Our Gastroenterology Blog
By NASHVILLE GASTROINTESTINAL SPECIALISTS
December 06, 2018
Category: GI Care
Tags: heartburn  

Got heartburn? Heartburn, also known as acid indigestion, is a form of indigestion felt as a burning pain in the chest. It's caused when stomach acid flows up into your esophagus. More than just a minor discomfort, acid indigestion can reduce quality of life. The following tips will help you rid yourself of heartburn.

1. Change your diet. Stay away from beverages and foods that commonly cause heartburn. A good way to work out what beverages and foods trigger your heartburn symptoms is to keep track of what you eat. Common offenders include tea, coffee, tomatoes, garlic, fatty foods, spicy foods, milk, chocolate and peppermint. 

2. Don't overeat. Overeating can trigger heartburn. Big meals put pressure on the muscle that helps keep stomach contents from backing up into the esophagus. The more food you eat, the longer it takes for your stomach to empty, which contributes to acid reflux. Try eating five small meals a day to keep reflux at bay.

3. Avoid alcohol. Alcohol can trigger heartburn. Alcohol can relax the sphincter muscle at the lower end of your esophagus, causing stomach acid to flow up into your esophagus If your aim is to unwind after a long day at work, try exercise, stretching, listening to soothing music, or deep breathing instead of drinking alcohol.

4. Lose weight. If you overeat, lose weight- but be sure to consult your doctor before starting a vigorous exercise program. The increased risk of heartburn is thought to be due to excess abdominal fat causing pressure on the stomach.

5. Stop smoking. Nicotine is a muscle relaxant. Nicotine can relax the sphincter muscle, causes acid from the stomach to leak upward into the esophagus. Nicotine gums, patches, and lozenges are healthier and safer than cigarettes, and they are less likely to give you heartburn. 

6. Contact your doctor. Your doctor may suggest antacids for occasional heartburn. Sometimes, more powerful prescription medications such as proton pump inhibitors or H2 blockers and are needed to treat chronic heartburn. When all else fails, surgery may be required to repair the LES.

Chronic heartburn can affect your daily activities and make life frustrating and miserable. Don't hesitate to contact a gastroenterologist about heartburn.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
November 16, 2018
Category: GI Care
Tags: Diverticulitis  

What is diverticulitis?

Normally, we pay no attention to our large intestines, but if you have symptoms of diverticulitis, you're well aware of your bowel. Painful, inflamed bulges in the intestinal wall, diverticula are worrisome and potentially dangerous. If your physician suspects you have this GI condition common in the over-60 population, seek the services of a gastroenterologist. Specially trained in diverticulitis, and the less serious diverticulosis, a GI specialist can diagnose and treat your bowel health for better long-term function and well-being.

Symptoms of diverticulitis

Diverticulitis is serious infection which requires medical attention. Symptoms include:

  • Fever
  • Intense lower abdominal pain
  • Blood in the stool
  • Pus and mucus with your bowel movements, indicating infection
  • Nausea
  • Vomiting
When infection is severe, the individual puches of the intestinal wall may rupture, spilling bowel contents into the abdomen. This is a medical emergency and may require treatment with IV antibiotics and even surgery to repair the tears.
 
Being proactive with diverticulitis
 
Certainly, age is a factor in development of diverticula. Genetics, obesity and a sedentary lifestyle add to this GI problem, says the American Academy of Family Physicians.
 
However, gastroenterologists advise that dietary changes help decrease the chances of infection and rupture. In other words, you can live well even with diverticulosis by lowering your intake of fermentable carbohydrates such as:
  • Cabbage
  • Beans
  • Fruits and vegetables
  • Onions
  • Garlic
  • Dairy products
  • Sauerkraut
In decades past, physicians recommended that patients with diverticulosis avoid seeds, nuts, corn and other foods which could collect and fester in the small intestinal pouches. More recent research, however, indicates that this may not be the case but that patients should keep track of foods which seem to increase symptoms.
 
Just as with Irritable Bowel Syndrome (IBS) and other complaints of the gastrointestinal tract, diverticular disease improves with increased daily intake of water, a high fiber diet, and probiotic supplements (which add "good" bacteria and yeasts to the gut). Exercise always improves GI health and overall well-being, too.
 
Diagnosing diverticulitis
 
Your gastroenterologist is the best person to see for precise diagnosis of this common condition. A barium enema, colonoscopy, sigmoidoscopy and CT imaging help your specialist determine the exact cause of your symptoms and how to proceed with treatment--both for acute flare-ups and for long-term management of diverticulitis.
 
Take control
 
Your gastroenterologist encourages you to know more about your intestinal health and to stay on top of conditions such as diverticular disease. Be proactive about all aspects of your health for a longer, better life!
By NASHVILLE GASTROINTESTINAL SPECIALISTS
November 02, 2018
Category: GI Care

Is it constipation? Is it diarrhea? Frankly, when a patient complains to his or her physician about GI problems, the doctor has to wonder, "Is it Irritable Bowel Syndrome?" If you alternate between infrequent and too frequent bowel movements, you may need evaluation by a gastroenterologist. An expert in all things from your esophagus through your stomach and intestines, a GI doctor can uncover the reasons behind bowel issues, including IBS.

About IBS and its symptoms

Unfortunately, no one knows the real origin of Irritable Bowel Syndrome. However, it definitely is a cluster of symptoms which millions of people in the US--more women than men--suffer, before the age of 50. The International Foundation for Gastrointestinal Disorders reports that stress appears to increase symptoms; however, anxiety and a high-pressure job or life circumstance do not actually cause the condition.

Besides constipation and/or diarrhea, individuals with IBS have:

  • Bouts of gas
  • Bloating
  • Nausea
  • Pain
  • Cramps
  • Mucus in the stool
  • Fatigue
  • Intolerance to a variety of foods, including those containing gluten and lactose (dairy)
What you can do
 
Your primary care physician may refer you to a GI doctor for additional evaluation. This specialist will listen to your symptoms; so be sure to tell him or her what they are, when and how often they occur, how long they last and what, if anything, helps.
 
The doctor may order blood work, including a complete blood count to check for anemia, an indicator of bleeding in the GI tract. Also, he or she may wish to look into your intestine via colonoscopy. This common examination introduces a lighted, flexible tube through the entire length of the large intestine. It allows the doctor to visualize and take photos of the lining of the bowel and to biopsy areas as needed.
 
Treatments for IBS
 
If you are diagnosed with Irritable Bowel Syndrome, you can manage your symptoms. No, IBS cannot be cured, but rest assured that many patients live well with this GI condition. Many gastroenterologists ask individuals to eliminate suspect foods such as:
  • Alcohol
  • Dairy products
  • Chocolate
  • Caffeinated drinks
  • High fat or fried foods
On the positive side, you may gradually increase your intake of fibrous dietary choices such as:
  • Beans
  • Legumes
  • Oats
  • Bran
  • Yams
  • Whole grains
  • Barley
The doctor may recommend easy-to-take fiber supplements such as Fibercon or Metamucil which regulate the water in the bowel and normalize stools. Probiotics--natural supplements containing beneficial bacteria and yeast--are a common part of an IBS regimen.
 
Feeling better
 
If you suspect you have Irritable Bowel Syndrome, or are just not sure what's going on with your digestive health, consult a board-certified gastroenterologist. This highly-skilled doctor will get to the source of your issues, answer your questions and help you function at your best.
 
By NASHVILLE GASTROINTESTINAL SPECIALISTS
October 16, 2018
Category: GI Conditions
Tags: Hemmorrhoids  

Wondering if you have hemorrhoids? Hemorrhoids are very common, especially among people ages 45 to 75. Hemorrhoids are inflamed and swollen veins around the anus or in the lower rectum. One of the main causes of hemorrhoids is straining when you’re trying to have a bowel movement. Other contributing factors include heredity, diarrhea, chronic constipation, pregnancy, and aging. Here's how to tell if you have hemorrhoids.

1. A lump near the anus- Although many individuals have hemorrhoids, not all experience symptoms. External hemorrhoids are felt as swelling or a hard lump near the anal area. Internal hemorrhoids protrude with bowel movements; usually, they return to the inside by themselves.

2. Painless bleeding- Hemorrhoids can cause bleeding. If you have hemorrhoids, you may see blood in the toilet bowl or on the toilet paper. Rectal bleeding is also a symptom of diverticulitis, colitis, colon polyps, and colorectal cancer. If you experience rectal bleeding, you should see a doctor. An evaluation and proper diagnosis by a gastroenterologist is important any time bleeding from the rectum lasts for more than a few days. 

3. Itching around the anus- Hemorrhoids can cause severe itching around the anus. Initial treatment of anal itching is directed toward relieving the soreness and burning. Your gastroenterologist may prescribe hydrocortisone cream, gel, foam, or ointment or rectal suppositories to treat itching.

4. Pain or discomfort- Pain is a common symptom of external hemorrhoids, especially during bowel movements or when sitting. Internal hemorrhoids are typically painless, even when they produce bleeding. When hemorrhoids are painful, it’s hard to think about anything else. Your gastroenterologist may prescribe pain medication, hydrocortisone cream or rectal suppositories to ease your pain. 

Why suffer? If you think you may have hemorrhoids, you should schedule an appointment with a gerontologist right away. The symptoms hemorrhoids cause are hard to ignore. Thankfully, there are many treatments that can provide relief.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
September 28, 2018
Category: GI Care
Tags: Gallstones   Healthy Diet   Cancer  

Unfortunately, many of us eat the foods we crave before thinking about how it affects our digestive health. Your digestive health is directly impacted by the lifestyle you live and the foods you eat. Exercising, drinking water, and adding fiber all contribute to better digestive health. Here are five digestive problems that are caused by a poor diet.

1. GERD- GERD is a digestive disorder in which stomach acid or bile irritates the food pipe lining. Symptoms include heartburn, hoarseness, and trouble swallowing. Some foods and beverages are known to cause reflux. If you're at risk for GERD, avoid fatty foods, acidic foods, spicy foods, chocolate, and caffeinated beverages. Being overweight and obesity are also causes of GERD. 

2. Cancer- Diet can also directly affect your risk of stomach and bowel cancer. Some foods, such as processed and salt-preserved foods, and red meat can increase the risk of developing stomach and bowel cancer. While others, such as vegetables and fruits, are especially potent cancer fighters. Choosing whole-grain breads, cereals, and pastas instead of refined grains, and eating poultry, fish, or beans may also help lower your risk of stomach and bowel cancer.

3. Gallstones- Slimming down (if you're overweight) and changes to your diet may help prevent gallstones. Gallstones are hardened deposits of bile inside the gallbladder. Because cholesterol plays a role in the development of gallstones, you should avoid eating too many foods that are high in saturated fat. Eating too many foods that are high in cholesterol and fat and not enough of a high-fiber diet can increase your risk of gallstones.

4. Ulcerative Colitis- Eating a high-fat diet increases the risk of developing ulcerative colitis. Ulcerative colitis is a digestive disease that results in inflammation and ulcers in your digestive tract. Symptoms of ulcerative colitis include fatigue, rectal bleeding, anemia, diarrhea, abdominal pain, and feeling an urgent need to take a bowel movement. It's a serious disease that can cause dangerous complications if you don't get the right treatment.

5. Diverticulosis- Diverticulosis is a condition in which protruding pockets develop in the digestive tract. These pouches form when high pressure inside the large intestine pushes against weak spots in the intestinal wall. A high-fiber diet will reduce the risk of developing diverticular disease. Symptoms of diverticulitis include abdominal pain, diarrhea, constipation, bloody stools, fever, nausea, and vomiting. Diverticulitis can become serious, requiring hospital admission.

We really are what we eat! Swap those poor eating habits over for better ones. A healthy diet provides important minerals, vitamins, and nutrients to keep the body healthy. You can start making proactive changes to your diet today that can benefit your digestive health now, and throughout your entire life.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
September 14, 2018
Category: GI Care
Tags: Gallstones  

Gallstones are a very common problem. You're at risk of developing gallstones if you're overweight or obese, female, or 40 or over. Gallstones are hardened deposits of bile inside the gallbladder. Many people with gallstones are unaware that they have them, as they produce no or little symptoms. For some people, however, gallstones can cause problems. Here are four signs and symptoms of a gallstone. 

1. Abdominal Pain

Symptoms of a gallstone may include severe abdominal pain. This pain goes and comes back repeatedly. The pain often occurs after eating and can last a few hours before it resolves. Chronic, ongoing pain that persists beyond a few hours may also occur, and may indicate a severe gallbladder problem.

2. Referred Pain

Gallstone pain can cause referred pain to the upper back and right shoulder. The pain usually comes on suddenly and may last for several hours. Prescribed painkillers are used to relieve pain associated with gallstones. You may also be given advice about eating a healthy diet to help control the pain.

3. Jaundice

Jaundice is a symptom of gallstones. Jaundice is a yellowish appearance of the whites of the eyes and skin due to high bilirubin levels. If a stone moves out of your gallbladder and one of your bile ducts and blocks the bile flow, jaundice occurs. Sometimes the gallstone passes from the bile duct on its own. If it doesn't, you may need to have gallbladder surgery.

4. Vomiting

A gallstone can cause nausea and vomiting, which may relieve some of the abdominal pressure and discomfort. Pain that occurs with appetite loss, nausea, vomiting, and a fever may suggest the presence of infection or inflammation of the gallbladder. Vomiting and diarrhea also occur with food poisoning and the flu, but the pain tends to come and go rather than be constant.

If you're experiencing the symptoms of a gallstone, you should notify your gastroenterologist right away. When a gallstone blocks your bile ducts, it can cause excruciating pain, which means you need emergency care right away.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
August 29, 2018
Category: GI Care
Tags: Diarrhea  

Diarrhea is very common. When you have diarrhea, your bowel movements are loose and watery. In most cases, diarrhea lasts a couple of days. Chronic diarrhea is diarrhea that lasts longer than two weeks. When diarrhea lasts for weeks, it can indicate a serious disorder. Although diarrhea is usually not serious, it can become dangerous or signal a more serious problem. Read on to find out how chronic diarrhea is treated.

1. Replacing lost fluids- Chronic diarrhea is treated by replacing lost fluids and electrolytes to prevent dehydration. Adults with diarrhea should drink water, sports drinks, sodas without caffeine, or fruit juices. Fluid can also be delivered through a vein (intravenously) if the dehydration is severe. 

2. The use of medication- Your doctor may prescribe antibiotics and medications that target parasites to treat parasitic or bacterial infections. If a virus is causing your diarrhea, antibiotics won't help. Pain relief medications can help alleviate fever and pain. Your doctor may also prescribe medications to treat an underlying condition that may be causing your chronic diarrhea.

3. Treating medical conditions- How doctors treat chronic diarrhea depends on the cause. Chronic diarrhea is sometimes caused by an underlying medical condition that requires treatment. Common conditions that cause diarrhea include irritable bowel syndrome, Chrohn's disease, ulcerative colitis, inflammatory bowel disease, celiac disease, and chronic pancreatitis. 

4. The use of probiotics- Your doctor may recommend probiotics to treat diarrhea. Probiotics are good bacteria that are very similar to the bacteria that are already in your body. Probiotics reduce the growth of harmful bacteria and promote a healthy digestive system. If your gastroenterologist recommends probiotics, talk with him or her about how much probiotics you should take and for how long. 

Chronic diarrhea can affect your daily activities and make life frustrating and miserable. Don't hesitate to contact a gastroenterologist about diarrhea. A visit to the gastroenterologist will bring all the relief you need, with little hassle or expense. 

By NASHVILLE GASTROINTESTINAL SPECIALISTS
August 14, 2018
Category: GI Care
Tags: Constipation  

Having trouble going to the bathroom? Find out what might be to blame.

Constipation is an annoying and embarrassing problem that all of us will experience at some point. Constipation is when you are unable to have a bowel movement or you have trouble passing stools. If you are having less than three bowel movements a week then you could be dealing with constipation.

This problem isn’t usually something to worry about, as it usually resolves itself on its own. Of course, there are times in which you may want to turn to a gastroenterologist for care.

What causes constipation?

This usually happens when the stool moves too slowly through the digestive tract, making it difficult to expel. Causes of constipation include:

  • Dehydration
  • Poor diet
  • Bowel obstruction
  • Anal fissures
  • Bowel stricture (narrowing of the colon)
  • Conditions that affect the nerves of the colon or rectum (e.g. stroke; Parkinson’s disease)
  • Weak pelvic muscles
  • Hormone changes due to pregnancy, diabetes, or certain thyroid disorders

There are also certain factors that can increase your chances for chronic constipation:

  • Age (older adults are more likely to experience constipation)
  • Dehydration
  • Not getting enough fiber in your diet
  • Living a sedentary lifestyle
  • Taking certain medications (e.g. antidepressants; blood pressure medications)
  • Certain mental health disorders such as depression

How can you prevent constipation?

If you deal with constipation regularly there are some ways to help lessen the chances for this problem. Make sure that you are drinking enough water throughout the day and include a lot of fiber-rich foods in your diet such as whole grains, fruits and vegetables, and beans. Stay away from processed foods, and make sure you are staying active.

When should I see a doctor?

It’s a good idea to give your GI doctor a call if you’ve been experiencing constipation for over 3 weeks or if lifestyle modifications such as drinking more water or adding more fiber to your diet just aren’t working. It’s also important to see a specialist as soon as possible if your constipation is accompanied by pain or if you see blood on the toilet paper (this could be a sign of hemorrhoids or an anal fissure).

 

If you are experiencing chronic or severe constipation it’s a good idea to turn to a GI specialist who will help you get to the root of the problem and help get your digestive tract moving in the right direction.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
August 01, 2018
Category: GI Care
Tags: Upper endoscopy  

This diagnostic procedure could determine the root cause of your digestive issues.

An upper endoscopy is a simple procedure in which your gastroenterologist will insert a small, flexible tube that contains a camera in the mouth and guide it carefully into the upper digestive tract (stomach and small intestines). Why is this outpatient procedure performed? Many reasons, actually. Your gastroenterologist may recommend getting this procedure if there are signs of bleeding within the upper digestive system.

An endoscopy is also a great tool for being able to detect inflammation within the digestive tract, as well as ulcers and tumors. You may benefit from an endoscopy if you are experiencing:

  • Difficulty swallowing
  • Chronic heartburn
  • Abdominal pain
  • Chest pain
  • Nausea and vomiting

An upper endoscopy is a much better and more accurate diagnostic tool for detecting growths and other abnormalities within the lining the digestive system than x-rays. Furthermore, many gastrointestinal issues can often be treated during the endoscopy. This includes the biopsy and/or removal of polyps, opening up narrowed areas of the esophagus or stomach, removing objects or obstructions within the intestinal tract or stopping a bleed.

Before your procedure, your gastroenterologist will give you detailed instructions to follow. This includes not eating or drinking anything for eight hours before your endoscopy. Patients with certain conditions such as a history of endocarditis (an infection of the heart valve) or those with artificial heart valves may need to take antibiotics beforehand to reduce their risk for an infection. Patients who take medications may still take their medication before the procedure with a little bit of water.

An endoscopy is performed under sedation so you won’t feel anything or remember the procedure. It’s important that you bring someone with you who will be able to drive you home afterwards, as sedation’s effects can last up to eight hours after. Prior to the procedure, a local anesthesia may be sprayed in the back of the throat to numb the area. You will then receive a combination or pain and sedation medication through an IV. Then the thin endoscope will be placed in the mouth and directed through the esophagus into the stomach. The procedure takes approximately 15-20 minutes.

 

If you are experiencing symptoms of bleeding, ulcers, or other issues within the digestive system, an endoscopy can be an amazing tool for determining what’s going on and what can be done to treat the problem.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
July 16, 2018
Category: GI Care
Tags: Ulcerative Colitis  

Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes severe and even bloody diarrhea that can result in abdominal pain and unexpected weight loss. While people have probably heard about Crohn’s disease more often than they have ulcerative colitis, this condition actually affects as many as 907,000 of the 1.6 million Americans living with IBD.

While ulcerative colitis can happen to anyone, a gastroenterologist most often diagnoses it during a person’s later teen years or by early adulthood. While there is no definitive cause of ulcerative colitis, a family history of this condition can certainly increase your chances of developing this chronic GI problem.

Those with ulcerative colitis experience diarrhea, which can be bloody at times. Some patients may experience rectal pain, occasional constipation, abdominal discomfort, fever, or weight loss. In order to diagnose this gastrointestinal issue, a GI specialist will often need to perform imaging tests such as a CT scan or run an endoscopy to check the health of the gastrointestinal tract and to look for signs of ulcerative colitis.

While there is currently no cure for this condition, there are certainly an array of medications and treatment options available to help you keep your symptoms and flare-ups in check. The type of treatment plan that your GI doctor will create for you will depend on the type and severity of your symptoms.

The main goals of treating ulcerative colitis are to reduce inflammation within the colon while also speeding up the remission process and making sure that your symptoms stay in remission for as long as possible. Of course, it is still possible, even with the right medication, to experience symptoms.

Common medications for treating ulcerative colitis include:

  • Antibiotics: to target any infections within the GI tract
  • Aminosalicylates: to treat mild to moderate inflammation within the colon
  • Corticosteroids: for short-term treatment of moderate to severe symptoms
  • Biologics: to target a specific protein, which leads to inflammation

Sometimes, over-the-counter medications and supplements may be used in conjunction with prescription medications. These may include vitamins and nutritional supplements, pain medications and antidiarrheal. If your ulcerative colitis doesn’t respond to these medications then you’ll want to discuss the benefits with your gastroenterologist of getting surgery to remove parts of the colon or rectum to alleviate severe or persistent symptoms.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
July 02, 2018
Category: GI Care
Tags: C. Diff   C. difficile  

C. difficile (Clostridium difficile) is an infection that should be talked about more often than it is despite the fact that it infects half a million Americans each year. While C. diff bacteria can be found within the gut of healthy individuals the healthy gut bacteria work to keep the potentially harmful bacteria in check. C. diff spores can be found in our environment through the air we breathe, or even the clothes on our back or the foods we consume. This is usually how we end up with C. diff in our guts.

However, sometimes circumstances arise in which C. diff bacteria are able to multiply within the gut. This most often occurs in someone who is taking antibiotics because while antibiotics are being used to fight an infection it can also kill off some of the healthy bacteria in our gut.

Unfortunately, C. diff bacteria are resistant to many kinds of antibiotics, giving it free range to thrive and multiply quickly within the gut. These bacteria, particularly in larger numbers, can also produce toxins. It’s usually the toxins themselves that lead to symptoms such as diarrhea, stomach cramps, nausea, and fever.

C. diff infections can range from mild to severe. In milder cases, patients may liken their symptoms to an infection within the stomach (also known as gastroenteritis). These symptoms may be mild and self-limiting, lasting anywhere from a couple of days to multiple weeks. Usually, medication or treatment isn’t needed in order to treat the infection.

However, those dealing with severe diarrhea, blood in the stool, severe abdominal pain, fever, and dehydration should seek the care of a gastroenterologist as soon as possible. While these symptoms can be indicative of several different gastrointestinal issues, if you suspect that you might have a C. diff infection it’s important that you seek immediate medical treatment.

Since most people have C. diff within their gut, if it isn’t causing any issues then no treatment is necessary. As we mentioned before, those dealing with minor symptoms may be able to let the issue run its course. Those with severe infections may need to be hospitalized. If you are still taking the antibiotics that may have caused this problem then you will most likely need to stop taking it so that the healthy gut bacteria have a chance of returning and making the gut healthier.

Those with severe diarrhea or colitis (inflammation of the colon) may be prescribed very specific antibiotics known to kill the C. diff bacteria. In the meantime, make sure you are drinking enough water and fluids to keep your body hydrated. If diarrhea is severe, your doctor may need to give you fluids and nutrients through an IV.

Luckily, most people dealing with this infection will be able to fully recover, even if they don’t get treatment; however, those who are older or have a weak immune system should seek medical attention as soon as possible if they suspect an infection. While symptoms can be unpleasant, they will usually go away in a few weeks.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
June 19, 2018
Category: GI Care
Tags: GERD   heartburn  

Do you find that most mealtimes end up being ruined by gnawing, nagging heartburn? While most people will experience heartburn at some point during their lifetime, if you are someone who suffers from this problem several times a week then you may just have a digestive disorder known as gastroesophageal reflux disease (GERD).

 

What is GERD?

Whenever you eat food, it travels from the esophagus to the stomach. Once food enters the stomach, the stomach produces acid to break up the food. Of course, in healthy individuals the food travels from the stomach to the intestines; however, if you have GERD then the acid and food contents actually flow back up to the esophagus from the stomach, irritating the lining of the throat and causing a nasty case of heartburn.

 

What are the symptoms?

Heartburn is a classic symptom of GERD. Heartburn is a burning in the chest that also affects the lining of the throat. Heartburn sometimes produces an acidic or bitter taste in the mouth. Symptoms may get worse if you eat a big meal, consume something spicy or lie down immediately after eating.

 

How is GERD diagnosed?

In some situations a gastroenterologist may be able to determine that you have GERD based on the symptoms you describe and through a simple physical exam; however, sometimes a diagnostic test is required in order to determine whether your symptoms are truly caused by GERD or something else. An upper endoscopy is one common diagnostic procedure performed to check for signs of inflammation or damage to the lining of the esophagus, which are indicative of GERD.

 

What are my treatment options?

Your treatment plan will most likely consist of lifestyle modifications and medications.

 

Lifestyle modifications

If you are overweight or obese you may be at a higher risk for developing GERD. It’s important to lose that excess weight and to maintain a healthy weight to reduce your symptoms. Quit smoking if you are currently a smoker. Make sure to eat slowly and eat smaller meals. Don’t lie down immediately after eating and eat about three hours before going to bed.

 

Also, there are certain foods that can trigger heartburn symptoms including chocolate, caffeine, alcohol, tomato sauce, garlic, or fatty and spicy foods. Limit or avoid any of these foods if they are known to cause you heartburn.

 

Medication

Those with milder symptoms may be able to use an over-the-counter antacid or medication to manage their symptoms; however, if symptoms are moderate-to-severe, or if you have damage to the lining of the esophagus, then you’ll need a stronger medication to reduce or even prevent the production of stomach acid until the damage has healed.

 

If you deal with heartburn on a regular basis or can’t seem to get heartburn under control it’s important that you turn to a GI doctor who can help you find the proper treatment option to prevent digestive complications and to make mealtimes more enjoyable again.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
June 05, 2018
Category: GI Care
Tags: Hepatitis C  

Hepatitis C is an infectious disease that causes liver inflammation, sometimes leading to serious liver damage. Most people have no symptoms right after they have been infected, and since any symptoms are likely to go away in a few weeks, you may not know you have Hepatitis C for a long time. Here are the most common signs of Hepatitis C.

1. Jaundice

Jaundice is a yellowish appearance of the whites of the eyes due to high bilirubin levels. Normally bilirubin gets broken down in the liver and released from the body in the stool. But if the liver is damaged, it cannot properly process bilirubin.

2. Dark Urine

Urine naturally has some yellow pigments called urobilin or urochrome. The color of the urine can vary when certain medications are taken and when foods of certain types are consumed. Chronic dark-colored urine can be related to serious liver conditions, including Hepatitis C and cirrhosis.

3. Chronic Fatigue

The severity of this fatigue differs from person to person. Some individuals are able to work, but then feel burned out in the evening. Some people spend a large amount of time sleeping. However, someone people feel very tired after a good night's sleep. The fatigue associated with Hepatitis C often improves with treatment.

4. Aches and Pains

Some people with Hepatitis C experience abdominal pain. Many suffer from aches and pains in their joints. A variety of different joints can be involved but the most common are in the wrists and hands. The pains can range from mild to severe. In such cases, medications can be used to ease the pain.

5. Poor Appetite

Loss of appetite implies that hunger is absent. Your appetite may worsen if you have cirrhosis or liver failure. Loss of appetite can also be caused by other diseases and conditions. Some of the conditions can be temporary, such as appetite loss from the effects of medication.

6. Low-grade Fever

Everyone gets a fever from time to time. Most usually don't indicate anything serious. However, some people with Hepatitis C experience a low-grade fever (fever up to 102°F). You should book an appointment with a doctor if you've had a fever for more than three days.

7. Cognitive Changes

Some people with Hepatitis C experience problems with concentration, short-term memory, and completing complex mental tasks such as mental arithmetic. Studies have shown that about half of those with Hepatitis C experience cognitive disturbances.

Many people are surprised to learn that they have been infected with Hepatitis C. Some people feel overwhelmed by the changes they need to make in their lives. At a time when life feels out of control, remember that you can take an active role in your health- and your life.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
May 15, 2018
Category: Uncategorized
Tags: heartburn  

You would love to just be able to sit down and enjoy a meal, but you know that not long afterward you are going to be dealing with the burning, Heartburngnawing pain in your stomach caused by heartburn. No matter if this is something that you have been facing for a while or this is a new issue you are dealing with, it’s important that you have a gastroenterologist that can help you figure out what’s going on.

It’s important to understand that heartburn isn’t a condition but a symptom of gastroesophageal reflux disease (GERD), in which stomach acid travels back up through the esophagus causing burning and irritation of the esophageal lining.

So, what are the leading culprits of heartburn? There are quite a few things that could cause this issue including:

  • Certain foods or drinks: Everything from alcohol and caffeine to acidic and spicy foods can exacerbate heartburn symptoms. Diets that are high in fatty or fried foods can also make heartburn worse.

  • Medications: There are certain over-the-counter medications that can also cause heartburn to flare-up.

  • Smoking: Smoking cigarettes can actually affect how the lower esophageal sphincter functions, allowing stomach acid to travel back through the esophagus.

  • A hiatal hernia: A condition in which some of the stomach protrudes into the chest.

  • Pregnancy: Pressure placed on the abdomen during pregnancy could increase your chances of heartburn.

  • Obesity: Having any additional pressure placed on the abdomen, which is common if you are overweight or obese, can bring on a nasty bout of heartburn.

Fortunately, there are many ways in which to reduce the severity and frequency of heartburn. Turning to a GI specialist is the best approach, as they can provide you with a variety of lifestyle changes and medications based on your symptoms, current health, lifestyle, and how much damage has already taken place within the esophagus.

From there, they will create a tailored treatment plan with a medication that will either greatly lessen the amount of acid the stomach produces or temporarily block stomach acid from being produced to help promote healing within the esophagus.

Lifestyle changes may include eating smaller meals, not eating right before bedtime, avoiding exacerbating foods or drinks, losing excess weight, and quitting smoking.

Don’t let heartburn make you dread sitting down to enjoy your favorite meals. There are so many ways in which to get your heartburn symptoms under control. If you are having trouble finding the right treatment option for you don’t hesitate to turn to a gastroenterologist for guidance and treatment.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
May 01, 2018
Category: GI Care
Tags: Colonoscopy  

Chances are good you’ve heard of a colonoscopy before, whether through a health report on the news or because you know someone who had toColonoscopy get one. A colonoscopy is a diagnostic procedure and often a screening tool that allows your gastroenterologist to be able to see what the lining of the colon and intestines looks. A thin scope is inserted into the rectum and carefully directed through the lower intestines. The scope has a camera at the end that allows your doctor to pinpoint potential problems with the lining of the intestines or colon. There are a few reasons why your doctor might recommend getting a colonoscopy.

If a patient comes in complaining of abdominal pain, rectal bleeding, or persistent diarrhea and these symptoms can’t be explained through a routine exam and testing then your GI doctor may recommend performing a colonoscopy to be able to determine the root cause for these symptoms. This might be particularly helpful if you or a family member has a history of colon cancer or colon polyps.

Even if you are feeling fine, both men and women, once they reach 50-years-old, will need to start getting routine colonoscopies to screen for colon polyps and other signs of colorectal cancer. A colonoscopy is one of the most effective screening tools a gastroenterologist has for being able to pinpoint warning signs of cancer with the large intestines and colon. No other screening tool will be able to provide the detailed imaging that a colonoscopy can.

If the results of your routine colonoscopy come back normal then you probably won’t need to repeat the procedure for another 10 years. If one or more polyps were detected during your colonoscopy your GI specialist may choose to remove them during the procedure but may recommend that you come in more regularly for a colonoscopy.

You may also need to have this procedure performed more often if you have a family or personal history of colon cancer or colon polyps. It’s important to be upfront about your detailed medical history when talking to a gastrointestinal specialist to determine the best colonoscopy schedule to protect your digestive health.

No matter if you are experiencing distressing intestinal symptoms or you just turned 50-years-old, it’s a good idea to turn to a gastrointestinal specialist who can provide you with the individualized care you need. Remember, getting a colonoscopy after you turn 50 could just end up saving your life!

By NASHVILLE GASTROINTESTINAL SPECIALISTS
April 13, 2018
Category: GI Care
Tags: Ulcer  

Peptic ulcers, or stomach ulcers, are breaks or holes in the lining of the stomach. An ulcer in the first part of the intestines is known as a duodenal ulcer. An ulcer in the stomach is known as a gastric ulcer. If you think you may have an ulcer, you should see a gastroenterologist. Gastroenterologists are specialists in the diagnosis and treatment of peptic ulcers. Here are 5 signs you may have a peptic ulcer. 

1. Burning pain- The most common peptic ulcer symptom is a burning sensation or gnawing pain in the middle of your abdomen. The pain may come and go for several days or weeks. Even though discomfort may be mild, peptic ulcers can worsen if they aren’t treated. Taking antacids can relieve the discomfort, but it will keep coming back until the peptic ulcer is treated by a doctor.

2. Nausea- The symptoms of peptic ulcers may include nausea. Nausea is a feeling of sickness with an inclination to vomit. Nausea has many possible causes. Some common causes of nausea include appendicitis, infection, reactions to some medicines, migraines, food poisoning or intestinal blockage.

3. Vomiting- The symptoms of peptic ulcers may include vomiting. Vomiting after consumption of food may be caused by an ulcer, food poisoning, or gastritis (inflammation of the stomach lining). Usually, vomiting is harmless, but it can be a sign of a serious condition. Some examples of serious conditions that may result in vomiting include Acute liver failure, appendicitis, Pancreatic cancer, or intestinal blockage.

4. Discolored stool- Blood in the stool is often a sign of a problem in the digestive tract. Blood in the stool may come from any area along your digestive tract. A stomach ulcer can cause discolored stools that appear darker or bloody. A bloody stool may indicate that your stomach ulcer is growing in size or is becoming more severe. 

5. Heartburn- Another symptom of peptic ulcers is heartburn. Heartburn is a condition that's caused when stomach acid flows up into your esophagus. This leads to a burning discomfort below your breastbone or in your upper belly. Your doctor will prescribe medications to relieve your symptoms and help your ulcer heal. 

If you have any of these signs and symptoms, you should seek treatment. A visit to the gastroenterologist will bring the relief you need. Peptic ulcers can not only be uncomfortable causing you pain but can also lead to other complications that may be dangerous.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
March 30, 2018
Category: GI Care
Tags: heartburn  

Got heartburn? Heartburn, also known as acid indigestion, is a form of indigestion felt as a burning pain in the chest. It's caused when stomach acid flows up into your esophagus. More than just a minor discomfort, acid indigestion can reduce quality of life. The following tips will help you rid yourself of heartburn.

1. Change your diet. Stay away from beverages and foods that commonly cause heartburn. A good way to work out what beverages and foods trigger your heartburn symptoms is to keep track of what you eat. Common offenders include tea, coffee, tomatoes, garlic, fatty foods, spicy foods, milk, chocolate and peppermint. 

2. Don't overeat. Overeating can trigger heartburn. Big meals put pressure on the muscle that helps keep stomach contents from backing up into the esophagus. The more food you eat, the longer it takes for your stomach to empty, which contributes to acid reflux. Try eating five small meals a day to keep reflux at bay.

3. Avoid alcohol. Alcohol can trigger heartburn. Alcohol can relax the sphincter muscle at the lower end of your esophagus, causing stomach acid to flow up into your esophagus If your aim is to unwind after a long day at work, try exercise, stretching, listening to soothing music, or deep breathing instead of drinking alcohol.

4. Lose weight. If you overeat, lose weight- but be sure to consult your doctor before starting a vigorous exercise program. The increased risk of heartburn is thought to be due to excess abdominal fat causing pressure on the stomach.

5. Stop smoking. Nicotine is a muscle relaxant. Nicotine can relax the sphincter muscle, causes acid from the stomach to leak upward into the esophagus. Nicotine gums, patches, and lozenges are healthier and safer than cigarettes, and they are less likely to give you heartburn. 

6. Contact your doctor. Your doctor may suggest antacids for occasional heartburn. Sometimes, more powerful prescription medications such as proton pump inhibitors or H2 blockers and are needed to treat chronic heartburn. When all else fails, surgery may be required to repair the LES.

Chronic heartburn can affect your daily activities and make life frustrating and miserable. Don't hesitate to contact a gastroenterologist about heartburn.

If you ever chewed gum as a kid then you probably remember an adult telling you not to swallow that gum or else it would get stuck in your intestines. Is this actually true or just an Old Wives Tale? What happens if you do swallow your gum? Could it cause you intestinal distress or other complications now or down the road?

Well, the good news is that most people, at some point during their lifetime, will swallow gum and never experience any issues. Even though the body really can’t digest chewing gum it doesn’t mean that it will get stuck inside the body or will cause gastrointestinal issues. Even if our bodies cannot digest something they can still move the gum along through the body. While the body can easily digest other ingredients found in gum (e.g. sweeteners), the foundation or gum resin won’t be able to be digested properly. But don’t worry; this undigested portion of chewing gum should pass through your body without issue and leave through a normal bowel movement.

However, it is possible that gum may cause a blockage within the digestive system. How? While this is very rare, it is possible that if you swallow a rather large piece of gum (or if you swallow multiple pieces over a short span of time) that this could lead to a blockage. This may be more likely to occur in children, especially children that are too young to understand that gum should be chewed and not swallowed. Make sure that your child isn’t given gum until they fully understand the purpose of chewing gum.

Of course, if you notice some bloating or abdominal discomfort after chewing gum then you could point your finger at this seemingly innocent treat. This is because you might be swallowing excess air while chewing gum, which can lead to some pain and discomfort. If you notice this issue then you may want to limit how often you chew gum or opt for sucking on a mint instead.

If you have questions about your gastrointestinal health or if you start to experience symptoms such as abdominal pain, diarrhea or nausea that doesn’t go away, then it’s important that you have a gastroenterologist on your side who can help.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
March 02, 2018
Category: GI Care

Tummy troubles? When some people are diagnosed with celiac disease, they also discover that they are lactose intolerant and have difficulty digesting milk and dairy products. Read on to learn all about lactose intolerance and celiac disease and their symptoms. Gastroenterologists are doctors who specialize in the diagnosis and treatment of digestive disorders, including lactose intolerance and celiac disease.

Lactose Intolerance Overview

Lactose intolerance is a condition in which people have digestive symptoms after eating or drinking milk or dairy products. People with lactose intolerance are unable to fully digest the sugar in dairy products. Lactose intolerance is caused by a deficiency of an enzyme in the body called lactase. Lactose intolerance is not serious. Your doctor may do a breath, blood or stool test to find out if your problems are due to lactose intolerance.

Symptoms of Lactose Intolerance

After drinking or eating dairy products, you may feel sick to your stomach. You may also have loose stools or diarrhea, gas, pain, or cramps in the lower belly, rumbling or gurgling sounds in the lower belly. or swelling in your stomach. If you are lactose intolerant, you may still be able to eat or drink small amounts of milk. Some individuals do better if they have dairy with a meal.

Celiac Disease Overview

Celiac disease is a disorder triggered by consuming a protein called gluten, which is rye, barley, and wheat. When an individual with celiac disease eats foods that contain gluten, an abnormal immune reaction is triggered that damages a small part of the intestine called villi. Long-term complications of celiac disease include intestinal cancer, liver disease, and malnutrition, which can lead to osteoporosis and anemia. The longer people go untreated, the greater the risk for long-term complications.

Symptoms of Celiac Disease

Many individuals with celiac disease have no symptoms. Digestive symptoms, including stomach bloating, flatulence, pain, diarrhea, constipation, nausea, vomiting, and irritability are more common in children. Adults may experience numbness in hands and feet, joint or bone pain, fatigue, anxiety, depression, canker sores inside the mouth, seizures, itching, and a skin rash.

If you are experiencing any symptoms of lactose intolerance or celiac disease, make an appointment with a gastroenterologist. Get your life back on track by receiving the best treatment available. A visit to the gastroenterologist will bring all the relief you need, with little hassle or expense.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
February 16, 2018
Category: GI Care

Sometimes nothing sounds better than a generous helping of ice cream. Of course, if you are lactose intolerant this may sound like a one-way ticket to gastrointestinal distress. Lactose intolerance is an issue in which the body has trouble digesting lactose, a naturally occurring substance found within dairy products. Since the lactose isn’t fully digested before it enters the intestines, this can lead to some rather unpleasant GI tract symptoms such as,

  • Gas
  • Bloating
  • Abdominal pains and cramping
  • Stomach noises
  • Diarrhea or watery stools
  • Nausea or vomiting

While noticing these symptoms only once doesn’t necessarily mean that you are lactose intolerant, if you notice these symptoms every time you consume milk, yogurt, ice cream or other dairy products then you may be suffering from lactose intolerance. Just keep in mind that lactose intolerance is not the same as a food allergy.

If you suspect that you may be lactose intolerant, it’s a good time to schedule an appointment with a gastroenterologist. When you come in for a diagnostic evaluation there are several tests that may be performed to determine if your symptoms are caused by lactose intolerance. Tests include the hydrogen breath test, stool acidity test or lactose tolerance test. We will also ask specific questions regarding your symptoms.

Since there is no way to retrain your body so that it can digest lactose easily, you will have to make changes to your diet to ensure that you don’t experience these distressing symptoms. The most obvious change you can implement is to avoid milk and dairy products, particularly in large quantities. If you do want to consume dairy products do so while eating other foods, which may lessen your symptoms.

We know that giving up ice cream and dairy products can be a challenge; fortunately, there are so many different products on the market that do not contain lactose and are digestive-friendly for those with lactose intolerance. Some people also find relief in taking an over-the-counter lactase enzyme medication (e.g. Lactaid®) before consuming dairy products.

Lactose intolerance can vary from person to person. Some people only experience mild, self-limiting symptoms while others experience more severe problems. If you are experiencing intestinal issues every time you consume dairy products it’s a good time to have this problem checked out.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
February 14, 2018
Category: GI Care
Tags: GERD   heartburn  

Whenever you eat spicy foods do you know that you’ll be suffering for it shortly after? Do you find that heartburn keeps you up at night or makes it impossible to enjoy a lot of your favorite foods? Do you suffer from heartburn symptoms more often than not? If so then you may be dealing with gastroesophageal reflux disease (GERD), a digestive disorder in which food and stomach acid travel back into the esophagus. Over time the stomach’s acidity can wear away at the lining of the esophagus and cause irritation.

Someone with GERD will not only experience heartburn on a regular basis but also may have difficulty or pain when swallowing. Since the acid continues to travel back through the esophagus this can lead to persistent or recurring sore throats, as well as a dry cough or changes in your voice (e.g. hoarseness). You may even feel some of your food (as well as the stomach acid) travel back up through your throat.

If you find yourself taking a heartburn medication more than twice a week or if your symptoms are severe then this is the perfect time to turn to a GI doctor who can find a better way to manage your symptoms. If over-the-counter remedies aren’t cutting it then a gastroenterologist will prescribe a stronger medication. Some medications work by reducing acid production while other medications prevent acid production altogether to give the esophagus time to heal.

While most people find that their GERD symptoms can be properly controlled with over-the-counter or prescription medications, there are some people who still don’t find the relief they want or those who don’t want to use medications for the rest of their lives. If this is the case, there are also certain surgical procedures that can be recommended to help improve how the lower esophageal sphincter functions to prevent food and stomach acid from flowing back into the esophagus.

Of course, there are some simple lifestyle modifications that can also help. Besides maintaining a healthy weight, it’s important to avoid certain foods that can trigger your symptoms (e.g. caffeine; alcohol; chocolate). When you do eat try to eat smaller meals and avoid eating right before bedtime. If you are a smoker, you will want to strongly consider quitting.

If you have questions about GERD and managing your heartburn symptoms then it’s time you turned to a gastroenterologist who can diagnose you with this digestive disease and then create a tailored treatment plan to help make mealtimes less painful.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
February 14, 2018
Category: GI Care
Tags: Fiber   Diet  

Everyone knows that it’s important to have enough fiber in your diet, but not as many people understand why and how it can benefit your health; fortunately, there are many foods that you can incorporate into your diet if you aren’t getting enough fiber on a daily basis (and don’t worry; a lot of these foods are also pretty delicious, too!).

If you want to increase your fiber intake all you have to do is add more legumes, whole grains, fruits and vegetables to your diet. Simple right? We think so, too! Fiber offers so many wonderful benefits from helping you maintain a healthy weight to reducing your risk of developing potentially serious and chronic health problems such as heart disease or diabetes. It’s even believed that consuming enough fiber could potentially reduce the risk of colorectal cancer.

There are two types of fiber: soluble and insoluble. Regardless of whether you are at risk for high cholesterol or not, making sure you get enough soluble fiber in your diet is a great way to keep cholesterol and glucose levels in a safe and healthy range. Soluble fibers include beans, citrus, barley, oats and peas.

Insoluble fibers, as you might already know, are great for your digestive tract and help improve the function of your bowels. If you are having issues with constipation then adding more insoluble fibers to your diet may help make it easier to go. Common insoluble fibers include whole-wheat flour, beans, vegetables and potatoes.

So, how much fiber should you be consuming on a daily basis? If you are a man who is 50 years or younger than you should consume about 38 grams of fiber a day, while men over 51 years old only need to consume 30 grams of fiber per day. Women under 50 years old should make sure they are getting about 25 grams of fiber every day, while women over 51 years old should consume about 21 grams.

Making sure you get enough dietary fiber in your diet is just one great way to maintain a healthy GI tract. Of course, if you have questions about your diet and how it is impacting your gastrointestinal health then it’s time you turned to a gastroenterologist who can answer all of your questions or address any symptoms or concerns you might have.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
January 02, 2018
Category: GI Conditions
Tags: Crohn's Disease  

Crohn's disease can cause chronic pain and inflammation in your gastrointestinal tract. Although the inflammatory bowel disease can't be cured, treatments and lifestyle changes can help you avoid flare-ups.

Inflammation can cause a range of problems

When your digestive tract is inflamed, you may experience multiple symptoms, in addition to abdominal pain. They include:

  • Cramping
  • Frequent diarrhea
  • Ulcers in the digestive tract
  • Fever
  • Weight loss
  • Lack of appetite
  • Fatigue
  • Lack of energy
  • Rectal bleeding
  • Blood in your stool
  • Flatulence
  • Bloating
  • Sores in your mouth
  • Fistulas around your anus

If you have moderate to severe Crohn's disease, persistent vomiting and diarrhea, anemia, severe weight loss, abscesses and intestinal abscesses can occur. The disease can be life-threatening in some cases.

What causes Crohn's disease?

No one is sure what causes Crohn's disease, although immune system issues or genetics may make you more susceptible. You may be more likely to develop the disease if you are younger than 30, smoke, have a family history of Crohn's disease, or are white or of Ashkenazi Jewish descent.

How is Crohn's disease treated?

Reducing inflammation is the goal of Crohn's disease treatment. Your doctor may prescribe anti-inflammatory medications and immune system suppressors that prevent your immune system from triggering an inflammatory response. Antibiotics may be recommended if you have an infection or a fistula. Because people who have Crohn's disease can experience diarrhea 10 or more times per day, anti-diarrheal medication can be helpful. Frequent diarrhea can deplete nutrients. Your doctor may recommend B12 shots or iron, vitamin D and calcium supplements to prevent malnutrition.

If your symptoms are severe, your doctor may recommend a feeding tube for a period of time to give your bowel plenty of time to rest and recover. Sometimes, Crohn's disease can damage your digestive tract. Surgery may be needed to remove the damaged portions or open up areas of the intestines that have narrowed.

Eating several small meals during the day and limiting low-fat, dairy and high-fiber foods may also help you manage your symptoms. Prompt treatment and dietary changes may reduce flare-ups and might even lead to a remission of your syndrome.

Although living with Crohn's disease can be challenging at times, medical treatments and lifestyle changes can help you avoid the most serious consequences.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
December 13, 2017
Category: GI Care

Irritable bowel syndrome, also known as IBS, is a condition affecting the large intestine or colon. It is associated with a variety of symptoms, including abdominal discomfort and diarrhea. The exact cause of irritable bowel syndrome is not known and the condition tends to affect women more often than men. If you are experiencing any of the symptoms of irritable bowel syndrome, a gastroenterologist can determine if you truly have the condition and develop an appropriate treatment plan for your symptoms.

Symptoms

A variety of gastrointestinal symptoms is associated with irritable bowel syndrome. If you experience any of these symptoms regularly, consult a gastroenterologist who can make a proper diagnosis. A diagnosis of IBS is usually made by ruling out other gastrointestinal problems through blood tests, stool sample tests, x-rays, a colonoscopy or a sigmoidoscopy. Symptoms of irritable bowel syndrome include:

  • abdominal pain or cramping
  • bloating
  • gas
  • constipation
  • diarrhea
  • mucus in stools
  • recurring urgent need to have a bowel movement

Treatment

Although the exact cause of irritable bowel syndrome is unknown, there are several treatment options for alleviating some of the discomfort associated with IBS. Dietary habits can have an impact on the frequency and severity of symptoms. Eating smaller meals during the day can ease digestion and lessen symptoms. Including more fiber during the day can also help with symptoms such as constipation. Eliminating foods, such as dairy, that aggravate the symptoms of IBS can also help alleviate some of the pain and discomfort.

Other strategies for treating irritable bowel syndrome include medications, probiotics and managing stress. Increased stress can aggravate IBS symptoms so keeping stress levels low can minimize symptoms. Additionally, probiotics and certain medications can also help improve digestion and alleviate some of the symptoms of IBS, such as gas or diarrhea. A gastroenterologist can help you determine which treatments options are best for your symptoms.

Irritable bowel syndrome can result in a lot of pain and discomfort. Fortunately, there are treatments that can provide relief. See a gastroenterologist for diagnosis and a treatment plan.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
December 01, 2017
Category: GI Care
Tags: Colonoscopy  

What your gastroenterologist wants you to know

The right time to get a colonoscopy is if you are over 50 years old, or if you have a family history of colon cancer. There are also signs and symptoms to pay attention to which may indicate the need for a colonoscopy. You should see your gastroenterologist to schedule a colonoscopy if you have:

  • Rectal bleeding
  • Black, tarry stools which may indicate blood in your stool
  • A family history of intestinal growths or polyps
  • Chronic, recurrent constipation or diarrhea
  • Chronic, recurrent pain in your abdomen

A colonoscopy is the primary screening tool to determine if you have colorectal cancer. A colonoscopy also helps to diagnose colorectal cancer at an early stage, when it is more easily treatable. Don’t delay having a colonoscopy because the longer you wait, the more serious colorectal cancer becomes.

The American Cancer Society states that colorectal cancer is the third leading cause of cancer-related deaths in this country, with over 49,000 people dying from the disease this year alone.

A colonoscopy typically requires you to be sedated. A long, ultra-thin flexible tube is inserted into your rectum and guided up through your intestines. The tube contains a camera at one end which allows your gastroenterologist to view your colon, remove polyps or take a small sample of tissue for biopsy.

When you come in for your colonoscopy, be sure to bring a driver with you to take you home, and plan on spending 2 to 3 hours in the office. The procedure takes about 45 minutes, and additional time is required for you to recover from sedation.

Remember that early diagnosis is made possible by having a colonoscopy and that early diagnosis is critical to start early treatment. You don’t want to be a cancer statistic, so if you are over 50 or have a family history of colon cancer, take the time to schedule your colonoscopy. Protect your health by calling today!

By NASHVILLE GASTROINTESTINAL SPECIALISTS
November 13, 2017
Category: GI Care

People in commercials love to talk about diarrhea and constipation, but in real life, the subjects are rarely discussed, even though they affect us all. Understanding what causes the conditions may help you avoid them.

What causes diarrhea?

Diarrhea occurs when your stools are loose, runny or completely watery. Although occasional diarrhea won't harm your health, frequent diarrhea can lead to dehydration. The condition is often caused by viruses or bacterial infections. Washing your hands frequently, particularly after touching raw foods, and cooking food completely can help reduce your chance of developing diarrhea. If you know a friend or family member is sick or has diarrhea, don't share utensils or glasses with them.

Diarrhea can also occur due to stomach irritation caused by taking antibiotics or by an intolerance to certain foods. Lactose intolerance, a condition that occurs when you have difficulty digesting sugars found in dairy products, is a common cause of diarrhea. If you've ever had to dash to the restroom after eating ice cream or pasta covered in creamy Alfredo sauce, you might have lactose intolerance.

Some health conditions can also cause diarrhea, including diabetes, celiac disease, irritable bowel syndrome, hyperthyroidism, inflammatory bowel disease, chronic pancreatitis and Addison's disease.

What causes constipation?

If you're constipated, it may be difficult or impossible to pass stools. Even if your trip to the restroom is successful, the stools you produce may be small and hard. Diet can play a part in constipation. Reducing your intake of dairy products, caffeine, alcohol and junk food can be helpful.

Resisting the urge to defecate can lead to constipation. If you're at work and decide to ignore the urge to go, you may not be able to produce any stools when you finally get home. Constipation can also occur if you change your diet or normal routine, don't exercise regularly or eat foods that aren't usually part of your diet when you're away from home.

Some health conditions can also cause constipation, including

  • Diabetes
  • Irritable bowel syndrome
  • Inflammatory bowel disease
  • Parkinson's disease
  • Multiple sclerosis
  • Pregnancy
  • Spinal cord injury
  • Hypothyroidism
  • Lupus

Occasional bouts of diarrhea and constipation are usually nothing to worry about, particularly if they accompany an illness. If you're frequently constipated or experience diarrhea often, it's a good idea to make an appointment with a gastroenterologist, a doctor who specializes in diagnosing and treating conditions and diseases of the gastrointestinal system.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
November 01, 2017
Category: GI Care
Tags: Moles   Skin Cancer  

Although moles are usually harmless, in some cases they can become cancerous, causing melanoma. For this reason, it is important to Monitoring Molesregularly examine your skin for any moles that change in size, color, shape, sensation or that bleed.  Suspicious or abnormal moles or lesions should always be examined by your dermatologist.

What to Look For

Remember the ABCDE's of melanoma when examining your moles. If your mole fits any of these criteria, you should visit your dermatologist as soon as possible.  

  • Asymmetry. One half of the mole does not match the other half.
  • Border. The border or edges of the mole are poorly defined or irregular.
  • Color. The color of the mole is not the same throughout or has shades of tan, brown, black, blue, white or red.
  • Diameter. The diameter of a mole is larger than the eraser of a pencil.
  • Evolution. The mole is changing in size, shape or color.

Moles can appear anywhere on the skin, including the scalp, between the fingers and toes, on the soles of the feet and even under the nails. The best way to detect skin cancer in its earliest, most curable stage is by checking your skin regularly and visiting our office for a full-body skin cancer screening. Use this guide to perform a self-exam.

  • Use a mirror to examine your entire body, starting at your head and working your way to the toes. Also be sure to check difficult to see areas, including between your fingers and toes, the groin, the soles of your feet and the backs of your knees.
  • Pay special attention to the areas exposed to the most sun.
  • Don't forget to check your scalp and neck for moles. Use a handheld mirror or ask a family member to help you.
  • Develop a mental note or keep a record of all the moles on your body and what they look like. If they do change in any way (color, shape, size, border, etc.), or if any new moles look suspicious, visit your dermatologist right away.  

Skin cancer has a high cure rate if detected and treated early. The most common warning sign is a visible change on the skin, a new growth, or a change in an existing mole. Depending on the size and location of the mole, dermatologists may use different methods of mole removal. A body check performed by a dermatologist can help determine whether the moles appearing on the body are pre-cancerous or harmless.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
October 13, 2017
Category: GI Conditions
Tags: Carcinoid Tumors  

Cancerous carcinoid tumors form in the lining of your gastrointestinal tract and can be caused by certain digestive conditions. The rare tumors are often treated with surgery and medications.

What are carcinoid tumors?

Carcinoid tumors develop when a mutation occurs in the neuroendocrine cells in your digestive system. The dual-purpose cells have both nerve and endocrine features and are capable of producing hormones. Over time, the cancerous cells gradually take over healthy cells and form a tumor. Carcinoid tumors tend to form in the colon, stomach, small intestine or rectum.

Who gets carcinoid tumors?

If anyone in your family has had multiple endocrine neoplasia type 1 syndrome (MEN1) or neurofibromatosis type 1 syndrome (NF1), you may be at greater risk of developing a carcinoid tumor. Your risk also rises if you have Zollinger-Ellison syndrome, pernicious anemia or atrophic gastritis. Older people and women are more likely to develop carcinoid tumors.

What are the symptoms of carcinoid tumors?

There are often no symptoms when a carcinoid tumor is small. In fact, you may only learn that you have a tumor after undergoing a routine colonoscopy or another diagnostic test. Symptoms may occur if the tumor secretes hormones or grows larger. Symptoms depend on the location of the tumor, but may include:

  • Pain in the abdomen
  • Diarrhea
  • Constipation
  • Nausea
  • Vomiting
  • Heartburn
  • Fatigue
  • Unexplained weight loss
  • Rectal pain
  • Stool color changes or blood in the stool
  • Bloating
  • Abdominal pain

How are carcinoid tumors treated?

Surgery is used to remove all or as much of the tumor as possible. Medications may also be helpful. Depending on your condition, your gastroenterologist may recommend interferon injections that enhance the immune system's ability to attack the tumor or medications that prevent the tumor from releasing hormones.

If your carcinoid tumor has spread to your liver, your gastroenterologist can offer several other treatment options, including cryoablation (freezing) or radiofrequency (heat) treatments to kill the cancer cells. Removing part of the liver during a surgical procedure may be helpful, as can closing off the hepatic artery that feeds the tumor.

Although most gastrointestinal symptoms aren't caused by cancer, it's important to see your gastroenterologist if you experience frequent heartburn, nausea, vomiting, diarrhea, constipation, bloating or other symptoms.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
October 02, 2017
Category: GI Conditions
Tags: Ulcerative Colitis  

Ulcerative colitis, a type of inflammatory bowel disease, causes painful open sores in your large intestine and rectum. The disease can affect both children and adults. Although there is currently no cure for ulcerative colitis, symptoms can be managed with medications and dietary changes in many cases.

What are the symptoms of ulcerative colitis?

Although symptoms of ulcerative colitis vary depending on the severity of the disease, diarrhea that contains blood or pus is a frequent problem. It may be difficult to get the bathroom in time, particularly if a bout of diarrhea strikes in the middle of the night. Other symptoms can include:

  • Nausea
  • Constipation
  • Abdominal cramping and pain
  • Fever
  • Joint pain
  • Dehydration
  • Weight loss
  • Canker sores
  • Anemia
  • Rectal pain
  • Fatigue
  • Difficulty defecating

If you have severe ulcerative colitis, you may be more likely to develop one or more serious complications, such as severe dehydration or bleeding, a perforated colon, osteoporosis, megacolon, blood clots or colon cancer.

What are the risk factors for ulcerative colitis?

Ulcerative colitis symptoms usually appear between the ages of 15 and 35. You're more likely to develop ulcerative colitis if other people in your family have it. Your ancestry may also affect your risk. Caucasians and people of Ashkenazi Jewish descent get the disease more often than other ethnic groups.

How is ulcerative colitis treated?

Medications that relieve inflammation and suppress your immune system can be helpful if you have ulcerative colitis. Corticosteroids may also reduce inflammation and bring about a remission of symptoms. Because prolonged use of corticosteroids can cause high blood pressure, diabetes and osteoporosis, they're only recommended for short-term use. Anti-diarrheal medications can reduce the frequency of diarrhea, while iron supplements may prevent anemia caused by bleeding.

Approximately 25 to 40 percent of people who have ulcerative colitis will eventually need surgery to remove the colon, according to the Crohn's and Colitis Foundation. In some cases, your surgeon may be able to connect to your small intestine to your anus, which will allow you to defecate normally. If that's not possible, a bag attached to the abdomen will be used to collect stool.

Ulcerative colitis is a serious inflammatory bowel disease, but it's symptoms can often be managed with medication, dietary changes and stress relief techniques, allowing you to live a fairly normal life.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
September 15, 2017
Tags: Diverticulitis  

Diverticulitis is a condition in which small pouches or sacs called diverticula form in the large intestine, or colon, and become inflamed. When the sacs are inflamed, they can bulge outward and cause abdominal pain and discomfort. In addition to abdominal pain, several other symptoms can be associated with diverticulitis. If you are experiencing any of the symptoms associated with this condition, see a gastroenterologist for a diagnosis and possible treatment options.

Symptoms & Causes

The exact cause of diverticulitis is unclear. However, there seems to be a link between a diet too low in fiber and the development of diverticulitis. When fiber is lacking in the diet, the colon works harder to move stools through the intestinal tract. It is possible that the pressure from the increased effort to move the stool can lead to the formation of diverticula along the interior of the color or large intestine. Maintaining a diet with sufficient fiber intake can potentially help prevent diverticulitis.

Various symptoms can be associated with diverticulitis. Abdominal pain is a common symptom and tends to be felt primarily on the left side. Other symptoms associated with diverticulitis include:

  • fever
  • nausea
  • vomiting
  • chills
  • abdominal pain
  • cramping
  • constipation
  • bloating

Treatment

A variety of options are available for treating diverticulitis. For less severe cases, a combination of antibiotics, pain relievers and a liquid diet can be sufficient to resolve the diverticulitis. More serious cases of diverticulitis in which patients cannot drink liquids can require a hospital stay. While in the hospital, all nutrition will be obtained intravenously. Avoiding eating and drinking by mouth gives the bowel time to rest and recover and can help clear up the diverticulitis. If the condition is still severe, surgery might be required.

Diverticulitis can result in a lot of pain and discomfort. Fortunately, there are treatments that can provide relief. See a gastroenterologist for diagnosis and a treatment plan.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
September 01, 2017
Category: GI Conditions
Tags: Hemorrhoids  

Many people develop hemorrhoids at some point, particularly between the ages of 45-65. Hemorrhoids are typically associated with pain, discomfort, itching and irritation around the anus. They can also result in pain and discomfort during bowel movements. As uncomfortable as hemorrhoids can be, there are treatments that can help. See a gastroenterologist if you suspect you might have hemorrhoids. If a gastroenterologist determines you do have hemorrhoids, an appropriate treatment can be prescribed to ease the pain and discomfort.

Causes

The exact cause of hemorrhoids is not necessarily known, but several factors or conditions do seem to increase the likelihood of development hemorrhoids. Factors associated with an increased risk for development hemorrhoids include:

  • Family history of hemorrhoids
  • Pregnancy
  • Chronic constipation
  • Sitting for extended periods
  • Straining during bowel movements

Treatment

Hemorrhoids often go away on their own, even without treatment. However, there are various options to ease the pain and discomfort of hemorrhoids. A gastroenterologist might recommend a variety of methods for easing the pain at home. These include taking over-the-counter pain relievers, and fiber supplements for softening stools. Other things that can help provide relief include soaking in a warm bath and applying a cold compress to the anus to reduce swelling.

In addition to at home remedies for alleviating the pain and discomfort of hemorrhoids, there are medical procedures a gastroenterologist can perform to reduce the size of the hemorrhoids. Two popular procedures for treating hemorrhoids include a rubber band ligation and injection therapy. These procedures can be performed if other treatments and remedies have not provided substantial relief.

When struggling with hemorrhoids, the itching, irritation, pain and discomfort can interfere with your quality of life. Fortunately, there are treatments that can provide relief and even reduce the size of the hemorrhoids. See a gastroenterologist for the treatment of your hemorrhoids.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
August 15, 2017
Category: GI Care
Tags: Acute Pancreatitis  

Acute pancreatitis strikes suddenly, causing severe pain and vomiting. More than 300,000 people are admitted to U.S. hospitals every year due to acute pancreatitis, according to The National Pancreas Foundation.

What causes acute pancreatitis?

If you have gallstones, you may be at increased risk of developing acute pancreatitis. The condition can occur when stones get stuck in the common bile duct and prevent pancreatic fluids from flowing freely. Stones can also force bile to flow back into the pancreas, which may damage it.

You may also develop acute pancreatitis if your calcium or triglyceride levels are very high, or you have an autoimmune disorder, infection, an overactive parathyroid gland, cystic fibrosis or regularly take certain medications. High alcohol consumption can cause pancreatitis, particularly if you've been a heavy drinker for years. In some cases, the cause of acute pancreatitis can't be determined.

What are the symptoms of acute pancreatitis?

Pain from acute pancreatitis is felt in the upper part of the abdomen, although it can extend to your back. The pain may be mild at first, but may become severe and constant and may worsen after you eat or drink alcohol. Other symptoms include fever, nausea, vomiting, diarrhea and a rapid pulse. Prompt treatment is essential if you experience any of these symptoms. The condition can cause bleeding, infections and may even damage your kidneys, lungs and heart if the attack is severe. Although most people recover from acute pancreatitis, the condition can be life-threatening.

How is acute pancreatitis treated?

If your condition is caused by gallstones, you'll need surgery to remove the stones. In some cases, surgery may also be needed to keep your bile ducts open. If you're admitted to the hospital, you'll be given fluids to prevent dehydration caused by vomiting and diarrhea and may receive medication for nausea and pain. Foods and beverages are usually stopped for one to two days after you're admitted to the hospital.

Changing your medications, avoiding alcohol and addressing the causes of high triglyceride or calcium levels may help prevent further bouts of acute pancreatitis. If you have numerous attacks of acute pancreatitis or continue to drink alcohol, the condition can become chronic.

Although it's not always possible to prevent acute pancreatitis, you can reduce your risk by exercising regularly, following a healthy diet and avoiding heavy consumption of alcohol.

By NASHVILLE GASTROINTESTINAL SPECIALISTS
August 14, 2017
Category: GI Care
Tags: Endoscopy  

Gastroenterologists are concerned with conditions that affect the stomach, intestinal tract, colon and other organs involved in digestion and waste elimination. These conditions include certain types of cancer, biliary tract disease, ulcers and Irritable Bowel Syndrome. The test that checks for these potential health issues is called an endoscopy. There are several different endoscopic procedures that allow your doctor to check the digestive system, including a colonoscopy, enteroscopy and an upper gastrointestinal endoscopy. Find out more about getting an endoscopy and whether it’s time for you to have this test.

What Is an Endoscopy?
During an endoscopy, a long tube is inserted into an orifice (usually the mouth or anus) to look at the organs of the body. The tube, called an endoscope, has a camera that allows your doctor to view the targeted area. In the case of a colonoscopy, the endoscope is inserted into the rectum and provides a visual of your colon and intestines. An enteroscopy views the small intestine and an upper GI endoscopy looks at the parts of your upper intestinal tract, including the esophagus.

What Does an Endoscopy Detect?
An endoscopy can detect polyps (benign and precancerous) as well as cancerous tumors. It can also identify the presence of ulcers, inflammation and other damage to the wall of the intestines or stomach. An upper GI endoscopy can determine the cause of heartburn, chest pain and problems swallowing your food. In some cases, polyps or objects can be removed during the procedure or tissue samples may be taken. A stent can also be inserted in restricted areas of the stomach, esophagus or intestinal tract.

Do You Need this Test?
Here are a few indications that you should see your gastroenterologist soon for an endoscopy:

  • You have intense pain in the abdomen or have been diagnosed with digestive problems
  • You have severe acid reflux or chronic heartburn
  • You feel as if there is some type of blockage in your intestinal tract (such as long-term constipation)
  • There’s blood in the stool
  • There’s a family history of colon cancer
  • You’re over the age of 50

See Your Gastroenterologist
An endoscopy is not a test that you want to delay long if you’re concerned about your stomach, colon and digestive health. Call a gastroenterologist in your area to schedule an initial consultation and exam today.

By Nashville Gastrointestinal Specialists
July 17, 2017

Gastroenterologists, also called GI doctors, are concerned with a wide array of issues involving the digestive system. One concern for gastroenterologists is precancerous polyps in the colon, rectum and other areas of the intestinal tract. It’s wise to be informed about polyps and how they may affect your gastroenterological and overall health.

What Are Precancerous Polyps?
A polyp is a small, fleshy nodule that forms on the inside of the intestines or colon. It is considered an abnormal growth, but in many cases, they are found to be benign (commonly in the early stages). However, over time polyps can become large and malignant if they aren’t treated. Many polyps are found to be pre-cancerous, which means they have the potential to turn cancerous if they aren’t removed. With early detection through an endoscopic test, the risk can be eliminated by your gastroenterologist.

What Are the Potential Causes?
Doctors aren’t definitively sure what causes polyps to form, but there are a number of theories. Here are a few:

  • Heredity (a family history of colon or intestinal problems) or certain hereditary conditions
  • Poor diet or lack of nutrition
  • Lack of exercise and regular physical activity
  • Being overweight or obese
  • Diagnosis of ulcerative or Crohn’s colitis
  • The natural aging process for some patients (which is why regular exams are recommended after age 50)

What to Do About Them
The good news is that precancerous polyps can usually be quickly and effectively treated by your gastroenterologist. They are diagnosed through an exam called a virtual colonoscopy. A tube called a fiber-optic scope is inserted into the rectum that can identify the presence of a polyp and take a sample for a biopsy. If it is precancerous, your GI doctor can remove the polyp at another colonoscopy appointment. You should make this polyp removal appointment a priority.

Make an Appointment with a Gastroenterologist
The health of your digestive and elimination system is crucial to your overall health. Whether you’re in need of an initial endoscopic test to check for polyps or you’ve already been diagnosed with a precancerous polyp, call a gastroenterologist in your area for an appointment.

By Nashville Gastrointestinal Specialists
July 03, 2017
Category: GI Care
Tags: Gastroenterology  

When it comes to matters involving your digestive tract, stomach, and colon, a gastroenterologist is the doctor to consult with. GIGastroenterology specialists also help patients with matters involving the pancreas, gallbladder, liver and other organs involved in the elimination of waste. Here are some of the most common frequently asked questions that patients have for gastroenterologists.

What Does a Gastroenterologist Do?
A gastroenterologist is tasked with studying, managing and treating disorders involving the gastrointestinal tract. They diagnose potential problems that stand in the way of your body’s ability to comfortably and easily digest food, move it through the body and get rid of waste. It’s important that your gastrointestinal system is healthy so that your body absorbs the nutrition it needs for energy and vitality. GI doctors undergo rigorous training in this specialized area of medicine for five or six years after medical school.

What Tests Are Needed?
There are a number of tests that a gastroenterologist may recommend depending on your digestive concerns. Here are a few of the most common ones:

  • Colonoscopy (checks rectum, colon, and intestinal tract)
  • Upper GI endoscopy (checks esophagus and upper gastro system)
  • Flexible sigmoidoscopy (similar to a colonoscopy, but only examines a portion of the colon)
  • Endoscopic or abdominal ultrasound
  • Abdominal Angiogram
  • CT enterography

What Treatments Are Administered?
If a problem is identified in the gastrointestinal tract or system, there are a number of possible solutions your GI doctor may explore:

  • Polyp removal (done with an endoscope)
  • Esophageal, colonic, duodenal or bile duct stent placement (allows the comfortable passage of bodily fluids, solids, and waste)
  • Cecostomy (clears bowels)
  • Surgical procedures (such as bowel surgery, appendectomy, colostomy, proctectomy, gastric bypass surgery, etc)

Ask More Questions at Your Initial Appointment
Whatever specific questions you may have for a gastroenterologist, they are best addressed at your first visit. You should make this important appointment when recommended by your primary physician or when you have symptoms of a GI problem (bleeding, chronic constipation or diarrhea, heartburn and similar concerns), Call a gastroenterologist in your area to schedule a consultation today.

 
By Nashville Gastrointestinal Specialists
July 03, 2017
Category: Welcome Blog
Tags: Gastroenterology  

Are you suffering from bloating or constipation? Is your heartburn becoming a serious nuisance, or a serious problem? Are you in need of a gastroenterologist? If these are only a few of the problems you are experiencing with your gastrointestinal tract, then you may need to speak to a gastroenterologist.

The goal of this blog is to provide its readers with the adequate information they need to help take care of themselves. We provide an array of topics to keep you updated and informed.

Make sure to check back regularly for updates! If you’d like to subscribe to our blog, just use the ‘Subscribe to Our RSS Feed’ link at the top of the blog page with your favorite RSS reader. And, as always, feel free to contact our office with any questions or concerns.

 




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