A better (more comfortable) colonoscopy

Small switch minimizes gas and cramping after the exam

Northville MPU colonoscopy.(blogpic)jpg

Dr. Leslie Aldrich uses a simulator to demonstrate what doctors look for during colonoscopy. Procedure rooms at Northville Health Center are among those equipped with CO2 delivery systems.

It’s the exam that’s made colon cancer one of the most preventable cancers yet. Most people don’t remember colonoscopy when it’s done, but for those age 50 and over it can be life-saving.

Digestive health specialists are taking action to make the process easier – from simpler instructions on prepping for a colonoscopy to medical advances that patients never see.

One switch:  using carbon dioxide during the exam. Rather than air, University of Michigan gastroenterologists use carbon dioxide to inflate the colon to help get a better look at its lining.

Resulting in less gas and cramping later — it’s a small change that can make a big impact when patients are ready to go home. Continue reading

Preparing for daylight saving time

How to avoid feeling sleep deprived come Monday morning

clock blogThis week is National Sleep Awareness Week, which concludes on Sunday, March 8, the same day we will “spring forward” for daylight saving time and lose one hour of precious sleep. The week is not just intended to talk about how to make the daylight saving transition smoother, but also to highlight the importance of sleep and the damaging effects of sleep deprivation.

It may sound trite to be concerned about losing just one hour of sleep, but with so many Americans juggling a full schedule and a growing dependence on technology that keeps us up late, many people are already struggling to get the full seven to nine hours we need. When we lose that extra hour, we put ourselves at risk of sleep deprivation, which can impair our daytime performance and have consequences like increased weight gain and improper glucose utilization.

Continue reading

Reaching out to the Doctors of Tomorrow

University of Michigan Medical School takes on diversity in health care

Doc of Tomw alternate crop

Cass Tech students begin training day at U-M C.S. Mott Children’s Hospital.

The University of Michigan Medical School attracts the best and brightest students from across the country even the world. But it’s hard to ignore the fact that when you look at the medical school students, trainees and faculty there doesn’t seem to be a lot of racial diversity.

To be fair it’s not just a Michigan problem, but a national one. While Black Americans make up 13 percent of the U.S. population, just 6 percent of today’s practicing physicians are Black. The numbers are not much better for Hispanic Americans.

The reasons are varied, but I think part of the problem is we have not done a good enough job of finding, recruiting and preparing Black and Hispanic students for medical school.

The University of Michigan Medical School’s Doctors of Tomorrow program was born out of a desire to change the face of medicine by recruiting and nurturing high-achieving students and changing the view of the state’s most populous city. Black and Hispanic ninth grade students from Detroit’s Cass Technical High School are provided mentorship and tools for success for a career in science and medicine through hands-on activities and discussions at the U-M Medical School. The monthly visits are designed to give them a sense of what it’s like to be a doctor.

On their first trip to Ann Arbor I was brimming with enthusiasm for the program but completely clueless on how to work with high school students. That first day when two dozen freshmen stepped off the maize and blue University of Michigan bus they appeared – as adolescents often do — tired and even sullen. But as soon as they came in and put on those white coats something changed. Continue reading

Monitoring medications in IBD patients

In patients suffering from ulcerative colitis and Crohn’s disease, an overactive immune system affects the gastrointestinal tracts, leading to inflammation, pain, and several other symptoms. Steroid like prednisone control inflammation and help patients’ symptoms in the short term. However, patients should not remain on steroids for an extended period of time as long-term exposure causes problems such as weakening of the bones (osteoporosis), diabetes, and weight gain, which can outweigh the symptom relief. 200214568-001

We use another class of medications called immunomodulators to help regulate the immune systems of patients with Inflammatory Bowel Disease (IBD). The two main medications are azathioprine, also known as Imuran®, and mercaptopurine (Purinethol®). These medications prevent your body from making certain kinds of white blood cells that cause inflammation in the gut. They are immunosuppressive medicines, which means they partially block the action of the immune system, but do not completely turn it off. Most of the risks associated with these medications seem to be related to latent viral infections and non-melanoma skin cancers. Patients taking azathioprine/mercaptopurine need to have their blood tested on a routine basis to check blood cell counts and liver function.

Anti-TNF (tumor necrosis factor) medications such as infliximab (Remicade®), adalimumab (Humira®), and certolizumab pegol (Cimzia®), are another type of medication used for IBD patients. These medications block the activity of TNF, which contributes to inflammation in the GI tract. These medications are very effective for controlling IBD. Like all medications, allergic and other reactions can occur, though there are some special considerations with this class of medicine. Like other immunomodulators,  Anti-TNFs can increase the risk of infections, mostly bacterial infections like pneumonia and fungal infections like histoplasmosis. This risk is higher if you take steroids along with an anti-TNF. Lymphoma and other cancers have been associated with their use as well, though this is a rare occurrence.  However, unlike azathioprine and mercaptopurine, anti-TNF agents do not require routine monitoring. Your physician may recommend labs every six to 12 months to assess for rare liver reactions. You should also inform your doctor if you experience fever, muscle pain or yellowing of the skin.

Take the next steps:


Akbar Karim Waljee, MD, is an assistant professor of internal medicine who specializes in gastroenterology and internal medicine. He graduated from the Emory University School of Medicine and completed his residency and fellowship at the University of Michigan Health System. Dr. Waljee sees patients at the Taubman Center and at the University Hospital.

 

 

The University of Michigan Digestive and Liver Health HS_180x180services is one of the largest programs in the country, providing prevention, diagnosis and treatment of diseases involving the gastrointestinal tract and liver. Our 60-plus physicians are experts in the diagnosis and treatment of all diseases of the gastrointestinal system.

6 hidden food allergy triggers that might surprise you

Know where your food allergy triggers are hiding!

hidden food allergy triggersOK, you know you have food allergies. And you know what foods trigger your allergies. And no one needs to tell you how much a food allergy attack can ruin your day. But food allergic reactions still account for more than 30,000 emergency room visits each year, and one reason is that many food allergy triggers are hiding in foods you may not expect!

For example, did you know:

  • canned tuna contains milk
  • bouillon cubes contain wheat
  • hot dogs contain egg
  • natural and artificial flavorings may contain peanuts and/or shellfish
  • Worcestershire sauce contains fish
  • deli meat may contain soy

Continue reading

Variety and expertise: the rehabilitation recipe that worked.

Paul was up to challenge and his abilities continue to improve.

020
Paul continues to see improvements in his abilities and credits the skilled physicians and staff at U-M MedRehab.

The MedRehab program is celebrating 25 years of service. Paul and Joan Christensen shared how Paul was able to recover after an unexpected stroke put him in the hospital.

Paul: I had a stroke when I was 59. I was not a candidate for stroke, being a non-smoker who exercised regularly and was in good health, so it was definitely a complete surprise. The stroke resulted in left side paralysis and I was unable to walk at first. I was originally admitted to St. Joe’s Hospital in Pontiac, but I wanted to come back to Ann Arbor for outpatient care. U-M is our home hospital, and we wanted to come back to where our doctors were.

Continue reading