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'Gastroenterology' posts

A patient's experience with the Swedish Digestive Health Network

We recently received this post from a patient who asked us to share her story and her experiences with Dr. Schembre and Dr. Tschirhart with the Swedish Digestive Health Network. Thank you, Yevette, for sharing your story with us!

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Dec 2nd,  2012 I was out of town doing some promotion for work when I collapsed in my hotel room. I went to the local hospital ER.  They found I had a gallstone lodged in my common bile duct. As they attempted to remove this, the surgeon ripped my intestine.  This created a whole host of life threatening problems. After 5 days I was airlifted to Swedish Medical Center in Seattle.  Dr. Tschirhart was assigned my case.  By June I was stable enough for surgery.  Dr. Schembre referred to this surgery as a “Leap of Faith”. There was a team of 4 surgeons involved in this surgery.  Their concern that I may not survive was apparent. I actually said goodbye to my 17 year old daughter before this surgery.  After having me in surgery for only a few minutes he told my family that he didn’t think there was anything he could do for me & that my insides look like paper mache and were very fragile. But he never gave up.  I ended up with 9 different drainage tubes in my abdomen along with a J tune, G tube, every tube possible I think.  When I drank, the fluid would go in and then come out several of the tubes.  Dr. Schembre from GI worked with Dr. Tschirhart to help make my treatment plans. In October I was in a better situation to endure another surgery. Dr. Tschirhart explained exactly what needed to be done & explained the “Best Case Scenario” that he hoped he could perform. Fortunately he was able to achieve what he set out to do.   I ended up with 3 major surgeries and countless procedures.

Finally in December of 2013 they wanted me to go to rehab but I insisted on recovering at home in Marysville. I felt if there was a chance I was not going to make it I wanted to die at home.  Dr. Tschirhart assured me that if I had trouble and had to go to my local hospital he would have me airlifted immediately back to Swedish. As soon as I got home and on my couch I felt better!  I was discharged Dec 18, 2013 after a total of 381 days in the hospital.

Recently (August of 2014) I was able to return to work and can drive too!  I did have trouble this past April when my side split open and went into Swedish ER.  I commented to my friend that I needed to call Dr. Tschirhart so he could come get me.  The intake gal overheard me and said doctors never do that.  I tried to tell her that Dr. Tschirhart would. The ER was trying to gather info as to what had happened to me. My situation is too much to explain so I kept referring them to my file.  I was very frustrated. As they were questioning me I saw this hand come through the door and slowly he walked in. There he was!  I instantly started crying. He immediately had me transferred up to the 10th floor, order CT, medication etc.  He came for me as promised. I knew he would.
 

Dr. Tshirhart always told me  ....

What you can do about nonalcoholic fatty liver disease

Nonalcoholic Fatty Liver Disease (NAFLD) is a term used to describe the presence of fat accumulation in the liver. NAFLD affects approximately 20-30% of United States population, and is most commonly diagnosed between 40 – 50 years of age. Recent studies have shown an even distribution of NAFLD between men and women.
 
A healthy liver may contain some fat. However, NAFLD occurs when the liver has trouble breaking down fats, causing excess fat to build-up in the liver. Mild fat accumulation usually does not result in inflammation of the liver. More severe fat accumulation can cause inflammation, and potential progression to cirrhosis (scarring of liver tissue). People who drink too much alcohol can get a condition similar to NAFLD, but NAFLD happens in people who do not drink alcohol or only a little alcohol.
 
We still have much to learn about the specific cause of NAFLD, but it is often associated with:

How to deal with gas and bloating

We all have occasional gas, usually from something we have eaten, but many people feel that they pass too much gas or burp too frequently. Intestinal gas can result in abdominal pain, bloating and embarrassment.
 
The amount of gas produced by the body depends upon your diet and other factors. Most people with symptoms of excessive gas do not produce more gas than the average person, but are more aware of normal amounts of gas.
 
Where does the gas come from?

Kids and lactose intolerance

Do you wonder if your child might have “lactose intolerance”?    Have you ever thought of removing dairy from your child’s diet?  If the answer to either of these questions is yes, here are a few things to remember when it comes to lactose intolerance in kids:

  • Lactose is broken down by lactase.

While lactose is the carbohydrate (sugar) found in milk, lactase is the enzyme that digests the sugar. This enzyme is found in the lining of the small intestine, breaks down lactose into simpler molecules that are easier to absorb.  When there isn’t enough lactase, the sugar isn’t properly absorbed, which leads to the symptoms of “intolerance”, which include gas, bloating, pain and diarrhea.

  • True lactose intolerance is rare in young children.

Although children as young as infants can “transiently” have less lactase in their digestive tracts (most often, this happens for a week or two after an infection), lactase production remains ...

Gluten intolerance or low FODMAPs?

Despite test results that show no evidence of their children having neither any detectable allergies to wheat nor any signs of celiac disease, many parents choose to have their children follow a gluten-free diet.  This is because of convincing stories of how gluten (a protein found in wheat and other grains) seems to cause their kids to have belly aches, nausea, bloating and a variety of other symptoms.  

For years, this was hard to explain without a scientific explanation.   Gastroenterologists like me had a hard time supporting families who wanted to follow gluten free diets, without a good “medical reason”.  Then, in 2011, researchers from Australia conducted a double-blind, randomized, placebo-controlled, rechallenge trial in nearly 3 dozen patients (none of whom had celiac disease or wheat allergy), all of whom described worsening symptoms when unknowingly ingesting small amounts of gluten.  The results of this study described a condition termed, “Non-celiac gluten intolerance”.    It was after reading this landmark study that many physicians, including myself, began to validate parents’ concerns about gluten being the culprit behind their children’s gastrointestinal (GI) problems.

But then in 2013, just as word of non-celiac gluten intolerance was gaining popularity amongst physicians like me, the exact same group of researchers from Australia published a follow-up study on a similar set of about 3 dozen patients.  The findings of this 2nd study showed that instead...

Does your child have a food allergy or food sensitivity?

“Every time my child eats, his belly hurts. I think he must have a food allergy. Can you help us?”

Countless times have I heard this from parents of children worried about foods being the cause of their child’s gastrointestinal (GI) complaints. Some families wonder whether their child should start a “gluten-free” or other type of dietary change. More often than not, families have already tried a few diets before meeting with me.

Parents considering these types of elimination diets need to be aware of a few key points:
The difference between “food allergy” and “food sensitivity”:

Helping kids with Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (IBD): Do you know what it is?  Do you know what symptoms people suffer from? Do you know that 1.4 million Americans have IBD, and that it can affect both children and adults alike?  The gastroenterology team at Swedish takes care of both children and adults who suffer with this chronic, disease of the gastrointestinal tract

As the pediatric gastroenterology nurse who works intimately with the pediatric IBD patients at Swedish, I know all too well that many can suffer with the “ups and downs” of this sometimes debilitating disease.  Often, I tend to hear from kids when they are “down”, but my favorite time to hear from them is when they are excited about upcoming special events like the “Take Steps” walk, or Camp Oasis (a camp just for kids with IBD), both events sponsored by the CCFA.  It’s often at these events, that children first say that they start to feel “normal”. 

This year, we want to invite you to ...

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