This month we celebrated the 238th birthday of our country. This summer is also the 50thanniversary of the Freedom Summer – a time when the Congress on Racial Equality and the Student Non-Violent Coordinating Committee mobilized to register Black voters in the U.S. South. Both “revolutions” required upsetting the status quo so the country could move forward.
As we focus on national and personal freedoms, let’s not forget that “upheaval” is also needed in health care. With patriotism must come national self-reflection; a collective look at our failure to ensure equitable health care for all. I continue to wave the flag of freedom from inequitable health care for people who are poor and elderly, or otherwise treated differently. Continue reading →
Inflammatory bowel disease (IBD) is an umbrella term used for diseases that involve chronic inflammation of all or part of the digestive tract. Crohn’s disease and ulcerative colitis are two most common forms of IBD. IBD is different from IBS (irritable bowel syndrome), which can have some of the same symptoms, but does not cause inflammation or permanent damage to the digestive tract.
Symptoms of IBD include rectal bleeding, abdominal cramping, fatigue, weight loss and diarrhea. Most people with IBD begin experiencing symptoms before the age of 30. It is more common in Caucasians, but can occur in any ethnic group. Those with family members with IBD are also at higher risk. There may be environmental factors involved as well, as people who live in an urban area or industrialized country are more likely to develop IBD.
IBD is diagnosed after ruling out many other potential causes of the symptoms. Doctors may use several diagnostic tests, including blood tests, stool samples, colonoscopy, sigmoidoscopy, and various imaging tests.
As a geriatrician, I have helped counsel families who are in one of the most difficult stages of caregiving: when their loved one’s advanced dementia has progressed so far that eating without help is no longer possible.
Naturally, people want their family members to be comfortable and from the beginning of life, we have learned that being fed – whether through a shared homemade meal or hot bowl of soup when you’re ill – is among the greatest expressions of love.
In up to 20 percent of patients with Crohn’s disease, the disease is isolated to an area of the small bowel that is out of reach of an upper endoscopy (a procedure where a scope is passed through the patient’s mouth and into the esophagus, stomach and upper part of the small intestine) or a colonoscopy (a procedure where a tube is inserted into the patient’s rectum and passed through the colon). This makes getting a proper diagnosis challenging. Without a correct diagnosis, we can’t know if we are treating the right disease.
We have made strides in imaging techniques that allow us to see a patient’s small bowel. During a capsule endoscopy the patients swallows a pill-sized camera. As the capsule passes through the patient’s body, Continue reading →
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