Withdrawal Time, Cecal Intubation Rate Matters for Quality Colonoscopy

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Colonoscopy is the most effective screening for colon cancer because it allows a gastroenterologist to examine your entire colon for precancerous polyps called adenomas. All adenomas are benign in their initial stages, but some benign adenomas can become malignant if a GI doctor does not remove them during a colonoscopy.
 

Adenoma Detection Rate: The Primary Quality Colonoscopy Indicator

The best indicator for a quality colonoscopy is adenoma detection rate (ADR), which measures your gastroenterologist’s effectiveness in detecting adenomas in screening colonoscopies. Two other indicators for a quality colonoscopy are withdrawal time and cecal intubation rate.

Withdrawal Time

The goal of a colonoscopy is to view the entire colon from the rectum to cecum. If you have done a thorough bowel preparation, your gastroenterologist should be able to advance the colonoscope all the way to the cecum, near your appendix. Withdrawal time refers to the number of minutes your GI doctor spends inspecting your colon wall for adenomatous polyps. This quality indicator is always expressed in minutes.

You should expect your gastroenterologist to have an average withdrawal time of at least six minutes. Longer withdrawal times often reflect that your physician is especially meticulous and methodical in performing a colonoscopy, which usually produces a higher adenoma detection rate.

Cecal Intubation Rate

The percentage of success in which a gastroenterologist advances the colonoscope to the cecum in his or her patients is called cecal intubation rate. This indicator is always expressed as a percentage. The national standard for cecal intubation is 90 percent, but you should expect your gastroenterologist to have a higher cecal intubation rate. A high cecal intubation rate means your specialist takes time to fully insert the colonoscope to detect any precancerous polyps or lesions.

The quality of your bowel preparation affects your gastroenterologist’s cecal intubation rate. An incomplete bowel flush can impact a doctor’s ability to view the cecum and provide a complete visual inspection. Patients who do not follow instructions in the bowel preparation literature put themselves at increased risk for expensive re-testing or missed polyps.

A colonoscopy is an important component of preventative healthcare. Use quality indicators like ADR, withdrawal time and cecal intubation rate as criteria for selecting a gastroenterologist. It’s likely that you won’t have another colonoscopy for ten years, so make an informed decision when choosing your partner in colon cancer prevention. 

 

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Tennessee’s Colon Cancer Rate Exceeds US Average

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Colon cancer is a preventable disease, but it continues to be a leading cause of cancer death in the United States. About one in every five Americans will develop colon cancer and about one in every 25 Americans will die from the disease. Although most new cases of colon cancer occur in those who are 50 and older, no age is too young to develop colon cancer.

Colon cancer incidence and mortality rates are slightly higher in Tennessee than the national average, so this means that, as a Tennessean, you have an increased risk for colon disease. The higher incidence in our state is mostly due to lifestyle risk factors like food choices, activity level and unhealthy habits.

Five Perks of Wearing Polarized Sunglasses

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When you’re shopping for a pair of new sunglasses, you might notice certain brands or styles have polarized lenses. Have you ever wondered what advantages polarized lenses offer? Here are five facts you may not know about polarized lenses.

  1. NASA Jet Propulsion Laboratory developed polarized lenses after studying eagle vision. Eagles’ eyes contain a natural oil that prevents light from scattering.
  2. Polarized lenses were designed to mimic eagle vision. The lenses reduce glare from sunlight that reflects off shiny or smooth surfaces like water, glass, chrome or asphalt (VisionSource.com).
  3. Polarized lenses don’t block UVA or UVB rays. Some polarized lenses, but not all, offer UVA and UVB protection. Read stickers and labels carefully.
  4. Polarized lenses can help increase eye comfort during activities like driving, skiing, boating and fishing (AAO).
  5. Polarized lenses might help you see better, but they shouldn’t be considered “healthier” for your vision.

If you live an active lifestyle and participate in outdoor sports, you may find that polarized lenses help reduce squinting and cut down on eye strain. But the most important feature to look for in a new pair of sunglasses is 100 percent UVA and UVB protection. Proper eye protection will delay degenerative eye diseases like cataracts and macular degeneration.

If it has been over a year since your last comprehensive eye exam, make an appointment with a board-certified ophthalmologist. Click here to be connected with one of our vision experts.

Best Sandals for Plantar Fasciitis, Bunions and More

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With a change of seasons often comes a change of footwear — and when that season is summer, one of the most popular choices is sandals. While sandals can be cool, freeing and fashionable, they can also cause foot pain and even injure your feet if you don’t choose the right type.

So what makes for a “good” pair of sandals? As a general rule, they should have these three characteristics:

  1. A supportive sole
  2. Straps
  3. Some type of back

While these guidelines clearly rule out flip-flops, it still can be hard to know exactly what type of sandals is best for you. Here are more features to look for:

  • “Bump” in the insole: Look for a small raised “bump” in the center of the insole which is designed to provide arch support. Sandals that have it will keep your foot better aligned, and there will be less chance of it pronating (rolling inward) or supinating (rolling outward).
  • Thick sole: When a sandal is too thin and flat, there is little protection of the heel and arch, which can result in foot pain over time. Keep in mind that when it comes to soles, a bit of heel height can be a good thing, although they should be short, chunky heels, not high-heel styles.
  • Thick straps: If you’re looking for a new pair of sandals, try on styles with thick straps first — and the more straps the better, since they offer more support. Also, choose sandals that have back or ankle straps for optimal support.
  • No gripping required: In a slide, flip-flop or any other open sandal, your toes must grip the sole to keep it from sliding off your foot. This can cause foot and toe pain, so avoid styles that require you to “grip” with your toes.

Best Sandals for Foot Conditions

Just because you’re dealing with a foot problem doesn’t mean you need to avoid sandals. Here are some tips if you have any of the following conditions:

  • Bunions: Look for styles that allow your foot to breathe and provide as little covering as possible. Consider a toe post style that has ankle and back straps that offer a good fit while leaving the bunion alone.
  • Plantar fasciitis: Choose sandals with a snug foot strap and a deep heel cup, which will help provide stability.
  • Mallet toe or hammerhead toe: Choose open-toe styles that do not have an upper surface to rub against. Just make sure to choose sandals that also offer good overall support.
  • Diabetic neuropathy: Open sandals can be useful if you have neuropathy because they help encourage good blood and air circulation. Try to avoid seams on the interior, since the friction can cause foot pain. If you choose a closed design, make sure the upper does not bind your foot in any way.

A final tip: Always try sandals on before buying them and don’t ignore warning signs — if your feet don’t feel comfortable the first time you put them on, chances are they won’t later either. If you’re buying sandals online, consider buying from a source that offers free return shipping, so you can return them if they don’t feel right.

Finally, keep in mind that an orthopedist, podiatrist or doctor can make you custom sandals using a mold of your foot. A custom sandal may be the best option if you are having a hard time finding a design that looks good, feels right and offers the proper support.

Why GI Fellowship, Surgical Residency is a Must in a GI Doctor

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Colon cancer affects one in 20 Americans, making it the third-leading cause of cancer death in the United States. Most cases of colon cancer are preventable through routine colonoscopy, but one out of every three Americans is not up to date on their colon screenings.

Although colon cancer rates are decreasing among men and women who are 50 and older, colon cancer incidence is steadily increasing among younger Americans. For this reason, the American Cancer Society recommends that men and women who are at average risk for colon cancer begin preventative screenings at age 45.

A colonoscopy is a life-saving procedure, so it is important to make an educated decision when selecting your gastroenterologist. Here are some guidelines to help you choose the best GI doctor in your area:

  1. Call several gastroenterologists and take notes. Choosing a gastroenterologist requires as much time and attention as you would dedicate to making any major purchase. Research your options, read online physician reviews, call several endoscopy centers and take detailed notes.
  2. Select a gastroenterologist who is board certified by the American College of Gastroenterology.
  3. Inquire about each GI doctor’s area of specialty. All gastroenterologists are required to complete a fellowship in gastroenterology that trains them to examine, assess, diagnose and treat digestive disease. Most fellowships last anywhere from two to four years, and during that time, gastroenterologists select a few areas of specialty. These can include pediatric gastroenterology, hepatology, celiac disease, gastroparesis or inflammatory bowel disease. When you’re seeking to schedule a colonoscopy, you will want to look for gastroenterologists who specialize in endoscopy.
  4. Ask the endoscopy center for the center’s ADR or an individual physician’s ADR. Adenoma detection rate (ADR) is the most important quality measure in colonoscopy. ADR is calculated by the percentage of patients in whom a physician detects one or more adenomas (precancerous polyps) during a screening colonoscopy. When choosing a gastroenterologist, keep in mind that the national average ADR is 30 percent in male patients and 20 percent in female patients.

If during your screening colonoscopy, your gastroenterologist suspects you may have a colon tumor, he or she will remove a segment for biopsy. If the growth is cancerous, you may need a surgeon who specializes in colorectal surgery to remove the tumor. 

You can follow many of the same guidelines above when qualifying a surgeon, but you may want to ask about the surgeon’s area of expertise, and how many years of experience he or she has had in colorectal surgery.

If you are at least 45 and have not yet had a baseline colonoscopy, it’s time to select a gastroenterologist for your procedure. As a patient, you have a right to ask qualifying questions and inquire about physicians’ areas of specialty and expertise.

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Associated Endoscopy Tops US Average in Quality Colonoscopy

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When selecting a GI doctor near you for a colonoscopy procedure, there’s no substitute for quality. If you’re at average risk for colon cancer, you may only need a screening colonoscopy once every 10 years, so you want a gastroenterologist with expertise and precision.

Associated Endoscopy, just east of Nashville, is an accredited ambulatory surgery center (ASC) with six board-certified gastroenterologists who exceed the national benchmarks for quality colonoscopy procedures.

When choosing a GI doctor for your screening colonoscopy, there are two qualifying criteria: adenoma detection rate (ADR) and cecal intubation rate. As one of Middle Tennessee’s premier GI specialty centers, Associated Endoscopy is proud to share its GIQuIC quality measures.

Poor Gut Health Increases Depression, Anxiety Risks

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For years, physicians and researchers sought to treat depression by treating the brain, but recent research is shifting our attention to the gut as the center of mental health.

The Gut, Our “Second Brain”

The nervous system transmits and interprets information from all parts of the body through an intricate network of neurons. Although we mostly associate neurons with the central nervous system and the brain, the gut serves as a secondary hub of neurological activity. Trillions of bacteria and over 100 million neurons line the digestive tract, and they communicate with the central nervous system, endocrine system and immune system. This complex network is called the enteric nervous system or the “second brain.”

“Gut Feeling” Isn’t Just a Saying

We’ve all had a “gut feeling” or “butterflies in our stomach,” but those expressions aren’t just idioms.  According to a study by E.M.M Quigley, the second brain strongly influences emotions, moods and behavior. The enteric nervous system and gut microbiome control 80 percent of the communication between the body and the brain.

Gut Inflammation Increases Depression, Anxiety Risk

Healthy emotions begin with a healthy gut. One study proposes that gut inflammation initiates chronic conditions like depression and anxiety. A healthy gut is comprised of a wide diversity of bacteria and high concentrations of beneficial strains of bacteria. Poor diet, illness or antibiotic use can disrupt the delicate balance of gut flora, and this imbalance can result in inflammation and increased risk for depression and anxiety disorders (Huffington Post).

Gut Health Diet: How to Maintain Healthy Gut

Eating many colorful varieties of fresh fruits, vegetables, whole grains, lean proteins, nuts and seeds is essential for a nutritious diet and healthy digestion. You can boost concentrations of beneficial bacteria in your gut by adding probiotics to your diet like yogurt, kefir, kimchi, sauerkraut, tempeh, miso and kombucha.

A GI Doctor Can Help

Depression and anxiety is a serious condition that requires a physician’s care. Make an appointment with your doctor to discuss how improving your digestive health can boost your mental wellness. 

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Early Cataracts: Signs You May Need Cataract Surgery

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Cataracts are a degenerative eye condition usually associated with advanced age, but people of all ages can be treated for cataracts. June is Cataract Awareness Month, so let’s explore some of the most common questions about early cataract development and treatment.

What Causes Cataracts

Most people will eventually develop a cataract, but some cataracts form earlier or quicker. Certain environmental factors, health conditions and lifestyle habits can cause cataracts to form more rapidly. These include cigarette smoking, UV exposure, eye trauma, hypertension, diabetes, steroid use, or genetic predisposition to early cataracts.

How Do You Know If You Have Cataracts

Cataract development is a slow and progressive process. In fact, you probably won’t know you have a developing cataract until your ophthalmologist tells you. It may be years before the cataract begins to impair your vision and cause symptoms like double vision, blurred vision, muted colors, glares and halos.

When to Have Cataract Surgery

Over time, a cataract will impact your daily activities. You’ll find it difficult to drive at night, read street signs, decipher fine print, and do detailed crafts and hobbies like needlework. When cataracts affect your schedule or your independence, it’s time to talk to your ophthalmologist about scheduling cataract surgery.

Once your ophthalmologist determines that you’re a candidate, there’s no reason to put off the procedure. It’s time to make decisions about the type of intraocular lens (IOL) that would be best for your eye, and whether you should have traditional or laser-assisted surgery.

Benefits of Early Cataract Surgery

Cataract surgery is truly a cure for cataracts, and many people can experience 20/20 vision again.  It takes only about 15 minutes per eye, and most people can resume their normal activities within a few days. Cataract surgery improves quality of life, increases independence and reduces the risk of falls, hip fractures and automobile accidents (American Academy of Ophthalmology).

Talk to your ophthalmologist about whether you’re a candidate for cataract surgery. With over 3.6 million procedures performed each year, cataract surgery is one of the most common operations in the United States. Make an appointment for a comprehensive eye exam today.