Gastroenterologists and colonoscopies go hand-in-hand, but few people realize the full extent of care available from a GI’s office. Janet Daily, NP-C, a nurse practitioner specializing in gastroenterology at Williamson Medical Group in Franklin, talks more about how GI practices diagnose and treat a broad range of disorders including Hepatitis C, fatty liver disease and Irritable Bowel Syndrome.
Once considered a disease with a grim prognosis, Hepatitis C is now routinely cured with an eight- to 12-week course of oral medications. “I treat a lot of Hep C patients, partly because the transplant world is now utilizing organs of donors with the disease,” Daily said. “Treatment over the last ten years has come a full 360.” Not long ago, Hep C patients endured severe illness and dangerous weight loss for a 60 to 80 percent chance of being cured. Some would slip into remission and revert back to being Hep C positive. Daily said today’s treatments are 99 percent effective, with new medications designed to treat specific types of Hep C. That’s an impressive stat that Daily said too few people really understand. “A lot of people know someone who’s been through the old treatment and they believe we’re still waiting on a better one, so there’s a big misconception about that,” Daily said. “There also used to be insurance company restrictions that made treatment very expensive, but most of those have been lifted and almost anyone can get treated now.” The Centers for Disease Control and Prevention recommend Hep C screening for everyone born between 1945 and 1965, when the risk of bloodborne diseases was still misunderstood. “If you’ve had a transfusion, shared razors or toothbrushes or have been in contact with someone with open bleeding you could be at risk,” Daily said. Anyone with unexplained elevated liver enzymes also should get screened for the disease, which often goes undiagnosed for decades until symptoms of liver cirrhosis develop.
Fatty Liver Disease
As obesity takes a nationwide toll, providers like Daily are seeing more and more patients with non-alcoholic fatty liver disease. In fact, NAFLD is estimated to affect 80 to 100 million Americans. The disease is broken down into two types: simple fatty liver and nonalcoholic steatohepatitis (NASH). NASH is of particular concern to providers, as it can lead to dangerous complications such as cirrhosis and liver cancer as well as insulin resistance and hypertension. However, monitored diet and exercise have proven to be extremely effective in the fight against NASH. General symptoms of NAFLD can include fatigue or elevated liver enzymes, but Daily said it often goes asymptomatic for years. “Patients have sometimes shown up in the ER vomiting blood, and by then they’ve developed liver cirrhosis,” Daily said. “You want to catch it early so you can start reversing the disease.”
Irritable Bowel Syndrome
Irritable Bowel Syndrome affects between 25 and 45 percent of Americans and is characterized by abdominal pain or discomfort and altered bowel habits. The exact cause of IBS is not known, although doctors believe it results from a disturbance in the way the gut, brain, and nervous system interact, causing changes in normal bowel movement and sensation. “A lot of IBS patients come to us from their primary care provider with frequent abdominal pain with diarrhea or constipation that’s become chronic to the point of affecting quality of life,” Daily said. Diagnosis is based on symptoms, which can also indicate inflammatory bowel disease or Celiac Disease. Physicians can recommend dietary changes as well as over-the-counter medications and pelvic floor therapy. “A lot of people with IBS don’t really get the care they’re looking for, but there are things to do to get relief,” Daily said.
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