Oropharyngeal dysphagia is related to problems with the initiation of the swallows and clearing the food bolus from the mouth to the esophagus. This usually occurs within a second of swallowing and you may feel that you cannot initiate a swallow or food hangs up in the neck region. A test that is commonly used to evaluate this is a modified barium swallow or videofluoroscopic swallowing study. This study provides critical information on inability or excessive delay in initiation of swallowing, unintentional inhalation of food, unintentional expulsion of food from the nose or mouth, and/or abnormal retention of food in the back of the throat after swallowing. Most ...
Gluten is a hot topic these days, and is hitting the headlines again. Why? At the American College of Allergy, Asthma, and Immunology annual meeting, Dr. David Stukus (a pediatric allergist) set out to clarify frequent myths that he encounters in his practice. So, why is he saying that gluten allergies do not exist?
Gluten is a protein found in foods processed from wheat and related grain products. In celiac sprue (affecting up to 1% of adults), gluten intake leads to damage of the small intestine, impairing its ability to absorb nutrients. I like to imagine that a healthy small intestine is like a shag carpet, and small intestine affected by active celiac sprue is more like a tile floor. Celiac sprue is not a gluten allergy, but rather an autoimmune condition where the gluten is triggering an inflammatory response in the body.
Studies find that ...
People often fear the worst about constipation. Constipation is very common and only rarely signifies something serious. Just because the average person has a bowel movement daily doesn’t mean you have to—if normal for you is every 3, 5, or 7 days that is okay so long as it’s not adversely affecting your life. In many cases, people with constipation struggle with it all their lives and are looking to be certain nothing more serious is going on and for a way to treat their symptoms. Even in people with relatively new onset of constipation, there usually is a simple solution. It is certainly reasonable to have your constipation assessed but in the absence of other warning signs for more serious disease, additional testing related to constipation is not always essential.
What are the causes of constipation?
- Most cases of constipation are caused by colonic inertia, which is simply a slow moving colon. Different people are made differently, and the muscles and nerves that are supposed to act in concert to push stool along just work a little slower in people with constipation. In such cases, if we could look at the colon under the microscope it would look normal but if we took an x-ray of how quickly it pushed stool through, it would on average move things along more slowly.
Pelvic floor dysfunction
- If ...
FODMAPs is an acronym, coined by two Australian researchers, that refers to Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. These are small chain sugars, fibers, and sugar alcohols that are poorly digested by humans, but are easily digested by the bacteria in your intestine and colon. When the bacteria consume FODMAPs, they produce gas, which leads to symptoms of gas, bloating, abdominal discomfort, and changes in bowel movements. The FODMAP diet is used to alleviate the impact these types of foods have on your gastrointestinal tract.
A diet low in FODMAPs food was designed to help minimize symptoms in individuals that suffer from irritable bowel syndrome (IBS) and functional bloating. You should discuss your symptoms with your physician prior to starting this diet since other gastrointestinal related disorders need to be excluded first (i.e., celiac disease, thyroid disease, inflammatory bowel disease, and others).
If a diet low in FODMAP is recommended for you ...
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 ...
The recommended daily intake of dietary fiber is 25-35 grams per day. Despite this, the average American consumes about 15 grams of fiber per day. You may have heard fiber is important, but read on to learn more about why it matters in your diet.
What is fiber?
Fiber is the portion of plants that is not digested in the gastrointestinal tract. Therefore, it stays in the intestine, aiding in digestion and contributing to stool consistency. Dietary fiber is categorized into soluble fiber and insoluble fiber.
- Sources of soluble fiber: fruits, legumes, oats, and barley
- Sources of insoluble fiber: wheat, rye, grains, and many vegetables
What are the health effects of fiber?
- Decreased risk of coronary artery disease and stroke. This is the leading cause of death in the United States and a diet high in soluble fiber decreases this risk by 40-50%.
- Decreased risk of type 2 diabetes mellitus and improved glucose control in people with diabetes on a diet high in soluble fiber.
- Insoluble fiber is beneficial for many digestive diseases including hemorrhoids, diarrhea, constipation, and diverticular disease.
Is there a downside to a high-fiber diet?
Many people suffer from difficulty swallowing (dysphagia) acutely or chronically. Difficulty with swallowing may be a result of a problem anywhere from the lips to the stomach. It may be identified by weight loss, coughing or choking when eating, delayed cough or regurgitation, or outright obstruction. This is more likely to be an issue after a stroke or in elderly and frail individuals. In the inpatient population, symptoms suggesting some level of dysphagia may be as high as 34%. So what do you do if you feel like your swallow isn’t quite right?
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