Irritable Bowel Syndrome

Everyone experiences discomfort in their gut from time to time. It can occur when we are nervous about something, or when we eat something that doesn’t agree with us. But if you regularly feel pain in your abdomen, it might be a sign of a disorder called irritable bowel syndrome (IBS).

Irritable bowel syndrome affects about 1 in 5 Americans, and occurs more often in women than men, and usually begins before the age of 35.

There’s no medical test to identify irritable bowel syndrome. Your doctor may make a diagnosis based on the patient’s symptoms and through exclusion of other problems. The most common IBS symptoms include bloating and pain in the abdomen, along with changes in bowel habits. People with irritable bowel syndrome may have constipation, diarrhea or both.

IBS doesn’t lead to cancer or other health problems, but the discomfort it causes can be difficult to live with. No one really knows what causes irritable bowel syndrome yet everyone agrees stress plays an important role in triggering symptoms.  Stress reduction strategies can help relieve these symptoms.

Some researchers suspect that IBS can be caused by a change in bacteria in the digestive tract.   Digestion is aided by helpful bacteria, but sometimes the bacteria in our gut can change, especially after taking certain medications. We often suggest a supplement of probiotics to aid digestion and reduce IBS symptoms. Probiotics are available as capsules, tablets and powders, and they’re found in some dairy foods, such as yogurt. The benefits of probiotics is still however under investigation.

Many people with irritable bowel syndrome find that certain foods can make them feel worse. Irritable bowel syndrome patients are generally more sensitive to a variety of foods.  Some researchers believe a diet low in Fermentable Oligo, Di & Mono-Saccharides and Polyols (FODMAP) may help eliminate chronic bloating and gas.  We recommend patients keep a diary of the foods they eat and how they make them feel so that they can share this information with their doctor.

Every case of irritable bowel syndrome is unique, so if you have symptoms that disrupt your life, don’t suffer in silence. Your doctor can work with you to find the treatment that works best for you.



Cyclospora Outbreak

During the summer, many people tend to eat lighter and consume more salads.  To that end, we wanted to alert you to a recent outbreak of an intestinal illness that may be attributable to eating prepackaged salad.  The Center for Disease Control (CDC) is working diligently with local health departments in several states to determine the possible link between a Cyclospora outbreak and bagged salad mix sold across the country.  Hundreds of people have become ill  and 22 people in five states have been hospitalized over the past several weeks. 

Cyclospora is an intestinal illness caused by a microscopic parasite Cyclospora cayetanensis.  The disease is transmitted by fecal matter ingested in foods or water supply.  Symptoms can include loose, water diarrhea, fatigue, bloating, stomach cramps, nausea and low grade fever.  Public health workers in several states have noticed that a large number of the afflicted had eaten the same brand of prepackaged salad mix.  CDC and public health officials are also investigating salad mix sold to patrons of a large national restaurant chain where they have identified clusters of Cyclospora outbreaks. The national restaurant chain purchased its salad ingredients for a single source. 

We recommend that you thoroughly wash all lettuce and vegetables before consuming them, even if your prepackage salad mixes are labeled as pre-washed. 

We would also like to remind you to use precaution when swimming in local lakes and ponds this summer.  Outbreaks of intestinal illness due to waterborne parasites such as Giardia occur in water supplies that are home to water fowl like ducks and geese.  Check with local officials to make sure that your lakes and ponds have been properly treated and inspected before jumping in.  

Colonoscopies Save Lives and Reduce Healthcare Expenditures

Dr. Elliot A. Heller responds to the New York Times Article – “The $2.7 Trillion Medical Bill: Colonoscopies Explain Why U.S. Leads the World in Health Expenditures”

Dear DDAR Patient

My colleagues and I were extremely disappointed to see the New York Times article unfairly blaming colonoscopies for our nation’s growing healthcare costs. We’re very concerned about the negative impact this article could have on patients getting screened for colon cancer. Studies have shown that death due to colorectal cancer has been reduced by 53% in the United States as a result of screening colonoscopies. The New York Times article failed to note that early detection by colonoscopy results in millions of dollars of cost savings to the nation’s healthcare bottom-line, money that would otherwise be spent on the care and treatment of patients with terminal colon cancer.

We at DDAR go to great lengths to provide cost-effective delivery of high-quality care to our patients. Having your colonoscopy procedure at an office-based surgical (OBS) facility is a real quality value. Nothing is compromised, as all Office Based Surgical (OBS) facilities, like our DDAR endoscopy suite, are accredited and must adhere to the same standards for quality, infection control and patient safety as any Ambulatory Surgical Center (ASC) or Outpatient Hospital Facility.

Lastly, we’d like to note that the federal government, under the Patient Protection and Affordable Care Act, has placed a priority on eliminating all barriers to getting Americans over 50 years of age to have a colorectal cancer screening procedure. Colonoscopies are on the short list of procedures for which insurance carriers cannot impose cost-sharing requirements, such as co-pays, co-insurance and deductibles. This means your carrier should provide you with first dollar coverage for your screening colonoscopy.

The New York Times article was biased in holding colonoscopies responsible for the rising healthcare costs. The only cost we see regarding colonoscopies is that it could cost you your life by NOT being regularly screened.

Read original NYT Article

CDC Recommends One-time HCV Testing for Baby Boomers

In August 2012, the Center for Disease Control and Prevention issued final guidance recommending that all people born from 1945 to 1965 be tested once for Hepatitis C virus (HCV). This recommendation was based upon an analysis of the 1999-2008 National Health and Nutrition Examination Survey (NHANES), which found that one in 30 baby boomers is infected with Hepatitis C. Baby boomers account for 75% of HCV prevalence in the United States. Many were infected prior to any awareness of HCV, and consequently, any understanding of how HCV is transmitted. Most HCV infected individuals are asymptomatic and unaware of their infection until significant complications from chronic HCV occur.

HCV is the most common bloodborne illness in the US with an estimated 2.7 million to 3.9 million people living with the disease. The virus is spread through exposure to contaminated blood. HCV can also be transferred through sharing of personal items such as a razor or toothbrush. Approximately 80% of patients with HCV have no symptoms. Despite delayed onset of symptoms in many patients, HCV- infected patients are at an increased risk of developing many serious complications.

Our goal at DDAR is to diagnose early and initiate treatment to prevent future complications. Our physicians, in collaboration with Deborha Caputo CNP, understand that treatment and management of HCV patients must be customized for each patient. As such, we stay abreast of all updates and progress in HCV treatment and therapy. We are optimistic that the 20+ new HCV treatments in clinical research trials in the U.S. will pave the way for further improvements in DDAR’s HCV patient management.

Please check with your physician about Hepatitis C Virus screening during your next office visit.



  We are pleased to announce that Dr Janice Jang will be joining our professional staff in July 2021. Dr Jang will be completing her fellowship in Gastroenterology at NYU Langone Health in June...

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