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Ulcerative Colitis

Even the words sound miserable.

It belongs to a group of conditions called inflammatory bowel disease (IBD). Affectionately known as UC, it causes irritation and ulcers (open sores) in the large intestine. It often causes diarrhea with blood, cramping and urgency. Sometimes these symptoms are so intense, it can wake a person up at night to go to the bathroom as well.

Abnormal immune response, genetics, microbiome, and environmental factors are all contributing factors to ulcerative colitis. Stress doesn’t help it either. Research implies that ulcerative colitis could be generated by an interaction between a virus or bacterial infection in the colon and the body’s immune response. A normal immune response would cause temporary inflammation to battle an illness or infection. The inflammation would then go away, once you are healthy and free of the illness. With UC patients, the inflammation persists, and the body continues to send white blood cells into the intestinal lining where they produce the inflammation and ulcers.

It usually begins in the rectum toward the end of the digestive tract and can spread and affect all or part of the colon. When these areas are affected, it is called Ulcerative Proctitis. If the entire large intestine is affected, it is called Pancolitis. If only the left side of the colon is affected, it is known as limited or Distal Colitis. Left-sided Colitis is when the Inflammation extends from the rectum up through the sigmoid and descending colon.

Everyone experiencing disease may have it a little different. The severity depends on how much inflammation and where that inflammation is located. You could have severe inflammation in the rectum (small area) or very mild inflammation in the entire colon (large area). Ulcerative colitis can be debilitating and may lead to life-threatening complications. While it has no known cure, treatment can reduce signs and symptoms of the disease and bring about long-term remission.

Signs and symptoms may include:

  • Diarrhea, often with blood or pus
  • Abdominal pain and cramping
  • Rectal pain
  • Rectal bleeding
  • Urgency to defecate
  • Inability to defecate
  • Weight loss
  • Fatigue
  • Fever
  • In children, failure to grow

Who is Affected?

  • Ulcerative colitis can occur at any age, though most people are diagnosed in their mid-thirties.
  • While both men and women are equally likely to be affected, older men are more likely to be diagnosed than older women.
  • The risk of developing ulcerative colitis is between 1.6 percent and 30 percent if you have a first-degree relative with the disease.
  • Ulcerative colitis can affect people of any racial or ethnic group.

See your doctor if you experience:

  • Change in your bowel habits
  • Abdominal pain
  • Blood in your stool
  • Ongoing diarrhea that does not respond to over-the-counter medications
  • Diarrhea that awakens you from sleep
  • An unexplained fever lasting more than a day or two

To diagnose ulcerative colitis, doctors review your symptoms with your medical and family history. They will perform a physical exam and tests. Medical tests may include blood tests, stool tests, and endoscopy of the large intestine.

There is no cure, but treatment will alleviate the symptoms by reducing inflammation. If they can reduce inflammation in the large intestine with medication, this will help bring on and maintain remission. If you do not respond to medication and your symptoms are severe, surgery may be recommended.

Waiting is not your friend when it comes to pain and discomfort. At Monmouth Gastroenterology, you are well cared for with our very well trained, experienced staff. You can be at ease, knowing you are getting some of the highest-level care for gastrointestinal, liver disease and colorectal cancer prevention, detection, and screening in the Monmouth & Ocean County area.

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Discomfort In Your Digestive Tract

Many people experience varying degrees of discomfort in their digestive tract, and just do not know when it is time to seek medical help.

  • Is your pain and cramping due to the leftover exotic food you woofed down for lunch or something more?
  • Do you have diarrhea because you ate too much fruit yesterday or something more?
  • Are you constipated because you had too many carbs the last few days or something more?
  • One minute you are constipated, and the next you explode. What is with that?
  • Your bowel movements are inconsistent. Does your diet change so much day to day?
  • You are often bloated and uncomfortable, was it something you ate?
  • Certain foods trigger you that never used to. Are you developing allergies?
  • You are fatigued often. You must be getting old?
  • You often feel anxious or depressed.

Believe it or not, any of the above statements can mean you may have IRRITABLE BOWEL SYNDROME, affectionately called IBS. Worldwide, it is estimated that 5-10% of the population has IBS, so you are not alone. IBS affects between 25 and 45 million people in the United States. About 2 in 3 IBS sufferers are female.

If you have heard the term but do not know what it means, this is a fairly common disorder which affects the large intestine. There is no known cause, just factors that seem to contribute to the problem. Stress is definitely a factor as is food choices.

Signs and symptoms range from mild to severe. If it persists for three months or longer, or you feel it interferes with your daily life, especially the quality of it, time to seek medical help to diagnose the problem, especially if you are losing weight, bleeding rectally, vomiting, anemic, nighttime diarrhea, or persistent pain.

 

A gastroenterologist specializes in digestive disorders and disease. They are well versed in IBS and other potential problems you may be experiencing. At Monmouth Gastroenterology, A Division of Allied Digestive Health, there is a team of six specially trained doctors and two nurse practitioners along with an experienced staff to give their patients the highest level of care. Times of discomfort call for compassionate care with an individualized touch.

The good news is that it does not leave any visible signs of damage or disease in your digestive tract. Even better. it is generally manageable.

Lifestyle changes may be in your future. Something as simple as over the counter laxatives and hydrating more often can alleviate symptoms. Probiotic supplements may help, as would avoiding digestive stimulants like caffeine

You may need to learn to avoid FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols). These are nondigestible short-chain carbs that force water into your digestive tract. They are responsible for that bloating, gassy feeling. You would be surprised which foods are triggers and which foods are not.

UNFRIENDLY FOODS

  • Oligosaccharides: wheat, rye, nuts, legumes, artichokes, garlic, and onion
  • Disaccharides: lactose-containing products (dairy)
  • Monosaccharides: fructose-containing foods, including certain fruits and sweeteners such as honey, agave nectar, and high fructose corn syrup
  • Polyols: mannitol and sorbitol in apples, pears, cauliflower, stone fruits, mushrooms, and snow peas, as well as xylitol and isomalt in low calorie sweeteners, such as those in sugar-free gum and mints

FRIENDLY FOODS

  • Proteins: beef, chicken, eggs, fish, lamb, pork, prawns, tempeh, and tofu
  • Whole grains and starches: white and brown rice, lentils, corn, oats, quinoa, and potatoes
  • Fruit: blueberries, raspberries, pineapple, honeydew melon, cantaloupe, kiwi, limes, guava, starfruit, grapes, and strawberries
  • Vegetables: bean sprouts, bell peppers, radishes, bok choy, carrots, celery, eggplant, kale, tomatoes, spinach, cucumber, pumpkin, and zucchini
  • Nuts: almonds, macadamia nuts, peanuts, pecans, pine nuts, and walnuts (in moderation)
  • Seeds: pumpkin, sesame, and sunflower seeds, as well as linseeds
  • Lactose-free dairy milk, Greek yogurt, and Parmesan, Colby, cheddar, and mozzarella cheeses
  • Oils: coconut and olive oils
  • Beverages: peppermint tea and water
  • Condiments: cumin, saffron, cinnamon, paprika, coriander, cardamom, soy sauce, fish sauce, some chile-based products, ginger, mustard, pepper, salt, white rice vinegar, and wasabi powder

Waiting is not your friend when it comes to pain and discomfort. At Monmouth Gastroenterology, you are well cared for with our very well trained, experienced staff. You can be at ease, knowing you are getting some of the highest-level care for gastrointestinal, liver disease and colorectal cancer prevention, detection, and screening in the Monmouth & Ocean County area.

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March is National Colorectal Cancer Awareness Month

Why should this matter to you?    Because awareness saves lives.

Colorectal cancer is the 2nd leading cause of death from cancer in the United States, after breast cancer in women and prostate cancer in men. The risk of the average person between the ages of 50 to 80 developing colon cancer is about 6%, or almost 1 in 20.

Increases Risk Factors:

 Family history of colorectal cancer

 certain other cancers (ovarian, uterine, breast and other GI cancers)

 inflammatory bowel disease (Ulcerative and Crohn’s Colitis)

 Obesity

 smoking

Colorectal cancer begins when cancer cells form in the lining of the colon or rectum. Colon cancer and rectal cancer are often grouped together because they have many features in common. The colon and rectum make up the large intestine (or large bowel), which is part of the digestive system, also called the gastrointestinal (GI) system.

Food enters the stomach by way of the esophagus, passes through twenty feet of small bowel, where most absorption of nutrients occur, and the remainder traverses the large bowel where excess water is absorbed, ultimately becoming stool which exits the rectum. Colon cancer can occur anywhere in the large bowel or rectum and usually begin as a small growth called a polyp. At first, a polyp is small and harmless, and causes no symptoms. Over time, polyps get bigger. This can lead to bleeding, or blockage of the colon. By the time these symptoms occur, the polyp most likely has developed into a cancer that continues to grow and spread to other organs (metastasize.) 

There are preventative measures we all can take to prevent, detect, and treat many major health issues, including colorectal cancer.

Beginning age 45, regular screening of the colon or rectum is a simple preventative step. These tests can be used to find polyps or colorectal cancer.  If your test result is positive or abnormal on some screening tests (stool tests, flexible sigmoidoscopy, and CT colonography), a colonoscopy test is needed to complete the screening process. Colonoscopy is the gold standard in polyp and colon cancer detection, and the only detection mode that allows removal of the polyp at the time of the test.

Some types of polyps can change into cancer over time, but not all polyps become cancer. The chance of a polyp turning into cancer depends on the type of polyp it is. There are several types of polyps.

∙ Adenomatous polyps (adenomas): These polyps sometimes change into cancer; therefore, they are called a pre-cancerous condition. The three types of adenomas are tubular, villous, and tubulovillous.

∙ Hyperplastic polyps and inflammatory polyps: These polyps are more common, but in general they are not pre-cancerous. Large ones may call for colorectal cancer screening with colonoscopy more often.

Sessile serrated polyps (SSP) and traditional serrated adenomas (TSA): These polyps are often treated like adenomas because they have a higher risk of colorectal cancer.

Step One is calling Monmouth Gastroenterology Associates to set up a consultation. The team of six specially trained doctors in the field of gastroenterology, and two nurse practitioners, along with the staff, offer patients the highest care possible. Speak to your doctor about the pros and cons of each different test, your medical history, family history and your preferences to conclude which type of screening is most effective for you.

At Monmouth Gastroenterology, you are well cared for with our very well trained, experienced staff. You can be at ease, knowing you are getting some of the highest-level care for gastrointestinal, liver disease and colorectal cancer prevention, detection, and screening in the Monmouth & Ocean County area.

 

 

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Colonoscopy

Whenever you hear people talking about Colonoscopy; whether it is to schedule, to go, waiting for results… the word is always surrounded by dread.

Personally, I never quite understood that.  You go to see your Gastro Doctor, who is a totally nice and personable healthcare professional with a very understanding staff.  You discuss your overall health care and set up the date.  So far so good.

The night before you do the prep. The purpose for the prep is that the colon and rectum need to be cleared of any stool residue before the colonoscopy is performed. For you newcomers on the colonoscopy scene, the prep is so much easier and less distasteful than it used to be. In the “old days”, you used to have to chug down what seemed like an entire tanker truck of liquid that didn’t go down easily. The liquid is less volume and a bit more palatable than it used to be.

You arrive on your scheduled day and time, either at the hospital or an outpatient facility.  You get all comfy in your hospital gown and bed, watch a little TV while you wait your turn, and wait for the intravenous sedative to start to wooze you. That is generally the last thing you remember.

You wake up in your comfy bed in a recovery room, a little dopey from the remnants of the sedative.  You may feel a little bloated or gassy, that is normal.  You may need to do things that you would want to say “excuse me” for. You relax there for about an hour until you feel a bit more refreshed and ready to rejoin your normal day.  It is best to take it easy and not make any extraordinary plans for the balance of the day.

While you were asleep, the staff was busy.  Your doctor inserted a long, flexible, lighted tube called a colonoscope, or scope, into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with air to give the doctor a better view. A small camera which is mounted on the scope transmits a video image from inside the large intestine to a computer screen, allowing the doctor to carefully examine the intestinal lining. If you are still awake, the doctor may ask you to move periodically so the scope can be adjusted for better viewing. Once the scope has reached the opening to the small intestine, it is slowly withdrawn, and the lining of the large intestine is carefully examined again.

During the procedure, your doctor can remove growths, called polyps, and later test them in a laboratory for signs of cancer. Polyps are common in adults and are usually harmless. Understand that most colorectal cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer. The doctor can also take samples if there are abnormal-looking tissues during colonoscopy. The procedure, called a biopsy, allows the doctor to later look at the tissue with a microscope for signs of disease.

Really not a bad procedure, and you slept through most of it. It is really important for you to do as often as your doctor feels is necessary based on your medical issues and family history. This one routine test can spare you a world of pain if you have issues that are not caught early.

At Monmouth Gastroenterology, you are in good hands with our very well-trained, experienced staff of 6 specially trained Doctors and 2 Nurse Practitioners. You can be at ease, knowing you are getting some of the highest-level care for gastrointestinal, liver disease, and colorectal cancer prevention, detection, and screening in the Monmouth & Ocean County area.