A better (more comfortable) colonoscopy

Small switch minimizes gas and cramping after the exam

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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

A Better (More Comfortable) Colonoscopy

Better Colonoscopy blogA colonoscopy cannot only detect colon cancer, it can also prevent it. Colorectal cancer is the second leading cancer killer in the United States, so it’s important to follow screening and prevention guidelines. Unfortunately, many people are so anxious about getting a colonoscopy that they avoid this potentially lifesaving procedure. With medical advances, today’s colonoscopy is a much better experience than those in the past.

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Colorectal cancer risk and genetics

colon cancer blogEveryone is at risk for colon cancer, but that risk is not the same for everyone. Colorectal cancer is the third most common cancer affecting men and women and each year, there are about 93,000 new cases of colon cancer and 39,610 new cases of rectal cancer diagnosed in the United States. The average person has a 5 percent chance of developing colon cancer, but some people are at a higher risk.

The most common risk factors for colon cancer are:

  • Age
  • Lifestyle
  • Race/ethnic background
  • Personal medical history
  • Family medical history

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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.

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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.

When the burn becomes unbearable

Some heartburn can be caused by structural or biochemical abnormalities, but other individuals with heartburn have no such abnormalities — those individuals may have what is called functional heartburn. In addition to the burning pain in chest and throat, other symptoms include belching, regurgitation and bloating. HeartburnPeople with functional heartburn typically do not respond to medications used to treat GERD.

Advances in the field, such as esophageal pH-impedance testing, now allow for better diagnosis and characterization for patients presenting with heartburn. These advanced have highlighted the inadequacy of one-size-fits-all treatments such as modifying diets and trial PPI therapy.  Seventy-five percent of patients with functional heartburn also have esophageal hypersensitivity, which means they experience the symptoms more strongly than most people — making the symptoms even more frequent and painful.

Studies have also shown a link between stress and functional heartburn. Continue reading

Medical hypnosis — it’s a real thing!

Medical hypnosis is a real clinical intervention. Often when hypnosis is introduced as a potential intervention for an individual, people will give a puzzled look. This isn’t your stage show hypnosis. You will not walk out of a session clucking like a chicken at the sound of a bell. With appropriate education about medical hypnosis, patients are often excited and ready to try it.            hypnosis words

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