Gotham Gastroenterology

09/14/2020

Check out this important PSA from our very own Dr. Antoine-Gustave and colleagues in gastroenterology.

07/14/2020

Cologuard in the time of COVID:

At the height of the COVID pandemic, age appropriate cancer screening (including colon cancer screening) was delayed for many patients. As states begin to reopen and cancer screening resumes, it is important that patients continue life-saving screening.

Colore**al cancer (cancer of the colon or re**um) is the second leading cause of cancer deaths in the US and affects people of all racial and ethnic backgrounds. Symptoms of colon cancer include blood in stool, change in bowel habits, abdominal pain, anemia or weight loss. However, colon cancers don’t always cause symptoms. Colon cancer screening is essential because it can detect pre-cancerous polyps and early cancers before they may cause symptoms. People who are diagnosed with cancers at early stages have a greater chance of cure and survival.

For most people, colon cancer screening should begin between the ages of 45-50. While colonoscopy remains the gold standard for colon cancer screening, there are several other options for screening which include at home stool tests. Cologuard (FIT-DNA test) is one type of stool test available. It detects blood and DNA markers that may indicate the presence of colore**al cancer or premalignant lesions called polyps. Patients are provided with a collection kit to mail in a sample of stool for a**lysis. If the test is negative, it is usually repeated in 3 years for screening purposes. If the test is positive, patients are then recommended for colonoscopy to look for cancers and polyps.

The benefit of a stool-based test is that it can be done at home without the need for dietary changes, laxative preparation, sedation and time away from home or work. The drawbacks of stool testing include the risk of a false positive result and a lower sensitivity for some premalignant polyps as compared with colonoscopy. Stool testing should only be used for colon cancer screening in average risk patients who are asymptomatic and is not indicated for patients with gastrointestinal symptoms, a family history of colon cancer or a personal history of colon polyps or colon cancer. While there are several options for colon cancer screening, the best test is the one that gets done.

If you have a positive Cologuard test and would like an expedited evaluation or if you would like to talk to our doctors about which test is right for you, please contact us to schedule an appointment.

You can book an appointment by calling 212-794-0240 or scheduling online https://bit.ly/2Y20rQc

06/16/2020

What Causes Abdominal Pain?

If you are experiencing severe abdominal pain, it could be something as simple as trapped gas or something as serious as appendicitis or cancer. Many people ignore abdominal pain, attributing it to something they ate, but if you are having ongoing abdominal pain, you should make an appointment with Gotham Gastroenterology for a consultation.

The Location of Your Abdominal Pain May Help Diagnose Your Condition

Where you are experiencing the abdominal pain can help determine what is causing it. Pain in the upper abdomen is usually attributed to ulcers, gallbladder issues, kidney infections, certain liver issues, and even heart attack. Lower abdominal pain can be a symptom of colore**al cancer, kidney stones, an intestinal obstruction, a UTI, IBD, or Crohn’s disease.

Diagnosing the Cause of Abdominal Pain

Because abdominal pain can be a symptom in so many different conditions, your physician will speak to extensively about your other symptoms too. Your doctor may review your dietary and lifestyle habits, review any food allergies you may have, and may run diagnostic tests such as a colonoscopy, an upper GI, and other exploratory evaluations. In some cases, you may need a CT scan or MRI.

How Do I Know the Abdominal Pain Is Serious Enough to Warrant an Exam?

If the abdominal pain is severe or lasts more than a few days, you should make an appointment. If your abdominal pain is accompanied by high fever, blood in the stool, or severe swelling, you should see a doctor right away. Other symptoms that may be serious include changes in appetite, vomiting blood, jaundice, or persistent vomiting.

Most of the Time, Abdominal Pain Is Temporary

Most abdominal pain is the result of gas or overeating. You may feel bloated or perhaps you overindulged in alcohol. The abdominal pain you experience in these cases is temporary and will normally pass on its own or with the help of an over-the-counter treatment. However, if your abdominal pain is persistent or you experience any of the accompanying symptoms, you should request an appointment with Gotham Gastroenterology.

For more information or to book an appointment with Gotham Gastroenterology, contact our office one of two ways:

-Call Our Office: 212-794-0240
-Book Online: https://bit.ly/2Y20rQc

05/21/2020

Can Colorful Eating Improve Colon Health?

Adding color to your diet – in the form of fruits and veggies, not food dyes – can improve your colon health, help you lose weight, ensure you get the nutrients you need, and even help to prevent colon cancer. In a recent Loma Linda study, a colorful and diverse diet that included a variety of vegetables decreased the risk of colore**al cancer by more than 20%. Here’s our guide to eating your way to better health by adding a rainbow of fruits and veggies.

Seeing Red: The Benefit of Eating More Red Fruits and Veggies
Beets. Cooked tomatoes. Cherries. In addition to boosting your Vitamin B and C, these foods also contain lycopene, which reduces inflammation. Eating more red fruits and veggies doesn’t just improve colon health – they’re also great for your memory, your heart, and your lungs, too.

Add a Little Sunshine with Yellow and Orange Fruits and Veggies
Squash, mangoes, carrots, and oranges all contribute to better colon health but also improve the health of your eyes, stomach and immune system. These fruits and veggies are filled with antioxidants that can even help improve your skin tone.

Be Sure to Get Enough Green
Leafy greens like kale, lettuce, and spinach, as well as veggies like broccoli are exceptionally good for colon health. These veggies also promote better bone health, improve your immune system, and can reduce your risk of cancer.

Give Your Body the Royal Treatment with Blue and Purple Veggies and Fruits
Royally colored fruits and veggies like eggplant, grapes, and blueberries contain a powerful antioxidant called anthocyanin. In addition to protecting you from colore**al cancer, anthocyanin can help prevent esophageal cancer as well as macular degeneration. Eating well is the first step in protecting your colon health. In addition to your rainbow diet, adding exercise and getting regular preventative screenings can improve the quality – and length – of your life.

For more information or to book an appointment with Gotham Gastroenterology, contact our office one of two ways:

-Call Our Office: 212-794-0240
-Book Online: https://bit.ly/2Y20rQc

05/12/2020

Gotham Gastroenterology Newsletter for 05/12/2020 -

Important News and Medical Information

05/09/2020

Hemorrhoids and how to handle them:

What are Hemorrhoids?
Hemorrhoids, also known as piles, are enlarged veins in the lower re**um and a**s. They are one of the most common causes of re**al bleeding. Hemorrhoids come in two varieties, internal, which occur in the lower re**um, and external, which develop around the a**s.

What are the most common causes of hemorrhoids?
Hemorrhoids often result from chronic constipation. They can also result from sitting too long on the toilet, being pregnant, having liver disease or obesity.

What are the symptoms of hemorrhoids?
Hemorrhoids often cause blood on the toilet paper or in the bowl. Depending on the location, they can be painful or painless and may cause a**l itching. Patients may also note a bulge or lump protruding from the a**s. Occasionally, hemorrhoids can become thrombosed or strangulated leading to sudden and severe a**l discomfort.

How do I prevent hemorrhoids?
Use the following tips to prevent hemorrhoids from occurring:
Maintain an active lifestyle to help keep your body moving stools
Eat plenty of fiber
Drink plenty of water
Avoid sitting on the toilet for long periods
Avoid straining to pass stools
Use the restroom as soon as you have the urge

How do I treat hemorrhoids?
Some hemorrhoids are self-resolving. However, others require either homecare or minorprocedures. The first line of treatment is usually dietary modifications and medicated creams/ointments.
First line treatment includes:
-High fiber diet: Aim to have around 20-35g of fiber a day through the diet and/or addition of a fiber supplement such as psyllium husk, wheat dextrin or methylcellulose.
-Stool softeners or gentle laxatives may also be helpful in managing hemorrhoids related to chronic constipation.
-Over the counter remedies such as PrepH or witch hazel may be helpful. Your doctor may also prescribe an ointment or cream.
-Sitz baths: soaking the area in warm water for 10-15 minutes, 2-3 times a day may be helpful.

If these treatments are not effective, your doctor might recommend one of the following hemorrhoid medical treatments:
-Sclerotherapy
-Hemorrhoidectomy
-Band ligation
-Infrared coagulation

When Should I See a Doctor for Hemorrhoids?
You should see a doctor for hemorrhoids if you experience bleeding with bowel movements, significant pain with bowel movements or if the hemorrhoids fail to get better after a week of care at home. You should seek immediate attention if you have severe re**al bleeding or lightheadedness.

For more information or to book an appointment with Gotham Gastroenterology, contact our office one of two ways:

-Call Our Office: 212-794-0240
-Book Online: https://bit.ly/2Y20rQc

05/07/2020

Inflammatory Bowel Disease and COVID: What you need to know

Patients with COVID-19, caused by SARS-CoV2, may experience gastrointestinal symptoms alone or in conjunction with respiratory symptoms. Gastrointestinal symptoms include diarrhea, nausea, vomiting, loss of appetite, and abdominal discomfort, which are often similar symptoms to those IBD patients experience related to their disease. If you develop these symptoms, it is important to discuss with your doctor whether this could be related to COVID-19, or another cause, such as medication side effects, a flare of your IBD, or a different gastrointestinal infection.

In general, it is recommended that all patients follow social distancing and stay-at-home orders as well as frequent hand washing and avoidance of touching your face. These measures will decrease your risk of infection and help to flatten the curve.

Having IBD has not been shown to increase your risk of infection with SARS-CoV2. However, IBD is often treated with immune modulating or immune suppressing medications. These medications may make you more susceptible to infections, like SARS-CoV2.Not all IBD mediations fit within this category, so it is important that you discuss with your doctor if your IBD medications place you at higher risk. It is recommended that you stay on your IBD medications to keep the inflammation in your intestinal tract under control. If you have concerns, and/or if you contract SARS-CoV2, even if you don’t have symptoms, you should notify your gastroenterologist to discuss if you should temporarily adjust your medications.

If you receive infusions, please do not skip these appointments. Our office is taking extra precautions during infusions. If you have symptoms that you think may be related to COVID-19, please contact your doctor prior to your infusion.

If you, or someone you know, has IBD and contracts SARS-CoV2, please encourage them to speak to their healthcare provider about registering for the SECURE-IBD database. This research is aimed to better understand how COVID-19 affects IBD patients and if IBD therapies may affect the course of COVID-19. To date, 580 patients worldwide have been enrolled in the study.[1] Thirty percent of patients required hospitalization with 5% requiring ICU care, and the risk of hospitalization increased with age. The majority of patients in remission or mild disease were treated as outpatients whereas a little less than half of patients with moderate/severe disease required hospitalization. More information is available at https://covidibd.org.

For more information or to book an appointment with Gotham Gastroenterology, contact our office one of two ways:

-Call Our Office: 212-794-0240
-Book Online: https://bit.ly/2Y20rQc

References:
[1] Brenner EJ, Ungaro RC, Colombel JF, Kappelman MD. SECURE-IBD Database Public Data Update. covidibd.org. Accessed on April 17, 2020
[2] IOIBD Update for Patients with COVID-19 Crohn’s Disease and COVID-19 Ulcerative Colitis. https://www.ioibd.org/ioibd-update-on-covid19-for-patients-with-crohns-disease-and-ulcerative-colitis/ Accessed April 17, 2020
[3] Coronavirus (COVID-19): What IBD Patients Should Know, https://www.crohnscolitisfoundation.org/coronavirus/what-ibd-patients-should-know Accessed April 17, 2020

05/06/2020

Constipation Consternation

Anyone who has ever been constipated knows how miserable this problem can be. Whether stools are hard, lumpy and painful to pass or seem rarely to make an appearance at all, irregular bowel habits can cause suffering and concern for men and women alike.

There are several common causes of constipation, but one major predisposing factor is inactivity. During the COVID 19 pandemic, with shelter in place orders keeping many of us indoors, now is a time when you might find your bowels becoming particularly sluggish. This is in part because the movement of stool through your bowels requires good muscle tone in the gastrointestinal tract, and muscles become weaker with inactivity.

The good news is that exercise can help. Aerobic exercise stimulates natural contractions of muscles in your gut, speeding the movement of waste through the system. After the small intestine absorbs nutrients from your food, the large intestine, or colon, works on the remaining digestive contents, extracting water and rendering stool more solid, much as a trash compactor might package waste. The faster the undigested products move through the system, the less water is pulled out, ultimately leaving stool softer and easier to expel.

Simply getting up and off the couch can help with constipation. Regularly walking up to 15 minutes a day can make a difference, especially if you are also drinking plenty of fluids and eating high fiber foods. Stretching and yoga, particularly twisting motions, can also promote passage of stool through the bowels, easing discomfort or bloat.

While exercise is critical for healthy bowel habits, it is not the only factor impacting regularity. If you are having pain with constipation, experiencing any re**al bleeding, or losing weight, or if symptoms are new, it is important to discuss your constipation with a medical provider in case something more serious is going on.

For more information or to book an appointment with Gotham Gastroenterology, contact our office one of two ways:

-Call Our Office: 212-794-0240
-Book Online: https://bit.ly/2Y20rQc

05/05/2020

COVID 19 and Gastrointestinal Symptoms

Can diarrhea, abdominal pain, nausea, loss of taste be a sign of COVID 19? The answer is yes. Coronavirus disease 2019 (COVID-19) presents with multiple symptoms. Many patients may not have the typical respiratory symptoms, instead, they may present with digestive symptoms. Up to 25% of COVID patients present with symptoms of diarrhea, abdominal pain, loss of appetite and loss of taste (combined with loss of smell). Patients who present with digestive symptoms may have delayed diagnosis and may have longer delay before they clear the virus. In some cases, the digestive symptoms, like diarrhea, can be the initial presentation of COVID-19, and may only later or never present with respiratory symptoms and fever. Due to the fact that currently, New York represents the epicenter of coronavirus pandemic, it is important for patients to pay attention to their symptoms and contact their doctor or a gastroenterologist immediately. Of course, it is important to keep in mind that diarrhea and abdominal pain could be caused by multiple other causes such as food poisoning, bacterial infections, gastric ulcers, and others. Your gastroenterologist can guide you in this situation to ascertain that your diagnosis is made correctly and appropriate treatment is provided.

For more information or to book an appointment with Gotham Gastroenterology, contact our office one of two ways:

-Call Our Office: 212-794-0240
-Book Online: https://bit.ly/2Y20rQc

Thank you for trusting Gotham Gastroenterology with your care. Wash your hands, stay safe, and be well.

05/04/2020

We are now offering telehealth. Here is how you can book an appointment with one of our providers...

1. Book a Virtual Visit one of two ways:

-Call Our Office: 212-794-0240
-Book Online: https://bit.ly/2Y20rQc

2. You will receive an activation link via email or text message 20 minutes prior to your Virtual Visit.

3. At the time of your appointment, click the activation link to connect with your doctor. All you need is your smartphone!

4. After your visit, message your doctor, view labs, request
refills, and schedule follow-ups, using our healow patient portal app.

-Download healow Portal App (iOS): https://bit.ly/3eKluMV
-Download healow Portal App (Android): https://bit.ly/2Vz3bCJ
-Access Web Portal: https://bit.ly/3bAVyRT

04/29/2020

Gotham Gastroenterology now offers telehealth!

Use Telemedicine Virtual Visits to Stay Well While You Stay Home!

All of us at Gotham Gastroenterology hope this message finds you healthy, safe, and home with your loved ones. Social distancing is the first line of protection to slow the spread of COVID-19.

Our Telemedicine Virtual Visits offer an invaluable way to stay connected with your Gastroenterologist from the safety of your home.

Virtual Visits bring Gastroenterology and Hepatology care directly to you through our patient portal, using either your web-browser, iOS, or Android-based device.

Just follow these simple steps to book a Virtual Visit with your Gastroenterologist:

1. Book a Virtual Visit one of two ways:

-Call Our Office: 212-794-0240
-Book Online: https://bit.ly/2Y20rQc

2. You will receive an activation link via email or text message 20 minutes prior to your Virtual Visit.

3. At the time of your appointment, click the activation link to connect with your doctor. All you need is your smartphone!

4. After your visit, message your doctor, view labs, request
refills, and schedule follow-ups, using our healow patient portal app.

-Download healow Portal App (iOS): https://bit.ly/3eKluMV
-Download healow Portal App (Android): https://bit.ly/2Vz3bCJ
-Access Web Portal: https://bit.ly/3bAVyRT

Thank you for trusting Gotham Gastroenterology with your care. Wash your hands, stay safe, and be well.

04/24/2020

Liberty Endoscopy at 156 William Street: https://bit.ly/3cItnkc

Liberty Endoscopy Center at 156 William Street: https://bit.ly/3cItnkc