAHC accredited and is one of only two facilities certified by the American Society of Gastrointestinal Endoscopy (ASGE).

Status as an accredited organization means Valley Endoscopy has met nationally recognized standards for the provision of quality health care set by AAAHC. Fewer than 10 ambulatory health care organizations across West Virginia are accredited by AAAHC and Valley Endoscopy is the only center to be certified in the Ohio Valley.

“We believe our patients deserve the best,” stated Dr. Ratnakar. “When you see our certificate of accreditation, you will know that AAAHC, an independent, not-for-profit organization, has closely examined our facility and procedures. It means we as an organization care enough about our patients to strive for the highest level of care possible.”

Ambulatory health care organizations seeking accreditation by AAAHC undergo an extensive self-assessment and on-site survey by AAAHC expert surveyors – physicians, nurses, and administrators who are actively involved in ambulatory health care. The survey is consultative and educational, presenting best practices to help an organization improve its care and services

“Going through the process challenged us to find better ways to serve our patients, and it is a constant reminder that our responsibility is to strive to continuously improve the quality of care we provide,” said Ann Arno, RN, Nurse Manager at Valley Endoscopy.

The Accreditation Association of Ambulatory Health Care, founded in 1979, is the leader in ambulatory health care accreditation in the United States. AAAHC accredits a variety of organizations including, ambulatory surgery centers, office-based surgery centers, endoscopy centers, student health centers, military health care clinics, and large medical and dental practices. AAAHC serves as an advocate for the provision of high-quality health care through the development of nationally recognized standards and through its survey and accreditation programs. AAAHC accreditation is recognized as a symbol of quality by third-party payers, medical organizations, liability insurance companies, state and federal agencies and the public.


Music, film and TV star, Will Smith, decided he could no longer delay the inevitable. At age 51, and at the direction of his physician, he underwent his first colonoscopy.

This humorous and informative 17-minute video walks you through his entire colon cancer screening experience, including the surprising results. Turns out, his gastroenterologist found and removed a pre-cancerous polyp in his colon. Had Will Smith either delayed or avoided getting screened, that polyp would have continued to grow and had a high probability of turning into colon cancer.

Check out his experience.


Wheeling, WV – Nitesh Ratnakar, M.D., FACG has been elected to serve as the West Virginia Governor of the American College of Gastroenterology (ACG) a national organization representing more than 13,000 gastroenterologists and other specialists in digestive diseases. In this position, Dr. Ratnakar will play an essential role in communicating the ACG’s messages to and from ACG members, physicians, and policymakers. Governors also play an integral role in the College’s membership outreach activities.

Dr. Ratnakar, a digestive disease specialist at Valley Gastroenterology & Endoscopy, is board certified in gastroenterology, internal medicine and geriatric medicine. He is a member of the medical staff at all local hospitals in the Ohio Valley.

“I am honored to have been elected by my fellow physicians to represent them at the American College of Gastroenterology. I will do my utmost to promote the patient centered mission of the ACG and represent the interests of patients and Gastroenterologists in West Virginia at local, state and national level” said Dr. Ratnakar. “I believe our challenges are great as health care is going through immense changes that impact the practice of medicine. I am confident that Dr. Ratnakar will effectively carry forward the agenda of the American College of Gastroenterology to improve both the delivery and quality of healthcare to the residents of West Virginia” commented Dr. Faisal Bukeirat the outgoing Governor of the ACG.

Governors are ACG Fellows that are elected from the membership of a particular state or region. Dr. Ratnakar is one of 76 Governors elected across 7 different regions in the United States and abroad. The mission of the ACG is to advance world-class care for patients with gastrointestinal disorders through excellence, innovation and advocacy in the areas of scientific investigation, education, prevention and treatment.

Dr. Ratnakar completed his training in Gastroenterology and Hepatology at the University of Wisconsin Medical School where he also finished his training in advanced therapeutic endoscopy. He completed a fellowship in Geriatric Medicine at the University of South Florida College of Medicine, and completed an internship and residency in internal medicine at the Chicago Medical School. He graduated medical school from University of Delhi / Maulana Azad Medical College, New Delhi, India.

Dr. Ratnakar, consults on all aspects of digestive and liver diseases. Dr. Ratnakar has a special interest in therapeutic endoscopy, pancreatico-biliary endoscopy, colon cancer screening non-surgical treatment of Hemorrhoids and ablative therapy for Barrett’s esophagus. Additionally, he has specialized training and interest in Geriatric Medicine and the care of seniors with digestive and liver diseases. Dr. Ratnakar is a member of the task force of the American Society of Gastrointestinal Endoscopy (ASGE) on innovations in endoscopy, and the American Medical Association (AMA).

Dr. Ratnakar and other physicians of Valley Gastroenterology & Endoscopy including Daniel Shats, M.D. and George Goetz, M.D.; Ph.D. along with Kirby Fazio, FNP-C and Renea Jones, FNP-C provide medical care for a wide variety of digestive and liver diseases at office locations in Wheeling, St Clairsville, Weirton, Glen Dale, Martins Ferry and Bellaire; and at all local hospitals in the region.