A new survey released by the AGA provides some alarming statistics concerning Hepatitis C and Baby Boomers. The survey showed that 74% of Boomers have either never been tested for Hep C or are unsure if they have ever been tested. Also, 80% of those surveyed believe that they are not in any risk of developing the disease and 83% have never even discussed the issue with their Doctor.

The other side of the statistical coin is that it is estimated that nearly 5 million Americans have the disease and that 82% of those are Baby Boomers. The real problem is that it is estimated that 75% of those infected are unaware that they have the disease.

Those are startling statistics. Do you know the risk factors for Hep C?  According to the Mayo Clinic the risk factors are:

Our Pediatric Department, at GI Associates, is a source of pride for us. Our Doctors are wonderful examples of the kind of caring, well-trained professionals you would want treating your child. So, excuse us while we brag about one of our own...

Dr. Sara Rippel has co-authored an important paper recently published in the Journal of the American Gastroenterology Association (AGA). The title of the paper is "Pediatric Patients With Dyspepsia Have Chronic Symptoms, Anxiety, and Lower Quality of Life as Adolescents and Adults". Now to most of us that may not mean anything; but if you have a child with Dyspepsia it should be a great comfort to you that our Doctors are studying the condition and are working on ways to help improve the quality of life for their patients.

Congratulations, Dr. Rippel, we are so glad that you are part of the GI Associates team. Do you want to know more about our Pediatric Department or view the journal article?

Have you heard about the newest (and dumbest) diet craze which uses a feeding tube? Yes, a feeding tube like the kind you find taped to the side of critically ill patients in a hospital. Those folks are really sick or injured, not trying to shed weight. Trust me on this one - I am sure they would much rather be sitting down to a nice meal instead of having a tube stuck down their nose. I have heard it isn’t the most pleasant experience.

Apparently, the K-E diet or “Feeding Tube Diet” is one of those diet crazes which migrated across the big pond from Rome (of all places!). Not sure what K-E stands for…maybe it should be called the IQF Diet (Idiotic Quick Fix) instead. Folks are fed a liquid 800 calorie formula consisting of protein, fat and zero carbohydrates throughout the day. Since the formula is zero carbohydrates, the person goes into ketosis. Ketosis, in turn, causes the person to not feel any hunger. This is the basis of the Atkin’s Diet and other low carbohydrate diet plans à Lose weight without being hungry.

Last July, the diet made its debut in the United States as way to help the morbidly obese. Instead, brides-to-be saw it as a great way to shed pounds to fit into their skinny wedding dress….imagine being able to drop 20 pounds in only 10 days! It will cost the bride-to-be $1500 along with the pleasure of having a tube down your nose and lugging formula around in a bag slung over your shoulder 24/7. Of course it is only for 10 days!

The K-E diet is nothing more than a quick fix. When the tube comes out you still have to face eating again. I would much rather eat my 800 calorie low carbohydrate diet and skip the tube! GI Associates offers such a program - the Ideal Protein Program. The program is initially a low carbohydrate diet. It uses a four phase protocol. Unlike the K-E diet, it does not leave you wondering how to handle the eating issue when the tube comes out. During the four phases, the program addresses the underlying issues which contributed to the weight. You gain the knowledge and skills to keep the weight from returning. You can’t find that in a tube!

Want more from Sandy? Visit our nutrition corner.

Crohn's and Colitis Foundation of America (CCFA) is working hard to bring awareness to digestive disorders that plague millions of Americans. As described on their site www.ccfa.org, "Take Steps for Crohn's & Colitis is CCFA's largest fundraising event. Participants raise funds and awareness throughout the year and come together to celebrate the steps that have been taken towards a cure."

The local walk is this weekend - Sunday, April 22 at the Old Trace Park, we hope to see you there. 

Gas is a common problem that many people deal with, most people just deal with it knowing that it’s a because of varying foods. It’s common for a person to pass gas up to 20 times a day but sometimes bloating and pain can be the symptoms of something more serious.

One of the first steps when you begin to notice excessive gas is to keep a food diary to see if it’s specific foods that are causing the gas. If you find relief from pain when you pass gas, notice a difference when you change your diet, or the pain doesn’t continue or get worse.

If you determine that food isn’t the problem then excessive gas can sometimes be a sign of an underlying issue. There could be problems with your digestive system or some other issue that you gastroenterologist may be able to determine through tests. Talk to your gastroenterologist if you are suffering from excessive gas.

Although 90% of all colon cancers are diagnosed in people of 50 that should not be an excuse to dismiss symptoms. That's the moral to the story being told by 42 year old country singer Wade Hayes recently diagnosed with stage 4 colon cancer. He dismissed the bleeding as a probable hemorrhoid after all he lifts wights and works out strenuously. He dismissed the fatigue as a natural by-product of a busy touring schedule. But, he couldn't dismiss the sudden excruciating pain which ultimately lead to the diagnosis.

Early symptoms can be vague and easily to explain away, but if you are having persistent symptoms it is time to get it checked out! Don't let your age or lack of family history be a hinderance to knowing your body and getting screened. 

On the preventative side of the discussion...what can you do to lower your risk?

• Eat a variety of fruits, vegetables and whole grains. Fruits, vegetables and whole grains contain vitamins, minerals, fiber and antioxidants, which may play a role in cancer prevention. Choose a variety of fruits and vegetables so that you get an array of vitamins and nutrients.
• Drink alcohol in moderation, if at all. If you choose to drink alcohol, limit the amount of alcohol you drink to no more than one drink a day for women and two for men.
• Stop smoking. Talk to your doctor about ways to quit that may work for you.
• Exercise most days of the week. Try to get at least 30 minutes of exercise on most days. If you've been inactive, start slowly and build up gradually to 30 minutes. Also, talk to your doctor before starting any exercise program.
• Maintain a healthy weight. If you have a healthy weight, work to maintain your weight by combining a healthy diet with daily exercise. If you need to lose weight, ask your doctor about healthy ways to achieve your goal. Aim to lose weight slowly by increasing the amount of exercise you get and reducing the number of calories you eat.

The American College of Gastroenterology has issued a statement concerning the link between colon cancer and obesity. It is true that obesity is linked with a variety of serious diseases and the ACG is joining forces with the Campaign to End Obesity to stress the close link diet plays in the development of colon cancer.

It is estimated that as much as 90% of all colon cancers are caused by diet or other modifiable risks - let me say that again, 90%! Screening is essential to the early detection of colon cancers and everyone should have their baseline screening by the age of 50. The ACG recommends that African-Americans be screened by the age of 45. It is important to talk to your primary care physician and evaluate if your timetable should differ because of family history or other factors in your personal medical history.

If you are among the 33% of Americans who are considered obese (statistics from the CDC Nov 2011) you need to be aware that you are at a greater risk for developing colorectal cancers and need to be screened sooner rather than later. If detected early, there is a very high cure rate. But, left undetected colon cancer accounts for the second most cancer deaths in America.

March is Colorectal Cancer Awareness Month - get the information you need and schedule a screening for you or someone you love.

When you ask someone why they have postponed their colonoscopy you mainly get just one answer...fear; they are afraid of the prep. While we won't try to tell you that prepping for a colonoscopy is easy we do want to stress that the risk of not being screened far out weights the discomfort of being prepped. Screening saves countless lives and provides piece of mind to patient. 

Once you get past the prep, the rest is quite simple. 

March marks the beginning of colorectal cancer awareness month. It is the second leading cause of cancer deaths in the Unites States and there are more than 140,000 people diagnosed with colorectal cancer each year, most cases occurring in people over the age of 50.

Colorectal cancer usually doesn’t have any symptoms, especially at first, and that’s why it’s important to get screened. People who have had symptoms have complained of blood in their stool, stomach pain or cramping and unexplained weight loss.

Colorectal cancer screenings save lives because they help gastroenterologists spot any precancerous polyps. If cancerous polyps are found they can be removed before they turn into cancer.

If you think you might be suffering from some of these symptoms or want more information about colorectal cancer be sure to talk with your gastroenterologist. They’ll be able to answer any questions you have and get your scheduled for a colorectal cancer screening.

March is Colorectal Awareness Month, a great time to educate yourself on the risks of colon cancer. But, it is also important to learn the truth about the benefits of screenings. 

Fear causes people to postpone their first colonoscopy, but would you postpone if you knew that screenings reduce the death rate by 53%? That's a significant number, one not easily ignored. A study recently published in the New England Journal of Medicine follows two groups, one that had precancerous polyps removed during routine colonoscopies and one group that was not regularly screened. The rate of death in the screened group was 53% lower than the unscreened group. The conclusion is that screenings find polyps while they are still precancerous; once the polyp is removed it doesn't have the chance to grow into a tumor. Unscreened patients run a greater risk of not being diagnosed until the cancer has become advanced. 

Are you 50 years of age or older? Have you had your baseline colonoscopy? Call 601-355-1234 to make an appointment.

Our bodies should be able to digest just about anything we put into our mouths, however with more processed foods these days and for those with gastrointestinal issues like IBS digesting certain foods is harder. Here are some foods that are difficult to digest and should be eaten in moderation.

• Spicy Foods- most people who suffer from heartburn know to stay away from spicy foods, but those with some digestive problems including IBS also suffer from heartburn due to spicy cuisine.
•  High-fat/fried foods- your digestive system can only process so much food at one time and these two types of foods easily overwhelm the digestive system resulting in acid reflux or heartburn. 
• Alcohol and carbonated beverages- these products relax the esophageal sphincter, which keeps stomach acid confined to the stomach, causing cramping, diarrhea or heartburn. Alcohol also inflamed the stomach lining keeping nutrients and enzymes from being absorbed into the body. 
• Dairy Products- it’s important to get plenty of calcium into your diet, but for people are lactose intolerant eating dairy products results in bloating, cramps, diarrhea or gas. 
• Chocolate- it can be a problem for many people due to the milk products or caffeine in the chocolate causing cramps, bloating or diarrhea.

If you suffer from any of these gastrointestinal issues be sure to talk with your gastroenterologist. They will be able to answer any questions you have and help you find ways to reduce your pain and symptoms.

We remind you all of the time about the importance of keeping your digestive system in good working order; but research is being done that shows it's more than preventing a tummy ache - it could effect your entire body.

From the esophagus to the intestine the entire system is sometimes referred to as the gut and is a single digestive organ. What is really amazing is that it also has it's own nervous system that allows it to operate independently from the brain. This nervous system also controls the pancreas and gall bladder and, like the brain and spinal column, is full of nerve cells. The small intestine alone contains around 100 million neurons which is about the same number found in the spinal cord. It is believed that the vagus nerve - the large nerve running from the gut to the brain - actually transmits more information to the brain than it carries "orders" from the brain. Interesting, but what does it mean?

Researchers don't yet know how all of this effects the entire body, but there are some really amazing issues being studied. For example:

• 95% of the body's serotonin is produced in the gut! So research is being done to link GI disorders with depression and anxiety. Serotonin also is necessary for digestion of food, cell repair in the liver and lungs, heart development, and bone-mass accumulation.
• electrically stimulating the vagus nerve has been shown to reduce symptoms of depression and epilepsy. Another study of a similar procedure has been shown to help improve learning and memory in an animal study.
• a very small study marks the beginning of research of autistic children and a bacterium that is found in intestines
• Parkinson's Disease damages the neurons in the brain, it also damages neurons in the gut. There is research being done in France to see if Doctors can track the disease through easily procured colon biopsy samples rather than dangerous brain biopsies.

All of these studies are in the early stages and it may be years before we see any office level treatments for these health concerns; but, it should give us all a greater motivation to take care of our "guts". If you have any concerns about your health you should seek medical treatment right away. If you would like to make an appointment with a physician at GI Associates please call 601-355-1234.

February is American Heart month to help raise awareness for heart disease and promote healthy lifestyles. Heart disease is one of the leading causes of death in America in both men and women. Although heart disease can be genetic it can also be cause of sedentary lifestyles. There are many easy lifestyle changes that can make for a healthier you.

The American Heart Association gives 7 simple changes that can make a big difference.

Get active- Exercise and activity are not only good for your heart but it can have an impact on blood pressure, cholesterol, weight and fatigue. Activity can be adding moderate exercise like walking or bike riding to your weekly routine or taking the stairs and not waiting for the closest parking spot to the building.

Eat Healthier- A heart healthy diet contains foods rich in fiber, protein and whole grains with lots of fruits and veggies. When preparing a meal try to have lots of different colors of vegetables that are full of vitamins and minerals. Keeping healthy snacks in the house makes for good choices between meals. Cut back on processed sugars, cholesterol and sodium.

Lose Weight- Becoming more active and changing your eating habits will help with losing weight. When you are at a healthy weight you may find you feel better, your blood pressure is lower and that your cholesterol and blood sugar are in normal range.

Stop Smoking- Cigarette smokers are more at risk for cardiovascular disease and lots of different cancers. Although stopping may seem like a daunting task it is well worth it for your health and for those you love.

The last 3 changes are lowering your blood pressure, reducing your blood sugar and lowering cholesterol.

This month take control of your health one step at a time and choose a better quality for your life. These simple steps today can make a big difference tomorrow.

On Friday, February 21 at 6 pm our own Dr. Sara Rippel will be giving a presentation in the Community Room at the Madison campus of Baptist Hospital. If your child or teenager suffers from chronic constipation please be sure to attend this presentation. Dr. Rippel is one of our Pediatric GI physicians and is taking new patients. Don't let your child suffer any longer,

Constipation_flyer.pdf

A new study released in BMC Gastroenterology shows that an antioxidant found in fruit and vegetables called luteolin is capable of blocking cell signal pathways that are needed for colon cancer growth. This is the first study that shows that luteolin can block certain signal pathways that triggers the cancer cells to grow rapidly and spread.

Much more research is needed before we can understand how this antioxidant works and if it will be viable as an anti-cancer agent; but, it does sound intriguing. What is even more interesting is that it points to the fact that healthy eating does for us than just trimming our waistline. So, take a look at our Nutrition Corner and lets set out to eat a balanced, healthy diet and maybe throw in some carrots and celery!

It is getting dangerous at GI Associates with all of the pounds dropping off our beta group on our new weight loss program – Ideal Protein! So far our eight beta group members have lost close to 125 pounds in the last 3-4 weeks since starting the program. One of our nurses on the program has been taken off her blood pressure medicine. You can well imagine how thrilled she is!

We started with a small group of selected staff prior to rolling it out to the rest of our staff and patients. This enabled us to “test drive” the program. The beta group is thrilled with the program and their shrinking waist lines – even during the challenging holiday season.

The Ideal Protein has been around for about twenty-five years in France. It recently migrated to the United States a few years ago and is offered in select medical clinic settings. It was created by a medical doctor, Dr. Tran Tien Chanh, who studied under the renowned Dr. George Blackburn at Harvard. The deceased Dr. Atkins also studied under Dr. Blackburn who is the creator of the first wave of low carb diets.

The Ideal Protein program is initially a low carbohydrate diet but is much different from the Dr. Atkins diet. It is not an “all you can eat protein and fat” type diet. You will not find anyone on the Ideal Protein diet munching on pork rinds! It is a right amount and type of protein and fat-type diet.
The weight loss program consists of a four phase protocol. Weight loss is during the first two phases and maintenance during the last two phases. The diet has a beginning and an end. This is an important point as most weight loss programs leaves you “hanging” after you lose your weight. The last two phases of the diet gives you the knowledge and skills to keep the weight from returning.

During the program, specialty blended high-biological protein products which are low in fat are the cornerstone of the program. Ideal Protein’s line of superior quality products are manufactured in a special certified laboratory in accordance with Health Canada’s pharmaceutical and food standards. Strict controls to monitor the manufacturing process are in place and also follow the United States FDA regulations.

The program offers one-on-one meetings with specialty trained GIA staff. The medical director is Dr. Cindy Haden-Wright and has a dietitian overseeing the program àme! Leslie Overby is our Ideal Protein Coordinator and Coach à everyone will love here dynamic personality! We are offering two open houses a month for the public to find out about the program. The open houses are on the first and third Tuesday of the month at 3 PM in our 4th floor conference center in the same building as the Endoscopy Center. The first open house is planned for Tuesday, January 3rd so mark your calendar. Please check our GIA Website for upcoming information about this new great program and meeting times. In the meantime, wear your hard hat to protect yourself from all the falling pounds!

Gastroesophageal reflux disease, GERD, is becoming international! Researchers tracking the complaint of persistant heartburn are now seeing the rise of incidence in Asia, where it was virtually unheard of a decade ago. Also, some believe that 20% of Americans experience occasional reflux and as many as 7% suffer daily.

Most people think that heartburn is something that you "just have to live with", but left untreated it can cause bleeding or ulcers in the esophagus, build up of scar tissue and in extreme cases - cancer.  One theory for the rise in the number of cases is the increase in peoples weight. As people gain weight fat is stored around the internal organs increasing pressure on the stomach. So, now there is another reason to lose weight.

If you suffer from persistant heartburn, meaning twice a week a week, you should seek medical advice. Call and make an appointment with one of the Physicians at GI Associates. Other steps you can take include:

• Making a concerted effort to lose weight, by exercising and adopting a healthy diet.
• Learning which foods are more likely to trigger excess acid or reflux, and then avoiding them.
• Eating the final meal of the day two to three hours before bedtime, thus reducing the amount of food in the stomach that would press against the esophageal valve.
• Elevating the head of the bed, if nighttime reflux is a problem, as this can reduce the pressure of stomach acid and contents on the valve

Resolutions come and go, "I'm going to exercise everyday" usually falls by the wayside by January 5. But, a healthy new year is a serious goal that deserves serious consideration.

People usually only think about their GI track when something goes wrong or when you turn some magical age that requires screening tests to be run. But, so many issues that we deal with everyday at GI Associates can be aided by simple lifestyle changes in our patients.  So lets talk about what you can do to be healthier this year and every year.

• Lose Weight - if you are carrying excess weight you increase your risk of many different diseases and ailments. It is not easy to change the way you eat but if you start with small changes, like adding more fresh fruit and vegetables to your diet, you will end up seeing results. The more results you see, the easier it will be to...
• Get Regular Exercise - start walking!  If you have not been exercising at all please talk to your Doctor before starting any program.
• Make an Appointment for your yearly physical and make sure you are up to date on all of your screenings - we admit it...we know that no one really likes to go see their Doctor; but we want you to know that early detection of diseases makes all the difference in how you will be able to live your life.  For example, detected early, colon cancer is highly curable. If you are due for a colonoscopy then schedule it today, if you have never had one and you are 50 years of age or older then schedule one today! If you are seeing your primary care Physician you should know that you can request your Doctor to refer you to GI Associates for screenings.
• Talk to us - things that you've been "living with" like, heartburn, can be treated by a Physician at GI Associates. Resolve to stop suffering and get some help.

We would like to help you keep your resolution to be healthier in 2012. Call for an appointment at 601-355-1234.

According to a new study, just published in the January issue of Clinical Gastroenterology and Hepatology, there is not a long term link between Celiac Disease and an increased risk for GI cancer.  In the short term, they did report a spike in cancer occurrence in the year following the diagnosis of Celiac, inflammation or latent celiac disease. While this study is no cause for alarm, if you, or someone you know has celiac, it does support the important relationship between patients with a number of gi issues and their gastroenterologist - regular visits with your physician at GI Associates will increase your chances of an early diagnosis should a cancer occur.

You should be able to talk frankly with your doctor about any concerns you have and follow their  recommendations for diet, lifestyle and medications. Our goal, as we enter the new year, is to inform, educate and give you the tools you need to take charge of your health. 

There are many foods that help promote healthy digestion, but recent studies have shown that adding rosemary to your dishes may help promote good digestion, protect the immune system and improve circulation.

Rosemary has been used for stomach problems such as indigestion, bloating and stomach cramps and constipation. It’s still unclear how it helps but many think it has a detoxifying effect on the liver and helps to increase the flow of bile, which aids digestion.

While too much rosemary might make you sick, adding a little to your meals might help with occasional digestion problems. For those who suffer from frequent or chronic digestion problems, be sure to call GI Associates and make an appointment with your gastroenterologist.

Well, it has come and gone with hardly a wimper but the nation just marked it's first ever Crohn's and Colitis Awareness Week from December 1 -7.  Didn't hear about it? Well you are not alone. Hopefully, with more time to plan next years week should bring more public awareness to these two painful gastrointestinal disorders.

In the mean time, if you want more information on Crohn's and Colitis explore our site...there is additional information in our nutrition corner. 

A new study showed that a course of probiotics can prevent antibiotic associated diarrhea or AAD. The courses ranged from 5 days to 3 weeks with the average patient receiving probiotics for 1.5 weeks.  

AAD is caused by an imbalance of healthy bacteria in the colon from a course of antibiotic therapy.  Risk factors for AAD include recent antibiotics use, old age, recent hospitalization, low albumin, and immunosuppression. This study points to the importance of everyone who is at risk for AAD start a round of probiotics along with the prescribed antibiotics.

All of the Thanksgiving goodies can take a toll on your digestive system and ironically this week is Gastroesophageal Reflux Disease awareness week.

When you eat, that food passes from your mouth to the stomach through the esophagus. Once the food is in the stomach there is a ring of muscle fibers, called the sphincter muscle, that prevent the food from going back into the esophagus. If these fibers don’t close then contents on the stomach can leak back into the esophagus causing gastroesophageal reflux.

Usually the symptoms of gastroesophageal reflux are:

• Heartburn or a burning pain in the chest that may increase when you bend down, lie down or are eating. 
• Sometimes it may also feel like there is food stuck behind the breastbone or nausea after eating. 
• Regurgitation, difficulty swallowing and hiccups may also be a common symptom. 
• Heartburn usually gets worse at night and can often be relieved by antacids.

You may find that eating certain foods makes things worse. If your symptoms worsen or you seem to have frequent or even chronic heartburn be sure to talk with your gastroenterologist. Lifestyle changes may be necessary but your gastroenterologist will be able talk with you how to make living with GERD better and answer any questions you may have.

Gastric cancer, or stomach cancer, affects the stomach and while the American Cancer Society has seen a decrease in the amount of people diagnosed with stomach cancer over the last 60 years it’s still important to be aware of signs.

After you finished chewing and swallowing food it then passes down the esophagus and into the stomach. There is mixes with gastric juice and begins the digestion process.

You might have a higher risk of getting stomach cancer if you have:

• A family history of stomach cancer 
• A history of certain gastric polyps or chronic atrophic gastritis 
• Helicobacter pylori infection (a bacteria that can cause stomach ulcers) 
• Smoked or are a current smoker

Stomach cancer is often difficult to diagnose because many of the symptoms can be similar to other gastrointestinal diseases. If you think you might be at higher risk for stomach cancer and are experiencing any of these symptoms you might want to talk with you need to talk with your gastroenterologist.Symptoms include:

• Difficultly swallowing that may increase over time 
• Excessive belching 
• Loss of appetite 
• Abdominal fullness or pain 
• Nausea or vomiting 
• Dark stool 
• Weakness or fatigue 
• Unexplained weight loss 
• Vomiting blood

You gastroenterologist will be able to run tests to see if you have stomach cancer or not. If you are diagnosed with stomach cancer your gastroenterologist will be able to talk with you about treatment options and answer any questions you may have.

Colon cancer has been in the news again. This time in a study released by the American Institute for Cancer Research in Washington, D.C.. The study shows a clear link to prolonged periods of sitting to colon and breast cancer. Even in people that exercise regularly, but sit for extended periods of time, there is an increased risk of developing these cancers. Alpa Patel, an epidemiologist at the American Cancer Society has dubbed the habit “sitting disease.”

There has long been a known connection between people that live sedentary lives and cancer but this study goes one step further. Even if you go the gym and exercise for an hour everyday but follow that up with sitting at your desk all day your risk increases. Recommendations are to stand up and walk around your office at regular intervals in order to break up your day.

If you are concerned about colon cancer or have postponed your screening, call GI Associates today and make an appointment.

Irritable bowel syndrome (IBS) is a baffling series of symptoms that can be vague and hard to diagnose. There is a small, but growing, group of Doctors, mainly in Australia that are looking at food intolerances as the source of the problem – and a new dietary approach, called the low-Fodmaps diet, is being touted as a potentially successful treatment.

The theory is that many people with IBS have trouble absorbing certain carbohydrates in their small intestines. Large molecules of those foods travel to the colon and are attacked by bacteria and ferment, causing gas, bloating, constipation or diarrhea – the symptoms of IBS.

The list includes common foods—such as dairy products, some fruits and vegetables, wheat, rye, corn syrup and artificial sweeteners. Physicians have long known that some of these foods can cause stomach upset individually, like those that suffer from lactose intolerance.

The low-Fodmaps diet recommends eliminating all of those foods for a period of six to eight weeks, and then gradually adding back one group after another to identify which cause the most trouble. This study was a very small study and it needs to be investigated more thoroughly. But, if it is found helpful it could be a real relief to those who suffer from IBS.

Nearly twenty percent of Americans suffer from Irritable Bowel Syndrome (IBS) however many do not even realize they have it. Gastroenterologists are still trying to gain more knowledge on the subject but the main symptoms of IBS can be broken down into three main parts: diarrhea, constipation or a combination of both.

IBS is referred to as a “syndrome” because it involves so many varying signs and symptoms such as abdominal pain, cramping, bloating, sensitivity to certain foods, beverages and medications in addition to constipation and diarrhea. These symptoms seem to get worsen with stress.

Many sufferers take laxatives to help relieve constipation but they’re still left with abdominal pain and many medications taken to help the abdominal pain make the constipation worse. If you think you may have IBS be sure to talk to your gastroenterologist. They will be able to make sure there are no additional gastrointestinal problems and help you learn how to relieve the pain and live with IBS.

The American College of Gastroenterology, and The American Cancer Society recommend a normal-risk person (someone without a family history of colon cancer) begin colorectal screening at age 50. It is the number two killer in the United States, yet is one of the most preventable types of cancer and often curable when detected early.

Are you or someone you love over 50? We are running out of time to have your 2011 screening done. Don't put it off any longer, call for an appointment today.

Millions of Americans suffer from heartburn and rely on over the counter antacids to help relieve their pain. The FDA however is now warning that these antacids may be causing more harm than you think.

Studies have shown that large doses or prolonged use of these antacids increase the risk of infection, bone fractures and dementia. They also hinder the body’s ability to absorb some nutrients, reduce resistance to infection and may increase the risk of cancer or other gastrointestinal diseases.

While an occasional antacid is ok, frequent or chronic heartburn suffers who take large doses or are taking antacids on a daily basis should talk with a gastroenterologist. These frequent gastrointestinal problems could be a sign or a more serious issue or could be treated in a more safe and effective way rather than popping an antacid everyday

If you experience persistent pain or discomfort in the stomach after eating it may be something more than just heartburn. Sometimes persistent indigestion can indicate problems with the gallbladder, often gallbladder disease.

During proper digestion, the gallbladder helps store bile and carries it into the small intestine. Gallbladder disease keeps the bile from entering the small intestine, usually with a gallstone, which is made up of hardened pieces of bile or cholesterol. This can cause pain that ranges can be similar to heartburn or can cause nausea and vomiting.

Since the symptoms of gallbladder disease are similar to other digestive problems: gas, bloating or constipation, many people have gallbladder disease without even knowing it. The most common symptom is a severe pain in the upper abdomen.

If you think you may have something more than just heartburn or are experiencing some of these symptoms be sure to talk with your gastroenterologist. They will be able to run any tests needed to diagnose your problem and help you get treatment as soon as possible.

A new study has been published that links symptoms of GERD to people that were exposed to the dust cloud that enveloped lower Manhattan on 9/11. This covers people that prior to the terror attacks exhibited no symptoms but since have developed lasting heartburn, acid reflux, indigestion and other symptoms of gastroesophageal reflux disease.

The new findings appear in the American Journal of Gastroenterology. They bolster the results of another recent study that looked at the lingering health effects, including heartburn and acid reflux, seen among rescue and recovery workers at Ground Zero.

“This study provides more evidence to support that there could be a relationship between 9/11 exposure and GERD symptoms,” says researcher Jiehui Li, MBBS. She is with the New York City Department of Health and Mental Hygiene in Long Island City, N.Y.

The study looked at symptoms of GERD including:

• Heartburn
• Acid reflux
• Indigestion
• Stomach discomfort (dyspepsia)
• Cough
• Chest pain

Researchers surveyed more than 37,000 adults who lived or worked near Ground Zero who did not report any GERD symptoms prior to 9/11. Of these, 20% had some new GERD symptoms after 9/11. For 13%, these symptoms persisted for at least five to six years, the study showed.

The researchers speculate that alkaline cement -- one of the components seen in the dust cloud that enveloped lower Manhattan may have damaged the digestive track after mixing with saliva and being swallowed. This opens up a whole new research angle of environmental factors for development of GERD.

If you are having frequent heartburn or indigestion that occurs more than three times per week, particularly at night that interferes with your sleep, or develop difficulty swallowing, you need to see a physician to rule out the possibilities of underlying causes.

Our own Dr. Reed Hogan was honored yesterday by Becker's ASC Review in their list of the 125 Leading Gastroenterologists in America! The physicians were selected for this list based on the awards they received from major organizations in the field, leadership in those organizations, work on professional publications and distinguished service in a GI ambulatory surgery center. All of those who placed on this list have undergone substantial review from the editorial staff of the publication.

We are proud of Dr Hogan and of all of our excellent physicians who are working hard everyday on behalf of our patients. We also take great pride in the quality of care our patients receive from the time the check in to one of our own Endoscopy Centers until the time the are assisted to their car to go home. Your health and well being is our motivation.

Normal bowel movements are thought to be a sign of good health and, when you are tracking your infant or child's bathroom routine, any change can cause worry for parents. Most infants have two to three bowel movements a day and most children have at least one a day. Constipation usually occurs when the infant or child goes longer than expected in having a bowel movement.

At least half of the children who suffer from constipation have abdominal pain or anal or rectal pain in addition to the constipation. Constipation can create other problems such as decreased appetite, urinary tract infections and accidents regarding potty training.

Once a parent realizes that their child is having constipation problems they can help by increasing fiber and making sure the child gets enough water. Adding raw fruits, vegetables and whole grains can also help promote better digestion and help with bowel movements as well.

If the problem persists then it’s important to talk with your gastroenterologist to make sure there are no underlying problems. They’ll also be able to provide additional tips for better digestion and bowel movements.

I chuckled reading the Wednesday, August 17th article in The Clarion-Ledger by Sherry Lucas aptly titled Witless on Wheatless. The article started with a woman in the bread aisle frantically trying to find a loaf of oatmeal bread for her grandson who couldn’t eat wheat. The woman muttered to herself “Why do they call it oatmeal bread if the first ingredient is wheat?” How true! Most folks mistakenly assume oatmeal bread is made from oats and not wheat. Those on gluten-free diets may fall into that same trap by not closely reading the food label. They purchase the oatmeal bread assuming it is a safe and a good choice. Wrong! One of my recent pediatric patient’s father came home very proud of himself after cleaning the local grocery store out of their potato bread. He thought he was doing a good thing for his daughter who is on a gluten free diet. His wife blithely pointed out “wheat” as the first ingredient listed on the food label. It is a good thing dad likes potato bread!

Wheat is not the only gluten-containing culprit. Barley and rye also contain gluten and must be avoided for those on a gluten-free diet. Oats and oat-containing products, unless it specifies it is gluten-free, is also a source of gluten through cross-contamination. In fact, all cereal grains (including grits) are a potential source of gluten through cross-contamination. Think about it.

There are a number of steps before any type of cereal grain reaches your plate or cereal bowl.
Each step in the growing and manufacturing process has the potential for cross-contamination. Grains may become contaminated with gluten-containing grains by sharing the same fields, trucks which transports grains to the plant for processing or at the processing plant itself. It is important to note that unless a product is manufactured in a dedicated facility and under gluten-free handling practices; all cereal grains have the potential of becoming cross-contaminated with gluten. Gluten testing should also be performed at the facility.

There are a number of special gluten free breads available. Beware of those which have a shelf life of a year! Shelf life of a year and breadàYikes! A number of my patients on gluten-free diets have tried these types of breads and as a result, fear they will never enjoy another sandwich.

Don’t check all gluten-free bread off your diet so fast! There are actually some good tasting ones such as Udi’s, Rudy’s and Canyon Bakehouse. All may be ordered on the internet and shipped to your house. Udi’s is also being carried in Kroger stores nationwide.

Enjoy!

Most people know that they need to eat healthy, but nutrition goes beyond just eating healthy. It’s important because it fuels your body and helps to provide specific nutrients to various parts of the body that help build strong bones, teeth and keep your body working the way it should.

Not only do these nutrients fuel the body, but antioxidants in foods like blueberries, cherries and carrots can provide protection against free radical damage, helping to protect against disease and aging. Answer the questions below to help you examine the foods you eat and how they impact your body.

What foods do you normally eat throughout the week?
How have those foods made you feel? Tired, uncomfortable, energetic, etc?
Are there any specific foods that help, or hurt?

For more information about healthy eating and how to get the nutrients your body needs see what the resident GI Associaties Dietician, Sandy Davis has to say...

Bloating can often be the symptom of various gastrointestinal problems, like irritable bowel syndrome, or it could be caused by a variety of everyday things that you do without even being aware. You may be surprised at some of the causes of bloating.

Re-heating starchy food changes the molecular structure, turning it into a resistant starch. This makes it almost impossible for the food to be digested properly in the small intestine and once it reaches the large intestine it produces gas and causes bloating.

Most women suffer from bloating during their menstrual cycle, however they usually attribute this to fluid retention but its actually relaxed muscles. Progesterone levels are increased this causes the abdomen to relax which is what makes a woman feel and look bloated.

Chewing gum can also cause bloating. You swallow more air when chewing gum which can cause bloating and the sugar-free versions are worse because the ingredients sorbitol and xylitol are actually fermented by bacteria in the gut and this can increase your chance of bloating.

Adding fiber too quickly or eating too much at one time can cause bloating as well and the key to adding fiber it to do it slowly and to eat snacks and regular meals slowly, chewing each bit well before swallowing.

For those who suffer from chronic bloating or digestive problems, be sure to talk with your gastroenterologist. They will be able to talk about your symptoms, run tests and make sure there are no underlying problems.

Healthy eating is more than just eating the right foods, how you eat is just as important. Many people eat without really chewing the food properly and close to 90% of people have irritated intestines, which can result in chronic health conditions if left untreated.

Not only can chewing food help aid in digestion, but people tend to eat less when they chew properly. Chewing helps release the nutrients in food allows the body to absorb those nutrients more effectively.

Good digestion is the key to maintaining good overall health. Making this small change in eating habits can not only ward off many digestive problems, but it can also provide more energy, focus and help you sleep better.

Use these tips to help you eat healthier and keep away digestive problems.

• Drink plenty of water; at least 4-6 cups a day.
• Eat slowly and make sure you chew your food well before swallowing.
• Watch the foods you put in your mouth and try to avoid “empty” foods with no nutritional content.
• Watch your portion sizes and if you find healthy snacks for in between meals.
• Exercise for at least 30 minutes a day.

With the temperature in the upper 90s and the heat index putting us into the 100s it’s important to make sure you’re getting enough water.

In addition to having other benefits, water is essential for proper digestion. Temperature regulation and how the body flushes waste depend on the availability of water.

Most health experts recommend drinking around 6-8 glasses of water a day to prevent dehydration. This amount varies based on height, weight and other factors, but generally at least 6 glasses is a good start. Those who work out, especially during the hot and humid summer months, will need to drink more water to compensate for the water lost when sweating

Most people have reported experiencing frequent bloating, gas, diarrhea, or constipation. While many may write this off as "just one of those things everyone puts up with", it could actually be the result of dysbiosis, or poor digestion.

The digestive system has a huge impact on the rest of the body. If it is irritated or inflamed it cannot do its job properly and can cause additional heath problems. Poor nutrition can eventually lead to imbalances in the intestinal flora of the gut. Since many Americans indulge in high-carb, sugar filled and highly processed foods they are setting themselves up for dysbiosis.

Signs of a healthy digestive tract are:

• No upper indigestion or acid reflux.
•  Little or no regular gas or bloating. 
•  Regular soft and formed bowel movements once or twice a day. 
• No partially digested food or oils in the stool. 
• No intestinal cramping or pain with foods or with defecation. 
•  No joint pain or stiffness. 
•  No skin problems.

In order to improve digestive health it’s important to minimize sugars, wheat and dairy and see if the symptoms improve and eat nutritious meals. Be sure to drink lots of water and chew food well. Your gastroenterologist will be able to provide more tips and help you get your digestive system back in healthy working order and make sure there are no other underlying problems

Thank goodness the food guide pyramid is history! It has been around for more years than I care to remember. Who stacks up food choices inside a psychedelic colored pyramid when trying to figure out what to eat for good health? Not me. Using a plate to convey what makes up a healthy diet makes sense. The U. S. Department of Agriculture finally got it right with the new food guidance icon – ChooseMyPlate.

You may be asking why the big change? The food guide pyramid has been around for almost twenty years, so why the big change now? The change coincides with the new 2010 Dietary Guidelines for Americans released this past January. The guidelines are revised every five years. Usually the revisions are simple ones. The guidelines are used to direct federal government’s nutrition education programs, federal assistance nutrition assistance programs and dietary advice provided by health and nutrition professionals. The new guidelines focus on empowering folks to make healthier food choices and slim down in the process.

In the past, the food guide pyramid was used to help visualize the underlying Dietary Guidelines. A new simple visual icon was needed to convey the underlying messages from the revised guidelines. The key word is “simple”. The current food guide pyramid didn’t cut it. Thus the new plate icon was developed to go along with the newly released 2010 Dietary Guidelines. Lots of new interactive tools are also in the works to be rolled out later in the year. Please feel free to check out www.ChooseMyPlate.gov

Along with the new visual plate, simple how-to messages to help us make healthier choices will be rolled out throughout the year. Stay tuned…in good health!

Many parents might be shocked to learn that gastrointestinal disorders are common among children. Similar to adults, the symptoms may include stomach pain, vomiting, nausea and bowel problems. Some of the most common gastrointestinal disorders are abdominal pain, chronic constipation, and irritable bowel syndrome (IBS). Studies show that about 1 in 5 children and teenagers develop some sort of gastrointestinal disorder.

Parents often dismiss the idea that their child has a gastrointestinal disorder thinking that those problems only occur in adults. While occasional abdominal pain, constipation, and other bowel problems are common; parents need to be aware that if the problem persists or worsens then they need to take the child to a gastrointestinal specialist.

Most of the gastrointestinal problems children have can easily be resolved either with a diet change or medication. On a rare occasion the child may have a severe gastrointestinal disorder such as intestinal pseudo-obstruction, these are rare, however it’s always a good idea for both children and adults to talk with a gastroenterologist about any gastrointestinal problems, especially if they worsen.

Regardless what the problem may be, if it persists for more than a few days be sure to talk with a gastroenterologist. The GI Associates are proud of our commitment to Pediatric Gastroenterology - with doctors on staff that are Peds Specialists. They’ll be able to help diagnose the problem and talk with you about concerns, treatments or questions you may have.

Most people have heard the old saying, “an apple a day keeps the doctor away.” It is true that apples are a great source of nutrients, but they may hold some added benefits you may not realize. Plus, apples are almost always available in the grocery store making it an easy fruit to eat year-round.

Apples are an excellent source of fiber, which can help to lower cholesterol build-up in the lining of the blood vessels and possibly helping reduce the risk of heart problems. The fiber content in an apple though also helps to cleanse the intestinal tract and help the food move faster through the digestive system.

The skin of the apple is almost more nutritional than the actual meat of the apple and contains large amounts of vitamin C. For those who suffer from digestive discomforts from drinking coffee, eating an apple can provide that boost of energy and help keep you awake, just as the caffeine in the coffee does.

For those who have diarrhea and need something to replenish the nutrients in their body apples are a great source, however the high fiber content might be a little too much for the digestive system to handle until you’re better so try having applesauce or cooked apples which provide some of those nutrients without making the problem worse.

Healthy eating can seem like a difficult thing to do, but start off by eating an apple a day and be sure to check out more healthy eating tips.

Most GI problems have one thing in common – no one likes to talk about them! Despite the silence, they are in fact very common. And hemorrhoids fit both categories. They other little known fact about hemorrhoids is that many people may not even realize that they have them.

Hemorrhoids are merely inflammation of the vascular anal strictures where fecal matter passes through. There are two basic types of hemorrhoids; internal and external. If you have heard about hemorrhoids then you most likely have heard about the external kind. The only different between the two is where the hemorrhoids are located, either inside the anal cavity or outside the anal cavity.

Symptoms can include pain and discomfort, itching and burning inside the anus, and sometimes bleeding. Hemorrhoids can become dangerous if they become clotted. Most hemorrhoids are caused by ineffective bowel habits. Not having enough fiber can lead to constipation which can cause hemorrhoids or make them worse. On the opposite side of the scale, diarrhea can also cause hemorrhoids. Straining when using the bathroom can also eventually cause hemorrhoids. Many women who are pregnant may also have hemorrhoids due to the pressure and straining that occurs during labor.

The best way to avoid hemorrhoids is to maintain good fiber to avoid constipation or diarrhea and keep your colon healthy. Over the counter ointments can ease the pain of hemorrhoids, however if they continue or worsen it’s a good idea to talk with your gastroenterologist. They’ll be able to talk more in depth about treatments, eating habits and any additional problems you may be experiencing

Constipation can certainly make one cranky. Who knew it could also be a danger to your ticker? It may be the case if you are an older woman. A recent study published in the American Journal of Medicine studied 73,000 postmenopausal women for six to ten years. More than one-third suffered from constipation. Those which had severe constipation had twice the chance of having a heart attack or stroke.

Let’s define what constipation is. It doesn’t mean if you “miss a day” you are constipated. A number of things can contribute to a little irregularity every now or then. The standard definition for constipation is fewer than three bowel movements per week. Severe constipation disrupts daily routine. It is estimated more than 4 million Americans have chronic constipation and spend about $700 million on laxatives yearly. Wow, that’s a lot of Ex-Lax!

I found this study to be very interesting. Why would there be a possible relationship between constipation and heart disease? The study dug deeper and found women with constipation usually have a number of other health problems and/or risks. A great number were either overweight or obese, have high blood pressure, elevated cholesterol levels, don’t exercise and eat a low fiber diet. A great many of patients referred to me for nutrition counseling have constipation with associated health problems and/or risks.

The study did go on to say more research is needed to confirm the findings and look at other groups such as men and younger adults. For now, be good to both your heart and your colon. Eat your fiber-rich fruits, veggies and whole grains, exercise regularly and drink plenty of fluids. In good health!

Constipation is not something that is really talked about, despite being a common gastrointestinal disorder. Both adults and children suffer from constipation and if it progresses it can cause other problems. Most symptoms include pain, gas and bloating, discomfort in the abdominal region and sometimes nausea and vomiting.

Treating constipation has various stages. While it may be embarrassing at first the best solution is to talk to your gastroenterologist. They will be able to talk to you about medications to help soften the stool Taking these medications without consulting a gastroenterologist can be unsafe as these medications have varying effects and prolonged use of laxatives can lead to further constipation. Having an active lifestyle can also help to prevent constipation and stimulate intestinal motility.

Adding some extra fiber into your diet can also help avoid constipation in the future. It’s best to add fiber slowly though to avoid the diarrhea. Extra fiber can come from foods such as fruits and vegetables, not just oatmeal and bran products. It’s also important to make sure you’re drinking enough water.

Your gastroenterologist will be able to talk to you about other treatments and answer any questions you may have. If you have been dealing with chronic constipation they may be able to perform tests to determine the cause and to make sure there are no underlying problems.

Here are some of the issues you may need to be aware of in Pediatric Gastroenterology:

My child is diagnosed with Inflammatory Bowel Disease--- Now What?

Diagnosis of a child with any chronic medical problem can be overwhelming for families. The first thought that comes to most parents minds is: what did I do wrong? It's important to remember that there is nothing that you could have done to prevent your child from being diagnosed with inflammatory bowel disease.

There are two types of inflammatory bowel disease: Crohn's disease and ulcerative colitis. There is also another category of indeterminant colitis if the distinction is not clear. Crohn's disease involves any area of the gastrointestinal tract while ulcerative colitis only involves the large bowel or colon. Children with these conditions often present with abdominal pain, diarrhea, rectal bleeding, weight loss, poor growthand rectal bleeding. This disease can also affect areas outside of the gastrointestinal tract such as the joints.

Inflammatory bowel disease is diagnosed using endoscopy and imaging techniques. Bloodwork and stool studies are typically needed as well to ensure that there is not an infection present. Treatment of inflammatory bowel disease typically involves life-long medications. Dietary changes may play a role in treatment as well. Your doctor will discuss the best treatment options for your child.

Encopresis in Children

Encopresis is involuntary fecal soiling in a toilet trained child 4 years of age or older. Though parents don't discuss this problem in polite conversation, it's more common that you think with 1-4% of children being affected. Someone in your child's class may suffer from it and it can start to affect self-esteem.

Although fecal soiling can be caused by otherconditions in children, chronic constipation is the most common reason that this problem continues. Bloodwork or X-rays may need to be performed to assess for underlying medical problems. Treatment of this problem includes education, bowel re-training, dietary changes and laxatives. There's no need for children and families to suffer with this disease so please allow the physicians at GI Associates to help!

Meet our newest Doctor, specializing in Pediatric Gastroenterology:

Dr. Sara Waller Rippel, a native of Roswell, GA, is delighted to be joining GI Associates in August to practice Pediatric Gastroenterology. Dr. Rippel received her Bachelor of Science degree from Vanderbilt University in Nashville, TN with a major in Mathematics and a minor in Economics. She completed her Doctor of Medicine at the Medical College of Georgia in Augusta, GA. She completed a residency in pediatrics at University of South Florida in Tampa, FL. She will soon complete a fellowship in Pediatric Gastroenterology and a Masters of Clinical Investigation at Vanderbilt University.

Dr. Rippel is board certified in Pediatrics and board eligible in Pediatric Gastroenterology. She is actively involved in research, has authored numerous academic articles, and is frequent presenter at regional and national conferences. Sh is excited to be relocating to Mississippi with her husband, John Rippel, and her three-year-old son, Jackson Rhodes.

Heartburn is on the rise with 25 million Americans experiencing daily symptoms. This number is up by about 15 million compared to ten years ago. Stress seems to play a key factor in heartburn, however studies have shown that overeating is a growing cause for heartburn.

While many may feel like this increase in heartburn comes with age, it seems that chronic overindulgence is the culprit. Heartburn can occur at almost any age and studies have shown that no matter what the age, excess of cheeseburgers, fried foods, etc. are causing heartburn.

If the sphincter muscle at the top of the stomach is weak and acid washes into the esophagus during digestion, it can cause heartburn. Symptoms range from queasiness to coughing, burning sensations, asthma and hiccups. Heartburn is very common at night, causing lack of sleep, which can eventually worsen digestive problems. Anything that puts pressure on the stomach can cause heartburn to occur, which is also why pregnant women often have heartburn.

To help alleviate heartburn try some of these tips:

• Eat a light dinner at least three hours before going to bed. 
• Avoid mint-flavored antacids. The mint relaxes the valve between the stomach and the esophagus making the problem worse. 
• Begin making healthy food choices and spend at least 30 minutes a day exercising. 
• Eliminate or cut back on foods that you know cause heartburn. Most common heartburn inducing foods are chocolate, spicy foods, citrus fruits, alcohol and caffeine.

Most adults with heartburn will talk to friends before going to a doctor to talk about heartburn. Regardless of how unimportant it may seem, the Doctors of GI Associates urge people to talk to a them about your heartburn. They will be able to help you learn how to keep heartburn from occurring and what to do if it should flare up. It’s also a good idea to find the underlying causes.

Gluten is on everyone’s radar. In fact, it is this decade’s demon child. Remember when fat was labeled public enemy number one a few years back? Everyone was avoiding fat and stocking up on “fat-free” foods (unfortunately our waistlines didn’t become fat-free as a result!). Now the newest diet craze is for gluten-free products. For some reason, gluten free diets are associated with being healthier for you…not necessarily true. One can have a pretty unhealthy gluten free diet. Alessio Fasano, MD, who is one of the country’s leading researchers at the University of Maryland School of Medicine and medical director of the Center for Celiac Research states “People are blaming everything under the sun on gluten.”

Manufacturers are taking advantage of the demand for gluten free products. The sales of gluten-free products are skyrocketing and projected to reach $2.6 billion by 2012. Wow! Take a slow stroll through the grocery aisles next time you aren’t making a mad dash in and out. Don’t faint when you check out some of the price tags. Gluten-free products are popping up everywhere! Kroger’s is using product shelf identifiers to help their customers readily find products which are gluten-free. If you have celiac disease or gluten sensitivity, it is a whole lot easier to eat like everyone else with all the new products available.

What exactly is gluten anyway? Gluten is one of the proteins found in wheat, rye and barley (this is where malt comes from). Other grains may also become contaminated with gluten through the growing, transportation or manufacturing process. Gluten causes a number of gut problems and non-gut problems for those with celiac disease or gluten sensitivity.

There are an estimated 3 million Americans who have celiac disease and about 20 million who are sensitive to gluten. At one time, researchers thought celiac disease was a pretty rare occurrence. The rate of celiac disease has risen 20-fold in the USA (same rates in Europe) to about 1 in 133. I have seen some estimating anywhere from 1 in 80 to 100. That is a dramatic increase! Researchers are seeking causes to the rise in celiac occurrence.

Don’t panic – remember not everyone needs to mark gluten off their list. Your GI doctor is your best guide as to whether you should avoid gluten or not. Making an appointment with a dietitian who specializes with celiac disease (and gluten sensitivity) will be able to educate you on the ins and outs of the gluten free diet. A word of caution - not all dietitians work with gluten free diets on a routine basis. Therefore, they may not be well versed with both the nuances of the gluten free diet, special nutritional needs and menu planning.

IBS is a gastrointestinal disorder that causes symptoms such as abdominal pain, bloating, diarrhea or constipation. While this gastrointestinal disorder is more common in women than men its sufferers know the frustrations of feeling helpless and out of control.

Recent studies have shown that peppermint may help to reduce some of the symptoms of IBS. The study has shown that the peppermint stimulates an anti-pain channel called TRPM8, which is located the colon. It helps to reduce the sensitivity of pain-sensing fibers that are activated by spicy foods and soothes the inflammation.

For IBS sufferers this is NOT a call to dive into the candy bowl! The study was done using peppermint oil as enteric capsules or in a gel form. The sugar found in peppermint candies can exaserbate symptoms in some patients. Be sure to talk with your gastroenterologist about your IBS, especially in severe cases. They will be able to discuss available treatments and medications in addition to tracking your progress

Gastrointestinal problems are some of the most common complaints for marathon runners and endurance athletes, second only to overuse injuries. The most common gastrointestinal disorders are:

• Gastroesophageal Reflux Disease: occurs when stomach contents and acid build up in the esophagus causing symptoms like heartburn, regurgitation, and sour taste in the mouth. 
• Exercise-induced GI bleeding: this can occur in the upper or lower GI tract and may result from intense exercise. This will result in bloody stools, diarrhea and abdominal pain and anyone experiencing these symptoms should see their gastroenterologist immediately. 
• Diarrhea: both frequent and occasional.

There are ways to help reduce these incidents. Many gastroenterologists recommend altering their training schedule or diet while also following some of these suggestions:

• Start by lowering the intensity level of exercise and then gradually increase activity. 
• Void and defecate before exercise.
•  Avoid intense exercise within three hours of a meal. 
• Avoid high-fiber or high-fat foods before exercise. 
• Limit caffeine for one to two hours before exercise. 
• Stay hydrated.

If your gastrointestinal problems worsen or do not seem to be getting better talk to your gastroenterologist about other ways or medications that might be able to help.

Exhaustion seems to be a common problem in our fast-paced society. With busy schedules and the ability to stay connected through phones and the Internet it’s easy to become exhausted. While these periods of exhaustion may come and go, prolonged stress and sleep deprivation should not be ignored and what most people don’t understand is that exhaustion can create or worsen gastrointestinal problems.

Americans have longer work schedules and more sleep loss than most countries and these habits can lead to physical and emotional exhaustion as well. Additionally, continual stress and exhaustion can affect the gastrointestinal tract, causing problems or making other gastrointestinal disorders worse.

When you’re feeling stressed your body releases additional adrenaline, causing the valves in the upper digestive tract to stay open. This, plus irregular sleep can cause reflux, heartburn or other gastrointestinal problems.

Exhaustion can also be the indicator that there are other problems. It’s important to mention any additional stressors and lack of sleep to your gastroenterologist. Some ways to help eliminate exhaustion and ward of possible gastrointestinal problems are:

Exercise at least 30 minutes a day. Take small breaks during stressful situations to compose yourself. Stay focused on the present, worrying about future events will only make exhaustion and stress worse.
If you are suffering from exhaustion or excessive stress talk with your gastroenterologist. They can talk with you about ways to help eliminate that stress or to curb current gastrointestinal problems that may have gotten worse due to stress or exhaustion.x

April is IBS Awareness Month and while IBS is a common complaint of many Americans it is not talked about very often. IBS affects around 20% of the world’s population. The hopes of those who helped establish April as IBS Awareness Month wanted to bring attention to the disorder, treatment and quality of life issues.

IBS can vary from bouts of urgent diarrhea or chronic constipation, sometimes alternating between the two.. The most common symptom of IBS is pain and it affects almost 80% of sufferers. This pain is usually frequent or continuous and for a rare 25% the pain is constant. Many sufferers feel frustrated that IBS seems to control their lives and restricting their activities.

Researchers are still trying to find a common cause for IBS, but they have found that IBS and stress go hand in hand. The more stressed out a person is, the worse their IBS gets. IBS treatment might also include stress relief for this very reason.

IBS can be treated using presciption medication, over the counter medicine for constipation or diarrhea, diet changes, psychotherapy or stress management. IBS does not lead to a shorter life expectancy, nor does it lead to other gastrointestinal disorders. For those who struggle with IBS though, treatment can allow them to feel more in control of their life.

Watch out Cheetos – you may have some competition in the near future! Yep, that’s right (or I hope so anyway). Trying to get our kids (or ourselves for that matter) to make the switch from snacking on typical junk food (such as chips or cookies) to something healthy (like fruits and vegetables) is a daunting challenge. I think when we attach the “healthy” label to any food or beverage is where we may go wrong. Children typically rebel when we attach the word “healthy” to any food we are trying to finagle them to eat. Somehow the “healthy” just doesn’t taste as good as something labeled “junk food”.

Along the same lines, I recently read a fascinating article about one of the powerhouses in the multimillion dollar baby carrot industry investing in a baby carrot marketing campaign. Apparently baby carrot sales are also suffering as a result of economy woes. Folks are buying regular carrots instead of baby ones to save money. The baby carrot industry took note and hired a marketing firm.

Much work went into studying suburban moms and kids shopping and snacking habits. They found (as we all know), no one ever looks in the refrigerator vegetable or fruit drawer for a snack. Things which are “healthy” lives there! One of the kids studied, called it “the drawer of death.” As a result of much research, the head carrot (person in charge of marketing) decided to market baby carrots as a junk food. If you think about it, they do have some similarities to one of kid’s favorite junk foods - neon orange, crunchy, dippable and somewhat addictive (who eats only one baby carrot?).

In the near future, baby carrots may be displayed and sold in very different manners than we are used to seeing them. In fact, they are being marketed as “Let ‘Em Like Junk Food” in some parts of the country as a test. They are selling baby carrots in high school vending machines in those crinkly sounding and colorful chip type bags.

Cheetos better watch its back….baby carrots are on the way! Happy munching!

High-definition (HD) is not just for televisions anymore; doctors are now joining in and using high-definition. Gastroenterologists now have the ability to use high-definition for various procedures. The high-definition gives the gastroenterologists a better view during tests like colonoscopies.

During a normal colonoscopy the bowel wall is a pale pink. Thanks to the high-definition gastroenterologists can zoom in and look at all the details without any lack of sharpness or lack of focus. It allows them to view the colon in different lights to look for both raised and flat polyps, which had been more difficult to see. The high-definition also gives the gastroenterologists a better look at the actual polyp and its borders, which can help them determine which instruments to use to remove it.

As technology advances, these changes give gastroenterologists and other doctors a better idea of what they’re dealing with and how to best handle the situation. Since this equipment is still new most clinics have not upgraded, regardless of which equipment a clinic is using gastroenterologists highly recommend getting a colonoscopy. The older equipment still works perfectly fine and is still vital in catching polyps and possible cancers such as colorectal cancer

There are many things that can cause colorectal cancer but studies have shown that these are some of the most common. Talking with your gastroenterologist about any risks you may have will help them determine your risk factor. They will also be able to tell you what other things may be a cause for colorectal cancer and how to avoid them.

1. Age: by age 50, one in four people have already developed polyps. Gastroenterologists recommend beginning colorectal cancer screenings by age 50 for early detection. 
2. Diabetes: A recent study published in the Gastroenterology journal indicates that insulin dependency contributes to colon cancer development. In general, diabetics are up to 40% more likely to develop colon cancer. 
3. Diet: high fat and cholesterol have been linked to colon cancer. Talk with your gastroenterologist about how to change your diet and which foods to eat and which to avoid. 
4. Family Medical History: Unfortunately colorectal cancer is hereditary so be sure to talk with your gastroenterologist about any family medical history of colorectal cancer or polyps. 
5. Inflammatory Bowel Disease (IBD): IBD may increase your risk of developing colorectal cancer. Additionally, the longer a person has had inflammatory bowel disease, the greater the risk may be. 
6. Polyps: Almost all forms of colorectal cancer develop from polyps in the colon. A personal or family history of polyps will put you at higher risk for colorectal cancer.

Despite being the second leading cancer killer in the United States, colorectal cancer doesn’t get a lot of attention. Very few people know that blue is the color associated with colorectal cancer, or even that March is Colorectal Cancer Awareness Month.

Mississippi is one of at least twelve states with a high rate of colorectal cancer diagnoses. While both men and women can get colorectal cancer, it is most often found in people age 50 or older.

Colorectal cancer does not always cause symptoms in its early stages. Some of the possible symptoms can include rectal bleeding, stomach pain or aches and cramps that don’t go away and unexplained weight loss.

You might be at more at risk for colorectal cancer if you have had colorectal polyps if you have family members who have had polyps or colorectal cancer. Talk with your gastroenterologist about any risks you may have.

Screening is vital in helping catch colorectal cancer in its early stages when treatment is most effective. Those over the age of 50 years old should talk to their gastroenterologist about having regular colorectal cancer screenings. If you are more at risk your gastroenterologist will look at your medical history and determine when your screenings should begin.

If you have any questions or concerns be sure to talk with your gastroenterologist. They will be able to assess your risks and talk about what steps need to be taken.

Last year the F as in Fat 2010 Mississippi Press Release (yes there is such a report!) gave Mississippi the dubious number one ranking as being the fattest state in the nation. Not only does the title hold true for adults, but also for the children. One out of every three children or teens is overweight or obese in Mississippi. Sadly, most parents (84% in fact) think their children are at a healthy weight. Unhealthy weights, even in children, may translate into increased risk for chronic disease. I have seen young, school age children in our clinic with Type 2 diabetes mellitus (used to be called adult-onset diabetes – no more!), hypertension and fatty liver.

Children, like adults in Mississippi, aren’t active enough and don’t eat the right types of foods. The newly released Dietary Guidelines for Americans 2010 gives a shocking snapshot of what our kids are eating. The top 25 sources of calories in our kids diets are (in order) sugary refined white flour desserts (think of all those cookies, brownies and little packaged cakes), pizza and sodas. Where are the fruits and veggies? Unfortunately, fruit and veggies are much further down on the list and not the best of choices either. French fries and potato chips round out what kids are eating for their top vegetable choices. Fruit juices, not fruits are the “fruits” of choice. Where’s the green stuff and fresh fruit?

Good eating habits must start at a very early age to prevent children from traveling down the same fat path most adults are struggling to get off. Good eating habits must start well before children reach the age of two. Why is that? Individual taste preferences start forming at a very early age - before the age of two. After the age of two, children develop neophobia (the fear of new things). Dinner time may turn into a battleground if you wait too late to introduce the green stuff. Most parents can relate to “I don’t like that!” in their quest to introduce a new veggie at the dinner table.

Introduce colorful veggies such as cooked broccoli, carrots or green beans with your one year old. Chunk the sugary white flour refined stuff and offer sliced up fruit for dessert. Healthy munching!

March marks the beginning of Colorectal Cancer Awareness Month. Colorectal (colon) cancer, while common, is one of the most preventable cancers. While things like family history may play a role is your risk for colorectal cancer there are ways to help protect yourself and your loved ones from the disease. Follow these tips to keep your risk of colorectal cancer as minimal as possible

• Go to a doctor if you have any colon cancer symptoms. Colorectal cancer does not have any symptoms in the beginning stages, however in the later stages, symptoms may include thin stools, cramping, unexplained weight loss, and bloody stools.
• Schedule a colon cancer screening if you're 50 or older. Most people diagnosed with colorectal cancer are over the age of 50 and the average age of diagnosis is 64.
• Eat a balanced diet. Diets high in fat and cholesterol have been linked to increased colorectal cancer risk while high-fiber diets seem to have the opposite effect.
• Maintain a healthy weight. Studies have shown that certain body types that store extra fat in the waist may be more at risk for colorectal cancer. Additionally obese men are more at risk for colorectal cancer than women are.
• Maintain an active lifestyle. Besides having addition health benefits having an active lifestyle can reduce colorectal cancer risk by as much as 40 percent.
• Consider your family history. Colorectal cancer is hereditary so be sure to talk with your gastroenterologist about any family members who might have had colorectal cancer or polyps. Other cancers such as stomach, liver and bone may also be relevant so be as thorough as you can. Knowing your family medical history can help you greatly as you consider your possible risk for colorectal cancer.
• Stop smoking. Smoking isn’t just bad for your lungs; it can affect many areas of your body including increasing your risk for colorectal cancer. Smokers are at risk because inhaled or swallowed tobacco smoke transports carcinogens to the colon and tobacco use appears to increase polyp size.

Talk with your gastroenterologist about any questions you may have about colorectal cancer and other ways you can help prevent it. They will be able to answer any questions you have and help you better understand colorectal cancer and your risks.

More than 30 million people take over-the-counter and prescription drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs) for relief from pain, headaches and arthritis, Aspirin being the most common. While these drugs are very beneficial there are potential side effects. These drugs can cause problems ranging from mild stomach upset and pain to serious stomach bleeding and ulcers (holes in the lining of the stomach) and even death.

While anyone could be at risk those who are older than 60, have had previous ulcers, take steroid medications or blood thinners or who consume alcohol on a regular basis may have a higher risk. If you take more than the recommended dosage or take NSAIDs for long periods of time this also increases the risk. Problems can even occur within one week of starting to take these pain relievers and in addition to gastrointestinal problems they can also be linked to some cardiovascular issues causing chest pains and shortness of breath.

If you have been taking NSAIDs and have noticed stomach pain, dark or black tarry or bloody stool or you are vomiting blood or matter that looks like coffee grounds be sure to call your gastroenterologist. More than eighty percent of people who have a serious stomach problem because of NSAIDs have no warning symptoms so it’s important to talk with your gastrointologist about the medications you’re taking and be sure to read the labels on all medications to avoid an overdose

February is the month of valentines and thoughts of the heart. It is also ushers in colorectal cancer awareness month. We usually don’t link hearts with colons, but we should…health wise that is. Many of the same preventative measures taken for a healthy heart are also on the same list for colon cancer prevention. Likewise, the same things unhealthy for the heart are also linked with an increased risk for colon cancer. The thought of having a heart attack, stroke, colon cancer or all three is pretty daunting indeed. What are some of the preventative measures we can take to protect ourselves from both heart disease and colon cancer?

Lose belly fat – be more active! Having a beer belly or an extra tire around our waist line makes it difficult to see our feet. It also is bad for our heart along with an increased risk for diabetes. What you may not know is it also places us at an increased risk for colon cancer. Increased physical activity helps shed those unwanted and unhealthy inches from our waistline. It also is a good measure for the prevention of colon cancer.

Go for the fruits and veggies! Our mothers nagged us about eating our fruits and veggies. Mother knows best after all! A diet high in fruits and veggies promotes numerous health benefits including reduced risks of heart disease, stroke, Alzheimer disease, cataracts, diverticulosis, high blood pressure and provides important nutrients for overall good health. Increased intake of fruits and veggies are on the list as a good preventative measure with colon cancer.

Include foods high in magnesium! A diet high in magnesium is also on the list for colon cancer preventative measures. Good sources of magnesium includes nuts, legumes (translation: beans, lentils and peanuts), whole grains, green veggies, seafood, cocoa and chocolate. Don’t get too excited about the chocolate – increased sweets can translate to increased belly fat!

Remember, “An ounce of prevention is worth a pound of cure!” – Ben Franklin.

Probiotics are small organisms that help maintain the natural balance of organisms in the intestines and over the last few years products have flooded the market as more people seek natural or non-drug ways to maintain their health. Scientists are still working out exactly how probiotics work but they may help boost your immune system, promote good digestion and help prevent infection and harmful bacteria. There are often used for people who have Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD) and various kinds of diarrhea. Probiotics are now in everything from yogurt to chocolate and granola bars to powders and capsules.

The growing varieties of probiotics also come with varying side effects. The most common as gas and bloating, usually mild or temporary, but more serious side effects like an allergic reaction, could result. In addition to talking with your gastroenterologist before taking probiotics you should:

• make sure you check the label for the probiotic’s group, species and strain, and how many of the microorganisms will still be alive on the use-by date. The more information available the better.
•  Buy products from well-known companies. The longer a company has been around, the more likely its products have been tested and studied repeatedly and the bigger the reputation the company has to protect. 
• Be especially careful in ordering off the Internet because there are plenty of companies who will take your money and disappear. More frightening is the prospect of getting a product with additional ingredients. While many of these extra ingredients could be harmless, like garlic powder, they could also be laced with powerful herbs, prescription medications or illegal drugs.

While probiotics have been around for generations, with so many products on the market now it’s hard to know which are beneficial and which are a waste of time and money. Most probiotics are safe, but you should always talk to your gastroenterologist before adding any kinds of probiotics to your diet. You gastroenterologist will also know which probiotics might interfere with other medications or if they may cause any additional problems.

It is a brand new year and many have decided to become weight loss warriors…again. The vow to lose weight is one of the most common New Year’s resolutions made along with exercise. We start the New Year off with good intentions for weight loss. Oftentimes the need to lose weight isn’t just about fitting into those skinny jeans stashed in the back of our closets but for health reasons. Carrying extra pounds translates into a number of increased health risks we are all familiar with such as type 2 diabetes, hypertension, sleep apnea and heart disease and unhealthy blood fat levels. There are also some increased risk for GI medical conditions associated being overweight/obese such as GERD (reflux) and fatty liver.

Losing weight is difficult - no doubt about it. It is even more challenging to keep the pounds lost at bay. It is frustrating to lose weight, gain it back and then some….very frustrating. What is the key to lasting weight loss? Sorry, it isn’t found in the number of weight loss potions found at your local Wal-mart or those concoctions offered for on special time limited television commercial offers which magically melts the pounds away.

Sadly, research has found approximately two out of ten individuals are successful in maintaining weight loss. A number of years ago, researchers (Drs. James Hill and Rena Wing) established the National Weight Control Registry (NWCR) to study individuals who have been successful at not only losing weight but kept it off. Individuals eligible for the NWCR must be older than 18 years of age, have lost a minimum of 30 pounds and have maintained weight loss for more than one year. It is an ongoing study. The NWCR provides a glimmer into the strategies of successful weight loss warriors.

Almost all successful individuals combined both diet and exercise. Diet without exercise was listed in being a successful strategy in only one out of ten individuals. Better stop using the treadmill for hanging clothes! Interestingly, more than half of the individuals had help losing weight – commercial program, doctor, or nutritionist. Some of the strategies used are a lower calorie type diet, higher levels of exercise, weighing on a regular basis and keeping a food/activity journal. They also ate breakfast every day of the week. For more on strategies for successful and lasting weight loss check out the National Weight Control Registry.

Happy New Year to a healthier you!

The holiday season is a tough time to think about weight loss. Who wants to think about weight loss when we are too busy relishing that extra serving or two of holiday indulgence? Enjoying the holiday season often times translates into overeating and not making time for exercise. As a result we gain a few holiday pounds (or more) and find ourselves making a nose dive for our favorite antacid. I would speculate the sales of OTC (Over The Counter) antacids and prescription medicines to treat GERD rises during the holidays.

Why is this? There is a strong link between gaining weight, being overweight or obese with GERD. Think about where many of us gain weight – our bellies. All of that extra belly weight puts pressure on our stomach which in turn causes stomach contents to back up into our esophagus. The result is that familiar discomfort associated with GERD - indigestion, heart burn, acid reflux and nausea.

In many cases the cure for GERD is losing weight. Generally, women find losing just 5% of their body weight results in a significant improvement in GERD. Sorry gents, it generally takes about a 10% weight loss. What does this amount of weight loss look like? For a 200 pound woman, it translates into mere ten pounds weight loss. For a 250 pound man, a 10% weight loss is twenty-five pounds.

New Years resolutions may come early this year…..

Fiber is one of those overlooked important nutrients many of my patients are deficient in. If you don’t get enough of it, you can be quite frankly miserable – constipated, being bloated, things aren’t working right type feeling. If you get too much of it, the same thing happens – misery for you and also for those around you. It strikes all ages. Children as well as adults suffer from constipation.

Most of the time, the cure is increasing the amount of fiber in your diet – gradually. Gradually is a key word when I have my patients start introducing more fiber to their daily diet. One of my patients was tossing back handfuls of a very high fiber cereal on a regular basis as his snacks. As you can well imagine, both he and all of his co-workers suffered as a result of his zealous overindulgence with fiber. Adding high fiber foods too quickly or in greater than recommended results can result in gas – lots of it!

Okay, now how much fiber are we talking about? The recommendation for fiber intake for adults is 25-35 grams daily. Children’s needs are age specific. Including a serving of some key foods daily is an easy way to up your fiber intake – high fiber cereal, fresh fruit, vegetables especially cruciferous vegetable (Brussels sprouts, broccoli, broccoflower, bok choy, cabbage and greens), whole grains including bread, brown rice, beans and peas. Sorry lettuce does not count as it is one of the lower fiber containing vegetables!

Not only does getting enough fiber daily keep you from getting constipated and regular, it may also help lower the risk of developing a number of certain conditions – heart disease, cancer, diverticular disease and diabetes. It also helps keep weight under control. Fiber anyone?

PPI’s or protein pump inhibitors are medications that markedly decrease the stomach production of acid. They are very common prescription and over the counter medications used successfully to treat peptic ulcers and reflux esophagitis (GERD). They are among the safest medications prescribed and have been used now for several decades. Included in this group are Prilosec (omeprazole), Protonex, Nexium, Dexilant, Aciphex, Prevacid and Zegrid. Their success is noted by the great reduction in complications of peptic ulcer disease, such as bleeding and the need for surgery, common problems years ago. Many people find that PPI’s are the only medicines that control their heartburn.

Recently a study from Canada suggested that there may be a link between osteoporosis, a common weakening of bones that occurs in older people, and taking PPI’s. Osteoporosis is more common in older populations as a rule and can increase the risk of hip, wrist and spinal fractures. This is important because older individuals tend to have more problems with falls. The study did not prove that PPI’s cause osteoporosis, but looked back on a large group of people over 50 and found that more of them took PPI’s than would be expected in a similar sized group of people over 50 who did not have osteoporosis. Importantly, this link was noted only in patients who took PPI’s regularly for over seven years. There was no increased osteoporosis in patients who had taken PPI’s for less than seven years or used milder acid blockers, such as Pepcid, Tagamet, Axid or Zantac. Often patients find that these milder acid blockers don’t control heartburn as well as PPI’s.

Another study suggested that PPI’s might reduce the effectiveness of Plavix, an anti-coagulant often give to heart patients, but this study and its results are controversial.

So what should a patient do if he or she has been taking daily PPI’s? If you are on Plavix, talk with your doctor about it. If you are a GERD patient, be sure you are first looking at lifestyle changes. Often a small amount of weight loss, even 5 pounds, can decrease reflux. Don’t eat late at night since this causes acid production just before you lie down. Sleep with your head elevated on pillows, a mattress wedge or by placing one or two bricks under the head of your bed. Try to reduce aspirin-type medications that might irritate your GI tract.

After you are sure you are doing all you can in the lifestyle arena, try using a milder form of acid medication. Antacids, like Tums, Rolaids or Gaviscon are good for reducing symptoms immediately, but they usually only last an hour or so and don’t block production of future acid. They are worth a try, however, and can be used along with acid blockers.

You might try a milder acid blocker, like Tagamet, Zantac, or Axid. These can be bought without a prescription and may allow you to stop or reduce your PPI. If they don’t help reduce symptoms, you may simply try reducing your PPI to a smaller milligram size or going to every other day or even once every three days on your dosing. Despite all this you may still be one of the people who cannot miss a single dose of PPI without heartburn. If this is the case, work with your physician by getting bone density studies and watching for any signs of osteoporosis.

Six Questions That Could Save Your Life (or the Life of Someone You Love)

Test your knowledge about colorectal cancer (CRC) screening. If you think the answer is true or mostly true, answer true. If you think the answer is false or mostly false, answer false.

1. Colorectal cancer is predominantly a “man’s disease,” affecting many more men than women annually.
FALSE. Colorectal cancer affects an equal number of men and women. Many women, however, think of CRC as a disease only affecting men and might be unaware of important information about screening and preventing colorectal cancer that could save their lives, says the American Society for Gastrointestinal Endoscopy. 2. Only women over the age of 50 who are currently experiencing some symptoms or problems should be screened for colorectal cancer or polyps.
FALSE. Beginning at age 50, all men and women should be screened for colorectal cancer EVEN IF THEY ARE EXPERIENCING NO PROBLEMS OR SYMPTOMS.

3. A colonoscopy screening exam typically requires an overnight stay in a hospital.
FALSE. A colonoscopy screening exam is almost always done on an outpatient basis. A mild sedative is usually given before the procedure and then a flexible, slender tube is inserted into the rectum to look inside the colon. The test is safe and the procedure itself typically takes less than 45 minutes.

4. Colorectal cancer is the third leading cause of cancer deaths in the United States.
TRUE. After lung cancer, colorectal cancer is the third leading cause of cancer deaths in the United States. Annually, approximately 150,000 new cases of colorectal cancer are diagnosed in the United States and 50,000 people die from the disease. It has been estimated that increased awareness and screening would save at least 30,000 lives each year.

5. Tests used for screening for colon cancer include digital rectal exam, stool blood test, flexible sigmoidoscopy and colonoscopy.

TRUE. These tests are used to screen for colorectal cancer even before there are symptoms. Talk to your healthcare provider about which test is best for you. Current recommended screening options* include:
Beginning at age 50, men and women should have:
•An annual occult blood test on spontaneously passed stool (at a minimum);
•A flexible sigmoidoscopy every 5 years; or,
•A complete colonoscopy every 10 years.
* Important: You may need to begin periodic screening colonoscopy earlier than age 50 years if you have a personal or family history of colorectal cancer, polyps or long-standing ulcerative colitis.

6. Colon cancer is often preventable.
TRUE. Colorectal cancer is highly preventable. Colonoscopy may detect polyps (small growths on the lining of the colon). Removal of these polyps (by biopsy or snare polypectomy) results in a major reduction in the likelihood of developing colorectal cancer in the future.

F.Y.I. The American Society for Gastrointestinal Endoscopy encourages you to talk with your healthcare provider about colon cancer screening and encourages everyone over the age of 50 to undergo the appropriate screening.
Colon Cancer Screening Saves Lives Approximately 150,000 new cases of colorectal cancer are diagnosed every year in the United States and nearly 50,000 people die from the disease. It has been estimated that increased awareness and screening would save at least 30,000 lives each year. Colorectal cancer is highly preventable and can be detected by testing even before there are symptoms. The American Society for Gastrointestinal Endoscopy encourages everyone over 50, or those under 50 with a family history or other risk factors, to be screened for colorectal cancer.

IMPORTANT REMINDER: This information is intended only to provide generalguidance. It doesnotprovide definitive medical advice. It is very important that you consult your doctor about your specific condition.

You finally have a diagnosis – celiac disease! After the initial relief, reality sets in. The big questions is “Okay, now what can I eat that is gluten-free?” Maybe you have already ventured into the grocery store only to walk out with a box of Gluten-Free Chex, bananas and a few other items. The sad thing is it took you over an hour to put those few items in your grocery cart! Yes, that first trip to the grocery store can be very overwhelming. I have had parents of newly diagnosed children with celiac disease break down in tears in my office relating their first trip to the grocery store in pursuit of gluten-free faire for their child.

There are tons of good tasting gluten-free foods readily available in a regular grocery store. Some are naturally gluten-free such as fresh fruits, vegetables, plain packaged meat, plain white or brown rice and dried beans. There are also some great tasting gluten-free new products available in most grocery stores such as the Gluten-Free Chex cereal, Nature Valley Gluten-Free Roasted Nut Crunch, Gluten-Free Bisquick and the line of Gluten-Free Betty Crocker mixes (brownies, cake and cookies).

Finding good gluten-free bread is a challenge. There are two I recommend which may be purchased online: www.udisglutenfree.com and www.canyonbakehouse.com. Nature’s Own is coming out the end of this year or beginning of next year with gluten-free breads. I have been told by the company the bread may not be available in some areas and markets.

Making an appointment with a dietitian who specializes with celiac disease may make life much easier. Not all dietitians see individuals with celiac disease on a routine basis. Therefore, they may not be well versed with both the nuances of celiac disease, nutritional needs and menu planning.

Essays describe pain, perseverance 

Living with Crohn's I've faced many different obstacles. Some being that I was going through lots of pain earlier when I was not aware of what I had, and others being the diet that I have to follow now and the medicine I have to take every day. Even though this is quite a struggle, if I follow all the rules of living with Crohn's, I could live a normal life like any other kid.

Those words, an excerpt from an essay written by Gavin Turner, 12, of Florence, are a peek inside his world of living with a chronic disease. Gavin wrote the essay at the request of Dr. April Ulmer, his pediatric gastroenterologist of GI Associates & Endoscopy Center in Jackson. Ulmer, a Magee native, treats several hundred children with inflammatory bowel disease - either Crohn's or ulcerative colitis. She asked them to write essays titled "I'm Stronger than Crohn's" as part of a contest to win a trip to the Crohn's and Colitis Foundation of America camp in Georgia being held this week.Except for the registration fee of $150, the foundation pays the camp expense. Ulmer promised to pay the registration fee of the winner, but after getting the essays, decided to pay the fees for all six who submitted their stories.The kids left Sunday.
Ulmer came up with the contest idea after she and Jennifer Easley, a triage nurse at the center, learned from foundation administrators there has never been a delegation of Mississippi kids sent to the camp. "It's gonna provide them with a sense of belonging, and it's gonna provide them with an experience that will be unforgettable," Ulmer says. "The biggest thing we want them to do is learn from each other. Find that support system by finding kids their own age that they can talk to." Gavin is looking forward to the trip - his first plane ride.
His ordeal with Crohn's began several years ago when doctors constantly dismissed his headaches, nausea and eventually, hemorrhoids. "If he played ball, he would say, 'My head is killing me,' " says his stepmother Tommie Turner, of Florence. "I can't tell you how many days per school year that Gavin would actually come home and lay down when he got it in." But his parents knew something wasn't right. He was starting to look pale after being sick all of the Christmas holiday.
In January they went to see Ulmer, who, after a battery of tests including a pill camera screening, diagnosed him with Crohn's - a chronic disorder that causes inflammation anywhere from the mouth to the anus of the digestive tract. Kids with Crohn's can have a litany of symptoms. "Some of my kids who have small intestinal disease like Gavin can have symptoms like abdominal pain, can react to foods. Some kids have difficulty with gaining weight because the small intestine is where nutrients are absorbed," Ulmer says. "The thing about the diet, there hasn't been shown that there's any particular food that's gonna make your disease worse. It can just make your symptoms a lot worse."
For Gavin, avoiding raw vegetables, raw fruits, grains and chocolate tends to reduce flare-ups. "It hasn't been bad. I got to diet. If I mess up sometimes, I have to pay the consequences," Gavin says. "I learned that chocolate does hurt. I tried peanut butter before, and found out that it really doesn't hurt."
Destani Hall, 12, was diagnosed with ulcerative colitis at age 4 and Crohn's at 10. Her culprit is spicy foods. She's attended two camps in Texas through the foundation where she rode a zip line, danced and went canoeing. In her essay, she talks about being criticized by kids and adults because of her weight — a side effect of the medications she takes. "I have overcome this obstacle by doing things that make me feel better about myself," Destani wrote. She is an honor roll student and will attend McLaurin Attendance Center this fall.
Typically kids with ulcerative colitis will have abdominal pain and/or rectal bleeding, Ulmer says. A colonoscopy and an EGD are the best tests to diagnose Crohn's or colitis. The pill camera is instrumental in diagnosing cases when the disease is in the small intestine, unreachable with a scope. The child swallows a pill camera that takes about 60,000 pictures for eight hours as it travels through the digestive tract. The pictures are sent to a belt the kid wears. Ulmer watches the "eight-hour movie" a couple of times before a diagnosis is made.
"It's really remarkable technology," Ulmer says. "It's really changed a lot of the way we practice because it does allow us information and technology that we just didn't have before, and it's made a difference in the lives of a lot of my kids." Diagnosis is a process. Turner expressed aggravation about the month's worth of tests Gavin endured. "But it was worth the wait. It's worth the trouble, especially when you see the progression Gavin's made."He's gained 7 pounds.
"You just want to be careful with kids. And you don't want to diagnose them with something general like irritable bowel syndrome," says Ulmer, "because even though that's an entity that exists, it basically means that there's nothing wrong with your gut, your gut just misbehaves."Once kids get diagnosed with that, people tend to stop looking. It's one of the worst things you can do is diagnose a child with that."  article reprinted with permission of Clarion-Ledger

 

Gavin Turner, 12 and pediatric gastroenterologist Dr. April Ulmer,  chat about his plans to attend the Crohn's and Colitis Foundation of  America camp for children, like himself, who have such diseases. Photo credit: Vickie D. King/The Clarion-Ledger

If you are nearing the age of recommended screening you may be “shopping” for the right physician to perform the procedure. It is important to make an educated choice. The ASGE (American Society of Gastrointestinal Endoscopy) has listed the top ten questions you should ask before you consent to having your endoscopy. Education is the key to making the best decisions for your health care and at GI Associates we want our patients to feel confident that they have made the best choice possible.

Print this out and take it with you to your appointment.

The answers to all of these should be yes and should re-assure you that you are seeing a trained endoscopist who will safely and effectively perform your colonoscopy or other endoscopic procedure.

1. Are you a board certified Gastroenerologist?

2. Have you had formal training in GI endoscopy?
Not learned during a short 2-3 day course or
self -instruction without supervised experience

3. Is your rate of cecal (total colon) intubation greater than 90%?

4. Do you perform more than 100 colonoscopies annually?

5. Do you have endoscopic privileges at a licensed health care facility or hospital?

6. Is polypectomy (polyp removal) routinely performed during elective colonoscopy?

7. Does your endoscopic facility have dedicated reprocessing
(disinfection) personnel and equipment?

8. Do you offer intravenous sedation for colonoscopy?

9. Do you monitor blood pressure, pulse and blood oxygen levels during sedation?

10. Do you employ a trained endoscopic assistant or nurse?

ASGE - The Source for Colonoscopy and Endoscopy

IMPORTANT REMINDER:
The preceding information is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. It is very important that you consult your doctor about your specific condition.

The Endoscopy Center is an outpatient facility that provides both comfort and convenience to patients needing GI procedures. In our facility, patients coming in to have procedures done tend to experience less hassle and shorter waiting times than those patients using a hospital setting. Hospital outpatient departments cannot always provide the focused attention that GI Associates can as they are trying to accomplish many things at one time. The gastroenterologists at GI Associates strive to do one thing and to do it well.

GI Associates understands that your time is precious and tries to keep their turn around time between 1-2 hours for procedures done at the Endoscopy Center. Contrast that to the average time spent in hospital, for the same procedure, which can be up to 4 hours. In addition, to ensure faster results the GI Associates employ two full-time pathologists whose job is to focus solely on gastroenterology and to provide the highest level of care for the patients of GI Associates. These pathologists work to try and complete your pathology within 24 hours of a procedure and the results and procedure notes are sent to your primary care doctor within 48 hours.

The Endoscopy Center allows GI Associates to monitor physician quality indicators such as polyp detection rates, withdrawal times and complications and use the results to ensure a level of care that is better than national standard. Many hospitals do not monitor these results and have no oversight into the quality of their services. GI Associates also offer an in-center sedation service that allows patients to experience the safest level of sedation and comfort during a procedure, which is extremely uncommon in a hospital setting as anesthesia services are only used upon request.

The physicians who make up GI Associates are from various parts of the United States and are all board certified in Internal Medicine and Gastroenterology, having accumulated at least six years of training after medical school. The gastroenterology training experience is far more intense than that undertaken by general surgeons, internists, or family practitioners that decide to add endoscopy to their practices. Our physicians are trained to interpret and treat the conditions they identify and uphold the safest level of endoscopy. This expertise and extensive training is not always present in hospital-based endoscopy and therefore they cannot provide the same level of quality and safety that GI Associates provides. All our gastroenterologists participate in clinical studies that provide GI Associates the latest information about medications and scientifically based therapy. They are recognized nationally as an innovative, progressive practice that provides patients with the most up to date information and treatments.

GI Associates strives to provide excellence in all they do. It is their goal to help diagnose your problems, give you tips on living with specific gastrointestinal diseases, and provide the highest level of comfort and service during their procedures. For your convenience they have clinics and endoscopy centers in Jackson, Madison and Vicksburg.

GI Associates receives the ASGE Quality Recognition

Everyone believes that quality of healthcare is important, but it is often not easy to tell whether or not you are receiving “quality care”. For this reason, the following paragraphs describe how GI Associates are assuring that our patients receive the highest quality of care.

Generally, quality means the excellence of a product or service. The physicians and staff of GI Associates seek to continuously improve our care to patients so we constantly collect data, analyze it and fine tune care practices and procedures when needed to assure patient safety and sound care. Unfortunately, not all health care providers do this! GI Associate recently received the American Society of Gastrointestinal Endoscopists (ASGE) Quality Recognition, a process that required proof of our ongoing efforts to provide high quality care.

The ASGE suggests that all consumers should ask the following ten questions before they decide which doctor they want to perform their colonoscopy or other endoscopic exam, to make sure that a trained endoscopist will safely and effectively perform the procedure:

1. Are you a licensed medical doctor?

2. Have you had formal training in GI endoscopy?
(Not learned during a short 2-3 day course or self instruction without supervised experience)

3. Is your rate of cecal (total colon) intubation greater than 90%?
(meaning that the procedure was completed)

4. Do you perform more than 100 colonoscopies annually?
(The number performed is associated with fewer complications)

5. Do you have endoscopic privileges at a licensed health care facility or hospital?

6. Is polypectomy (polyp removal) routinely performed during elective colonoscopy?

7. Does your endoscopic facility have dedicated reprocessing (disinfection) personnel and equipment?

8. Do you offer intravenous sedation for colonoscopy?

9. Do you monitor blood pressure, pulse and blood oxygen levels during sedation?

10. Do you employ a trained endoscopic assistant or nurse?
(ASGE, 2010)

All of the answers should be yes, to assure the most safe and effective patient experience. GI Associates meet all of the criteria stated in the questions above, a fact that should re-assure all patients that they are receiving the highest possible quality of gastrointestinal care.

In addition to the quality information above, in this issue you will find an expanded section dealing with consumer issues related to gastrointestinal care. We believe that informed patients can act as partners in care decisions, which also serves to improve quality of care. And, having the latest information can help you and your loved ones avoid serious health problems and in some cases, may save your life!

MASTOCYTIC ENTEROCOLITIS
Mastocytic enterocolitis (entero=small intestine, colitis- colon + -itis= inflammation) is a newly discovered disorder defined by the presence of increased mast cells in the intestine. Mast cells are a type of immune cell involved in allergy reactions, infection fighting and neural regulation. Mast cells contain chemicals that help regulate certain body reactions. Histamine is one of the main chemicals mast cells release when triggered. Mast cells are present in the intestinal lining in small numbers except when there are parasites, food allergies, stress or the presence of other chronic inflammatory bowel diseases such as Crohn's disease or ulcerative colitis. When mast cells release histamine a cycle of pain and gut injury results from irritation of the lining. This process can make the intestinal linining more permeable or leaky, resulting in diarrhea.

WHAT ARE THE SYMPTOMS?
The most common symptoms are diarrhea, bloating and abdominal pain. However, constipation may occur due to gut paralysis. Nausea, vomiting and various non-GI symptoms such as flushing, headaches, and fatigue may also occur. When histamine is released, it can cause leaky gut, increased contractions of the gut or decreased contractions, increased secretions and increased pain.

HOW IS IT DIAGNOSED?
When you have an endoscopic procedure at GI Associates to evaluate chronic diarrhea, your physician takes samples of tissue, biopsies, from the lining of your intestines. Our GI pathologist looks at it under the microscope with a special stain for tryptase, an enzyme present in mast cells. When excess mast cells are present in the small bowel or the colon mastocyte enterocolitis is diagnosed.

HOW IS IT TREATED?
There are medications that can reduce or block the release of chemicals by mast cells. The most common are Type I and II antihistamines. Type I antihistamines are typically used for allergies symptoms such as Zyrtec, Allegra, Claritin etc. The type II antihistamines are also acid blockers such as Zantac, Tagamet and Pepcid. Another therapy for mastocytic enterocolitis is a medication that stabilizes mast cells known as cromolyn sodium (Gastrocrom). This drug also prevents the release of chemicals including histamine from mast cells. It is typically prescribed four times a day for about 4-6 weeks. Along with these medications, the physicians of GI Associates frequently recommend allergy testing for the most common allergies. Pprobiotic supplement are also considered to have some potential benefit.

Not being able to tolerate gluten is a lifestyle changing event. Read more about a new support group dedicated to dealing with Celiac disease.