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Featured press release: DHPA Supports USPSTF Recommendations to Begin CRC Screening at 45, Calls for More Research on Disparities in Communities of Color

The Digestive Health Physicians Association recently announced its support for the U.S. Preventive Services Task Force (USPSTF)’s draft recommendation to begin colorectal cancer screenings at age 45. Gastro Health Partners endorses these changes as well. Read more about the DHPA’s support for the changing guidance in this press release:

“Washington, DC – The Digestive Health Physicians Association (DHPA) voiced its support for a draft recommendation by the U.S. Preventive Services Task Force (USPSTF) that Americans begin screening for colorectal cancer at the age of 45, an update of 2016 guidelines that had recommended that adults without risk factors for CRC should begin screening at age 50 and continue periodically until 75.”

Click here to read the full press release

Actor Will Smith and His Colonoscopy

Actor Will Smith recently posted a vlog on his YouTube channel documenting the process of getting a colonoscopy. His video is a great up-close look at the process and why it is so important for everyone.

The Colonoscopy Video

Will uploaded the video on YouTube on November 6, 2019. Will Smith turned 50 in 2019 and his doctor advised him to get screened for colorectal cancer. The video starts with him asking his doctor about the logistics of the procedure. He also documents the effects of the colonoscopy prep, and shows footage of him entering the exam room on the day of the procedure. We also see Will after the procedure under lingering effects of anaesthetic. The video ends with Will’s doctor talking through the exam results with him.

During the procedure, doctors actually found a polyp and removed it. Polyps are pre-cancerous lesions that are common in the colon. They removed the polyp and sent it to biopsy, where it was determined to be a tubular adenoma, a benign type of polyp that has the potential to become cancerous.

Will’s doctor speaks about her gratefulness that he was a compliant patient who took her recommendation for screening. She explains that the type and location of polyp Will had could have made it virtually unnoticeable if he hadn’t gotten screened; it is likely that by the time he started to show symptoms, it would have spread to other parts of his body. The video ends with his doctor talking through all of this and recommending a follow-up screening in the next two or three years, since he had a polyp. You can watch the video here.

A History of Celebrities Raising Awareness of Screenings

Will isn’t the first celebrity to publicize their own experience with a screening. Back in 2000, Katie Couric got a colonoscopy on the Today show to raise awareness on the importance of colon cancer screenings. Her husband had died of colon cancer in 1998. She went on to co-found the National Colorectal Cancer Research Alliance. In 2018, Couric also accompanied TV host Jimmy Kimmel through the colonoscopy process on his show.

The impact of celebrity promotion of screenings may be significant. In the year following Katie Couric’s Today show colonoscopy, there was a significant increase in screenings in the United States. A study from 2003 found that colonoscopy utilization rates increased in two large data sets following Katie’s promotion.  The first data set found an increase in the number of colonoscopies performed per month from 15 to 18.01. Additionally, analysis of the second data set, which was comprised of adults in a managed care organization, found that colonoscopies increased from 1.3 per 1000 people per month to 1.8 per 1000. This finding of increased screenings is called the Katie Couric Effect.

The Importance of Destigmatizing Colonoscopies

This video is important in a lot of ways. Having a celebrity share their experience with colon cancer screening can impact a lot of people and save many lives. As of the writing of this blog post, over 3.2 million people have watched the video.

Many people are uncomfortable with the idea of a colonoscopy, and avoid screenings for far too long. In particular, the idea of having an endoscope enter your body through your anus and the bowel prep associated with the procedure are barriers for some people. This is a problem, because screenings are extremely effective: colon cancer is the second leading cause of cancer-related death in the US and the survival rate for early detection of colon cancer is around 92%. Clearly, screenings save lives.

Our experienced team at GHP has years of experience performing colorectal cancer screenings. 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.

Remembering Chadwick Boseman and the Importance of Colon Cancer Screening

The loss of Chadwick Boseman on Friday, August 28th came as a tragic surprise to the world. Only 43 years old, the actor, writer, and director had made a name for himself through his leading portrayals of American heroes such as Jackie Robinson in 42 (2013), James Brown in Get On Up (2014), and Thurgood Marshall in Thurgood (2017). His most iconic role was that of superhero T’Challa in Black Panther (2018). This role cemented his place in the Marvel franchise and the hearts and minds of people worldwide. Boseman’s cause of death was colon cancer, of which he had privately fought for four years prior.

This form of cancer is the third most commonly diagnosed and second most likely cause of death in men and women. Boseman’s death serves as a moving testament to our own mortality and the silent struggles many face. It also is a reminder to practice preemptive measures against this aggressive form of cancer. 

About Chadwick

Chadwick Boseman was born in 1976 in Anderson, South Carolina. He attended Howard University, where he pursued the dream of becoming a director. After graduating, he moved to New York City, where he wrote and directed plays, teaching acting on the side. It was only once he was cast in a recurring role on ABC’s “Lincoln Heights” that he began to consider a career as an actor.

On a whim, he moved to Los Angeles, acting in a number of roles before his breakout lead as Jackie Robinson in 42. Brian Helgeland, the writer of 42, noticed Boseman’s talent and stage presence immediately. “It’s the way he carries himself, his stillness — you just have that feeling that you’re around a strong person…” In the following years, Boseman continued to gain widespread acclaim, earning MTV Movie Award’s “Best Hero” title in 2018 and the top award of Outstanding Performance at the 2019 SAG Awards. Indeed, it felt as though Boseman’s career was just beginning.

Colon Cancer Screenings

Chadwick Boseman’s untimely death shines a light on the very serious risks of colon cancer. According to the Colon Cancer Coalition, one in 24 people develop colon cancer, with an equal risk in males and females. There are often no signs or symptoms associated with the onset of the disease. Therefore, diagnosis can be late, worsening chances of remission. A lot of people are only diagnosed through routine screenings, which doctors recommend to begin at 45 years of age. Many people fail to follow through with these recommendations. According to The National Colorectal Round Table, “if 80% of the eligible population was screened at the age of 50, the number of colorectal cancer-related deaths could be cut by 230,000.” Thus, following through with basic preventative measures can drastically reduce incidence.

Prevention

Prevention can begin at any age. Regular exercise, good diet, not smoking, and limiting processed foods/red meats can reduce the risk of developing colon cancer. Colon cancer does run in the family. Those with relatives who have had it have a 2 to 3 times higher chance of developing the disease.

You can dramatically reduce the risk of developing colon cancer. Educate yourself on personal risks and stay up-to-date with colon cancer screenings. For more information on colon cancer prevention and screenings in Kentucky and Southern Indiana, you can schedule an appointment with a gastroenterologist at Gastro Health Partners. Contact an office near you today for details.

Featured article: Colon cancer screening should start at 45, government panel recommends

Colon cancer screening guidelines are changing, and starting screenings earlier will help save lives. Gastro Health Partners fully endorses these changes. Read more about the changing guidelines in this featured article from NBC News:

Colon cancer screening should start at 45, government panel recommends

Screening for colorectal cancer should start at age 45, five years earlier than is currently recommended, according to draft guidelines from the U.S. Preventive Services Task Force.

The update was prompted by recent studies showing the rate of colorectal cancer rising in younger people, according to the draft, published Tuesday.

Click here to read the full article…

 

Chronic Diarrhea: What You Should Know

Chronic diarrhea can be caused by a variety of things, including infections, GI disorders, food intolerance, and a reaction to medication. Let’s take a closer look at the condition.

Causes and Risk Factors

Diarrhea is chronic when it occurs three or more times per day for more than two weeks. It has several potential causes. Infection is one main cause. This infection can be parasitic, and from parasites like Giardia or Cyclospora. Infection can also be bacterial, from bacteria like Salmonella and E. coli. Some viral infections cause chronic diarrhea too, like some rhinoviruses and rotoviruses.

Outside of infections, there are several other potential causes. Pancreatic disorders like pancreatitis and cystic fibrosis can be a cause. GI diseases like Chrohn’s and IBS can cause diarrhea as well. Intolerance to foods can be at play too- lactose intolerance and fructose malabsorption are two examples. Additionally, some medications like laxatives and antibiotics can cause chronic diarrhea.

Symptoms of Chronic Diarrhea

As previously mentioned, diarrhea becomes chronic if it occurs three or more times per day for two or more weeks. Diarrhea is characterized by loose, watery stools that occur often more frequently than usual. Other symptoms include abdominal pain, abdominal cramps, bloating, nausea, blood or mucus in stool, and a fever. It also dehydrates you over time. If left untreated, this can be very dangerous. You should always see a doctor for chronic diarrhea.

Diagnosis

Chronic diarrhea itself is simple to diagnose, based on the definition outlined above. When you see a doctor for chronic diarrhea, they will work to diagnose the underlying cause. Depending on your symptoms, medical history, medications, the results of a physical exam, and other factors, they will select the appropriate testing measures. Stool samples can be tested to help identify if parasites, bacteria, or viruses are a cause. Your doctor may also want to do a blood test. If initial testing does not reveal a cause, your doctor may order an x-ray or endoscopy.

Chronic Diarrhea Treatment and Prevention

The cause of the condition dictates its treatment. With any case of diarrhea, fluid replacement is key. You should consume fluids and salts to replace those lost through diarrhea, unless otherwise ordered by your doctor. Some fruit juices and soup can be good options here. If liquids are upsetting your stomach, your doctor may recommend an IV to help rehydrate you.

Diarrhea caused by infection can often be treated with antibiotics or other medications. Your doctor will prescribe the proper medication for you depending on your case. If infection isn’t the cause, it will likely take more time to determine the underlying cause and therefore appropriate treatment. Conditions like IBS, Chrohn’s, fructose malabsorption, and Ulcerative Colitis all have their own treatment approaches. Your doctor will work with you to determine the best treatment options depending on the underlying cause.

Preventing chronic diarrhea involves mitigating risk factors for its various causes. To avoid infections that cause diarrhea, always drink safe, clean, properly-treated water. You should also use good food handling techniques, and practice good hand hygiene after using the bathroom and around food. If some foods trigger diarrhea for you, narrow down what they are and avoid them if possible.

Our experienced team at GHP has years of experience treating GI conditions like chronic diarrhea. 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 Esophageal Manometry?

Esophageal Manometry is a test that helps doctors measure the force and coordination of your esophagus. Here’s what you need to know about the test.

When it is used

Esophageal Manometry tests whether your esophagus is working correctly. Your esophagus is a smooth muscular tube that pushes food and liquid from the mouth to the stomach. Every time you swallow, your esophagus contracts and helps move everything to your stomach. Your esophagus can have trouble functioning correctly if you have certain disorders.

There are a few scenarios in which this test may be used. If your primary symptoms are pain while swallowing or a difficulty swallowing, your doctor will likely recommend other testing (like an Upper Endoscopy). Your doctor may recommend you undergo Esophageal Manometry if you present symptoms that could be due to an esophageal disorder. These disorders include Scleroderma, Achalasia, and diffuse esophageal spasms. Additionally, if your doctor is considering surgery to treat your GERD, esophageal manometry can help diagnose Achalasia or Scleroderma, both of which can’t be treated surgically. Also, if you are experiencing chest pain unrelated to your heart and are unresponsive to GERD treatment, this test can help identify the cause of the pain.

Preparing for Esophageal Manometry

You should not eat or drink during the 6 hours before the test. This is because an empty stomach helps your doctor perform the safest and most effective test. Additionally, you should discuss any medications you are taking with your doctor. Some medications can affect esophageal pressure, and should be discontinued before the test.

During the test

You will not be under a general anaesthetic during the testing. However, a topical anaesthetic will be used in your nose and a numbing spray will be used in your throat. Your doctor will pass a thin tube (catheter) through one of your nostrils and down into your esophagus. You may gag briefly as this happens. Once the catheter is placed, you may be asked to lie on your back. Next, you will swallow small sips of water as directed by your doctor. The catheter will help measure the pressure your esophagus exerts as you do this. You will need to breathe slowly and smoothly during the test, remaining still and following your doctor’s instructions. The test takes around 30 minutes in total.

After the test

Following the test, there are a few mild symptoms you may experience. These include a sore throat, a nosebleed, and a stuffy nose. These should resolve in a few hours. You can immediately resume normal activities after your testing, unless your doctor tells you otherwise. If you experience any lasting or unusual symptoms, contact your doctor.

Side effects from Esophageal Manometry are very rare. These include aspiration, an irregular heartbeat, and perforation of the esophagus.

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

Bile Duct Diseases: An Introduction

Bile ducts are tubes that primarily carry bile from the liver and gallbladder to the small intestine to help digest fats.

Several diseases in the bile ducts can prevent proper bile duct functioning. Read along to find out more.

Bile duct disease

There are several bile duct diseases that can occur. Gallstones are one common issue for bile ducts. These form when deposits of digestive fluid harden in the gallbladder. They can cause inflammation, increasing pressure in the gallbladder and potentially blocking a bile duct. Another common bile duct condition is cholangitis, which is inflammation in the bile duct system. This is often caused by a bacterial infection.

Bile ducts can also have strictures (narrowing). In other cases, they can leak. Cancer can also occur in the bile ducts. Bile duct cancer is rare and aggressive. Additionally, some infants are born with a condition called biliary atresia, in which bile ducts are scarred and blocked. This causes a buildup of bile in the liver and can damage it.

Symptoms of Bile Duct Diseases

Bile duct diseases tend to have some of a group of symptoms. These include abdominal pain, nausea, vomiting, itchy skin, fever, chills, weight loss, loss of appetite, and jaundice. Pain may occur in the upper abdomen and radiate to the back in some cases. Depending on the disease, these symptoms can be at differing levels of severity and present in varied ways. The progression the disease also influences the severity and types of symptoms.

Diagnosis

Doctors diagnose bile duct diseases in a few different ways. Bilirubin blood testing can identify high levels of bilirubin in your bloodstream and can diagnose jaundice. Doctors can perform an Endoscopic Retrograde Cholangiopancreatogram (ERCP) to diagnose diseases. In an ERCP, they can inject contrast dye to help image your bile ducts during an x-ray. They can also perform an Endoscopic Ultrasound (EUS) to examine your bile ducts and make a diagnosis.

Treatment

Treatments vary depending on the type of bile duct disease. ERCP, in addition to helping with diagnosis, can help treat disease. Doctors can pass tools through the endoscope during an ERCP and open blocked ducts, remove or break up gallstones, insert stents, and even remove tumors. Doctors can also help drain bile during an EUS by inserting a stent to help drain into the small intestine or stomach. One other emerging treatment involves using Radiofrequency Ablation for palliative care to treat the symptoms of bile duct cancer. This can be a way to manage pain for long-term cases of cancer.

Surgery may also be necessary in some cases. For example, with patients who have bile duct cancer, surgery can help to remove tumors. If tumors are very large, doctors may need to remove the liver and perform a liver transplant.

Our experienced team at GHP has years of experience treating conditions including bile duct diseases. 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.

A Quick Summary of Esophagitis

Esophagitis is an inflammation of the esophagus. Here’s what you need to know about the condition.

Causes

Esophagitis can be caused by various things. One of the most common causes is reflux. Reflux occurs when stomach acid backflows into the esophagus. A condition called GERD (gastrointestinal reflux disease) causes this to happen recurrently, and is a likely culprit for esophagitis in many cases. GERD can cause chronic inflammation over time. Infection can also cause esophagitis in rarer cases, mostly in people with diminished immune system function.

Oral medications can also cause inflammation in the esophagus if they are incontact with the esophagus for too long. This can happen if you take oral medications without enough liquid, oral medications that are irregularly shaped or large, if you take medications immediately before sleeping, or if you take them lying down. These medications include pain relievers like ibuprofen and aspirin, and some antibiotics.

Symptoms of Esophagitis

Several symptoms occur with this condition. These include difficulty swallowing, heartburn, chest pain occurring with eating, acid regurgitation, and a sore throat. Over time, irritation can cause tissue damage and ulcers can form. Additionally, strictures can occur with continued irritation. Strictures are a narrowing of the esophagus caused by a buildup of scar tissue. This leads to further difficulties with swallowing.

Diagnosing Esophagitis

There are a few different tests doctors use to diagnose esophagitis. They often perform a physical examination and review your medical history to identify symptoms that could indicate the condition. Additionally, they may perform a barium x-ray. For this test, patients drink a solution containing barium that coats the esophagus and makes it visible for imaging. Then, doctors take an x-ray to visualize the esophagus and identify any abnormalities. They may perform an endoscopy to look at the esophagus and biopsy tissue for a diagnosis. Biopsy tests can diagnose infections and identify any precancerous or cancerous cells.

Treatment and Prevention

Treating esophagitis involves treating symptoms, lowering the risk of complications, and treating the underlying cause. In cases of reflux esophagitis, some over the counter medications can help reduce acid production and heal the esophagus. There are also prescription medications available, including some proton pump inhibitors, H-2 receptor blockers, and prokinetics. Surgery may also be required in some cases. This involves wrapping part of the stomach around the lower esophageal sphincter to strengthen it and help prevent acid reflux. Last, in cases where a stricture has formed, doctors can perform an esophageal dilation to widen the esophagus.

For cases of drug-induced esophagitis, avoiding the drug causing the inflammation and changing the way you take medication can help. There are also alternative drugs you can take that won’t cause inflammation. Plus, by simply drinking water with medication and standing or sitting upright for 30 minutes after taking a pill, you can avoid causing some inflammation. Last, in cases of infectious esophagitis, doctors can prescribe medications to treat the underlying cause of infection.

Our experienced team at GHP has years of experience treating conditions including esophagitis. 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.

Pancreatitis: An Overview

Pancreatitis is an inflammation of the pancreas. It can be either acute or chronic, and has several potential causes. Here’s what you need to know about the condition. 

Pancreatitis Causes and Risk Factors

Pancreatitis occurs when digestive enzymes are activated while in the pancreas, irritating cells and causing inflammation. It can be acute or chronic. Repetitive acute cases can cause permanent damage to the pancreas and lead to chronic issues. 

Some potential causes include gallstones, alcoholism, infections, cystic fibrosis, genetic disorders, obesity, cancer, and abdominal injuries. Acute cases are most often caused by gallstones. Chronic cases are most often a result of heavy alcohol use or genetic disorders. 

There are several risk factors for pancreatitis. Heavy alcohol use and smoking are both risk factors. Heavy drinkers- people drinking 4-5+ drinks each day- have an increased risk. Smokers are around 3x more likely to develop the condition, and people who quit smoking decrease their risk by about half. 

Symptoms

The most common symptom of pancreatitis is upper abdominal pain that can spread to your back. In acute cases, the pain usually begins in the upper abdomen and sometimes spreads to the back. It can last for a few days and can be mild to severe. People with acute cases may also have a fever and a swollen abdomen, and experience nausea, vomiting, and a fast heartbeat. 

In chronic cases, people also usually feel pain in their upper abdomen that sometimes spreads to the back. However, in some cases people may not feel any symptoms if the condition is not advanced. If it does become advanced, the pain can become severe and constant, becoming worse after eating. Other symptoms in these cases can include nausea, vomiting, diarrhea, weight loss, and greasy stools. Severe chronic and acute cases require medical attention.

Diagnosing Pancreatitis

An array of tests can help diagnose pancreatitis. Doctors often use blood tests to check for elevated pancreatic enzyme levels. In chronic cases, stool tests can help identify high levels of fat that indicate malabsorption. Plus, CT scans and abdominal ultrasounds can identify gallstones and the amount of pancreatic inflammation. MRIs can also look for issues in the pancreas, gallbladder, and ducts. Also, doctors can use endoscopic ultrasounds to identify blockages and inflammation in the pancreatic or bile ducts. 

Treatment and Prevention

Treating pancreatitis usually begins with a few steps in the hospital. Usually, patients fast for a few days to rest the pancreas. Doctors may place an IV to prevent or treat dehydration. Medications can help with pain as well.  

After these initial steps, doctors work to treat the underlying cause of pancreatitis. Sometimes, this can mean gallbladder surgery to remove the gallbladder if gallstones are a factor. In other cases, it may mean surgery on the pancreas to drain fluid or remove diseased tissue. An ERCP can help diagnose and treat causes like bile and pancreatic duct problems as well. 

If heavy alcohol use is a factor, reducing alcohol consumption is an important step to prevent serious complications. Additionally, in chronic cases of pancreatitis, ongoing pain management may be necessary. This can include a combination of medications, surgery, and endoscopic ultrasounds to relieve pain. Also, dietary changes (pursuing low-fat, high-nutrient diets) can also help in chronic cases.

Our experienced team at GHP has years of experience treating conditions including pancreatitis. 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.

Malabsorption: An Overview

Malabsorption is a condition in which a person has difficulty digesting and/or absorbing nutrients from food. Here’s what you need to know. 

Causes of Malabsorption

Malabsorption can be caused by various diseases. Typically, malabsorption involves difficulty absorbing nutrients like vitamins, fats, proteins, or sugars. Any disease that hinders the body’s ability to absorb nutrients can cause this condition. Common diseases that cause it include cystic fibrosis, lactose intolerance, celiac disease, whipple disease, crohn’s disease, an infection affecting the pancreas, HIV and AIDS, parasitic infection, and some genetic disorders. Some medications can cause the condition as well. Additionally, malabsorption can occur as a side effect of radiation treatments and surgeries that remove part of the small intestine or pancreas. 

Symptoms

Several symptoms can accompany malabsorption. These include bloating, gas, abnormal stool, and chronic diarrhea. Children with the condition may have a weight or rate of weight gain that is much lower than average, and may not grow and develop at expected rates. Adults can experience weight loss, weakness, and difficulty thinking. 

Diagnosis

Diagnosing malabsorption can involve several types of exams and tests. Doctors evaluate a patient’s medical history and symptoms to gather initial evidence. They then may pursue different testing approaches. Stool tests can measure the amount of fat in a patient’s stool to diagnose the malabsorption of fat, one of the most common symptoms of the condition. Stool samples can also be examined under a microscope to identify any undigested food fragments or parasites. Doctors may also perform blood or urine testing to detect high levels of undigested substances like Vitamin B-12 or lactose. 

Once malabsorption is diagnosed, identifying the underlying cause is an important next step. Biopsies, imaging testing (including x-rays and CT scans), and pancreatic function tests can all help identify the underlying cause. 

Treating and Preventing Malabsorption

Treatment involves both treating symptoms and treating the underlying cause of malabsorption to ensure proper nutrient absorption. Medication can treat symptoms like diarrhea. Nutrient and fluid replacement can treat nutrient deficiency and dehydration. Additionally, high-calorie diets can help the body absorb more nutrients. These diets can include varying amounts of proteins, fats, carbohydrates, and key vitamins and minerals. Injections of vitamins and minerals can also sometimes help. There are also some medications that can slow down the digestion process in the small intestine. This allows food to be in the small intestine for a longer time. 

Prevention measures vary based on the underlying cause of the condition. When diseases like cystic fibrosis or celiac are a factor, managing those diseases is an important way to prevent malabsorption issues. Additionally, since some antibiotics and laxatives can cause malabsorption, you should use them carefully. Follow your doctor’s instructions to manage and treat the condition and prevent it from becoming severe. 

Our experienced team at GHP has years of experience treating conditions including malabsorption. 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.