Gastroparesis: A Summary of the Condition

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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?

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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

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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://gastrohealthpartners.com/ to learn about the options we offer and schedule an appointment today.

Anal Fistulas: A Brief Overview

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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.