Did you know that people born from 1945-1965 are five times more likely to have Hepatitis C? Dr. David Dies discusses Hepatitis C on KTBS Healthline 3. Watch the replay here or read about Hepatitis C below.
Dr. David Dies Q&A: Hepatitis C
How big a problem is Hepatitis C infection?
In the United States, it is estimated that 3.2 million persons are infected with HCV. To put it into perspective, there are 2.8 million with breast cancer, 2.5 million with prostate cancer and 0.9 million with HIV, so there are more people with hepatitis C than these other significant diseases. Sadly, between 50-75% of people with HCV do not even know that they have it.
What are the potential long term consequences of hepatitis C?
Between 60-70% will develop chronic liver disease. Approximately 20% will develop cirrhosis after 20-30 years of infection. After progression to cirrhosis, several studies estimate that somewhere there is between a 1 to 5 per cent chance of liver cancer per year. Further, after a diagnosis of cirrhosis, up to 1/3 of patients will start to develop liver failure over the next 10 years.
What medical specialty cares for the Liver?
While there is overlap in all medical specialties, the main specialist for the liver is called a Hepatologist. There are specialized training programs and even board certification in Hepatology. The Liver Center at GastroIntestinal Specialists has two Board certified Hepatologists, Dr. Humberto Aguilar and myself.
Can Hepatitis C be cured?
Of course it can, but in the past it was very difficult. In the early days we used injections of interferon and probably cured no more than 9%. Later, we found other drugs to add to the interferon injections and the cure rate increased to over 50% of the patients we treated. However, interferon had a lot of side effects.
Studies suggest that only about 10% of all patients with hepatitis C have been treated. Many chose not to be treated due to the side effects of therapy. This changed in the Fall of 2014 when the new direct acting antivirals (called DAA’s) were released.
As stated, the new medicines are called DAA’s. DAA’s are pill (not injections) that can be taken without any interferon shots. Our research has shown that we can successfully cure over 95% of patients with pills: there is no longer a need for the interferon injections. Our Liver center was recently recognized as the #2 prescriber of hepatitis medicine in the country. We have ongoing studies for even newer therapies for hepatitis C in our clinical research company, Louisiana Research Center.
What are the Side Effects of Treatment?
In the “old days” of interferon, patients basically felt like they had a bad case of the flu for 48 weeks. That is no longer the case as interferon will not be used much anymore. The newer therapies are pills initially given for just 12 weeks. Side effects of these pills are minor. It was the interferon that mainly gave the side effects.
When will the new medicines be released and when will they be available?
They are available now. There are several to choose from. More are expected to be released in the next 12-18 months.
Do you treat other kinds of liver disease?
Yes! We are the only private clinic in North Louisiana that has board certified doctors in Liver Medicine. We provide care in liver transplant medicine, cirrhosis care, liver masses, liver drug reactions, fatty liver disease, genetic liver disease, autoimmune hepatitis and just about any liver condition. We also have a large hepatitis B clinic.
What have been the biggest obstacles?
Most patients (and even health care providers) do not understand that most liver diseases now have a cure – including hepatitis C! However, the highest chance of cure is when we treat early, when the numbers are not that high and there are no symptoms.
How can I make an appointment?
You can make an appointment by calling (318) 631-9121.
Colon Cancer By Dr. James C. Hobley
Still considered the number two overall cause of cancer death in the United States in men and women, colorectal cancer is a disease that should and will be dealt with. We now understand the most common cause of this disease. 85% of all cases are due to pre-cancerous growth called polyps. These polyps grow unnoted and undetected within the colon over a period of time.
There are some factors that increase your risk of developing colon polyps, hence developing colon cancer. These risks include, but are not limited to, age, family history, environmental factors and other diseases that exist in the person. The recommended age for screening is 50 yrs. Some studies have recommended that African Americans should start screening at 45. Knowledge about family history is critical in understanding the source of developing colon polyps and preventing colon cancer. Removing the precancerous polyps before they become a cancer prevents Colon cancer. It is important to note that colon cancer is a very treatable disease and if found in it’s early stages can be cured.
One of the greatest barriers to the prevention of colon cancer has to do with the actual procedure that can prevent the cancer itself. Colonoscopy has some urban myths that may have prevented people from receiving the true benefit of colon cancer prevention by removing these polyps. Understanding these myths and dispelling them is critical in our quest to reduce the burden of colon cancer deaths in this country.
One big myth is that this procedure is painful. Today with the use of anesthesia during these procedures we can render a painless procedure for our patients. Another myth is that this is a very embarrassing procedure. There’s great care and concern taken when caring for our patients. The patient’s privacy is protected in this procedure.
Another myth is that patients feel that when they have no symptoms there are no problems. As stated earlier: polyps can grow undetected and unnoted by the patient. It’s not about symptoms it’s about early detection. The only way to detect colon cancer early is to look for it. While there are other means of looking for polyps (i.e. CT colonography) colonoscopy can both find the polyps and remove it at the same time. This cuts down on patient exposure to procedures and it also save the patient any exposure to possible painful experiences, as most CT scans are not done with sedation.
We are presented with a time in medicine where we have a disease that we know its origins and we have the opportunity to prevent the disease or cure it in its very early stages. Patients have the power to prevent this disease by choosing to view screening for colorectal cancer as a routine part of their health care maintenance. We have an opportunity to bring our country into the new millennium by eliminating one of the top causes of cancer related death. I invite you to join me in this task. Call (318) 631-9121 to schedule an appointment.
Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract. It has two main conditions – ulcerative colitis and Crohn’s disease. Ulcerative colitis affects the colon and Crohn’s can affect any part of the GI tract from the mouth to the anus. Learn more about the differences of Crohn’s & Colitis below.
Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract. It has two main conditions – ulcerative colitis and Crohn’s disease. Ulcerative colitis affects the colon and Crohn’s can affect any part of the GI tract from the mouth to the anus. Symptoms include: abdominal pain, cramps, diarrhea, constipation, weight loss, and loss of appetite. Let GIS find a treatment that works for you!
Inflammatory Bowel Disease: Q&A with Dr. Aguilar
Inflammatory bowel disease is a chronic inflammatory condition of the gastrointestinal tract. It has two main conditions – chronic ulcerative colitis and Crohn’s disease. Typically, it is diagnosed by endoscopy with some assistance of radiological techniques. The difference between Crohn’s and ulcerative colitis is that ulcerative colitis only affects the colon and Crohn’s can affect any part of the GI tract from the mouth to the anus.
Do I have ulcerative colitis or Crohn’s and how to differentiate that?
The difference is that ulcerative colitis is limited to the colon and Crohn’s disease typically has a combined involvement of the small bowel and the colon, although Crohn’s can also affect the stomach and any part of the GI tract. The way to tell the difference depends on the parts that are affected and the behavior of the disease.
What part of my intestine is affected?
Typically, Crohn’s affects any part of the GI tract but ulcerative colitis only the colon.
Could any other disease be causing my symptoms?
Typically, the most common presentation is bloody diarrhea, diarrhea and abdominal pain and, in young patients, weight loss. The symptoms could be caused by a problem as simple as IBS and in the absence of bleeding sometimes it is very difficult to differentiate between IBD and IBS.
How is IBD different from IBS? Can I have both?
The difference between IBD and IBS is IBD is chronic, usually persistent, is associated with bleeding, weight loss and is a more severe condition. IBS tends to be mainly symptoms that are not associated with any alarm signs. Some people with IBD do also have IBS and those two diseases can overlap.
How is IBD treated?
The treatment of IBD depends on the severity of the condition. When the disease is mild, we can treat that with tablets but when the disease is more aggressive, we tend to use injectables that are called biologics, usually monoclonal antibodies that are designed to decrease inflammation that is causing this disease.
What are the potential side effects of the medicines?
Regarding the potential side effects of the medication, first of all we need to say that the medications overall are extremely safe. The risks for complications are small and infrequent and usually the benefits of the treatment outweigh the risks.
Regarding diet, there are so many different diets that have been used throughout the years for IBD but none of those have proven to be consistently effective. My behavior regarding diet is if the diet is not detrimental to the overall health of my patients, I let them try because of the potential benefits of the patient’s dedication to those diets but overall they have not been consistently shown to be effective. There are some specific kinds of patients that will benefit from a low fiber diet but most of the time, diet is very well tolerated, especially patients with ulcerative colitis.
Regarding smoking, smoking has been noticed to be detrimental for patients with Crohn’s disease and maybe somewhat protective for the ulcerative colitis; however, the damage that smoking causes is much worse than any potential benefit in ulcerative colitis, so we always encourage patients to stop smoking.
What are the possible complications of Crohn’s disease and ulcerative colitis?
Well, one of the most detrimental complications of this condition is colon cancer. Chronic inflammatory changes are also associated with increased risk for colon cancer. For that reason, it is recommended that when you have a duration of the disease for more than 8 – 10 years to undergo colonoscopies every other year. Other complications are the development of abscess and perforations that would require surgery.
Will I need an operation and, if so, will the surgery cure my IBD?
About 30% of patients with IBD, especially with Crohn’s, undergo surgery within 5 – 10 years of the diagnosis of the disease. In Crohn’s disease, surgery is not curative and in ulcerative colitis a total colectomy would be curative; however, there could be a relapse at the level of the anastomosis. So, with surgery, you have a new beginning and at that time would tend to know that it is better to treat patients before the disease comes back. Increase of colon cancer as already mentioned, but you have the duration of more than 8 – 10 years that increases the risk for colon cancer.
Regarding treatments, we have many treatment opportunities now. We are doing high scientific research and we have many options for patients, so we will offer that to them. Call (318) 631-9121 to make an appointment.
GIS Family Health Tree
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Pancreatic cancer is the fourth most common cause of cancer death in men and the fifth in women. It accounts for more than 37,000 new cases per year in the United States. Cancer of the pancreas is resistant to many standard treatments including chemotherapy and radiation therapy. This cancer grows insidiously and initially does not cause symptoms, which is a major reason why it’s a leading cause of cancer death. Signs and symptoms may not appear until pancreatic cancer is quite advanced and complete surgical removal isn’t possible.
Your pancreas is about 6 inches (about 15 centimeters) long and looks something like a pear lying on its side. The pancreas secretes hormones, including insulin, to help your body process sugar in the foods you eat, and it produces digestive juices to help your body digest food.
How pancreatic cancer forms
Pancreatic cancer occurs when cells in your pancreas develop mutations in their DNA. These mutations cause cells to grow uncontrollably and to continue living after normal cells would die. These accumulating cells can form a tumor.
Most pancreatic cancer begins in the cells that line the ducts of the pancreas. This type of cancer is called pancreatic adenocarcinoma or pancreatic exocrine cancer.
Rarely, cancer can form in the hormone-producing cells of the pancreas. This type of cancer is called islet cell cancer or pancreatic endocrine cancer.
Factors that may increase your risk of pancreatic cancer include:
- African-American race
- Excess body weight
- Chronic inflammation of the pancreas (pancreatitis)
- Family history of genetic syndromes that can increase cancer risk
- Personal or family history of pancreatic cancer
Signs and symptoms of pancreatic cancer often don’t occur until the disease is advanced. When signs do appear, they may include:
- Upper abdominal pain that may radiate to your back
- Yellowing of your skin and the whites of your eyes (jaundice)
- Loss of appetitie
- Weight Loss
- Blood Clots
Although there’s no proven way to prevent pancreatic cancer, you can take steps to reduce your risk, including:
- Stop smoking. If you smoke, stop. Talk to your doctor about strategies to help you stop, including support groups, medications and nicotine replacement therapy. If you don’t smoke, don’t start.
- Maintain a healthy weight. If you currently have a healthy weight, work to maintain it. If you need to lose weight, aim for a slow, steady weight loss — 1 or 2 pounds (0.5 or 1 kilogram) a week. Combine daily exercise with a diet rich in vegetables, fruit and whole grains with smaller portions to help you lose weight.
- Choose a healthy diet. A diet full of colorful fruits and vegetables and whole grains may help reduce your risk of cancer.
If you have any symptoms of pancreatic cancer, talk to our doctors. Advanced tests to diagnose pancreatic cancer are available at GastroIntestinal Specialists.
Call (318) 631-9212 to make an appointment.
The Accreditation Committee of the College of American Pathologists (CAP) has awarded accreditation to GastroIntestinal Specialists AMC Pathology Laboratory, Shreveport, Louisiana based on results of a recent on-site inspection as part of the CAP’s Accreditation Programs.
The facility’s director, Enrique Gonzalez, MD, was advised of this national recognition and congratulated for the excellence of the services being provided. GastroIntestinal Specialists AMC Pathology Laboratory is one of more than 7,600 CAP-accredited facilities worldwide.
GastroIntestinal Specialists is a 2015 Safety Star Award Winner
GastroIntestinal Specialists has been named as one of three winners of the 2015 Safety Star Award, sponsored by the Louisiana Hospital Association (LHA) Trust Funds. The program acknowledges LHA Trust Fund member facilities that have developed innovative ideas that improve patient safety.
GastroIntestinal Specialists received this award for improving their patient follow-up and follow through with staff education and process redesign to improve workflow and communication among staff.
This is GastroIntestinal Specialists’ first Safety Star Award. Alice Jett, Director of Clinical Operations at GastroIntestinal Specialists, received recognition along with the $5000 cash award for the facility at the Louisiana Hospital Association Summer Conference.
Today is World Hepatitis Day!
Worldwide 400 million people are infected with viral hepatitis; a disease that kills 1.4 million people every year. With better awareness and understanding of how to prevent hepatitis, we can eliminate this global killer! Check out the World Health Organization’s infographic and learn the facts! http://worldhepatitisday.org
The Center of Diesease Control (CDC) defines Hepatitis C as a serious liver disease that results from infection with the Hepatitis C virus. Hepatitis C has been called a silent epidemic because most people with Hepatitis C do not know they are infected.
This infographic by the CDC tells us why people born from 1945-1965 should get tested for Hepatitis C.