Posts

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.

 

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.

Dr. Emori Carrara On Solving Gastroenterology Enigmas

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

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

Common patient complaints include:

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

Dr. Emori Carrara Specializes in Treating Susceptible Female Patients

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

GI & The Psyche

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

Colon Cancer

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

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

Read the full article here:

Dr. Abdul Jabbar on Saving Lives with Colon Screenings

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

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

What is a colonoscopy?

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

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

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

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