Barrett’s Esophagus: Five Things You Need To Know

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Barrett’s Esophagus is a condition that develops from chronic gastroesophageal reflux disease (GERD). GERD causes stomach acid to back up into the esophagus, and over time tissue in the esophagus can change to become tissue similar to that in the intestines. This tissue change is the defining element of the condition. 

Here are 5 things you need to know about Barrett’s Esophagus. 

Causes and Risk Factors

The exact cause of Barrett’s Esophagus is not known. However, a major risk factor is having GERD symptoms for 10 years or more. While some people who develop the condition have no history of GERD, it does increase the likelihood of the condition. Additionally, men, older adults, White people, overweight people, and people who smoke or have smoked are more likely to develop it. 

Barrett’s Esophagus Symptoms

Many of the symptoms people experience with Barrett’s Esophagus are the same symptoms associated with GERD. These include frequent heartburn, difficulty swallowing, upper abdominal pain, a dry cough, and chest pain. However, many people with the condition do not have any of these symptoms. 

Diagnosis

Barrett’s Esophagus is diagnosed through a procedure called an upper endoscopy. During this procedure, a physician uses an endoscope (a flexible tube with a camera) to examine the upper gastrointestinal tract. The endoscope is fed through the mouth and gives a view of any changes in the lining of the esophagus. Then, the physician may take a tissue sample of the lining, which will later be studied for any signs of metaplastic cells that can confirm a diagnosis. Since the condition doesn’t affect all areas of the esophagus, biopsy samples are taken from multiple places on the esophagus lining. 

Complications from Barrett’s Esophagus

People with Barrett’s Esophagus have an increased chance of developing esophageal adenocarcinoma, a rare type of cancer. When their esophageal tissue is replaced with intestine-like tissue (in a process called metaplasia), if the stimuli causing the metaplasia is not removed by addressing the acid reflux, dysplasia can occur. 

Dysplasia is a process where cells develop abnormally, and can lead to cancerous growth. The extent of dysplasia is diagnosed through a biopsy. Low-grade dysplasia is when cells show a small amount of change, and high-grade dysplasia is when advanced change has occurred and may lead to cancer. As a preventative step, people with Barrett’s Esophagus are often monitored through regular exams to check for precancerous cells. Procedures like ablation can be performed on precancerous cells to prevent cancerous growth. 

Treatments

Treatment for Barrett’s Esophagus varies based on the extent of the condition. For people with no or low dysplasia, lifestyle changes like eliminating heartburn triggers and maintaining healthy weight can ease symptoms. In addition, regular check-ups are often recommended to monitor any changes over time. 

When high-grade dysplasia is present, more serious interventions may be required. These treatments include removing damaged cells through an endoscopy, surgery to remove damaged parts of the esophagus, using cold therapy to damage abnormal cells, and using light therapy to destroy damaged cells.

Our experienced team at GHP has years of experience helping people manage and treat Barrett’s Esophagus. 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?

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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.

 

 

Dr. Michael Krease on a Broad Scope of Practice

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Dr. Michael Krease was recently featured in an MD-Update Magazine article where he discussed broadening perceptions of what gastroenterology is:

 

 “Scope Junkie.” “Scope Monkey.” He’s heard them all, and he gets the joke, but Michael Krease, DO, wants to make sure that everyone understands that there is much more to what he does than performing scopes.

 “That really is the common misconception,” he says of gastroenterology, which he practices at Gastroenterology Health Partners’ Louisville location. “We are much more than that.”

 It wasn’t the opportunity to perform endoscopies and colonoscopies, after all, that drew Krease to the medical field in particular. Growing up in the suburbs of Detroit, Michigan, Krease had an early interest in being a veterinarian, but by high school he knew he wanted to be a doctor. He narrowed his field of interest to internal medicine before attending medical school at the West Virginia School of Osteopathic Medicine. He met his wife, Megan, there. She is a pediatrician at All Children Pediatrics in Louisville. They did their residencies together at Oklahoma State University Medical Center. Krease then completed his Fellowship in gastroenterology, hepatology, and nutrition at the University of Louisville School of Medicine.

 

Read the full article here:

 

Michael Krease

Dr. Matthew McCollough on Teachable Moments

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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:

 

Lowering Your Risk of Liver Disease

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Liver disease is a general term used to cover multiple types of diseases that affect the liver and its functions in the body. These diseases include cirrhosis, cancer, infectious hepatitis, and blood flow abnormalities, to name a few. 

The liver has a role in many important bodily functions, including iron storage for red blood cell production, bile production, and generally digesting food and getting rid of toxins. Liver disease can affect these functions negatively and eventually lead to serious outcomes if untreated. 

Liver disease can be caused by a variety of things, come of which are controllable and others which aren’t. Luckily, though, there’s a lot you can do to reduce your risk. Let’s take a look at some key factors you can manage to lower your risk for liver disease. 

Exposure to toxins

A healthy liver helps filter out toxins from the blood. However, when too many toxins are present over time, the liver can become damaged. Chemicals found in household products, pesticides, and the like can cause liver damage over time if ingested. Always read warning labels for any chemicals you use to make sure you are employing proper safety measures and practices. Wash your fruits and vegetables before consumption too. In fact, go for clean produce and fruit when you can- pesticide-free food is the best way to ensure you aren’t overexposed to toxins when you eat. 

Alcohol consumption

Liver injury can occur due to alcohol abuse. When you drink too much over a long period of time, this starts to cause fat accumulation in your liver and can eventually lead to more damage. There are also other coinciding factors that can increase risk, like smoking. 

One key way to lower your risk of liver disease due to alcohol consumption is to decrease use. Abstaining from alcohol is incredibly effective in lessening damage, and in earlier stages of fatty accumulations in the liver may even reverse some damage. Even just reducing your amount of consumption to a healthier level is significant. For reference, moderate drinking is defined as up to 1 drink per day for women and up to 2 drinks per day for men. Heavy drinking is defined as 8 or more drinks per week for women and 15 or more drinks per week for men. 

Infection

Liver disease can also develop as a result of infection, which can occur from viruses or parasites. Viruses causing liver damage may be spread through close contact with an infected person, their blood or semen, or contaminated food and water. It’s important to take precautions to avoid virus exposure, including using protection during sex, avoiding needle sharing if you use drugs, and ensuring clean equipment is used on any tatooing equipment you come in contact with. 

Obesity, Diabetes, and High Cholesterol

Obesity, Diabetes, and High Cholesterol can lead to fatty accumulations in the liver. This can turn into nonalcoholic fatty liver disease, which like other types of liver disease, can become more severe over time. Fortunately, liver health can be improved by cutting simple carbohydrates and adding in more healthy fruits, vegetables, and proteins to your diet. 

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

Understanding Crohn’s Disease

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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.