Featured article: Colon cancer screening should start at 45, government panel recommends

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Colon cancer screening guidelines are changing, and starting screenings earlier will help save lives. Gastro Health Partners fully endorses these changes. Read more about the changing guidelines in this featured article from NBC News:

Colon cancer screening should start at 45, government panel recommends

Screening for colorectal cancer should start at age 45, five years earlier than is currently recommended, according to draft guidelines from the U.S. Preventive Services Task Force.

The update was prompted by recent studies showing the rate of colorectal cancer rising in younger people, according to the draft, published Tuesday.

Click here to read the full article…

 

Chronic Diarrhea: What You Should Know

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Chronic diarrhea can be caused by a variety of things, including infections, GI disorders, food intolerance, and a reaction to medication. Let’s take a closer look at the condition.

Causes and Risk Factors

Diarrhea is chronic when it occurs three or more times per day for more than two weeks. It has several potential causes. Infection is one main cause. This infection can be parasitic, and from parasites like Giardia or Cyclospora. Infection can also be bacterial, from bacteria like Salmonella and E. coli. Some viral infections cause chronic diarrhea too, like some rhinoviruses and rotoviruses.

Outside of infections, there are several other potential causes. Pancreatic disorders like pancreatitis and cystic fibrosis can be a cause. GI diseases like Chrohn’s and IBS can cause diarrhea as well. Intolerance to foods can be at play too- lactose intolerance and fructose malabsorption are two examples. Additionally, some medications like laxatives and antibiotics can cause chronic diarrhea.

Symptoms of Chronic Diarrhea

As previously mentioned, diarrhea becomes chronic if it occurs three or more times per day for two or more weeks. Diarrhea is characterized by loose, watery stools that occur often more frequently than usual. Other symptoms include abdominal pain, abdominal cramps, bloating, nausea, blood or mucus in stool, and a fever. It also dehydrates you over time. If left untreated, this can be very dangerous. You should always see a doctor for chronic diarrhea.

Diagnosis

Chronic diarrhea itself is simple to diagnose, based on the definition outlined above. When you see a doctor for chronic diarrhea, they will work to diagnose the underlying cause. Depending on your symptoms, medical history, medications, the results of a physical exam, and other factors, they will select the appropriate testing measures. Stool samples can be tested to help identify if parasites, bacteria, or viruses are a cause. Your doctor may also want to do a blood test. If initial testing does not reveal a cause, your doctor may order an x-ray or endoscopy.

Chronic Diarrhea Treatment and Prevention

The cause of the condition dictates its treatment. With any case of diarrhea, fluid replacement is key. You should consume fluids and salts to replace those lost through diarrhea, unless otherwise ordered by your doctor. Some fruit juices and soup can be good options here. If liquids are upsetting your stomach, your doctor may recommend an IV to help rehydrate you.

Diarrhea caused by infection can often be treated with antibiotics or other medications. Your doctor will prescribe the proper medication for you depending on your case. If infection isn’t the cause, it will likely take more time to determine the underlying cause and therefore appropriate treatment. Conditions like IBS, Chrohn’s, fructose malabsorption, and Ulcerative Colitis all have their own treatment approaches. Your doctor will work with you to determine the best treatment options depending on the underlying cause.

Preventing chronic diarrhea involves mitigating risk factors for its various causes. To avoid infections that cause diarrhea, always drink safe, clean, properly-treated water. You should also use good food handling techniques, and practice good hand hygiene after using the bathroom and around food. If some foods trigger diarrhea for you, narrow down what they are and avoid them if possible.

Our experienced team at GHP has years of experience treating GI conditions like chronic diarrhea. 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 Esophageal Manometry?

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Esophageal Manometry is a test that helps doctors measure the force and coordination of your esophagus. Here’s what you need to know about the test.

When it is used

Esophageal Manometry tests whether your esophagus is working correctly. Your esophagus is a smooth muscular tube that pushes food and liquid from the mouth to the stomach. Every time you swallow, your esophagus contracts and helps move everything to your stomach. Your esophagus can have trouble functioning correctly if you have certain disorders.

There are a few scenarios in which this test may be used. If your primary symptoms are pain while swallowing or a difficulty swallowing, your doctor will likely recommend other testing (like an Upper Endoscopy). Your doctor may recommend you undergo Esophageal Manometry if you present symptoms that could be due to an esophageal disorder. These disorders include Scleroderma, Achalasia, and diffuse esophageal spasms. Additionally, if your doctor is considering surgery to treat your GERD, esophageal manometry can help diagnose Achalasia or Scleroderma, both of which can’t be treated surgically. Also, if you are experiencing chest pain unrelated to your heart and are unresponsive to GERD treatment, this test can help identify the cause of the pain.

Preparing for Esophageal Manometry

You should not eat or drink during the 6 hours before the test. This is because an empty stomach helps your doctor perform the safest and most effective test. Additionally, you should discuss any medications you are taking with your doctor. Some medications can affect esophageal pressure, and should be discontinued before the test.

During the test

You will not be under a general anaesthetic during the testing. However, a topical anaesthetic will be used in your nose and a numbing spray will be used in your throat. Your doctor will pass a thin tube (catheter) through one of your nostrils and down into your esophagus. You may gag briefly as this happens. Once the catheter is placed, you may be asked to lie on your back. Next, you will swallow small sips of water as directed by your doctor. The catheter will help measure the pressure your esophagus exerts as you do this. You will need to breathe slowly and smoothly during the test, remaining still and following your doctor’s instructions. The test takes around 30 minutes in total.

After the test

Following the test, there are a few mild symptoms you may experience. These include a sore throat, a nosebleed, and a stuffy nose. These should resolve in a few hours. You can immediately resume normal activities after your testing, unless your doctor tells you otherwise. If you experience any lasting or unusual symptoms, contact your doctor.

Side effects from Esophageal Manometry are very rare. These include aspiration, an irregular heartbeat, and perforation of the esophagus.

Our experienced team at GHP has years of experience performing Esophageal Manometry. 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.

Bile Duct Diseases: An Introduction

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Bile ducts are tubes that primarily carry bile from the liver and gallbladder to the small intestine to help digest fats.

Several diseases in the bile ducts can prevent proper bile duct functioning. Read along to find out more.

Bile duct disease

There are several bile duct diseases that can occur. Gallstones are one common issue for bile ducts. These form when deposits of digestive fluid harden in the gallbladder. They can cause inflammation, increasing pressure in the gallbladder and potentially blocking a bile duct. Another common bile duct condition is cholangitis, which is inflammation in the bile duct system. This is often caused by a bacterial infection.

Bile ducts can also have strictures (narrowing). In other cases, they can leak. Cancer can also occur in the bile ducts. Bile duct cancer is rare and aggressive. Additionally, some infants are born with a condition called biliary atresia, in which bile ducts are scarred and blocked. This causes a buildup of bile in the liver and can damage it.

Symptoms of Bile Duct Diseases

Bile duct diseases tend to have some of a group of symptoms. These include abdominal pain, nausea, vomiting, itchy skin, fever, chills, weight loss, loss of appetite, and jaundice. Pain may occur in the upper abdomen and radiate to the back in some cases. Depending on the disease, these symptoms can be at differing levels of severity and present in varied ways. The progression the disease also influences the severity and types of symptoms.

Diagnosis

Doctors diagnose bile duct diseases in a few different ways. Bilirubin blood testing can identify high levels of bilirubin in your bloodstream and can diagnose jaundice. Doctors can perform an Endoscopic Retrograde Cholangiopancreatogram (ERCP) to diagnose diseases. In an ERCP, they can inject contrast dye to help image your bile ducts during an x-ray. They can also perform an Endoscopic Ultrasound (EUS) to examine your bile ducts and make a diagnosis.

Treatment

Treatments vary depending on the type of bile duct disease. ERCP, in addition to helping with diagnosis, can help treat disease. Doctors can pass tools through the endoscope during an ERCP and open blocked ducts, remove or break up gallstones, insert stents, and even remove tumors. Doctors can also help drain bile during an EUS by inserting a stent to help drain into the small intestine or stomach. One other emerging treatment involves using Radiofrequency Ablation for palliative care to treat the symptoms of bile duct cancer. This can be a way to manage pain for long-term cases of cancer.

Surgery may also be necessary in some cases. For example, with patients who have bile duct cancer, surgery can help to remove tumors. If tumors are very large, doctors may need to remove the liver and perform a liver transplant.

Our experienced team at GHP has years of experience treating conditions including bile duct diseases. 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.

A Quick Summary of Esophagitis

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Esophagitis is an inflammation of the esophagus. Here’s what you need to know about the condition.

Causes

Esophagitis can be caused by various things. One of the most common causes is reflux. Reflux occurs when stomach acid backflows into the esophagus. A condition called GERD (gastrointestinal reflux disease) causes this to happen recurrently, and is a likely culprit for esophagitis in many cases. GERD can cause chronic inflammation over time. Infection can also cause esophagitis in rarer cases, mostly in people with diminished immune system function.

Oral medications can also cause inflammation in the esophagus if they are incontact with the esophagus for too long. This can happen if you take oral medications without enough liquid, oral medications that are irregularly shaped or large, if you take medications immediately before sleeping, or if you take them lying down. These medications include pain relievers like ibuprofen and aspirin, and some antibiotics.

Symptoms of Esophagitis

Several symptoms occur with this condition. These include difficulty swallowing, heartburn, chest pain occurring with eating, acid regurgitation, and a sore throat. Over time, irritation can cause tissue damage and ulcers can form. Additionally, strictures can occur with continued irritation. Strictures are a narrowing of the esophagus caused by a buildup of scar tissue. This leads to further difficulties with swallowing.

Diagnosing Esophagitis

There are a few different tests doctors use to diagnose esophagitis. They often perform a physical examination and review your medical history to identify symptoms that could indicate the condition. Additionally, they may perform a barium x-ray. For this test, patients drink a solution containing barium that coats the esophagus and makes it visible for imaging. Then, doctors take an x-ray to visualize the esophagus and identify any abnormalities. They may perform an endoscopy to look at the esophagus and biopsy tissue for a diagnosis. Biopsy tests can diagnose infections and identify any precancerous or cancerous cells.

Treatment and Prevention

Treating esophagitis involves treating symptoms, lowering the risk of complications, and treating the underlying cause. In cases of reflux esophagitis, some over the counter medications can help reduce acid production and heal the esophagus. There are also prescription medications available, including some proton pump inhibitors, H-2 receptor blockers, and prokinetics. Surgery may also be required in some cases. This involves wrapping part of the stomach around the lower esophageal sphincter to strengthen it and help prevent acid reflux. Last, in cases where a stricture has formed, doctors can perform an esophageal dilation to widen the esophagus.

For cases of drug-induced esophagitis, avoiding the drug causing the inflammation and changing the way you take medication can help. There are also alternative drugs you can take that won’t cause inflammation. Plus, by simply drinking water with medication and standing or sitting upright for 30 minutes after taking a pill, you can avoid causing some inflammation. Last, in cases of infectious esophagitis, doctors can prescribe medications to treat the underlying cause of infection.

Our experienced team at GHP has years of experience treating conditions including esophagitis. 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.