Quantcast
Channel: GI Consultants
Viewing all 61 articles
Browse latest View live

New Physician Joins Gastroenterology Consultants

0
0

Carson City, NV (May 2, 2018) – The physicians and staff of Gastroenterology Consultants proudly welcome Dr. Jason Collins to Northern Nevada and to the practice. Dr. Collins moved to the area in May 2018. Prior to, Dr. Collins owned and operated his practice in the Rocky Mountains of Colorado in the city of Glenwood Springs.

Dr. Collins enjoys practicing in the field of GI as it allows him to not only talk to and interact with patients, but it also provides him with the opportunity to do intervention through endoscopy that can make real time and life altering differences for patients. Dr. Collins has a clinical interest in Inflammatory Bowel Disease.

Originally from Chicago, IL, Dr. Collins completed medical school and his residency at the University of Illinois at Chicago.  He completed his fellowship at the Howard University Hospital in Washington, D.C. He is a member of the American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy.

Dr. Collins is seeing and accepting patients at the Carson City office on 1385 Vista Lane. Patients can be scheduled with Dr. Collins at (775) 884-4567.

 

 

 

About Gastroenterology Consultants:

 

Gastroenterology Consultants (GIC) has been serving residents of Northern Nevada and adjacent cities in California since 1986. Our 19 Board-certified Physicians specialize in the diagnosis and treatment of digestive and liver problems in both adult and pediatric patients. GIC has three medical office clinics and three adjacent endoscopy centers in the Reno and Carson City areas.


Gastroenterology Consultants Welcomes New Physician Assistant

0
0

Reno, NV (May 23, 2018) – The physicians and staff of Gastroenterology Consultants are pleased to announce that Sunny Sawyer, PA-C, has joined the practice. Prior to becoming a Physician Assistant, Sunny was a biologist for 5 years working throughout the mountain and desert West.

Sunny received her medical training at Campbell University in Buies Creek, North Carolina, where she earned her Master of Physician Assistant Practice degree. She is a member of the American Academy of Physician Assistants and the Nevada Academy of Physician Assistants.

Sunny practices all aspects of general gastroenterology. She enjoys the complexity of gastrointestinal health and the importance of patient involvement for positive outcomes.

Sunny is seeing and accepting patients at the Reno-North location at 880 Ryland St. Patients can be scheduled with Sunny at (775) 329-4600.

 

 

 

About Gastroenterology Consultants:

 

Gastroenterology Consultants (GIC) has been serving residents of Northern Nevada and adjacent cities in California since 1986. Our 19 Board-certified Physicians specialize in the diagnosis and treatment of digestive and liver problems in both adult and pediatric patients. GIC has three medical office clinics and three adjacent endoscopy centers in the Reno and Carson City areas.

Gastroenterologist, Dr. Craig Sande, Talks Colon Cancer Prevention with the Reno Gazette Journal

Give your liver a hand

0
0

Unlike age or family history, these liver cancer risk factors are preventable.

Imagine your liver sort of like a high-tech purifier.

Often called the workhorse of the digestive system, its main job is to filter anything eaten or consumed by you — whether that’s food, alcohol, medicine or toxins. It also helps to detoxify chemicals and metabolize drugs.

The liver deserves some kudos.

It also deserves some help.

Certain behaviors increase our risk of cancer, specifically liver cancer. And while you can’t change some things, like your age or your family history, you can actively reduce your chance of developing cancer and, in turn, ease some of the burden on your second-largest organ.

It is, after all, the only one you got.

Obesity

Studies have shown that a high body mass index (BMI) and a large waist circumference are associated with an increased risk of liver cancer.

According to the US Centers for Disease Control and Prevention, more than 70 percent of adults aged 20 and older are overweight — and about 40 percent are obese. As Americans grow in size, so does the liver cancer rates.

For every 5 kg increase in BMI, scientists have seen a 38 and 25 increase in risk for liver cancer among men and women, respectively. An 8 percent increase in risk accompanied every 5 cm increase in waste circumference.

The good news is that even modest weight loss can improve or prevent obesity related health problems.

What to do?

  • Exercise regularly: You need at least 150 to 300 minutes of moderate-intensity activity a week to prevent weight gain.
  • Step on the scale: People who weigh themselves at least once a week are more successful in keeping off extra pounds.
  • Eat healthy: Look for low-calorie, nutrient dense foods at the grocery store. We recommend vegetables, fruits and whole grains. Kick the saturated fats, sweets and alcohol to the curb. When you do indulge, remember to do so in moderation.

Heavy alcohol use

The best amount of alcohol is no alcohol. But, unfortunately, not many people want to toast to that.

So, when you do drink, moderation is key. That’s one drink per day for women, and two for men.

In the United States, amounts are based on a “standard drink,” says Ting-Hui Hsieh, MD, a gastroenterologist at Gastroenterology Consultants. This can be defined as 14 to 15 grams of ethanol, 5 ounces of wine, 12 ounces of beer or 1.5 ounces of 80-proof spirits.

Research from the World Cancer Research Fund found evidence suggesting that only three drinks or more each day for male, and two drinks or more each day for female can lead to liver damage and liver cancer. And why is that?

Because alcohol acts like a poison to your liver.  The body can’t store alcohol, and so the liver works to detox the beverage from your system. However, in the process, the alcohol destroys the liver’s cells.

In many cases, this is reversible.  (Turns out, the organ also has superpowers: regeneration. To a point, the liver can heal itself after it’s been damaged.)

However, once the damage crosses into cirrhosis, it might be too late.

Hepatitis B and C Infection

More than 3 million Americans live with hepatitis C and don’t even know they have it. HCV can remain unrecognized for years, or even decades, before causing any trouble.

Baby boomers, who were born between 1945 and 1965, are five times more likely than average population to have hepatitis C, Dr. Hsieh said.

The CDC recommends routine screening for hepatitis C in baby boomers and high-risk patients. While there is no vaccine for HCV, the right treatment can eliminate the virus in most cases.

Hepatitis B, like C, is common and transmitted by similar means: unprotected sex and sharing of needles. Vaccines for hepatitis B are available.

If left untreated, both can lead to cirrhosis and liver cancer. If you think you’re at risk for either hepatitis B or C infection, speak to your physician about a screening test.

Cirrhosis

Each time your liver is damaged, it tries to repair itself. In the process, scar tissue forms. Cirrhosis is late-stage scarring of the liver.

Not everyone who drinks heavily develops cirrhosis. In fact, cirrhosis can be the result of many forms of liver diseases and conditions. For example, nonalcoholic fatty liver disease occurs when too much fat is stored in the liver cells – and can slowly progress to cirrhosis over decades.

Often, cirrhosis shows no signs or symptoms until damage is extensive. However, they may include: fatigue, itchy skin, weight loss, nausea and jaundice.

Ting-Hui Hsieh, MD, pronounced “Dr. Shay,” completed his medical education, internal medicine residency and gastroenterology fellowship at National Taiwan University Hospital. He moved to the United States in 2006 to continue his training at the Mayo Clinic. In 2015, Dr. Hsieh moved to Reno to join Gastroenterology Consultants.

For more information, you can schedule an appointment with Dr. Hsieh or one of our other physicians, located conveniently in Reno and Carson City.

Don’t get spooked by this year’s Halloween candy

0
0

Healthy alternatives keep your body full and happy this October.

No matter what costumes your children — or maybe even your ghoulfriends — wear, when the Halloween candy comes out, everyone becomes a goblin.

Blame it on the sugar. Most of the treats distributed on All Hallow’s Eve throw our bodies into a sugar rush, which often ends in a crash. In fact, studies have linked high sugar intake to a greater risk of depression, increased joint pain and faster skin aging.

All of which truly sound more terrifying than the ghosts and ghouls haunting your neighborhood this month.

But, keep calm. There is a way to trick and treat yo’ self. We put together a list of healthy options so you can trade in the candy bars and gummies for alternatives that will still keep a smile on everyone’s face.

Breakfast

We often get told that breakfast is the most important meal of the day — so don’t skip out this Halloween just because you can’t figure out how to satisfy that sweet tooth. This recipe from Healthful Pursuit will spice up your morning yogurt bowl while still packing a nutritional punch.

While it calls for non-dairy yogurt, you can swamp it out for Greek, if that better suits your taste buds. But, the best thing about this “smoothie” is that the spinach adds volume, color and minerals to the brew. One cup of the raw leafy green contains vitamins A, K, C and other B vitamins. It also meets some of your daily iron needs, and is an excellent source of fiber.

But, it isn’t just the spinach that gives this potion its power. Flax seeds have been called one of the most powerful plant foods on the planet — and there’s some evidence that they can help reduce your risk of heart disease, cancer, stroke and diabetes. So, don’t feel guilty about consuming this Halloween treat.

If you’re looking for something a bit more portable or kid friendly, try these silly apple bites from Fork and Beans.

Snacks

Forget everything your parents ever told you about playing with your food and get creative with these ghoulish ideas. Turn your oranges into pumpkins and your bananas into ghosts with this recipe from Keep Recipes.

Super Healthy Kids combines crunchy vegetables with smooth cheese sticks to create witches brooms. (Pretzels can be substituted for the celery and carrots.) These brooms can be made in a matter of minutes — and can help fill children up with veggies and protein before going trick or treating.

Lunch

Pinterest offers plenty of fangtastic options for your Halloween menu, but a couple of our favorites are the Monster Pita Pizza from Eating Well and the pimento cheese bat sandwiches from Delish.

Neither one require baking, which means they are easy to throw together Halloween morning for the kids or even yourself (no judgment here).  Plus, the avocados in the guacamole on the Pita Pizza give you a dose of healthy fats, which reduces inflammation and the risk of heart disease.

Dinner

This quick recipe for eyeball pasta by Spend with Pennies can be ready in 30 minutes or less with some earlier prep. That way, you don’t have to worry about cooking and applying (and re-applying, let’s be honest) that Halloween makeup.

If you want something a little fancier, serve this squash soup. The recipe still comes together in less than an hour — and who wouldn’t have a gourd time using pumpkins as bowls? We love the idea.

Then, after dinner, you can clean out the inside of your pumpkins, rub the inside with cinnamon, add a few cloves in the flesh – and create a pumpkin pot-pourri. Just light a candle inside and enjoy the fresh autumn scent!

Send an email to marketing@giconsultants.com to share your photos and experiences with these recipes — or send us your own favorites — that we can feature on our social media! We’d love to hear from you. 

Liver cancer jumps to sixth leading cause of death

0
0

Hepatitis C virus, often a silent enemy, can increase risks of developing liver cancer in both men and women

Half the population of Carson City. The entire capacity of the Mackay Stadium at the University of Nevada, Reno. About 100 times the seating in an average movie theater.

That’s how many men and women die of liver cancer each year — approximately 26,000.

In fact, even as cancer deaths across the country have fallen, liver cancer continues to kill more and more each year. According to a recent study by the Centers for Disease Control and Prevention (CDC), death rates for the disease jumped 43 percent among adults between 2000 and 2016.

“The increase in death rate related to liver cancer is twofold,” said Timothy Halterman, MD, a gastroenterologist with Gastroenterology Consultants. “There has been an obvious increase in the number of liver cancer cases likely due to hepatitis C infection, as well as other risk factors including fatty liver disease related to obesity and alcohol use.  Also, the prevention and treatment of other common cancers, such as colon and breast cancer have improved compared to advances made in diagnosis and treatment of liver cancer.”

During this 16 year period, liver cancer rose from the ninth leading causing of death to the sixth, with more men dying of the disease than women.

Researchers say the spike could partly be due to Hepatitis C, a virus that causes inflammation of the liver and, if left untreated, can eventually lead to cirrhosis.

“The main problem with hepatitis C currently is it is under-diagnosed,” Dr. Halterman said. “Approximately 4 to 5 million Americans — or 1 percent of the population — are living with chronic hepatitis C, but only about half of them know they have it.  In order to prevent more liver cancers, we need to do a better job finding those with hepatitis C and treating it before it has a chance to cause irreversible liver damage and liver cancer.”

A lack of symptoms associated with the virus is one barrier to diagnosis. Like a handful of viruses, including mono and shingles, Hep C can lay dormant in your body for years, or even decades, before causing any trouble.

The CDC estimates up to 80 percent of people with chronic hepatitis C won’t experience any symptoms until the damage is done. That means it’s often too late — even though the virus can be successfully treated with antiviral medication.

How did we get here

The largest group at risk for liver cancer includes those born between 1945 and 1965. Some scientists point to the virus’ spread during the 60s, 70s and 80s — before medical professionals understood how it was transmitted.

Up until 1992, blood transfusions and organ transplants weren’t screened for HCV, according to the CDC.

So, maybe you’re asking: what does this mean for me?

If you were born between 1945 and 1965, the CDC recommends that you be screened by your doctor for hepatitis C.

If you underwent a blood or organ transfusion before 1990 and haven’t been tested for the virus, you should also speak to your physician.

And, don’t think you’re off the hook if you were born after 1965. People can also be exposed to the virus in other ways, such as unprotected sex or sharing needles used to inject drugs.

In fact, the leading cause of new cases of hepatitis C in younger people is due to the rise of the opioid epidemic, Dr. Halterman said.

Not everyone who gets Hepatitis C will develop liver cancer, but complications from the virus can be serious, regardless.

Anything that increases your chance of developing cirrhosis will increase your risk of liver cancer. People who have hepatitis C should not drink alcohol, and should consult their doctor before taking certain prescription and non-prescription drugs.

Ultrasounds tend to be the main screening tool to check for liver tumors. However, people who don’t have cirrhosis most likely won’t need to be monitored closely for HCV-related liver cancer.

In those with cirrhosis of the liver due to any cause, they should be screened with an ultrasound of the liver as well as blood test called AFP (liver tumor marker) every 6 months.

Because liver cancer doesn’t usually display any outward signs or symptoms, these screenings are important as the earlier the disease is found, the better chance of treatment and survival.

When signs are present, they can include:

  • Weight loss (without trying)
  • Loss of appetite
  • Feeling very full after a small meal
  • Nausea or vomiting
  • An enlarged liver, felt as a mass under the ribs on the right side
  • An enlarged spleen, felt as a mass under the ribs on the left side
  • Pain in the abdomen or near the right shoulder blade
  • Swelling or fluid build-up in the abdomen
  • Itching
  • Yellowing of the skin and eyes (jaundice)

Other risk factors for liver cancer include chronic infection with hepatitis B virus, inherited liver disease, long-term obesity and excessive alcohol consumption.

If you have a question or concern about your health, please schedule an appointment with Dr. Halterman or one of our other physicians or mid-levels.

Born in Columbus, Ohio, Timothy Halterman, MD, did not stray far from home while completing his medical education and residency at Ohio State University. His interest in gastroenterology led him to the west coast, where he completed his fellowship training. Dr. Halterman moved to Reno in September 2011 to begin practice with Gastroenterology Consultants. When he’s not in the office, Dr. Halterman enjoys being outdoors.

Can a detox help your liver?

0
0

Reviewed by Dr. James Nachiondo

Sure, we get it. In fact, most of us have been there — a day spent bingeing on unhealthy foods or a night of too much alcohol.

You’re looking for a quick fix or an easy solution to feel better.

But, a detox isn’t the miracle cure-all. It won’t help cleanse or flush your system, and it definitely won’t help your liver do its job.

The liver is the body’s second largest organ. Often called the digestive system’s workhorse, it helps remove waste products and process various nutrients and medicines.

In recent years, liver cleanses have flooded Facebook and Instagram purporting to be the answer for the ills plaguing your body’s natural filtration system.

However, we don’t recommend them.

Most, if not all, haven’t been tested properly and aren’t regulated by the U.S. Food and Drug Administration. This means there’s absolutely no proof they work. Researchers also recently found unapproved and sometimes dangerous drugs in more than 700 diet, weight loss and sexual enhancement supplements, meaning some of the supplements you’re taking to cleanse your system are doing more harm than good.

On occasion, people do report feeling better while completing a liver cleanse. Most likely, that’s due to the fact that detox diets don’t let you consume highly processed foods containing solid fats and added sugars.

Liver detoxification has typically been associated with a variety of negative symptoms, such as fatigue, headaches, anxiety and diarrhea. Dehydration can also become a problem.

Instead, we suggest diet and lifestyle changes to improve your overall health and aid in liver function.

Follow these tips to keep your liver healthy:

  • Limit your daily alcohol intake. The recommended amount if one standard drink per day for women, and two for men. If possible, eliminate alcohol entirely. A recent study by The Global Burden of Diseases stated no amount of alcohol is safe for consumption.
  • Eat a healthy, well-balanced diet.
  • Maintain a healthy weight.
  • Get vaccinated against hepatitis B, and avoid risky behaviors associated with hepatitis C, such as sharing needles and unprotected sex.

If you are still considering a detox, consult your physician first. It’s important to understand possible side effects. Some people do use detoxes to transition to a new healthy lifestyle, while others say it makes it easier to ditch a certain type of food. Keep in mind fad diets aren’t a long-term solution.

If you’re worried about your liver health, consider making an appointment with Dr. Nachiondo or one of our other physicians located at three convenient offices in Reno and Carson City.

James Nachiondo, MD, is a Northern Nevada native. He attended Santa Clara University for his undergraduate studies, but returned to his home state to attend medical school. After completing post-medical school training, Dr. Nachiondo relocated to Reno for the lifestyle the community offers. When not caring for patients, he enjoys skiing, road cycling, traveling and spending quality time with his family.

Get Screened: Which option is best for you?

0
0

Trivia question: what is expected to kill more than 50,000 Americans this year alone — and yet can be prevented with a simple screening test?

Did you guess colorectal cancer because if you did, you’re spot on.

Colorectal cancer is the second leading cause of death in the United States. But the good news is when it’s caught early, the survival rate is very high.

That’s why screening for colorectal cancer is so important. Screening is generally recommended for all average-risk patients aged 50-75.

People who have a family member with colorectal cancer or polyps are at increased risk and might need to start screening before age 50.

High-risk factors include a personal history of polyps, inflammatory bowel disease, chronic ulcerative colitis, or a family history of colorectal cancer or polyps.

 

What are the Options for Screening?

You can be screened for colorectal cancer in four ways:

  1. Colonoscopy: Colonoscopy uses a flexible, lighted tool called a colonoscope to view the entire colon and remove cancerous and precancerous growths called polyps if they are detected.
  2. Fecal immunochemical test (FIT): This test checks the stool for tiny amounts of blood given off by polyps or colorectal cancer.
  3. CT colonography: This involves a CT scanner and computer programs to create a three-dimensional view of the inside of the colon and rectum that can be used to identify polyps or cancer.
  4. Cologuard: This tests the stool for tiny amounts of blood and identifies altered DNA from cancer or polyps that end up in the stool.

 

Which Screening Option is Best?

Now, I’m sure you’re wondering: what’s my best option?

Well, most colorectal cancers begin as polyps. Finding, quantifying, localizing, and removing polyps through screening colonoscopy is the most effective strategy for preventing colorectal cancer. That’s why colonoscopy remains the gold standard for colon cancer screening.

The Multi-Society Task Force on Colorectal Cancer recommends physicians offer a colonoscopy first. For patients who decline to have a colonoscopy, the FIT test should be offered next, followed by second-tier tests such as Cologuard and CT colonography for patients who decline both first-line options.

A 2014 study published in the New England Journal of Medicine of 10,000 patients found that screening colonoscopy was better at finding cancer than both Cologuard and the FIT test. FIT and Cologuard were also not as good as colonoscopy at finding pre-cancerous polyps – and unlike colonoscopy, FIT and Cologuard can’t remove polyps.

Cologuard missed 1 in 13 people who had colorectal cancer detected by screening colonoscopy. Cologuard also missed more than 30 percent of polyps that will soon be cancer, and almost 60 percent of polyps that may become cancer.

The FIT test missed almost 1 in 4 people who had colorectal cancer detected by screening colonoscopy. FIT also missed more than 50 percent of polyps that will soon be cancer and more than 75 percent of polyps that may become cancer.

 

Check with Your Insurance Provider

Patients may also have insurance considerations when choosing a test. A follow-up colonoscopy is recommended for positive FIT and Cologuard tests. Individuals with a positive FIT test or Cologuard test who are covered by Medicare may face a costly co-insurance bill after the recommended follow-up colonoscopy.

While insurance covers 100 percent of the preventive screening test, a follow-up colonoscopy for a positive FIT or Cologuard is considered a diagnostic or therapeutic service and may not be fully covered.

Almost one in six people who use the Cologuard test will have a positive result that suggests the presence of colorectal cancer. For almost half of those patients (45 percent), the colonoscopy will show their result from the Cologuard test was a false positive.

Check with your insurance provider before you are screened. Ask how much you should expect to pay if you need a follow-up colonoscopy for a positive FIT or Cologuard test result. This can help you avoid surprise costs.

 

Talk with Your Doctor

Remember, Colonoscopy is the gold standard, but if you’re unable to be screened by colonoscopy there are other appropriate options.

Talk with your  physician about which screening test is best for you and do research about the available options to ensure you’re choosing the best test according to science.


Four things you may not know about C. diff, a common bacteria that can wreak havoc on your gut

0
0

Reviewed by Craig Sande, MD

When we think of the battle between “good vs bad,” we don’t often think of the little guys in our guts.

But, maybe we should.

You, in fact, have trillions of bacteria residing in your own body — some that do their part to maintain the peace and some that disrupt it.

Helpful microbial species, particularly those in the gastrointestinal tract, can produce required vitamins, stimulate the immune system and even detoxify certain otherwise harmful chemicals.

Sometimes the balance falls out of alignment, and the bad guys start to run the show.

Enter Clostridium difficile, commonly known as C. diff.

Each year, the deadly bug infects more than 450,000 Americans. According to a 2015 report, almost all of those cases are caused by an overuse of antibiotics. While we expect our antibiotics to help cure what ails us, they often come with collateral damage: all of our good bacteria.

With a void left by the loss of normal intestinal bacteria, C. diff often seizes the opportune moment — especially in patients with weakened immune systems who are ill-prepared to handle the added stress. Maybe you’ve heard of C. diff or maybe you haven’t, but here are some interesting facts to get you up-to-date:

C. diff is on the rise

According to the Centers for Disease Control, C. diff infections in the United States increased by 8 percent between 2015 and 2016 alone.

Traditionally, these cases affect older adults in hospitals or long-term care facilities. However, recently, C. diff has increasing impacted younger, healthy individuals who have not been exposed to these types of environments.

Even worse, a strain that emerged in 2000 is more easily transmitted than others and often causes a more severe infection.

Probiotics may help keep C. diff at bay while on antibiotics

A 2016 study suggests that probiotics may be effective in reducing the risk of C. diff in hospitalized patients.

Probiotics are good bacteria that are either the same or similar to the bacteria already living in your body. They can be found in some yogurts, some cheeses, sauerkraut and kimchi — or as over-the-counter supplements. But, it’s important to remember not all probiotics are the same.

If you are considering dietary supplement, it’s best to check with your health care professional first.

C. diff is a pretty hardy bacteria.

Even though scientists discovered C. diff in 1935, they didn’t recognize it as the major cause of antibiotic-related diarrhea until more than 40 years later.

As the bacteria passes through its life cycle, it transforms into the spore stage. There, C. diff doesn’t cause any issues but remains extremely hard to kill.

Disinfectants, such as hand sanitizer, doesn’t bother them — and even some of the most powerful antibiotics do little damage to the hardy spore.

The bacteria begins to cause trouble, however, when its spores are inadvertently transmitted to hands and food. After they become consumed by another person, the spores reactivate. In most cases, the good bacteria can keep the C. diff in check.

However, if your good bacteria has been killed off by a recent dose of antibiotics, C. diff can flourish due to lack of competition.

Though the most common symptom is diarrhea, it can lead to life-threatening inflammation

Symptoms of C. diff can be wide-ranging due to the fact that people’s bodies respond to the bacteria differently.

In its mildest form, the bacteria produces diarrhea about three times a day, usually accompanied by abdominal cramps. Modern Clostridium difficile-associated disease causes profuse diarrhea, abdominal pain and fever.

In severe cases, however, blood pressure may fall to critically low levels, severe diarrhea can lead to dehydration, and even intestinal perforation and life threatening infection can develop.

For more information about C. diff or to discuss your digestive health needs, please reach out to Dr. Craig Sande or one of our other physicians at three locations throughout Reno and Carson City.

Dr. Sande is a Reno native and the fifth of six children raised by Naomi and John Sande. Medicine was not exactly the career path he had in mind when he left Reno to do his undergrad at Stanford University. He initially considered a career in electrical engineering, but after further exploration, he decided to follow his father’s footsteps and entered the field of medicine. Dr. Sande has a special clinical interest in inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis, gastroesophageal reflux disease and esophageal motility disorders.

An ounce of prevention and a pound of cure

0
0

Tim Watkins, a Reno local, knew his family had a history of colon cancer, but he still waited to get screened. By the time he made it in, it was too late.

When Tim Watkins woke up from his colonoscopy, he heard those three words no one ever wants to hear: “We found something.”

That something, he would come to learn, was Stage III colon cancer.

It was a diagnosis Watkins suspected, but wasn’t any less devastated to receive. He’d put his colonoscopy off for a year, until a pain in his abdomen forced him into the office of Clark Harrison, MD, at Gastroenterology Consultants.

“It stops you in your tracks,” Watkins said. “I was very much a ‘Type A’ personality before this whole process, but now, I realize there isn’t a lot that matters outside of friends, family and the relationships you have with them. The rest is just … stuff.”

At a high risk for colorectal cancer, Watkins got his first colonoscopy when he was 40 years old. The recommended age for average-risk individuals is 50 — but Watkins knew he needed to start much earlier.

In fact, his family history really says it all: “Mother, diagnosed with colon cancer; paternal grandfather, diagnosed with colon cancer; brother, diagnosed with colon cancer at age 41; daughter, deceased, diagnosed with glioma of the brain.”

Because of his risks, Watkins was scheduled for another colonoscopy when he turned 45. He didn’t make it in.

At first, Watkins pushed the procedure back because he wasn’t having symptoms. Then, he pushed it back because his 8-year-old daughter was diagnosed with brain cancer.

Six months after she passed away, Watkins received his own diagnosis.

“It’s a devastating word,” he said. “I immediately started trying to understand what the process was, how I was going to live my life and what I needed to do to get healthy again, to get rid of the cancer.”

A surgeon removed 18 inches of Watkins’ colon, as well as numerous lymph nodes.

According to Watkins, doctors told him the plan of attack was to cut out as much cancer as they could — and then mop up the rest with chemotherapy. He thinks he did nine months of chemo, going in for a treatment every other week, but these days, the treatments all blur together.

“Turns out, the better I did with chemo, the more I could do,” he said. “But, by the third or fourth session, I’d be dead for a week after. I started adapting my schedule at work because I knew I could work hard one week, and then be dead the next week. I can’t even tell you how many times I napped in my office.”

Now, Watkins looks back and thinks about how much easier it would have been to deal with polyps, the pre-cancerous masses, than it was to deal with surgery and chemo.

“Colon cancer is one of the most preventable cancers, period,” Watkins said. “The colonoscopy is designed to uncover issues that start out as negligible, but if left untreated, turn into cancer. It’s like getting a splinter, leaving it to become infected and having to cut your finger off.”

These days Watkins is living cancer free. But, a lot of his friends are 45 to 50 years old, and he’s really been encouraging them to make an appointment. He reminds them how easy the procedure is, how simple the prep is now — and that there’s no reason to be scared or nervous.

Watkins’ new motto? An ounce of prevention is worth a pound of cure.

How polyps turn into cancer

0
0

Reviewed by Dr.Victor Chen

Our colon cells grow so rapidly that our body actually replaces the entire lining of our colon about once a week.

Sure, this means healthy intestines are constantly sloughing off older cells and repairing themselves. But, with so much growth, there’s the chance something can go wrong.

When this happens, the abnormal group of cells begins to form a polyp.

Not all polyps turn into cancer. In fact, many polyps don’t. Nearly all colorectal cancers start out as a polyp, however, and removing the masses during a colonoscopy can reduce one’s risk.

Is there a way to tell a non-cancerous polyp from a pre-cancerous one just by looking at it?

Not until it is biopsied or examined under a microscope.

The most common types of polyps are hyperplastic and adenomatous. Hyperplastic polyps are usually small and located in the end-portion of the colon. These polyps usually have no potential to become malignant and, more often than not, are not worrisome.

The majority of significant (or cancerous) colon polyps, though, are adenomas. These do have the potential to become cancer. The larger these polyps become, the more likely they are to turn cancerous.

Unfortunately, for the most part, it is not possible to tell the difference between these two during a colonoscopy by only looking at them. So, it’s best to remove them for pathology to determine their nature and guide any potential follow-up testing.

As physicians navigate their way through the colon, a tube-like structure with a flat surface and curved folds, they look for the “tell-tale” signs of a polyp. Some are flat, while others extend outward – but some polyps are subtle. As a result, it is important for you to have a colonoscopy by an experienced gastroenterologist. Often, the rate of polyp detection is determined by experience.

Because the lining of the colon doesn’t feel pain, removing these polyps is not painful. Any removed tissue will be sent to the in-house pathologist to test the samples for cancer.

How often will I need a colonoscopy?

Based on risk, pathology results, and family history, your gastroenterologist will recommend when you should have your next colonoscopy. Everybody is different. The time range can vary from three months to 10 years.

For more information or to schedule an appointment, please call 1-800-442-0041.

Dr. Victor Chen believes in a straightforward approach to life and medicine. He developed an interest in gastroenterology after his grandfather died of esophageal cancer. After completing his medical training, Dr. Chen moved to Reno for the opportunity to introduce Endoscopic Ultrasound (EUS) to the region — and was the first physician in Nevada to perform the procedure. 

Nevada has one of the lowest rates of colon cancer screening

0
0

The Silver State ranks in the bottom ten states for colorectal cancer screening

Reviewed by Dr. Craig Sande

Here’s the truth: a colonoscopy is the only cancer screening tool that can actually prevent the disease.

But, we still believe the best test is the one that you or your friend, spouse or family member will get done.

In Nevada, those screening tools are simply not being used as adequately as they need to be.

The Silver State ranked in the lowest ten states across the country for screening rates during 2016, which includes either a fecal blood test, a sigmoidoscopy or a colonoscopy, according to the Centers for Disease Control and Prevention. This means Nevada falls at seventh place for lowest screening rates, at just 61.5 percent of all adults over the age of 50 getting screened for colon cancer.

We barely squeeze in front of Montana (61.3 percent) and Wyoming (60.9 percent).

On the other hand, the incidence of colorectal cancer for Nevada ranks above the national average, as do the state’s colon cancer-related mortalities.

“Colonoscopies shouldn’t be feared – not when the benefits so far outweigh the drawbacks.” said Craig Sande, MD. “So many people say they are worried the colonoscopy will be painful, but usually they won’t have any recollection the procedure even happened.”

You probably won’t experience any symptoms when polyps start to grow in the colon, Dr. Sande said. However, the masses can turn into cancer if left untreated.

This is why colonoscopies are considered the gold standard of cancer screening. Unlike the Fecal Immunochemical Test, which checks for blood in the stool, colonoscopies allow doctors to see inside the colon and remove any growths before they become too large.

Regular screening should begin at age 50 for average-risk individuals and be continued every 10 years until age 75 – unless otherwise directed by a physician. Individuals age 76 to 85 should ask their doctor if they should be screened.

It is important to notice that you may need to begin screening earlier if:

  • You have a close relative who had colorectal polyps or colorectal cancer.
  • You have inflammatory bowel disease, such as Crohn’s or ulcerative colitis.
  • You have a genetic syndrome, such as hereditary non-polyposis colorectal cancer, that would make you more inclined to develop colorectal cancer.

Other Screening Options

  • Fecal immunochemical test (FIT): This test checks the stool for tiny amounts of blood given off by polyps or colorectal cancer. Remember, this type of test could produce a false-positive if blood is present in the stool for any other reason, such as hemorrhoids. It must be performed on an annual basis.
  • CT colonography: This involves a CT scanner and computer programs to create a three-dimensional view of the inside of the colon and rectum that can be used to identify polyps or cancer. While this cannot remove polyps, it is fairly quick and noninvasive. However, it works best for large polyps.
  • Cologuard: This tests the stool for tiny amounts of blood and identifies altered DNA from cancer or polyps that end up in the stool. While Cologuard™ is noninvasive, it will miss most polyps. The test comes with a high chance of false-positive results.

To schedule your colonoscopy or to discuss other digestive health needs, please reach out to Dr. Craig Sande or one of our other physicians at three locations throughout Reno and Carson City.

Dr. Sande is a Reno native and the fifth of six children raised by Naomi and John Sande. Medicine was not exactly the career path he had in mind when he left Reno to do his undergrad at Stanford University. He initially considered a career in electrical engineering, but after further exploration, he decided to follow his father’s footsteps and entered the field of medicine. Dr. Sande has a special clinical interest in inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis, gastroesophageal reflux disease and esophageal motility disorders.

New Physician Joins Gastroenterology Consultants: Daniel R. Cummings, MD

0
0

Reno, NV (June 3, 2019) – The physicians and staff of Gastroenterology Consultants proudly welcome Dr. Daniel R. Cummings to Northern Nevada and to the practice. Dr. Cummings is moving to the area from Placerville, CA. Prior to joining Gastroenterology Consultants, Dr. Cummings owned and operated his own practice in the Placerville area for the past 35 years.

Dr. Cummings was drawn to the field of gastroenterology because of his interest in minimally invasive procedures like colonoscopies. The process of treating diseases without causing significant pain to the patient seemed the ideal route for him, and since then Dr. Cummings has enjoyed gastroenterology due to the variety of diseases he treats within this field.

Dr. Cummings is originally from El Cajon. He attended Stanford University for his undergraduate studies and returned to the San Diego area for medical school and his internal medicine residency at UC San Diego. He completed his gastroenterology fellowship at UC Irvine. In 1984, he practiced at David Grant USAF Medical Center for four years before opening a private practice in Placerville, California. He is a member of the American Gastroenterological Association, the American College of Physicians, the American Medical Association, and the American Society of Gastrointestinal Endoscopy.

Dr. Cummings is seeing and accepting new patients in our Reno offices. Patients can be scheduled with Dr. Cummings at (775) 329-4600.

Men should be aware of these common GI issues

0
0

Reviewed by Dr. Clark Harrison

June marks the beginning of warm weather, outdoor activities, father’s day celebrations, and in Reno, the wild, west rodeo! But June is also Men’s Health Month, a month-long campaign meant to increase awareness about health issues that are important to men.

When it comes to GI issues, everyone experiences some level of gastrointestinal discomfort at one point or another in their lives. However, men are much less likely to go to a doctor than women when they’re having problems.

According to a survey conducted by the Cleveland Clinic, 40% of men nationwide don’t visit their doctor for yearly check-ups, citing several reasons for their absence. Some of these excuses are busy lives, fear of finding something wrong, or general discomfort with endoscopic procedures, like colonoscopies. Even so, routine exams like colonoscopies can be lifesaving and should be performed beginning at the age of 50 for most men. If there’s a family history of colon cancer, screenings should be done at an earlier age.

Colorectal Cancer

Colorectal cancer is the third leading cause of all cancer-related deaths, and it’s expected to kill over 51,000 people in the U.S. in 2019 – that’s nearly the entire population of Carson City, Nevada, at 54,000 people! Though colorectal cancer affects people of all ages and genders, the cancer is slightly more common in men. According to the American Cancer Society, men have a 4.49% likelihood of contracting colorectal cancer as opposed to the 4.15% likelihood of it occurring in women.

“Due to lifesaving colonoscopy screenings, the death rate from colorectal cancer has dropped by nearly a third in recent years,” says Clark Harrison, MD. “This makes it all the more important for everyone to get their routinely scheduled procedures.” There are over one million survivors of colorectal cancer as of 2019.

Aside from colorectal cancer, there are other GI issues that tend to be a bit more of a problem for men than women, including Barrett’s esophagus and ulcers.

Barrett’s Esophagus

For the most part, both men and women commonly suffer from gastroesophageal reflux, more commonly called heartburn or acid reflux, with about the same frequency. Chronic gastroesophageal reflux can cause serious complications, one of these being Barrett’s Esophagus. Keeping track of how often you experience heartburn or acid reflux can help your doctor determine whether to test for Barrett’s Esophagus. Men have a higher rate of this precancerous condition, which can lead to esophageal cancer if left untreated. Treatment for this condition can be easily implemented with a doctor if a patient is diagnosed with Barrett’s Esophagus.

Peptic Ulcers

Another GI condition more common in men is peptic ulcer disease, which is ulceration of the stomach or upper small bowel (also called duodenal ulcers). Peptic ulcers typically appear between ages 30-50 and often cause significant pain or bleeding. Ulcer symptoms can include a gnawing pain in the abdomen, heartburn, indigestion, feeling full on an empty stomach, bloating, gas, or even nausea. Although, it is possible that people with ulcers experience no symptoms. Treatment for ulcers may include medication or antibiotics, depending on the cause of the condition.

Health Tips for all Genders

The best tip we can give is to make sure that you are going to the doctor for your annual wellness checks, be honest and open with them, and make sure that you are doing your routine procedures, like colonoscopies, when it’s time to do them.

As GI doctors, we also recommend eating plenty of fiber, lean proteins, and avoiding sugar, excess saturated fats, and processed foods with artificial ingredients. All of this will help regulate your gut health and optimize your overall health in the long run.

Dr. Harrison grew up in Virginia and attended medical school there. After completing his fellowship training at Oregon Health Sciences University in gastroenterology, he moved to Reno and joined Gastroenterology Consultants in 1992. Since then, he and his wife have raised two children in an area they love to call home. Dr. Harrison has a special interest in promoting colon cancer screening and prevention.

Gut-Healthy Recipe of the Month: Chicken, Quinoa & Chickpea Medley

0
0

January’s Gut-Healthy Recipe of the Month

Looking for a new meal to add to your repertoire of gut healthy recipes? We’ve got one for you! This quinoa-chickpea mix with chicken and veggies is loaded with fun colors, fiber, and tons of nutrients that will delight both your tongue and tummy alike. The following recipe yields 4 servings.

 

Ingredients You’ll Need:

  • 1 cup of dry quinoa
  • ¼ teaspoon of salt (to boil with quinoa)
  • 1 ¾ cups of water
  • 1 cup canned garbanzo beans, drained and rinsed
  • 1 clove of garlic, minced
  • 2 tablespoons of lime juice
  • 2 teaspoons of olive oil (for the quinoa/chickpea mix)
  • ¼ teaspoon chili powder
  • 1 pinch of and pepper to taste (for the quinoa/chickpea mix)
  • 1 tablespoon olive oil (for the chicken and veggies)
  • 1 yellow bell pepper, chopped into smaller pieces
  • 12 spears of asparagus, chopped into smaller pieces
  • 12 cherry tomatoes, halved or quartered
  • 1 pound chicken breast
  • 1 teaspoon turmeric
  • 1 teaspoon salt (for chicken)
  • 1 teaspoon of pepper
  • Zest of 1 lemon, plus a drizzle of lemon juice

Directions:

  1. Place the quinoa in a fine mesh strainer, and rinse under cold, running water until the water no longer foams. Put the rinsed quinoa in a saucepan with the salt and water, then bring to a boil. Reduce heat to medium-low, cover, and simmer until the quinoa is tender, which will take about 20-25 minutes.
  2. Once the quinoa is done cooking, add in the drained and rinsed chickpeas, garlic, lime juice, chili powder, and olive oil. Finish with a pinch of salt and pepper to taste, and stir well.
  3. While the quinoa is cooking, season the chicken with turmeric, salt, pepper, zest of lemon, and finish it off with a drizzle of lemon juice. Prepare a pan on medium heat, and once hot, add olive oil and seasoned chicken to the pan, cooking the chicken breast for approximately 10 minutes each side. Ensure the chicken breast reaches at least 165 degrees internal temperature with a meat thermometer.
  4. Pull the chicken off to the side and allow it to rest while adding the chopped vegetables (asparagus, cherry tomatoes, and yellow bell pepper) to the pan. Cook vegetables in the pan until barely tender, which should take about 3-5 minutes.
  5. Serve a decent scoop of the quinoa-chickpea mix with the chicken and vegetable medley, and enjoy!

Yields 4 servings

Nutrition Facts for 1 serving:

  • 490 calories
  • 41.6 g protein
  • 25.3 g carbs
  • 5.6 g fiber
  • 11.6 g fat

Gastroenterology Consultants Welcomes Two New Advanced Practice Providers!

0
0

Welcome, Megan King and Leah Walsh!

Megan King
Megan King, MSN, FNP-C
Leah Walsh
Leah Walsh, MSN, FNP

Reno and Carson City, NV (February 12, 2020) – The physicians and staff of Gastroenterology Consultants, Reno-Carson’s largest digestive health and gastroenterology practice in Northern Nevada, are pleased to announce that Megan King, FNP-C and Leah Walsh, FNP, have both joined the practice. Both of these Nurse Practitioners come to us from the East Coast, with Megan hailing from Jasksonville, FL and Leah coming to us from a small town outside of Pittsburgh, PA.

Megan King is seeing and accepting patients at the Reno-North location at 880 Ryland St. Patients can be scheduled with Megan at (775) 329-4600.

Leah Walsh is seeing and accepting patients at the Carson City location at 1385 Vista Lane. Patients can be scheduled with Leahat (775) 884-4567.

 

About Gastroenterology Consultants:

Gastroenterology Consultants (GIC) has been serving residents of Northern Nevada and adjacent cities in California since 1986. Our 18 Board-certified Physicians specialize in the diagnosis and treatment of digestive health and liver problems in both adult and pediatric patients. GIC has three medical office clinics and three adjacent endoscopy centers in the Reno and Carson City areas.

Gut-Healthy Recipe of the Month: Veggistrone

0
0

February’s Gut-Healthy Recipe of the Month

This vegetable-heavy soup is sure to please both your taste buds and your GI system! When cold weather strikes, this soup is the perfect remedy to warm yourself back up. This recipe yields about 10 servings.

Veggie Minestrone Soup

 

Ingredients You’ll Need:

  • 2 tablespoons extra-virgin olive oil
  • 2 cups chopped onions (2 medium)
  • 2 cups chopped celery (4 medium stalks)
  • 1 cup chopped bell pepper (1 medium)
  • 4 cloves garlic, minced
  • 3 cups chopped cabbage
  • 3 cups chopped cauliflower (about ½ medium)
  • 2 cups chopped carrots (4 medium)
  • 2 cups green beans, cut into 1-inch pieces, or frozen, thawed
  • 8 cups low-sodium vegetable broth or chicken broth
  • 2 cups water
  • 1 (15 ounce) can tomato sauce
  • 1 (14 ounce) can diced tomatoes
  • 1 (15 ounce) can kidney or pinto beans, rinsed
  • 1 bay leaf
  • 4 cups chopped fresh spinach or 1 (10 ounce) package frozen chopped spinach, thawed
  • ½ cup thinly sliced fresh basil
  • 10 tablespoons grated Parmesan cheese

Directions:

  1. Heat oil in a large soup pot or Dutch oven (8-quart or larger) over medium heat. Add onions, celery, bell pepper and garlic; cook, stirring frequently, until softened, 13 to 15 minutes.
  2. Add cabbage, cauliflower, carrots and green beans; cook, stirring occasionally, until slightly softened, about 10 minutes more.
  3. Add broth, water, tomato sauce, tomatoes, beans and bay leaf; cover and bring to a boil. Reduce heat and simmer, partially covered, until the vegetables are tender, 20 to 25 minutes.
  4. Stir in spinach and simmer for 10 minutes more.
  5. Discard the bay leaf. Stir in basil. Top each portion with 1 tablespoon cheese.

Yields 10 servings, about 2 cups each serving

Nutrition Facts for 1 serving:

  • Calories: 170
  • Carbohydrates: 24 g
  • Fiber: 9 g
  • Protein: 7 g
  • Fat: 5 g

COVID-19 – GI Consultants Response: March 20, 2020

0
0

Dear patients and community,

The physicians and team of Gastroenterology Consultants have been actively monitoring the COVID-19 (Coronavirus) outbreak and are regularly checking on updates from the Centers for Disease Control and Prevention (CDC) and the Nevada Department of Health and Human Services.

With recent developments and mandates from the State, we want you to know that your health and safety is our top priority. As a medical practice, Gastroenterology Consultants falls into the category of essential business and will stay open to provide much needed GI care to the community and our patients. While the COVID-19 situation is fluid, we will continue to monitor the situation and make changes as needed to keep our patients, staff, and community safe.

In the past few weeks, our practice has taken additional steps to protect our patients and staff and to prevent the spread of the virus in our community. These are the following precautionary measures that have been implemented:

  • We are working diligently to make all the providers more accessible remotely to our patients through Telemedicine. Details will be released in the coming week.
  • Our practice is following the guidelines set out by the CDC and the state and federal government public health agencies. There are signs at each of our entrances with information regarding our new screening procedures.
  • We are sending reminders encouraging patients who are experiencing symptoms to reschedule, screening patients upon arrival, and providing masks to patients with any kind of respiratory symptoms.
  • The specialized janitorial team we have is aware of the severity of the COVID-19 situation, so on top of their normal, hospital-grade cleaning procedures, they’ve been ensuring all high-touch areas are being deep-cleaned and sanitized on a daily basis.
  • Our staff follow standard best practices for cleaning and sanitizing exam rooms, scheduling areas, and all high touch areas in the office after every patient, and additional cleaning supplies have been given to staff to continue this practice.
  • We have asked patients to limit the number of guests they bring, and we are asking that all guests of patients who will not participate in appointments wait in their vehicles rather than in our waiting rooms. Additionally, we have asked that drivers who pick up patients from procedures wait in their vehicles, as well.
  • Additional hand sanitizers have been placed in each of our offices for patients to use during their visits.
  • Staff have been reminded in several communications to use proper hand washing techniques, with signs in each bathroom serving as secondary reminders, and to practice social distancing as much as possible with patients and amongst each other.
  • We have increased leniency on our absence policy and encourage any staff that are showing any of the confirmed signs of illness to stay home.

We encourage you to give us a call if you have any questions at 775-329-4600 for either of our Reno Offices or 775-884-4567 for our Carson office. Again, if you have a fever or respiratory symptoms, like a cough or shortness of breath, please contact us to reschedule your appointment.

Thank you,

Gastroenterology Consultants

COVID-19: A Message to Patients with IBD or AIH

0
0

A message to those with Crohn’s Disease, Ulcerative Colitis, or Autoimmune Hepatitis:

We hope you and your family are well during this tumultuous time. We realize there may be many out there with underlying GI conditions who have concerns or questions regarding an underlying condition and the 2019 novel coronavirus (COVID-19).

For patients with underlying conditions (such as Crohn’s Disease, Ulcerative Colitis, or Autoimmune Hepatitis) taking immunosuppressive medications, the Joint Gastroenterology Society has recommended the following:

“Patients on immunosuppressive drugs for IBD and autoimmune hepatitis should continue taking their medications. The risk of disease flare outweighs the chance of contracting coronavirus. These patients should also follow CDC guidelines for at-risk groups by avoiding crowds and limiting travel.”

This means that patients with Inflammatory Bowel Disease and Autoimmune Hepatitis who are on immunosuppressive medications should remain on their medications. The risk of disease complications is more likely to occur without the continued use of the immunosuppressive medications. HOWEVER, please contact our office to discuss your care if you are currently taking prednisone, prednisolone, or methylprednisone.

In order to decrease your risk of getting sick, please follow the “CDC Recommended Guidelines for At-Risk Groups” by avoiding crowds, practicing social distancing, and limiting travel. You can read the “CDC Recommended Guidelines for At-Risk Groups” by following this link: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/get-ready.html

Please see the list below for Immunosuppressive Medications:

  • Azathioprine (Imuran)
  • Mercaptopurine or 6-MP
  • Cyclosporine
  • Tacrolimus
  • Methotrexate
  • Adalimumab (Humira)
  • Certolizumab pegol (Cimzia)
  • Infliximab (Remicade)
  • Ustekinumab (Stelara)
  • Vedolizumab (Entyvio)

We realize you may have questions about your risk, your underlying condition, or your medications. We are working hard to make your provider more accessible to you during these unprecedented times, and we will have more details on increased accessibility in the coming weeks. We appreciate your patience and understanding as we navigate further developments.

Here are some other useful tips to keep safe and healthy during these dynamic times:

  1. Practice social distancing. This is the only way to “flatten the curve” and ensure we have enough resources to manage cases that require hospitalization (approximately 10% of COVID-19 cases are severe). More information on what the phrase “flatten the curve” means can be found in this useful article: https://www.washingtonpost.com/graphics/2020/world/corona-simulator/
  2. If you are not feeling well, you must self-quarantine. The elderly, those with underlying health conditions, and immune compromised individuals are particularly vulnerable. Please help look out for our fellow Nevadans by limiting contact with other individuals.
  3. The best information on COVID-19 can be found on the CDC’s website. https://www.cdc.gov/coronavirus/2019-nCoV/index.html Many news sources often present unverified info.
  4. Information specific to Nevada is also available at https://nvhealthresponse.nv.gov/

We’re Now Offering Tele-Medicine Services!

0
0

doctor on electronic tablet conducting medicine

In response to the COVID-19 pandemic, we are incorporating a new Tele-Medicine program called GI-On Demand.

GI On-Demand will help our providers and patients practice safe social distancing, while allowing us to care for patients with gastrointestinal and liver conditions.

GI On-Demand is appropriate to evaluate mild and most moderate illnesses. A Tele-medicine visit is also appropriate for management of health conditions such as chronic hepatitis C, constipation, diarrhea, diverticulosis, gastritis, acid reflux, inflammatory bowel disease, irritable bowel syndrome, and other gastrointestinal and liver conditions.

Call 775-329-4600 to make an appointment.

Viewing all 61 articles
Browse latest View live




Latest Images