Discovering, treating and leading the way to improved digestive and liver health. The University of Michigan is home to over 60 expert physicians and health care providers focused on the prevention, diagnosis and treatment of diseases of the digestive tract and liver.
A 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.
Everyone 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:
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.
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.
Learn why you should choose University of Michigan for your digestive and liver health issues.
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 services 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.
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. People 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 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.
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