
Patricia Garcia
Clinical Associate Professor, Medicine - Gastroenterology & Hepatology
Bio
Patricia Garcia, MD is a board certified gastroenterologist and fellowship trained neurogastroenterologist who specializes in treating disorders of gastrointestinal motility including trouble swallowing, heartburn, reflux, constipation, fecal incontinence and pelvic floor dysfunction.
Clinical Focus
- Gastroenterology
- Neurogastroenterology and Motility
Administrative Appointments
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Associate Clinical Information Officer, Ambulatory Care, Stanford Health Care (2022 - Present)
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Director, GI Motility Laboratory, Stanford Digestive Health Center (2018 - Present)
Boards, Advisory Committees, Professional Organizations
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Member, American Neurogastroenterolgy and Motility Society (2014 - Present)
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Member, American Gastroenterology Association (2011 - Present)
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Member, American College of Gastroenterology (2011 - Present)
Professional Education
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Fellowship, Johns Hopkins University, Neurogastroenterology and Motility (2015)
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Board Certification: American Board of Internal Medicine, Gastroenterology (2014)
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Fellowship: New York Presbyterian Hospital of Columbia and Cornell Universities (2014) NY
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Board Certification: American Board of Internal Medicine, Internal Medicine (2011)
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Residency: University of Pennsylvania Health System (2011) PA
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Medical Education: University of Michigan Medical School (2008) MI
All Publications
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The Impact of Intermittent Fasting on Patients With Suspected Gastroesophageal Reflux Disease.
Journal of clinical gastroenterology
2022
Abstract
GOAL: The aim was to investigate the short-term impact of time restricted feeding on patients with suspected gastroesophageal reflux disease (GERD).BACKGROUND: Lifestyle modifications are often suggested, but the role of diet in GERD is unclear. Intermittent fasting is popular in the media and has demonstrated potential benefits with weight loss and inflammatory conditions as well as alterations in gastrointestinal hormones.STUDY: Patients who were referred for 96-hour ambulatory wireless pH monitoring off proton pump inhibitor to investigate GERD symptoms were screened for eligibility. Patients were instructed to maintain their baseline diet for the first 2 days of pH monitoring and switch to an intermittent fasting regimen (16 consecutive hour fast and 8h eating window) for the second 2 days. Objective measures of reflux and GERD symptom severity were collected and analyzed.RESULTS: A total of 25 participants were analyzed. 9/25 (36%) fully adhered to the intermittent fasting regimen, with 21/25 (84%) demonstrating at least partial compliance. Mean acid exposure time on fasting days was 3.5% versus 4.3% on nonfasting days. Intermittent fasting was associated with a 0.64 reduction in acid exposure time (95% CI: -2.32, 1.05). There was a reduction in GERD symptom scores of heartburn and regurgitation during periods of intermittent fasting (14.3 vs. 9.9; difference of -4.46, 95% CI: -7.6,-1.32).CONCLUSIONS: Initial adherence to time restricted eating may be difficult for patients. There is weak statistical evidence to suggest that intermittent fasting mildly reduces acid exposure. Our data show that short-term intermittent fasting improves symptoms of both regurgitation and heartburn.
View details for DOI 10.1097/MCG.0000000000001788
View details for PubMedID 36730832
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High Resolution Anorectal Manometry Findings in Men and Women With Parkinson's Disease, Using London Classification
LIPPINCOTT WILLIAMS & WILKINS. 2022: S407-S408
View details for Web of Science ID 000897916001174
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The Effects of Intermittent Fasting on Gastroesophageal Reflux Disease
LIPPINCOTT WILLIAMS & WILKINS. 2021: S214
View details for Web of Science ID 000717526100484
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Marijuana, Ondansetron, and Promethazine Are Perceived as Most Effective Treatments for Gastrointestinal Nausea.
Digestive diseases and sciences
2020
Abstract
BACKGROUND: Many anti-nausea treatments are available for chronic gastrointestinal syndromes, but data on efficacy and comparative effectiveness are sparse.AIMS: To conduct a sectional survey study of patients with chronic nausea to assess comparative effectiveness of commonly used anti-nausea treatments.METHODS: Outpatients at a single center presenting for gastroenterology evaluation were asked to rate anti-nausea efficacy on a scale of 0 (no efficacy) to 5 (very effective) of 29 commonly used anti-nausea treatments and provide other information about their symptoms. Additional information was collected from the patients' chart. The primary outcome was to determine which treatments were better or worse than average using a t test. The secondary outcome was to assess differential response by individual patient characteristics using multiple linear regression.RESULTS: One hundred and fifty-three patients completed the survey. The mean efficacy score of all anti-nausea treatments evaluated was 1.73. After adjustment, three treatments had scores statically higher than the mean, including marijuana (2.75, p<0.0001), ondansetron (2.64, p<0.0001), and promethazine (2.46, p<0.0001). Several treatments, including many neuromodulators, complementary and alternative treatments, erythromycin, and diphenhydramine had scores statistically below average. Patients with more severe nausea responded better to marijuana (p=0.036) and diphenhydramine (p<0.001) and less so to metoclopramide (p=0.020). There was otherwise no significant differential response by age, gender, nausea localization, underlying gastrointestinal cause of nausea, and GCSI.CONCLUSIONS: When treating nausea in patients with chronic gastrointestinal syndromes, clinicians may consider trying higher performing treatments first, and forgoing lower performing treatments. Further prospective research is needed, particularly with respect to highly effective treatments.
View details for DOI 10.1007/s10620-020-06195-5
View details for PubMedID 32185665
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Recurrent Small Bowel Obstruction with Intraluminal Structures.
The journal of trauma and acute care surgery
2020
View details for DOI 10.1097/TA.0000000000002956
View details for PubMedID 33003015
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Gastric per-oral endoscopic myotomy: Current status and future directions
WORLD JOURNAL OF GASTROENTEROLOGY
2019; 25 (21): 2581–90
View details for DOI 10.3748/wjg.v25.i21.2581
View details for Web of Science ID 000470246400004
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Gastric per-oral endoscopic myotomy: Current status and future directions.
World journal of gastroenterology
2019; 25 (21): 2581-2590
Abstract
Gastroparesis, or symptomatic delayed gastric emptying in the absence of mechanical obstruction, is a challenging and increasingly identified syndrome. Medical options are limited and the only medication approved by the Food and Drug Administration for treatment of gastroparesis is metoclopramide, although other agents are frequently used off label. With this caveat, first-line treatments for gastroparesis include dietary modifications, antiemetics and promotility agents, although these therapies are limited by suboptimal efficacy and significant medication side effects. Treatment of patients that fail first-line treatments represents a significant therapeutic challenge. Recent advances in endoscopic techniques have led to the development of a promising novel endoscopic therapy for gastroparesis via endoscopic pyloromyotomy, also referred to as gastric per-oral endoscopic myotomy or per-oral endoscopic pyloromyotomy. The aim of this article is to review the technical aspects of the per-oral endoscopic myotomy procedure for the treatment of gastroparesis, provide an overview of the currently published literature, and outline potential next directions for the field.
View details for DOI 10.3748/wjg.v25.i21.2581
View details for PubMedID 31210711
View details for PubMedCentralID PMC6558440
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Under Pressure: Do Volume-Based Measurements Define Rectal Hyposensitivity in Clinical Practice?
DIGESTIVE DISEASES AND SCIENCES
2019; 64 (5): 1062–63
View details for DOI 10.1007/s10620-019-05613-7
View details for Web of Science ID 000466886100002
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Under Pressure: Do Volume-Based Measurements Define Rectal Hyposensitivity in Clinical Practice?
Digestive diseases and sciences
2019
View details for PubMedID 30963367
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REFRACTORY GASTROPARESIS: GASTRIC PERORAL ENDOSCOPIC MYOTOMY (G-POEM) VS. INTRAPYLORIC BOTULINUM TOXIN INJECTION
MOSBY-ELSEVIER. 2018: AB241–AB242
View details for Web of Science ID 000434248200406