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Dr. Emori Carrara On Solving Gastroenterology Enigmas

Dr. Emori Carrara was recently featured in an MD-Update Magazine article where she is credited with treating her patients with both compassion and insight.

Dr. Carrara has been practicing gastroenterology and hepatology at Gastroenterology of Southern Indiana since 2010. As the Kentuckiana area is “one of the nation’s hot spots for obesity related epidemics such as colon cancer and non alcoholic liver disease,” Carrara treats a wide variety of patients and offers endoscopic diagnostic and therapeutic procedures.

Common patient complaints include:

  • Acid Reflux
  • Irritable Bowel Syndrome
  • Constipation and Diarrhea
  • Celiac Disease
  • Crohn’s/Ulcerative Colitis
  • Hepatitis C
  • Alcoholic Liver Disease
  • Fatty Liver Disease
  • Pancreatic Disease

Dr. Emori Carrara Specializes in Treating Susceptible Female Patients

As most women prefer a female doctor when it comes to these rather sensitive topics, Carrara’s patient base is mostly female. According to MD-Update, “Functional gastrointestinal diseases or conditions in which doctors can’t pinpoint a root cause, even after a thorough evaluation, are more common among women.” For example, a woman’s hormone levels have been known to complicate GI symptoms, and can even cause bowel movement issues. Carrara specifically treats the needs of pregnant women and has seen problems like gallstones and liver issues arise during pregnancy.

GI & The Psyche

When it comes to GI disorders, Carrara believes in taking note of one’s behavioral patterns and considering lifestyle changes before treatment. “Anxiety can contribute to nearly every gastrointestinal symptom and heighten each one,” says Carrara. IBS for example often stems from anxiety or depression. This is why Carrara recommends “stress reduction through exercise or engaging in hobbies as well as a healthy, balanced diet” in addition to medication.

Colon Cancer

In addition to participating in clinical trials and supporting the latest in preventive care, Carrara sees preventing colon cancer as one of the most important things she does as a gastroenterologist. “Colon cancer can be prevented with a colonsocopy as we are able to remove polyps before they can develop into colon cancer,” says Carrara.

To talk to your doctor about screening, contact us today.

Read the full article here:

Young Adult Colorectal Cancer National Clinical Alert: Part 1

The rate of young adult colorectal cancer has been on the rise in the United States since the mid-1980s. Adults born in the 1990s (now in their 20s) and beyond have double the lifetime risk of colon cancer, and quadruple the risk of rectal cancer, compared to adults born in the 1950s. Currently, approximately 20% of all colorectal cancer cases diagnosed in the United States are patients under the age of 55.

Unfortunately, patients diagnosed with colorectal cancer prior to the age of 55 are 58% more likely than older patients to be diagnosed with a more advanced stage of the disease (stage III or IV). This is due to a delay in diagnostic evaluation of symptoms and less access to medical care. Delays in diagnosis, late stage presentation, and limited access to care all contribute to an increase of mortality for young adult colorectal cancer patients. Both the increasing incidence and mortality of young adult colorectal cancer are in sharp contrast to the overall declines in incidence & mortality observed in people over the age of 55.

Patients with these symptoms and signs need to be referred for diagnostic evaluation. To schedule an appointment, contact the Gastro Health Partners location nearest you today.

Dr. Abdul Jabbar on Saving Lives with Colon Screenings

According to Gastro Health Partner physician Dr. Abdul Jabbar, “When you look at a colon cancer map of the USA, you’ll be surprised to see that along the Ohio river, specifically over Clark and Floyd county, there are significantly higher incidences of colon cancer.” This is due in large part to the region’s lifestyle. A lack of exercise, high obesity rates, excessive alcohol consumption, tobacco use and a diet high in processed red meat and low in fibrous fruits and vegetables can lead to colorectal cancer. 

Having recently sat down with Baptist Health Floyd for one of their Health Topics episodes, Dr. Jabbar is quick to point out how colon screenings can save lives. “A colonoscopy is one of the best tools available,” he says. With timely colon screenings, the rate of colorectal cancer mortality in the area has decreased as much as 53%. 

What is a colonoscopy?

A colonoscopy is done using a colonoscope which is a flexible tube with a camera attached to it. This allows physicians to look inside the organ without doing any surgery. A colonoscopy is minimally invasive with minimal sedation required, and can be completed within 10 to 30 minutes.

The procedure helps to identify polyps that either are cancerous or could potentially turn cancerous. These polyps are then removed and the patient’s care is expedited. To schedule a colonoscopy, contact the Gastro Health Partners location nearest you today.

Watch the full episode of Dr. Abdul Jabbar on Baptist Health Floyd’s Heath Topics here:

Dr. Abdul Jabbar joined Gastroenterology of Southern Indiana in 2006. He earned his medical degree from Nishtar Medical College in Pakistan. For one year he served as Research Fellow at the University of Pennsylvania in Philadelphia before completing his Internal Medicine Internship and Residency at Columbia University teaching program in Summit, New Jersey. He received his dual Fellowship training in Gastroenterology & Hepatology at the University of Louisville, followed by additional training in hepatology and endoscopic ultrasound. Prior to moving to Southern Indiana, Dr. Jabbar served as Assistant Professor of Medicine in the Department of Gastroenterology at the University of Louisville. Dr. Jabbar is board certified in both Internal Medicine and Gastroenterology.

 

Dr. Whitney Jones Discusses Colorectal Cancer

Dr. Whitney Jones is a national expert and frequent speaker on early-age onset colorectal cancer prevention, genetic GI cancer syndrome testing and risk management, and communication strategies for population-based cancer prevention.

On this episode of KET’s Kentucky Health, Dr. Jones explains how we can decrease incidents and mortality rates of colorectal cancer.

Colorectal cancer is the second cause of death due to cancer in the United States. Prior to 2004, Kentucky had one of the highest death rates from colon cancer. One major factor was a lack of screenings. However, now the mortality rate has decreased by more than 20% and we have gone from being 49th in the U.S. for people being screened for colon cancer to a current ranking of 20th.

This is due in large part to the development in 2003 of the Colon Cancer Prevention Project by Dr. Whitney Jones; an organization dedicated to spreading the message of colon cancer.

While the rates are decreasing for those over the age of 55, for reasons unknown, rates of colorectal cancer, specifically rectal cancer, have increased in those under the age of 55. Genetics and lifestyle habits could be prominent factors in this increase. Early screening is an important preventive tool as these rates are projected to continue to rise. 

Causes of Colorectal Cancer

  • Obesity
  • Tobacco use
  • Diets high in red processed meat and low in fresh fruits or veggies
  • Lack of exercise 
  • A family history
  • Excessive or ongoing alcohol use

Symptoms of Colorectal Cancer

  • Rectal bleeding
  • Change in bowel habits
  • Weight loss
  • Unexplained abdominal pain

However, the most common symptom of colon cancer is no symptom at all. It is known as the silent killer and early onset colon cancer has an average 6 month delay from the time a person has symptoms until they see a doctor. 

Screenings

Those with a family history should start screening a decade before their family history indicates, even as early as one’s twenties. 20% of those with a family history of colorectal cancer are at more of a risk themselves. 

If no warning signs or family history exist, screenings should being at the age of 45.

All colonoscopy screenings are covered in the state of Kentucky due to the Affordable Care Act. For those who don’t want a colonoscopy,  there are other options available. However, colonoscopies are still the gold standard of screenings as they remove polyps and the removal of polyps help prevent cancer from developing.

Knowing Your Family History

Genetic medical grade testing is an important proactive tool in diagnosing colorectal cancer. It is now more affordable and accessible than ever before.

Lynch syndrome for example is the most common genetic trait for colorectal cancer. Polyps in the colon develop into cancer faster for persons with Lynch syndrome than those with other genetic predispositions. Those who have it are also at an increased risk of ovarian cancer, endometrial cancer, and pancreatic cancer, among several others. 

Other Preventative Measures

  • Increase the amount of veggies in your diet.
  • Aspirin has been known to reduce the formation of polyps, but has it’s side effects.
  • If you have had polyps in the past, keep up with your follow up surveillance.

Watch the full episode of Dr. Whitney Jones on Kentucky Health here: 


Dr. Whitney Jones is a practicing Gastroenterologist, former therapeutic endoscopist and Clinical Professor at the University of Louisville from 1994 until 2017. He joined GHP in 2017 cofounding its new east Louisville division, Gastroenterology & Endoscopy Associates, PLLC, alongside Drs. Ashok Kapur and Laszlo Makk.

Prevent Colorectal Cancer: Get Screened

Colorectal cancer is the second leading cause of cancer death in the United States. It’s expected to kill more than 50,000 Americans this year alone. The good news? If caught early, the survival rate is very high.

Colorectal Cancer in the U.S.

That’s why screening for colorectal cancer is so important. Screening is generally recommended for all average-risk patients aged 50-75.

People who have a family member with colorectal cancer or polyps are at increased risk and might need to start screening before age 50.

High-risk factors include a personal history of polyps, inflammatory bowel disease, chronic ulcerative colitis, or a family history of colorectal cancer or polyps.

What are the Options for Screening?

There are four main ways to screen for colorectal cancer:

Colonoscopy: Colonoscopy uses a flexible, lighted tool called a colonoscope to view the entire colon and remove cancerous and precancerous growths called polyps if they are detected.
Fecal immunochemical test (FIT): This test checks the stool for tiny amounts of blood given off by polyps or colorectal cancer.
CT colonography: This involves a CT scanner and computer programs to create a three-dimensional view of the inside of the colon and rectum that can be used to identify polyps or cancer.
Cologuard: This tests the stool for tiny amounts of blood and identifies altered DNA from cancer or polyps that end up in the stool.

Colonoscopy is The Best Colorectal Screening Method

Which Screening Option is Best?

Preventing cancer should always be the first goal. Most colorectal cancers begin as polyps. Finding, quantifying, localizing, and removing polyps through screening colonoscopy is the most effective strategy for preventing colorectal cancer. That’s why colonoscopy remains the gold standard for colon cancer screening.

The Multi-Society Task Force on Colorectal Cancer recommends that physicians should offer colonoscopy first. For patients who decline to have a colonoscopy, the FIT test should be offered next, followed by second-tier tests such as Cologuard and CT colonography for patients who decline both first-line options.

A 2014 study published in the New England Journal of Medicine of 10,000 patients found that screening colonoscopy was better at finding cancer than both Cologuard and the FIT test. FIT and Cologuard were also not as good as colonoscopy at finding pre-cancerous polyps – and unlike colonoscopy, FIT and Cologuard can’t remove polyps.

Cologuard missed 1 in 13 people who had colorectal cancer detected by screening colonoscopy. Cologuard also missed more than 30 percent of polyps that will soon be cancer and almost 60 percent of polyps that may become cancer.

The FIT test missed almost 1 in 4 people who had colorectal cancer detected by screening colonoscopy. FIT also missed more than 50 percent of polyps that will soon be cancer and more than 75 percent of polyps that may become cancer.

Which Colorectal Screen Test is Most Effective

Check with Your Insurance Provider

Patients may also have insurance considerations when choosing a test. A follow-up colonoscopy is recommended for positive FIT and Cologuard tests. Individuals with a positive FIT test or Cologuard test who are covered by Medicare may face a costly co-insurance bill after the recommended follow-up colonoscopy.

While insurance covers 100 percent of the preventive screening test, a follow-up colonoscopy for a positive FIT or Cologuard is considered a diagnostic or therapeutic service and may not be fully covered.

Almost one in six people who use the Cologuard test will have a positive result that suggests the presence of colorectal cancer. For almost half of those patients (45 percent), the colonoscopy will show their result from the Cologuard test was a false positive.

Check with your insurance provider before you are screened. Ask how much you should expect to pay if you need a follow-up colonoscopy for a positive FIT or Cologuard test result. This can help you avoid surprise costs.

Insurance Coverage for Colorectal Screening

Talk with Your Doctor

There are several ways to be screened. Remember, Colonoscopy is the gold standard, but if you’re unable to be screened by colonoscopy there are other appropriate options. Talk with your primary care physician about which screening test is best for you and do research about the available options to ensure you’re choosing the best test according to science.