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What is Adenoma Detection Rate (ADR)?

For decades, the screening colonoscopy has been recognized as the most effective modality to prevent and detect colorectal cancer. By identifying and  removing precancerous polyps (adenomas), colonoscopies save thousands of  lives each year. Regularly-scheduled screening colonoscopies are crucial for  adults aged 45 and older.  

However, it’s important to note that the effectiveness and quality of each colonoscopy varies from doctor to doctor. Different levels of education,  experience, and methodologies have been found to influence the “success” of a medical practitioner at performing screening colonoscopies. These case-by-case disparities ultimately led to a need for a standard of quality, a numerical  framework. In 2002, a Multi-Society Task Force was assembled to create just that: the adenoma detection rate, or ADR. ADR gives a percentage value to  each doctor’s levels of safety, quality, and thoroughness when performing a  colonoscopy.  

How does ADR work? ADR measures the average rate of precancerous polyps that a doctor identifies and removes in each colonoscopy. In the U.S., it has been  established that at least 30% of men and 20% of women aged 50+ should have  one or more adenoma found in a colonoscopy. It has been found that doctors  that meet or exceed these national quality benchmarks are generally more likely to prevent colorectal cancer, including advanced-stage or fatal cancer. In fact, even a marginally higher ADR can indicate a significant improvement in outcome. Likewise, doctors with lower-than-average ADRs have been connected with the  failure to identify cases of colorectal cancer.  

While the ADR is considered the “gold-standard” of evaluating endoscopic quality, it is not the only measure of a doctor’s ability to identify polyps. Other well-regarded quality metrics include practices such as: the quality of bowel  preparation; patient assessments; compliance rates with general screening  guidelines; rate of complications; cecal intubation rate; withdrawal time (the  amount of time a doctor should spend withdrawing the colonoscope at the end of  the procedure, which should be at least 6 minutes); and documentation of  informed consent. 

By meeting and exceeding these standards of safety and thoroughness, your doctor directly improves your chance of identifying or preventing colorectal  cancer. Therefore, it’s not rude or uncommon to ask about your doctor’s ADR,  withdrawal time, or other procedures that ensure a quality colonoscopy. These  are serious, relevant questions that can aid in your decision to choose a gastroenterologist.  

Our board-certified team of gastroenterologists has addressed many common concerns related to colonoscopies on our website. Click on any of the questions below to see complete answers: 

  1. When should I get a colonoscopy? Isn’t 45 too young?
  2. What should I expect from my colonoscopy? How should I prepare for it? What happens during and after?
  3. Where can I read about someone else’s experience with colon cancer? 
  4. I tend to be constipated. How should I prepare for my colonoscopy?
  5. Why should I get a colonoscopy instead of other screening tests? What makes it more effective? (Video)
  6. What’s the difference between a screening colonoscopy, Cologuard, and other screening tests? (Video)

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

The Gluten Free Diet: Bad or Good?

Diet is known to affect the gut microbiome, the ecosystem of helpful bacteria that lives in our stomach and intestinal tract. Certain foods can promote diversity and multitude of “good” bacteria, improving energy metabolism, boosting immune response, reducing inflammation, and affecting many other areas of physical and mental health. 

Gluten, a wheat protein naturally occurring in rye, farro, barley, oats and other grains, is found in hundreds of popular foods, from pasta, to beer, to salad dressing, to candies. For those with a gluten intolerance, gluten can harm the gut microbiome, increasing inflammation and damaging the intestinal tract. Others report having a “gluten-sensitivity,” which is accompanied by stomach pain, diarrhea, bloating, and cramping. 

The gluten-free diet has gained enormous traction in recent years, not just as a treatment for chronic gluten-intolerances such as celiac disease or wheat allergies, but as a way to lose weight and be healthier. In a survey conducted by the Consumer Reports National Research Center, 63% of Americans thought that following a gluten-free diet would improve physical or mental health and 25% thought that gluten-free foods were higher in vitamins and minerals. For many, a “gluten-free” label has become synonymous with healthfulness. 

Unfortunately, food retailers have weaponized this phenomenon by using the nutritional authority of the “gluten-free” label to sell products that aren’t necessarily healthier, at higher prices. This infographic by Consumer Reports compares products with and without gluten. Gluten-free products often have more calories, sugar, sodium, and fat, as well as less beneficial nutrients like fiber and protein. Wheat flour, which contains gluten, is often replaced with rice flour and other less-nutritional alternatives. 

While the widespread accessibility of gluten-free products has been life-changing for those with gluten-sensitivities, the influx of processed, less-nutritional gluten-free foods has arguably been harmful for many. Like other food trends, the gluten-free diet should be approached with mindfulness and skepticism. 

Is The Gluten-Free Diet Right For You?

For those suffering from celiac disease, a gluten sensitivity, gluten ataxia, a wheat allergy, IBD, or another condition tied to gluten-intolerance, a gluten-free diet is crucial for managing symptoms. If you suspect that you may be suffering from a gluten-related medical condition, consult a doctor for testing. Diagnosing yourself, or choosing to eat totally gluten-free for weight loss without consulting a nutritionist is not recommended. Receiving adequate nutrients on a gluten-free diet can be difficult for many. 

For those of us who don’t suffer from a gluten-related medical condition, gluten is recommended in moderation. Ultimately, avoiding processed foods is far more effective than cutting out gluten altogether. As discussed, many gluten-free products are highly-processed and can be harder to digest, less nutritional, and harmful for the gut microbiome. Consuming more naturally-occurring gluten-free foods, such as fruits, vegetables, legumes, certain whole grains, fish, dairy, and meat, is the best way to cut out gluten, get plenty of vitamins and minerals, and avoid sneaky branding. 

As with any medical condition, it is always best to seek assistance from a qualified medical professional if you are experiencing symptoms that are causing you difficulty. If you need a gastroenterologist in Southern Indiana, or in the Louisville or Lexington Kentucky-area, contact Gastroenterology Health Partners today for more information or to schedule an appointment.  

 

Popular Food Emulsifier Found To Harm Gut Microbiome

While you probably haven’t heard of carboxymethylcellulose (CMC), you’ve definitely eaten it. As the most widely-used cellulose-based emulsifier in the world, CMC is found in almost every type of processed food. And, unfortunately, new research has connected CMC to a range of negative gastrointestinal symptoms. 

What is CMC?

CMC is a stabilizing and thickening agent used in food and nonfood products, including ice cream, milk, fruit juice, toothpaste, detergents, water-based paints, chewing gum, dye, protein drinks, laxatives, and many more processed items. Its use is extensive and fair-reaching, from adding bulk to ketchup to acting as a viscosity modifier in the oil industry.

CMC’s makeup is what has made it so versatile and popular. Considered nontoxic and hypoallergenic, the highly viscous (thickening) substance is derived from cellulose, an organic compound. It easily absorbs/retains water and is clear, tasteless, and colorless. It is known as an emulsifier, a ubiquitous agent used to improve the experience and longevity of food. While it has no nutritional value and cannot be digested by humans, it has long been considered safe to consume. 

In fact, CMC has been used in the food industry since the 1960s. It is generally used in the production of baked goods, since its calorie-free and gluten-free. It is also used as a “texture enhancer,” creating a thicker, creamier “taste experience” in many sauces, jams, and even sausages. On labels, CMC may also go by the name of sodium carboxymethyl cellulose or sodium CMC. 

The Truth About CMC 

Clinical research published in Gastroenterology Journal this past November 2021 found important new insights into the impact of CMC on gut health. In this randomized controlled-feeding study, a group of healthy volunteers were either subjected to a CMC-free diet or a diet with CMCs. Research found that those who consumed CMCs experienced stomach pain, loss of gut bacteria diversity, loss of short-chain fatty acids and amino acids, and symptoms associated with IBD and gut inflammation. 

This isn’t the first study to find fault in CMC, or emulsifying agents in general. In 2015, a study published in Nature found a direct connection between dietary emulsifiers and low-grade inflammation, changes in gut microbiota, obesity/metabolic syndrome, and colitis in mice. 

The findings of both studies can suggest that the widespread use of emulsifying agents like CMC may directly correlate to the rise in IBD (irritable bowel disease), colon cancer, and chronic inflammatory conditions in human populations. By altering the composition of the gut microbiome and number of metabolites present, these agents cause chronic, lasting detriment to gut function and health. 

Beyond suggesting a need to study the effects of CMC and other emulsifiers more extensively, this study “provides a general blueprint to carefully test individual food additives in humans in a well-controlled manner,” according to co-senior author Dr. James Lewis of the University of Pennsylvania. Indeed, this study has highlighted the necessity for large-scale research into the assembly of processed foods, especially components long-believed to be safe and nontoxic, like CMC. 

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

Understanding Crohn’s Disease – An Overview

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

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

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

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

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

Limiting Crohn’s Disease Flare Ups with a Dietary Approach

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

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

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

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

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

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

Why You Need To Add More Fiber To Your Diet

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

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

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

What Is Fiber?

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

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

Why Is Fiber Important?

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

Try These High Fiber Foods

High Fiber Fruits

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

High Fiber Vegetables

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

High Fiber Grains

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

High Fiber Legumes

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

High Fiber Nuts/Seeds

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

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

Surprising New Connections Found Between Food Insecurity And Liver Disease

Liver disease is routinely associated with alcoholism and excessive alcohol consumption. However, non-alcoholic fatty liver disease (NAFLD) is actually the most common form of liver disease in the United States. One in 3 adults and 1 in 10 children in the United States suffer from the disease. NAFLD is characterized by excessive fat stores in the liver that leads to inflammation, liver scarring (cirrhosis), liver fibrosis, and liver-related morbidity. NAFLD is usually caused by diabetes, insulin resistance, being obese or overweight, having high blood pressure, having polycystic ovarian syndrome, or having elevated levels of cholesterols or triglycerides. 

Food Insecurity and NAFLD

A study released in October found that 32% of adults with NAFLD were also suffering from food insecurity. According to the USDA, food insecurity is “a lack of consistent access to enough food for an active, healthy life.” Food insecurity is directly caused by a lack of financial resources, and can be connected to many social and physical determinants, such as low wages, lack of affordable housing, high medical costs, health problems, lack of social support, lack of access to educational opportunities/work training, lack of transportation, physical barriers (of the built and natural environment), and other socioeconomic conditions. Food insecurity affects communities across the United States; an estimated 1 in 9 Americans are food-insecure.

Until this point, very little research has been conducted in the United States concerning the connections between food insecurity and health outcomes. Dr. Ani Kardashian, an assistant professor of clinical medicine at the University of Southern California Keck School of Medicine, presented thoughts on the research at the International Liver Congress 2021:

“This study really highlights the importance of us focusing on upstream social determinants of health in the long-term outcomes of people with NAFLD and advanced liver fibrosis…Future studies should focus on designing interventions to reduce food insecurity in our at-risk patients with fatty liver disease.”

Addressing Food Insecurity to Reduce Rates of NAFLD 

As Dr. Kardashian discussed, treating food insecurity like a public health risk could result in better outcomes for those suffering from NAFLD and related conditions. But how do we address something as pervasive and widespread as food insecurity?

Change starts at the local level. Supporting reputable organizations such as Feeding America and mutual aid funds can help. Volunteering at local organizations, contacting your government representatives, educating your community, or even organizing a food drive can incite change. Donating to your local food bank or food pantry is beneficial as well. In Louisville, Dare To Care is an option. In Lexington, God’s Pantry is a widely known resource. In Southern Indiana, Hope Southern Indiana and Center for Lay Ministries are two highly-regarded options. Visit foodpantries.org to see more food pantries near you. There are many ways we can inspire change, and it begins with individual action.

For more information about diagnosing digestive conditions, reach out to Gastroenterology Health Partners (GHP) today. Our clinicians have a passion for seeking out and refining new treatments and advanced solutions for those suffering from disorders of the digestive system. Each of our physicians offers expert specialization, evaluating and treating the entire spectrum of digestive conditions. To learn more about the treatment options available to you, schedule an appointment at one of our locations throughout Louisville, Lexington, and Southern Indiana.

Stomach Pain After Eating? Here Are 7 Things It Could Be

A recent online survey conducted across 26 countries found that 1 in 10 people experience post-meal abdominal pain. Of the 54,000 people who were polled, 13% of women and 9% of men reported frequent gastrointestinal discomfort after eating a meal. Individuals reported bloating, a swollen stomach, feeling full quickly, constipation, and diarrhea. Interestingly, these individuals had twice the rates of anxiety and depression as people who reported no symptoms.

This study illuminates the connection between food and diet, gastrointestinal health, mental health, and chronic gastrointestinal conditions, such as irritable bowel syndrome or ulcerative colitis. It suggests the importance of an individualized and multidisciplinary approach to treating digestive disorders. 

If you experience frequent gastrointestinal discomfort after eating food, seek medical help. A gastroenterologist can help diagnose the cause of your symptoms and build an effective treatment plan, based on your unique symptoms. In the meantime, follow along for common causes for stomach pain after eating:

7 Causes For Stomach Pain After Eating

1. Food Allergy or Intolerance. Many people experience food allergies and intolerances that result in persistent gastrointestinal symptoms, such as gas, bloating, cramping, and diarrhea. Common allergens include eggs, tree nuts, peanuts, shellfish, milk, soy, wheat, and more. If symptoms are minor, these conditions can go undiagnosed for years! 

2. IBS. Irritable Bowel Syndrome (IBS) is a common disorder that affects the large intestine (colon). IBS can cause bloating, abdominal cramping, diarrhea, constipation, gas, and other negative gastrointestinal symptoms. IBS is chronic and requires managing symptoms, often through dietary changes.

3. Gastritis. Gastritis is a broad term for inflammation/swelling of the stomach lining. It can be caused by infection, overuse of pain medications (NSAIDs), injuries, certain foods, and overuse of alcohol. Gastritis can result in abdominal pain, nausea, vomiting, and weakness. 

4. Celiac Disease. Celiac Disease is a chronic immune disease that is characterized by an inability to eat gluten. Eating foods with gluten damages the small intestine and immune system of people with Celiac. Symptoms include abdominal pain, diarrhea, weight loss, bloating, and mood changes. It is often genetic and can be diagnosed with a blood test. 

5. IBD. Inflammatory Bowel Disease (IBD) refers to conditions such as Crohn’s Disease and Ulcerative Colitis, which are a result of inflammation of the intestinal tract. Believed to be a result of an abnormal immune response, these conditions can result in symptoms such as cramping, loss of appetite, abdominal pain, persistent diarrhea, fatigue, and blood in stool.

6. GERD.  If you experience pain after eating that is located higher than the stomach and more in your upper abdomen or throat, you may be suffering from acid reflux or Gastroesophageal Reflux Disease (GERD). Symptoms can also include heartburn, nausea, a burning sensation in the throat, or pain with swallowing.

7. You ate too much or ate something that is difficult to digest. Before diagnosing yourself with a food allergy or chronic disease, consider what you ate. Did you eat a very large portion of food? Did you eat acidic, spicy, or fried foods? Perhaps you ate something high in artificial sugar? These types of foods, especially in larger portions, are difficult to digest and can result in negative symptoms for anyone. 

For more information about diagnosing digestive conditions, reach out to Gastroenterology Health Partners (GHP) today. Our clinicians have a passion for seeking out and refining new treatments and advanced solutions for those suffering from disorders of the digestive system. Each of our physicians offers expert specialization, evaluating and treating the entire spectrum of digestive conditions. To learn more about the treatment options available to you, schedule an appointment at one of our locations throughout Louisville, Lexington, and Southern Indiana.

6 Fermented Foods For Better Gut Health

Did you know that eating fermented foods can enhance the diversity of the gut microbiome, which reduces inflammation and improves immune response?

If you did not know this, it’s okay. New research is only beginning to unlock the exciting connections between diet, gut microbiome, and body response. A research paper published by Stanford Medicine this July was one of the first formal efforts to delve into the powerful effects of fermented foods on gut health, in particular.

So What Exactly Is Fermentation?

Humans have been fermenting foods for thousands of years. Fermentation is a metabolic process that utilizes live microbes such as bacteria or yeast to create a chemical reaction. In the absence of oxygen, these microorganisms will break down carbohydrates such as sugars and starches into different compounds altogether. This is how simple yeast can turn barley malt into carbonated, alcoholic beer, or how grapes become wine. Fermentation is a natural, nutritious preservation process. You can easily ferment foods yourself, find them on many restaurant menus, or purchase them at a local grocery store!

Why Do Fermented Foods Help The Gut?

Millions of microbes live in your gut, intestines and colon. Known as the gut microbiota, this system of bacteria helps digest food as well as plays a role in your overall health, immune response, metabolism and even mental health. While each person’s unique gut composition is influenced by genetic makeup, your lifestyle can also impact the quality of your gut microbiome. Factors such as your daily levels of exercise and diet can greatly impact the diversity and functionality of gut microbiota.

The live microorganisms found in fermented foods are a source of probiotics, which have innumerable health benefits. These natural probiotics aid the immune system, and in doing so, boost the body’s response to pathogens. Plus, the enzymes and lactic acid created in the fermentation process helps better absorb nutrients such as Vitamin B and C. The full extent of the benefits of fermented foods are only beginning to be realized.

6 Fermented Foods For Better Gut Health

1. Plain Yogurt – Plain yogurt is low calorie, low sugar, and teaming with beneficial probiotics. Add fresh fruit, oatmeal, or granola to make the perfect gut-boosting breakfast.

2. Kombucha – Kombucha is a popular fermented tea beverage. It is carbonated, with a bitter, fruity taste. A single bottle can have as little as 50 calories and millions of good bacteria. Keep in mind that there are many different brands on the market including options without added sugar.

3. Tempeh – Tempeh is made from fermented soybeans, pressed together. Similar to tofu, it is a great meat substitute to be cooked, fried, or baked. It is also a source of antioxidants, probiotics, and is high in protein.

4. Kefir – Kefir is a tangy, yogurt-like beverage made of fermented kefir grains. It is proven to reduce inflammation, strengthen bones, and even reduce symptoms of lactose-intolerance in some people.

5. Kimchi – Kimchi is a Korean dish made of fermented cabbage or similar vegetables like radishes. It can be eaten alone or used as a topping on sandwiches, salads, pasta, etc. You can find it in most grocery stores. Studies have found that it may improve insulin resistance and lower cholesterol.

6. Sauerkraut – Another form of fermented cabbage, sauerkraut is plentiful in fiber, Vitamin C, and antioxidants. It’s also low calorie, and can be put on/in just about anything.

Within recent years, the gastrointestinal microbiome has become an increasingly popular area of scientific study due to its close link to human health and wellbeing. Not only does a person’s gut microbiome help with the digestion of food, but it also plays an important role in supporting the body’s immune system. Future research will no doubt provide additional insight about ways we can improve and support our body’s gut health.

For more information about improving your gut health or other digestive conditions, reach out to Gastroenterology Health Partners (GHP) today. Our clinicians have a passion for seeking out and refining new treatments and advanced solutions for those suffering from disorders of the digestive system. Each of our physicians offers expert specialization, evaluating and treating the entire spectrum of digestive conditions. To learn more about the treatment options available to you, schedule an appointment at one of our locations throughout Louisville, Lexington, and Southern Indiana.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Identifying Different Types of Colorectal Polyps

What Are Polyps?

Polyps are small growths of abnormal tissue, found projecting from the inner lining of the colon (large intestine). Polyps can range in size from a few millimeters to several centimeters. Polyps are very common: In fact, an estimated 25 to 40% of Americans over the age of 50 develop colon polyps. While developing polyps is most associated with being 50 and older, other factors are also considered including: having a family history of polyps/colon cancer, being obese, smoking, heavy alcohol consumption, a history of inflammatory bowel diseases, a poor diet, and other environmental factors. 

The vast majority of polyps are harmless, but they can also be precancerous or cancerous in nature. Polyps can take a long time to become cancerous, and are best to be removed upon identification. During a medical exam or colonoscopy, your doctor may identify and remove polyps. Larger or complex polyps are more likely to be cancerous, and can require additional procedures to remove. Colon polyps rarely cause any symptoms, which means scheduling a colorectal screening test is vital for identification.

Identifying Types of Polyps

There are two main categories of polyps: nonneoplastic and neoplastic. Neoplastic polyps are typically precancerous or cancerous, while nonneoplastic polyps are usually benign (non-cancerous). Within these categories, there are many types of polyps. Some of the most common include:

Types of Neoplastic Polyps

  • Adenomatous polyps (Adenoma): The most common type of polyp as well as the most common cause of colon cancer. Structurally, they’re described as tubular, villous, or tubulovillous. Tubular adenoma is less likely to develop into cancer, and makes up 70% of adenomatous polyps. Villous adenoma is flatter and more difficult to remove, and makes up 15% of adenomatous polyps. Tubulovillous is a mix of the two.
  • Serrated polyps: Serrated polyps cause 20-30% of colon cancers. They are divided into two categories: sessile serrated adenoma (SSA) and traditional serrated adenoma (TSA). SSA’s and TSA’s are very rare and almost always precancerous. 

Types of Nonneoplastic Polyps

  • Inflammatory polyps: Typically found in people with Inflammatory Bowel Disease. Usually benign.
  • Hamartomatous polyps: Rare. Usually caused by autosomal disorders. 
  • Hyperplastic polyps: A form of serrated polyp, but are very common and almost always benign. 

Polyp Shapes

Polyps generally grow in three different shapes: pedunculated, sessile, and flat. Pedunculated (polypoid) polyps grow out from the side of the inner lining of the colon like mushrooms, a clump of tissue on a thin stalk. Sessile polyps, on the other hand, do not have a stalk, but rather grow against the side of the colon. The least common shape is a flat polyp. Flat polyps grow completely flat, or depressed into the side of the colon. Sessile and flat polyps are generally more difficult to detect than pedunculated polyps.

Symptoms of Polyps

There are typically no signs of polyps. However, in some rare cases, they can be associated with symptoms such as:

  • Abdominal pain
  • Blood in stool
  • Diarrhea 
  • Constipation
  • Anemia caused by internal bleeding
  • Weakness or tiredness caused by anemia
  • Weight loss
  • Changes in bowel habits
  • Changes in stool color

Diagnosis and Treatment

If you experience any symptoms of colorectal polyps, it’s recommended that you consult a medical professional as soon as possible. Otherwise, most polyps will be diagnosed and treated through a screening test, like a colonoscopy or flexible sigmoidoscopy. In some cases, polyps are too large or complex to be removed immediately and require further surgical procedures.

It’s also important to note that if you have a neoplastic polyp, like an adenoma or a serrated polyp identified and removed during your screening test, you’re still at an increased risk of developing cancer, and will need regular screenings for polyps. The type, amount, and size of the polyps identified will determine how often you need a screening. This can vary from 6 months to 10 years

The experienced team at GHP has years of experience treating patients with various GI conditions including colorectal polyps. 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 to schedule an appointment today.