Gastroparesis Awareness Month Calls for Action in August

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What is Gastroparesis?

Gastroparesis is a condition characterized by delayed stomach emptying. In a normally functioning stomach, gastric contractions move food material through the gastrointestinal tract. Patients with gastroparesis experience slow or erratic stomach contractions, which halts the digestive process. Common symptoms of gastroparesis include abdominal pain, bloating, reduced appetite and weight loss.

What Causes Gastroparesis?

One of the most common causes of gastroparesis is a damaged vagus nerve, the main nerve that communicates with the digestive tract. Injury to the vagus nerve interrupts impulses that control involuntary muscles in the stomach, gallbladder and intestines which stimulate secretions and contractions.

Gastroparesis can also be caused by uncontrolled diabetes, medications and other nerve disorders.

Common Misconceptions about Gastroparesis

Many people think that gastroparesis is an eating disorder because it is associated with malnutrition and weight loss, but this is untrue. Gastroparesis is a gastrointestinal disorder that causes a sensation of fullness because the stomach cannot empty properly.

Fatigue and nausea are common with gastroparesis because the body is not being properly nourished. Therefore, people who have gastroparesis are sometimes mischaracterized as being lazy or lacking in motivation. It is important to remember that although those who suffer from gastroparesis may want to perform the daily tasks that most people can accomplish, they may not be able to, since they lack nutritional availability.

 How You Can Help

You can get involved in Gastroparesis Awareness Month by paying attention to your own digestive health. If you are experiencing symptoms of gastroparesis, make an appointment with a gastroenterologist. Undiagnosed gastroparesis can lead to serious health risks.

You can also talk to your friends and family about the condition to spread awareness about the disorder. Many people are unfamiliar with gastroparesis, so start a conversation and share your knowledge with someone else.

Finally, go to the International Foundation for Functional Digestive Disorder’s web page. You will find many resources on gastroparesis including management and prevention tips, personal testimonials and ways you can get involved in your local community.

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Children’s Eye Health and Safety Month

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Vision problems negatively impact school performance, so schedule comprehensive eye exams for your children to be sure they have healthy vision before school begins.

Here are the top 5 reasons a comprehensive eye exam should be a part of your family’s back-to-school routine each year:

Comprehensive Eye Exams Correct Problems Early

The right and left eye must function as a team for normal vision to develop. Regular visits to your children’s pediatrician from infancy through preschool will help ensure that eye alignment problems are detected early. However, if you suspect your child has an issue with eye alignment, make an appointment with an ophthalmologist.

Comprehensive Eye Exams Offer More than School Vision Screenings

School vision screenings can only identify vision problems, not correct them. Often admistered by volunteers, screenings offer limited testing with minimal equipment. On the other hand, through comprehensive eye exams, licensed eye care professionals perform several tests and can make specific diagnoses. During an eye exam, a child can receive immediate treatment and corrective options for vision problems.

Comprehensive Eye Exams Correct More than Eye Problems

A common complaint among school-aged children is headaches due to refractive errors like nearsightedness, farsightedness and astigmatism. When children cannot see clearly, they often strain their vision by squinting, which often results in headaches. Many children experience relief after refractive errors are diagnosed and treated with eyeglasses.

Comprehensive Eye Exams Increase Self-Confidence

Children with vision problems often cannot read words and images in books or on display boards, which may affect their academic performance. Eye problems may also impact their ability to participate in activities like physical education classes and youth sports, resulting in low self-esteem. Through yearly eye exams, providers can diagnose and correct vision problems early on so children can perform at their highest level.

Comprehensive Eye Exams Provide Overall Health Assessments

During comprehensive eye exams, ophthalmologists use tests including eye dilation to evaluate the health of the retina and blood vessels. Some of these tests may even identify undiagnosed chronic health conditions like diabetes or hypertension, and children can then be referred to a specialist for further evaluation.

A comprehensive eye exam is an essential component of back-to-school readiness. Make an appointment with an ophthalmologist for a full comprehensive eye exam with dilation for your children. You can then feel confident that they are equipped with clear vision and are ready for a successful school year. 

Urinary Incontinence: Procedures to End Your Suffering

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When it comes to urinary incontinence — that is, the inability to control the flow of one’s urine — every patient’s experience is unique. In addition to there being different challenges for women and men, there are also a variety of reasons the problem may be occurring.

Plus, some urinary incontinence may be temporary, such as incontinence caused by a urinary tract infection (UTI). Other times, it is ongoing and could become worse over time if not treated.

When a Surgical Procedure Is Needed for Urinary Incontinence

Doctors use a number of different treatments for urinary incontinence, ranging from medications to self-care practices designed to strengthen the muscles. But if medications or non-surgical treatments don’t lead to improvement, surgery can be used to treat urinary incontinence. Surgery typically offers a permanent solution.

A doctor will explain the available procedures and discuss which is best for the patient. In offering this recommendation, the doctor will have to take a number of factors into consideration, such as the patient’s overall health and existing damage to the urinary tract or surrounding tissues.

Here are some common procedures used to treat urinary incontinence:

Artificial Urinary Sphincter Placement (for Men)

Urethral sphincters are the muscles that control the release of urine from the bladder. When the urethral sphincters are contracted, this blocks the opening of the bladder, preventing urine from leaking out. When functioning properly, the urethral sphincters remain contracted until a person urinates, at which point, the sphincters relax. In males who cannot voluntarily control urination, one surgical option is implantation of an artificial urinary sphincter (AUS). During an AUS procedure, the doctor makes small incisions near the scrotum and below the abdomen. Next, an inflatable urethral cuff, pump and balloon are inserted. After the procedure, the patient will then be able to urinate by squeezing and releasing a small pump located in the scrotum. This causes fluid to pass from the cuff into the balloon, allowing the cuff to expand and the urethra to open so the patient can urinate.

Bladder Neck Suspension (for Women)

Stress incontinence is a term used to describe an involuntary emission of urine when there is sudden pressure on the bladder and abdomen, such as when sneezing, laughing or jumping. It is one of the most common types of incontinence issues experienced by women. To correct stress incontinence, a doctor can perform a bladder neck suspension. This procedure involves the physician pulling up or “suspending” the bladder neck to give it greater support, then attaching it to the surrounding bone or tissue. This protects against urine leakage.

Sling Procedures (for Men and Women)

Both men and women can have sling procedures. Slings are made of soft mesh that is inserted permanently into the body.

  • For Men – The sling is inserted to reposition the urethral sphincter muscle. This supports the muscle and helps stop bladder leakage. During the procedure, the doctor makes a small incision between the scrotum and anus. Next, he or she places the sling around part of the urethra. The sling repositions and squeezes the urethra, which helps the sphincter function properly.
  • For Women – Women can also have a sling procedure to stop or lessen urinary incontinence. In women, the sling is positioned so it raises and supports the urethra as well as the neck of the bladder. There are several approaches a doctor can use for the procedure that are performed on an outpatient basis and typically take just a half an hour.

Improved Quality of Life

Treating urinary incontinence with a surgical procedure can lead to a much better quality of life. If you are suffering from urinary incontinence, schedule an appointment with a doctor to discuss your options.

A Weak Pelvic Floor Can Lead to Vaginal Wall Prolapse

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This causes the organ or organs that they are supporting — whether that’s the vagina, uterus, bladder, urethra, small bowel or rectum — to shift position and put pressure on the vagina. In some cases, these tissues can cause so much pressure that they protrude out of the vagina.

There are a variety of reasons pelvic floor muscles can become weak, making pelvic prolapse more likely. For instance, if a woman:

  • Has given birth vaginally, and the labor was long or the baby was very large
  • Has had a hysterectomy
  • Is post-menopausal; women who are post-menopause have lower levels of estrogen which causes the muscles and soft tissues of the pelvis to weaken
  • Is obese
  • Experiences chronic coughing
  • Strains almost every time she has a bowel movement

Vaginal Prolapse Symptoms

If you think you might have pelvic organ prolapse, one or some of these symptoms may be familiar to you:

  • Difficulty with bowel movements
  • Heaviness or pressure in the pelvic area
  • Lower back pain
  • Pain during intercourse
  • Tissue protruding from the vagina or a feeling that it could
  • Urinary problems from incontinence to chronic urge to urinate to urine retention

Pelvic organ prolapse can worsen over time, so it’s important to make an appointment to see a doctor if you are experiencing any of these symptoms.

Non-Surgical POP Treatment Options

If your prolapse is not causing pain or interfering with your daily life, your doctor may suggest no treatment, exercises or non-surgical treatment. One non-surgical option frequently used to treat POP is a pessary, which is a small device that fits inside the vagina and helps support the pelvic organs.

A pessary must be fitted to each woman, and there is no scientific method available to determine the perfect size a patient needs. For that reason, after the first fitting, a woman will need to return to the doctor several days later to have it checked. If the pessary is working well, the woman will likely not need to return for several months. A pessary can be used on an ongoing basis, and it’s estimated that about half of the women who have one continue to use it. However, they must be cared for and used correctly. Otherwise, problems can occur, such as bleeding or vaginal infections.

Kegel exercises are another non-surgical care method that may be recommended by a doctor to help strengthen the pelvic floor. The National Institutes of Health offers instructions on how to perform Kegel exercises.

Pelvic Organ Prolapse Surgery

There are several surgical solutions for patients who have pelvic organ prolapse. The particular procedure depends on factors such as a woman’s unique anatomy and whether or not she wants to be sexually active. Here are some examples:

  • Anterior Vaginal Prolapse Repair: Lifts the front vaginal wall back into the body so the bladder has support
  • Apical Suspension: Repairs the top of the vagina and helps maintain sexual function
  • Posterior Vaginal Prolapse Repair: Repairs a bulge in the back wall of the vagina

A doctor may be able to perform these procedures laparoscopically, using small incisions in the vagina or abdomen. This can help shorten recovery time.

For More Information

For more details about pelvic organ prolapse and surgical procedures for POP, visit the American College of Obstetricians & Gynecologists (ACOG).

Methylene Blue Dye Could Increase Colonoscopy Effectiveness

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A blue tablet could help increase your gastroenterologist’s ability to detect polyps during a colonoscopy.

Blue Dye Increases Adenoma Detection Rate (ADR)

A recent study found that oral tablets with methylene blue dye could boost adenoma detection rate (ADR) as much as nine percent. ADR is the percentage of patients undergoing screening colonoscopies in whom a physician detects one or more adenomas, or precancerous polyps.

Alessandro Repici, M.D., of Humanities University Medical School in Milan, Italy, led the study. He and his research team analyzed over 1,200 colonoscopy patients at 20 facilities. Patients received either a placebo, a half-dose of delayed-release methylene blue dye tablet or a full dose. The patients who received the full dose of delayed-release methylene blue had nine percent more adenomas detected because the dye identified small, flat polyps that typically would have been missed.

Blue dye is commonly used during colonoscopy, but it is sprayed into the colon during the exam to highlight specific areas. The oral tablet used in the study is innovative because it is quick, easy to administer and has no known side effects.

ADR and Colon Cancer Prevention

Increasing physician ADR directly affects colon cancer prevention. For every percentage point increase in a physician’s ADR, a patient’s colon cancer risk is reduced by three percent.

Improving colon visualization during colonoscopy is the first and most essential step in boosting ADR since adenomas must be detected before they can be removed. Use of the delayed-release blue tablet still requires further testing but could become an integral part of the colonoscopy procedure.

Colon cancer is currently the third-leading cause of cancer death among men and women in the United States, but the disease is mostly preventable with routine colonoscopy. The American Cancer Society recommends that people who are at average risk for colon cancer begin screening at age 45. If colon cancer or colon polyps run in your family, however, you should be screened at a younger age.

Call Your Gastroenterologist

Talk to a gastroenterologist about when you should begin colon cancer screening. Only a colonoscopy allows your GI doctor to detect and remove precancerous polyps during the same procedure. It is so effective that you won’t have to repeat the procedure for a whole decade if you are at normal risk for colon cancer and have a clean bill of health.

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Optometrist vs Ophthalmologist vs Optician: The Difference?

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To receive the best in vision care, you need to visit the right type of professional.

When talking about eye care specialists, people sometimes use “ophthalmologist,” “optometrist” and “optician” interchangeably, but these three terms describe distinct professions.

What Opticians Do

An optician is a technician who has trained to fit eyeglasses, contact lenses and other corrective devices. Opticians are not licensed to perform eye exams, write prescriptions or treat eye diseases.

What Optometrists Do

An optometrist is an eye doctor who has earned a Doctor of Optometry (O.D.). A Doctor of Optometry usually requires a four-year undergraduate degree in the sciences and four years of post-graduate training at a school of optometry.

Optometrists perform comprehensive eye exams, correct refractive errors (nearsightedness, farsightedness and astigmatism) and write prescriptions for eyeglasses and contact lenses. Some optometrists have specialized training to treat low vision problems. Optometrists are not medical doctors and cannot perform surgery.

What Ophthalmologists Do

An ophthalmologist is a medical doctor (M.D.) or doctor of osteopathy (D.O.) who is licensed to practice medicine and surgery. Ophthalmologists have completed a bachelor’s degree and a minimum of eight combined years of medical school and residency. Ophthalmologists perform all tasks that optometrists are licensed to do, but they also perform eye surgery as well as treat all types of eye disease.

Some ophthalmologists complete additional training called fellowships to specialize in specific areas of ophthalmology like glaucoma, cornea, retina, neuro-ophthalmology, plastic surgery or pediatrics.

For a comprehensive eye exam and assessment of your vision health, schedule an appointment with an ophthalmologist. Annual comprehensive eye exams help keep your vision clear and prevent eye disease. Your ophthalmologist will test your visual acuity, evaluate your current eye prescription and screen you for degenerative eye diseases like cataracts, glaucoma and macular degeneration. 

7 Reasons to See a Foot and Ankle Specialist, Podiatrist

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Even though the majority of people use their feet every day, many put off seeing a foot doctor — also known as a podiatrist — if they have foot pain. Reasons people put off visiting the doctor vary but generally fall into these categories:

  • They believe their foot pain will go away on its own
  • They think the foot issue is not severe enough to warrant seeing a podiatrist
  • They do not recognize common foot problems or know that they can be treated
  • They are worried that they’ll need surgery

If you’re experiencing any of the foot problems below, it might be time to schedule an appointment with a podiatrist.

  1. Thick calluses or corns. While these areas of built-up skin aren’t always painful, if they become too large, they can cause pain. Additionally, there might be an underlying condition that’s causing them, like bunions (bony growths under the skin). A podiatrist can properly diagnose you, then offer treatment such as a cortisone injection to reduce pain. He or she can also painlessly remove the dead skin cells.
  2. Heel issues that aren’t going away. If your heels are dry and the skin splits and bleeds, you are at higher risk for infection. Heel pain may also indicate a heel spur, which is another type of abnormal bony growth. Tendonitis can cause heel pain, too. A podiatrist can determine what’s causing the problem and suggest helpful treatments.
  3. An ingrown toenail that’s getting worse. If a toenail is trimmed too short, it can grow into the skin causing pain and possibly infection. People who attempt to care for ingrown toenails themselves often make the problem worse, damaging the nail and the surrounding tissues. A podiatrist can prescribe medication or safely remove part of the nail if needed.
  4. A persistent fungal infection. Athlete’s foot is an itchy and unpleasant condition that can make the skin between toes look scaly. If you’ve tried antifungal treatment at home for more than a couple of weeks, and it’s still not working, see a podiatrist. He or she can check for a bacterial infection and if present, prescribe antibiotics as treatment.
  5. Bunions that are causing discomfort. If you have a bunion, you should see a podiatrist sooner rather than later. Bunions often get worse unless they’re treated. Surgery may be needed, but other options such as a medication or taping may also work.
  6. Chronic joint pain. If your foot or ankle joints are swollen, red, stiff or tender, or it simply hurts when you stand or walk, you could have arthritis or another condition. A podiatrist can properly diagnose you, then offer treatments to reduce joint pain, from medications to minimally invasive procedures to joint surgery or replacement.
  7. Numbness and tingling. People with diabetes are more susceptible to foot problems. These can range from dry skin to infections to a nerve condition (neuropathy). If you’re experiencing foot numbness along with tingling or burning, it could be a sign of neuropathy. If you have been diagnosed with pre-diabetes or diabetes, you should make an appointment with a podiatrist at least once a year.

Some foot problems go away on their own, but others get worse. For this reason, it makes good sense to see a podiatrist early on if you are experiencing foot issues. Because of their focused expertise in issues of the foot and ankle, podiatrists can expertly diagnose conditions, then offer treatments that can help you experience less pain and more enjoyment in your life.

Endocuff Device May Help GI Doctors Find More Colon Polyps

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Mechanics of a Colonoscopy

During a colonoscopy, a GI doctor inserts a flexible tube called a colonoscope into the rectum and extends it to the farthest point in the large intestine known as the cecum. The colonoscope is equipped with a tiny camera that transmits live video to a monitor. As the tube is withdrawn, the doctor examines the colon wall for adenomas and removes suspicious growths.

Adenoma detection rate (ADR) is the primary indicator of the quality of a colonoscopy procedure because adenoma removal is associated with decreased colon cancer risk. Therefore, any method or device that enhances a physician’s ability to detect polyps or lesions has the potential to lower colon cancer incidence.

The Endocuff was designed to smooth out folds in the colon wall and help maintain colonoscope stability during withdrawal. Another quality measure of an effective colonoscopy is withdrawal time, the number of minutes it takes for a physician to view the colon from cecum to rectum. The Endocuff can help improve withdrawal time by steadying the scope and preventing it from slipping. The flexible arms on the disposable attachment can help anchor the colonoscope to improve visualization and prevent missed adenomas.

In one clinical study, the Endocuff enhanced visualization of the colon and boosted physician ADR by 16 percent. The Endocuff’s ability to stabilize the colonoscope reduced average withdrawal time, suggesting that the cuff can help achieve a more thorough colonoscopy in a shorter amount of time.

Adenoma detection rate has historically been determined by a physician’s skill, experience and imaging technology. Although the Endocuff requires additional testing, this new technology may become a valuable component of endoscopy and may contribute to higher adenoma detection rates.

The American Cancer Society now recommends that people of average risk for colon cancer have a baseline colonoscopy at age 45 instead of 50. If you have not scheduled a colonoscopy or have questions about the procedure, make an appointment with a gastroenterologist today. 

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Eyelid Surgery Can Restore Youthful Appearance

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Blepharoplasty can be medically necessary if excessive tissue around the eyes interferes with your vision, but you may also elect to have cosmetic blepharoplasty to improve your appearance.

Reasons for cosmetic blepharoplasty

An eyelid lift is one of the most common cosmetic procedures. Cosmetic blepharoplasty can rejuvenate your face and restore an energetic and youthful appearance to your eyes. By removing folds of skin around the upper eyelids, your surgeon can restore the natural contour of your eyes making you look years younger.

If you have noticed increasing puffiness or bags under your eyes, you may want to consider cosmetic blepharoplasty to remove fatty deposits from your lower eyelid area. You can also choose to have a lower eyelid lift if your lower lids have begun to sag and expose the white part of your eye underneath the iris.

Questions for your ophthalmologist

If you feel that cosmetic eyelid surgery is right for you, talk with your ophthalmologist at your next comprehensive eye exam. Make a list of questions before your appointment so you can prepare for your conversation. You may want to use a few of these:

  1. Do you perform cosmetic blepharoplasty, or do I need a referral to a plastic surgeon?
  2. Do I have a medical need for an eyelid lift or would my eyelid surgery be cosmetic?
  3. Do I need treatment for one eye or both eyes?
  4. Should I expect my vision to improve after the procedure?
  5. Will insurance cover any portion of my surgery?
  6. What fees should I anticipate when estimating my out-of-pocket expenses?
  7. What are the risks of blepharoplasty?
  8. Will I need to have a second treatment in the near or distant future? (American Society of Plastic Surgeons).

PCOS: Symptoms, Causes and Treatment for Women

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Polycystic ovarian syndrome (PCOS) is a common hormonal disorder that affects about 5 to 10 percent of all women. It is also the leading cause of infertility in women — although many people have never heard of it.

PCOS causes the ovaries to produce an excess of “male” hormones called androgens. With PCOS, the ovaries can also grow larger and form small cysts on their outer edges. All this can interfere with a woman’s menstrual cycle, which can cause infertility.

It is estimated that about half of women who have PCOS don’t know they have it. Part of the reason it’s hard to recognize and diagnose is because the primary symptoms of PCOS are quite common. They include:

  • Acne
  • Excess facial or body hair
  • Fatigue
  • Missed, irregular or heavy periods
  • Mood changes
  • Weight gain

PCOS Can Increase Health Risks

If a woman experiences these symptoms, they can be easy to ignore, since they are often very mild. However, untreated PCOS can lead to increased risk for certain diseases and serious health issues, so it’s important to recognize the symptoms and see a doctor if a woman believes she may have it. Undiagnosed and untreated PCOS can lead to increased risk of:

  • Diabetes
  • High blood pressure
  • High cholesterol
  • Uterine cancer (due to irregular periods)

Mental health can also be affected. Early in 2018, a study reported that women with PCOS are more likely to develop mental health disorders. The same study also suggests that women who have it may have a slight increased risk of giving birth to children with attention deficit hyperactivity disorder (ADHD) and autism.

Doctors Can Perform Tests and Offer Treatments

No one knows exactly why some women get PCOS and others don’t. But what experts do agree on is that getting diagnosed and treated sooner rather than later is the best way to lower your chances of health problems in the future and to get relief right now.

Because PCOS can be difficult to diagnose and treat, a doctor may perform several tests or refer you to other specialists to get you the help you need. Your doctor may:

  • Perform blood tests to measure your hormone levels
  • Schedule an ultrasound to see if there are cysts on the ovaries
  • Prescribe diabetes medication called metformin that can help control the symptoms of PCOS
  • Prescribing birth control pills to keep hormones balanced and to get your menstrual cycle back on track

What You Can Do on Your Own

Although it is not possible to avoid developing PCOS, some experts recommend a high protein, low carb diet along with weight loss if a woman is obese.

These experts point out that obesity contributes to insulin resistance, which increases androgen, and in turn can worsen the symptoms of PCOS. For some women, even losing 10 pounds could make a significant difference in reducing or eliminating PCOS symptoms. Additionally, if a woman who is obese is having problems getting pregnant, the weight loss could help increase the chance of pregnancy.

Finally, if you think you, your daughter or another family member or friend may have PCOS, it’s better to seek out expert advice from a doctor sooner rather than later. You’ll feel better, and you’ll be proactively taking steps to stay as healthy as possible as you move towards the future.

For More Information, visit PCOS Awareness Association.