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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.

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

Dr. Matthew McCollough on Teachable Moments

Dr. Matthew McCollough was recently featured in an MD-Update Magazine article highlighting his passion for communicating with patients:

 

 Like all physicians, Matthew McCollough, MD, completed years of education and training before reaching his current position as gastroenterologist at Gastroenterology Health Partners’ (GHP) New Albany, Indiana location. As much as he enjoyed learning, he also enjoys imparting that knowledge to his patients, enabling them to better understand and manage their own health. But, contrary to what you might think, imparting that knowledge begins not with a lecture, but by listening.

 “When it comes to talking to patients, I make sure they know I’m listening to them,” McCollough says. “I need to make a personal connection with them that I care about their disease, I care about their complaints. I always ask the question, ‘If I could fix one or two things magically today, what would you like me to do? I’m having a one-on-one conversation with you, you can trust me, I’m going to listen to your complaints, and even if I can’t fix them, I’ll be honest with you about it and try to get you to the right place.’ Having a connection and being able to educate them on their disease and also letting them know that I care, because I do.”

 Those instincts to educate and care for others led to McCollough developing an interest in the medical profession at an early age. He grew up in western Kentucky and attended Georgetown College, in central Kentucky, where he met his wife Robin, who is a physical therapist. He attended the University of Louisville School of Medicine, graduating in 2003. He completed his internal medicine residency there and served as chief medical resident for a year, enjoying the opportunity to teach students. He stayed in Louisville to complete his gastroenterology fellowship in 2010.

 “I love knowledge and teaching people about things,” McCollough says. “Helping people’s quality of life is the main reason I became a doctor. Gastroenterology has allowed me to have a breadth of knowledge that was broad and affords me the ability to continue to learn and help people in a unique way.”

Read the full article here:

 

Lowering Your Risk of Liver Disease

Liver disease is a general term used to cover multiple types of diseases that affect the liver and its functions in the body. These diseases include cirrhosis, cancer, infectious hepatitis, and blood flow abnormalities, to name a few. 

The liver has a role in many important bodily functions, including iron storage for red blood cell production, bile production, and generally digesting food and getting rid of toxins. Liver disease can affect these functions negatively and eventually lead to serious outcomes if untreated. 

Liver disease can be caused by a variety of things, come of which are controllable and others which aren’t. Luckily, though, there’s a lot you can do to reduce your risk. Let’s take a look at some key factors you can manage to lower your risk for liver disease. 

Exposure to toxins

A healthy liver helps filter out toxins from the blood. However, when too many toxins are present over time, the liver can become damaged. Chemicals found in household products, pesticides, and the like can cause liver damage over time if ingested. Always read warning labels for any chemicals you use to make sure you are employing proper safety measures and practices. Wash your fruits and vegetables before consumption too. In fact, go for clean produce and fruit when you can- pesticide-free food is the best way to ensure you aren’t overexposed to toxins when you eat. 

Alcohol consumption

Liver injury can occur due to alcohol abuse. When you drink too much over a long period of time, this starts to cause fat accumulation in your liver and can eventually lead to more damage. There are also other coinciding factors that can increase risk, like smoking. 

One key way to lower your risk of liver disease due to alcohol consumption is to decrease use. Abstaining from alcohol is incredibly effective in lessening damage, and in earlier stages of fatty accumulations in the liver may even reverse some damage. Even just reducing your amount of consumption to a healthier level is significant. For reference, moderate drinking is defined as up to 1 drink per day for women and up to 2 drinks per day for men. Heavy drinking is defined as 8 or more drinks per week for women and 15 or more drinks per week for men. 

Infection

Liver disease can also develop as a result of infection, which can occur from viruses or parasites. Viruses causing liver damage may be spread through close contact with an infected person, their blood or semen, or contaminated food and water. It’s important to take precautions to avoid virus exposure, including using protection during sex, avoiding needle sharing if you use drugs, and ensuring clean equipment is used on any tatooing equipment you come in contact with. 

Obesity, Diabetes, and High Cholesterol

Obesity, Diabetes, and High Cholesterol can lead to fatty accumulations in the liver. This can turn into nonalcoholic fatty liver disease, which like other types of liver disease, can become more severe over time. Fortunately, liver health can be improved by cutting simple carbohydrates and adding in more healthy fruits, vegetables, and proteins to your diet. 

Our experienced team at GHP has years of experience helping patients manage and treat liver disease. We can help you 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.

Understanding Crohn’s Disease

Crohn’s disease is an inflammatory bowel disease that causes inflammation in the digestive tract. Crohn’s can occur in any area of the digestive tract from mouth to anus, but most often affects the lower small intestine. 

Here’s what you need to know about Crohn’s Disease. 

Causes and Risk Factors

The cause of Crohn’s disease isn’t fully understood. It may be due to an abnormal immune response to a microorganism, where the immune system injures cells in the digestive tract. Heredity may also be a cause, as Crohn’s is more common for people with a family history of the disease. However, most people with the disease do not have a family history of it. 

There are some risk factors for Crohn’s that are important to be aware of too. Age plays a role- you are most likely to develop Crohn’s before the age of 30. Smoking can cause Crohn’s to increase in severity. Using NSAID’s like ibuprofen can cause inflammation in the bowels and worsen symptoms. Higher fat and processed foods seem to increase the odds of developing Crohns. Having a family member with Crohn’s is a significant risk factor as well- around 1 in 5 people with a family history of Crohn’s disease will develop it themselves. 

Symptoms

As a chronic disease, Crohn’s often affects people differently over time. Flare-ups and periods of remission are common. Disease severity varies widely, with cases ranging from mild to severe. In severe cases, Crohn’s can affect multiple layers of the intestine, while other times some layers may remain healthy. 

Some of the most common symptoms are persistent diarrhea, abdominal pain, rectal bleeding, an urgent need to defecate, weight loss, and a loss of appetite. More severe complications may develop from the disease. These include anal fissures, strictures, and fistulas. Crohn’s disease also increases the risk of colon cancer.

Diagnosis

Crohn’s disease is usually diagnosed after a process of ruling out other explanations for symptoms. Diagnostics are done through several types of testing. Blood tests can check for anemia or infection. A colonoscopy can provide a view of the colon and give the opportunity for tissue samples doctors can check for clusters of inflammatory cells. Additionally, an MRI, CT scan, capsule endoscopy, or balloon-assisted enteroscopy may be pursued depending on the situation. 

Treatment

Treating Crohn’s centers on reducing inflammation, increasing periods of remission, and decreasing flare-ups. Treatment plans vary based on each person’s situation. Several types of medication can help decrease inflammation, including aminosalicylates, corticosteriods, immunomodulators, and biologic therapies. Many of these medicines decrease inflammation by targeting and reducing aspects of the immune system. Another type of treatment for more severe Crohn’s is bowel rest. This can entail intravenous (IV) nutrition or a feeding tube over the course of days or weeks. 

Surgery is another common treatment for people with Crohn’s disease. While surgery won’t cure the disease, it can significantly improve symptoms and decrease complications. Surgical procedures can treat fistulas, internal obstructions, and life-threatening bleeding. Some procedures can even remove part of the small or large intestine. Sometimes patients need to have their entire colon and rectum removed through a surgery called a proctocolectomy. During this procedure, surgeons also create an opening in the abdomen called a stoma. A removable collection pouch (called an ostomy pouch) then collects stool outside of the body. 

While there is no cure for Crohn’s, there are a multitude of ways medical professionals can help people manage the disease and live healthier lives. 

Our experienced team at GHP has years of experience helping patients manage and treat Crohn’s disease. We can help you 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.

 

Peptic Ulcer Disease: What You Need To Know

Peptic Ulcer Disease (PUD) occurs when a person has chronic peptic ulcers. Peptic ulcers are sores in the stomach or duodenum lining that develop when stomach acid deteriorates the lining. There are several treatment options available for PUD based on the cause of the disease in a particular person. 

Here’s what you need to know about Peptic Ulcer Disease. 

Causes and Risk Factors 

PUD is usually caused by one of two things. First, a bacterial infection from a bacteria called H. pylori can lead to inflammation in stomach lining and eventually cause ulcers. H. pylori can be transmitted from human-to-human contact, food, or water. Second, the long-term use of anti-inflammatory medications including ibuprofen and aspirin can lead to PUD because these medications can inflame the stomach lining. 

Risk factors associated with Peptic Ulcer Disease include smoking, which can increase risk of ulcers for people infected with H. pylori, and drinking, which can wear away mucus in the stomach lining and increase stomach acid production. 

Symptoms

Common symptoms of Peptic Ulcer Disease include burning stomach pain, nausea, heartburn, bloating, and fatty food intolerance. Burning stomach pain is the most common symptom, and having an empty stomach typically increases pain. While pain may be relieved by eating foods that help buffer stomach acid or taking anti-acid medication, it usually comes back between meals and at night. Notably, while spicy foods and stress may worsen symptoms, they do not cause ulcers. More severe symptoms can include vomiting blood, blood in stool, feeling faint, and trouble breathing. People with severe symptoms should seek medical attention. 

Diagnosis

Doctors diagnose PUD through a combination of a person’s medical history, symptoms, medication history, and tests. One test, an endoscopy, uses a hollow tube with an attached lens to view the throat, stomach, and small intestine to visually detect ulcers. Additionally, doctors often perform a test by blood sample, stool sample, or breath test to determine if H. pylori is present. A tissue sample from an endoscopy may also be used in this case. If an ulcer is found during an endoscopy, doctors may take a tissue sample for a biopsy. Lastly, an x-ray is sometimes used for diagnosis- patients drink barium prior to an x-ray to allow doctors to see internal organ detail. 

Treatment 

Treatments for PUD vary. For ulcers caused by H. pylori, antibiotics can help kill the bacterium through two weeks of treatment. Thereafter, antacid medication may be used to control stomach acid for the patient. Another treatment utilizes proton pump inhibitors, medications that reduce stomach acid by blocking cell production of acid. Another medication group used for treatment is H2 blockers, which reduce stomach acid along with reducing pain and helping healing. Lastly, antacids, medications that neutralize stomach acid, may be used to help relieve symptoms. 

Lifestyle changes are also an important part of treating Peptic Ulcer Disease. Avoiding smoking and alcohol can help reduce risk factors that lead to and worsen PUD. Managing stress can help too- relaxation and exercise can help lower stomach acid production. Lastly, changing diet can help treat PUD too. Unhealthy choices like junk food, fried food, and processed foods make it harder to heal, while whole grains, fresh produce, and fresh fruit may promote healing. 

Our experienced team at GHP can help you get the treatment you deserve for PUD. We can help you establish the best plan of care for your situation. Contact any of our office locations learn about the options we offer and schedule an appointment today.

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.

What is Infusion Therapy?

When people become severely sick or weighed down by compound disease conditions, oftentimes they have difficulty swallowing. This can make seemingly simple things like eating, drinking and taking medications difficult.

Additionally, certain medications may not be recommended orally since an individual’s stomach acids may affect their quality, rendering them ineffective when it comes to treating diseases.

There are many reasons why people may receive medication through their body instead of their mouth (orally).

What is Infusion Therapy?

Infusion therapy is an alternative to oral treatment that entails the administration of drugs or medicine through a sterile catheter or needle. These are often introduced into a patient’s vein and secured by a professional healthcare provider. This treatment option has been used for a long time by hospitals.

Increasingly, infusion therapy is also applied in outpatient healthcare settings and community care centers, by specialized nurses who are professionally trained to carry out this procedure. At Gastroenterology Health Partners, our outpatient infusion center is available to patients in a convenient and higher quality setting, with no wait time and ample appointment availability. Depending on one’s insurance carrier and plan, this procedure can often be done at a lower cost, with the benefit of getting to know the same infusion RN over time.

What Medical Conditions Does Infusion Therapy Treat?

Infusion therapy is primarily used to treat severe or chronic diseases and infections that may not respond to oral antibiotics. There are many examples of disease conditions and infections that are treated continuously using infusion therapy. This includes different types of cancers, gastrointestinal tract infections, Crohn’s disease, ulcerative colitis, and inflammatory bowel disease.

An Overview of What to Expect with Outpatient Infusion Treatment

There are a couple of factors that you need to expect with outpatient infusion treatment or therapy.

The infusion process typically lasts for an hour, but this does vary. The time taken during this therapy is based on the type of medication administered and also the kind of illness or infection being treated. While some medicines require more extended periods of infusion, others take a short time.

Dosage also dictates the length of infusion. In some cases, patients receive their infusion dosage slowly, especially for their first time. Whereas for others, it may take a longer length of time. This may be done to confirm that a patient doesn’t develop adverse reactions to the medication offered via infusion.

Prior to the administration of infusion therapy, there is also some preparation. This might involve recording a patient’s blood pressure, weight, height, and body temperature.

Prior to infusion therapy your doctor might ask you to prepare by drinking a specific amount of water. You may also be advised to wear comfortable clothing for the procedure.

As an infusion patient, you have a choice in deciding a location for your infusion therapy. Cost and convenience are critical to this decision.  GHP offers the convenience of this service to its patients at a cost which is far lower than an inpatient setting. Contact any of our office locations to reach a dedicated infusion therapy concierge to confirm options available to you based on your specific health plan.

Understanding IBD (Inflammatory Bowel Disease)

Inflammatory bowel disease (IBD) is a disorder of the digestive tract that results in chronic inflammation. Ulcerative colitis and Crohn’s disease are the two most common forms of IBD. Ulcerative colitis specifically affects the colon and rectum while Crohn’s disease inflames all areas of the gastrointestinal tract. While a direct cause is not known, inflammatory bowel disease is thought to be a result of an abnormal immune response that causes the immune system to attack the digestive track.

Signs & Symptoms

  • Diarrhea
  • Unexplained weight loss
  • Loss of appetite
  • Blood in stool
  • Fever
  • Fatigue
  • Abdominal pain and cramping
  • Lack of childhood development

While one’s stress and diet may not be directly causing inflammation, lifestyle changes can help to relieve symptoms. Avoid dairy products and other problematic foods to see how they affect your flare-ups. Additionally, while fiber is known to help with bowel issues, it could behaving an adverse effect. Drink plenty of water and experiment with more frequent smaller meals.

Risk Factors

  • Age: Most patients are diagnosed with inflammatory bowel disease before the age of 30.
  • Race & Ethnicity: Caucasians and those of Ashkenazi Jewish decent are at the most risk for inflammatory bowel disease.
  • Family History: Those with a first-degree relative who have suffered from IBD are more likely to develop it themselves.
  • Cigarette Smoking: IBD is most common among smokers.
  • Medications: Anti-inflammatory medicines such as ibuprofen, Advil and Aleve have been known to aggravate IBD.
  • Environment: The disease tends to affect those who live in more urbanized and developed areas as well as northern climates.

Patients who are experiencing signs of IBD or know that they are at an increased risk for developing it should take preventive measures by routinely checking in with a healthcare professional. Having IBD increases your risk for colon cancer and blood clots.

Although there is no cure for inflammatory bowel disease, medication is an effective treatment option for those with ulcerative colitis. However, 70% of those with Crohn’s disease often require surgery in order to relieve their symptoms.

If you or a loved one feels they could have ulcerative colitis or Crohn’s disease, schedule an appointment with one of our fellowship-trained gastroenterologist 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: