Swedish News Blog

Swedish Digestive Health Network – call 1-855-411-MYGI (6944)

Debra Cadiente, RN,BC

Debra Cadiente, RN,BC
Nurse Navigator, Swedish Digestive Health Network

In the fall of 2011, Swedish opened the largest, most advanced endoscopy center in the Pacific Northwest. This state-of-the-art unit serves as the procedural space for a broad range of minimally invasive cases performed by gastroenterologists, colorectal specialists, thoracic and bariatric surgeons and pulmonologists on patients with a broad range of digestive and respiratory diseases.  As we celebrated this accomplishment, we were reminded of the complexity of digestive disease and that many times, patients and possibly even referring physicians aren’t sure of what type of specialist is best suited to a particular digestive problem.

There is nothing more distressing as a health care professional than hearing patient horror stories about trying to access care. A chronic illness can cause depression and discouragement; an acute illness or a cancer diagnosis can overwhelm the patient and the patient’s family with plenty of unknowns. 

To address these challenges, a group of 50+ specialists came together and created the Swedish Digestive Health Network.

The Swedish Digestive Health Network focuses on collaboration to ease the way for ...

What is Gastroenteritis?

Karlee J. Ausk, MD

Karlee J. Ausk, MD
Gastroenterologist

This past week, Britain’s Queen Elizabeth II was hospitalized with a “stomach bug”. Gastroenteritis (also called the “stomach flu”) is the second most common illness in the United States. So, chances are good that your family has been affected by gastroenteritis already this year!

What are the symptoms of gastroenteritis?
Gastroenteritis is inflammation of the stomach and intestines causing symptoms of diarrhea, vomiting, cramping, and fever. If a person is not able to keep up with fluid losses from diarrhea and vomiting, then they can become dehydrated. Gastroenteritis occurs year-round and affects people of all ages. Those who are young, old, or have a suppressed immune system are more susceptible to severe gastroenteritis and to dehydration.

What causes gastroenteritis?
The majority of cases are caused by a viral infection (occasionally, a bacterial infection) transmitted through contact with another sick person or contaminated food/drink.

I have gastroenteritis, how can I feel better?
Rest and fluids! Staying hydrated is the most important step to controlling gastroenteritis. Some good options for staying hydrated include sports drinks or oral rehydration solutions (such as Pedialyte in drug and grocery stores).

I typically do not recommend any anti-diarrheal medications as this may even prolong the illness. In addition, antibiotic therapy is not helpful unless a specific bacterial cause is identified.

When should I call my doctor?
If you have questions or concerns you should always call your provider. However, things to watch for if you have gastroenteritis include:

Preventing progression of Barrett's esophagus to cancer without surgery

Drew Schembre, MD, FASGE, FACG

Drew Schembre, MD, FASGE, FACG
Medical Director, Swedish Gastroenterology

Many people wonder what the treatment for Barrett's Esophagus (BE) is. Treatment for BE without dysplasia consists primarily of controlling esophageal acid exposure, usually with once a day proton pump inhibitor (PPI) medications like omeprazole (Prilosec®). Occasionally, twice a day dosing or even anti-reflux surgery may be necessary to completely control acid reflux. Unfortunately, suppressing acid does not usually cause the Barrett’s tissue to regress or even prevent it from progressing to cancer.

If dysplasia is found on any biopsies, treatment recommendations change:

  • Low-grade dysplasia: Close surveillance with endoscopy every 6-12 months or ablation.
  • High-grade dysplasia: Endoscopic therapy to destroy Barrett’s tissue or surgery.
  • Early cancer: Endoscopic removal of focal cancer followed by tissue destruction or surgery

Experiments performed 20 years ago showed that in most people, once the Barrett’s tissue has been removed or destroyed, normal squamous tissue tends to regrow in the area as long as acid reflux is suppressed.

Endoscopic tissue destruction can be performed many ways:

Barrett’s Esophagus and Esophageal Cancer: The dark side of the acid reflux epidemic

Drew Schembre, MD, FASGE, FACG

Drew Schembre, MD, FASGE, FACG
Medical Director, Swedish Gastroenterology

Heartburn (which was once considered an annoying result of over-eating) has matured into a full-blown medical condition better known as gastro-esophageal reflux or GERD.

GERD, or the sensation of acid or other gastric fluids washing up into the chest or mouth, affects as many as 1 in 5 adults in the US on a monthly basis with up to 6% experiencing symptoms 2 or more times per week. Estimates suggest that about 5% of those who suffer from reflux will develop a potentially pre-malignant condition called Barrett’s esophagus (BE). Named after the British thoracic surgeon who erroneously suggested the condition resulted from a congenitally short esophagus, BE is characterized by “specialized intestinal lining” replacing normal squamous epithelium (ie, wet skin, like the lining of the mouth) in the lower esophagus in response to long-term, repetitive exposure to stomach acid.

While this may seem like a protective adaptation—Barrett’s tissue will not ulcerate and develop scarring the way squamous tissue does—it is inherently unstable and can progress to cancer. The risk for developing adenocarcinoma of the esophagus for people with BE is more than 30 times greater than for people without it.

Luckily, the absolute risk of progression from BE to cancer is relatively low. BE progresses to esophageal cancer at the rate of around 0.2% per year. Further, cancer doesn’t usually develop suddenly. Instead, it progresses through a series of stages termed “dysplasia” meaning bad or unfavorable changes that can be identified on biopsies collected at endoscopy. These changes progress from...

Make a new year's resolution to be screened for colorectal cancer

Karlee J. Ausk, MD

Karlee J. Ausk, MD
Gastroenterologist

We have come upon the time of year when we reflect back on the events of 2012 and look forward to new beginnings in 2013. About 45% of Americans make New Year’s resolutions every year and frequently these resolutions are health-related.

Why not let 2013 be the year you resolve to be updated on colorectal cancer screening?

Why should I worry about colorectal cancer?

Colorectal cancer is the second leading cause of cancer death in the United States. The average lifetime risk of developing colorectal cancer is about 5%. In the colon, cancer usually arises over time from abnormal polyps, called adenomas. This provides us the rare and life-saving opportunity to intervene and remove polyps to prevent cancer from developing. Pre-cancerous polyps or early cancers do not always cause symptoms, highlighting the need for routine screening.

Simply stated, there are large studies showing that screening for colorectal cancer prevents cancer. Screening saves lives. Screening detects cancer at an early and more treatable stage. How can you argue with that?

Who should be screened for colorectal cancer?

Regardless of your age, you should discuss any GI symptoms you are concerned about with your healthcare team.

If you are without symptoms...

Probiotics and our gut - what you should know

Karlee J. Ausk, MD

Karlee J. Ausk, MD
Gastroenterologist

Did you know that the bacteria that live in our intestines account for over two pounds of our body weight? And that there are 10 times the number of bacterial cells in our body than human cells? Some bacteria play a beneficial role in a normal gastrointestinal (GI) tract and are known as probiotics.

Probiotics have a variety of functions in the GI tract including aiding the intestinal immune system and the intestinal nervous system, breaking our food into nutrients, blocking the bad bacteria, and promoting a healthy intestinal lining. With so many important tasks, it is no surprise that probiotics can be used to treat some common GI conditions. Though studies of probiotics are small with considerable variability, there is evidence supporting probiotic use for prevention of diarrhea caused by antibiotic use and treatment of infectious diarrhea, ulcerative colitis, clostridium difficile, and irritable bowel syndrome.

What you should know:

The U.S. FDA considers probiotics as dietary supplements, so their production is not tightly regulated and quality can vary widely. In addition, insurance companies do not cover probiotics, and the cost adds up quickly.

Should I ....

Swedish Uses Colon Cancer Live Stream to Fight Disease; Physicians will Respond on Camera to Questions During Live Streamed Colonoscopy on March 28

Swedish News

SEATTLE, March 27, 2012 – Colorectal cancer doesn’t broadcast its presence until it’s too late. Swedish Health Services hopes to change that by getting the word out about safe and effective prevention options.

On Wednesday, March 28, 2012 from 9 a.m. to 12 p.m. (PST), Swedish physicians and staff will host its first-ever online chat and video stream of a colonoscopy procedure. The stream will be made available online at www.swedish.org/colonlive.

In the United States today, colorectal cancer is the second leading cause of cancer-related deaths for both men and women. It is estimated that 51,000 people will die of the disease this year and 143,000 new cases will be diagnosed.

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