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Hemorrhoids: An Overview

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

Here’s an overview of hemorrhoids. 

Symptoms of Hemorrhoids

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

Causes and Risk Factors

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

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

Treatment for Hemorrhoids

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

Prevention

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

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

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

Everything You Should Know About Constipation

Constipation is a gastrointestinal condition which is generally characterized by three or fewer stools passed in a week. It is very common and affects around 30% of the population. Here’s everything you should know about constipation. 

Symptoms of Constipation

Constipation is defined by a few key symptoms. These symptoms include passing three or fewer stools in a week, having difficulty passing stools, having hard or dry stools, noticing blood in stool, having intense rectal or abdominal pain, and feeling like stool is not completely passed. Mild symptoms often resolve quickly, so they are usually not cause to seek medical attention. However, serious symptoms like blood in stool or needing to manually remove stool are signs that you should seek medical help. 

It’s important to note that not having a bowel movement every day is not necessarily a sign of constipation. Bowel habits fluctuate for everyone based on a variety of factors. However, you should use the described symptoms as a guide to determine if you need medical help. 

Causes and Risk Factors

Constipation most often is caused by stool moving too slowly in the digestive tract. Slow-moving stool is not effectively passed and can become hardened and dried out. Slow-moving stool can happen for a variety of reasons. Blockages from anal fissures, a bowel obstruction, bowel strictures, and certain cancers can lead to constipation. Also, neurological problems can affect nerves that help move stool through the digestive tract. These problems include Parkinson’s disease, Multiple Sclerosis, and spinal cord injuries. Muscular problems can be the root cause too. Weakened pelvis muscles, improperly coordinated pelvic muscles (dyssynergia), and chronically unrelaxed pelvic muscles (anismus) can all prevent proper stool movement. Hormones can play a role sometimes as well. Hormones that help balance fluids may be unbalanced for people who are pregnant, diabetic, or have an underactive thyroid. 

There are a few risk factors for constipation. Older people and women are more likely experience constipation. Dehydration, a low-fiber diet, a sedentary lifestyle, some medications, and mental health conditions including depression and eating disorders are also risk factors. 

Treatments and Prevention

In most cases, constipation can be treated easily. Most of the time, constipation is a disorder of bowel function and not due to other structural issues. In these cases, focusing on softening stool and getting it moving again is the best treatment. You can do this by hydrating more, eating fiber, and getting more exercise. Sometimes, taking a laxative until the constipation passes may be helpful as well. You should consult a doctor for laxative use, especially if your constipation is severe or chronic. 

The same lifestyle changes that can treat constipation are also great ways to prevent it in the first place. Always drink plenty of fluids- six to eight glasses of water per day is a good baseline. However, this varies based on factors including your age, height, weight, sex, and activity level. Avoid consuming too much caffeine, which can cause some dehydration. Eat fiber-rich fruits, vegetables, and whole grains to promote regular bowel movements. You should aim for at least 20 to 35 grams of fiber each day. Regular exercise is another great way to promote bowel movements too. Finally, always use the restroom when you feel the urge. Holding it in can cause fecal matter to accumulate and lead to constipation. 

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

Dr. 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:

 

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. Sunana Sohi on Following Her Gut

Dr. Sunana Sohi was recently featured in an MD-Update Magazine article highlighting her passion for helping others.

Dr. Sohi has been practicing at Louisville Gastroenterology Associates since 2010 where she treats conditions ranging from IBS and heartburn, to incontinence, hemorrhoids, liver issues and inflammatory bowel disease.

Although Dr. Sohi once studied to become a psychiatrist, she ultimately fell in love with internal medicine. “Gastroenterology is fascinating. It affects people on a quality of life level in a way you wouldn’t necessarily think of,” says Dr. Sohi. 

While Dr. Sohi treats patients of all ages (18 years old to 90 plus) she has noticed a bigger percentage of female patients. This is because, while diet and stress commonly affect the gastroinestinal tracts, hormones in the female body can as well. For example, studies show primarily women are affected with IBS and it is normal for a change in the bowel during premenstrual and menstrual periods. “There’s also a whole slew of GI issues that can come up during pregnancy.” says Dr. Sohi.

Solutions for Everyone

Of all the complaints Dr. Sohi hears, bloating is a reoccurring one. However, according to Dr. Sohi, bloating can be attributed to any number of causes. Often she must explore further to find the root cause and appropriate treatment.

Through diagnostic testing and evaluation, Dr. Sunana Sohi works to find a multitude of solutions for a multitude of patients. Whether the solution lies in adjustments to one’s diet or lifestyle, a probiotic or laxative, or via yoga and meditation, Sohi is a firm believer that there is a solution for everyone. “I try to work with the individual where they are at and what they want to get themselves feeling better.”

If you are experiencing a life impacting GI condition, contact Dr. Sohi or one of the many other Gastroenterology Health Partners today.

Read the full article here:

 

Irritable Bowel Syndrome – Signs and Symptoms

Irritable Bowel Syndrome (IBS) is a gut disorder affecting the large intestine. Though the exact cause is not known, this chronic condition is thought to be the result of hormonal or bacterial changes in the gut, as well as the disruption in communication between one’s gut and brain; as together they are tasked with controlling digestion.

While the syndrome afflicts mostly those under the age of 50, women are twice as likely than men to suffer from IBS. The following are the most common signs and symptoms of IBS, most of which can be relieved with the passing of a bowel movement.

Signs & Symptoms

  • Cramping & Abdominal Pain
  • Bloating & Gas
  • Diarrhea and or Constipation

Pain is usually felt as the muscles in the lower abdomen contract and excessive gas from bacteria can leave the stomach feeling full and protruding.

The three main types of IBS are:

  • Diarrhea-Predominant (D-IBS)
  • Constipation-Predominate (C-IBS)
  • Alternating Constipation and Diarrhea (A-IBS)

Both diarrhea and constipation are key symptoms of IBS. This is because the condition causes the muscles to contract in an abnormal way. As a result, they either speed up or slow down one’s bowel movements. Blood or mucus in the stool is another sign for concern as well.

While there is no cure for IBS, one’s diet, lifestyle and stress levels can play an important role in managing the symptoms.

Diet

Removing specific carbohydrates form one’s diet may help prevent flare ups. Food allergies, a lactose intolerance and celiac disease for example tend to cause inflammation and irritation in the gut.

Lifestyle

Exercise and proper sleep have been effective in stimulating normal contractions in the intestines. Additionally, proper hydration, high fiber foods and natural or probiotic supplements can help regulate bowel movements.

Stress

As the nervous system controls the gut, IBS is also thought to be linked to one’s mental health. Effectively treating anxiety, depression and stress therefore could help reduce psychological events that may be triggering IBS.

As one’s sensitivity varies from person to person, a gastroenterologist can help best identify IBS triggers. A gastroenterologist can also and discuss options for managing symptoms with or without medication. More serious signs of IBS including weight loss, pain that isn’t relieved by gas or a bowel movement, fever, vomiting, and iron deficiency. These symptoms might be indicative of colon cancer. Those with a family history of IBS and or mental health issues are at more of a risk for suffering from the condition. In order to get an accurate diagnosis and treatment regiment, it is recommended that you see a specialist in digestive diseases

If you are experiencing some of the signs and symptoms of IBS contact Gastroenterology Health Partners today. Our clinical team of 21 fellowship-trained Gastroenterologists and 13 advanced practice clinicians have been providing care to patients suffering from disorders of the digestive system since 2013. Each of our five locations in the Louisville, Lexington and Southern Indiana area offer expert specialization in gastrointestinal care. Just visit our website to schedule an appointment at the location most convenient to you.