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Colonoscopy: What to Expect

A colonoscopy is a procedure that allows a physician to examine a patient’s colon. Colonoscopies are often used to evaluate GI disorders and screen for colon cancer. Here’s what you need to know if you are preparing for a colonoscopy.  

When it’s used

There are a few reasons your doctor may recommend a colonoscopy. The procedure is commonly used as a screening tool for colon cancer, which starts from polyps in the colon. A colonoscopy can help your doctor examine your colon for any polyps and other warning signs of colon cancer. You may also need a colonoscopy if you have previously had polyps. In this case, your doctor will likely look for more polyps and remove any, as a preventative measure against colon cancer. Last, you may need a colonoscopy if you have any GI pain or distress that your doctor needs to identify and diagnose through examination. 

Preparing for a Colonoscopy

There are a few important pre-procedure steps you need to take leading up to a colonoscopy. You will be asked to adhere to a cleansing routine the day before the procedure. This typically consists of taking a liquid laxative the day before to empty your bowels, and switching to a clear liquid diet. You may be asked to drink plenty of liquids as well. Following the instructions on laxative use is a crucial step to properly prepare for the exam, so always be diligent in this regard. 

In addition to the cleansing routine, you should also discuss any medications you use with your doctor. You may have to stop use of some medications like blood-thinners prior to the procedure. This is because some of these medications can increase the risk of excessive bleeding. If you use insulin, you may need to adjust dosage and timing the day of the procedure. Your doctor will also want to know about any allergies to medication you have. 

What to Expect During the Procedure

A colonoscopy takes about 20-30 minutes in total. You will be sedated for the entire procedure, so there is no discomfort during it. Your doctor will monitor your heart rate, blood oxygen levels, and blood pressure throughout the process as well. During the procedure, your doctor will insert a colonoscope (a thin, flexible tube with a light and camera) in your anus while you lay on your side and advance it to the end of your colon. The camera and light allow your doctor to fully examine the colon lining. 

If your doctor sees anything they want to analyze further, they may take a small tissue sample (biopsy) for later analysis. In the case that they see any bleeding during the examination, they can feed instruments through the colonoscope to medicate, cauterize, or clip affected areas and control bleeding. If they find any polyps, they can use an instrument threaded through the colonoscope to remove them. None of these techniques cause discomfort during the procedure. 

After the Procedure

It typically takes around an hour to mostly recover from the sedation after a colonoscopy. As such, you should always have someone take you home afterwards. The effects can linger to an extent for the next 24 hours, so you should avoid driving, making important decisions, or working for that period of time as well. If any polyps were removed during the procedure, you may be prescribed a temporary special diet. It’s common to pass gas and feel bloated for a few hours after the exam. Walking can help ease some of this discomfort. 

You may see a small amount of blood in your stool during your first bowel movement post-procedure; this is not cause for alarm most of the time. However, if bleeding persists or you develop a fever or consistent bowel pain within a week or two of the procedure, you should contact your doctor. 

Our experienced team at GHP has years of experience performing colonoscopies. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Flexible Sigmoidoscopy: Everything You Should Know

A flexible sigmoidoscopy is an endoscopic examination that helps doctors view the lower colon and rectum.  Here’s a closer look at the procedure. 

Why is a Flexible Sigmoidoscopy performed?

Flexible sigmoidoscopies can help doctors determine the cause of symptoms like rectal bleeding, abdominal pain, and changes in bowel habits. Additionally, doctors can use the procedure as a screening tool. They may recommend that people over the age of 50 have these exams on a regular basis to check for signs of colon cancer. While a colonoscopy is often used to do this, the flexible sigmoidoscopy offers a few advantages. For one, it is less involved in terms of preparation and exam time. It also does not typically require an anaesthetic, and it has a lower risk of perforation.

Preparing for a Flexible Sigmoidoscopy

To prepare for the procedure, you should always talk to your doctor about any medications you are taking. Additionally, they will give you instructions for bowel prepping before the exam. A bowel prep helps ensure there is as little stool as possible is present in the intestine during the exam. Doctors usually prescribe a clear liquid diet the day before the exam, and avoiding consuming anything after midnight the day of the exam. The bowel prep may also involve laxatives or enemas. You may need to consume a certain volume of liquid laxative leading up to the procedure. If your doctor prescribes an enema, you should use it the night before the procedure to wash out the rectum. 

During the procedure

During a flexible sigmoidoscopy, the patient is positioned on their left side with their knees drawn up towards their chest. The doctor first does a digital rectal exam, inserting a lubricated, gloved finger into the patient’s rectum to check for anything abnormal. Next, they insert the sigmoidoscope into the rectum. This may feel like pressure to the patient. The doctor then adds air through the sigmoidoscope to expand the colon, allowing them to see more clearly. The sigmoidoscope has a camera on the end of it that gives video feed to a monitor that the doctor views. Lastly, the doctor examines the lining of the bowel while slowly removing the scope. If necessary, they can insert forceps through an empty channel in the sigmoidoscope to take a tissue sample for biopsy. The entire procedure usually takes around 15 minutes.

Post-procedure

Following the procedure, patients can expect some mild abdominal discomfort, cramping and bloating for a few hours. Since the procedure is fairly non-invasive, you can return to your normal and activity level immediately. If a biopsy was performed, you may experience some light rectal bleeding from the site of the tissue sample. If the bleeding is persistent, or if you develop a fever of 100 degrees Fahrenheit or higher, contact your doctor. 

Your doctor will give you post-exam instruction on home care. They will also discuss the results with you. A negative test is when no abnormalities are found during the procedure. If your doctor finds any polyps or other issues during the exam, it is a positive test. This may lead to further testing, including a full colonoscopy. If a biopsy has been performed, the results are usually available after a few days and are communicated to you by your doctor. 

Our experienced team at GHP has years of experience performing flexible sigmoidoscopies. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

What is Colorectal Cancer?

Colorectal cancer refers to a cancer that starts in the colon or rectum. While cancers that start in either place may be called colon cancer or rectal cancer, respectively, they are often known collectively as colorectal cancer because of similarities between the cancers. 

Here’s what you need to know about colorectal cancer. 

Causes and Risk Factors

Scientists are not exactly sure what causes colorectal cancer. We do know that colorectal cancer begins when healthy cells’ DNA mutates. These cells can then overgrow and divide, creating tumors. Cancerous cells can also destroy healthy tissue and travel to other parts of the body and form deposits. However, there are several well-documented risk factors. These include being over 45, having diabetes, smoking, drinking alcohol, having a high-fat diet, having an inflammatory bowel disease, and having a family history of colon cancer or polyps. 

Types

Most colorectal cancers (around 96%) are Adenocarcinomas. This kind of cancer starts in mucus-producing cells which lubricate the colon and rectum. 

There are a few other kinds of colorectal cancers that are much more rare. Lymphomas, cancers of immune system cells, can start in the colon or rectum (although they typically start in lymph nodes). Carcinoid tumors start from hormone-producing cells in the intestine. Gastrointestinal stromal tumors start from cells in the colon wall, and while most are non-cancerous, some can be. 

Symptoms

It’s common for colorectal cancers to have few symptoms until they have advanced. There are some potential warning signs, but they may be indicators of other issues. These symptoms include lower abdominal pain, blood in stool, bloating, cramps, vomiting, unexplained weight loss, and changes in bowel functions. As always, it’s best to consult a medical professional to determine what your symptoms are caused by. 

Diagnosis

The best way to cure colon cancer is to identify it at an early stage. However, since symptoms may not present early on, doctors recommend screenings for healthy people, usually beginning around age 50. People with more risk factors, as discussed above, may be advised to be screened at a younger age. 

A colonoscopy is one of the most common methods of screening. This involves using a scope to examine the inside of the colon. Your doctor can pass tools through the scope to take tissue samples if they see something suspicious. Biopsies of these tissue samples can help determine if cancer is present. Doctors also may remove polyps found during a colonoscopy to prevent them from becoming malignant. 

Treatment and Prevention

There are three main treatments for colorectal cancer- surgery, chemotherapy, and radiation therapy. These three treatment options are often used together in various combinations, depending on a patient’s situation. The best treatment options for each person depends on factors including overall health, the cancer’s stage, and whether the cancer is recurring. 

Localised, small, early-stage cancer in a polyp can be removed during a colonoscopy. A more invasive surgical procedure called a partial colectomy can remove the cancerous area of the colon and some surrounding healthy areas. This can prevent the cancer from growing back. Lymph nodes near the surgical site are removed and tested. Surgery can also be pursued to relieve symptoms and provide comfort for people in very poor conditions. 

Chemotherapy is another treatment option, often used after surgery to destroy remaining cancer cells. If the cancer has spread beyond the colon lining, this may be recommended. 

Radiation therapy utilizes beams of intense energy to destroy cancer cells. Radiation may be utilized before surgery to reduce tumor sizes, or after surgery to kill off remaining cancer cells. 

Preventing colorectal cancer is extremely important, and it starts with screening (as discussed above). Additionally, you can reduce your risk of developing colorectal cancer by avoiding smoking, reducing or avoiding alcohol consumption, staying active, maintaining a healthy weight, and eating a healthy diet. 

Our experienced team at GHP has years of experience helping people manage and treat colorectal cancer. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

 

Dr. Michael Krease on a Broad Scope of Practice

Dr. Michael Krease was recently featured in an MD-Update Magazine article where he discussed broadening perceptions of what gastroenterology is:

 

 “Scope Junkie.” “Scope Monkey.” He’s heard them all, and he gets the joke, but Michael Krease, DO, wants to make sure that everyone understands that there is much more to what he does than performing scopes.

 “That really is the common misconception,” he says of gastroenterology, which he practices at Gastroenterology Health Partners’ Louisville location. “We are much more than that.”

 It wasn’t the opportunity to perform endoscopies and colonoscopies, after all, that drew Krease to the medical field in particular. Growing up in the suburbs of Detroit, Michigan, Krease had an early interest in being a veterinarian, but by high school he knew he wanted to be a doctor. He narrowed his field of interest to internal medicine before attending medical school at the West Virginia School of Osteopathic Medicine. He met his wife, Megan, there. She is a pediatrician at All Children Pediatrics in Louisville. They did their residencies together at Oklahoma State University Medical Center. Krease then completed his Fellowship in gastroenterology, hepatology, and nutrition at the University of Louisville School of Medicine.

 

Read the full article here:

 

Michael Krease

5 Things to Know About Ulcerative Colitis

Ulcerative Colitis (UC) is a chronic inflammatory bowel disease that causes inflammation in the digestive tract. When someone has UC, ulcers form where inflammation has injured cells lining the colon and these ulcers eventually may bleed and create pus. This can lead to the colon needing to be emptied frequently. 

While there is no cure, healthcare professionals can help patients with Ulcerative Colitis pursue proven treatment options for managing their symptoms, and researchers continue to study the disease. Here are 5 things to know about Ulcerative Colitis. 

Causes and Risk Factors

Medical understanding of the cause of Ulcerative Colitis is limited. There are two primary causes of UC that researchers are working to understand. 

First, it could be related to your immune system. A virus or bacterium might trigger UC because of inflammation from an immune response. Some developing research may support this theory. In a recent study, Stanford researchers found that a group of patients with Ulcerative Colitis had a depleted amount of a specific family of bacteria that produces anti-inflammatory substances. 

A second possible cause of Ulcerative Colitis is related to hereditary factors. There is evidence that UC is more common in people with family histories of the disease, so family history is considered a risk factor. However, most people with the disease do not have a family history, so it is not considered a proven cause of UC. 

Types

There are several types of Ulcerative Colitis, each of which is classified by location in the digestive tract. Ulcerative Proctitis is a classification for UC where inflammation is confined to the rectum. Proctosigmoiditis is a type where inflammation occurs in the rectum and lower end of the colon. Left-sided Colitis is when inflammation extends further into the descending colon. Pancolitis is a classification for inflammation that goes beyond just the descending colon and often affects the entire colon. Lastly, Fulminant Colitis is an acute life-threatening form of UC that affects the entire colon.

Symptoms 

Symptoms of Ulcerative Colitis can vary by type and degree of the disease. Loose and urgent bowel movements, bloody stool, abdominal pain and cramps, and persistent diarrhea are common symptoms. Outside of the intestine, symptoms may include fever, nausea, loss of appetite, and weight loss. Often times, symptoms will not be constant. Flare-ups are a common occurrence for people with UC, as are remission periods without symptoms.

Diagnosis

Patients are advised to see a medical professional if they are experiencing persistent changes in their bowel habits or other Ulcerative Colitis symptoms. When a patient is tested for UC, there are several possible approaches. Blood tests, barium enemas, CT scans, colonoscopies, and flexible sigmoidoscopies can all be used to diagnose UC. 

Treatment

Treatment for UC is focused on managing symptoms, as there is no known cure. A combination of medications and lifestyle changes is often helpful, including anti-inflammatory drugs, antibiotics, corticosteriods, avoiding gassy foods, managing stress, and staying hydrated. If these measures do not relieve symptoms, surgery may be recommended by a doctor. Surgery typically means removing the entire colon and rectum. 

Ulcerative Colitis can often be effectively managed with professional guidance and care. GHP is dedicated to helping patients with UC manage their symptoms and live healthy, happy, and full lives. Contact any of our office locations learn about the options we offer and schedule an appointment today.

October’s MD Update: Dr. Jones Speaks “Going on Offense Against Cancer”

Our very own Dr. Whitney Jones graced the cover of MD-Update’s October issue.  Read about how he embraces preventative measures to beat colon cancer before it starts in the following article.

“We spend a lot of money on healthcare and health insurance. The problem is, we’re not spending enough on prevention.”— Whitney Jones, MD

 In the movie “Karate Kid,” there’s a scene where Mr. Miyagi asks the title character if he’s training to fight. In his light bulb moment, the student responds that he trains, “So I won’t have to fight.”

Make no mistake, Whitney Jones, MD, knows how to treat cancer. He’s trained for it and has years of experience in it. But it’s a fight he would prefer doesn’t take place.

“We’re going on offense against cancer,” says Jones, a gastroenterologist at Gastroenterology Health Partners (GHP) in Louisville. “We are working on becoming the number one state and the first in the nation to develop programs where we can use genetic testing. We spend a lot of money on healthcare and health insurance. The problem is, we’re not spending enough on prevention. The cost of cancer treatments totally overwhelms the cost of prevention.”

That has been the central message and purpose of the Kentucky Colon Cancer Prevention Project, which Jones helped found in 2004. The project’s work includes education, advocacy, survivor support, and health system change.

“It put the work of the state in front of the legislature,” Jones says, noting that a diverse group of leaders from across the state formed the project’s advisory committee. “It added a mix of healthcare, politics, and business that was catalytic.”

The project has received state funding as well as additional funding from the Kentucky Cancer Foundation, which Jones also helped found in 2012. “We have helped pay for a lot of uninsured people to get colorectal cancer screening,” Jones says.

The impact of the Colon Cancer Prevention Project is reflected in the state’s improvement versus the rest of the country. Jones notes that Kentucky ranked 49th out of 50 in the nation in colon cancer prevention statistics when the project was launched. The state also had the highest rates of incidence and mortality in the nation. Earlier this year, Kentucky ranked 17th best in the nation in the same colon cancer related categories and earned an American Cancer Society Achievement Award for the most improved state in the nation for colorectal screening over the past 15 years.

“When we started our work at the Colon Cancer Prevention Project, there was a huge gap between what could be done and what we were doing,” Jones says. “It’s been a broad coalition, including many of our state leaders and city officials. I think it’s proven that Kentucky can address its own problems, we can develop solutions, we can implement them locally, and we can save lives and save money.”

Read the full article here:

Common Causes of Constipation

Constipation is often defined by tough, hard to pass bowel movements that occur infrequently. Other signs and symptoms include bloating, having the sensation of an incomplete evacuation, abdominal pain and blood present in the stool.

While constipation is known for being both physically uncomfortable and embarrassing, the condition is more common than one might think. Constipation affects approximately 30 percent of the general population, and is most prevalent in women, children and the elderly. Persistent constipation should not be ignored as it could be the sign of a more serious condition, such as colon cancer or Irritable Bowel Syndrome (IBS).

What are some of the Common Causes of Constipation ?

Dehydration

“If you don’t have enough water in your body already, the large intestine soaks up water from your food waste,” making for harder to pass stools. Caffeine can cause dehydration, and even dairy has been known to constipate some people. Proper hydration however, can help move food through the intestines and create softer stools.

Lack of Fiber

Fiber encourages regular bowel movements by allowing more water to remain in your stool and hastening it’s passage through the gut. Foods like fruits, vegetables, whole grains, beans and nuts are the best natural source of fiber. However, fiber supplements can be helpful as well.

Stress

Just like most of your bodily functions, the nervous system is in constant communication with your digestive system. During periods of intense stress, the digestive system can slow down resulting in constipation. Waiting too long to go to the bathroom for example, can cause a build up.

Not Enough Physical Activity 

Regular activity helps to stimulate the muscles in intestines and can also help alleviate stress.

Medication

Though laxatives can help ease constipation, they can also become habit forming meaning that one’s bowel movements end up depending on them. Overusing laxatives can over time can weaken the bowel muscles. Additionally, many anti-depressants and pain medications are common causes of constipation. It is recommended that any and all medications should be discussed with your doctor.

While many lifestyle changes can help to relieve constipation, if you experience chronic constipation, schedule an appointment with one of our fellowship-trained gastroenterologist today.

 

2019 Kicking Butt 5K Event Saves Lives

Kicking Butt 5k at the waterfront Dr. Whitney Jones at the 2019 Kicking Butt 5K

Thank you to everyone who came out and participated in this year’s Kicking Butt 5K! Survivors, fighters, advocates, healthcare providers and community partners all came together on what turned out to be a beautiful Saturday to help raise awareness of colon cancer. Gastroenterology Health Partners was proud to be one of the many sponsors who made this event possible. The Waterfront Park and Big Four Bridge were gracious hosts!

2019 Kicking Butt 5K booths Gastro Health Partners at the 2019 Kicking Butt 5k

The Kicking Butt 5k is an annual race put on courtesy of the Colon Cancer Prevention Project. Our very own physician Dr. Whitney Jones founded the Colon Cancer Prevention Project in 2004.  All of the funds raised as a result of the event go towards supporting their mission of eliminating preventable colon cancer death and suffering. The Project’s resources span from education and advocacy, to health systems improvement and survivor support. While colon cancer is the second leading cause of cancer deaths, many don’t understand how preventable it is. A donation of $50 can help reach over 100 people who may need to be screened for colon cancer.

5K at the big four bridge 5k at the Louisville Waterfront Park

While the 5k is over, donations can still be made online. For more information on when you or a loved one should start the screening process, schedule an appointment with us online. We have a clinical team of 21 fellowship-trained Gastroenterologists and 13 advanced practice clinicians. All of which conveniently serve the Louisville, Lexington, Kentucky and Southern Indiana communities.

 

2019 Kicking Butt 5K

Join us Saturday, August 24th at at the beautiful Big Four Bridge on Waterfront Park in Louisville, Kentucky for the 2019 Kicking Butt 5k!

This annual family friendly event is put on by the Colon Cancer Prevention Project whose mission it is to eliminate preventable colon cancer death and suffering. Participants are encouraged to spend the morning walking, strolling, running, and rolling to a world without colon cancer! Whether you’re a survivor, fighter, advocate, healthcare provider or community partner, all are welcome!

You can donate to the cause or register for the event online. The race starts at 8:30am with day of registration beginning at 7:30am.

Kicking Butt 5k

About the Colon Cancer Prevention Project

Our very own Dr. Whitney Jones founded the Colon Cancer Prevention Project in 2004. Since then, colon cancer is down more than 25% in the state of Kentucky. The project works to bring awareness to what is a highly preventable disease as well as offer support to those fighting it.

While colon cancer is the 2nd leading cause of all cancer deaths in the United States, when it is detected early, colon cancer is up to 90% curable. According to the Colon Cancer Prevention Project, “It is estimated that 6 out of 10 (60%) deaths from colon cancer could be prevented if everyone were screened at 50.” However, even young people are at risk for developing the disease. 1 in every 10 patients diagnosed are under the age of 50.

How to Take Action

Prevent colon cancer by talking to your doctor about the right time to get screened. It is recommended that men and women of average risk should start screenings by age 50. However, those with a family history or symptoms may need to be screened sooner. Don’t be afraid to ask your family if they’ve been screened as doing so could save their life.

The Gastroenterology Health Partners proudly sponsors the 2019 Kicking Butt 5k. Get screened and schedule an appointment by contacting us today!

National Clinical Alert Part 3: Preventing Young Adult Colorectal Cancer

Health care providers can aid in young adult colorectal cancer prevention by taking steps to educate the public on the rising rate of colorectal cancer found in people under the age of 55. For example, 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. This is in large part due to a general lack of awareness of young onset colorectal cancer.

The following are important actions steps health care providers can take in preventing young adult colorectal cancer:

1. Be Informative About Basic Digestive Health

Educating patients on the basics of digestive health should be part of regular office visits, especially yearly exams. Patients should understand what and where the colon is and know to take symptoms seriously should they experience them. For example, rectal bleeding and blood in the stool is never normal. Such symptoms require further assessment by a doctor to determine the root cause.

2. Relaying the Risk Factors

Patients should also be made aware of the risk factors associated with having a family history of colorectal cancer and or advanced colorectal polyps. Assessing one’s family history is critical in determining one’s risk for developing colorectal cancer themselves. Those at an increased risk may be eligible for more frequent colorectal screenings at an earlier age than others.

3. The Importance of Early Assessments

Patients at any age that are presenting symptoms or signs of colorectal cancer should be referred for diagnostic evaluation immediately and be given an early assessment with their physical exam. If found and treated early, colorectal cancer has a 90% survival rate.

To schedule an appointment or refer a patient, contact the Gastro Health Partners location nearest you today.