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What is the low FODMAP diet?

The low FODMAP diet is a temporary diet designed to help people with IBS (irritable bowel syndrome). In this diet, you tactically remove FODMAP foods to eliminate IBS symptoms, and then slowly add them back in to identify which cause you issues. You can think of it as a short diet that will help identify problem foods to avoid long-term. Today on the blog, we’ll go into detail on the FODMAP diet and how it can help you.

What is FODMAP?

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Basically, these are all short-chain carbohydrates (sugars) that you can find in foods. The small intestine may absorb these poorly, causing stress on the digestive system. Many people with IBS are sensitive to some of these sugars, and can experience symptoms like bloating, diarrhea, and cramping if they eat them. This diet is designed to remove foods that contain the sugars to help relieve symptoms first.

Phase 1 of a FODMAP Diet

In the first phase of this diet, you’ll avoid eating certain foods. The foods you remove in a FODMAP diet include milk, honey, fruits, beans, sweeteners, and more. Your medical provider will provide specific guidelines to follow. For this phase, you’ll need to avoid FODMAP foods for 4-6 weeks. This may help eliminate symptoms you’ve had from the foods. For people with a bacterial overgrowth issue in their small intestine, it gives time for the bacteria levels to decrease.

The diet does eliminate a lot of foods you may be used to eating. Some foods you can continue to eat in this phase of the diet include eggs, meat, certain cheeses (like brie), potatoes, grapes, and almond milk.

Phase 2

Phase 2 involves slowly reintroducing certain foods. While Phase 1 is all about eliminating everything and calming down symptoms, Phase 2 is an exploration of what specific foods you react to. The way this usually works is by adding one FODMAP food back into your diet every few days. This gives you time to see if the latest food you added causes any reaction. When you encounter a reaction from a specific food, you will be able to avoid that food long-term with this knowledge.

Effectiveness

The FODMAP diet approach is considered one of the most effective therapies for treating IBS. It reduces symptoms in around 86% of people. However, since it is so restrictive initially, you will need to work with a doctor or dietitian who can coach you on staying healthy while avoiding FODMAP foods. They can provide a full list of FODMAP foods, and provide key guidance while you undergo this therapy. When successful, the long-term dietary changes you make as a result of FODMAP dieting are a powerful tool to reduce IBS and bacterial overgrowth symptoms.

Our experienced team at GHP has years of experience treating for IBS. 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.

Gastroparesis: A Summary of the Condition

Gastroparesis is a condition in which the stomach is unable to empty normally. Read along for an overview of the disease. 

Causes and Risk Factors

Gastroparesis is usually caused by a nerve injury of some sort. When the vagus nerve, the nerve controlling stomach muscles, becomes damaged it can stop working properly. When the nerve functions properly, it contracts the muscles in the stomach to help food move through your digestive tract. If the nerve is damaged, food can sit in your stomach longer than normal. 

The root cause of this nerve damage can vary. Some viral infections can be at the root of the issue. In other cases, it may be a side effect of surgery on the stomach or nerve. Narcotic pain medications can also slow the rate the stomach empties. 

There are a few risk factors that increase your chance of developing gastroparesis. People with type 1 or 2 diabetes are at a heightened risk. Additionally, people with nervous system diseases like Parkinson’s or MS are at an increased risk. 

Symptoms of Gastroparesis

This condition is characterized by a number of potential symptoms, which can vary by person. Vomiting, nausea, heartburn, and GERD are symptoms many people with the condition experience. Abdominal pain and bloating are also symptoms in some cases. You may feel full after eating very little and lose weight with the condition as well. You may also become malnourished and dehydrated due to the condition.

Diagnosis

Doctors can diagnose gastroparesis with a number of tests. They may want to see how quickly your stomach empties. To do this, they can use a technique called scintigraphy in which they have you eat a light meal with a small amount of radioactive material in it. They place a scanner on your abdomen that tracks the material and the rate that food is passing through your stomach.Another test they can utilize is an upper endoscopy. Here, they use a long tube with a camera on the end to visualize your upper GI system. This can also help diagnose other conditions with similar symptoms. 

Treatment

Gastroparesis is often a chronic condition. As such, your doctor will focus on treating symptoms and identifying the underlying cause. If you are diabetic, you should focus on controlling your blood sugar levels, as this can reduce gastroparesis issues. Dietary changes are crucial as well. You should work with a dietitian to identify foods and habits that lend themselves to easy digestion. You can also eat smaller, more frequent meals and chew food thoroughly. In some cases, medication can also help stimulate the stomach muscles and control nausea. Follow your doctor’s advice for any prescriptions. 

Our experienced team at GHP has years of experience treating gastroparesis. 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 are Gallstones?

Gallstones are hard deposits that can form in your gallbladder. Here’s what you need to know about the condition. 

Causes

Gallstones are mostly made up of cholesterol (around 80%) and bilirubin and calcium salts (around 20%). Doctors believe that cholesterol may be tied to the root cause of gallstones. The gallbladder stores bile, a fluid that helps dissolve fats. If your liver produces more cholesterol than your bile can handle, hardened crystals can form and eventually turn into hard deposits (gallstones). The previously mentioned chemical bilirubin may cause gallstones as well. Your body produces bilirubin to break down red blood cells. If your liver produces too much bilirubin (due to conditions like blood disorders and liver cirrhosis), excess bilirubin can lead to gallstones. One last potential cause of is a slow-draining gallbladder. If bile does not exit your gallbladder correctly, it can become concentrated.

Risk Factors

There are a few significant risk factors for gallstones. Some of these are lifestyle factors. These lifestyle risk factors include being obese or overweight, rapidly losing weight in a short timeframe, and eating a high fat or cholesterol diet with low fiber intake. Additionally, people over 60, women, Native American and Mexican people, and people with a family history of gallstones are at a higher risk. Last, there are some relevant medical risk factors. These include being pregnant, having cirrhosis, taking cholesterol-lowering medication, and taking medication with high estrogen content. 

Symptoms of Gallstones

Gallstones commonly cause several symptoms. If a gallstone becomes stuck in a duct and blocks it, this can cause symptoms. One of the first may be a sudden onset of intensifying pain in your upper right abdomen. This pain could also occur in the center of your abdomen. You may experience back pain between your shoulder blades, pain in your right shoulder, and nausea and vomiting as well. These symptoms can last minutes or hours. Serious complications can occur, and are indicated by symptoms like yellowing skin and eye whites, a high fever, and tea-colored urine. Seek medical attention immediately if you experience these symptoms. 

In some cases, you may not have pain at all. In fact, some experts estimate around 80% of people with this condition have no symptoms. 

Diagnosis

Doctors diagnose gallstones in a few ways depending on your situation. If you see them due to any of the above symptoms, they may start with a physical exam to check for signs of jaundice. There are a few diagnostic tests they can perform as well. Often, they will order an ultrasound to visualize your abdominal area and identify signs of gallstones. They may also perform an endoscopic ultrasound (EUS) if they think they could have missed any smaller gallstones with an ultrasound. Another procedure they may perform is an Endoscopic Retrograde Cholangiopancreatogram (ERCP), which can also help identify gallstones. They can also order a blood test to see if your bilirubin levels are abnormal. 

In many cases, your doctor may identify gallstones incidentally while performing one of the above procedures for another purpose . This is particularly true if you have asymptomatic ones. As mentioned before, most people with do not have symptoms, so this is a fairly common way they may diagnose your gallstones. 

Treatment

Often times, you may not need any specific treatment for gallstones (especially if they cause no symptoms). You may be able to pass them without any pain. If you are experiencing any of the more serious symptoms discussed previously, you may need surgery. Doctors can perform a procedure called a cholecystectomy, in which they remove your gallbladder. This prevents gallstone recurrence. Your gallbladder is not essential, so removing it does not cause major issues. If surgery would be risky for you, your doctor may prescribe medication to dissolve your gallstones. In this case, you will likely have to continue medication use for a long period of time.

Our experienced team at GHP has years of experience treating gallstones. 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.

Coronavirus Vaccines: Best Practices for People with IBD

People with Inflammatory Bowel Disease (IBD), such as Crohn’s and Ulcerative Colitis, may have questions about how they should approach coronavirus vaccines. The International Organization for the Study of Inflammatory Bowel Disease (IOIBD) recently highlighted an article titled ‘SARS-CoV-2 vaccination for patients with inflammatory bowel diseases: recommendations from an international consensus meeting.’ In this article, the organization highlights the recommendations related to coronavirus vaccines IOIBD has developed for people with IBD. Here are a few highlights:

1. People with IBD should get a coronavirus vaccine

Overall, there was broad and overwhelming agreement among IOIBD members that coronavirus vaccines are safe and necessary for people with IBD. This consensus was reached through multiple questions that explored IOIBD member opinions on the efficacy and safety of the vaccines for IBD patients.

2. People with IBD should get a coronavirus vaccine as soon as it is possible

Not only does the IOIBD recommend vaccines for people with IBD, they recommend people with IBD receive a vaccination as soon as they are eligible.

3. Coronavirus vaccines, including messenger RNA vaccines, replication-incompetent vector vaccines, inactivated vaccines and recombinant vaccines, are safe for people with IBD

IOIBD members considered the main types of vaccines that may be available for people with IBD. They did this to ensure safety across all vaccines. After review, they broadly agreed that all vaccine types are safe.

4. Coronavirus vaccination shouldn’t be delayed if a person with IBD is receiving immune-modifying therapies

Some people with IBD may be undergoing immune-modifying therapy to suppress an inflammatory response. Still, coronavirus vaccines are safe for them.

5. People with IBD who receive a coronavirus vaccine should be informed that the vaccine’s efficacy can decrease if they are receiving systemic corticosteroids

This is also an important insight for people with IBD. They should receive a coronavirus vaccine when possible. However, if they are receiving corticosteroids to calm a flare-up, the vaccine may be less effective.

Our experienced team at Gastro Health Partners continues to safely provide care for our patients during the coronavirus pandemic. We can help establish the best plan of care for your situation. Visit us online at https://www.gastrohealthpartners.com/ to learn about the options we offer and schedule an appointment today.

Anal Fistulas: A Brief Overview

Anal fistulas are tube-like passages that connect an infected anal gland to the outside of the skin near the anus. They do not usually heal on their own, and often require surgery. Here’s what you need to know about the condition.

Causes

Typically, anal fistulas originate from an anal abcess. Anal abcesses are collections of pus. These can form when anal glands become infected. Then, a tunnel can form from the abscess to an opening on the skin. This tunnel is an anal fistula. Other less common causes include Crohn’s disease, cancer, trauma, and diverticulitis.

Symptoms of Anal Fistulas

Anal fistulas typically cause a few symptoms. These include pain and swelling around the anus and painful bowel movements. There is often drainage from an opening around the anus, and pain may decrease after drainage. The drainage may be pus and be bloody or foul-smelling. You may also experience fatigue, fever, and chills. Any of these symptoms are good cause to see a doctor.

Diagnosis

Doctors diagnose anal fistulas by first performing a physical exam to identify an opening or boil on the skin near the anus. If there is no visible opening, they may need to perform an anoscopy, MRI, or ultrasound to visualize the fistula tract and determine the severity and size of the fistula.

Treatment

If you have an anal fistula, you will need surgery. Anorectal surgeons will evaluate your fistula to determine how the fistula is affecting your anal sphincter muscle and then minimize the surgery’s effect on anal function. A procedure called a fistulotomy allows doctors to open the fistula tunnel and allow it to heal. Doctors usually prefer this approach if a small amount of the anal sphincter muscle is involved with the fistula. If a significant amount of the muscle is involved, another viable approach is placing a band called a seton through the fistula to promote drainage. The seton stays in place for at least 6 weeks. There is typically a follow-up procedure in this case to get rid of the fistula. Another common surgical technique is the advancement flap procedure. This, like the seton approach, is also useful if a large amount of the sphincter muscle is involved. Here, surgeons cut or scrape out the fistula and then cover the hole where it enters the bowel with a flap of skin from the rectum.

Prognosis and Disease Management After Surgery

Unfortunately, some fistulas may require several surgeries to eliminate them. Following surgeries, you may need to take stool softeners and soak the affected area in a warm bath. Plus, to help with pain, your doctor may inject a local anaesthetic and prescribe pain pills for a short time. The good news is that when properly treated, fistulas rarely come back.

Our experienced team at GHP has years of experience treating anal fistulas. 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.

Celiac Disease: What You Need to Know

Celiac disease is an immune disorder that gluten triggers. For people with the disease, it causes an immune response that damages the small intestine when eating gluten, which is found in foods like wheat, barley, and rye. Here’s an overview of celiac disease.

Causes and Risk Factors

This disease causes an immune response when you consume gluten. This response attacks the lining of the small intestine and leads to inflammation. This damages cilli, hair-like structures that line the small intestine. Cilli are key in absorbing nutrients from food; as such, celiac disease can cause problems with nutrient absorption and lead to malnourishment.

Celiac disease often runs in families. The causes of the disease are thought to be a combination of genes and consuming gluten. Sometimes celiac can be activated after a viral infection, childbirth, pregnancy, surgery, or severe stress. There are a few notable risk factors for celiac disease. These include a family history of the disease, type 1 diabetes, down’s syndrome, Addison’s disease, and autoimmune thyroid disease.

Symptoms of Celiac Disease

Symptoms for this disease are wide-ranging and vary significantly person to person. As mentioned before, celiac damages your body’s ability to absorb nutrients in food. Many of the symptoms you may experience are related to this lack of nutrition. Digestive issues like bloating, constipation, diarrhea, gas, pale stool, and weight loss are common. A tingling feeling in the legs is possible due to low calcium and nerve damage. People with celiac can also have musculoskeletal issues like bone and joint pain, cramps, and dental enamel defects. Anemia and hepatitis can occur too. Children with the disease can experience growth issues and a failure to thrive.

Diagnosis and Treatment

Doctors can diagnose celiac disease with blood testing. Serology blood testing examines your blood for antibodies that might indicate an immune response to gluten. Additionally, they can use genetic testing for certain antigens to potentially rule out the disease. In some cases, they may test for iron levels, as anemia (low iron) can happen with celiac. In some cases, they may want to biopsy some tissue from your small intestine to search for signs of damage. They can do this with an endoscopy, where they pass an endoscope through your mouth to your small intestine and take a tissue sample.

Treating celiac involves managing symptoms and avoiding trigger foods. You can’t eat foods with gluten, which include wheat, malt, and rye. Removing gluten from your diet will help reduce inflammation over time. You may also need to take some vitamin supplements. Your doctor may recommend you work with a dietician to establish a healthy diet without gluten. You may also need regular follow-up visits so your doctor can check in on your condition over time.

Our experienced team at GHP has years of experience diagnosing and treating Celiac disease. 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.

 

An Overview of Diverticulitis

Diverticulitis is a condition where pockets formed in the colon wall (called diverticula) become inflamed. Here’s what you need to know about the condition.

Causes and Risk Factors

Diverticula can form when weak areas of the colon give due to pressure, creating pockets in the colon wall. This pressure can be influenced by many things, including diet. If you do not eat enough fiber, waste can build up in your colon and increase pressure on its walls. If these diverticula tear, they can become infected and inflamed.

There are a few notable risk factors for diverticulitis. As previously mentioned, you are at risk if you do not eat enough fiber in your diet. Not eating enough fruits, vegetables, grains, nuts, and beans can all contribute to low fiber intake. If you have a diet high in fats and red meat your risk increases as well. Exercise is a factor as well- too little regular exercise can increase risk for diverticulitis. NSAIDs like ibuprofen and aspirin can heighten your risk too. Also, people over 40, men, and people who are obese have a higher chance of developing the condition. Overall, this is a very common condition, particularly for people in Western countries as they age.

Symptoms of Diverticulitis

Diverticulitis is characterized by a few symptoms. Abdominal pain in the lower left part of the abdomen is a common symptom. This pain can persist for several days, and may be mild and slowly building or can develop suddenly. Your abdomen may be tender as a result of the pain. Other potential symptoms include nausea, vomiting, constipation, and occasionally diarrhea.

Diagnosis, Treatment and Prevention

Abdominal pain is the most common symptom of this condition, and is associated with many other potential issues. As such, doctors typically perform a number of diagnostic steps to determine the underlying issue. They may ask you about your diet, bowel movements, and symptoms. They may also perform a physical exam to investigate abdominal pain and tenderness. Your doctor might want to run blood and urine tests to check for signs of infection. In some cases, they may want to do a stool test as well. They can also order a CT scan to visualize any inflamed or infected diverticula and illuminate the severity of the diverticulitis.

Treating mild diverticulitis usually involves taking prescribed oral antibiotics. You will also need to rest and switch to a liquid diet while your colon heals. In more severe cases, people with complicated diverticulitis are hospitalized and given intravenous antibiotics. Surgery may be warranted if an abscess (a pocket of infection) forms or if there is a colon puncture or fistula. In surgery, doctors remove diseased parts of the colon and reconnect healthy parts of the organ. If infection is widespread, doctors can perform a colostomy to connect the colon to a hole in the abdomen. Doctors attach a bag to the opening where waste can pass.

You can prevent diverticulitis by eating a fiber-rich diet and exercising regularly. Seek out whole grains, legumes, fruits, and vegetables. Stay in touch with your doctor if you do have a case of diverticulitis, as they may recommend other steps to prevent recurrence.

Our experienced team at GHP has years of experience treating diverticulitis. 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.

Colorectal Polyps: What You Need to Know

Colorectal polyps are excess tissue that can form in the lining of the colon or rectum. While most are harmless, some can develop into cancer. Here’s what you need to know about polyps.

Causes, Risk Factors, and Symptoms of Colorectal Polyps

Polyps occur when certain mutations in genes cause uncontrolled cell growth. This continued growth can turn into groups of tissue- polyps- in your large intestine. Some of the risk factors for polyps include family history, being 50 or older, obesity, low exercise levels, and tobacco or alcohol use.

In many cases, polyps may not cause any symptoms at all. You may find you have a polyp only after an examination like a colonoscopy. However, in some cases polyps do cause symptoms. These include rectal bleeding, pain, changes in bowel habits, and a change in stool color (red streaks or black stool).

Neoplastic Polyps

One of the two main kinds of polyps is neoplastic. Neoplastic polyps have the potential to become cancerous. Within this classification, there are a few additional types of polyps. Adenomas are the most common type of polyp, making up around 70% of polyps. When found, it’s tested for cancer. It can take many years for these kinds of polyps to become cancerous, so with proper screenings they can be taken care of before they become a major problem. Serrated polyps are the second main type of neoplastic polyps. These can become cancerous depending on their location and size. Larger polyps have a higher risk of becoming cancerous.

Non-neoplastic Polyps

In comparison, non-neoplastic polyps usually do not turn cancerous. One common kind, hyperplastic polyps, are small and very rarely become cancerous. Another type, inflammatory polyps, are common in people with inflammatory bowel disease. These do not grow like other polyps- they develop in response to chronic inflammation. They tend to be benign. One final type is hamartomatous polyps. These may occur as part of a genetic syndrome, and tend to be benign as well.

Reducing Risk and Preventing Colorectal Cancer

In general, there are several lifestyle and screening measures you should take to reduce the risk of polyps and colorectal cancer. Eating fruits and vegetables and reducing fat intake are key dietary steps that can help you remain healthy. In addition, you should limit alcohol and tobacco consumption. Plus, staying active is a must.

You should also consider your risk for colorectal cancer or polyps based on family history. In some cases, you may want to pursue genetic counseling if your family has a history of colon polyps. Additionally, if you have a hereditary disorder that causes polyps, you may need earlier and more regular screenings.

Screenings themselves are a key aspect of preventing colorectal cancer. The colonoscopy remains the gold standard for screenings. It allows doctors to both detect and remove polyps to prevent colorectal cancer. In fact, annual colonoscopies reduce cancer incidence by around 89%. Screenings are now recommended earlier- at GHP we endorse annual colonoscopies for all patients ages 45-75. Visit our website to learn more.

Our experienced team at GHP has years of experience screening for and treating colorectal cancer. 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 H. Pylori?

H. pylori is a bacteria that can infect the stomach and cause complications like stomach ulcers. Here’s an overview of how doctors identify and treat this infection.

Causes and Risk Factors

H. Pylori is very common- in the United States, around 30-40% of people are estimated to have an infection with the bacteria in their lifetime. Most It may spread through contaminated food and water, and through an infected person’s saliva or other bodily fluids. As such, risk factors include eating food that is not cooked properly or safely and drinking contaminated water. Living in crowded conditions also increases risk, as does living in a developing country where living conditions may be less sanitary and more crowded. Additionally, if you live with someone who has H. pylori, you have an increased risk.

Symptoms and Complications

Most people with H. pylori never have any symptoms. For people who do experience symptoms, they can include a burning or ache in the abdomen, loss of appetite, nausea, boating, weight loss, frequent burping, and nausea. There are some complications that can occur with H. pylori as well. The infection can damage the stomach’s protective lining and allow stomach acid to create an ulcer (an open sore). Additionally, the infection can cause gastritis (inflammation) on the stomach lining. H. pylori infection is also a risk factor for some kinds of stomach cancer.

Diagnosis

There are a few ways doctors can diagnose H. pylori. They can perform blood testing to see if you have an active or past infection. They can also perform breath testing; in this case, you swallow a pill containing carbon molecules and then breathe into a bag. Doctors check for carbon in your breath- if it’s present this means the bacteria is present. Another testing option is a stool test, in which doctors analyze a stool sample for abnormal bacteria or proteins that indicate an H. pylori infection. In some cases, your doctor may perform an upper endoscopy to visualize your stomach and take a tissue biopsy.

Treatment and Prevention

Most often, doctors treat H. pylori infection with multiple antibiotics. They may use two simultaneously to hedge against the bacteria becoming resistant to one. Your doctor may recommend other treatments depending on your case. This can include prescribing proton pump inhibitors, which block stomach acid production. They may also prescribe histamine blockers, which block histamine, the substance that triggers acid production. Often times, you may undergo follow-up testing a few weeks after treatment to determine if the bacteria has been eliminated.

You can take some steps to prevent H. pylori infection. Always wash your hands thoroughly with soap and water after using the bathroom and before eating. Only consume food that has been cooked in a clean and safe manner. Avoid unclean drinking water if possible. Doing these things can cut down on risk factors for H. pylori.

Our experienced team at GHP has years of experience diagnosing and treating H. pylori. 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.

Hereditary Diffuse Gastric Cancer: What You Need to Know

HDGC, or Hereditary Diffuse Gastric Cancer, is an inherited condition that increases your risk of stomach cancer. Here’s what you need to know about the condition.

What is Hereditary Diffuse Gastric Cancer?

Hereditary Diffuse Gastric Cancer syndrome is passed down genetically. This condition causes signet-ring shaped cells to grow on the stomach wall. It can spread throughout the stomach, and it does not usually cause a mass. As a result, it is difficult to diagnose early on before symptoms occur with typical testing like an Upper Endoscopy. Later-stage symptoms of HDGC that can indicate the condition include weight loss, loss of appetite, vomiting, nausea, trouble swallowing, and stomach pain.

Only around 1-3% of all stomach cancers are HDGC, so this is a rare condition. It puts you at a higher risk of stomach cancer and lobular breast cancer. In particular, there is a higher risk of diffuse gastric cancer for people with the syndrome. Diffuse gastric cancer is a type of stomach cancer that tends to affect most of the stomach. Somewhere around 20% of stomach cancers are of this type.

Cancer risk for people in families carrying an HDGC gene is high. The risk of developing stomach cancer by age 80 is 67% for men and 83% for women. The lifetime risk for women with HDGC developing lobular breast cancer is around 20-40%.

Diagnosis

People with a family history of HDGC can receive genetic testing to identify gene mutations associated with the condition. There is no single gene mutation that indicates HDGC most of the time. In fact, in families with a strong history of diffuse gastric cancer, the most common gene mutation (CDH1) for this condition only accounts for around 30-50% of cases. In all cases of gastric cancers, CDH1 mutation only cause around 1-3% of cases. So, there are a particular set of circumstances that dictate whether genetic testing should be pursued. Family history has to be taken into account. The guidelines for testing for a CDH1 may include:

  • A diffuse gastric cancer diagnosis before age 35
  • A diagnosis of both diffuse gastric and lobular breast cancer
  • Over two cases of diffuse gastric cancer in a family
  • Multiple cases of diffuse gastric cancer in a family, with one or more diagnoses occurring before age 50

Reducing Cancer Risk

People with an HDGC diagnosis or confirmed CDH1 gene mutation have a few treatment options. Unfortunately, as alluded to earlier, early screening for HDGC is very difficult since the diffuse cancer involved is hard to detect. People with a CDH1 mutation may want to consider getting their stomach removed through a prophylactic total gastrectomy, as this is the only proven way to completely prevent diffuse gastric cancer. This is a significant surgery with long-term side effects, so you should discuss the option thoroughly with your doctor. If you do not want to pursue the surgery, intensive surveillance is another option. This involves an annual EGD (Esophagogastroduodenoscopy) with multiple mucosal biopsies. Additionally, women at risk of HDGC should consider early breast cancer screening starting at age 30. They may also want to consider biannual clinical breast examinations, monthly self-examinations, and frequent breast imaging tests.

Our experienced team at GHP has years of experience screening for and treating conditions including HDGC. 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.