DDAR Blog

Medical Specialty Group Homes

There are over 60 million people suffering from Gastrointestinal Disorders in the United States today.  Their conditions range from the annoying complaints like constipation, gas or abdominal bloating to the ultra-serious conditions like Crohn’s/IBD, Pancreatitis or Esophageal Cancer. 

A number of “Medical Specialty Group Homes”, more commonly known as “Centers of Excellence” are springing up throughout the country and are now playing a leading role in the care of patients’ with gastrointestinal disease such as Crohns/IBD.  These Model Programs are using a multifaceted approach to treating patients with challenging conditions.  Their focus is patient-centric and their goal is to improve each patient’s quality of life and reducing hospitalizations and readmissions.  Patient’s suffering with Crohn’s disease across the county have a very high 30-day readmission rate.  Some estimates are as high as 18 to 20 percent.  A reduction in the 30 day readmission rate would save millions of dollars each year in the cost of managing Crohn’s in the United States.  

The approach used by these Centers is to bundle a variety of services to compliment your medical management.  Diet management is a key part of their strategy.  They will use Registered Dietician to conduct a comprehensive nutritional assessments which includes diet history, and nutrient analysis and heavy doses of Nutritional education to develop patient-specific goals.  Other complementary services, such as Exercise Physiology, Yoga, other Stress Reduction modalities, etc. are used to develop a wellness plan customized to each patient. 

The physicians at Digestive Disease Associates of Rockland are fully invested in the wellness of their patients.  We will be looking to collaborate with other services to develop a wellness blueprint for our patients with chronic disease.  We are fortunate to have Debbie Caputo NP on board to help co-manage the medical care of many of our chronic patients.  We look forward to more collaborations with community services to add a greater “wellness value” to the care you receive.

What I Need to Know About Diarrhea

Diarrhea is frequent, loose and watery bowel movements. Stool contains what is left after your digestive system absorbs nutrients and fluids from what you eat and drink. If your body does not absorb the fluids, or if your digestive system produces extra fluids, stools will be loose and watery. Loose stools contain more water, salts and minerals and weigh more than solid stools. Diarrhea that last a short time is called acute diarrhea.  Acute diarrhea is a common problem and usually lasts only 1-2 days.  Diarrhea that lasts for at least 4 weeks is called chronic diarrhea.  In addition to loose stools, other possible symptoms include cramps, an urgent need to use the bathroom and loss of bowel control.

Causes of Diarrhea include:  Bacteria from contaminated food or water; viruses that cause illnesses, such as the flu; parasites, which are tiny organisms found in contaminated food or water; medicine such as antibiotics; problems digesting certain foods; diseases that affect the stomach, small intestine or colon, such as Crohn’s disease and problems with how the colon functions, caused by disorders such as irritable bowel syndrome. 

In order to diagnosis the cause of your diarrhea, your gastroenterologist will perform a physical exam, ask you about the medicines you are taking, test your stool or blood for bacteria, parasites or other signs of disease or infection. Your doctor may ask you to stop eating certain foods to see whether your diarrhea goes away.  If you have chronic diarrhea, your doctor may perform other tests to look for signs of disease.

Diarrhea is treated by replacing lost fluids, salts and minerals to prevent dehydration.  Taking medicine to stop diarrhea can be helpful in some cases. Medicines you can buy over the counter without a prescription include Imodium, Pepto-Bismol and Kaopectate. Stop taking these medicines if symptoms get worse or if the diarrhea lasts more than 2 days.  If you have bloody diarrhea, you should not use over-the –counter medicines.  These medicines may make the diarrhea last longer. Your Gastroenterologist will usually prescribe antibiotics instead.

 If you have diarrhea, you should eat soft, bland foods such as bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, baked chicken without the skin or fat.  In order to prevent dehydration, it is important to drink plenty of water, fruit juices, sports drinks, soda without caffeine and salty broths. Sometimes eating yogurt with active live bacterial cultures may help you feel better faster.

Traveler’s diarrhea is preventable.  It is caused by eating food or drinking water that contains harmful bacteria, viruses or parasites. You can prevent traveler’s diarrhea by being careful.  Do not drink tap water or use it to brush your teeth. Do not eat or drink unpasteurized milk or milk products. Do not eat raw fruits or vegetables, unless they can be peeled and you peel them yourself. Do not eat raw or rare meat or fish. Do not eat meat or shellfish that is not hot when served to you; and lastly do not eat food sold by street vendors.  In some cases taking antibiotics before traveling can prevent traveler’s diarrhea. 

March is National Colorectal Cancer Awareness Month

 Early detection is vital, over 90% of all cases of colon cancer can be prevented with recommended screening. Despite its high incidence, colon cancer is one of the most detectable and, if found early enough, most treatable forms of cancer.

If you’re 50 or older, getting a screening test for colon cancer could save your life. Here’s how:  Colon cancer usually starts from polyps in the colon or rectum. A polyp is a growth that shouldn't be there. Over time, some polyps can turn into cancer. A screening colonoscopy can find polyps, so they can be removed before they turn into cancer. A screening colonoscopy can also find colon cancer early. When it is found early, the chance of being cured is good.

You should begin screening for colorectal cancer soon after turning 50 and then keep getting screened regularly, we recommend every 5 years.  Some people are at a higher risk than others for developing colorectal cancer. Having any of these things may increase your risk—

  • Inflammatory bowel disease.
  • A personal or family history of colorectal polyps or colorectal cancer.
  • Genetic syndromes, like familial adenomatous polyposis or hereditary non-polyposis colorectal cancer (also known as Lynch syndrome).

If you think you may be at high risk for colorectal cancer, talk to your doctor about when and how often to get tested.

ACG: What Patients Need to Know Re: New Study Linking PPIs to Dementia

A recent study plublished  by a German Health Plan suggested an association between Proton Pump Inhibitor use and dementia in the elderly.  The following statement was released by Anerican College of Gastroenterology President Kenneth R DeVault MD FACG,  "We appreciate and respect the data in the study, but believe more research is needed to understand the impact of PPIs on cognitive function, especially since studies of this type do not control for diet or lifestyle factors, nor do they establish causation. The study authors noted that this analysis of administrative data from the health plan in Germany can only provide a statistical association between PPI prescription and occurence of dementia and does not prove that PPIs caused dementia.  They further recognized that in order to evaluate the cause and effect relationship in the elderly more research in the form of randomized prospective clinical trials are needed."

In light of this study, along with other recent studies suggesting complications with long-term PPI use, The ACG urges patients to discuss the use of PPIs and any other medications with their healthcare provider.  Dr. Elliot Heller on behalf of the physician staff at Digistive Disease Associates of Rockland noted that any patients who have any concerns about continue use of PPIs should contact us and/or set up a follow-up appointment.  He further commented that any patient with serious esophageal disorders should consult with us before stopping their medication or changing the dose.  

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