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Understanding Crohn’s Disease – An Overview

Sometimes referred to as Ileitis, Crohn’s disease is a chronic condition known to cause inflammation and scarring in the intestinal tract. While the intensity of the symptoms may vary, most people with Crohn’s disease experience uncomfortable abominable pain and cramping along with diarrhea, fatigue, a reduction in appetite, sores in the mouth, and anemia. The condition is often marked by periods of severity or flare-ups, followed by remissions.

Estimates from the Crohn’s & Colitis foundation suggest that upwards of 800,000 Americans suffer from Crohn’s disease, which is sometimes misdiagnosed as ulcerative colitis. 

While anyone can get Crohn’s disease, it tends to run in families, and to be more common among teenagers and young adults from ages 15 to 35 years. Additionally, females are slightly more likely than males to experience the condition. It is also slightly more common in the Caucasian population, and among those identifying as Ashkenazi Jews. Additionally, people who smoke are more likely to get it than nonsmokers. Smoking also can also hinder treatment outcomes and make the symptoms more frequent and severe.

If you or someone you love is suffering from symptoms that may be related to Crohn’s disease, it is important to seek out qualified medical attention from a gastroenterologist like the physicians at Gastroenterology Health Partners. Diagnosing the condition generally involves a variety of tests that may include blood tests, fecal tests, imaging tests including CT or MRI, colonoscopy procedure, endoscopy, and more. 

At present, there is not a cure for Crohn’s disease, but there are a variety of treatment approaches that depend in part on a person’s specific symptoms and the severity of the condition. Sometimes certain medications including anti-inflammatory drugs, antibiotics and corticosteroids may provide relief. 

Limiting Crohn’s Disease Flare Ups with a Dietary Approach

People with Crohn’s disease are encouraged to follow specific dietary recommendations to reduce the chance for disease flare ups. This tends to include the following:

  1. Avoid beverages with a lot of carbonation including soft drinks and carbonated waters.
  2. Limit certain high-fiber foods including the skins of vegetables, popcorn and nuts.
  3. Increase fluid intake, especially water.
  4. Drink beverages more slowly and without a straw, in order to avoid ingesting air, which can cause gas.
  5. Focus on eating foods made with basic techniques including boiling, poaching, or steaming.
  6. Avoid artificial sugars like sorbitol and mannitol, often used in sugar free candy and chewing gum.
  7. Limit lactose in milk, soft cheeses, cream cheese, and other dairy products.
  8. Limit foods that have a lot of fat including butter, coconut, cream, fried foods, greasy foods, etc.
  9. Limit beverages that contain caffeine and/or alcohol.
  10. Limit high spice foods, especially hot foods.
  11. Eat more fruits that are lower in fiber like melons (cantaloupe and honeydew) and bananas.
  12. Eat four to six frequent smaller meals a day rather than two or three larger ones.

Since each person’s experience with foods that trigger the condition may be unique, it is also advisable that people with Crohn’s keep some type of food journal to better identify patterns including which foods and beverages cause the most discomfort.

Surgery is also not uncommon for people with Crohn’s disease. In fact, estimates suggest that upwards of three out of four people with Crohn’s require surgery at some time. Though surgery does not provide a cure, it can help to preserve a person’s GI tract enough to provide some essential relief. Surgery is typically a consideration only after a person is no longer able to manage symptoms with dietary practices and medications. It may also be required if a person develops some type of intestinal obstruction, fissure, or fistula.  

For additional information about Crohn’s disease, or to schedule an appointment with an experienced gastroenterologist, contact Gastroenterology Health Partners today by reaching out to a practice location near you. 

If you are suffering from symptoms of a GI condition, the experienced team of medical professionals at Gastroenterology Health Partners is here for you using the most advanced treatment options available. We strive to provide the highest quality, most cost-effective GI care in the region. For more information or to schedule an appointment, contact Gastroenterology Health Partners today at a location near you. 

Why You Need To Add More Fiber To Your Diet

These days, the importance of consuming dietary fiber is fairly common knowledge. Most of us make an effort to add fiber to our diets, whether it be through a fiber-rich cereal or daily multi-vitamin. 

But, even if you’re taking strides to include fiber in your diet, you’re likely not getting enough! On average, Americans eat about 15 grams of fiber a day. That number should be between 25 and 35 grams, or more. And not just from supplements or vitamins, but from whole foods.

Fortunately, there are many ways to incorporate more fiber into your diet. Keep reading to learn about what fiber is, why it matters, and some high-fiber foods to add to your grocery list. 

What Is Fiber?

Dietary Fiber is a carbohydrate found in plants such as fruits, vegetables, nuts, seeds, legumes, and whole grains. Unlike other nutrients such as proteins and fats, fiber cannot be digested by the body. It simply passes through the stomach, small intestine, and colon. 

There are two types of dietary fiber: soluble and insoluble. They are important for different reasons, and many foods contain both types. Soluble fibers can be dissolved in water, which helps regulate blood sugar and cholesterol levels. Insoluble fibers cannot be dissolved in water, which adds necessary bulk to stool, promoting regularity of the digestive tract. 

Why Is Fiber Important?

Beyond fiber’s ability to regulate blood sugar levels, balance cholesterol, and promote regularity, adequate fiber consumption has been linked to a reduction in the risk of heart disease, diabetes, certain types of cancer, and many gastrointestinal conditions such as colorectal ulcers, hiatal hernias, gastroesophageal reflux disease, diverticular disease, and hemorrhoids. Plus, by reducing the risk of constipation, fiber helps improve gut health. High fiber foods are also generally healthier and more filling than processed, low-fiber foods. 

Try These High Fiber Foods

High Fiber Fruits

  • 1 cup of Raspberries: 8 grams of fiber
  • 1 Pear: 5.5 grams of fiber
  • 1 Apple: 4.5 grams of fiber
  • 1 Banana: 3 grams of fiber
  • 1 Orange: 3 grams of fiber

High Fiber Vegetables

  • 1 cup of Green Peas: 9 grams of fiber
  • 1 cup of Broccoli: 5 grams of fiber 
  • 1 cup of Turnips: 5 grams of fiber
  • 1 cup of Brussel Sprouts: 4 grams of fiber
  • 1 Potato: 4 grams of fiber

High Fiber Grains

  • 1 cup of Spaghetti: 6 grams of fiber
  • 1 cup of Barley: 6 grams of fiber
  • 1 cup of Quinoa: 5 grams of fiber
  • 1 cup of Oatmeal: 5 grams of fiber
  • 1 cup of Brown Rice: 3.5 grams of fiber

High Fiber Legumes

  • 1 cup of Split Peas: 16 grams of fiber
  • 1 cup of Lentils: 15.5 grams of fiber
  • 1 cup of Black Beans: 15 grams of fiber
  • 1 cup of Baked Beans: 10 grams of fiber

High Fiber Nuts/Seeds

  • 1 ounce (2 tablespoons) of Chia Seeds: 10 grams of fiber
  • 1 ounce of Flax Seeds: 8 grams of fiber
  • 1 ounce of Pumpkin Seeds: 5 grams of fiber
  • 1 ounce of Almonds: 4 grams of fiber
  • 1 ounce of Pistachios: 3 grams of fiber

If you are suffering from symptoms of a GI condition, the experienced team of medical professionals at Gastroenterology Health Partners is here for you using the most advanced treatment options available. We strive to provide the highest quality, most cost-effective GI care in the region. For more information or to schedule an appointment, contact Gastroenterology Health Partners today at a location near you. 

Getting Ready For A Colonoscopy Prep When You Tend To Be Constipated

Preparing for your colonoscopy is important because it enables your physician to visibly access all areas of your colon to provide the best screening possible. A successful prep – one where your colon is thoroughly cleansed in advanced – makes it easier for your gastroenterologist to do their job thoroughly and accurately. When patients do not have a successful colonoscopy preparation, and stool is still visible in the colon, it makes it much harder for your doctor to do a thorough evaluation.

If you’re a person that tends to struggle regularly with constipation, the colonoscopy prep may be a bigger concern. You may wonder if the prep will actually work and feel an added worry about how this relates to the actual procedure. Fortunately, there are some additional things you can do a week or so in advance to make the entire process easier and more successful.

People who are often constipated frequently have a longer, tortuous colon which may be more challenging to completely empty out. In these cases, your doctor may provide some additional guidance regarding your prep.  Follow along for some helpful suggestions for preparing for your colonoscopy if you tend to be constipated.

8 Things To Know If You Are Preparing For A Colonoscopy And Are Often Constipated

1. You should tell your doctor in advance that you struggle with constipation. People who tend to be constipated may have to think about their colonoscopy prep further in advance than those who are not. Make sure to let your doctor know in advance if constipation is something that you struggle with frequently. Depending on your symptoms and medical history, your doctor may advise additional things like Dulcolax to help make sure your colonoscopy prep is a success.

2. Ask your doctor about medications, vitamins and supplements you normally take. You may be advised to adjust your normal routine in some way depending on your situation.

3. Cut out high fiber foods several days before your procedure. This includes things like raw fruits and vegetables, canned and fresh corn, whole grains like oatmeal, brown rice, quinoa, popcorn, and wheat bread, all kinds of nuts, and seeds (including sunflower, sesame, and poppy). Focus instead of non-fibrous foods like soups (without vegetables), eggs, yogurt, white bread and puddings.

4. Your doctor may advise you to begin the clear liquid diet for your prep a day early (two days in advance). This involves avoiding solid foods and consuming clear liquids that are NOT red, blue, or purple in color. This includes things like gelatin, clear broth, sports drinks with electrolytes, black coffee, fruit juice like apple or white grape, and popsicles.

5. It can be helpful to drink lots of extra water the week leading up to your procedure to make sure you are very well hydrated. Not only is hydration a key part of addressing constipation, but it also may help to make your overall prep experience easier. Keep in mind that if you tend to drink caffeinated beverages like coffee and tea, these tend to have a dehydrating effect on your body, and you may need to compensate with additional water.

6. Make the time to deal with your worry and stress. Sometimes constipation is exacerbated by stress. It is important that you recognize and deal with this if possible. Find ways to help yourself relax. Consider trying mindfulness, meditation and/or breathing exercises, listen to relaxing music, and engage in other healthy practices that help you feel calmer and more relaxed.

7. Prioritize a healthy routine including getting enough sleep leading up to the procedure. While it is always important to focus on a healthy routine, including getting enough sleep each night, it may become even more important the week leading up to your colonoscopy. This can help you feel your best for the procedure, enabling you to follow the prep with greater ease, also reducing your level of stress and worry.

8. Don’t be embarrassed, constipation is something many people experience. According to the U.S. Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney diseases, constipation is common among people of every age and population in the U.S. Approximately 16% of adults experience symptoms of constipation on a regular basis, with this number increasing with age, to a third of adults 60 years and older.

Data reported by the Centers for Disease Control and Prevention (CDC) suggests that upwards of one in three adults ages 45 to 75 has not had a colonoscopy, the recommended screening for colorectal cancer. While there are many reasons why people may opt to avoid this recommended procedure, concerns about what is required to prepare for the exam certainly play a role for some.

The experienced team of medical professionals at Gastroenterology Health Partners is committed to making every patient’s experience with a colonoscopy as low stress and easy as possible. For more information or to schedule an appointment, contact Gastroenterology Health Partners today at a location near you.

What is Anorectal Manometry?

Anorectal Manometry is a procedure that measures the function of anal and rectal muscles. This test helps doctors measure function and pressure in sphincter muscles involved in bowel movements. Here’s what you need to know about the procedure.

When is Anorectal Manometry used?

Anorectal Manometry is used to help evaluate patients with fecal incontinence or constipation. As a type of manometry, it measures the coordination and force of smooth muscles. In particular, it can help evaluate the strength and coordination of sphincter muscles. In short, Doctors use Anorectal Manometry to investigate in cases of abnormal bowel movements. So, if you have difficulty passing stool, struggle with uncontrolled bowels, or experience constipation, your doctor may recommend Anorectal Manometry. Doctors also use Anorectal Manometry to assess anal and rectal muscles pre and post-surgery, investigate functional anorectal pain, and make differential diagnoses regarding anal pain.

Preparing for the Procedure

There are a few preparatory steps you need to take before an Anorectal Manometry. Your doctor will give specific instructions before the procedure. You should not eat or drink anything starting midnight the night before the test. Additionally, your doctor may ask you to take one or two enemas a few hours before the test to empty your bowels. You should also discuss any medications you are taking before the procedure. In particular, you should not take smooth muscle relaxants the day before the procedure.

During the Anorectal Manometry Procedure

Anorectal Manometry does not involve any sedatives. During the procedure, you will lie on your left side with your knees bent. Your doctor will slowly insert a small catheter (tube) through your anal sphincter to your rectum. The catheter has a balloon attached at the end. Once the balloon is in place, your doctor will attach the exposed end of the tube to a machine that inflates the balloon. Your doctor will then measure the muscle coordination and strength in your rectum and anal sphincter. You may be asked to squeeze, push, and relax at various points as they are performing the testing. The machine measures subsequent pressure changes in the balloon. Your doctor may also measure other things like rectal volume, sensation, and muscle reflexes. Once they complete measurements, your doctor will deflate the balloon and remove the catheter and balloon. The procedure takes around 30-45 minutes in total.

After the Procedure

Since no anaesthetic is used during the test, recovery is immediate. You can resume normal activities and diet. Your doctor will discuss their findings with you after the procedure. This can take some time depending on their findings.

Depending on the findings, your doctor may make some recommendations. These may include dietary changes, using certain medication, and muscle strengthening exercise. In some cases, surgery may be required.

Our experienced team at GHP has years of experience performing procedures including Anorectal Manometry. 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.

 

Everything You Should Know About Constipation

Constipation is a gastrointestinal condition which is generally characterized by three or fewer stools passed in a week. It is very common and affects around 30% of the population. Here’s everything you should know about constipation. 

Symptoms of Constipation

Constipation is defined by a few key symptoms. These symptoms include passing three or fewer stools in a week, having difficulty passing stools, having hard or dry stools, noticing blood in stool, having intense rectal or abdominal pain, and feeling like stool is not completely passed. Mild symptoms often resolve quickly, so they are usually not cause to seek medical attention. However, serious symptoms like blood in stool or needing to manually remove stool are signs that you should seek medical help. 

It’s important to note that not having a bowel movement every day is not necessarily a sign of constipation. Bowel habits fluctuate for everyone based on a variety of factors. However, you should use the described symptoms as a guide to determine if you need medical help. 

Causes and Risk Factors

Constipation most often is caused by stool moving too slowly in the digestive tract. Slow-moving stool is not effectively passed and can become hardened and dried out. Slow-moving stool can happen for a variety of reasons. Blockages from anal fissures, a bowel obstruction, bowel strictures, and certain cancers can lead to constipation. Also, neurological problems can affect nerves that help move stool through the digestive tract. These problems include Parkinson’s disease, Multiple Sclerosis, and spinal cord injuries. Muscular problems can be the root cause too. Weakened pelvis muscles, improperly coordinated pelvic muscles (dyssynergia), and chronically unrelaxed pelvic muscles (anismus) can all prevent proper stool movement. Hormones can play a role sometimes as well. Hormones that help balance fluids may be unbalanced for people who are pregnant, diabetic, or have an underactive thyroid. 

There are a few risk factors for constipation. Older people and women are more likely experience constipation. Dehydration, a low-fiber diet, a sedentary lifestyle, some medications, and mental health conditions including depression and eating disorders are also risk factors. 

Treatments and Prevention

In most cases, constipation can be treated easily. Most of the time, constipation is a disorder of bowel function and not due to other structural issues. In these cases, focusing on softening stool and getting it moving again is the best treatment. You can do this by hydrating more, eating fiber, and getting more exercise. Sometimes, taking a laxative until the constipation passes may be helpful as well. You should consult a doctor for laxative use, especially if your constipation is severe or chronic. 

The same lifestyle changes that can treat constipation are also great ways to prevent it in the first place. Always drink plenty of fluids- six to eight glasses of water per day is a good baseline. However, this varies based on factors including your age, height, weight, sex, and activity level. Avoid consuming too much caffeine, which can cause some dehydration. Eat fiber-rich fruits, vegetables, and whole grains to promote regular bowel movements. You should aim for at least 20 to 35 grams of fiber each day. Regular exercise is another great way to promote bowel movements too. Finally, always use the restroom when you feel the urge. Holding it in can cause fecal matter to accumulate and lead to constipation. 

Our experienced team at GHP has years of experience helping people manage and treat constipation. 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.

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.