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Flexible Sigmoidoscopy: Everything You Should Know

A flexible sigmoidoscopy is an endoscopic examination that helps doctors view the lower colon and rectum.  Here’s a closer look at the procedure. 

Why is a Flexible Sigmoidoscopy performed?

Flexible sigmoidoscopies can help doctors determine the cause of symptoms like rectal bleeding, abdominal pain, and changes in bowel habits. Additionally, doctors can use the procedure as a screening tool. They may recommend that people over the age of 50 have these exams on a regular basis to check for signs of colon cancer. While a colonoscopy is often used to do this, the flexible sigmoidoscopy offers a few advantages. For one, it is less involved in terms of preparation and exam time. It also does not typically require an anaesthetic, and it has a lower risk of perforation.

Preparing for a Flexible Sigmoidoscopy

To prepare for the procedure, you should always talk to your doctor about any medications you are taking. Additionally, they will give you instructions for bowel prepping before the exam. A bowel prep helps ensure there is as little stool as possible is present in the intestine during the exam. Doctors usually prescribe a clear liquid diet the day before the exam, and avoiding consuming anything after midnight the day of the exam. The bowel prep may also involve laxatives or enemas. You may need to consume a certain volume of liquid laxative leading up to the procedure. If your doctor prescribes an enema, you should use it the night before the procedure to wash out the rectum. 

During the procedure

During a flexible sigmoidoscopy, the patient is positioned on their left side with their knees drawn up towards their chest. The doctor first does a digital rectal exam, inserting a lubricated, gloved finger into the patient’s rectum to check for anything abnormal. Next, they insert the sigmoidoscope into the rectum. This may feel like pressure to the patient. The doctor then adds air through the sigmoidoscope to expand the colon, allowing them to see more clearly. The sigmoidoscope has a camera on the end of it that gives video feed to a monitor that the doctor views. Lastly, the doctor examines the lining of the bowel while slowly removing the scope. If necessary, they can insert forceps through an empty channel in the sigmoidoscope to take a tissue sample for biopsy. The entire procedure usually takes around 15 minutes.

Post-procedure

Following the procedure, patients can expect some mild abdominal discomfort, cramping and bloating for a few hours. Since the procedure is fairly non-invasive, you can return to your normal and activity level immediately. If a biopsy was performed, you may experience some light rectal bleeding from the site of the tissue sample. If the bleeding is persistent, or if you develop a fever of 100 degrees Fahrenheit or higher, contact your doctor. 

Your doctor will give you post-exam instruction on home care. They will also discuss the results with you. A negative test is when no abnormalities are found during the procedure. If your doctor finds any polyps or other issues during the exam, it is a positive test. This may lead to further testing, including a full colonoscopy. If a biopsy has been performed, the results are usually available after a few days and are communicated to you by your doctor. 

Our experienced team at GHP has years of experience performing flexible sigmoidoscopies. 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 Hepatitis B?

Hepatitis B is a liver infection that can cause both acute and chronic liver complications. It can lead to serious health issues over time. Here’s what you need to know about Hepatitis B. 

Causes and Risk Factors 

Hepatitis B is caused by the hepatitis B virus (HBV). This virus is transmitted in several ways, including blood, semen, and other bodily fluids, but not through sneezing or coughing. Some common modes of transmission are sexual contact, needle sharing, and mother to child. People who have unprotected sexual contact with someone infected with Hepatitis B are at a higher risk. They can contract the infection if any saliva, semen, blood, or vaginal secretions from the infected person enter their body. Also, since HBV can spread easily through infected blood on needles and syringes, intravenous drug-users who share equipment are at a heightened risk for contracting Hepatitis B. Mothers can pass the virus to their newborns during delivery as well. 

Types

Hepatitis B can be an acute or chronic infection. Acute cases last less than six months, and the immune system clears the virus from the body without long-term effects. Most adults who get the infection have an acute case. Chronic cases last over six months, and occur when the immune system can’t fight off the virus. Younger children are more likely to have a chronic case- 80-90% of infants who are infected in their first year develop chronic infections, and 30-50% of children under the age of 6 develop chronic infections. Fewer than 5% of healthy adults develop chronic cases.

Symptoms and complications

Symptoms of Hepatitis B can range from mild to severe, and usually appear one to four months after infection. They include joint pain, fever, loss of appetite, abdominal pain, dark urine, jaundice, fatigue, nausea, and vomiting. Some people, who are infected may show no symptoms; this is most often the case for younger children. 

Chronic Hepatitis B can lead to serious complications, including Cirrhosis, liver failure, liver disease, liver cancer, Hepatitis D, and kidney problems. 

Diagnosis

The symptoms of the infection overlap with numerous other viral infections. As such, blood testing is used to diagnose. People who may have been exposed to Hepatitis B, or who have been in high-risk occupations or places, are encouraged to get tested. Blood tests can indicate a number of things including whether you currently have HBV, whether you have ever had HBV, if you are infectious, and whether the infection is acute or chronic (through follow-up testing). 

Since Hepatitis B can cause no symptoms in some cases, certain groups of healthy people are often recommended for testing. These groups include pregnant women, HIV-infected people, hemodialysis patients, and people who require immunosuppressive or cytotoxic therapy. 

Treatment and Prevention

In cases of acute infection, treatment for Hepatitis B involves symptom management. In some cases, a timely post-exposure prophylaxis can prevent the infection. This usually involves administering the Hepatitis B vaccine, and may include adding immune globulin to bolster protection. 

The vaccine is an effective prevention measure. The vaccine schedule is usually for three injections: an initial injection, one a month later, and one six months from the initial injection. All infants should receive the vaccine, in addition to any unvaccinated children under 19, people at risk of exposure (including some health care professionals, people with Hepatitis B positive partners, and some people with diabetes). Prior to travel, seek guidance from a doctor regarding vaccination. 

Mitigating risk factors is also crucial for preventing infection. People who intravenously inject drugs should seek help to stop use, or use clean needles and avoid needle sharing. Additionally, you should always seek to know the HBV status of your sexual partner(s). People who have sex with partners that may have the infection should use a new latex or polyurethane condom every time they have sex. Additionally, if you are going to get a tattoo or piercing, make sure you utilize a reputable and sterile shop. 

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

 

What is Colorectal Cancer?

Colorectal cancer refers to a cancer that starts in the colon or rectum. While cancers that start in either place may be called colon cancer or rectal cancer, respectively, they are often known collectively as colorectal cancer because of similarities between the cancers. 

Here’s what you need to know about colorectal cancer. 

Causes and Risk Factors

Scientists are not exactly sure what causes colorectal cancer. We do know that colorectal cancer begins when healthy cells’ DNA mutates. These cells can then overgrow and divide, creating tumors. Cancerous cells can also destroy healthy tissue and travel to other parts of the body and form deposits. However, there are several well-documented risk factors. These include being over 45, having diabetes, smoking, drinking alcohol, having a high-fat diet, having an inflammatory bowel disease, and having a family history of colon cancer or polyps. 

Types

Most colorectal cancers (around 96%) are Adenocarcinomas. This kind of cancer starts in mucus-producing cells which lubricate the colon and rectum. 

There are a few other kinds of colorectal cancers that are much more rare. Lymphomas, cancers of immune system cells, can start in the colon or rectum (although they typically start in lymph nodes). Carcinoid tumors start from hormone-producing cells in the intestine. Gastrointestinal stromal tumors start from cells in the colon wall, and while most are non-cancerous, some can be. 

Symptoms

It’s common for colorectal cancers to have few symptoms until they have advanced. There are some potential warning signs, but they may be indicators of other issues. These symptoms include lower abdominal pain, blood in stool, bloating, cramps, vomiting, unexplained weight loss, and changes in bowel functions. As always, it’s best to consult a medical professional to determine what your symptoms are caused by. 

Diagnosis

The best way to cure colon cancer is to identify it at an early stage. However, since symptoms may not present early on, doctors recommend screenings for healthy people, usually beginning around age 50. People with more risk factors, as discussed above, may be advised to be screened at a younger age. 

A colonoscopy is one of the most common methods of screening. This involves using a scope to examine the inside of the colon. Your doctor can pass tools through the scope to take tissue samples if they see something suspicious. Biopsies of these tissue samples can help determine if cancer is present. Doctors also may remove polyps found during a colonoscopy to prevent them from becoming malignant. 

Treatment and Prevention

There are three main treatments for colorectal cancer- surgery, chemotherapy, and radiation therapy. These three treatment options are often used together in various combinations, depending on a patient’s situation. The best treatment options for each person depends on factors including overall health, the cancer’s stage, and whether the cancer is recurring. 

Localised, small, early-stage cancer in a polyp can be removed during a colonoscopy. A more invasive surgical procedure called a partial colectomy can remove the cancerous area of the colon and some surrounding healthy areas. This can prevent the cancer from growing back. Lymph nodes near the surgical site are removed and tested. Surgery can also be pursued to relieve symptoms and provide comfort for people in very poor conditions. 

Chemotherapy is another treatment option, often used after surgery to destroy remaining cancer cells. If the cancer has spread beyond the colon lining, this may be recommended. 

Radiation therapy utilizes beams of intense energy to destroy cancer cells. Radiation may be utilized before surgery to reduce tumor sizes, or after surgery to kill off remaining cancer cells. 

Preventing colorectal cancer is extremely important, and it starts with screening (as discussed above). Additionally, you can reduce your risk of developing colorectal cancer by avoiding smoking, reducing or avoiding alcohol consumption, staying active, maintaining a healthy weight, and eating a healthy diet. 

Our experienced team at GHP has years of experience helping people manage and treat 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.

 

 

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.

Gastro Health Partners’ Doctors Recognized as Louisville’s Top Docs for 2019

Louisville Magazine has just released their annual list of Louisville’s Top Docs for 2019. This year the doctors themselves cast their votes and four physicians from Gastro Health Partners were recognized in the category of gastroenterology.

When asked, “If you or a member of your family were in need of medical care or treatment, who among Louisville-area doctors would you choose to provide medical care in the following specialties?” our peers in the Greater Louisville Medical Society nominated (from left to right) Whitney F. Jones, M.D., Paul Eugene Brown, M.D., Alan J. Cox, M.D., and John C. Horlander, M.D.

                 

Dr. Whitney Jones joined Gastroenterology Health partners in 2017. He is the founder of the Colon Cancer Prevention Project and considered a national expert in the field of gastroenterology.

Dr. Paul Brown has been a member of the Louisville Gastroenterology Associates for 29 years and is Board Certified in both Internal Medicine and Gastroenterology.

Dr. Alan Cox is the author of several publications pertaining to the study of Gastroenterology. He is also Board Certified in Internal Medicine and Gastroenterology.

Dr. John Horlander is Board Certified in Internal Medicine and is actively involved in many research studies pertaining to gastroenterology.

On behalf of our team of 21 fellowship-trained Gastroenterologists and 13 advanced practice clinicians, we are proud to have been featured in this year’s issue of Louisville’s Top Docs among many other admiral physicians from the great city of Louisville. As the region’s leader in GI care, it is our mission to continue to offer cost-effective and comprehensive treatment options to those in Louisville, Lexington, Southern Indiana as well as the surrounding communities. Get screened by the best by scheduling your appointment online 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.

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