Why is this important? After all it’s just a little heartburn, right? Maybe not!

If you’re suffering from long-term, chronic acid reflux it’s no small matter. If not properly managed, over a long period of time acid reflux can progress into gastroesophageal reflux disease (GERD), which can be potentially serious if left untreated. Risk factors include peptic stricture, Barrett’s esophagus, asthma, chronic hoarseness, esophageal ulcers and dental problems.

Peptic stricture is a narrowing of the esophagus due to acid injury and scarring. This commonly causes food to stick in the lower esophagus, making it difficult to swallow.

Barrett’s esophagus, one of the most serious complications that can result from chronic acid reflux, occurs when the lining of the esophagus changes to resemble intestinal lining. This can increase the risk of esophageal cancer.

If you’re reading this and wondering how you can lessen the odds of becoming an “acid reflux statistic,” my first advice would be for you to watch your weight and avoid tobacco. Maintaining a healthy weight will help prevent symptoms of acid reflux as well as many other diseases that are commonly linked with obesity, such as diabetes. Tobacco may stimulate stomach acid production and relax the muscle between the stomach and esophagus, permitting the abnormal flow of stomach acid to occur.

If you are one of the growing number of people experiencing frequent heartburn, I encourage you to see your physician. Although there is no cure for acid reflux disease, with effective treatment, proper use of medication and lifestyle and diet changes, most people can easily manage this disease and avoid potential complications.

Robbie was born in Knoxville, Tennessee, and is a graduate of the University of Tennessee College of Nursing and the Fort Sanders School of Nursing in Knoxville. She worked as an RN for more than seven years at Fort Sanders Regional Medical Center before completing her master’s degree training and certification as an Adult Health Nurse Practitioner in 2006. Robbie has practiced gastrointestinal nursing since 2001, initially as an RN and currently as an advanced practice nurse. She is also certified in field of gastroenterology and joined GIA in 2011. Her spare time is spent enjoying quality time with her family and friends.

Our physicians measure up. Every physician at GIA is board certified by the American Board of Internal Medicine in both internal medicine and gastroenterology. We participate in continuing medical education programs annually to make sure we are on the cutting edge of gastrological procedures and technology. And each of our physicians is credentialed for active staff privileges in at least one area hospital.

Our care measures up. We have implemented quality assurance and performance improvement programs with measurable outcomes in both our practice and our endoscopic ASCs that allow us to continually monitor our care and make any necessary improvements. In the more than 20,000 procedures we performed last year, only 12 resulted in hospitalization, and none required surgery. In more than 13,000 colonoscopies last year, there were no perforated colons. We consistently outperform the national average in all quality measures.

Our staff measures up. An excellent staff is critical to providing quality care. Our highly trained and compassionate medical support staff makes sure your visit meets or exceeds your expectations. Our admissions staff provides patients with all the information they need for a successful appointment. They also make sure new patients are seen as soon as possible – typically within a week of a request – and that emergency patients are seen right away.

Our systems measure up. GIA is the only Knoxville GI practice with three licensed, certified and accredited endoscopic ambulatory surgery centers which allow us to perform procedures in a convenient, timely and cost-saving manner. We utilize electronic medical records and perform external chart and billing audits to ascertain proper documentation, coding and billing. And we are the only local practice to have a GI hospitalist ready to provide immediate response to GI hospital consultations and emergencies.

But who measures quality? Our patients do. We know we measure up because our patient satisfaction rating is excellent over 95 percent of the time. And that is the real test. Our goal at GIA is to continue to provide excellent quality of care that helps us achieve the highest levels of patient satisfaction because patients are our true test of quality.

Born and raised in Chattanooga, Tennessee, Amy graduated from Southern Adventist University School of Nursing in 2003. She worked as a registered nurse at Saint Mary’s Hospital in Knoxville for four years before pursuing a degree as a family nurse practitioner at East Tennessee State University.

Upon receiving her certification in 2008, she joined Gastrointestinal Associates as its first hospitalist gastroenterology nurse practitioner seeing patients in the hospital setting.

Amy is a member of the American Gastroenterological Association.

In her spare time, Amy enjoys traveling, hiking, and camping with her husband, Geoffrey White, principal and teacher at Knoxville Adventist School.

Amy was born in Knoxville, TN.  After attending the University of Tennessee, she started her career in the healthcare industry in 1975.

She has been the Insurance and Billing Supervisor at Gastrointestinal Associates since 1999.

After working for several years with the insurance and billing aspect of healthcare, Amy received her coding certification (CPC) from the American Academy of Professional Coders in 2000.

Amy currently serves as a member of Cigna Government Services Provider Outreach and Education Advisory Group.

In her free time, Amy enjoys spending time with her two grandchildren, Riley and Madison.

Donna has been married for 41 years and has 3 children and 4 grandchildren.  Her hobbies include reading, painting, and getting together with good friends.

“I believe in giving excellent quality, professional service in a kind and compassionate manner to all clients. Each person is to be treated with dignity and respect.”

In order to meet this goal, we are constantly reviewing new technologies and treatments. We have been recognized throughout the country for pioneering the use of photodynamic therapy, radiofrequency ablation and mucosal resection for the treatment of Barrett’s esophagus. In many cases, these therapies can eliminate the need for surgical removal of the esophagus.

We have also been among the first to test the Given capsule, a swallowable “pill” providing video pictures of the small intestine to help visualize and detect disorders of the gastrointestinal tract.

Leading the way in gastrointestinal research and development is not new to GIA. We have long been on the cutting-edge of developing ways to improve patient care. Our work in outpatient endoscopy led to the development of the first licensed and certified endoscopic ambulatory surgery center in the U.S.

In order to help advance the body of knowledge in gastroenterology throughout our industry, we constantly share our techniques and results with our fellow GI practices. We publish our findings in peer-reviewed journal articles. And we have been one of the co-founders of GI Roundtable, a national two-day conference bringing together more than 250 of the nation’s top gastroenterologists and practice managers to share information on improving health care and strengthening quality measures.

Measuring performance to advance quality care is gaining national attention and again we are setting the standard. Our quality assurance programs provide measurable outcomes that allow us to continually track our performance quality to ensure we are providing the best patient care possible. We consistently rate excellent and our performance measures far exceed the national average.

You can rest assured you will be well cared for by nationally recognized team and caring staff. Through research, technology and quality patient care we are setting the standard in gastrointestinal health care at Gastrointestinal Associates.

About the author:

Dr. Bergein “Gene” Overholt, co-founder and president of Gastrointestinal Associates, is a nationally recognized gastroenterologist who developed the flexible fiberoptic sigmoidoscope and colonoscope. Overholt’s work on the fiberoptic sigmoidoscope earned him the prestigious Schindler Award from the American Society for Gastrointestinal Endoscopy.

Vitamin D deficiencies have been linked to an increased risk of inflammatory bowel disease. Inflammatory bowel disease is a name given to a group of chronic digestive diseases of the small and large intestines, including colitis, proctitis, enteritis and ileitis. Typically, doctors divide IBD into two groups: ulcerative colitis and Crohn’s disease.

Ulcerative colitis causes ulcers and inflammation of the lining of the colon (large intestine). It almost always involves the rectum and usually causes a bloody diarrhea.

Crohn’s disease is an inflammation that extends into the deeper layers of the intestinal wall. In about 30 percent of cases the disease is limited to one or more segments of the small intestine, usually the ileum (ileitis); about 50 percent of the time it involves both the ileum and the colon (ileocolitis); and 20 percent of the time it is confined to the colon (Crohn’s colitis). Inflammation may also affect the mouth, esophagus, stomach, duodenum, appendix or anus.

Ulcerative colitis and Crohn’s disease are chronic conditions that may recur over a lifetime. Many people have long periods – sometimes years – when they are symptom-free. Unfortunately, doctors cannot predict with certainty when the disease will go into remission or when the symptoms will return.

There is good news for southerners, however.

In the study, a group of Boston researchers followed nearly 120,000 female nurses over a 20-year period. At the study’s inception none of the participants had inflammatory bowel disease. Over the course of the study, 284 participants developed Crohn’s disease and 332 developed ulcerative colitis.

Women who lived in southern latitudes at age 30 were about 50 percent less likely to have Crohn’s disease and about one-third less likely to have ulcerative colitis than those who lived in the north. Those born in the South or living in the South at age 15 also fared better, but the findings for that group were not as significant. Sunanda Kane, MD, a gastroenterologist with the Mayo Clinic in Rochester, Minn., said there is no reason to believe the findings would not also apply to men.

Researchers are working to determine cause and effect, and studies are underway to look at whether or not vitamin D supplements will help relieve symptoms of Crohn’s disease. In the meantime, southern women can bask in the knowledge that they have a reduced risk of inflammatory bowel disease.

Is it gallstone disease?

Most gallstones remain confined to the gallbladder and do not produce symptoms. But if you are experiencing unusual abdominal pain, it could indicate gallstone disease. The most typical symptom of the condition is a severe steady pain – lasting from 15 minutes to several hours – in the upper abdomen or right side, and sometimes between the shoulder blades or the right shoulder. Patients may also experience vomiting or sweating. Attacks of gallstone pain may be separated by weeks, months or even years.

Why does it hurt?

It is thought that gallstone pain results from blockage of the gallbladder duct (cystic duct) by a stone. When the blockage lasts more than several hours, the gallbladder may become inflamed. This condition, called acute cholecystitis, may lead to fever, prolonged pain and eventually infection of the gallbladder. Hospitalization is usually necessary for observation, treatment with antibiotics and pain medications, and frequently for surgery.

Is gallstone disease dangerous?

More serious conditions may occur when a gallstone passes out of the gallbladder duct and into the main bile duct. If the stone lodges in the main bile duct, it can lead to a serious bile duct infection. If it passes down the bile duct, it can cause an inflammation of the pancreas, which has a common drainage channel with the bile duct. Either situation can be extremely dangerous. Stones in the bile duct usually cause pain, fever, and jaundice (yellow discoloration of the eyes and skin). Patients with these symptoms should immediately seek treatment.

How do I treat gallstone disease?

Many new approaches to symptomatic gallstone treatment have been tried over the past several years, but surgical removal of the gallbladder (cholecystectomy) remains the most widely used therapy.

Laparoscopic cholecystectomy, used for about 80 percent of all cholecystectomies in the United States, is a technique whereby the surgeon makes several one inch incisions in the abdomen through which a tiny video camera and surgical instruments are passed. Because the abdominal muscles are not cut, patients experience less postoperative pain, quicker healing and better cosmetic results. Patients are typically able to go home from the hospital within a day and resume normal activities within a few days.

When laparoscopic cholecystectomy is not an option because of complications such as a severely inflamed gallbladder, the surgeon removes the gallbladder through a five- to eight-inch incision. This method, known as the open procedure, has been performed for over 100 years and is quite safe, although it usually requires four or five days of hospitalization and several weeks of at-home recuperation.

Can I manage without a gallbladder?

Patients generally do well after surgery and have no difficulty digesting food, even though the gallbladder’s function is to aid digestion.

If you’re suffering from symptoms of gallstone disease, I encourage you to see your physician for a proper diagnosis. Delayed treatment may cause more serious conditions and the need for open surgery rather than the less invasive laparoscopic procedure.

Janet was born in Knoxville, Tennessee and is a graduate of the University of Tennessee College of Nursing and the Fort Sanders School of Nursing in Knoxville. As a registered nurse, she practiced gastroenterology nursing for more than six years at Fort Sanders Regional Medical Center before completing her master’s degree training and certification as a family nurse practitioner.

She is also certified in gastroenterology and serves on the board of the Tennessee Society of Gastroenterology Nurses and Associates. She joined Gastrointestinal Associates in 2000 as its first gastroenterology nurse practitioner.

Most recently, Janet was selected as an adjunct faculty with UT Knoxville College of Nursing.

Her spare time is spent enjoying her twin granddaughters, Abigail and Caitlin.