Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Adenocarcinoma of the small bowel is associated with the following underlying conditions:
Crohn disease - An inflammation in the small intestine. Crohn disease usually occurs in the lower part of the small intestine, called the ileum. The inflammation extends deep into the lining of the affected organ, causing pain and making the intestines empty frequently, resulting in diarrhea.
Celiac disease - Gluten intolerance
Familial polyposis syndromes - An inherited disease in which the large bowel becomes carpeted by polyps of various dimensions during the second or third decade of life. If untreated, the disease invariably leads to cancer of the colon or rectum. Celecoxib (Celebrex) has been Food and Drug Administration (FDA) approved for FAP. After 6 months, celecoxib reduced the mean number of rectal and colon polyps by 28% compared to placebo (sugar pill) 5%.
Cancer is 50 times more common in the large bowel than in the small bowel. Risk factors in the general population include the following:
Consumption of salted or smoked meats and fish
Heavy sugar intake
Risk factors for developing cancer of the small intestine in Crohn disease include the following:
Long duration of disease
Associated fistulous disease: A fistula is an abnormal tube that passes from one surface to another, such as from the colon to the skin.
Surgical removal of part of the bowel
The risk of developing small intestinal cancer is 6 times greater for people with Crohn disease compared to the general population.
Lymphoma of the small intestine is associated with celiac disease but is also strongly associated with weakened immune systems such as occurs with AIDS.