Indigestion, also called dyspepsia, is a term that is used to describe discomfort and pain in the upper abdomen that can include symptoms like:
Indigestion is a common enough condition that most people ignore it or take over-the-counter medications like antacids to relieve symptoms. Indigestion can be a condition in and of itself or a symptom of a larger problem. [Read more…]
For many patients, hemorrhoids are merely an annoyance and will resolve on their own with simple care. But when a hemorrhoid becomes serious enough, a patient will come to your office seeking treatment — and perhaps surgery.
But when will a hemorrhoid require surgery? There are several factors you should take into consideration based on the type of hemorrhoid the patient has and the types of treatment options used in the past. [Read more…]
When a patient suffers from hemorrhoids, the hemorrhoid will typically resolve on its own with at-home treatment and care. But what if they don’t? Depending on diagnosis and the patient’s situation, hemorrhoid surgery may be required.
Hemorrhoid surgery is needed when the patient’s case is severe and the hemorrhoid does not resolve on its own.
For example, if a hemorrhoid has risen to a Grade IV, which means an irreducible prolapse, surgery is required. Additionally, if a hemorrhoid is still causing the patient problems after non-surgical treatment options like rubber band ligation, surgery may be necessary.
There are several surgical options available to treat hemorrhoids, though they should be reserved for hemorrhoids (like Grade III and IV) that do not respond to other methods of treatment:
These options can typically be performed as an outpatient procedure with the patient being sent home after the surgery is complete.
However, patients should be kept for observation after a hemorrhoidectomy and hemorrhoidopexy to ensure that their vital signs are stable after coming out of anesthesia.
After surgery is complete and patients have come out of anesthesia, educate them and their loved ones about post-surgical care and what they should expect.
Patients who receive hemorrhoid surgery like a hemorrhoidectomy should expect symptoms to last for a few weeks after treatment.
For aftercare, patients should eat a high-fiber diet, drink plenty of water, avoid heavy lifting, and not strain when they use the toilet. If needed, they can use a stool softener.
Stress that patients need to contact you if they experience:
If patients experience bleeding that does not stop, have severe pain in their stomach or anus or cannot urinate, they should immediately seek emergency care.
Celiac disease is an autoimmune disorder that causes damage to the small intestine when gluten is consumed. Celiac disease occurs in people who are genetically predisposed to the illness and is hereditary.
Research has yet to discern the cause of the disease, though it is noted that it can trigger after events like surgery, pregnancy, viral infections, and severe stress. Patients with celiac disease can be diagnosed as a child or an adult.
Symptoms of celiac disease include both digestive and non-digestive issues:
When gluten is consumed, the body’s immune system over-responds and attacks the patient’s small intestine, damaging the villi. These are small hair-like projections that line the intestine and are essential in helping the body absorb nutrients. As a result, the body cannot properly absorb the nutrients it needs, which can lead to complications.
It is estimated that 97% of those with celiac disease are undiagnosed. If left undiagnosed, celiac disease can cause complications in patients:
In children, complications can take the form of poor tooth enamel, delayed puberty, or intussusception (when the intestines fold in on themselves).
Currently, there are no treatments for celiac disease other than to strictly avoid foods that contain gluten like:
It’s also important to remember that some non-food items can contain gluten:
Of course, there are many good gluten-free versions of the above products available. Educate patients on how to read nutrition labels as well as what they can do to avoid gluten while still eating healthy.
Hemorrhoids are simple to treat and a very common condition. But what about diagnosing them? The symptoms of hemorrhoids can vary from person to person, and some may show no symptoms at all while others are similar to other conditions.
There are two initial methods for diagnosing a patient with hemorrhoids:
Examinations can cause stress and anxiety in patients. Before you begin digital or visual examinations to diagnose hemorrhoids, explain to them in simple terms what to expect and that this examination is very routine.
While performing the examination, let patients know what you’re doing and what you’ll do next. This will help alleviate any anxiety about the procedure.
During a digital exam, a gloved, lubricated finger is inserted into the rectum. If hemorrhoids are present, you should feel abnormal growths that are the swollen veins. This is a signal that further testing is needed to not only diagnose hemorrhoids, but also rule out other conditions.
If swollen veins cannot be felt, you may also perform a visual examination with an anoscope, procotoscope, or sigmoidoscope. This will allow you to see any problems related to rectal bleeding as well as diagnose hemorrhoids that are too soft to be felt by a digital examination.
While examining a patient, it is important to remember that the symptoms of hemorrhoids can also indicate other diseases and conditions, including:
Ask your patient about any other symptoms they have been experiencing and whether any have changed or worsened. This could indicate a larger problem. Also reassure your patients that there is no need to worry about hemorrhoids leading to cancer since the two are unrelated.
If hemorrhoids are diagnosed and can be treated via methods like rubber band ligation, it is advised to refer them to a doctor who specializes and is trained in proctology procedures for safe and effective treatment.
Remind patients that many hemorrhoids can heal on their own and to alleviate symptoms at home via methods like sitz baths and using topical treatments like hemorrhoid creams. Follow up with them to ensure their symptoms do not worsen.
As a gastroenterologist, you know patients who suffer from irritable bowel syndrome (IBS) have their quality of life affected due to its unpredictability. And to make matters worse, IBS can be the cause of additional health problems, including hemorrhoids.
Here’s what you need to know about the connection between IBS and hemorrhoids: [Read more…]
When talking to your patients about hemorrhoid treatments, it is imperative that they understand what to expect from the various options. Because some patients may be nervous about undergoing treatment, it is your duty to dissuade any fears or concerns and educate your patients. [Read more…]
