Summer is right around the corner. Barbecue grills are getting fired up, graduation parties with delectable cakes and sweet summertime drinks are just a few weeks away, and restaurants with outdoor patios are in full swing ready to serve you their finest southern cuisine. Don’t let difficulty swallowing interfere with your fun summer plans. It’s common to choke on food once in a while if you eat too quickly, but if this happens on a frequent basis, you may have a condition called dysphagia, which requires a thorough medical evaluation by a gastroenterologist. Dysphagia is the medical term for the symptom of difficulty in swallowing. Dysphagia may be a sensation that suggests difficulty in the passage of solids or liquids from the mouth to the stomach, a lack of sensation during the swallowing process, or various other inadequacies of the swallowing mechanism. Although many of us don’t think twice about the act of swallowing, numerous mechanisms are involved such as nerve processes, muscle strength, and secretion of saliva, which are all important in the passage of food from your mouth to your stomach. Central nervous disorders such as Parkinson’s disease or strokes, can sometimes affect the initial process of swallowing (oropharyngeal phase). Some signs of this condition may be coughing during swallowing or even regurgitation of food through the nose. More commonly, people may be able to initiate a swallow, but have a problem with their esophagus (a 10-inch long, hollow, muscular tube that connects your throat to your stomach), which may cause the feeling of “food getting hung up in their throat”. If this occurs frequently or for a prolonged period of time, this may be a medical emergency! Dysphagia may occur if you have muscles within the esophagus that are not working properly. Immune disorders, allergic reactions, inflammation of the esophagus (esophagitis), or even simple acid reflux may be the cause of your underlying problem. If so, a thorough evaluation by a gastroenterologist is needed, as certain conditions can be corrected with either medication or lifestyle changes. Dysphagia may also be caused by something blocking your esophagus, such as a tumor. Esophageal cancer occurs when cells in the esophagus begin to grow abnormally. They do not respond to regular cell growth, division, and death signals like they are supposed to. They also don’t organize normally. Instead, they grow into a tumor, which may extend into the open space inside your esophagus or break through underlying layers of your esophageal wall. This year, an estimated 16,940 adults (13,360 men and 3,580 women) in the United States will be diagnosed with esophageal cancer. Some of the risk factors for esophageal cancer include obesity, smoking, alcohol consumption, and even simple acid reflux. As part of the work-up for dysphagia, gastroenterologists may perform a test called an upper endoscopy. This 5-10 minute procedure involves taking a look into the esophagus with a small camera. Based on what we find, we may have the ability to treat your underlying problem, and potentially prevent cancer from occurring! If you are experiencing difficulty swallowing solids, liquids, or both; then it may mean you need to see a gastroenterologist for further information. Please contact our office at 336.768.6211 to make your appointment today! Dr. Dhyan Rajan
It’s March and that means a lot more than bracket busters and the final four. It’s colon cancer awareness month. It’s true; it doesn’t sound as exciting… But oh man, is it! Colon cancer is the second leading cause of cancer related deaths in the US. This month signifies the leaps and bounds we have made in the fight against colorectal cancer. CRC incidence rates have been decreasing in the US for several decades, with the pace accelerating 3% annually from 2003-2012. From 1975 -2000 this was thought to be secondary to awareness being brought to modifiable risk factors (diet, exercise, smoking, etc.) as well as screening. The recent steep decline however, in individuals 50 and older is thought to be primarily due to the uptake of screening colonoscopies. The decline of CRC in those individuals has increased from 38% in 2000 to 59% in 2013. (Do I have your attention now?) This is the beginning of the battle but we cannot stop now! With every step that we have made going forward we have had new hurdles placed in front of us. Although we are winning the fight against colon cancer in individuals over the age of 50, more recent data suggests that CRC is increasing in the under age 50 group. The reason behind this is unclear but as we wait for further studies to shine a brighter light on this we have to keep awareness alive. At Digestive Health we take colon cancer and its awareness very seriously. At the core of what we practice is our interaction with our patients. We evaluate every patient and assess their personal risk for CRC. We also have three Billboards up through the course of March to bring awareness to our community with various facts about colon cancer that may not be general knowledge. We have also placed large blue ribbons at all of our locations as a reminder about colon cancer awareness. We are helping to raise money for colon cancer by taking part in the “strong arm selfie” posts on Fridays. On March 1st , we live streamed a colon cancer kickoff from time square in our Winston Salem waiting rooms. Our employees are the heart of our practice and we take their health seriously. They are taking part in Employee wellness challenges that are centered on colon cancer prevention. As a practice, we not only use our knowledge to help patients but also try and give knowledge to enable our patients to recognize signs and symptoms early. After all “knowledge is power.” Here are some facts that may help you prevent colon cancer and also help you recognize signs and symptoms in yourself or those you love early. Although frequently colon cancer does not have symptoms; rectal bleeding, unintentional weight loss, and changes in bowel habits always warrants further evaluation Physically active individuals have a 25% lower risk of colon cancer then less active individuals Smokers have an increased risk of CRC If you have a first degree relative (mom, dad, brother, sister, son, daughter) who had colon cancer or colon polyps before the age of 60, you will require a colonoscopy earlier then the age of 50 as your risk of developing colon cancer at an earlier age is higher Higher consumption of red and/or processed meat increases the risk for colon and rectal cancers For every 10 grams of daily fiber consumption there is a 10% reduction in cancer risk CRC has been linked to moderate and heavy alcohol use. People who have a lifetime average of 2-4 alcoholic drinks per day have a 23% higher risk of CRC than those who consume less than 1 drink per day Over 60% of colon cancer deaths could be avoided with screenings Call our office today at 336-768-6211 to schedule your colonoscopy. With the proper knowledge and care this is a preventable cancer. Please help us spread the word. Dr. Apsara Prasad
Digestive Health Specialists is fighting back as a company against Colon Cancer! About three years ago, DHS formed a wellness team that acts as overall motivators and cheerleaders for the company’s health and well-being. At least 4 times a year, this team rolls out a “wellness challenge” that incorporates some part of their health that may be physical, stress management, healthy alternatives, fitness challenges, etc. This March, we decided to move beyond just personal health and roll out a challenge that incorporates the health of our entire company fighting against Colon Cancer. Below, our physician Dr. Apsara Prasad gives examples of things we can actually do to help prevent colon cancer, including: Being Physically Active Limiting our amount of red and processed meats Eating more fiber and whole grains Stop smoking Noticing if we have symptoms i.e. change in bowel habits, rectal bleeding and weight loss. Our team took these strategies and turned them into challenges. Check out the ways we are incorporating healthy changes in our daily lives! The staff are currently implementing these and documenting them with pictures throughout the month of March. Join us in the fight against Colon Cancer!
After years of seeing loyal DHS patients at JR Jones in King, NC we are building our own separate office location to continue the same excellent patient care. Starting in April, patients in communities north of Winston Salem, Stokes County, between Rural Hall and Mount Airy and even Virginia will be offered the same quality of GI healthcare received in our main office. Here in King, we will have our Endoscopy Suite and Clinic in the same building to ensure patients have access to both without driving further. Our Endoscopy suite will be modern and up to date with new technology, just like at our other locations! We plan to be open 5 days per week at our King location, giving patients expansive access to GI care. Doctors Gillis and Rajan will be the two physicians on staff and they will still be available for appointments in the Winston Salem office if it happens to be more convenient for the patient. Our schedule is open for booking procedures in the new office starting April 2017. Until then, we will continue to see patients in our clinic office in King at 167 Moore Rd, Suite 6. We look forward to serving your GI needs in King, NC!
On any given day, our providers here at Digestive Health Specialists see patients who experience a choking or strangling sensation in their throat. The medical term for this sensation is “dysphagia” and it means difficulty swallowing. It can occur in anyone but most commonly older adults. Occasional problems swallowing from eating too quickly or not chewing food thoroughly are usually not cause for concern, but persistent dysphagia may be a sign of a medical condition which requires treatment from a Gastroenterologist. Signs and symptoms of dysphagia… Pain while swallowing/unable to swallow Sensation of food getting stuck in throat or chest Drooling Hoarseness Regurgitation Frequent heartburn Stomach acid burning in throat Unexpected weight loss Having to eat very small bites to avoid choking on food The causes of dysphagia can be related to the narrowing or muscle spasms of the esophagus, weakening of throat muscles, affiliated with neurological damage/disorders, and in some cases cancer. Swallowing is a complex process and various conditions can interfere. The only two significant risk factors for experiencing dysphagia are aging (wear and tear on the esophagus) and certain health conditions that qualify as neurological or nervous system disorders. If you realize you need to see a doctor for dysphagia, in the meantime it will be helpful to chew food more slowly and thoroughly than normal. Eating smaller meals and avoiding eating right before bedtime may also help. Make sure to keep track of symptoms, personal information like major stresses or recent life changes, and to be prepared with questions to ask your doctor at your visit. Call us to make your appointment today if you have trouble swallowing!
After hearing many patient requests to open a Greensboro, NC office, we are pleased to announce the opening of our new location at 6316 Old Oak Ridge Road! Dr. Keith Toledo will begin seeing patients on Tuesdays and Thursdays for half-day clinic appointments in September 2016. We are so excited to have Dr. Toledo join our impressive team of providers after prior years of practice at a nearby gastroenterology practice. Dr. Toledo is highly experienced in all aspects of GI with special interests in GERD, IBD, liver disease, IBS, and colon cancer screenings. He attended school at the University of Louisville and then completed his Medical Residency at Indiana University and Fellowship at the University of South Alabama. Outside of work, Dr. Toledo enjoys boating with his family, fishing, and performing impromptu magic tricks to make people laugh. For outreach, he enjoys volunteering his time in civic organizations. He also is an advocate for increasing Autism Awareness in the Piedmont Triad. We are excited for the expansion of our wonderful practice. If you live in the Greensboro area and are seeking a skilled gastroenterologist, call us to schedule your appointment with Dr. Toledo today! Read More about our Greensboro Offce: http://digestivehealth.ws/greensboro-office/ Digestive Health Specialists, P.A. – Greensboro 336.768.6211 6316 Old Oak Ridge Road Greensboro, NC 27410
If you are a new patient to Digestive Health Specialists, consider scheduling your appointment with Dr. Dhyan Rajan! As our newest provider, his areas of expertise include Crohn’s disease, IBD, and ulcerative colitis. He is originally from rural Maryland but attended medical school in England, where he graduated magna cum laude with his Doctorate of Medicine in 2008. He completed internal medicine training and gastroenterology and hepatology fellowship at Nassau University Medical Center in New York where he was Chief Resident of the Internal Medicine Residency Program. In addition, he was awarded Intern of the Year, Resident of the year, and Fellow of the Year. What makes Dr. Rajan distinctly qualified is that he completed a 4th Year Fellowship in Advanced Inflammatory Bowel Disease at the University of Maryland Medical Center in Baltimore, MD. On a personal level, Dr. Rajan refers to himself as a silly guy. His kindness makes him very personable and it is obvious through his patient care. He is very dedicated to his patients and believes in extended interactions with them, including getting to know their families. When he is not practicing gastroenterology, he spends all his spare time with his wife and sweet newborn twin boys. As a sports fan, he can’t wait to play with them as they grow older. Call us at 336-768-6211 to schedule your appointment with Dr. Rajan today!
During these hot, lazy days of summer, you may find yourself moving slowly and feeling sleepy all the time. There is in fact an inverse relationship between the temperature outside and the temperature in your body. In summer, your balance may feel off because your body turns down its internal furnace as a means of protecting itself. This translates to the digestive system weakening, meaning you must be careful not to overload it with the wrong foods! One way to keep digestion working smoothly is to eat lighter. You can do this by eating smaller portions for each meal. In doing this your body will feel cooler, leaving you more alert and energetic throughout the hot day! Do not cut back by skipping meals; eat regular meals, just smaller ones. Try to eat your fair share of semi-liquid, easily digestible foods. Examples include cucumbers, melons, summer squash, and zucchini. If you enjoy snacking on nuts, soaking them overnight makes them easier to digest. Do not eat salty, roasted nuts because those increase the body’s internal heat. Drinking lots of water is important every season, especially in summer! Increase your daily intake of pure water and other liquids. Freshly squeezed fruit juices cool the body and replenish electrolytes lost in the heat. Certain spices like rosemary, basil, parsley and cilantro enhance digestive power. It is okay to add salt to your food because much of your body’s natural salt stores are lost through sweating. Daily movement is also important for keeping the digestive system from slowing down. One way to do this without getting overheated is by waking up early to exercise when the heat is at its lowest, or taking an evening walk when the sun sets. Swimming is also a great workout because it helps keep you cool. Whatever you do, don’t overexert yourself! Find creative ways to change up your routine and beat the heat.
Diarrhea, Fatigue, and Weight Loss… Oh My! Symptoms of IBD are no fun. IBD stands for inflammatory bowel disease and it involves chronic inflammation of all or part of your digestive tract. Two primary conditions we see patients for are ulcerative colitis and Crohn’s disease. Symptoms of both are usually severe diarrhea, pain, fatigue, and weight loss. Risk factors for IBD include: • Age (most are diagnosed under age 30 • Race or ethnicity (highest risk among whites and Ashkenazi Jewish descent) • Family history • Cigarette smoking • Isotretinoin use (Accutane – used to treat acne) • Nonsteroidal anti-inflammatory medications (ibuprofen, Aleve, etc.) • Where you live (high risk in urban areas/industrialized countries) Ulcerative colitis causes long-lasting inflammation and sores, or ulcers, in the innermost lining of your colon and rectum. Crohn’s disease causes inflammation of the digestive tract lining and this inflammation often spreads deep into affected tissues. Common symptoms of both Crohn’s disease and ulcerative include encompass diarrhea, fever, abdominal pain and cramping, blood in stool, loss of appetite, and unintended weight loss. What causes inflammatory bowel disease? Unfortunately the exact cause remains unknown. One possibility is an immune system malfunction. When a virus or bacterium is being fought off by your immune system, an abnormal response would cause the immune system to also attack the cells in the digestive tract. Stress is also known to aggravate symptoms. If you are wondering at what point you should see a doctor, do so if you see a fierce change in your bowel habits of if you exhibit any known IBD symptoms. Do not put off getting medical attention if you have IBD; it is unlikely to be fatal, but it is a serious disease that can cause life-threatening complications. If you missed Dr. Marcum Gillis covering this topic on radio station WSJS Wednesday, June 15th, click here to check it out!
Has it ever struck when traveling somewhere new and different? Maybe you thought nothing of it, but chances are it was traveler’s diarrhea. This is a digestive tract disorder that usually causes loose stools and stomach cramping. It stems from ingesting contaminated food or drinking water. The good news is traveler’s diarrhea is usually not serious, just inconvenient! Climate, social conditions, and sanitary standards are all factors that affect your likelihood of getting this unpleasant disorder while traveling. After all, you are not at home! With that being said, exercise caution when eating and drinking funky things on a trip. The most common signs and symptoms of traveler’s diarrhea include: Sudden occurrence of 3 or more loose stools per day Fecal urgency Nausea/vomiting Fever Although stress and diet change can play a role, contaminated food and water is usually to blame for traveler’s diarrhea. The contamination is a result of infectious agents like bacteria, viruses and parasites which enter your digestive tract and knock out your defense mechanisms. ETEC bacteria (enterotoxigenic Escherichia coli) are the most common cause; these bacteria attach to the lining of your intestine and release a toxin, causing diarrhea and stomach cramps. That does not sound like fun! Destination is primarily what determines your chance of getting traveler’s diarrhea. However, these groups of people have a greater risk of developing it than others: Young adults Those with weaker immune systems Diabetes or IBD patients Those who take acid blockers or antacids Seasonal travelers As far as location, you are at the highest risk for infection in these areas when traveling to Central and South America, Mexico, Africa, the Middle East, Asia, Eastern Europe, and select Caribbean islands. Now that you know where your chances are highest of getting traveler’s diarrhea, plan your travels accordingly. Symptoms usually go away within a few days, but you should seek medical help if you experience severe dehydration, vomiting that won’t stop, bloody stools, or high fever. Dr. Landon Weeks will be discussing this topic on the radio station WSJS Wednesday, May 18th 2016 so be sure to tune in and hear what he has to say!