Flexible Sigmoidoscopy: Everything You Should Know

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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?

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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.

 

Hemorrhoids: An Overview

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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

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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.