Digestive Health

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Research on LINX recently published

July 02, 2014

The Swedish Thoracic Surgery team recently had results from a study published in Annals of Thoracic Surgery, "Short-Term Outcomes Using Magnetic Sphincter Augmentation Versus Nissen Fundoplication for Medically Resistant Gastroesophageal Reflux Disease", in which a retrospective case-control study was performed of consecutive patients undergoing either procedure who had chronic gastrointestinal esophageal disease (GERD) and a hiatal hernia of less than 3 cm. Based on the study, the LINX device appears to restore the sphincter barrier function and preserve normal physiology which enables belching and vomiting.

Kids and lactose intolerance

June 23, 2014

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 l...

Gluten intolerance or low FODMAPs?

June 18, 2014

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 unkno...

Does your child have a food allergy or food sensitivity?

June 09, 2014

“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”:

Sports drinks and energy drinks

June 03, 2014

I recently wrote a short post for the Issaquah Soccer Club on the topic of sports & energy drinks.

What is inflammatory bowel disease (IBD)?

May 21, 2014

Inflammatory bowel disease (IBD) is a chronic (i.e. long-lasting) inflammatory condition of the gastrointestinal system. IBD is often confused with irritable bowel syndrome (IBS) because of their similar acronyms, but the two conditions are not related. IBD affects approximately 1.4 million Americans and is most commonly diagnosed between 15-40 years of age.

IBD can be categorized into ulcerative colitis and Crohn’s disease. Though there are clear differences between the two, they are closely related and sometimes difficult to distinguish.

Ulcerative colitis is a condition where inflammation affects the most superficial layer of the large intestine (colon). It typically starts at the rectum and can involve a varying amount of the colon. In contrast, the inflammation of Crohn’s disease can affect all layers of the intestine and can involve any area of the gastrointestinal tract – from the mouth to the anus. The type of inflammation seen in Crohn’s disease may lead to long-term complications such as strictures or fistulas (abnormal connections to other organs) that are typically not seen in ulcerative colitis.

Why aren't my bowel habits normal?

April 21, 2014

Do you have irregular, uncomfortable, or distressing bowel habits? Irritable Bowel Syndrome (IBS) is the most common gastrointestinal condition affecting an estimated 15% of the general population. It is most common among women aged 30 to 49 years old.

IBS is a chronic condition of the digestive system that is not generally associated with more concerning findings of anemia, weight loss, family history of colorectal cancer, inflammatory bowel disease, or celiac disease. Symptoms of IBS include abdominal discomfort, constipation and diarrhea. Despite extensive research, no common cause of IBS has been identified. Some theories include:

FDA finally defines gluten free

February 26, 2014
On August 5th, 2013, the U.S. Food and Drug Administration (FDA) at long last published a formal rule regulating the use of the term "gluten free" on foods and beverages.  Even though this came with a big sigh of relief to the millions of people with celiac disease living in the US, consumers should be aware that the law gives manufacturers one year to be in full compliance (and goes into effect August 5, 2014).

As we head into the final months before the law’s final compliance date, I thought I’d highlight a few other key points about this brand new law:

1. No symbols needed.  The law does not require or recommend manufacturers use any particular symbol or food label, but if a label should include any of the following phrases, compliance must be ensured:
  • "Gluten-free"
  • "Free of gluten"

Living with achalasia like Seahawk Malcolm Smith

February 06, 2014

On February 3, 2014, Yahoo Sports published an article regarding this years’ Super Bowl MVP, Malcolm Smith, as not only achieving recognition for his Super Bowl performance, but also dealing with a rare swallowing disorder known as achalasia.
 
Achalasia is a rare disorder with a prevalence of 10 cases per 100,000 individuals.  Men and women are equally affected and it is usually diagnosed between the ages of 25 to 60 years.  The disease often comes on slowly and is gradually progressive with problems swallowing solids and liquids, and movement of undigested food particles back up into the mouth unintentionally (bland regurgitation).  Patients also often complain of a burning chest sensation. Other symptoms include hiccups, difficulties belching, and sometimes weight loss.

The condition can be seen with radiology studies including a barium esophagram that shows a dilated, or larger than normal, cali...

Updates on LINX - GERD reflux management system

January 27, 2014

Since my initial LINX blog post 20 months ago, we have been engaged in a dialogue with patients from around the world who suffer from gastroesophageal reflux disease or GERD.  Despite my initial trepidation to “blogging”, this has been a rewarding experience to hear about patient’s problems, their concerns about the current treatments (PPI’s and Nissen fundoplication) and simply interacting with them.  I thank the patients who have taken time to share their thoughts on the blog.

 

When our social media manager asked me to provide an update on LINX, I realized that I have been simply responding to patient’s questions and I haven’t posted any of my thoughts or updates on what is happening with the LINX device.

There are some exc...