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GI Luminal Stenting

GI Luminal Stenting is a procedure that inserts a stent in the GI tract to relieve obstruction. Here’s everything you need to know about the procedure. 

When it’s used

GI Luminal Stents can relieve obstructions in the GI tract. Obstructions are caused by numerous diseases, like GI cancers. They can cause blockages of food, fluid, and waste, and lead to symptoms like vomiting, nausea, and severe abdominal pain. This can be life-threatening in some cases. Surgery used to be the only option to relieve obstructions. Fortunately, stents now provide a less invasive method. 

Preparing for GI Luminal Stenting

To prepare for stenting, there are a few pre-operative steps you may need to take. For lower GI stenting, you will need to adhere to a cleansing routine leading up to the procedure. This consists of a liquid laxative you will take the day before the procedure, preparing your bowels. You will also be instructed to consume only clear liquids the day before, and drink lots of fluids in general. For upper GI stenting, you may be asked to stop eating the midnight before the procedure.

You will also need to discuss any medications you are prescribed with your doctor. It’s especially important to mention any blood-thinners you are taking. These increase the risk of excessive bleeding, and you will need to stop taking them before the procedure. Additionally, if you use insulin, you will need to adjust your dosage and timing leading up to the procedure. 

During the procedure

Directly before your procedure, you will go to a pre-operation area where nurses will place an IV and take your medical information. You will also talk with an anaesthesiologist about the sedation used during the procedure. Machines will monitor your vitals throughout the stenting procedure. 

Your doctor will place the stent by using an endoscope. Depending on if the stent is being placed in the upper or lower GI tract, an endoscopy or colonoscopy will first be performed to evaluate the area. Once the blocked section is examined, the stent will be placed through the endoscope. 

Stents are simply hollow tubes made of flexible wire that is tacked to a mesh. The stent will be advanced through the endoscope with a guide wire. When it is positioned, your doctor will expand the stent to help open the obstruction. 

After GI Luminal Stenting

You will go to a post-operation area following the procedure. There, nurses will monitor you for any signs of complications from the sedation or procedure. Once you are recovered, your doctor will discuss preliminary findings with you. Some findings (like those from biopsies) may take several days to come back. 

You shouldn’t drive, operate machinery, or make important decisions for 24 hours following the procedure due to potential lingering sedative effects. You should also follow a clear liquid diet for a few days following the procedure, eventually transitioning to a bland diet. You’ll formally receive all of these instructions before you leave. 

Complications from GI Luminal Stenting are rare. Perforation occurs in less than 5% of cases, and requires surgery to repair. Stents can also migrate on rare occasion. When this happens, patients experience obstruction symptoms again, and should contact their doctor to remove or replace the stent. 

Our experienced team at GHP has years of experience performing GI Luminal Stenting. 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.

 

Single Balloon Enteroscopy: A Closer Look

Single Balloon Enteroscopy is a procedure that allows doctors to examine the small intestine. Follow along for everything you need to know about the procedure.

When Single Balloon Enteroscopy used

A Single Balloon Enteroscopy is used to examine, diagnose, and treat diseases in both the upper and lower GI tract. The advantage of the procedure is that it gives access to the entire small intestine, which is around 20 feet long on average. Other procedures cannot provide reach to effectively examine or treat the small intestine. The Single Balloon Enteroscopy lets doctors get access and live imaging of parts of the GI tract that are otherwise inaccessible. This is important for examining sources of GI bleeding, taking biopsies, removing polyps or foreign objects, and enlarging strictures.

Preparing for the procedure

There are a few important pre-operative steps you need to take prior to a Single Balloon Enteroscopy. You will need to discuss any medications you are taking with your doctor. Certain blood-thinning medications can pose risks of excessive bleeding during the procedure. Additionally, if you take insulin, you may need to adjust timing and dosage leading up to the procedure.

You will need to adhere to a clear liquid diet the day before the procedure. You will also be asked to refrain from eating starting the midnight before the procedure. In addition to these steps, you will need to use a cleansing routine the day before your procedure. This entails a liquid laxative that clears and prepares your bowels for examination. Your doctor will give clear instructions for all of these important steps leading up to your Single Balloon Enteroscopy.

During Single Balloon Enteroscopy

On the day of your procedure, you will first check in to a pre-op area where nurses will place an IV and take medical information. You will also meet with an anaesthesiologist to discuss sedation during the procedure.

The procedure takes around 60-75 minutes total. Your doctor will use a balloon system consisting of a flexible endoscope with a camera, an overtube, and an attached inflatable balloon at the tip of the overtube. They first insert the endoscope down your throat and into your intestine (you will have a mouthguard to protect your teeth and the endoscope). They will inflate the balloon to anchor the overtube, and then advance the endoscope further into your small intestine. Cyclically, they can then deflate the balloon, advance the overtube, reinflate the balloon, withdraw the overtube to shorten and straighten your small intestine, and advance the endoscope further. This pleats the small intestine over the overtube, shortening the small intestine’s length.

The endoscope is also able to inflate your intestine, rinse it with water, and guide biopsy and cautery instruments. Since you will be sedated, given pain medications, and given a local oral anaesthetic, the procedure is pain-free.

After the procedure

Following the procedure, you will return to a post-op area to recover from sedation. Nurses will monitor you for potential complications. After recovery, your doctor will discuss findings with you, although some results for biopsies and polyp removal can take a few more days to be finalized). You should not drive, make important decisions, or operate machinery for 24 hours after the procedure due to sedative effects.

You may feel bloated for a few hours after the procedure, which is normal. There are few severe complications and risks associated with Single Balloon Enteroscopy. On rare occasions, the procedure can cause perforation, excessive bleeding, and complications from sedation. If you experience excessive rectal bleeding, severe abdominal pain, or a fever, contact your doctor immediately.

Our experienced team at GHP has years of experience performing Single Balloon Enteroscopies 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.

Radiofrequency Ablation: What You Should Expect

Radiofrequency ablation (RFA) is a procedure that utilizes radio waves to destroy diseased tissue. Here’s what you need to know if you are preparing for the procedure. 

When it’s used

Radiofrequency ablation can be used during an upper endoscopy to treat Barrett’s esophagus. People with Barrett’s esophagus have an increased risk of esophageal cancer, and RFA can eliminate this risk by destroying pre-cancerous tissue in the esophagus. Patients with both high and low grade dysplasia should almost always pursue radiofrequency ablation. It has an 80-90% success rate in removing Barrett’s esophagus long-term. There is a chance that Barrett’s can develop again after a successful procedure. However, repeat treatments are effective and often able to eliminate abnormal tissues entirely. 

Preparing for Radiofrequency Ablation

To prepare for RFA, your physician will discuss preoperative steps with you. First, you will need to talk to them about medications you are taking that could be a risk factor. For example, blood-thinning medications can increase the risk of excessive bleeding during the procedure. Additionally, if you use insulin, you may need to adjust dosage or timing leading up to the RFA. Your doctor will also ask you about any allergies to medications. You will be instructed to stop eating at midnight the day before the procedure. 

During the procedure

Before the procedure, you will be on an IV and will give your medical information in a pre-op area. An anaesthesiologist will then discuss sedation for the procedure. Then, you will go to the procedure room. Doctors will connect you to monitors that measure your heart rate, blood pressure, and blood oxygen levels.

Your doctor will perform radiofrequency ablation during an upper endoscopy. You will be on your left side. A bite block will be in your mouth to prevent damage to your teeth or the endoscope. You will be under sedation for the duration of the procedure. 

Your doctor will advance the endoscope into your esophagus and examine the Barrett’s esophagus. If they see any visible abnormalities, they may perform an endoscopic mucosal resection. This involves either injecting or banding any identified lesions and then using a snare device to capture, cut, and remove them. If this is not necessary, your doctor will perform RFA. They will inflate a balloon-catheter to make contact with the targeted area and apply heat energy for a second or so. 

After the Radiofrequency Ablation

Afterwards, you will wait in a post-op area where you can recover from the sedation while being monitored for any complications. Once you have recovered, your doctor will discuss their findings with you. Some results may take days or weeks to return. They will also give you information on any follow-up appointments. 

For the first 24 hours after the procedure, you should not drive or make important decisions due to sedative effects. Your doctor will also recommend a clear liquid diet for a few days following the treatment. 

Patients commonly feel some chest discomfort and have difficulty swallowing for a few days after the procedure. Your doctor will be prescribe medications to help with any pain or nausea. You will also need to take a proton pump inhibitor twice a day for 30 days. 

Complications

There are a few complications that can occur from the procedure. In around 6% of cases a stricture or narrowing of scar tissue develops in the esophagus. Doctors can treat this with dilation during an upper endoscopy. Another more rare complication is a tear in the esophagus, which occurs less than .02% of the time. 

Our experienced team at GHP has years of experience performing radiofrequency ablation. 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.

Capsule Endoscopy: What You Need to Know

A Capsule Endoscopy is a procedure that allows doctors to examine the middle part of the gastrointestinal tract. Patients swallow a pill that contains a video camera, battery, and light source. The camera takes pictures as it travels through the GI tract, which allow doctors to examine the GI tract. 

Here’s what you need to know about the procedure. 

When it’s used

Capsule Endoscopies are used to examine the small intestine, which is not easily reached with other endoscopy procedures that involve passing an endoscope through the throat or anus. Specifically, the procedure can help doctors investigate causes of bleeding in the area, polyps, tumors, inflammatory bowel disease, and ulcers. 

Preparing for a Capsule Endoscopy

There are a few important steps to take to prepare for a Capsule Endoscopy. Your doctor will give you specific instructions leading up to the procedure. A cleansing routine is at the core of the preparations. You should stop eating and drinking 12 hours before the procedure, and may need to follow a clear liquid diet prior to that. You may also need to take a laxative to flush out your small intestine. All of this can help improve picture quality from the procedure. Additionally, you will need to discuss your medical history and medications with your doctor. 

During the procedure

The procedure begins with you swallowing the camera capsule with water. A monitor is attached to your abdomen to record images obtained from the camera. You are then able to leave the office and go about your day. Some restrictions apply as the camera records, like strenuous activity. 

As the camera in the capsule passes through your digestive tract, it will take thousands of color pictures. The images are saved and transferred to a computer, where they are then strung together into a video format. This is what your doctor will view to examine your digestive tract. Getting results back can take a week or two. 

After the Capsule Endoscopy

Around two hours after the procedure, you can start drinking clear liquids again. After four hours, you can have a light lunch or snack. The procedure is over after eight hours or when you see the capsule after a bowel movement, whichever occurs first. Since everyone’s digestive system varies, you may pass the capsule in a few hours or in a few days. At that point, you can remove the monitor, pack it up, and follow the equipment return instructions given by your doctor. You can flush the camera capsule. If you have not seen the capsule pass within two weeks, you should contact your doctor. 

Complications from a Capsule Endoscopy are rare. In some cases, the capsule can get stuck in the digestive tract, especially where there is a stricture from surgery, a tumor, or inflammation. Symptoms of obstruction include vomiting, abdominal pain, and unusual bloating. It’s important to recognize the signs of an obstruction early on. Contact your doctor if you experience any of these symptoms after the procedure. 

Our experienced team at GHP has years of experience performing Capsule Endoscopies. 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.

 

Preparing for an Upper Endoscopy

An Upper Endoscopy (EGD) is an outpatient procedure in which an endoscope is passed through the throat to examine the lining of the upper GI or digestive tract. There are a few things you should know about an EGD if you are preparing for one. Here’s an overview of the Upper Endoscopy: 

When it’s used

The Upper Endoscopy allows gastroenterologists to examine the upper digestive system. Doctors can use the procedure to diagnose or treat conditions affecting the stomach, esophagus, and duodenum (beginning of the small intestine). It can help determine the cause of digestive symptoms like vomiting, trouble swallowing, gastrointestinal bleeding, and abdominal pain. The procedure also allows doctors to collect tissue samples to test for specific conditions or diseases like anemia or cancer. They can even use the procedure to treat some conditions; doctors can clip off polyps, treat bleeding, remove foreign objects, and widen a narrow esophagus during the procedure. 

Preparing for an Upper Endoscopy

To prepare for an Upper Endoscopy, there are a few steps you need to take. Your doctor will discuss these with you. You should abstain from eating or drinking starting around six hours before the procedure. This is helpful because an empty stomach allows for a safer and more effective examination. Your doctor will give you specific guidance on timing for starting to fast, as it can vary case-to-case. 

Additionally, you should discuss any medications you are taking with your doctor. You may need to adjust the dosage of medication leading up to the procedure; in particular, blood-thinners can cause excessive bleeding during the procedure, so these should be addressed. If you take insulin, you will need to adjust your dosage or timing before the procedure as well. Last, you and your doctor will need to discuss any allergies to medication that you have. 

During the procedure

An Upper Endoscopy is an outpatient procedure, meaning that you will be able to leave the location of your procedure the same day it occurs. Directly before an EGD, you will enter a pre-op area where nurses will place an IV and record your medical history. An anaesthesiologist will also discuss how sedation will be used during the procedure.

After, once you have been taken to a procedure room, you will be connected to monitors that track your heart rate, blood oxygen levels, and blood pressure. You will be under sedation for the procedure’s duration, which takes around 10-15 minutes. During the procedure, a bite block is inserted in your mouth to prevent damage to your teeth or the endoscope. As you are on your left side, the doctor will pass the endoscope through your mouth and into your upper digestive tract. Depending on your situation, they will then examine, diagnose, or treat as needed. 

After the Upper Endoscopy

After an EGD, you are taken to a post-op room to be monitored for any potential complications. Your blood pressure, breathing, and pulse will be monitored for stability. Your doctor will discuss initial findings with you after you have recovered. Results from biopsies will take several more days to come back. Because of the sedative effects, you will need someone to drive you home. Additionally, you should avoid operating machinery or making important decisions for 24 hours. Your diet may return to normal, unless otherwise indicated by your doctor. It’s normal to feel gassy or bloated following the procedure, and mild cramping or sore throat is common for a brief time post-op. 

Though uncommon, there are some more severe complications to be on the lookout for following the procedure. If you notice tarry stools, severe abdominal pain, fever and chills, or difficulty swallowing after the procedure, contact your doctor immediately. These can be signs of complications like excessive bleeding from a biopsy, a perforated intestine, or a reaction to sedation. In general, these severe complications are very uncommon, and are far outweighed by the general safety and health benefits of an upper endoscopy. 

Our experienced team at GHP has years of experience performing EGDs. 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.

 

Crohn’s & Colitis Foundation 2020 Take Steps Walk

Join us on Saturday, June 20th for the Crohn’s and Colitis Take Steps Virtual Walk

The Take Steps Walk is put on by the Crohn’s & Colitis Foundation, an organization with a mission to provide support and resources for people suffering from Inflammatory Bowel Disease. The nationwide walk will help fund patient services, education, advocacy and research.

Gastroenterology Health Partners proudly sponsors this event. Through better treatment methods and cures, we can improve the quality of life for those affected by IBD. To schedule an appointment and get screened, contact us today.

This Year’s Virtual Walk

In light of CDC guidelines during the ongoing COVID-19 pandemic, the Crohn’s & Colitis Foundation will not be hosting in person walks this year. Instead, they are hosting a national TAKE STEPS + VIRTUAL walk experience on Saturday, June 20, 2020. Visit their website to read a full update on the event.

What is Inflammatory Bowel Disease (IBD)?

IBD is a term that describes disorders involving chronic inflammation of the digestive tract. Crohn’s Disease and Ulcerative Colitis are two of the most common types of IBD. Crohn’s Disease affects the lining of the entire digestive tract. Ulcerative Colitis specifically inflames the lining of the colon and rectum.

While the causes for Crohn’s Disease and Ulcerative Colitis are currently unknown, combined they affect nearly 3.1 million Americans. Patients tend to get diagnosed between the ages of 15 and 35. However, the fastest growing segment of patients is children under the age of 18.

IBD and COVID-19

The Crohn’s & Colitis Foundation has compiled helpful information and resources on the topic of COVID-19 and IBD on their website. This includes video interviews with medical professionals, helpful tips, and other resources. Visit their website to learn more.

Join and Support the Walk

The Crohn’s and Colitis Take Steps Walk is a great opportunity for patients, families, healthcare providers and organizations to come together as a community and offer lasting support to one another. For those interested in registering as a virtual walker, donating, or creating a team of virtual walkers, visit the Virtual Walk FAQ page for more information. Each team and individual is able to set their own fundraising goal. Visit the Kentucky Take Steps page or the Indiana Take Steps page to learn more, register, and make a donation!

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 Hepatitis B?

Hepatitis B is a liver infection that can cause both acute and chronic liver complications. It can lead to serious health issues over time. Here’s what you need to know about Hepatitis B. 

Causes and Risk Factors 

Hepatitis B is caused by the hepatitis B virus (HBV). This virus is transmitted in several ways, including blood, semen, and other bodily fluids, but not through sneezing or coughing. Some common modes of transmission are sexual contact, needle sharing, and mother to child. People who have unprotected sexual contact with someone infected with Hepatitis B are at a higher risk. They can contract the infection if any saliva, semen, blood, or vaginal secretions from the infected person enter their body. Also, since HBV can spread easily through infected blood on needles and syringes, intravenous drug-users who share equipment are at a heightened risk for contracting Hepatitis B. Mothers can pass the virus to their newborns during delivery as well. 

Types

Hepatitis B can be an acute or chronic infection. Acute cases last less than six months, and the immune system clears the virus from the body without long-term effects. Most adults who get the infection have an acute case. Chronic cases last over six months, and occur when the immune system can’t fight off the virus. Younger children are more likely to have a chronic case- 80-90% of infants who are infected in their first year develop chronic infections, and 30-50% of children under the age of 6 develop chronic infections. Fewer than 5% of healthy adults develop chronic cases.

Symptoms and complications

Symptoms of Hepatitis B can range from mild to severe, and usually appear one to four months after infection. They include joint pain, fever, loss of appetite, abdominal pain, dark urine, jaundice, fatigue, nausea, and vomiting. Some people, who are infected may show no symptoms; this is most often the case for younger children. 

Chronic Hepatitis B can lead to serious complications, including Cirrhosis, liver failure, liver disease, liver cancer, Hepatitis D, and kidney problems. 

Diagnosis

The symptoms of the infection overlap with numerous other viral infections. As such, blood testing is used to diagnose. People who may have been exposed to Hepatitis B, or who have been in high-risk occupations or places, are encouraged to get tested. Blood tests can indicate a number of things including whether you currently have HBV, whether you have ever had HBV, if you are infectious, and whether the infection is acute or chronic (through follow-up testing). 

Since Hepatitis B can cause no symptoms in some cases, certain groups of healthy people are often recommended for testing. These groups include pregnant women, HIV-infected people, hemodialysis patients, and people who require immunosuppressive or cytotoxic therapy. 

Treatment and Prevention

In cases of acute infection, treatment for Hepatitis B involves symptom management. In some cases, a timely post-exposure prophylaxis can prevent the infection. This usually involves administering the Hepatitis B vaccine, and may include adding immune globulin to bolster protection. 

The vaccine is an effective prevention measure. The vaccine schedule is usually for three injections: an initial injection, one a month later, and one six months from the initial injection. All infants should receive the vaccine, in addition to any unvaccinated children under 19, people at risk of exposure (including some health care professionals, people with Hepatitis B positive partners, and some people with diabetes). Prior to travel, seek guidance from a doctor regarding vaccination. 

Mitigating risk factors is also crucial for preventing infection. People who intravenously inject drugs should seek help to stop use, or use clean needles and avoid needle sharing. Additionally, you should always seek to know the HBV status of your sexual partner(s). People who have sex with partners that may have the infection should use a new latex or polyurethane condom every time they have sex. Additionally, if you are going to get a tattoo or piercing, make sure you utilize a reputable and sterile shop. 

Our experienced team at GHP has years of experience helping people prevent, manage and treat Hepatitis B. 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.

 

Hemorrhoids: An Overview

Hemorrhoids is a term given to a condition in which the veins around the anus or rectum become swollen or inflamed. They can occur inside the rectum or around the anus. Hemorrhoids are extremely common- around 3 in 4 adults will experience hemorrhoids, and about half of all people will have hemorrhoids by age 50. 

Here’s an overview of hemorrhoids. 

Symptoms of Hemorrhoids

The symptoms of hemorrhoids vary based on whether they are internal (inside the rectum) or external (around the anus). External hemorrhoids can cause bleeding, pain, irritation or itching around the anus, and swelling around the anus. Internal hemorrhoids don’t usually cause any pain or discomfort, but they can cause bleeding during bowel movements. Sometimes, these can also push through the anus (prolapse), which can lead to irritation and pain. 

Causes and Risk Factors

The veins around your anus stretch under pressure, and may swell or bulge as a result of too much pressure. As such, anything causing this pressure can cause hemorrhoids. This includes straining during bowel movements, heavy lifting, anal intercourse, having a low-fiber diet, being pregnant, being obese, and sitting on the toilet for long periods of time. 

The risk of developing hemorrhoids increases with age. Tissues supporting veins in the anus and rectum weaken and stretch with age, and can increase risk. Additionally, this same stretching and weakening can happen during pregnancy as baby weight puts pressure around the anus.  

Treatment for Hemorrhoids

Treatment can often take place at home, and for mild cases includes using medications and taking warm baths. Larger or more persistent cases may be cause for seeking further medical attention. Doctors may recommend surgery or banding. Banding is non-invasive and non-surgical. To perform banding, a doctor places a rubber band around a hemorrhoid to cut its blood supply and cause it to wither. This may be recommended for cases with significant persistent bleeding. Typically, two or more cases are required for treatment with banding. 

Prevention

Preventing hemorrhoids involves a few simple lifestyle changes and home remedies. First, eating the proper amount of fiber is important; fiber softens stools and makes them easier to pass, decreasing the likelihood of straining or pressure. Exercise also helps, stimulating bowel function and keeping you regular and less likely to have straining bowel movements. Try not to sit for long periods of time, as it can increase pressure around the anus. Always use the bathroom as soon as possible when you need to defecate as well- waiting can cause build-up and increase strain. Don’t strain during bowel movements either, as this will add pressure around your anus and rectum. All of these simple behavior changes can be incredibly effective prevention measures. 

A warm bath for the buttocks can also help relieve irritation around the anus. A 20 minute warm bath after defecation and a few more baths each day can ease any potential flare-ups. Last, avoiding hard sitting surfaces can prevent hemorrhoids from forming, and also helps ease symptoms of existing ones. 

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