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Modern Day Gastroenterology

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LEXINGTON Lexington Clinic Gastroenterology treats a wide variety of gastrointestinal (GI) issues. In recent years, two of the most common conditions treated are celiac disease and hepatitis C.

“While we do see patients with varying conditions in our office each day, we are beginning to see a rise in patients we treat with these two modern-day GI issues,” said An-Yu Chen, MD, head of Lexington Clinic Gastroenterology. “Both hepatitis C and celiac disease are highly relevant in today’s society. With hepatitis C, we are seeing a large number of baby-boomers, a generation with a high population of hepatitis C positive patients, come forward for screening or treatment of this disease. With celiac disease, this condition has become four times more common than it was 50 years ago, and we are seeing a reflection of this in our number of patients treated for it in our office.”

Both of these rising diseases, while dangerous to a patient, are manageable through proper treatment and consultation with a specialist. In fact, hepatitis C can now even be cured if caught in time. That is why Lexington Clinic gastroenterologists recommend early screening for these diseases among at-risk patients.

Hepatitis C is a blood-borne disease that attacks a patient’s liver. With more than 2.7 million people infected in the U.S., it is the leading cause of cirrhosis, liver cancer, and liver transplantation. It is spread through contact with blood from an infected person, meaning you are at risk only if you have come into contact, in some way, with the blood of someone positive for hepatitis C (shared needles, accidents at healthcare facilities, tainted blood transfusions). For this reason, hepatitis C once carried a negative stigma in society. This should not be the case, given how common hepatitis C really is, particularly among the baby-boomer generation. Once contracted, it can take years for symptoms to show up, often in the late stages of the disease.

However, with recent developments in treatment, new options have arisen; options that offer patients a 93–100 percent chance to be cured and little to no chance of relapse. And with cases of hepatitis C on the rise, this effective treatment is just in time for thousands of patients who are diagnosed with the disease.

“Up until last fall, hepatitis C was treated with interferon, which is much like chemotherapy, and this treatment was only about 35 percent effective in actual cases. Even when the treatment did work, the possible side effects were severe, as severe as suicide in some instances. Additionally, there was a high relapse rate among patients who received this treatment. But with new treatment options, all that has changed,” said Chen, who along with other Lexington Clinic gastroenterologists Scott A. Merkley, MD, and Matthew D. Ashmun, MD, are the leading providers of chronic hepatitis C care in Central Kentucky.

The new treatments, direct-acting antivirals taken orally, are extremely safe for patients. They have very few interactions with other medications and effectively cure this disease. This gives hepatitis C patients a chance to continue on with their lives in a way they may have been unable to before.

Unlike hepatitis C, a cure for celiac disease does not exist. However, it can still be managed.

“Celiac disease, an immune reaction experienced by a patient with sensitivity who has eaten gluten, produces inflammation within the small intestine, which can cause unexpected weight loss, bloating, and sometimes diarrhea,” said Ashmun. “If left untreated, the condition will in effect deprive a patient’s vital organs, including the brain, nervous system, bones, and liver, of vital nourishment.”

However, like hepatitis C, the signs and symptoms of celiac disease are sometimes difficult to see. The two most common symptoms, diarrhea and weight loss, are only present in one-third and half of those diagnosed, respectively. Additionally, only 20 percent of patients exhibit constipation, and only 10 percent are obese. Since it is so difficult to detect through physical symptoms, gastroenterologists recommend testing for the disease, usually through blood tests or endoscopies.

“Once a diagnosis is confirmed, we can work with patients to help them manage this disease through a gluten-free and wheat-free diet,” said Merkley. “Additionally, we may recommend vitamin and mineral supplements, and in some cases, medications to control the inflammation of the intestine.”

As both of these diseases continue to increase in today’s society, Lexington Clinic Gastroenterology continues to treat them. Chen, Ashmun, and Merkley, along with James B. Hunter, MD, work with each patient they see who may have either of these diseases to find a treatment that works for them.

“Both hepatitis C and celiac disease are conditions that can be managed, and in the case of hepatitis C, cured,” said Chen. “We work with each of these patients to find the treatment plan that works best for them, and help them get back the quality of life they deserve.”