Generated by All in One SEO v4.9.10, this is an llms.txt file, used by LLMs to index the site. # Endoscopy Center of the North Shore A state of the art facility for excellence. We diagnose and manage symptoms and diseases of the digestive tract. ## Sitemaps - [XML Sitemap](https://ginorthshore.com/sitemap.xml): Contains all public & indexable URLs for this website. ## Posts - [Hospital Colonoscopy Facility Fees 55% Higher Than Surgical Centers](https://ginorthshore.com/2024/08/hospital-colonoscopy-facility-fees-55-higher-than-surgical-centers/) - Researchers at the Johns Hopkins Bloomberg School of Public Health found that U.S. hospitals charge facility fees for colonoscopy procedures that are on average approximately 55 percent higher than fees billed by smaller clinics known as ambulatory surgical centers (ASC's). Blue Cross Blue Shield data suggests the cost of a diagnostic colonoscopy increased 6.1% at - [Hospital workers are working longer hours](https://ginorthshore.com/2024/02/hospital-workers-are-working-longer-hours/) - A 2023 survey of medical professionals found that more than 1 in 3 health care workers have made a mistake while working because of a lack of sleep, with 82% saying that patient care suffers the most when the workers are fatigued. 7 in 10 health care workers described their current workload and stress as - [Is this the right place for my GI procedure? Ask Oprah!](https://ginorthshore.com/2020/11/is-this-the-right-place-for-my-gi-procedure-ask-oprah/) - Oprah Winfrey advises of the 6 most important questions to ask if you are having a procedure at an out of hospital facility. See the article at Oprah.com here. This is not an endorsement by Oprah, these are answers from our facility to the questions she recommends you ask. Wherever you have your procedure, ask - [Welcome Dr. Laura Bianchi to The Endoscopy Center of the North Shore!](https://ginorthshore.com/2024/01/welcome-dr-laura-bianchi-to-the-endoscopy-center-of-the-north-shore/) - Dr. Laura Bianchi is the newest member of the team at The Endoscopy Center of the North Shore. Welcome, Dr. Bianchi! Read her full bio here - [ACG 2023 Practice Management Summit Friday, October 20. See you there!](https://ginorthshore.com/2023/10/acg-2023-practice-management-summit-friday-october-20-see-you-there/) - Proud to co-host this event with Michelle Hughes. We have a slate of great topics and speakers! It's not too late to register, even virtually! - [Fiber Intake Tied to Lower Risk for Inflammatory Bowel Disease](https://ginorthshore.com/2023/08/fiber-intake-tied-to-lower-risk-for-inflammatory-bowel-disease/) - Higher consumption of dietary fiber was associated with a lower risk for inflammatory bowel disease, according to a study published online in the July 18 edition of Alimentary Pharmacology and Therapeutics. Read the study here. - [Musings on the future of GI, the value of employees, and Fellowship training](https://ginorthshore.com/2022/10/musings-on-the-future-of-gi-the-value-of-employees-and-fellowship-training/) - Here's a short interview from Becker's ASC Review. #GITwitter #GIFellowship #GIFamily @AmCollegeGastro @AmerGastroAssn @ASGEendoscopy Click here for the interview. - [Cancer Risk Lower When Docs Are Better at Adenoma Detection](https://ginorthshore.com/2022/06/cancer-risk-lower-when-docs-are-better-at-adenoma-detection/) - A retrospective study of three large health systems found that the risk for colorectal cancer following a colonoscopy was lower when the colonoscopy was conducted by a physician with higher adenoma detection rates (ADR's). Adenomas are the usual precursor type polyps that can lead to colon cancer. At the Endoscopy Center of the North Shore, - [De-Escalation of PPI Therapy](https://ginorthshore.com/2022/04/de-escalation-of-ppi-therapy/) - The American Gastroenterological Association has released a new Clinical Practice Update providing best practice advice on how to approach de-prescribing proton pump inhibitors (PPI) in ambulatory patients. - [Microbiome therapeutic shows promise in recurrent C. difficile](https://ginorthshore.com/2021/11/microbiome-therapeutic-shows-promise-in-recurrent-c-difficile/) - CP101, an investigational microbiome therapeutic, restored microbiome diversity and prompted a sustained clinical cure among patients with recurrent Clostridioides difficile infection, according to a presentation at this year's ACG in Las Vegas. "(The c. dif) therapies lead to significant microbiome disruptions which impairs colonization resistance,” Jessica R. Allegretti, MD, MPH, FACG, the director of fecal - [Sugary drinks tied to early colon cancer](https://ginorthshore.com/2021/05/sugary-drinks-tied-to-early-colon-cancer/) - According to study results of 95,464 women published in Gut, there were 109 incident early-onset cancer cases over up to 24-years of follow-up. Compared with women who consumed less than one serving per week of sugary drinks, women who consumed more than two servings per day of had a 2.2-fold higher risk for early-onset colon - [Noncompliance with colonoscopy increases risk](https://ginorthshore.com/2021/04/noncompliance-with-colonoscopy-increases-risk/) - Patients who did not have a colonoscopy as recommended after a positive fecal occult blood test had a 103% higher risk of death, compared with those who had a colonoscopy. The cumulative mortality for CRC was 6.8 per 1,000 (95% CI, 5.9-7.6) for compliant patients and 16 per 1,000 (95% CI, 13.1-18.9) for noncompliant patients - [Depression with GI symptoms may mean IBD](https://ginorthshore.com/2020/11/depression-with-gi-symptoms-may-mean-ibd/) - It has long been recognized that depression can lead to GI symptoms. But do all GI symptoms in the setting of depression mean only depression? A recent study by Jonathan Blackwell et al at St George's University of London found that depression, in the absence of prior GI symptoms, is not associated with subsequent development - [Thoughts on how IBD emerges in developing countries](https://ginorthshore.com/2020/11/thoughts-on-how-ibd-emerges-in-developing-countries/) - It has long been noted that rates of IBD increase as nations develop. What drives this increase in "developing" nations, and what factors keep inflammatory bowel disease (IBD) rates high in the West? Gilaad G. Kaplan, MD, of the Department of Medicine, University of Calgary, discusses the epidemiological stages of IBD and reviews how disease - [Excerpts from a chat on colon cancer](https://ginorthshore.com/2020/11/excerpts-from-a-chat-on-colon-cancer-11/) - Seth (Chicago) - 12:47 PM:Are there any downsides to screening? Can it do more harm than good in any instances? Dr. Manoj Mehta Any screening test is only worth its trade-offs. That's why we select the patients, and do not just do it on everyone. We call the threshold a "pre-test probability". So, if you - [Excerpts from a chat on colon cancer](https://ginorthshore.com/2020/11/excerpts-from-a-chat-on-colon-cancer-10/) - Jim (Buffalo Grove, IL) - 12:44 PM:You mention a virtual colonoscopy. How does this procedure work and is it a viable option to the traditional colonoscopy? Dr. Manoj Mehta A traditional colonoscopy has the ability to not just identify polyps but remove them. So they are not really equivalent. A virtual colonoscopy is more like - [Excerpts from a chat on colon cancer](https://ginorthshore.com/2020/11/excerpts-from-a-chat-on-colon-cancer-9/) - Jose (Chicago, Illinois) - 12:40 PM:Is surgery the only way to cure colon cancer? Dr. Manoj Mehta Well, the transition from polyp to cancer is a gradual one, so we do sometimes see what we call "cancerous polyps". They are on the edge between a polyp and an invasive cancer. By removing these polyps, we - [Excerpts from a chat on colon cancer](https://ginorthshore.com/2020/11/excerpts-from-a-chat-on-colon-cancer-8/) - Andrea (Glenview) - 12:34 PM:What prompts the development of polyps in the first place? Does it have anything to do with the types of foods people eat? Dr. Manoj Mehta Colon polyps develop from a wide variety of factors. Part, of course is genetic, and has to do with our ability to repair local genetic - [Excerpts from a chat on colon cancer](https://ginorthshore.com/2020/11/excerpts-from-a-chat-on-colon-cancer-7/) - James (Morton Grove, IL) - 12:30 PM:I have family history of polyps but no colon cancer. My family has had several other types of cancer (brain, breast, non-smokers lung). Does this put me in the high-risk category? Dr. Manoj MehtaYes. There are some cancer-family syndromes to be aware of. Breast cancer is fairly common, and - [Excerpts from a chat on colon cancer](https://ginorthshore.com/2020/11/excerpts-from-a-chat-on-colon-cancer-6/) - Dan (Arlington Heights) - 12:26 PM:Thank you for your response. Could you elaborate on what is involved with the preparation? Dr. Manoj Mehta Unfortunately, any bowel exam will require a prep. Even newer modalities on the horizon such as a virtual colonoscopy will still require a prep. The quality of your prep is proportional to - [Excerpts from a chat on colon cancer](https://ginorthshore.com/2020/11/excerpts-from-a-chat-on-colon-cancer-5/) - Jose (Chicago, Illinois) - 12:18 PM:What are the different stages of colon cancer? Dr. Manoj Mehta There are a number of staging systems, but generally 1-4 would be a traditional scale. Stage 1 is confined to the colon lining, 2 and 3 deeper through the lining, and 4 spread to distant organs. It is important - [Excerpts from a chat on colon cancer](https://ginorthshore.com/2020/11/excerpts-from-a-chat-on-colon-cancer-4/) - Dan (Arlington Heights) - 12:16 PM:I have a standing order to get a colonoscopy so I understand why a screening is important and necessary. My concern is the actual procedure. I'm a bit hesitant because of the invasiveness of the procedure. What advice or guidance can you offer to help mitigate my apprehension? Dr. Manoj - [Excerpts from a chat on colon cancer](https://ginorthshore.com/2020/11/excerpts-from-a-chat-on-colon-cancer-3/) - Patrick (Chicago, Illinois) - 12:11 PM:All the recent rave is colon cleansing. How effective is it, if at all, and what is the best way of performing it? Dr. Manoj Mehta Rave is a good word. It does seem to be a fad, but there is little science behind it. One of the things we - [Excerpts from a chat on colon cancer](https://ginorthshore.com/2020/11/excerpts-from-a-chat-on-colon-cancer-2/) - Reagan (Atlanta) - 12:08 PM:My mother is a colon cancer survivor and I have had many GI issues, which have been mostly reflux issues. I am 36 and I am wondering if I should be pre-emptive and receive a colonoscopy now, rather than waiting until I am 40? Dr. Manoj Mehta For you, traditionally we - [Excerpts from a chat on colon cancer](https://ginorthshore.com/2020/11/excerpts-from-a-chat-on-colon-cancer/) - Jose (Chicago, Illinois) - 12:06 PM:As a diabetic, am I more prevalent to this disease? Dr. Manoj Mehta Data suggests that people with diabetes develop colon cancer more frequently than those without. They also do not do as well with the available treatment options and have a higher rate of recurrence. Whether this can be - [USPSTF discusses colon cancer screening at 45](https://ginorthshore.com/2020/11/uspstf-discusses-colon-cancer-screening-at-45/) - The American Cancer Society has been the first major organization to recommend colorectal cancer screening should begin at age 45. Now the US Preventative Services Taskforce has also suggested this is the correct age to begin screening for all patients. The proposed guideline is under review and comments are open until November 23. The American - [Screening delays due to COVID-19 could increase colon cancer mortality 12%](https://ginorthshore.com/2020/10/screening-delays-due-to-covid-19-could-increase-colon-cancer-mortality-12/) - Researchers created a two-step procedural model that considered the delays in time to coloscopy and estimated the impact of on mortality because of up-staging of patients. Data from the Italian screened population was used to compute the number of expected CRC cases. A meta-analytic approach was used to assess the estimates of the effects of - [Promising results for new oral microbiome drug for C. diff](https://ginorthshore.com/2020/06/promising-results-for-new-oral-microbiome-drug-for-c-diff/) - In PRISM3, a multicenter, randomized, double-blind, placebo-controlled phase 2 trial, researchers assessed an investigational oral microbiome drug CP101 in 206 patients with recurrent C. difficle at 51 sites across the United States and Canada. The drug did meet the primary endpoint of sustained clinical cure among 74.5% of the patients with recurrent C. difficile who received a - [IBD may raise odds of dementia](https://ginorthshore.com/2020/06/ibd-may-raise-odds-of-dementia/) - Individuals with inflammatory bowel disease had a 4.1% increased incidence of dementia - [We will perform on-site COVID testing before every procedure](https://ginorthshore.com/2020/05/we-will-perform-on-site-covid-testing-before-every-procedure/) - When we resume endoscopy services, we will screen all patients for COVID-19 at a separate, on-site visit right here in our office. The test will be administered by nursing personnel from Mobile Anesthesia of Chicago and billed directly through LabCorp. You do not need to go to the hospital (and potentially be exposed to high - [Non-invasive blood test might detect early colon cancer](https://ginorthshore.com/2020/05/non-invasive-blood-test-might-detect-early-colon-cancer/) - In a recorded audio presentation in lieu of the usual annual DDW meeting, Shai Friedland, MD, professor of medicine at the Stanford University Medical Center, presented information on a blood test that may detect colon cancer. He said techniques to detect circulating cells in the blood have become more sensitive, which creates the potential to - [COVID advice from CCFA for patients with IBD](https://ginorthshore.com/2020/03/covid-advice-from-ccfa-for-patients-with-ibd/) - Does your risk for COVID increase because of your IBD? Does your medical therapy increase your risk? Should you change your medication schedule? See advice from the Crohn's and Colitis Foundation here. - [The Modern Colonoscopist](https://ginorthshore.com/2020/02/the-modern-colonoscopist/) - Experts discuss multiple key strategies to improving the adenoma detection rate. From low-tech to high-def, some simple solutions may improve your ability to make meaningful changes. See the article in Gastroenterology & Endoscopy News here. - [Dividing Crohn’s Into Small Bowel and Colonic Diseases?](https://ginorthshore.com/2019/12/dividing-crohns-into-small-bowel-and-colonic-diseases/) - Parambir S. Dulai, MD, and colleagues at the Division of Gastroenterology, University of California San Diego have written a thoughtful discussion on the problem with phenotypes in Crohn's disease. We have long known that there are different types of disease, aggressiveness factors, and presentations. However, we tend to think of Crohn's as one disease. Is - [FDA warns companies selling medicinal CBD products](https://ginorthshore.com/2019/12/fda-warns-companies-selling-medicinal-cbd-products/) - With state-by-state legalization of cannabis products, comes a surge in purported medical benefits. But caution remains that the interest in cannabinoids will lead to the old "snake oil" type of cure-all claims. The FDA has only approved one product containing CBD, for the treatment of of a specific type of seizures. Warning letters from the - [New drug effective treatment for eosinophilic disease](https://ginorthshore.com/2019/11/new-drug-effective-treatment-for-eosinophilic-disease/) - A novel biologic agent lowered eosinophil counts and eased symptoms among patients with eosinophilic gastritis and eosinophilic gastroenteritis - [Anti-TNF therapy in early pregnancy tied to preeclampsia](https://ginorthshore.com/2019/11/anti-tnf-therapy-in-early-pregnancy-tied-to-preeclampsia/) - “We know that women with inflammatory bowel disease when they are pregnant are at increased risk for adverse pregnancy outcomes,” Sunanda V. Kane, MD, a gastroenterologist and professor of medicine at Mayo Clinic in Rochester, Minnesota, said at the American College of Gastroenterology Annual Meeting. Control of IBD has been felt to be fundamental for - [Close to $1T in Medical Waste, Mostly Bureaucratic](https://ginorthshore.com/2019/10/close-to-1t-in-medical-waste-mostly-bureaucratic/) - The estimated cost of waste in the US health care system ranges from $760 billion to $935 billion, accounting for approximately 25% of total health care spending. - [Increase in Young Colon Cancer in US Also Seen in Other High-Income Countries](https://ginorthshore.com/2019/09/increase-in-young-colon-cancer-in-us-also-seen-in-other-high-income-countries/) - The increase in colorectal cancer cases among people under 50 seen in the United States is also occurring in other countries, according to a recent study. Nine of the 43 countries analyzed showed a decrease in CRC cases among those older than 50, like the US, but an increase in younger adults. See the review - [Multidisciplinary care for severe IBS shows improvement over GI care alone](https://ginorthshore.com/2019/09/multidisciplinary-care-for-severe-ibs-shows-improvement-over-gi-care-alone/) - An abstract presented this year at DDW supports the benefit of a multidisciplinary approach for those with severe functional GI disorders. To test the efficacy of a multidisciplinary care approach, researchers recruited 35 patients with a severe manifestation of a functional gastrointestinal disorder (FGID) — defined as having symptoms for more than 3 years that - [App Improves Quality of Life With IBD](https://ginorthshore.com/2017/11/app-improves-quality-of-life-with-ibd/) - App use increases patient engagement, yields better health outcomes Patients with inflammatory bowel disease (IBD) who used a collaborative disease management app saw a significant improvement in care and quality of life (QoL), researchers reported here. Among 320 patients with IBD, those randomized to HealthPROMISE -- an app designed to increase patient engagement and self-management skills -- - [Liver enzymes tied to Alzheimer's](https://ginorthshore.com/2019/08/liver-enzymes-tied-to-alzheimers/) - A study in JAMA Network Open found that higher AST to ALT liver enzyme ratios, reduced ALT levels, and higher alkaline phosphatase readings were associated with Alzheimer's disease. Specific markers such as poor cognition, elevated amyloid-beta accumulation, increased brain atrophy, and lower brain glucose metabolism were noted. The findings were based on PET, MRI, and - [Approach to Symptomatic Diverticular Disease](https://ginorthshore.com/2019/06/approach-to-symptomatic-diverticular-disease/) - Dr. Lisa Strate from the University of Washington discusses this difficult topic in the attached video. At ACG 2018, Dr. Strate described the various presentations of symptomatic diverticular disease and reviewed current therapeutic approaches. See the video at the ACG Universe here. - [The Business of Health Care Depends on Exploiting Healthcare Providers](https://ginorthshore.com/2019/06/the-business-of-health-care-depends-on-exploiting-healthcare-providers/) - From the New York Times, a striking editorial suggests for the first time something that healthcare workers have long known firsthand--that if there is any flexibility in the healthcare system, it falls squarely on the shoulders of the people providing care. As author Danielle Ofri, MD, PhD states, "the one resource that seems endless — - [Choice of IBD Therapy Depends on Disease Phenotype](https://ginorthshore.com/2019/06/choice-of-ibd-therapy-depends-on-disease-phenotype/) - Miguel Regueiro, MD, chair of the Department of Gastroenterology, Hepatology and Nutrition at the Cleveland Clinic, discusses how to position therapies for the treatment of inflammatory bowel disease. - [How do you fight fake medical news? With real news!](https://ginorthshore.com/2019/06/how-do-you-fight-fake-medical-news-with-real-news/) - Fake medical news has driven the anti-vaccination movement to the point where the US may lose it's status as "eradicated". Hawksters prey on the suspicion patients have for traditional medicine, and sell detoxifying agents, probiotics, "special" tests, and even parasites and stool transplant kits. How do we combat this? @AustinChiangMD has become a leader in - [C. dif and IBD patients benefit from FMT](https://ginorthshore.com/2019/05/c-dif-and-ibd-patients-benefit-from-fmt/) - Patients with both Clostridiodes difficile infection and inflammatory bowel disease showed improvement after fecal microbiota transplantation, Jessica Allegretti, MD, director of the FMT program at Brigham and Women's Hospital, said during a presentation at Digestive Disease Week. The ICON study took place at four sites across the US. Results for FMT in C. dif alone - [Failed PPI Therapy and Functional Esophageal Disorders](https://ginorthshore.com/2019/05/failed-ppi-therapy-and-functional-esophageal-disorders/) - As many as 45% of patients with gastroesophageal reflux disease (GERD) still have symptoms after receiving a once-daily proton pump inhibitor (PPI) therapy. A recent study by Jason Abdallah and colleagues at MetroHealth Medical Center, Case Western Reserve University School of Medicine, utilized survey, pH, and other data. Although a small trial, the findings showed - [Awareness about fatty liver low in those at risk](https://ginorthshore.com/2019/05/awareness-about-fatty-liver-low-in-those-at-risk/) - Awareness of nonalcoholic steatohepatitis (NASH) and nonalcoholic fatty liver disease (NAFLD) is low among Americans who have risks associated with the diseases, according to a survey presented at the NASH Summit in Boston. Many clinical trials are currently underway regarding pharmacologic interventions in an area where diet and lifestyle are failing to curb rising incidence - [Fecal transplants reduce hospital bills and length of stay](https://ginorthshore.com/2019/05/fecal-transplants-reduce-hospital-bills-and-length-of-stay/) - FMT (or "stool transplant") reduced hospital stays and hospital costs for patients with recurrent C. difficile infection - [Many alternative medicine claims unproven, ineffective for celiac disease](https://ginorthshore.com/2019/05/many-alternative-medicine-claims-unproven-ineffective-for-celiac-disease/) - In a study of 500 alternative medicine providers, a significant number advertised tests or treatments for celiac disease with claims that are either false or unproven, according to Benjamin Lebwohl, MD, director of clinical research at Columbia University's Celiac Disease Center. See the Reuters Article referencing The American Journal of Gastroenterology article here. - [The Microbiome in Cancer](https://ginorthshore.com/2019/05/the-microbiome-in-cancer/) - We understand that the microbiome has emerged as an important consideration in clinical science, and this includes extension into the important world of oncology. The role of the microbiome in cancer is not just limited to causation and cancer risk. We now known that the microbiome modifies immune responses to tumors. It influences the clinical - [Do pets promote your microbiome?](https://ginorthshore.com/2019/04/do-pets-promote-your-microbiome/) - As a new pet owner (meet Jaxon!) I immediately noticed how much "overlap" there is with dog life and my life. Licks, kisses, and paws on you that have been...God knows where. And while I wouldn't trade it for the world, the infectious-conscious doctor in me wonders if this is a good thing or bad - [Anonymous Physician Reviews](https://ginorthshore.com/2019/04/anonymous-physician-reviews/) - Should we ignore anonymous physician reviews? Are they a fair form of free speech? Or are they subject to bias and potentially libelous? See my article on KevinMD.com. Comment here or on the website! - [Think you may have IBS?](https://ginorthshore.com/2019/04/think-you-may-have-ibs/) - It's IBS Awareness Month. Take the easy and free screening test from the ACG by clicking here. - [Even a half-sibling with colon cancer is a high risk factor](https://ginorthshore.com/2019/04/even-a-half-sibling-with-colon-cancer-is-a-high-risk-factor/) - Half-siblings of people with colon cancer have nearly the same colon cancer risk as full siblings do -- a 6% cumulative lifetime risk compared with 7% -- and a higher risk than other second-degree relatives have, researchers recently reported. The risk may be due both to genetics and to shared environmental factors, and the finding - [Is physician burnout really "moral injury"?](https://ginorthshore.com/2019/04/is-physician-burnout-really-moral-injury/) - Physician burnout is really “moral injury”. In combat veterans moral injury is called post-traumatic stress; among physicians it’s portrayed as burnout. It’s a symptom of a bigger problem, the failures of our healthcare system. - [Anxiety, depression prevalent in IBD patients](https://ginorthshore.com/2019/03/anxiety-depression-prevalent-in-ibd-patients/) - Patients with inflammatory bowel disease may also have undiagnosed anxiety and depression, according to a study by Charles Bernstein, MD, of the University of Manitoba in Canada. Researchers evaluated the prevalence of undiagnosed depression and anxiety by analyzing data from a cohort study of psychiatric comorbidity in immune-mediated disorders, including IBD. About a third of - [Colorectal cancer behaves differently in young patients](https://ginorthshore.com/2019/03/colorectal-cancer-behaves-differently-in-young-patients/) - Colorectal cancer is noted to be on the rise in younger patients. This is concerning as rates have steadily declined in other age groups. Although a small percentage overall, the rate of most marked rise in colon cancer is seen in the 20's. New research suggests colorectal cancer is clinically different in younger patients. The - [Does not remembering a procedure make it OK?](https://ginorthshore.com/2019/03/does-not-remembering-a-procedure-make-it-ok/) - An article from New York Times, discusses the possibility of PTSD resulting from unremembered medical procedures using medications like midazolam. Is this possible? I believe it is. If people can be traumatized by injury, sexual assault, and childhood abuse that they have repressed from their memories completely, then why not? - [Dietary factors in IBS](https://ginorthshore.com/2019/02/dietary-factors-in-ibs/) - Two-thirds of patients with IBS attribute their symptoms to dietary factors. Most traditional approaches involving pharmaceuticals are only modestly effective and patients are left seeking alternative approaches, including dietary manipulation. The article referenced below aims to review dietary restrictions as a non-pharmaceutical management approach for IBS. See the article by Drs. Afrin Kamal and Mark - [Female IBD patients report sexual dysfunction](https://ginorthshore.com/2019/02/female-ibd-patients-report-sexual-dysfunction/) - Nearly all women who were diagnosed with inflammatory bowel disease reported sexual problems, according to a study at the University of Minnesota that was published in Inflammatory Bowel Diseases. Scores were similar for patients with Crohn’s disease and ulcerative colitis. Surprisingly, remission of disease did not alleviate the symptoms, according to the study. “This is - [AI in the future of GI](https://ginorthshore.com/2019/02/ai-in-the-future-of-gi/) - There's a common misperception that artificial intelligence refers to robots doing humans work, someone wearing a virtual reality headset, or a machine taking decision-making processes away from human beings. Quite the contrary, artificial intelligence augments the abilities of people involved in complex tasks to make better decisions, quicker decisions, and sort out the wheat from - [Patients' Perceptions of PPI Risks](https://ginorthshore.com/2019/02/patients-perceptions-of-ppi-risks/) - A recent article shows patient safety concerns about PPI's are common and strongly associated with attempts at discontinuation, with or without a provider's recommendation. Patients at high risk for GI bleeding, who clearly benefit from PPI's, were just as likely to have tried stopping PPI's as others. Physicians should always discuss the risks and benefits - [Artificial Intelligence Augments Small Bowel Capsule Interpretation](https://ginorthshore.com/2019/01/artificial-intelligence-augments-small-bowel-capsule-interpretation/) - An artificial intelligence system with deep learning has been proposed to automatically detect erosions and ulcerations in WCE images. - [Rural clinic-pharmacist partnerships improve HCV outcomes](https://ginorthshore.com/2019/01/rural-clinic-pharmacist-partnerships-improve-hcv-outcomes/) - A study published in the Journal of Primary Care & Community Health showed that patients with hepatitis C virus treated at health facilities that served American Indian/Alaska Natives had better outcomes when the clinics collaborated with pharmacists. The study demonstrated that interdisciplinary teamwork improved outcomes in this at-risk and disadvantaged group. This could serve as - [Fluoroquinolone risks expanded](https://ginorthshore.com/2019/01/fluoroquinolone-risks-expanded/) - The FDA recently released results of a review that found an increased risk of aortic ruptures or tears with the use of fluoroquinolones. As part of the safety warning, the FDA has recommendations for providers, including avoidance of fluoroquinolones in patients with a history of aortic aneurysm or those at risk for an aneurysm; to - [Up to 6 mos PPI therapy may not affect bone health](https://ginorthshore.com/2019/01/up-to-6-mos-ppi-therapy-may-not-affect-bone-health/) - Research recently published in the seminal journal Gastroenterology failed to find evidence of alterations in key markers of bone formation and metabolism in postmenopausal women on PPI's. The study examined calcium absorption, serum or urine mineral levels, parathyroid hormone, Vitamin D status, or bone-mineral density with 6 months of PPI therapy. The prospective double-blind study - [IBD patients may see relief of inflammation with antidepressants](https://ginorthshore.com/2019/01/ibd-patients-may-see-relief-of-inflammation-with-antidepressants/) - Inflammatory bowel disease patients who take antidepressants may also get relief from their inflammation, according to a study published in Inflammatory Bowel Diseases. “Apart from improving mood, it is observed that the anti-inflammatory properties of antidepressants may influence the inflammatory response directly,” the authors wrote. “Other research suggests a bidirectional relationship between IBD activity and - [Low-gluten diet benefits may be due to low fiber](https://ginorthshore.com/2018/12/low-gluten-diet-benefits-may-be-due-to-low-fiber/) - Healthy adults had less bloating, increased well-being, and a small but significant weight loss on low-gluten compared with high-gluten diets, a study published in Nature Communications found. However, the study found those benefits may be linked to the diet's dietary fiber rather than lack of gluten. "Gluten-free may not necessarily be the healthy choice many - [IBD patients more likely to get vaccinations after visit](https://ginorthshore.com/2018/12/ibd-patients-more-likely-to-get-vaccinations-after-visit/) - Patients with inflammatory bowel disease and GI cancers were more likely to get vaccinations such as flu shots after a consultation with a health care provider, according to a study published in Alimentary Pharmacology & Therapeutics. IBD and GI cancer patients have a high risk of contracting flu or pneumococcus, but the vaccination rate is - [From our staff to yours, Happy Holidays!](https://ginorthshore.com/2018/12/from-our-staff-to-yours-happy-holidays/) - Blessed to work with the best staff anyone could ask for! Everyone on my team helps us all accomplish everything we do. Have a great 2019, everyone. - [Most patients over 65 don't want life expectancy discussions](https://ginorthshore.com/2018/12/most-patients-over-65-dont-want-life-expectancy-discussions/) - An online survey conducted in 2016 of a nationally representative group of 878 adults ages 65 and older found 59.4% did not want to talk about their life expectancy. Presented with a hypothetical situation that they were not immediately dying but had a shortened life expectancy, 59.9% indicated life expectancy discussions should not be initiated - [Do you spend > 1 hr per day on the toilet?](https://ginorthshore.com/2018/12/do-you-spend-1-hr-per-day-on-the-toilet/) - William Chey, MD, FACG, of the University of Michigan Health System, conducted the survey of 800 patients and 200 gastroenterologists. Shire Pharmaceuticals sponsored the survey. One of the main highlights of the survey, according to Chey, was that more than half of the patients reported that they spent more than an hour a day on - [Cost for GI procedures much higher at hospitals](https://ginorthshore.com/2018/12/cost-for-gi-procedures-much-higher-at-hospitals/) - The CMS said the average amount they pay for a colonoscopy at an ambulatory surgery center is $488, compared with $936 at a hospital outpatient center. This payment does not include the patient's responsibilities, deductibles, copayments, and cost of uncovered services. Still, it underscores important differences in costs, overhead, net charges, and payments on your - [IBD can contribute to sexual dysfunction](https://ginorthshore.com/2018/12/ibd-can-contribute-to-sexual-dysfunction/) - According to a study in Inflammatory Bowel Diseases, patients with inflammatory bowel disease often struggle with body image and sexuality and this could lead to sexual dysfunction. Men with IBD who were younger than 50 and women younger than 40 had a significantly increased risk, the study said. “Inflammatory bowel disease could have a major - [23andMe and GlaxoSmithKline team up using your DNA](https://ginorthshore.com/2018/11/23andme-and-glaxosmithkline-team-up-using-your-dna/) - 23andMe and GSK believe their partnership will accelerate the development of breakthroughs in medicine. Part of this is the concept of personalized medicine, where an individual's genetic makeup is used to determine which drugs might work best for them. Another big part is the development of new drugs altogether. Patrons are asked if they want to - [U.S. has highest rate of drug overdoses](https://ginorthshore.com/2018/11/u-s-has-highest-rate-of-drug-overdoses/) - The United States had more than double the rate of premature overdose deaths of at least 12 comparable countries in a recent study. The study compared the trends and patterns in premature mortality rates among people age 20 – 64 years due to drug overdose. The data was compiled from the 13 members of the Organisation - [FDA approves opioid more powerful than fentanyl](https://ginorthshore.com/2018/11/fda-approves-opioid-more-powerful-than-fentanyl/) - Each time a more powerful drug is developed, there are assurances, studies, and promises. Each sleep aid, narcotic, anxiolytic, and muscle relaxant has been released with "strict monitoring" and "no known adverse effects or dependency". And each time the public is burned in the long run. This poo-pooing of risk, although it may sound far-fetched, - [Weeding out the ‘good’ and ‘bad’ of probiotics for our patients](https://ginorthshore.com/2018/11/weeding-out-the-good-and-bad-of-probiotics-for-our-patients/) - Dr. Hecht is Professor of Medicine and Microbiology/Immunology and Chief, Gastroenterology and Nutrition at Loyola University Chicago. She is the former President of the American Gastroenterological Association. In a guest commentary in cooperation between the American Gastroenterological Association and Healio, Dr. Hecht offers advice on how health care professionals can best discuss probiotics with their patients. See the article - [Most clinical trials show antioxidants do not help healthy individuals](https://ginorthshore.com/2018/11/most-clinical-trials-show-antioxidants-do-not-help-healthy-individuals/) - How does the US supplement market get so big? In the US supplements are reviewed by the FDA, but not approved for any specific use by the organization. That means they are basically keeping an eye out for harmful products, but look the other way on everything else. Since most supplements are proprietary, you aren't even - [Gut Bacteria May Contribute to Multiple Sclerosis](https://ginorthshore.com/2018/10/gut-bacteria-may-contribute-to-multiple-sclerosis/) - A study recently published in the seminal scientific journal Nature suggests that byproducts of microorganisms living in the gut may influence the progression of neurodegenerative diseases, such as multiple sclerosis (MS). The proposed mechanism is via control of the interaction of microglia and astrocytes. Microglia and astrocytes modulate inflammation and neurodegeneration in the central nervous system (CNS). The findings may - [Weight loss after bariatric surgery increases risk of gallstones](https://ginorthshore.com/2018/10/weight-loss-after-bariatric-surgery-increases-risk-of-gallstones/) - Bariatric surgery that brings about rapid weight loss also raises the risk of hospital admissions for pancreatitis, gallstones and other gallbladder conditions by 10 to 100 times, researchers reported at the ACG Annual Scientific Meeting. The researchers said physicians may want to prescribe bile acid sequestrants to patients to reduce the risk of gallstones and - [Crohn’s & Colitis Congress 2019 in Las Vegas](https://ginorthshore.com/2018/10/crohns-colitis-congress-2019-in-las-vegas/) - Assessing which care guideline to follow can be a challenge for many providers who care for patients with inflammatory bowel diseases (IBD). To help IBD health care professionals navigate these complexities, the 2019 Crohn’s & Colitis Congress® will focus its opening session on How to Make Sense of Care Guidelines. See Dr. David Rubin from the University - [No single test identifies reflux as the etiology for extra-esophageal symptoms.](https://ginorthshore.com/2018/10/no-single-test-identifies-reflux-as-the-etiology-for-extra-esophageal-symptoms/) - It is well recognized that reflux can be causal in subgroups of patients with chest and ENT symptoms like asthma, cough, hoarseness, sore throat, sinusitis, and ear pain. However, the possibility of reflux as the cause for a variety of ENT symptoms is both overestimated and often abused. In fact, the cause of extraesophageal symptoms - [To lower the age of screening colonoscopy, or not?](https://ginorthshore.com/2018/09/to-lower-the-age-of-screening-colonoscopy-or-not/) - The recent issue of Clinical Gastroenterology & Hepatology addresses the American Cancer Society's new recommendation to lower the age of initial screening for colon cancer from 50 to 45. The recommendation follows a small spike in younger patients having colon cancer. However, those patients are not necessarily 45-50. Actually, patients in their 20's are the - [PPI's do not raise cardiovascular risk, study says](https://ginorthshore.com/2018/09/ppis-do-not-raise-cardiovascular-risk-study-says/) - Proton pump inhibitor therapy is not connected to an increased risk of cardiovascular disease, according to a study published in Alimentary Pharmacology & Therapeutics. The FDA has discouraged using PPI's with antiplatelet therapy clopidogrel because the drugs work with the same isoenzyme. “Inhibition of CYP2C19 by PPIs may reduce the bioavailability of the active metabolites of - [ACG position statement on antidepressants and psychological therapies in IBS](https://ginorthshore.com/2018/09/acg-position-statement-on-antidepressants-and-psychological-therapies-in-ibs/) - A meta-analysis and review of available supportive therapies for IBS finds that antidepressants are efficacious in reducing symptoms in IBS patients. Psychological therapies also appear to be effective treatments for IBS, although there are limitations in the quality of the evidence, and treatment effects may be overestimated as a result. See the paper here. - [Marital stress and leaky gut?](https://ginorthshore.com/2018/09/marital-stress-and-leaky-gut/) - Yes, that title leads to all kinds of imagery! "Leaky gut syndrome" is a hypothetical condition that is believed to cause chronic inflammation throughout the body and may result in a wide range of conditions. Proposed sequelae include chronic fatigue syndrome, rheumatoid arthritis, lupus, migraines, multiple sclerosis, and autism. The proposed mechanism is that the intestinal - [No microscopic colitis risk with gluten](https://ginorthshore.com/2018/09/no-microscopic-colitis-risk-with-gluten/) - An association between celiac disease and microscopic colitis has long been recognized. A study published in The American Journal of Gastroenterology explored the possibility of non-celiac sensitivity to gluten. The results suggested eating a diet that contains gluten did not increase the risk for microscopic colitis in women who do not already have celiac disease. See - [IBD and Unconventional Remedies](https://ginorthshore.com/2018/09/ibd-and-unconventional-remedies/) - An estimated 30-50%, and possible 60%, of patients with inflammatory bowel disease (IBD) turn to complementary and alternative medicines (CAM's) to ease symptoms and exert more control over their treatment. Very few studies have evaluated CAM's, and many of the studies were small, poorly designed, and uncontrolled. Predictors of CAM use include dissatisfaction with conventional therapies, - [Reflux treatments reduce risk of esophageal cancer](https://ginorthshore.com/2018/08/reflux-treatments-reduce-risk-of-esophageal-cancer/) - GERD affects 10% to 20% of adults in Western populations and has been known to be an increased risk factor for esophageal adenocarcinoma. Research on the association between antireflux medication or surgery and risk for esophageal adenocarcinoma has remained limited, although the typical approach has been to treat reflux aggressively when there are precancerous changes like - [Liver Frailty Index Predicts Mortality Risk](https://ginorthshore.com/2018/08/liver-frailty-index-predicts-mortality-risk/) - The Liver Frailty Index can give physicians better data about the mortality risk of cirrhosis patients than just subjective data, according to a study led by Dr. Jennifer Lai of the University of California at San Francisco. In the study, published in The American Journal of Gastroenterology, 529 patients were tested on grip strength, balance - [Nearly one in 5 IBD patients also has non-C. diff infection](https://ginorthshore.com/2018/08/nearly-one-in-5-ibd-patients-also-has-non-c-diff-infection/) - Almost 1 in 5 patients with symptomatic inflammatory bowel disease also had non-Clostridium difficile enteric infection, according to a study published in The American Journal of Gastroenterology. Although the infections had an effect on treatment, there was no long-term effect. See the article on MedPage Today here. - [Patient-to-patient support very beneficial](https://ginorthshore.com/2018/08/patient-to-patient-support-very-beneficial/) - While using the internet for a diagnosis is not recommended, there’s great power in finding other patients willing to share their own stories. Doctors may be too busy to properly inform or empathize on the level that patients need to hear. They may speak at a technical level well out of reach for most. Besides, - [Liver transplants for HCV cirrhosis on the decline](https://ginorthshore.com/2018/08/liver-transplants-for-hcv-cirrhosis-on-the-decline/) - A retrospective study in the journal Liver International found use of direct-acting antivirals may be associated with the reduced number of patients on a waiting list for a liver transplant for decompensated hepatitis C virus cirrhosis. Researchers found an increase in HCV patients whose indication for liver transplant was hepatocellular carcinoma during the study period, - [Entyvio safe and effective for UC in real-world study](https://ginorthshore.com/2018/08/entyvio-safe-and-effective-for-uc-in-real-world-study/) - An analysis of data from the VICTORY consortium through the University of California at San Diego, as published in The American Journal of Gastroenterology, found vedolizumab effective in ulcerative colitis. Cumulative rates of endoscopic remission and clinical remission were the main effectiveness outcomes of the review. Researchers analyzed secondary outcomes measures of cumulative rates of - [49% of Americans are concerned about healthcare data security](https://ginorthshore.com/2018/08/49-of-americans-are-concerned-about-healthcare-data-security/) - Almost half of Americans are extremely or very concerned about their healthcare data security, such as diagnoses, health history, and test results, according to a survey of more than 2,000 US adults by The Harris Poll on behalf of healthcare marketing firm Scout. The survey also found that US adults are most concerned about previously diagnosed medical - [Study Supports Safety of Infliximab in Pregnancy](https://ginorthshore.com/2018/08/study-supports-safety-of-infliximab-in-pregnancy/) - An analysis of data from the TREAT Registry found that babies born to women who continued to treat their Crohn's disease with infliximab during pregnancy had outcomes similar to those who did not take the drug. "The majority of both maternal pregnancies and partner outcomes resulted in live births of healthy infants across exposure groups" - [Fecal occult blood tied to elevated all-cause mortality risk](https://ginorthshore.com/2018/08/fecal-occult-blood-tied-to-elevated-all-cause-mortality-risk/) - Patients with detectable fecal hemoglobin or a positive guaiac fecal occult blood test result face a higher risk of dying from colorectal cancer, compared with those who had a negative test result, according to a study in Gut. This is as expected, as blood in the stool is a well-known sign of potential colon cancer. - [Mailed FIT kits nearly double colon cancer screening rates](https://ginorthshore.com/2018/08/mailed-fit-kits-nearly-double-colon-cancer-screening-rates/) - A study of Medicaid patients showed that those who received fecal immunochemical tests (FIT) in the mail were more likely to complete colorectal cancer screening than those who were just reminded. Colorectal cancer is more treatable if caught early, but only about 63% of the population is screened, and the rate drops further among vulnerable - [Doctor aims to lead by example with screening colonoscopy](https://ginorthshore.com/2018/08/doctor-aims-to-lead-by-example-with-screening-colonoscopy/) - Dr. Rob Allison, a physician in Pierre, S.D., has no history or symptoms of colon cancer but got his first colonoscopy at age 50 to encourage others to get the screening. Allison says the procedure is quick, painless and potentially lifesaving. See the video from KSFY (ABC-TV) here. - [Identifying IBS biomarkers will improve treatment](https://ginorthshore.com/2018/08/identifying-ibs-biomarkers-will-improve-treatment/) - Identifying biomarkers and symptoms will allow doctors to shorten the length of time it takes to find an effective treatment for IBS patients, writes Dr. William Chey of Michigan Medicine. IBS is not a single disease but likely is several issues that have similar symptoms, Chey writes. Unfortunately, no reliable markers which distinguish the subtypes - [Bariatric surgery linked to higher colorectal cancer risk](https://ginorthshore.com/2018/07/bariatric-surgery-linked-to-higher-colorectal-cancer-risk/) - Bariatric surgery doubles a patient's risk for colorectal cancer, UK researchers reported in the British Journal of Surgery. Researchers studied a cohort of 8,794 patients who underwent gastric bypass, sleeve gastrectomy or gastric banding. However, bariatric surgery was also associated with a five-fold decrease in the risk of hormone-related cancers (breast, endometrium, and prostate). The - [Celiac disease tied to functional dyspepsia](https://ginorthshore.com/2018/07/celiac-disease-tied-to-functional-dyspepsia/) - Celiac disease patients experience higher rates of functional dyspepsia, according to a study in The American Journal of Gastroenterology. Researchers also found an association between self-diagnosed wheat sensitivity (with no history of celiac disease, inflammatory bowel disease, or colorectal cancer) and irritable bowel syndrome. See the article on Clinical Advisor here. - [IBS may be diagnosed with bowel sounds](https://ginorthshore.com/2018/06/ibs-may-be-diagnosed-with-bowel-sounds/) - Nobel Prize winning gastroenterologist Barry Marshall discusses research in which the diagnosis of IBS may be made with bowel sound analysis. The underlying processes which lead to symptoms of IBS are well studied, well characterized, but not well understood in their entirety. Abnormalities of perception, gut rhythm, stool production, the microbiome, and the neuroendocrine system - [Colonoscopy starting age changed to 45](https://ginorthshore.com/2018/05/colonoscopy-starting-age-changed-to-45/) - In response to an increase in colorectal cancer rates in younger people, the American Cancer Society released a change in its screening guidelines to recommend adults at average risk begin CRC screening starting at age 45 instead of 50. Not all health societies, government models, or payors have responded yet. However, the news does reflect - [Young, obese African-Americans have more severe NAFLD](https://ginorthshore.com/2018/05/young-obese-african-americans-have-more-severe-nafld/) - Obese African-American youths had more severe nonalcoholic fatty liver disease, but overall NAFLD was more common among obese white or Hispanic youth, according to a study in Hepatology. Earlier studies have shown Hispanic adults and children had the highest rates of NAFLD, while African-Americans have a lower likelihood of developing hepatic fat accumulation. See the - [Few with celiac indications get tested](https://ginorthshore.com/2018/05/few-with-celiac-indications-get-tested/) - About 38% of 400 patients with undiagnosed celiac disease had one or more indicators for testing, but only 4.4% received testing, according to a study in the journal Alimentary Pharmacology and Therapeutics. "Gastroenterologists should think about celiac disease more broadly -- not just as a gastrointestinal condition but also as a systemic disorder with multiple - [Couldn't we do so much more with a truly integrated EHR?](https://ginorthshore.com/2018/05/couldnt-we-do-so-much-more-with-a-truly-integrated-ehr/) - One of the great promises of the push to EHR's was the integration of risk across multiple related people. Sure, it's nice to not have medical errors come up due to bad handwriting, and even nicer to have a linear record of your health--we won't get started on the idea of being able to access - [US cancer incidence, mortality rates decreasing](https://ginorthshore.com/2018/05/us-cancer-incidence-mortality-rates-decreasing/) - The Annual Report to the Nation on the Status of Cancer found cancer diagnoses and deaths in the US overall have been decreasing for men and women, mainly due to better treatments, prevention and screening in colorectal, lung and breast cancers. Prostate cancer death rates stabilized, however, after years of decline, and cases of oral - [Biosimilars in Europe lead to lower prices](https://ginorthshore.com/2018/05/biosimilars-in-europe-lead-to-lower-prices/) - Dr. Jonathan Kay of the University of Massachusetts Medical School told the 2018 Interdisciplinary Autoimmune Summit that biosimilar competition in Europe has reduced drug costs, made biosimilars more available and increased market share for some bio-originators. The European Union has approved 41 biosimilar drugs while the FDA has approved nine. Biosimilars in Europe lead to - [Online reviews influence patients' choice of physicians](https://ginorthshore.com/2018/05/online-reviews-influence-patients-choice-of-physicians/) - An Oliver Wyman survey of 4,000 consumers, presented at the Health Datapalooza conference, showed that 83% use online patient-generated reviews to choose a physician. Respondents said the medical practice qualities they look for the most are professional skill, shared decision-making, respectful treatment of patients, responsiveness to phone calls and acceptance of insurance. Online reviews influence - [Study links high BMI to failures with UC](https://ginorthshore.com/2018/05/study-links-high-bmi-to-failures-with-uc/) - Research published in the journal Alimentary Pharmacology & Therapeutics found ulcerative colitis patients with higher BMIs had a greater likelihood of biologic treatment failure. Increases in BMI also were associated with a higher risk of surgery or hospitalization. The reasons might be related to endogenous steroid production, misuse of medical steroids, or underdosing of conventional - [$300 hepatitis C cure as effective as $84,000 regimen?](https://ginorthshore.com/2018/04/300-hepatitis-c-cure-as-effective-as-84000-regimen/) - Trials are underway to evaluate an affordable hepatitis C treatment. So far, the therapy has been shown to be safe and effective, with very high cure rates for patients including hard-to-treat cases. The interim clinical trial results offers hope to the 71 million people living with the disease worldwide. The Drugs for Neglected Diseases initiative (DNDi), a - [Synthetic Cannabinoids Linked to Deaths from Bleeding](https://ginorthshore.com/2018/04/synthetic-cannabinoids-linked-to-deaths-from-bleeding/) - There have been three deaths in Illinois that have been linked to the use of synthetic cannabinoid products. The Centers for Disease Control and Prevention (CDC) issued warnings regarding potential side effects from these drugs, including from major bleeding episodes. Synthetic cannabinoids are man-made drugs that have similar chemical structures to those found in marijuana - [Jimmy Kimmel gets Live! Colonoscopy](https://ginorthshore.com/2018/03/jimmy-kimmel-gets-live-colonoscopy/) - https://youtu.be/10ndJuFP1PY - [Big government protects from Pharma, but not Alcohol](https://ginorthshore.com/2018/03/big-government-protects-from-pharma-but-not-alcohol/) - MedPage Today reports two interesting pieces of reporting simultaneously this week. First, Public Citizen published a report showing from 1991 through 2017, a total of 412 legal settlements were reached between the federal and state governments and pharmaceutical manufacturers. The fines, settlements, and fees comprised a whopping total of $38.6 billion. For 2016 and 2017, 38 settlements - [Long-term PPI use no greater risk for Alzheimer’s patients](https://ginorthshore.com/2018/03/long-term-ppi-use-no-greater-risk-for-alzheimers-patients/) - Several articles have shown an increased risk of fractures with PPI use as patients get older. Sanna Torvinen-Kiiskinen, PhD, of Kuopio Research Centre of Geriatric Care at the University of Eastern Finland, and colleagues wrote that an association between proton pump inhibitor (PPI) use and risk for fractures remains unclear due to contradictory study findings, and - [Fecal Profiling May Predict Response in IBS](https://ginorthshore.com/2018/03/fecal-profiling-may-predict-response-in-ibs/) - Researchers conclude that fecal profiling of volatile organic compounds (VOC's) may provide a low cost, non-invasive tool to predict the responses of irritable bowel syndrome (IBS) patients to probiotics and diets low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP's). Modeling baseline fecal VOC's, and using key features of VOC profiles, correctly predicted response to - [Lawmakers call for increased efforts on colon cancer](https://ginorthshore.com/2018/03/lawmakers-call-for-increased-efforts-on-colon-cancer/) - Two US House lawmakers say more must be done to reduce the mortality rate associated with colorectal cancer, including funding research into preventing and treating the disease. Rep. Donald Payne, D-N.J., and Rep. Charlie Dent, R-Pa., are sponsoring the bill. The Removing Barriers to Colorectal Cancer Screening Act, in part corrects a glitch in Medicare - [Peer support grows in young cancer survivors](https://ginorthshore.com/2018/03/peer-support-grows-in-young-cancer-survivors/) - Teens and young adults who are cancer survivors appear to have more social networks and support than those who have not had cancer, according to a study in the journal Cancer. Overall, the cancer survivors were found to have more emotional and other types of support and to get more advice on health topics such - [TV watching increases risk of colorectal cancer](https://ginorthshore.com/2018/03/tv-watching-increases-risk-of-colorectal-cancer/) - A recent study showed that men who watched more than four hours of TV daily had a 35% higher risk of colorectal cancer, compared with those who watched for no more than one hour per day. The study did not find a similar association among women but noted that men with higher levels of physical activity had - [Childhood Crohn's Progression Halted by Biologics](https://ginorthshore.com/2018/03/childhood-crohns-progression-halted-by-biologics/) - In children with Crohn's Disease, early use of biologic therapies helped prevent disease progression. However, it did not delay or avoid the need for surgery. Among 1,442 children with Crohn's disease enrolled in the Pediatric Inflammatory Bowel Disease Collaborative Research Group registry from 2002 to 2014, the risk of disease progression from inflammation alone to stricturing - [Bariatric Surgery and IBD Risk](https://ginorthshore.com/2018/03/bariatric-surgery-and-ibd-risk/) - A study published in Alimentary Pharmacology & Therapeutics showed bariatric surgery increased the odds of developing inflammatory bowel disease for some patients. Researchers said the risk was small and did not outweigh the benefits of weight-loss surgery. A longer length of time from surgery correlated with increased risk. Patients whose surgery had been done more - [Microbots Could Deliver Drugs by Tumbling Through the Body](https://ginorthshore.com/2018/02/microbots-could-deliver-drugs-by-tumbling-the-body/) - A new type of microbot that moves by tumbling through almost any kind of terrain--even liquids--could help usher in a new medical era. The tiny machines could be used for various medical applications, including super-focused drug delivery, breaking up blood clots, or closing off bleeding vessels. The “microscale magnetic tumbling robot,” or μTUM (microTUM), is about - [](https://ginorthshore.com/2018/03/944/) - A study in the journal Gut found taking daily calcium supplements may increase the risk of serrated colon polyps, a precursor lesion to colon cancer. People who took calcium or calcium plus vitamin D were more likely to develop polyps from six to 10 years after the study began, but calcium from dietary sources was - [Early colonoscopy changes outcome - a case example](https://ginorthshore.com/2018/03/early-colonoscopy-changes-outcome-a-case-example/) - Shawn Ryan's colorectal cancer was discovered during a routine colonoscopy at a stage where an advanced laparoscopic procedure could be used to remove it, sparing the New Jersey man from needing a colostomy. I find that people's biggest fear about the G.I. tract in general is the need for a colostomy. It is important to - [Nitrates may increase colon cancer risk](https://ginorthshore.com/2018/02/nitrates-may-increase-colon-cancer-risk/) - A recent study suggests nitrates in drinking water were associated with a higher risk of colorectal cancer. Researchers from Aarhus University in Denmark reported in the International Journal of Cancer wrote that exposure to the highest nitrate levels raised the risk of colorectal cancer by 15%, compared with exposure to the lowest concentrations. These findings - [How to Talk with Your Patients About PPIs and Cognitive Decline](https://ginorthshore.com/2018/02/how-to-talk-with-your-patients-about-ppis-and-cognitive-decline/) - From the AGA website, here is a nice review of the data thus far and how to alleviate your patients' concerns. See the AGA review here. - [Highly Processed Foods Tied to Higher Cancer Risk](https://ginorthshore.com/2018/02/highly-processed-foods-tied-to-higher-cancer-risk/) - Every 10 percent dietary increase in packaged snacks, fizzy drinks, sugary cereals and other highly processed foods boosts the risk for cancer by 12 percent, new research suggests. In several developed countries, ultra-processed foods may make up as much as 50 percent of the daily diet, the researchers noted. This includes convenience foods, such - [California investigates Aetna as medical director admits under oath he never looked at records](https://ginorthshore.com/2018/02/california-investigates-aetna-as-medical-director-admits-under-oath-he-never-looked-at-records/) - It has been long understood that insurance companies make money by balancing collection of premiums with distribution of care. Accusations that this is tantamount to denying care for profits are hard to ignore after a recent revelation--under oath--that Aetna's Medical Director routinely made decisions about whether or not to pay for care without ever looking - [12% of Adults Meet Criteria for Functional Dyspepsia](https://ginorthshore.com/2018/02/12-of-adults-meet-criteria-for-functional-dyspepsia/) - Symptoms meeting the Rome IV criteria for functional dyspepsia were found in 12% of US adults and 8% of people in the UK and Canada, researchers reported in The Lancet Gastroenterology & Hepatology. The most common subtypes were postprandial distress syndrome, epigastric pain syndrome and both syndromes together. These individuals had more-impaired health and used more - [Study links esophageal cancer risk to hot tea, tobacco, alcohol](https://ginorthshore.com/2018/02/study-links-esophageal-cancer-risk-to-hot-tea-tobacco-alcohol/) - A recent study in the Annals of Internal Medicine found people who consumed very hot tea and alcohol every day had a fivefold higher risk of esophageal cancer, compared with those who drank tea less than once per week and consumed less than 15 grams of alcohol daily. People who drank very hot tea daily - [Biomarkers Associated with Response to Vedolizumab](https://ginorthshore.com/2018/02/biomarkers-associated-with-response-to-vedolizumab/) - Vedolizumab is an anti-α4β7 monoclonal antibody approved for the treatment of inflammatory bowel disease (IBD). A recent study finds that pretreatment α4β7 expression and α4β7 receptor saturation during maintenance therapy were identified as candidate biomarkers for vedolizumab response. This assay leads to promise that we will be able to identify good candidates for biologic therapies - [FDA warns of opioid in loperamide](https://ginorthshore.com/2018/02/fda-warns-of-opioid-in-loperamide/) - The FDA sent letters to manufacturers of loperamide, a longstanding and commonly used treatment for diarrhea, asking them to change the size of the drug's packaging to limit the amount of opioid drugs in the package. The agency aims to discontinue the large bottles in which loperamide is often sold to deter its abuse. See - [Bariatric surgery reduces risk for certain cancers](https://ginorthshore.com/2018/02/bariatric-surgery-reduces-risk-for-certain-cancers/) - Bariatric surgery appears to reduce the risk for colon, breast, endometrial, pancreatic and other cancers, according to a review of medical data from 22,198 bariatric surgery patients. Overall, bariatric surgery was associated with a 40% risk reduction for 13 obesity-related cancers and a 23% reduction in risk for other cancers. See the article on Healio - [Opioid Overuse in Functional Abdominal Pain](https://ginorthshore.com/2018/02/opioid-overuse-in-functional-abdominal-pain/) - A nationwide study of Veterans Health Administration patients found a high percentage with functional abdominal pain received a prescription for an opioid medication during a 1-year period. The risks of opioid overuse has reached epidemic proportions and has received national attention. Compared with patients who had a structural GI disorder such as inflammatory bowel disease - [Death Rate Falls with Anti-TNF's](https://ginorthshore.com/2018/01/death-rate-falls-with-anti-tnfs/) - Reduced mortality was seen in Crohn's patients with comorbidities who have been treated with anti-TNF's, but primarily compared to those treated with prolonged steroids. There was a trend to positive outcomes for UC patients, but it did not meet statistical significance. Among 1,879 Crohn's patients initiating anti-TNF therapy, there was a significantly lower risk of - [Robotic Surgery in Esophageal Cancer](https://ginorthshore.com/2018/01/robotic-surgery-in-esophageal-cancer/) - Robot-assisted surgeries are becoming more commonplace, and having greater success. They have become state of the art for prostatic and pelvic surgeries and have a widespread recognition for being superior in the right hands. A recent randomized trial showed robotic laparoscopic esophagectomy led to significantly fewer complications while achieving similar cancer control, compared with open - [Esophageal allergy testing via prick test](https://ginorthshore.com/2018/01/esophageal-allergy-testing-via-prick-test/) - An esophageal prick test similar to the skin testing commonly used by Allergists, appears promising in a new article. The process, in which allergens are injected directly into the esophageal mucosa, appears to identify individuals with esophageal sensitization, researchers report in the January issue of Gastroenterology. The tests provide a meaningful alternative in the evaluation of - [Promising Hepatitis B Therapies](https://ginorthshore.com/2018/01/promising-hepatitis-b-therapies/) - A number of promising drugs in the pipeline can lower hepatitis B virus (HBV) DNA and antigen levels. Some may offer a functional cure for selected individuals, but agents that offer a reliable cure for most patients are not yet on the horizon. This would be expected to substantially reduce the likelihood of liver disease progression - [Common Food Additive May promote C. diff](https://ginorthshore.com/2018/01/common-food-additive-may-promote-c-diff/) - An article appearing in Nature suggested that a common food additive known as trehalose might be responsible for the current Clostridium difficile epidemic. The Nature paper shows us that two of the most virulent strains of C. diff, including the "hypervirulent" ribotype 027, can metabolize even trace amounts of trehalose. They go on to show that when strains are mixed together, low - [Cross-Epidemic of Hepatitis C with Diabetes, Obesity, and Kidney Disease](https://ginorthshore.com/2018/01/cross-epidemic-of-hepatitis-c-with-diabetes-obesity-and-kidney-disease/) - A cross-sectional and prospective analyses of 13,726 participants in the third National Health and Nutrition Examination Survey found that individuals with chronic hepatitis C have a high burden of major cardiometabolic comorbidities. Diabetes and chronic kidney disease, in particular, are associated with substantial excess mortality in persons with chronic hepatitis C. See the article - [Anesthesia Hand Off Mid-Surgery Increases Risk](https://ginorthshore.com/2018/01/anesthesia-hand-off-mid-surgery-increases-risk/) - Having an anesthesiologist hand off care and leave during the middle of a surgery was associated with worse outcomes for the patient on the operating table. Combined mortality, hospital readmission, and major complications within 30 days after the operation reached a rate of 44% when a handover between anesthesiologists occurred during surgery versus 29% when - [MR Enterography and Small-Bowel Healing in Crohn's](https://ginorthshore.com/2018/01/mr-enterography-and-small-bowel-healing-in-crohns/) - A Japanese study published in The American Journal of Gastroenterology showed magnetic resonance enterography (MRE) may effectively evaluate small-bowel endoscopic healing in Crohn's disease and predict patient outcomes similar to balloon-assisted small bowel enteroscopy (BAE). Researchers found patients who did not show small-bowel healing on MRE or BAE had a higher risk of relapse, hospitalization - [GERD linked to head and neck cancer risk](https://ginorthshore.com/2018/01/gerd-linked-to-head-and-neck-cancer-risk/) - According to a study published online Dec. 21 in JAMA Otolaryngology-Head & Neck Surgery, data for 13,805 patients aged 66 and older found that gastroesophageal reflux disease was linked to an increased risk of malignancy of the larynx, oropharynx, hypopharynx, tonsil, nasopharynx and paranasal sinuses. "GERD is associated with the presence of malignancy of the (upper aerodigestive - [Evidence for risks of PPI is weak](https://ginorthshore.com/2018/01/evidence-for-risks-of-ppi-is-weak/) - Experts say even though studies have linked proton pump inhibitor use to multiple health problems, the scientific evidence overall is weak, which should help providers reassure concerned patients and avoid unnecessary discontinuation of PPI use. The attention on PPI safety, however, does offer an opportunity for practitioners to discuss limiting use of the drugs because - [FDA issues guidance on gluten labeling for drugs](https://ginorthshore.com/2018/01/fda-issues-guidance-on-gluten-labeling-for-drugs/) - The FDA released draft recommendations for including gluten content on labels for oral drug products, saying the goal is to reduce uncertainty among health care practitioners and patients. Most oral medications contain very little or no gluten, the agency said. See the review on Healio (free registration) - [Fatty liver may predict polyp risk](https://ginorthshore.com/2018/01/fatty-liver-may-predict-polyp-risk/) - A fatty liver index of 30 or greater was tied to a greater risk of colorectal adenoma, and high-index patients had more adenomas and more advanced adenomas than those with a low-index, according to a study in the Diseases of the Colon & Rectum. "The high fatty liver index may be a useful predictor of - [Product protects gut from antibiotics](https://ginorthshore.com/2018/01/product-protects-gut-from-antibiotics/) - A new study shows a product based on activated charcoal protects the gut microbiome in patients taking antibiotics. The Phase I clinical trial showed promising results. The study reported in the Journal of Infectious Diseases compared DAV132, with a placebo. “DAV132 was highly effective to protect the gut microbiome of moxafloxacin-treated healthy volunteers and may - [Hi-Def Colonoscopy for IBD](https://ginorthshore.com/2017/12/hi-def-colonoscopy-for-ibd/) - A recent study in The American Journal of Gastroenterology found high-definition colonoscopy was as effective as dye spraying chromoendoscopy and virtual chromoendoscopy in the detection of neoplastic lesions in patients with inflammatory bowel disease. We use high-definition endoscopy at The Endoscopy Center of the North Shore, as well as Evanston and Glenbrook Hospitals. Read the - [Homemade Yogurt Resolved IBS in Study](https://ginorthshore.com/2017/12/homemade-yogurt-resolved-ibs-in-study/) - Consuming 2 to 3 cups of homemade yogurt daily led to a remission of IBS in 89% of participants in a study at two medical centers in eastern Kentucky presented at the World Congress of Gastroenterology at ACG2017. Although some study designs were noted, the experiment showed promise. See the review on Medscape here. - [Colonoscopies at Hospitals Cost Medicare 164% More Than Offices](https://ginorthshore.com/2017/12/colonoscopies-at-hospitals-cost-medicare-164-more-than-offices/) - Colonoscopies cost Medicare 164% more when they're performed in a hospital outpatient department rather than independent physician offices, according to a recent report by Physicians Advocacy Institute and Avalere. The study showed the stark disparity in payment between settings based on ownership. "Hospital consolidation pushes healthcare costs upward," said Robert Seligson, president of Physicians Advocacy - [Fatty Liver Linked to Brain Atrophy](https://ginorthshore.com/2017/12/fatty-liver-linked-to-brain-atrophy/) - A study in JAMA Neurology linked fatty liver disease to an accelerated risk of atrophic brain disease compared to normal aging. Researchers said NAFLD did not appear to be linked to indications of other brain injuries or stroke. The reduced brain volume linked to non-alcoholic fatty liver disease (NAFLD) is equivalent to an extra 4.2 - [FODMAP Diet Better for IBS](https://ginorthshore.com/2017/12/fodmap-diet-better-for-ibs/) - A low FODMAP diet was more effective at improving symptoms than general dietary advice (GDA) in a study published in the Journal of Gastroenterology and Hepatology. Gastrointestinal symptoms , stool frequency, and consistency improved after six weeks in the FODMAP group. However, both groups experienced reductions in symptom severity, abdominal pain, distension, consistency and frequency. - [Artificial Intelligence Improves Colonoscopy](https://ginorthshore.com/2017/12/artificial-intelligence-improves-colonoscopy/) - The use of artificial intelligence can increase the accuracy and sensitivity of adenoma detection during colonoscopy, even for small lesions, a new study shows. The results were discussed by Dr. William Karnes of the University of California at Irvine at the World Congress of Gastroenterology at ACG 2017. Dr. Yuichi Mori of Showa University in - [Bacteria linked to esophageal cancer](https://ginorthshore.com/2017/12/bacteria-linked-to-esophageal-cancer/) - Patients with higher levels of Tannerella forsythia bacteria, which can be associated with gum disease, may have a greater risk of esophageal cancer. The increase may be as much as 21% according to a study in Cancer Research. Other bacteria, for example Streptococcus and Neisseria bacteria, were linked to decreased risk. "Our study indicates that - [Neurologic Manifestations in IBD](https://ginorthshore.com/2017/12/neurologic-manifestations-in-ibd/) - Neurologic involvement in inflammatory bowel disease (IBD) is uncommon but probably underreported, and gastroenterologists must be ready to recognize it. For example, peripheral neuropathy is reported to occur in up to 13% of IBD patients. Neurologic complications due to nutritional deficiencies are thought to be even more common. Complications may arise spontaneously from the systemic inflammation - [Large study links moderate coffee consumption to health benefits](https://ginorthshore.com/2017/12/large-study-links-moderate-coffee-consumption-to-health-benefits/) - Drinking coffee might reduce the risks for cardiovascular disease, cardiovascular mortality and all-cause mortality in most people, but those benefits wane after about three cups a day, according to a review of 218 meta-analyses published in The BMJ. Coffee consumption was linked to lower rates of liver disease, diabetes and some cancers; however, the researchers - [Healthier lifestyle could cut risk of diverticulitis in half](https://ginorthshore.com/2017/11/healthier-lifestyle-could-cut-risk-of-diverticulitis-in-half/) - A study in the American Journal of Gastroenterology found that following an overall low-risk lifestyle could reduce the risk of diverticulitis by 50%. Elements of a low-risk lifestyle included reduced intake of red meat, increased intake of dietary fiber, vigorous exercise, a normal BMI and no history of smoking. “Diverticulitis is actually a very common - [Liver disease risk tied to Metabolic Syndrome and Alcohol](https://ginorthshore.com/2017/11/liver-disease-risk-tied-to-metabolic-syndrome-and-alcohol/) - Finnish researchers found that individuals with diabetes or a high waist circumference who consumed higher average amounts of alcohol were at an increased risk of developing liver disease. The findings in the journal Hepatology, based on an analysis of the Finnish Health 2000 study data involving 6,732 individuals without liver disease, revealed that the - [Peripheral blood eosinophilia may be biomarker of severe IBD](https://ginorthshore.com/2017/11/peripheral-blood-eosinophilia-may-be-biomarker-of-severe-ibd/) - A longitudinal study in the American Journal of Gastroenterology found that elevated peripheral blood eosinophils found in the white-cell differential of blood tests might better predict the severity of inflammatory bowel disease in a subgroup of patients. "These results are very important, as we are always searching for predictors of more severe disease in order - [IBS patients see improvements with hypnotherapy](https://ginorthshore.com/2017/11/ibs-patients-see-improvements-with-hypnotherapy/) - A study found 40% of irritable bowel syndrome patients treated with individual hypnotherapy, and 34% in group hypnotherapy, reported sufficient relief of discomfort and pain after three months, compared with 17% of those who received education and supportive care, researchers reported at United European Gastroenterology Week 2017. A second study presented at the conference showed - [Celiac disease linked to many other medical conditions](https://ginorthshore.com/2017/11/celiac-disease-linked-to-many-other-medical-conditions/) - An analysis of the Explorys database, which contains EHR data from 26 major US health care systems, linked celiac disease with a range of medical conditions, including gastroesophageal reflux disease, pancreatitis, colitis and autism, researchers reported at the World Congress of Gastroenterology at ACG2017. The rate of celiac disease is almost 20 times higher in - [Fatty liver disease may increase cancer risks](https://ginorthshore.com/2017/11/fatty-liver-disease-may-increase-cancer-risks/) - NAFLD Linked to Higher Incidence Rates of Cancer Significantly associated with HCC, colon cancer in men, and breast cancer in women Nonalcoholic fatty liver disease (NAFLD) was tied to an increased risk of hepatocellular carcinoma (HCC), colorectal cancer in men, and breast cancer in women, South Korean researchers found. Adjusted results from an observational meta-analysis - [42% of cancer cases linked to 17 modifiable risks](https://ginorthshore.com/2017/11/42-of-cancer-cases-linked-to-17-modifiable-risks/) - New research examined a total of 1,570,975 cancer cases. During the analysis, 26 cancer types and 17 risk factors were analyzed. These 17 risk factors are called "modifiable" because people can take active measures to change them. In the new study, such factors included: alcohol intake smoking (both first- and second-hand) excess body weight a low content of - [Preparation Crucial for Adolescents Transferring to Adult IBD Care](https://ginorthshore.com/2017/11/preparation-crucial-for-adolescents-transferring-to-adult-ibd-care/) - Psychological readiness, logistical barriers, appropriate selection of adult care providers is key. See the article on MedPage here. - [Opioid use worsens C. dif](https://ginorthshore.com/2017/10/opioid-use-worsens-c-dif/) - A study presented at the World Congress of Gastroenterology found patients with Clostridium difficile who received opioids during their hospital stay had higher rates of complicated infection and in-hospital mortality and longer length of average hospital stay, compared with patients in the control group. The findings were based on medical records of 302 patients hospitalized - [Native Americans Highest HCV Rates](https://ginorthshore.com/2017/10/native-americans-highest-hcv-rates/) - Within the U.S., Native American populations have the highest incidence of acute hepatitis C (HCV) infection of any racial or ethnic group. They also have a significantly greater risk for HCV-related mortality than the general population and are an important group to target in efforts to eliminate the disease. According to the Centers for Disease - [GERD symptoms tied to psychological factors](https://ginorthshore.com/2017/10/gerd-symptoms-tied-to-psychological-factors/) - A study in The American Journal of Gastroenterology found that people who did not get heartburn symptom relief from standard treatments but did not have detectable reflux tended to experience more distress and have a poorer quality of life, while symptoms for those with diagnosed gastroesophageal reflux disease who did not respond to proton - [VA's Hep C models could reduce disease burden](https://ginorthshore.com/2017/10/vas-hep-c-models-could-reduce-disease-burden/) - The U.S. Department of Veterans Affairs (VA) has developed models of care that can be used to reduce the overall burden of hepatitis C virus (HCV) infection. More than 92,000 veterans with HCV have been treated by the VA since January 2014. Their cure rates have exceeded 90 percent. Expansion of treatment capacity through - [Airway Disease and IBD](https://ginorthshore.com/2017/09/airway-disease-and-ibd/) - Shared inflammatory pathways and genetics may predispose patients with respiratory conditions to developing IBD Ever-mounting evidence is strengthening the link between inflammatory bowel disease (IBD) and immune-mediated respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). Research has suggested that IBD and airway illnesses likely share common inflammatory pathways as well as predisposing - [Gender-Specific IBD Burden Heavier for Women](https://ginorthshore.com/2017/09/gender-specific-ibd-burden-heavier-for-women/) - Safe conception and pregnancy during treatment, but also at issue: body image, sexuality, cervical cancer risk Inflammatory bowel disease (IBD), affecting approximately one in 500 people in the United States, occurs about equally in men and women. But gender-specific physiologic and psychological differences can have an impact on patient care and outcomes, especially in females - [Use domperidone with caution](https://ginorthshore.com/2017/09/use-domperidone-with-caution/) - Clinicians should advise patients taking domperidone for gastroparesis to inform their other heath care practitioners and check to ensure there are no interactions with other medications, writes ACG Past President Dr. David Johnson of the Eastern Virginia Medical School. An American College of Gastroenterology guideline states that gastroparesis patients who cannot take metoclopramide can use - [Recurrence of reflux after surgery](https://ginorthshore.com/2017/09/recurrence-of-reflux-after-surgery/) - A study found 17.7% of patients who had primary laparoscopic anti-reflux surgery experienced recurrent gastroesophageal reflux disease, researchers reported in the Journal of the American Medical Association. For patients who had recurrent reflux, 16.4% had a second surgery and 83.6% went on long-term anti-reflux medication. Study: 17.7% of patients get GERD after anti-reflux surgery - [Adenomatous polyps higher in blacks than predicted](https://ginorthshore.com/2017/09/adenomatous-polyps-higher-in-blacks-than-predicted/) - Results from a small group of mostly black patients who participated in a free screening colonoscopy initiative at an urban hospital showed adenomas were found in 78.8%, while advanced adenomas were found in 35%, researchers told the American Society for Clinical Pathology's annual meeting. Dr. Muhammed Hassan of Howard University Hospital said more research is - [A perfect playlist for colonoscopy prep?](https://ginorthshore.com/2017/09/a-perfect-playlist-for-colonoscopy-prep/) - Here's a hilarious list of music that might be appropriate--or inappropriate!--for your "private time" while prepping for a colonoscopy: Retired cantor Janice Woltag Cohen just turned 50. We Boomers all know what that means. It’s Colonoscopy Time! A colonoscopy! That fabulous 50th birthday present you give to yourself. Yes, it’s yucky. But it’s absolutely necessary. - [Women injecting drugs at higher risk for Hep C than men](https://ginorthshore.com/2017/09/women-injecting-drugs-at-higher-risk-for-hep-c-than-men/) - The risk of becoming infected with the hepatitis C virus is 39% higher for women who inject drugs compared with their male counterparts, according to findings published in the journal Clinical Infectious Diseases. The study evaluated data from seven studies on HIV and HCV involving 1,868 people in the US, Australia and Europe who inject - [San Diego Health Emergency from Hepatitis A Outbreak](https://ginorthshore.com/2017/09/san-diego-health-emergency-from-hepatitis-a-outbreak/) - Cases linked to the outbreak of Hepatitis A were first reported in November. As of Friday, more than 15 people in the area have died from hepatitis infections and more than 350 others are ill. San Diego's homeless population has been hit hardest by the highly contagious hepatitis A virus. According to the World Health Organization most - [Delay in IBD diagnosis may be linked to stunted growth in children](https://ginorthshore.com/2017/08/delay-in-ibd-diagnosis-may-be-linked-to-stunted-growth-in-children/) - Canadian researchers found an independent correlation between delay in pediatric inflammatory bowel disease diagnosis and height impairment, with every one standard deviation decrease in height-to-age z-score tied to a nearly 70% higher diagnostic delay risk. The findings in the Archives of Disease in Childhood also showed an independent link between bloody diarrhea and a reduced - [Factors identified which can predict risk in colitis](https://ginorthshore.com/2017/08/factors-identified-which-can-predict-risk-in-colitis/) - Clinical measures can predict risks in acute severe colitis A study in the Journal of Gastroenterology and Hepatology found evaluating clinical features in patients with acute severe colitis may help predict the long-term risk of colectomy and steroid dependence. The four measures included in the study were patient response on day seven of hospitalization, steroid - [Opioid Users Don't See Overdose as Wakeup Call](https://ginorthshore.com/2017/08/opioid-users-dont-see-overdose-as-wakeup-call/) - Brush with death had little effect on subsequent use As described in a JAMA research letter, Julie M. Donohue, PhD, of the University of Pittsburgh, and colleagues looked at five years of claims data for Medicaid-covered patients in Pennsylvania. They examined records of opioid use both before and after the overdose for 6,000 patients with - [Colon cancer increase in younger adults raises screening issues](https://ginorthshore.com/2017/08/colon-cancer-increase-in-younger-adults-raises-screening-issues/) - As we recently reported here, according to a research letter in the Journal of the American Medical Association, more adults ages 20 to 54 are dying from colorectal cancer than ever before. This raises issues regarding the benefits of earlier screening and better detection methods for younger patients. Although no new guidelines have yet emerged, and - [Colon cancer increases among younger white patients](https://ginorthshore.com/2017/08/colon-cancer-increases-among-younger-white-patients/) - Colon cancer incidence rate among younger white patients has increased, but has remained stable among blacks. Colorectal cancer deaths among white patients under age 55 have also increased, but they have decreased among blacks in the same age group. These findings were published in a research letter in the Journal of the American Medical Association - [Barbershop program boosts colon cancer screening in black men](https://ginorthshore.com/2017/08/barbershop-program-boosts-colon-cancer-screening-in-black-men/) - Black men who were paired with a community-based patient navigator were more likely to follow through on colonoscopies or other testing for colorectal cancer than those in a control group. Community health workers identified the men as eligible for colorectal cancer testing in visits to barbershops throughout New York City. “Although previous studies have shown - [Children with diabetes at risk for celiac](https://ginorthshore.com/2017/08/children-with-diabetes-at-risk-for-celiac/) - Celiac disease is seen more frequently in youth with type 1 diabetes, but there are variations between countries in how often the two conditions occur together, according to an Australian study in the journal Diabetes Care. The study found 3.5% of young people with diabetes had celiac disease, with the prevalence ranging from 1.9% in - [Rural living may reduce IBD](https://ginorthshore.com/2017/08/rural-living-may-reduce-ibd/) - The contribution of environmental factors, diet, and related issues like the status of the microbiome once again come into focus in a recent medical article. A Canadian study in The American Journal of Gastroenterology linked living in a rural area with a lower risk of inflammatory bowel disease. The protective effect was particularly strong among - [Obese teens have higher cancer risk as adults](https://ginorthshore.com/2017/07/obese-teens-have-higher-cancer-risk-as-adults/) - People who were overweight or obese as teens have a higher risk of developing colon cancer as an adult, according to a study in the journal Cancer. Obesity in adolescence was also linked to a higher risk of rectal cancer. “This is a huge cohort with a minimum follow-up of 10 years, and all individuals - [Antibiotics and IBD](https://ginorthshore.com/2017/07/antibiotics-and-ibd/) - Link Between Antibiotics and IBD Remains Circumstantial Effect stronger in children, and underscores need for antibiotic stewardship in prescribing for pediatric infections Since inflammatory bowel disease (IBD) is linked to disruption of the intestinal microbiome, antibiotics have come under increasing scrutiny as possible environmental catalysts in IBD – especially if taken in early childhood. So - [Costs higher when IBD patients fail to take medication](https://ginorthshore.com/2017/07/costs-higher-when-ibd-patients-fail-to-take-medication/) - There is sometimes heated discussion about adherence to medical regimens being of value, both to an individual patient and to broader patient categories. Inflammatory bowel disease is certainly one of these contentious areas. Patients often seem to go from doctor to doctor, seeking out one who agrees with the decisions they have already made. Even - [Western diet and bacteria linked to liver inflammation](https://ginorthshore.com/2017/07/western-diet-and-bacteria-linked-to-liver-inflammation/) - Researchers at the University of California, Davis found that chronic liver inflammation is associated with a Western diet via the type of bacteria present in the gut. "We know the transition from steatosis, or fatty liver, to steatohepatitis (inflammation in the fatty liver) plays a crucial role in liver injury and carcinogenesis," Yu-Jui Yvonne Wan, professor - [Better insurance may mean more than better access](https://ginorthshore.com/2017/07/better-insurance-may-mean-more-than-better-access/) - It's no surprise that better insurance coverage means more accessibility to tests. This includes higher rates of colon cancer screening, and of course better outcomes for those patients who do get screened. What's surprising though, is that the extent of coverage can also mean that a patient is more likely to have tests not necessarily - [Computer-Simulated Tests Eyed at FDA](https://ginorthshore.com/2017/07/computer-simulated-tests-eyed-at-fda/) - Computer simulations may get a role alongside human testing as part of an effort to bring new medications and medical devices to market more quickly and cheaply. The approval process for medical devices and drugs could incorporate computer modeling and virtual testing in an effort to modernize and streamline the regulatory pathway and make drugs - [Study ties prolonged PPI use to higher mortality risk](https://ginorthshore.com/2017/07/study-ties-prolonged-ppi-use-to-higher-mortality-risk/) - Fueling the fire of debate on PPI safety, a new observational study in BMJ Open found the use of proton pump inhibitors for at least a year was associated with a 51% higher risk of early death, compared with 31% among those treated for six months to a year and 17% for three- to six-month - [CDC: C. Diff Infections Falling](https://ginorthshore.com/2017/07/cdc-c-diff-infections-falling/) - C. difficile infection rates climbed annually from 2000 to 2010, and in 2011 caused almost 500,000 illnesses and killed about 29,000 people in the US according to the CDC. However, preliminary analysis of data from the CDC's Emerging Infections Program showed that the rate of new Clostridium difficile infections in hospitals and nursing homes nationwide - [Ever wonder how a pill dissolves inside your body?](https://ginorthshore.com/2017/07/ever-wonder-how-a-pill-dissolves-inside-your-body/) - [Diet and exercise boost cancer survival rates](https://ginorthshore.com/2017/07/diet-and-exercise-boost-cancer-survival-rates/) - A healthy diet and exercise could reduce colon cancer patients’ chance of death and simply walking could improve survival rates for breast cancer survivors, studies presented at the world’s largest cancer conference have found. A study of nearly 1,000 colon cancer patients found that those who exercised regularly, ate more fruits and vegetables and avoided - [Researchers link risk of gestational diabetes and glucose intolerances to nonalcoholic fatty liver disease](https://ginorthshore.com/2017/06/researchers-link-risk-of-gestational-diabetes-and-glucose-intolerances-to-nonalcoholic-fatty-liver-disease/) - A Canadian study in The American Journal of Gastroenterology showed that women with ultrasound evidence of nonalcoholic fatty liver disease (NAFLD) during their early pregnancy were more likely to develop gestational diabetes and dysglycemia in the second trimester of their pregnancy than those without NAFLD. The findings were based on 476 healthy women who underwent - [Fear, anxiety drive much of colonoscopy pain](https://ginorthshore.com/2017/06/fear-anxiety-drive-much-of-colonoscopy-pain/) - “A lot of people are afraid of colonoscopies but very few studies have documented the reasons why,” according to James M. Church, MD, of the department of colorectal surgery at the Cleveland Clinic. “Colonoscopy screening is the best way to prevent colorectal cancer but people often do not make use of the test because they are afraid of it. - ["Prolonged exercise may harm GI system"](https://ginorthshore.com/2017/06/prolonged-exercise-may-harm-gi-system/) - An analysis of eight studies found continuous endurance exercise, such as running or cycling, for more than two hours may lead to exercise-induced gastrointestinal syndrome, which includes gut injury and impaired gut function, researchers wrote in the journal Alimentary Pharmacology & Therapeutics. Prolonged vigorous exercise can cause a stress response that shuts down gut function, - ["BMI may be valuable tool in colon cancer risk assessment"](https://ginorthshore.com/2017/06/bmi-may-be-valuable-tool-in-colon-cancer-risk-assessment/) - A study in the Journal of Gastroenterology and Hepatology found a modified colorectal cancer screening tool that included body mass index led to improved risk prediction for advanced neoplasia. Researchers based the tool on the Asia Pacific Colorectal Screening score. See the abstract here. See the review article in Physician's Briefing here. - ["Limited success with fecal transplant in UC"](https://ginorthshore.com/2017/06/limited-success-with-fecal-transplant-in-uc/) - Considerable interest has arisen in recent years regarding the role of the human microbiome in health and disease, including in inflammatory bowel disease (IBD) -- a category of disease that includes ulcerative colitis and Crohn's disease and is thought to result from the interplay between immune system alterations, environmental triggers, genetic factors, and the interaction - ["Data on risk of dementia from PPIs conflicts with earlier publications"](https://ginorthshore.com/2017/06/data-on-risk-of-dementia-from-ppis-conflicts-with-earlier-publications/) - An NIH-supported study of 10,486 patients found no link between proton pump inhibitor use and patient risks for mild cognitive impairment, Alzheimer's disease and dementia, based on patient-reported data of PPI use. The data, reported in the Journal of the American Geriatrics Society, contradict findings of two other recent studies. “The current findings do not - ["Most HCV patients unsuccessful on previous regimens clear virus with triple therapy"](https://ginorthshore.com/2017/06/most-hcv-patients-unsuccessful-on-previous-regimens-clear-virus-with-triple-therapy/) - Triple-DAA Pill Offers HCV Retreatment Option A combination of three drugs that act directly to block hepatitis C (HCV) replication successfully cured most patients who had previously failed therapy with such agents, researchers reported. In two phase III trials, the investigational combination of sofosbuvir, velpatasvir, and voxilaprevir cleared the virus in 96% and 98% of - ["Molecules engineered from intestinal worms may help IBD"](https://ginorthshore.com/2017/06/molecules-engineered-from-intestinal-worms-may-help-ibd/) - Infestation with benign parasitic worms is one possible explanation for the low incidence of autoimmune diseases and allergies in less developed countries and, conversely, for the sustained increase in such inflammatory conditions in more sanitized and hence "dewormed" industrialized societies. Joel V. Weinstock, MD, of Tufts Medical Center in Boston, writing in Nature in an article - ["Older blacks have higher colorectal cancer risk"](https://ginorthshore.com/2017/05/older-blacks-have-higher-colorectal-cancer-risk/) - A study in the Annals of Internal Medicine found that older black patients had a 31% higher risk of colorectal cancer than older white patients. Researchers noted greater racial and ethnic disparities for distal colon and rectal cancer than for proximal colon cancer. “Black persons have the highest incidence of and mortality rates from CRC - ["FDA approves 1st drug for biomarker-based therapy"](https://ginorthshore.com/2017/05/fda-approves-1st-drug-for-biomarker-based-therapy/) - In an unprecedented move, the FDA today granted accelerated approval to the cancer drug pembrolizumab (Keytruda - Merck & Co) for treatment of any unresectable or metastatic solid tumors associated with the genetic abnormality known as microsatellite instability. It's the first time the agency approved a cancer treatment or indication that is not for a tumor - ["Healthy Lifestyle Adds to Colon Cancer Survival"](https://ginorthshore.com/2017/05/healthy-lifestyle-adds-to-colon-cancer-survival/) - "Colon cancer patients who had a healthy body weight, engaged in regular physical activity ... and drank small to moderate amounts of alcohol had longer disease-free and overall survival than patients who did not," Erin L. Van Blarigan, ScD, of the University of California San Francisco said during a press briefing prior to the American - ["Patient navigators boost colonoscopy success"](https://ginorthshore.com/2017/05/patient-navigators-boost-colonoscopy-success/) - A study published in Cancer examined if patient navigation impacted colonoscopy outcomes. Here's what they found: 1. Patients in the navigated group were 11.2 times more likely to complete colonoscopy than control patients. 2. Navigated patients were 5.9 times more likely to have adequate bowel preparation. 3. Navigated patients also missed no appointments compared to - ["The stigma of Hep C is not getting better"](https://ginorthshore.com/2017/05/the-stigma-of-hep-c-is-not-getting-better/) - U.S. health officials said new cases of hepatitis C rose nearly 300 percent from 2010 to 2015, despite the availability of cures for the liver disease, fueled by a spike in the use of heroin and other injection drugs, according to a report released on Thursday. In 2015, the national reported rate of hepatitis C - ["Tofacitinib may help in UC"](https://ginorthshore.com/2017/05/tofacitinib-may-help-in-uc/) - About 18.5% of patients with moderate to severe ulcerative colitis experienced remission after taking tofacitinib for eight weeks, compared with 8.2% of patients taking a placebo, researchers reported in The New England Journal of Medicine. In another trial, remission was experienced after one year by 34.3% of patients taking a 5-mg dose of tofacitinib and - ["Fecal Transplant Helps Hepatic Encephalopathy"](https://ginorthshore.com/2017/05/fecal-transplant-helpshepatic-encephalopathy/) - Patients with recurrent episodes of hepatic encephalopathy experience cognitive improvements and significantly fewer hospitalizations after fecal microbiota transplantation than after standard care, according to a phase 1 study designed to evaluate the safety of this treatment. Fecal microbiota transplantation "is a safe procedure in this population with advanced hepatic encephalopathy," said Jasmohan Bajaj, MD, from - ["Hep C Treatment Cures Most Patients"](https://ginorthshore.com/2017/05/hep-c-treatment-cures-most-patients/) - Recently approved direct-acting antiviral (DAA) regimens can safely and effectively treat hepatitis C without interferon, with cure rates often exceeding 95%, according to a recently published review. "Oral DAA regimens that are highly efficacious, well-tolerated, and relatively short in duration are now available for all [hepatitis C virus] genotypes and for patient populations historically considered - ["WHO: Hepatitis deaths rising"](https://ginorthshore.com/2017/04/who-hepatitis-deaths-rising/) - The rise in the number of deaths caused by hepatitis makes the disease a global health threat on the level of tuberculosis and HIV, according to a World Health Organization report. The data, presented at the International Liver Congress, showed a 22% increase in deaths resulting from chronic hepatitis B and C from 2000 to - ["Fecal Transplant Good For the Brain?"](https://ginorthshore.com/2017/04/fecal-transplant-good-for-the-brain/) - There is an old saying that brains are baffled by the end product of a bull's digestion. But a similar product, from carefully selected human donors, might reduce recurrent hepatic encephalopathy in liver disease patients and protect their brains, according to Jasmohan Bajaj, MD, of Virginia Commonwealth University in Richmond, Va. "This is the first - ["Doctors spend progressively more time in electronic records"](https://ginorthshore.com/2017/04/doctors-spend-progressively-more-time-in-electronic-records/) - Researchers find doctors spent an average of 3.08 hours on direct patient care and 3.17 hours on the computer during any given workday. The time spent on the electronic record varied greatly between physicians. Despite this, the time doctors spent online has increased steadily over the years. Progress notes accounted for the largest chunk of - ["Rise in hacking of health care providers"](https://ginorthshore.com/2017/04/rise-in-hacking-of-health-care-providers/) - Are the Russians still getting to you? A recent report suggests a 320% increase in the number of health care providers affected by hacking incidents from 2015 to 2016. Researchers also found that HHS' Office for Civil Rights received more than $23.5 million last year in settlements for HIPAA violations that occurred in 2012 and - ["IBD rate increases among young Canadian children"](https://ginorthshore.com/2017/04/ibd-rate-increases-among-young-canadian-children/) - A study in The American Journal of Gastroenterology showed the number of Canadian children under age 5 diagnosed with inflammatory bowel disease increased 7.2% yearly from 1999 to 2010. Researchers said new IBD diagnosis rates for children under age 16 were stable in most provinces, at about 2% annually, but overall, the number of children - ["Antibiotic use may predispose users to colon polyps"](https://ginorthshore.com/2017/04/antibiotic-use-may-predispose-users-to-colon-polyps/) - Study links extended antibiotic use to higher risk of colon polyps A study in the journal Gut found women who took oral antibiotics for at least two weeks in their 20s through 50s increased their risk of colon polyps in their 60s, compared with not taking the drugs for extended periods of time. "This suggests - [Biomarkers of liver injury may persist after hepatitis C treatment](https://ginorthshore.com/2017/04/biomarkers-of-liver-injury-may-persist-after-hepatitis-c-treatment/) - A biomarker of liver damage may persist after hepatitis C treatment: About one-third of patients who were successfully treated to eliminate the hepatitis C virus continued to exhibit liver inflammation, a German study showed. The findings include people who took direct-acting antiviral (DAA) drugs, the current preferred therapy for the virus. “This is the first - [Younger patients at risk for colon cancer, too](https://ginorthshore.com/2017/04/younger-patients-at-risk-for-colon-cancer-too/) - Doctors should also follow up on CRC (colorectal cancer) symptoms in younger adults: Sarah DeBord was 24 when she first noticed blood in her stool. She saw a gastroenterologist who did a procedure called a flexible sigmoidoscopy to examine her lower colon and rectum, then gave her a diagnosis of hemorrhoids. “I don’t see any - [Are home gut microbiome test kits reliable?](https://ginorthshore.com/2017/04/are-home-gut-microbiome-test-kits-reliable/) - Experts question value of at-home gut microbiome test kits The idea that different types of bacteria in the human gut play a role in health and disease is driving a new trend in consumer-oriented health-care kits. Startups are offering new services to analyze the complex community of microörganisms that live in the digestive tract—called the - [US physician shortage likely to worsen](https://ginorthshore.com/2017/04/us-physician-shortage-likely-to-worsen/) - Report: US physician shortage likely to worsen A recent Association of American Medical Colleges report predicts that the US physician shortage will get worse and a deficit of between 40,800 and 104,900 doctors will occur by 2030. Shortages will affect primary care, surgical specialties and medical specialties, including gastroenterology, but telemedicine, new drugs and other - [Could Virtual Reality Augment Actual Medical Practice?](https://ginorthshore.com/2017/04/could-virtual-reality-augment-actual-medical-practice/) - Sarah Murthi, MD, stood between an ultrasound monitor and a University of Maryland student supine on a medical bed at the Newseum here. Clad in a pink scrub, the University of Maryland School of Medicine trauma surgeon demonstrated a new way to view ultrasound images as a dozen or so onlookers stared and occasionally chuckled. - [The Six Warning Signs of Colorectal Cancer](https://ginorthshore.com/2017/03/the-six-warning-signs-of-colorectal-cancer/) - In honor of National Colorectal Cancer Awareness Month, Today.com interviewed physicians about symptoms that should never be ignored. "People are maybe sometimes uncomfortable about talking about that part of their body," Dr. Jennifer Inra, a gastroenterologist at Brigham and Women's Hospital in Boston, told Today.com. Still, the best way to address the risk is to - [Vedolizumab in Patients With UC](https://ginorthshore.com/2017/03/vedolizumab-in-patients-with-uc/) - Vedolizumab demonstrated significantly greater efficacy as induction and maintenance therapy for UC than placebo in patients naive to TNF antagonists and patients with TNF antagonist failure. There were numerically greater treatment differences at Week 6 among patients receiving vedolizumab who were naive to TNF antagonists than patients with TNF antagonist failure. An AGA Reading Room - [Microbial Signature Could Help in Crohn’s Diagnosis](https://ginorthshore.com/2017/02/microbial-signature-could-help-in-crohns-diagnosis/) - Researchers said Crohn's disease and ulcerative colitis have distinct microbiomes, which could help physicians differentiate between them and reduce the use of diagnostic endoscopy. The study reported in the journal Gut included analysis of 2,045 fecal samples and showed patients with Crohn's had less microbial diversity and a less stable microbiome compared with UC patients. - [Ever wonder how astronauts do their "GI Business" in space?](https://ginorthshore.com/2017/02/ever-wonder-how-astronauts-do-their-gi-business-in-space/) - https://youtu.be/5JPuaRBTMKs In 1969, US astronaut Russell Schweickart peed into a plastic receptacle while on the Apollo 9 mission. The condom-like vessel allowed Schweickart - and the other crew members - to relieve themselves in space. But they often made a big mess when they removed the receptacle - painfully, they learnt that size does - [Johnny Cash's family once blocked the use of "Ring of Fire" in a hemorrhoid ad!](https://ginorthshore.com/2017/02/johnny-cashs-family-once-blocked-the-use-of-ring-of-fire-in-a-hemorrhoid-ad/) - The family of late singer Johnny Cash once blocked an attempt by advertisers to use his hit song Ring of Fire to promote hemorrhoid-relief products. The idea had been backed by Merle Kilgore, who co-wrote the song with Cash's wife, June Carter Cash. Cash's daughter Rosanne said the family "would never allow the song to - [Approaches to Treating Malnutrition in IBD](https://ginorthshore.com/2017/01/approaches-to-treating-malnutrition-in-ibd/) - New study will compare the Mediterranean and specific carbohydrate diets The Crohn's & Colitis Foundation of America (CCFA) is sponsoring what it is calling the first-ever national study of the effect of dietary interventions to treat Crohn's disease. The study will compare the Mediterranean-style diet with the specific carbohydrate diet (SCD) in order to evaluate - [What can you expect from Anesthesia?](https://ginorthshore.com/2017/01/what-can-you-expect-from-anesthesia/) - Here is a brief video on our Anesthesia services at The Endoscopy Center of the North Shore. https://youtu.be/1DIaTG2jY4o - [Does eating red meat lead to diverticular disease?](https://ginorthshore.com/2017/01/does-eating-red-meat-lead-to-diverticular-disease/) - Study links eating red meat to higher diverticulitis risk Men with the highest percentages of red meat consumption had a 58% greater likelihood of developing diverticulitis, compared with men who had the lowest intake levels, according to a study in Gut. Men in the highest consumption group ate, on average, more than 12 servings of - [IBD relapse rates high when patients quit anti-TNF medication](https://ginorthshore.com/2017/01/ibd-relapse-rates-high-when-patients-quit-anti-tnf-medication/) - Study shows IBD relapse rates are high when patients quit their anti-TNF medication Almost half of inflammatory bowel disease patients who stop anti-TNF drugs when they achieve remission have a relapse, researchers reported in The American Journal of Gastroenterology. Researcher Dr. Maria Jose Casanova of Hospital Universitario de la Princesa in Madrid, said the study - [NIH Recommends Early Peanut Introduction for High-Risk Infants](https://ginorthshore.com/2017/01/nih-recommends-early-peanut-introduction-for-high-risk-infants/) - NIH Panel Recommends Early Peanut Introduction for High-Risk Infants Babies as young as 4 months can be exposed to peanuts Babies at high risk for developing peanut allergies should be introduced to peanut-containing foods in a controlled way as early as 4 to 6 months of age, according to new guidelines from an expert panel - [CDC Issues Guidelines to Limit Opioid Painkiller Prescriptions](https://ginorthshore.com/2017/01/cdc-issues-guidelines-to-limit-opioid-painkiller-prescriptions/) - The CDC has issued guidance recommending the use of non-opioid pain relievers, such as ibuprofen, aspirin or acetaminophen, for most chronic pain; limiting opioid prescriptions for acute pain to three to seven days; prescribing the lowest possible effective dose; and giving patients immediate-release formulations, among other measures designed to limit abuse of the highly addictive - [HCV Treatment Failures Rare in New Era](https://ginorthshore.com/2016/12/hcv-treatment-failures-rare-in-new-era/) - Direct-acting agents (DAAs) have demonstrated "astounding" success rates in the treatment of hepatitis C (HCV), making treatment failures rare. Indeed, failures may catch practitioners by surprise since cure rates range from about 95% to 100%. But non-response does happen, and key causes include virus genotype, the presence of liver cirrhosis, viral treatment resistance, and - [Scalp-cooling device during chemotherapy reduces hair loss](https://ginorthshore.com/2016/12/scalp-cooling-device-during-chemotherapy-reduces-hair-loss/) - Use of a scalp-cooling device during chemotherapy reduced the incidence of severe hair loss by 50% in patients with breast cancer on chemotherapy, according to a randomized study. Half of the patients who used the electronic scalp cap had moderate or no hair loss, whereas all patients assigned to control therapy had severe or total - [Fat intake may fuel cancer's ability to spread](https://ginorthshore.com/2016/12/fat-intake-may-fuel-cancers-ability-to-spread/) - We now have more evidence that fat fuels cancer's spread Scientists have stopped metastasis in mice. Metastasis is the leading cause of cancer-related deaths in the world, but until now, scientists have struggled to understand exactly how and why cancer cells go through the energy-intensive process of splitting off, travelling through the bloodstream, and taking - [Today's work schedule causes unhealthy burnout](https://ginorthshore.com/2016/12/todays-work-schedule-causes-unhealthy-burnout/) - The United States of Burnout Current work practices are unproductive, unhealthy, and unsustainable. This is damaging for both employees and employers. A 2016 report produced by the consulting group Deloitte found that one of the most pressing concerns for employers is the “overwhelmed employee.” Deloitte’s research shows that workers check their cellphones nearly 50 times per - [Doctors are more likely to misdiagnose patients who are argumentative](https://ginorthshore.com/2016/12/doctors-are-more-likely-to-misdiagnose-patients-who-are-argumentative/) - Leave your attitude outside the doctor's office next time. Going to see the doctor can bring out the worst in people. Being sick and fitting an appointment into an overcrowded schedule can be stressful. So can a long sit in the colorless cube of a waiting room. But if you've ever given a doctor attitude, - [Microbiome TED Talk](https://ginorthshore.com/2016/12/microbiome-ted-talk/) - http://www.ted.com/talks/rob_knight_how_our_microbes_make_us_who_we_are?utm_campaign=social&utm_medium=referral&utm_source=facebook.com&utm_content=talk&utm_term=science#t-779629 Rob Knight gives an outstanding overview of how the microbiome affects our health and much, much more in this timely summary. - [ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding](https://ginorthshore.com/2016/11/acg-clinical-guideline-management-of-patients-with-acute-lower-gastrointestinal-bleeding/) - The American College of Gastroenterology's new clinical guideline for acute lower gastrointestinal bleeding offers 27 recommendations graded by the strength of evidence. The recommendations, published in The American Journal of Gastroenterology, cover evaluation and management, colonoscopic and noncolonoscopic strategies, and preventing recurrent bleeding. Strate said the recommendations call for colonoscopy as the initial procedure for - [Ulcerative colitis patients more concerned about IBD complications than drug adverse events](https://ginorthshore.com/2016/11/ulcerative-colitis-patients-more-concerned-about-ibd-complications-than-drug-adverse-events/) - An online survey asking ulcerative colitis patients in the US and Australia about their biggest concerns found 37% said it was the increased risk for colon cancer, 29% said it was the possibility of needing an ostomy and 14% cited adverse events from medications. When asked about treatment issues, 84% were most concerned about surgery - [First-Of-Its-Kind Study Investigates Antidepressant as Treatment for Functional Heartburn](https://ginorthshore.com/2016/11/first-of-its-kind-study-investigates-antidepressant-as-treatment-for-functional-heartburn/) - Nonerosive reflux disease is a difficult entity with little or no evidence of acid injury, but persistent symptoms attributed to acid reflux. Many of these patients do not respond to even very potent acid blockers. Well, a study in The American Journal of Gastroenterology found the antidepressant imipramine was no better than a placebo in - [Assessing the Links Between Smoking and Crohn's Disease](https://ginorthshore.com/2016/11/assessing-the-links-between-smoking-and-crohns-disease/) - Detrimental effects include more aggressive disease and worse response to treatment. Once again, the immune effects on the microbiome may be the pathway to disease activation and drug response. Source: Assessing the Links Between Smoking and Crohn's Disease - [Homeopathy found to be effective for 0 out of 68 illnesses - Times of India](https://ginorthshore.com/2016/11/homeopathy-found-to-be-effective-for-0-out-of-68-illnesses-times-of-india/) - A leading scientist has declared homeopathy a "therapeutic dead-end" after a systematic review concluded the controversial treatment was no more effective than placebo drugs. A total of 57 systematic reviews, containing the 176 individual studies, focused on 68 different health conditions - and found there to be no evidence homeopathy was more effective than placebo - [CDC states 3.1 million US adults diagnosed with IBD in 2015](https://ginorthshore.com/2016/11/cdc-states-3-1-million-us-adults-diagnosed-with-ibd-in-2015/) - CDC data showed almost 3.1 million US adults reported being diagnosed with inflammatory bowel disease in 2015, with rates varying by age, education, ethnicity, income and employment status. The study, published in the CDC's Morbidity and Mortality Weekly Report, found higher IBD rates among adults ages 45 and older and non-Hispanic whites. MedPage Today (free - [Study: $15.4B spent by doctors annually on reporting quality measures](https://ginorthshore.com/2016/11/study-15-4b-spent-by-doctors-annually-on-reporting-quality-measures/) - With MACRA, the government has allocated $500M to $1B in bonuses to be paid for the upper tier of quality performers. But let's put that in perspective. A study by the Medical Group Management Association and Weill Cornell Medical College found that costs for reporting quality measures amount to more than $15.4 billion per year - [Noninvasive liver fibrosis scores lack accuracy in some patient groups](https://ginorthshore.com/2016/11/noninvasive-liver-fibrosis-scores-lack-accuracy-in-some-patient-groups/) - With Hepatitis C and non-alcoholic fatty liver disease being a healthcare issue of significant proportions to baby boomers, the availability of noninvasive tests to evaluate the degree of liver injury has become quite commonplace. But how accurate are these tests? Liver enzymes are notoriously inaccurate at determining the degree of either injury or scarring. Liver - [Colon Cancer's Location May Determine Patient Survival](https://ginorthshore.com/2016/10/colon-cancers-location-may-determine-patient-survival/) - Study found 'right-sided' tumors had worse prognoses, with implications for screening and treatment A study in JAMA Oncology showed that patients with cancer found on the left side of the colon were almost 20% less likely to die than those with cancer on the right side of the colon. Dr. David Bernstein at Northwell - [Cumulative adenoma sizes may be as good a predictor of polyp recurrence as current strategies.](https://ginorthshore.com/2016/10/cumulative-adenoma-sizes-may-be-as-good-a-predictor-of-polyp-recurrence-as-current-strategies/) - Study: Adenoma bulk may be used as surveillance strategy Analyzing adenoma bulk may predict metachronous neoplasia as well as the current surveillance strategy of size, number, and tissue type. This is according to research presented at the ACG 2016 Annual Scientific Meeting. Dr. Joseph Anderson of Dartmouth College's Geisel School of Medicine called adenoma bulk - [Bacterial DNA linked to short-term Crohn’s disease flare](https://ginorthshore.com/2016/10/bacterial-dna-linked-to-short-term-crohns-disease-flare/) - The bacterial microbiome raises its head once again. In a multicenter study reported in The American Journal of Gastroenterology found that bacterial genomic fragments found in the blood of patients in remission from Crohn's disease may be an independent risk factor for flare-ups at six months. "BactDNA" at six months also was tied to higher - [How Social Media Helped Identify an Abdominal Foreign Body](https://ginorthshore.com/2016/10/how-social-media-helped-identify-an-abdominal-foreign-body/) - This foreign body was removed from a non-healing abdominal wall incision in an elderly lady with many comorbidities and previous operations. It was a rigid plastic tube which was 7 cm long and 2 to 3 mm in diameter. There were four transverse grooves at either end. Physicians caring for her were unable to identify - ["It’s Time for a Seasonal Pumpkin-Spiced Bowel Prep!"](https://ginorthshore.com/2016/09/its-time-for-a-seasonal-pumpkin-spiced-bowel-prep/) - BOCA RATON, FL – Gomerblog has learned that Madre De Díos Hospital Chief Gastroenterologist Dr. Sri-Sheshadariprativadibankaram plans to capitalize on the pumpkin flavor craze by releasing a Pumpkin-Spiced Bowel Prep® for colonoscopies. Preorders from around the nation have been pouring into his office, and there is a fear that the tasty colon prep solution may - [Monday morning quarterbacking as a physician](https://ginorthshore.com/2016/09/monday-morning-quarterbacking-as-a-physician/) - Is it appropriate to comment on the perceived illnesses of public figures? When Britney Spears had one of her famous meltdowns--I can't recall if it was when she shaved her head or something worse--Dr. Phil of television fame came under fire for interjecting himself into the drama. He was providing medical opinion in public, and - [Survey shows physicians inaccurately overestimate both risks and benefits](https://ginorthshore.com/2016/08/inaccurate-estimates-risks-and-benefits/) - Most internal medicine residents and attending physicians overestimate the benefits and harms of common interventions, according to a new survey. Physicians and residents overestimated a treatment's benefits 79% of the time and the harms 66% of the time, according to a survey of clinicians working in primary care, hospital medicine and specialty care at two - ["Engineered colons" for cancer research](https://ginorthshore.com/2016/08/engineered-colons-for-cancer-research/) - Bioengineering has come a long way in the past few years. Organic is so passe. GMO's are mainstream. What's the next controversy? A recent hot topic you may have seen online is the idea of engineering ready-to-eat meat right in the research lab. Proponents tout it as a humane way to get us the protein - [Gallstones Linked to Higher Heart Disease Risk](https://ginorthshore.com/2016/08/gallstones-linked-to-higher-heart-disease-risk/) - Researchers say gallstone and heart disease association highlights a connection between the gut and the cardiovascular system. People who've ever suffered gallstones may have a slightly increased risk of developing heart disease down the road, a large new study suggests. This is especially true in women. Researchers suggested that changes in the gut's microbiome may - [Boutique Hangover Clinics Are All The Rage--But Are They Worth It?](https://ginorthshore.com/2016/08/boutique-hangover-clinics-are-all-the-rage-but-are-they-worth-it/) - The Hangover Clinic, a mobile center in Australia, joins a growing number of facilities that heal the ailments of over drinking with IV therapies. But these treatments aren’t worth the triple digit price tag. “Doctors, nurses, and paramedics have been using IVs to recover from hangovers for decades because it works,” said Max Petro, a - [Approach to the patient with refractory GERD](https://ginorthshore.com/2016/07/approach-to-the-patient-with-refractory-gerd/) - Is it reflux or not? Dr. Philip O. Katz discusses the dilemmas we face when people perceive ongoing reflux despite optimal medical management. See the webinar here. - [Lost, unsecured, non-encrypted cell phone costs facility $650k in HIPAA fines](https://ginorthshore.com/2016/07/lost-unsecured-non-encrypted-cell-phone-costs-facility-650k-in-hipaa-fines/) - The Catholic Health Care Services (CHCS) of the Archdiocese of Philadelphia, a nonprofit organization, was forced to pay a $650,000 fine. The action resulted after an employee lost a business cell phone containing sensitive information from the network's nursing home practices. The data included medical and personal information, including in some instances social security numbers. A - [How the FDA went after Kim Kardashian--and why.](https://ginorthshore.com/2016/07/how-the-fda-went-after-kim-kardashian-and-why/) - So. Kim Kardashian. I hate to even post her name because all it does is strengthen her multi-million dollar empire of nothingness. And part of that nothingness is the posting of countless product placement bits on social media like Instagram. You may think it's a harmless conduit between brainless posters and brainless viewers, but what - [The holy grail for GI may finally be around the corner!](https://ginorthshore.com/2016/07/the-holy-grail-for-gi-may-finally-be-around-the-corner/) - A new startup called ColonaryConcepts (yes, you read that correctly) seeks to "purge" the unpleasantness from colonoscopy prep. Dr. Corey Siegel and Dr. Joshua Korzenik (director of Brigham and Women’s Hospital Crohn’s and Colitis Center) have embarked on developing a new bar and beverage line to help people prep for colonoscopies. The goal, he says, is - [The Ethical Debate Behind a Live Medical Demonstration](https://ginorthshore.com/2016/07/the-ethical-debate-behind-a-live-demonstration-for-educational-purposes/) - A Japanese surgical expert is invited to perform a laparoscopic liver resection on a very ill patient at India's prestigious All India Institute of Medical Sciences (AIIMS). About 100 surgeons observe. During the operation, the patient starts to bleed. Reports say members of the audience encouraged the surgeons to switch to an open operation after - [Ongoing quality measures lead to post-colonoscopy complications remaining very low](https://ginorthshore.com/2016/06/ongoing-quality-measures-lead-to-post-colonoscopy-complications-remaining-very-low/) - Worldwide rates of post-colonoscopy complications either remained low or decreased in the past 15 years, confirming the global safety of colonoscopy as a diagnostic, screening, surveillance and therapeutic procedure. The results suggest improvement in techniques, better and more accurate quality end-points, and the benefits of feedback and modification of "best practices" based on the analysis - [Superbug Gene Isolated in U.S. -- Confers resistance to last-ditch antibiotic colistin](https://ginorthshore.com/2016/06/superbug-gene-isolated-in-u-s-confers-resistance-to-last-ditch-antibiotic-colistin/) - It was bound to happen -- a gene that confers resistance to a last-resort antibiotic has been detected in the U.S. - [Access to Subspecialty Hepatology Care Increases Survival Among V.A. Patients With Liver Disease](https://ginorthshore.com/2016/06/access-to-subspecialty-hepatology-care-increases-survival-among-v-a-patients-with-liver-disease/) - Access to Subspecialty Hepatology Care Increases Survival Among V.A. Patients With Liver Disease - [Can Blood Levels of Ammonia Predict Risk and Frequency of Hepatic Encephalopathy in Patients With Cirrhosis?](https://ginorthshore.com/2016/06/can-blood-levels-of-ammonia-predict-risk-and-frequency-of-hepatic-encephalopathy-in-patients-with-cirrhosis/) - We have long argued about the benefits of ammonia levels in following patients with cirrhosis and altered mentation. The textbook answer, long "re-posted", is that the levels are not useful. But, whenever we follow recommendations historically and by habit--without thinking about the underlying rationale--we are at risk of getting burned. So it may be with - [FDA warning on commonly used drugs like Cipro and Levaquin](https://ginorthshore.com/2016/05/fda-warning-on-commonly-used-drugs-like-cipro-and-levaquin/) - The U.S. Food and Drug Administration is advising that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with sinusitis, bronchitis, and uncomplicated urinary tract infections. These drugs are commonly used in the treatment of bowel infections as well, for example infectious diarrhea or diverticulitis, although the warning does - [P Polyp, a Colonic rapper from the South Side of the Splenic Flexure.](https://ginorthshore.com/2016/05/p-polyp-a-colonic-rapper-from-the-south-side-of-the-splenic-flexure/) - [Fecal Transplant May Be New IBD Treatment Option](https://ginorthshore.com/2016/05/fecal-transplant-may-be-new-ibd-treatment-option/) - FMT, fecal transplant, IBD, Crohn's - [Go big AND go home...with colon cancer??](https://ginorthshore.com/2016/05/go-big-and-go-home-with-colon-cancer/) - In what may come as a bit of a surprise, a new study found that overweight colon cancer patients tended to have better survival than their normal-weight peers. However, obesity increases the risk of having polyps and colon cancer to begin with. So although this is a little surprising, don't bank on being overweight as - [The high-security sales of PPI's...](https://ginorthshore.com/2016/05/the-high-end-sales-of-ppis/) - [New Microbiome Center to merge expertise of UChicago, MBL and Argonne](https://ginorthshore.com/2016/05/new-microbiome-center-to-merge-expertise-of-uchicago-mbl-and-argonne/) - New Microbiome Center to merge expertise of University of Chicago, Marine Biological Lab and Argonne National Laboratory. The University of Chicago, MBL and Argonne already have conducted some of the most influential research aimed at understanding and characterizing microorganisms.Argonne Director Peter B. Littlewood The University of Chicago, the Marine Biological Laboratory and the U.S. Department - [Treating SIBO (Part 6): Hydrogen vs. Methane SIBO - Hollywood Homestead](https://ginorthshore.com/2016/05/treating-sibo-part-6-hydrogen-vs-methane-sibo-hollywood-homestead/) - SIBO – or Small Intestinal Bacterial Overgrowth – is a serious condition in which there is too much bacteria and/or the wrong type of bacteria in the small intestine. There are two types of SIBO: hydrogen SIBO and methane SIBO. This is part of a series about treating SIBO. If you missed the last parts - [The growing pains of the health care act are frustrating patients.](https://ginorthshore.com/2016/05/the-growing-pains-of-the-health-care-act-are-frustrating-patients/) - "Sorry, We Don’tTake Obamacare" The growing pains of the health care act are frustrating patients. Research thus far suggests that the differences between plans offered through the ACA and those offered by employers may be quite significant. A study in the policy journal Health Affairs found that out-of-pocket prescription costs were twice as high in - [Is It Time to Retire The "Premed" Approach?](https://ginorthshore.com/2016/05/is-it-time-to-retire-the-premed-approach/) - During my junior year of college, I waited in line with classmates to use a chemistry lab scale. We held fragile containers with an unknown white powder and had to identify the mystery powder using techniques like chromatography, distillation, and recrystallization. It was the most important lab of the year in organic chemistry. Suddenly the girl next - [Study lends a proposed pathway to the previously reported association between PPI use and heart disease](https://ginorthshore.com/2016/05/study-lends-a-proposed-pathway-to-the-previously-reported-association-between-ppi-use-and-heart-disease/) - The previously reported association between PPI use and heart disease was just that...an association, not a cause and effect. Associations are the weakest form of science. However, researchers have found that long-term exposure to proton pump inhibitors led to faster aging of endothelial cells that line blood vessels by impairing the ability of the cells - [Education Universe Editors’ Choice: Video of the Week ](https://ginorthshore.com/2016/05/education-universe-editors-choice-video-of-the-week/) - From David Rubin, MD: The ACG Education Universe is a robust online educational library featuring video presentations from ACG’s national and regional meetings. It provides a wealth of content available FREE to ACG members. Sorry, you must be an ACG member. Each week there will be a select video. This Week: “Quality in the GI Practice,” with - [PPI's and their risks, in perspective, from the ACG President.](https://ginorthshore.com/2016/05/ppis-and-their-risks-in-perspective-from-the-acg-president/) - The biggest admitted downside of PPI therapy at their introduction was cost. With the advent of over-the-counter and generic PPI's, cost took a back seat and many more patients were managed on chronic, long-term PPI's with no real attempt to stop or decrease that therapy. Over the past several years, a number of potential adverse - [Diverticulosis vs. diverticulitis](https://ginorthshore.com/2016/05/on-wordpress-com/) - A recent clinical study in Clinical Gastroenterology and Hepatology found that diverticulitis only occurs in about 4% of people. Small pouches, or diverticula, may form in the weak areas of the large intestinal walls (the colon). For most people, the pouches do not become an issue and it is known as diverticulosis. For 5-25% of - [Coffee consumption linked to lower risk of colorectal cancer but higher risk of GERD](https://ginorthshore.com/2016/05/coffee-consumption-linked-to-lower-risk-of-colorectal-cancer-but-higher-risk-of-gerd/) - Source: Coffee consumption linked to lower risk of colorectal cancer | CTV News A new U.S. study has found more evidence for the health-giving properties of coffee, finding that more than 2.5 cups of coffee a day can significantly decrease your risk of colorectal cancer. But we all know coffee increases symptomatic reflux. It seems - [Continued Antiplatelet Therapy Does Not Boost Bleeding Risk in GI Procedures](https://ginorthshore.com/2016/05/continued-antiplatelet-therapy-does-not-boost-bleeding-risk-in-gi-procedures/) - Patients on continuous antiplatelet therapy before gastrointestinal procedures or surgery did not have a higher risk of intra-operative or post-procedure bleeding, compared with those who did not use the drugs, researchers reported. Data from 17 of 22 studies that focused on surgeries and on endoscopic procedures performed mostly by gastroenterologists showed no statistically significant difference - [Failed Hepatitis C therapy increases risk for hepatocellular carcinoma](https://ginorthshore.com/2016/05/failed-hepatitis-c-therapy-increases-risk-for-hepatocellular-carcinoma/) - Patients with hepatitis C virus infection who failed interferon-free therapy have an increased risk for a specific type of carcinoma of the liver compared with patients who achieved sustained virologic response, according to recently published data. - [Falls goes blue for colon cancer awareness | Local News | niagara-gazette.com](https://ginorthshore.com/2016/03/falls-goes-blue-for-colon-cancer-awareness-local-news-niagara-gazette-com/) - Niagara Falls in New York was illuminated by blue light to commemorate Colorectal Cancer Awareness Month. State Assemblyman John Ceretto said turning the falls blue creates a symbol of efforts to raise awareness of colorectal cancer and CRC screening. "We're letting people know, 'Go get that screening. We love you. We want you to stay - [Dr. Manoj Mehta is moving!](https://ginorthshore.com/2016/03/dr-manoj-mehta-is-moving/) - Dr. Manoj Mehta is proud to announce his move to a new, modern facility in downtown Wilmette! After 15 years practicing in nearby Kenilworth, we're moving to a 2400 square foot facility with a spacious waiting room, comfortable surroundings, and an in-office endoscopy suite with full-time anesthesia. As always, you can expect the same level ## Pages - [Homepage](https://ginorthshore.com/) - [Disclaimer](https://ginorthshore.com/disclaimer/) - ENDOSCOPY CENTER OF THE NORTH SHORE, LLC's STATUS AS AN INDEPENDENT ENTITY Dr. Mehta, Dr. Bianchi, and Dr. Tsang are gastroenterologists providing consultative, follow-up, telemedicine, and endoscopic services at this location. The Endoscopy Center of the North Shore, LLC (the "Endoscopy Center") is a business entity designed to provide endoscopy services. The employees and agents - [Procedure Preparation Instructions](https://ginorthshore.com/procedure-preparation-instructions/) - Preparation for EGD requires an empty stomach. You must be fasting prior to the procedure, and some further instructions regarding blood thinners and having a ride. Preparation for a colonoscopy involves a restricted diet, drinking the prep with the goal of clearing the colon, fasting prior to the procedure, and some further instructions regarding blood thinners and having a ride. - [“SUPREP” Colonoscopy Instructions](https://ginorthshore.com/suprep-colonoscopy-instructions-st-fran/) - Locations: Endoscopy Center of the North Shore, 1100 Central Ave. Suite H, Wilmette, IL 60091 (847) 256-1855, Fax (866)375-3001 Office Directions Evanston G.I. Lab, 2650 Ridge Ave. Suite 1134, Evanston, IL 60201 (847) 570-2236 or (847) 570-2298. Registration/ Covid Testing: 888-364-6400 Evanston Hospital Directions St. Francis G.I Lab, 355 Ridge Ave, Evanston IL 60202 (847) - [“SUTAB” Colonoscopy Instructions](https://ginorthshore.com/sutab-colonoscopy-instructions/) - Locations: Endoscopy Center of the North Shore, 1732 Central St, Evanston, IL 60201 (847) 256-1855, Fax (866)375-3001 Office Directions Evanston G.I. Lab, 2650 Ridge Ave. Suite 1134, Evanston, IL 60201 (847) 570-2236 or (847) 570-2298. Registration/ Covid Testing: 888-364-6400 Evanston Hospital Directions St. Francis G.I Lab, 355 Ridge Ave, Evanston IL 60202 (847) 316- 7338 - [Technology for Patients](https://ginorthshore.com/technology-for-patients/) - At the Endoscopy Center of the North Shore, we utilize several advanced technologies to help care for and communicate with patients. For example, we may use ambient listening to help take notes--and keep your doctor from burying their face in a laptop throughout your whole visit. We also use AI to help detect polyps during - [EGD Preparation Instructions](https://ginorthshore.com/egd-preparation-instructions/) - Locations: Endoscopy Center of the North Shore, 1732 Central St, Evanston, IL 60201 (847) 256-1855, Fax (866)375-3001 Office Directions Evanston G.I. Lab, 2650 Ridge Ave. Suite 1134, Evanston, IL 60201 (847) 570-2236 or (847) 570-2298. Registration/ Covid Testing: 888-364-6400 Evanston Hospital Directions St. Francis G.I Lab, 355 Ridge Ave, Evanston IL 60202 (847) 316- 7338 - [Announcing our new Patient Portal!](https://ginorthshore.com/announcing-our-new-patient-portal/) - Valued Patients: Yes, we still have access to all your records on NorthShore Connect (aka "Endeavor Health"). However, we are strenghtening our communication with other local centers like Northwestern Medical Center and Lutheran General Hospital. This helps us keep in contact with all your referring doctors, and provides better continuity of care. To do this - [Online Resource Center](https://ginorthshore.com/online-resource-center/) - Common GI Conditions — Patient Education Guide Here are online resources specific to each disease, condition, or symptoms listed. ASk us if you have other questions! 1. Gastroesophageal Reflux Disease (GERD) GERD occurs when stomach acid frequently flows back into the esophagus, causing heartburn, chest discomfort, and regurgitation. Long-term untreated reflux can lead to inflammation - [Patient Registration](https://ginorthshore.com/patient-registration/) - Please use the online assistant to contact the office, call, or email. You can also register for our portal here to begin registration and communication with our office. - [Anesthesia](https://ginorthshore.com/what-to-expect-from-anesthesia/) - At the Endoscopy Center of the North Shore, you can be assured that your comfort and safety are our highest priority. That's why we partner with Lake Anesthesia. The expertise of their CRNA's and physicians allows us to focus on your procedure while they focus their complete attention on making the procedure effortless for you. - [Our Facility](https://ginorthshore.com/our-facility/) - Welcome to our state of the art, spa-like facility on Central Street in Evanston. We are conveniently located near the Metra and just east of Green Bay Road. We offer high definition imaging to obtain the highest yield out of your exam, routine anesthesia services for optimal comfort, and the ease and convenience of an - [Colonoscopy](https://ginorthshore.com/colonoscopy/) - A colonoscopy is a test which allows your gastroenterologist to look in the colon. A thin tube with a camera is inserted into the rectum. This can be done for a variety of reasons, including as routine screening for polyps and cancers. The exam is usually done under sedation and requires a bowel cleansing preparation. - [EGD](https://ginorthshore.com/egd/) - Upper endoscopy (EGD) is a technique by which your physician can examine your esophagus, stomach, and duodenum. Please see the video below to learn more about this procedure, and use the link to get our instructions on how you should prepare for this procedure. http://www.youtube.com/watch?v=YwlCD1dET7Q EGD Instructions - [Blog](https://ginorthshore.com/blog/) - [FAQ's](https://ginorthshore.com/faqs/) - [Privacy policy](https://ginorthshore.com/privacy-policy/) - Endoscopy Center of the North Shore (“ECNS”) has created these policies to demonstrate its commitment to privacy. It discloses our information-gathering and dissemination practices for this Web site (the “Service”). You usually can visit the Service without submitting any information about yourself. If you send us e-mail, respond to a survey, join our Online Community or ## Doctors - [Cathleen](https://ginorthshore.com/staff/cathleen/) - Cathleen is our director of nursing and the nurse most likely to be present on your endoscopy day. Cathleen was born, raised and currently lives in the north shore. She attended Bradley University where she received a Bachelor's Degree in Nursing. Her professional career started in the Emergency Room where she worked for 15 years. - [Yaritza](https://ginorthshore.com/staff/yaritza/) - Yari began her healthcare career as a GI technician working with Dr. Mehta at Evanston Hospital, and later transitioned with him to his Wilmette location. There, she continued to expand her clinical experience. She subsequently completed nursing school and earned a Master’s degree in Nursing. Over the next three years, she gained additional clinical experience - [Jaxon "Jax"](https://ginorthshore.com/staff/jaxon-jax/) - Jax is an 8 year old rescue. His primary responsibilities include cleaning anything in the break room we might drop on the floor, sleeping, cuddling staff after a long day of prior authorizations, and performing unnecessary and often excessive office security. He does not have a phone or email, as he cannot read, - [Grace](https://ginorthshore.com/staff/grace/) - Grace is an aspiring physician with a foundation in healthcare. She graduated from the University of Wisconsin–Madison in 2023 with a Bachelor of Science in Biology. Prior to joining the office in March of 2025, she worked in research publications. She now serves as a Medical Assistant and Scheduler, supporting both clinical operations and patient - [Laura K. Bianchi, MD](https://ginorthshore.com/staff/laura-k-bianchi-md/) - Dr. Laura Bianchi joined the team at The Endoscopy Center of the North Shore at the start of 2024. She brings many years of experience, having been employed at NorthShore University for 16 years before moving to our practice. Dr. Bianchi has longstanding ties to the Chicagoland area, having grown up in Naperville. Dr. Bianchi - [Rebecca W. Tsang, MD, MPH](https://ginorthshore.com/staff/rebecca-w-tsang-md-mph/) - Dr. Rebecca Tsang is the newest member of The Endoscopy Center of the North Shore, joining the practice after working for nine years as a gastroenterologist at NorthShore University/Endeavor Health. A North Shore native, Dr. Tsang grew up in Wilmette and Winnetka, and she is a graduate of New Trier High School. She earned her - [Manoj K. Mehta, MD](https://ginorthshore.com/staff/manoj-k-mehta-md/) - Dr. Manoj Mehta has been a lifelong Chicagoan. He grew up in the south suburbs and completed his medical school, medical residency, and gastroenterology fellowship at Rush-Presbyterian-St. Luke's Medical Center in Chicago. While most students coveted the "private practice" residencies, Dr. Mehta elected to do rotations at Cook County Hospital to expand his exposure - [Jasmine](https://ginorthshore.com/staff/jasmine/) - Jasmine began working with Dr. Mehta the start of 2020 in the billing department, and shortly after cross trained to be part of the scheduling team assisting patients with scheduling needs. "It’s been a pleasure working with Dr. Mehta, as he really brings our work environment together. Working in the medical field can be challenging, - [Sandy](https://ginorthshore.com/staff/sandy/) - Sandy has been working with Dr. Mehta for about 4 years. She began as a G.I tech back in 2017 assisting during procedures and transitioned to the scheduling coordinator for the office. Se has become one of our most valuable and productive employee's. "I absolutely love working here and I couldn’t have asked for a ## FAQ's - [What medicines should I take or not take before my procedure?](https://ginorthshore.com/faq/what-medicines-should-i-take-or-not-take-before-my-procedure/) - You should take all your regular medicines up to and including the day of the procedure, with a few exceptions. You should try to take your regular medicines after the procedure, if possible. Anything essential, for example a blood pressure medicine, you could take with a little bit of water up to 2 hours before - [What about fiber before my procedure?](https://ginorthshore.com/faq/what-about-fiber-before-my-procedure/) - Anything you put in that creates residue, will take just that much more flushing to get you cleaned out for colonsocopy. This is why we have you cut back on fiber in the days before. Also note that seeds and nuts tend to clog the scope, so we have you limit those in the week - [What if I need some caffeine??](https://ginorthshore.com/faq/what-if-i-need-some-caffeine/) - Some people get headaches or other symptoms if you are very used to caffeine, and have not been able to have it as part of your prep. In order to stay within the clear liquid rules, but satisfy your caffeine needs, you could take Mountain Dew the day before your procedure. You can have some - [What are clear liquids and why do I need them before my colonoscopy?](https://ginorthshore.com/faq/what-are-clear-liquids-and-why-do-i-need-them-before-my-colonoscopy/) - Clear liquids means anything you could see through, or mostly through. Examples of clear liquids include 7-Up or Sprite, ginger ale, lemonade, hot or iced tea, and sports drinks. The most solid thing you can have would be clear soup broth, Jell-O, or popsicles. Coffee, cola, or soup are not considered clear. The job of - [What are polyps?](https://ginorthshore.com/faq/what-are-polyps/) - Polyps are benign growths that occur throughout the lining of the colon. These cause no symptos, but removing them is important as these are the precursor lesions for colon cancer. Removing them prevents colon cancer from developing in the near future. Once we know you grow polyps, even after removal, we will watch you more - [Why do I need to take the infant gas drops?](https://ginorthshore.com/faq/why-do-i-need-to-take-the-infant-gas-drops/) - The infant gas drops have been shown to reduce the amount of bubbles during the colonoscopy, making the prep slightly easier, and also increasing the detection of polyps. Since finding each and every polyp is usually the whole point of the test, it's worthwhile to use every tip and trick to optimize the outcomes. The - [Is there a cancellation fee, and why?](https://ginorthshore.com/faq/is-there-a-cancellation-fee-and-why/) - We allow the ability to cancel or reschedule office visits within reason. Endoscopy slots are very labor intensive and demanding for patients, however. Excessive rescheduling, late cancellations, or a no-show will incur a charge. Remember that we cannot just call someone to come in the day of a colonoscopy if someone doesn't show up. They - [Should we do the upper endoscopy along with the colonoscopy?](https://ginorthshore.com/faq/should-we-do-the-upper-endoscopy-along-with-the-colonoscopy/) - In most cases, no. Even if they are separately indicated, insurances and Medicare no longer pay for a full second procedure on the same date. Upper endoscopy is not routinely needed, so the idea of "while you're in there, take a look" doesn't fly any more. On rare occasions, we will make an exception if - [What does it mean to be board certified?](https://ginorthshore.com/faq/what-does-it-mean-to-be-board-certified/) - A board certified physician has demonstrated excellence in their field, as evaluated by a standard examination completed upon graduation from fellowship. An ongoing program of continuing medical education and re-examination is required to maintain board certification. This helps to ensure your physician has both completed a rigoruos initial training protocol and kept up to date - [What’s the deal with gluten?](https://ginorthshore.com/faq/whats-the-deal-with-gluten/) - A lot of attention has been paid to gluten in the past few years, and with good reason. Antibody levels to gluten have risen over the past decades and so have symptoms. Many people have no symptoms or nonspecific symptoms or findings, for example gas, being thin, or having low iron. Some people are gluten - [What are adenomas, sessile serrated polyps, and hyperplastic polyps?](https://ginorthshore.com/faq/what-are-adenomas-sessile-serrated-polyps-and-hyperplastic-polyps/) - Adenomas are the type of polyps that have potential to grow into colon cancers. Sessile serrated polyps are “flat polyps” that may be more difficult to find. They also may have some potential to become cancerous over time. Hyperplastic polyps, except in rare instances, are very low risk lesions and are generally thought to be - [What kind of charges are to be expected?](https://ginorthshore.com/faq/what-kind-of-charges-are-to-be-expected/) - It is difficult to predict exactly what kind of charges any individual might expect. A lot has to do with what is found, what tools are used to treat findings like polyps, how complex the overall interaction is, how much insurance covers, if the insurance has a contracted charge with us, if you have a - [How in the world did you get into this field?](https://ginorthshore.com/faq/how-in-the-world-did-you-get-into-this-field/) - For each physician, the answer would be different. Dr. Mehta, the Medical Director of Endoscopy Center of the North Shore, has a background in the visual sciences. Before becoming a doctor, he worked for PBS. He was a freelance artist while in college and also worked as a medical illustrator while in medical school. Gastroenterology - [Is it OK to have a colonoscopy while on my menstrual period?](https://ginorthshore.com/faq/is-it-ok-to-have-a-colonoscopy-while-on-my-menstrual-period/) - Yes it is. It is also okay to use a tampon during the procedure. - [Do I need to take antibiotics if I take them for other procedures?](https://ginorthshore.com/faq/do-i-need-to-take-antibiotics-if-i-take-them-for-other-procedures/) - Keep in mind that your colon is naturally filled with trillions of bacteria every day. Your body has developed a very effective barrier via the lining of the colon. Passing a scope through the colon does not release any more bacteria into the bloodstream than pushing stool out, and you do not need to take - [What about infection control during procedures?](https://ginorthshore.com/faq/what-about-infection-control-during-procedures/) - The benefits of colonoscopy clearly outweigh all combined risks, or we would not do it. The risk of infections with these procedure is exceedingly low, even during colonoscopy where one would expect to find many bacteria. Remember, your gut is filled with trillions of bacteria at every moment. It is very well adapted to handling routine - [What type of anesthesia is used for procedures?](https://ginorthshore.com/faq/what-type-of-anesthesia-is-used-for-procedures/) - At Endoscopy Center of the North Shore, all endoscopic procedures are performed with modified anesthesia care (MAC). Services are provided by a CRNA provided by Lake Anesthesia. Sedation can be provided by any number of drugs, but the most common is propofol. This is a safe and effective anesthetic when used appropriately. It is short - [Wait, isn’t propofol what Michael Jackson had?](https://ginorthshore.com/faq/wait-isnt-propofol-what-michael-jackson-had/) - Yes, but when used in the appropriate setting this is an excellent medication. Outpatient endoscopic procedures are exactly the type of situation that this sedative was designed for. It was not designed for being used regularly, being able to sleep on demand, as a replacement for normal sleep, or in any type of unmonitored home - [What’s with all the prep questions??](https://ginorthshore.com/faq/whats-with-all-the-prep-questions/) - To have a successful examination, we need to be able to see as much of the surface area of the colon as possible. The likelihood of achieving a complete exam--and the best odds of colon cancer prevention--are directly proportional to how clean you are able to get the colon. Any residual stool reduces the likelihood - [Do you take credit cards?](https://ginorthshore.com/faq/do-you-take-credit-cards/) - Yes, we do. We can take these over the phone, you can enter them online, or we can swipe in person when you arrive. We can keep your card on file with your permission to cover copays and deductibles whish often are calculated after all your insurance is processed. There is a nominal credit card - [Is the Facility Accredited?](https://ginorthshore.com/faq/is-the-facility-accredited/) - Yes, The Endoscopy Center of the North Shore is accredited by the global authority Quad A. Originally the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), Quad A is a non-profit, physician founded and led accreditation organization. They have worked with thousands of healthcare facilities worldwide to help standardize and improve the quality of - [Can I take a preparation using just pills?](https://ginorthshore.com/faq/can-i-take-a-preparation-using-just-pills/) - Yes! There is a newer bowel preparation as of 2021 called Sutab. It is the same medication in Suprep but in pill form instead of liquid. It works the same way, but of course there is no taste. It can still be harsh on the stomach, some patients report vomiting, and it can cause a - [Where are the procedures done?](https://ginorthshore.com/faq/where-are-the-procedures-done/) - Procedures can be done in our state-of-the-art office facility at 1732 Central St in Evanston, at Evanston Hospital, or occasionally at St. Francis Hospital. Please make sure you are 100% clear on when and where to show up. - [How close to the procedure can I eat or drink anything?](https://ginorthshore.com/faq/how-close-to-the-procedure-can-i-eat-or-drink-anything/) - You cannot eat anything solid for at least 8 hours prior to the procedure (for an EGD), and only a light, low fiber breakfast the day before a colonoscopy. You can have clear liquids (including the prep) up to 4 hours prior to the procedure. You can take an essential oral medication with a small - [What are “flat polyps”?](https://ginorthshore.com/faq/what-are-flat-polyps/) - Flat polyps are typically harder to find, and therefore are thought of as higher risk. At Endoscopy Center of the North Shore, we utilize high definition cameras and video monitors. Being thorough in finding these lesions is one of the reasons we emphasize the bowel preparation to be as optimal as possible. We inspect all - [What is gastroenterology?](https://ginorthshore.com/faq/what-is-gastroenterology/) - Gastroenterology is the medical specialty that deals with issues related to the digestive tract. It is frequently abbreviated “GI”. Even healthy people need periodic, if infrequent, input of a gastroenterologist to maintain their overall health. - [What is a gastroenterologist?](https://ginorthshore.com/faq/what-is-a-gastroenterologist/) - A gastroenterologist is a medical specialist that can help you with digestive issues and perform endoscopic examinations of your GI tract. Training consists of a four year undergraduate degree, four years of medical school, three years of internal medicine residency, plus several additional years of gastroenterology fellowship. Each level of training represents further subspecialization and - [What does a gastroenterologist do?](https://ginorthshore.com/faq/what-does-a-gastroenterologist-do/) - A gastroenterologist can provide consultative services, manage digestive diseases in a long-term fashion, and performs procedures such as upper endoscopy and colonoscopy. - [What other organs do gastroenterologists deal with?](https://ginorthshore.com/faq/what-other-organs-do-gastroenterologists-deal-with/) - We frequently deal with disorders of the liver, gallbladder, pancreas, and various symptoms such as nausea, loss of appetite, and nutritional deficiencies. - [Why might I need a gastroenterologist?](https://ginorthshore.com/faq/why-might-i-need-a-gastroenterologist/) - You might seek out a gastroenterologist to address specific symptoms, or as a matter of routine. A gastroenterologist can help review your history, your symptoms, and physical findings to help point towards a diagnosis. You might need a gastroenterologist to manage a known diagnosis outside the expertise of your primary physician. Gastroenterologists perform upper endoscopy - [What is an EGD, or upper endoscopy?](https://ginorthshore.com/faq/what-is-an-egd-or-upper-endoscopy/) - An upper endoscopy (“EGD”, or esophagogastroduodenoscopy) is an examination through the mouth, down the esophagus, through the stomach, and into the duodenum. The duodenum is the first part of the small intestine, and is just past the stomach. Collectively, these parts are known as the “upper GI tract”. The procedure uses a thin, flexible scope. - [What are reasons people might need an EGD?](https://ginorthshore.com/faq/what-are-reasons-people-might-need-an-egd/) - An upper endoscopy can be performed to address specific throat issues (for example, those suspected to be related to reflux), heartburn, difficulty swallowing, atypical chest pain, abdominal pain, dyspepsia, bleeding or blood in the stool, anemia, and sometimes diarrhea. - [What causes ulcers?](https://ginorthshore.com/faq/what-causes-ulcers/) - It used to be felt that stress and diet caused ulcers. While these may play some role, most ulcers are due to either bacteria in the stomach (H. pylori) or aspirin-like medications (NSAID’s). - [What are GERD, reflux, and heartburn?](https://ginorthshore.com/faq/what-are-gerd-reflux-and-heartburn/) - These are all related terms. Heartburn is the main symptom of acid reflux. Gastroesophageal reflux disease (GERD) is the technical name. Symptoms can vary beyond heartburn, and include throat discomfort (laryngopharyngeal reflux disease, or LPRD) or difficulty swallowing. Longstanding reflux can lead to strictures (narrowing of the esophagus) or Barrett’s esophagus (a precancerous condition). - [What is eosinophilic esophagitis?](https://ginorthshore.com/faq/what-is-eosinophilic-esophagitis/) - Certain individuals develop an allergic reaction in the esophagus which can cause difficulty swallowing or present similarly to reflux. It used to be common only in young people, but the incidence has risen dramatically in the last decade. - [How is an EGD useful in the diagnosis of diarrhea?](https://ginorthshore.com/faq/how-is-an-egd-useful-in-the-diagnosis-of-diarrhea/) - The small bowel is where you do the majority of absorption of nutrients. We can approach the small bowel easily for a biopsy by performing an upper endoscopy. Celiac sprue, caused by an allergy to gluten, is a common cause of small bowel diarrhea. - [What is a colonoscopy?](https://ginorthshore.com/faq/what-is-a-colonoscopy/) - A colonoscopy is a procedure using a flexible camera passed through the rectum and through the large intestine. The procedure is done as a matter of routine on even healthy people at specific ages and intervals. The patient is generally sedated, and completely unaware of the test. The difficult part of the test is taking - [What are reasons people might need a colonoscopy?](https://ginorthshore.com/faq/what-are-reasons-people-might-need-a-colonoscopy/) - People have colonoscopy as a matter of routine, to remove polyps that might be growing throughout the colon. Polyps are silent, and there is no other way to reliably diagnose and remove them. Polyps have the potential to grow into cancers. By removing the polyps, the risk of colon cancer is dramatically reduced. People also - [What is the likelihood of finding a polyp on my exam?](https://ginorthshore.com/faq/what-is-the-likelihood-of-finding-a-polyp-on-my-exam/) - For men, the likelihood of finding a polyp is reported at 31% for routine exams with no identifiable risk factors. For women, it is approximately 20%. At Endoscopy Center of the North Shore, our results are higher than the national average based on published studies. This speaks to the diligence with which we examine the - [What is colitis?](https://ginorthshore.com/faq/what-is-colitis/) - In its broadest sense, “colitis” simply means inflammation of the colon. This can encompass many causes. Diverticulitis is a form of colitis. Colitis can result from an infection, lack of blood flow, or an immune process such as ulcerative colitis or Crohn’s disease. - [What are the symptoms of colitis?](https://ginorthshore.com/faq/what-are-the-symptoms-of-colitis/) - Colitis can present with pain, bleeding, weight loss, diarrhea, and other symptoms. The type of symptoms, the duration, and the severity offer important clues as to the cause. - [What is diverticulitis?](https://ginorthshore.com/faq/what-is-diverticulitis/) - Diverticulitis is an acute condition that results when a diverticulum (a form of pocket or small herniation in the colon) strains to the point that it induces an inflammatory reaction. Bacteria entering the gut lining or even passing through the lining are part of the cause of inflammation. Treatment consists of bowel rest, antibiotics, and - [What is diverticulosis?](https://ginorthshore.com/faq/what-is-diverticulosis/) - Diverticula are small pockets that form in the lining of the colon. The prevailing theory has been that excess pressure from a lack of fiber is the cause. This theory is a largely historical one based on the fact diverticular disease is more common in the West, and Westerners eat less fiber than the rest - [What is the difference between diverticulosis and diverticulitis?](https://ginorthshore.com/faq/what-is-the-difference-between-diverticulosis-and-diverticulitis/) - Diverticulosis is the underlying condition of having the “pockets” in the colon. Once they form, they are there all the time. Most people have them, actually, by a certain age, and don’t have symptoms. An attack of diverticulitis is an acute, temporary condition. If you have diverticular disease, you always have diverticulosis. You may or - [Do I need to avoid seeds and nuts if I have diverticulosis?](https://ginorthshore.com/faq/do-i-need-to-avoid-seeds-and-nuts-if-i-have-diverticulosis/) - No. We used to recommend that, but better data over time suggest this is not helpful. In fact, people who consume nuts and seeds have less attacks of diverticulitis than those who don’t. See: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2643269/ - [What is ischemic colitis?](https://ginorthshore.com/faq/what-is-ischemic-colitis/) - Sometimes a situation develops where there is not enough blood flow in the colon. This can be the result of low output of blood from the heart or from poor delivery of blood due to hardening of the arteries in the abdomen. Just as people have heart attacks or strokes due to low blood flow - [What is infectious colitis?](https://ginorthshore.com/faq/what-is-infectious-colitis/) - Any type of infection that attacks the colon can cause infectious colitis. Common entities include salmonella, E. coli, campylobacter, and many others. Many causes resolve on their own, like gastroenteritis. Specific organisms need specific treatment. - [What is ulcerative colitis?](https://ginorthshore.com/faq/what-is-ulcerative-colitis/) - Ulcerative colitis is an immune-mediated condition that results in an inflammatory process of the lining of the colon. It can present with bloody diarrhea, pain, and weight loss. Sometimes it runs in families. Treatment has many forms. Initial medical therapy consists of suppositories, enemas, or pills with a timed release profile to target the colon. - [What is Crohn’s Disease?](https://ginorthshore.com/faq/what-is-crohns-disease/) - Crohn’s disease is also an immune mediated inflammatory process. However, it can extend beyond the colon and it can penetrate through the gut lining. It can effect anywhere in the GI tract, but it has a predilection for the end of the small bowel where it meets the colon. It can also present with pain, - [What is microscopic colitis?](https://ginorthshore.com/faq/what-is-microscopic-colitis/) - There are indeed forms of colitis that are not obvious on endoscopy, but can be seen on biopsies of the colon. There are two types of microscopic colitis, collagenous colitis and lymphocytic colitis. In collagenous colitis, a normally thin band of connective tissue known as collagen becomes excessively thickened. This creates a barrier to absorption - [When am I due for colonoscopy?](https://ginorthshore.com/faq/when-am-i-due-for-colonoscopy/) - Our office is happy to check for you if you had a previous examination. If you have a family history of colon cancer, we generally start routine screening at age 40. If you are of average risk, we start at age 50. African Americans generally start screening at age 45. If you have ever had - [What is the difference between a “screening” and “diagnostic” exam?](https://ginorthshore.com/faq/what-is-the-difference-between-a-screening-and-diagnostic-exam/) - A screening exam refers to a colonoscopy being done with no specific symptoms but as a matter of routine, for example to check for polyps. A diagnostic exam is generally being done to evaluate specific issues such as blood in the stool, anemia, or diarrhea. Insurances can be fussy about paying for screening versus diagnostic - [Do I need to hold my blood thinner before a procedure?](https://ginorthshore.com/faq/do-i-need-to-hold-my-blood-thinner-before-a-procedure/) - The reason you need a blood thinner is the key to knowing how important it is to continue this through the colonoscopy period. The reason we like to hold blood thinners, is so that we can remove polyps with less risk of bleeding. However, if your doctor feels strongly you need to stay on your - [What is a “clear liquid diet”?](https://ginorthshore.com/faq/what-is-a-clear-liquid-diet/) - This refers to a diet that you can see most all of the way through. Examples would include apple juice, any of the sports drinks, lemonade, clear soup broth, and semisolids made out of clear liquids such as Jell-O, hard candies, and popsicles. - [What does it mean to try to achieve “clear stools”?](https://ginorthshore.com/faq/what-does-it-mean-to-try-to-achieve-clear-stools/) - For colonoscopy, the bowel preparation is designed to evacuate the bowel of all solid material. The stool should be clear like water ideally. Sometimes it is yellow, and there can be small flecks of slight stool, and that is generally acceptable. - [What if I throw up drinking the prep?](https://ginorthshore.com/faq/what-if-i-throw-up-drinking-the-prep/) - Generally, we advise taking a break from drinking the prep and letting your stomach settle. You can reattempt to drink the rest of the prep later, or drink an alternative prep such as magnesium citrate. Magnesium citrate is available over-the-counter in a green bottle. If you know you have thrown up in the past, or - [What if I can’t drink the whole prep or it doesn’t work?](https://ginorthshore.com/faq/what-if-i-cant-drink-the-whole-prep-or-it-doesnt-work/) - Ideally, you would drink the preparation in the time span advised. There is some flushing action related to the timing, so sipping it over a longer period of time may not be as effective. However, we certainly understand that this is difficult process. If you need to compromise and slow it down a little to - [What if I had the test before and could not drink the whole thing?](https://ginorthshore.com/faq/what-if-i-had-the-test-before-and-could-not-drink-the-whole-thing/) - Let us know ahead of time, and we can review your history and results. There are almost always options available. - [What if I have the test, and I’m not clean enough?](https://ginorthshore.com/faq/what-if-i-have-the-test-and-im-not-clean-enough/) - Unfortunately, you will have to repeat the test. Sometimes be will have you drink extra preparation, and come back the next day to take advantage of the head start that you have. Sometimes we will ask that you reschedule on a different day with a different type of prep. In rare cases, if we feel - [What if I had the test before and I wasn’t clean enough?](https://ginorthshore.com/faq/what-if-i-had-the-test-before-and-i-wasnt-clean-enough/) - We can design a special program for you, including a combination of preps, extra prep, and a two day prep. Let us know how we can help you. - [If I am a small person, do I need to drink the same amount of prep?](https://ginorthshore.com/faq/if-i-am-a-small-person-do-i-need-to-drink-the-same-amount-of-prep/) - Unfortunately, yes. The colon is approximately the same size in all individuals, regardless of their body size. It stores about the same amount stool, and will require just as much cleansing. - [What if I don’t eat anything for several days before the test?](https://ginorthshore.com/faq/what-if-i-dont-eat-anything-for-several-days-before-the-test/) - Unfortunately, you still make stool even when you don’t eat. In fact, it gets harder and more difficult to pass. - [Are the preps safe?](https://ginorthshore.com/faq/are-the-preps-safe/) - Yes. There are some types of preparation which have side effects or potential risks. For the traditional preps, the risk is negligible. The main risk is absorption of extra salt, some electrolyte shifts while you are fasting, and dehydration. Keeping well hydrated with clear liquids is the key to avoiding issues. Preps containing phosphasoda are - [What if I have specific medical issues, such as diabetes, hypertension, or sleep apnea?](https://ginorthshore.com/faq/what-if-i-have-specific-medical-issues-such-as-diabetes-hypertension-or-sleep-apnea/) - For diabetics, we will try to schedule your procedure in the morning so you can stay as close to your usual routine as possible. If you are taking insulin, you should adjust this based on a sliding scale the day before while you on a clear liquid diet. Your primary physician can help. Do not - [My insurance does not cover the bowel prep, even though they cover the colonoscopy. Why is that?](https://ginorthshore.com/faq/my-insurance-does-not-cover-the-bowel-prep-even-though-they-cover-the-colonoscopy-why-is-that/) - Insurance carriers in Illinois are required by law to cover screening colonoscopy. They are not happy about that. Just recently, they stopped covering the prep by arguing that it is not part of the procedure. We are opposed to this for obvious reasons, and you should be too. - [Is there a consult or history and physical charge as well as the procedure?](https://ginorthshore.com/faq/is-there-a-consult-or-history-and-physical-charge-as-well-as-the-procedure/) - Oftentimes, there is. A physician does not act as a technician, and should not perform an invasive procedure on you without a full history and physical, an assessment of the indications, and an analysis of the risks and benefits. Even if you were just “referred for a procedure” the doctor will still examine you and - [Why do I need someone to get me if I feel I can walk, take the train, or take a cab?](https://ginorthshore.com/faq/why-do-i-need-someone-to-get-me-if-i-feel-i-can-walk-take-the-train-or-take-a-cab/) - Technically, you will be under the influence. This is a liability issue, even if it does not seem like a practical one. An adult you know personally must accompany you out of the G.I. lab and to your home, even if you live close enough to walk or are taking public transportation. Ideally, they will - [When can I resume normal activities after my procedure?](https://ginorthshore.com/faq/when-can-i-resume-normal-activities-after-my-procedure/) - You can eat whatever you feel up to when you leave the G.I. lab. There are a number of excellent local restaurants that are within walking distance of our office parking lot. Of course, someone must accompany you and be responsible for you. 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