>>> ON "HEALTH MATTERS,"
TELEVISION FOR LIFE, WHEN A
TUMMY ACHE BECOMES A LOT WORST
IT'S TIME TO CALL A DOCTOR.
>> IT TOOK ABOUT A YEAR FOR THEM
TO FIGURE IT OUT.
>> A COLLEGE STUDENT COPES WITH
CELIAC DISEASE.
>> CELIAC CAN ACTUALLY KILL
SOMEONE.
>> HOW CHANGING HER DIET MADE A
WORLD OF DIFFERENCE.
PLUS ANSWERS TO YOUR QUESTIONS
ON GASTROINTESTINAL ILLNESSES.
RIGHT NOW, ON "HEALTH MATTERS."
>> "HEALTH MATTERS" IS MADE
POSSIBLE BY OUR VIEWERS, THE
FRIENDS OF KSPS.
AND BY PROVIDENCE HEALTH CARE.
>> PROVIDENCE'S MOTTO IS KNOW
ME.
CARE FOR ME.
EASY MY WAY.
AND PROVIDENCE DOES THAT.
I'VE SEEN IT OVER AND OVER
AGAIN.
I'M DR. STEPHEN MURRAY, AND I
CHOSE PROVIDENCE BECAUSE I
BELIEVE IN THE MISSION
STATEMENT.
AND WORKING TOGETHER WITH OTHERS
OF LIKE MIND IS A VERY POWERFUL
WAY TO TAKE CARE OF PATIENTS.
>> MY NAME IS BETH PEREZ, AND I
AM A REGISTERED NURSE.
AND I WORK AT HOLY FAMILY
HOSPITAL ON THE LABOR AND
DELIVERY UNIT.
I'M ABOUT TO HAVE MY SECOND
CHILD, AND I CHOSE PROVIDENCE
BECAUSE I LOVE AND TRUST THE
PEOPLE THAT I WORK WITH, AND WHY
WOULDN'T I SEEK CARE FROM PEOPLE
I LOVE AND TRUST.
♪
>> GOOD EVENING AND THANKS FOR
JOINING US, I'M TERESA LUKENS.
EVERYONE GETS A STOMACH ACHE
FROM TIME TO TIME.
BUT WHEN IS IT A SIGN OF
SOMETHING MORE, THEN YOU NEED TO
SEEK HELP.
DIAGNOSING THE CAUSE OF
ABDOMINAL PAIN CAN BE DIFFICULT,
BECAUSE MANY DISEASES CAN CAUSE
SYMPTOMS IN YOUR GUT.
TONIGHT OUR PANEL DISCUSSES
GASTROINTESTINAL DISORDERS FROM
IRRITABLE BOWEL SYNDROME TO
CELIAC DISEASE, EVEN ACID
REFLUX.
SO LET'S MEET OUR PANEL.
DR. LANCE FERRIN SPECIALIZES IN
DIGESTIVE HEALTH.
HE WORKS AT ROCKWOOD DIGESTIVE
HEALTH CENTER.
DR. HAROLD PREIKSAITIS IS A
GASTROENTEROLOGIST AT KOOTENAI
CLINIC GASTROENTEROLOGY AND
ENDOSCOPY.
ALLI STANTON IS REGISTERED
DIETICIAN AT PROVIDENCE SACRED
HEART MEDICAL CENTER.
AND THANK YOU ALL FOR BEING HERE
THIS EVENING.
IT'S AN IMPORTANT TOPIC.
OR STOMACH AND OUR GUT IS
RELATED TO SO MANY OTHER
DISEASES AND THE WAY OUR BODY
WORKS AND HOW WE FUNCTION AND
OUR OVERALL HEALTH.
LET'S START WITH DR. FERRIN,
AND -- ACTUALLY, I WANT TO START
WITH DR. PREIKSAITIS AND TALK
ABOUT WHEN WE BECOME ALARMED
WHEN THAT STOMACH ACHE MIGHT BE
SOMETHING MORE, WHEN WE BECOME
CONCERNED OR WHAT WE SHOULD BE
PAYING ATTENTION TO.
>> WELL, THANKS, TERESA.
THAT'S AN EXCELLENT QUESTION.
I THINK THE ANSWER WOULD INCLUDE
A CONSIDERATION OF WHAT OUR
PATTERN OF STOMACH HAS BEEN IN
THE PAST.
EVERYONE GETS TUMMY ACHES FROM
TIME TO TIME.
IF YOU HAVE AN EXTRAORDINARY
SYMPTOM ONSET, IF THE DURATION
IS OUT OF WHAT WE USED TO, IF
THE SEVERITY IS MORE EXTREME
THAN WHAT WE ARE ACCUSTOMED TO
OR IF THERE ARE ASSOCIATED
SYMPTOMS SUCH AS NAUSEA,
VOMITING, CERTAINLY DIARRHEA
WITH BLEEDING WOULD BE SYMPTOMS
THAT SHOULD CAUSE ONE TO SUSPECT
THAT THIS IS NOT THE USUAL SORT
OF TUMMY ACHE THAT WILL
DISAPPEAR ON ITS OWN.
>> WE CAN TALK ABOUT EVERYTHING
FROM ACID REFLUX TO MORE SERIOUS
DISEASES SUCH AS CELIAC DISEASE
OR CROHN'S DISEASE.
WHEN I PICK UP THE PHONE AND
CALL MY DOCTOR TO MAKE THAT
APPOINTMENT, DO I WANT TO SEE
YOU AS A SPECIALIST THEN?
DO I GO TO MY G.P. FIRST?
WHERE DO I START THE PROCESS?
>> WELL, IT'S TYPICAL BEFORE
SEEING A GASTROENTEROLOGIST THAT
YOU SEE YOUR G.P. FIRST AND HE
WILL EVALUATE YOUR SYMPTOMS AND
PERHAPS DO SOME PRELIMINARY
TESTS AND REFER YOU TO A
GASTROENTEROLOGIST IF HE'S NOT
ABLE TO ANSWER YOUR PERSONAL
CONCERNS.
THEN WHEN YOU SHOW UP AT THE
GASTROENTEROLOGIST, HE WILL HAVE
SOME BASIC LAB WORK DONE, AND
THAT WILL SPEED UP THE
EVALUATION.
MOST OF THE PATIENTS THAT I SEE
ARE PATIENTS REFERRED
SPECIFICALLY FOR EVALUATION OF
ABDOMINAL PAIN BECAUSE IT'S SUCH
A DIFFICULT THING TO EVALUATE.
THERE ARE LOTS OF ORGANS IN THE
G.I. TRACT AND LOTS OF DISEASES
THAT CAN AFFECT EACH ORGAN AND
TRYING TO -- AND THEY SEEM TO
ALL CAUSE PAIN IN SOME PEOPLE,
AND SO FIGURING OUT EXACTLY WHAT
THE CAUSE IS CAN BE QUITE A
DAUNTING TASK.
BUT IT'S SOMETHING THAT
ESSENTIALLY WE DO FOR A LIVING,
PROBABLY HALF OF MY PATIENTS ARE
REFERRED FOR ABDOMINAL PAIN.
PLEASE FIGURE OUT WHY IT IS.
>> ARE YOU SEEING MORE OF IT?
>> YOU KNOW, I THINK OVER THE
LAST 20 YEARS, WE HAVE BEEN
SEEING MORE OF IT.
WE LIVE IN A VERY FAST PACED
LIFE AND PEOPLE ARE OVERWHELMED,
I THINK, WITH THE THINGS
HAPPENING IN THEIR LIFE AND WITH
ALL THE ADRENALINE IN THEIR
SYMPTOM AND IT SEEMS LIKE THAT
ADRENALINE REALLY TAKES IT OUT
ON THE G.I. TRACT.
AND SO I -- I THINK I DO SEE A
LOT MORE OF IT NOW THAN I
REMEMBER 10 OR 20 YEARS AGO.
>> MM-HMM.
AND THAT CAN BE SOMETHING LIKE
ACID REFLUX WHICH WHAT IS ACID
REFLUX?
>> WELL, ACID REFLUX IS WHAT
MANY PEOPLE UNDERSTAND TO BE
HEARTBURN, BUT FOR A LOT OF
PEOPLE, IT'S NOT JUST HEARTBURN.
IT CAN BE CHEST PAIN.
IT CAN BE MANIFEST AS
DIFFICULTIES SWALLOWING.
IT CAN BE A COUGH THAT WON'T
STOP, SORE THROAT.
THERE'S A WHOLE RANGE OF
SYMPTOMS AND PICKING UP ON THE
POINT THAT WAS JUST MADE, I
THINK ONE OF THE THINGS THAT IS
DRIVING THE INCREASE IN NOT JUST
GASTROINTESTINAL COMPLAINTS BUT
A WHOLE RANGE OF HEALTH PROBLEMS
IS, OF COURSE, THE OBESITY
EPIDEMIC THAT WE ARE SEEING AND
WE CERTAINLY SEE A LOT OF
PATIENTS WHO HAVE SYMPTOMS THAT
ARE RELATED TO THAT REFLUX BEING
ONE OF THEM.
>> ALLI, THAT'S WHERE COME IN AS
A DIETITIAN, A LOT OF THEM,
ESPECIALLY WITH ACID REFLUX, AND
TAKING THE WEIGH OFF AND
CONTROLLING THE DIET CAN REALLY
COME INTO PLAY.
>> ABSOLUTELY.
A LOT OF PEOPLE NEED TO LOSE A
LITTLE BIT OF WEIGH AND THEY
WILL ACTUALLY SEE A HUGE
IMPROVEMENT IN THEIR REFLUX
SIGNS AND SYMPTOMS BUT ALSO JUST
MAINTAINING A HEALTHY WEIGHT
HELPS WITH A WHOLE BUNCH OF
OTHER HEALTH PROBLEMS ACROSS THE
BOARD.
SO IT'S REALLY IMPORTANT THAT
PEOPLE ARE MAINTAINING A HEALTHY
WEIGH.
IT'S JUST PART OF A HEALTHY
LIFESTYLE.
>> WHEN YOU SIT DOWN WITH A
PATIENT WHO IS CONSCIOUSED WITH
SOMETHING LIKE ACID REFLUX, WHAT
ARE SOME OF THE FOODS THAT YOU
LIKE TO SEE THEM START EATING OR
MAYBE ELIMINATE FROM THEIR DIET?
>> THERE ARE SOME COMMON
CULPRITS THAT WE TALK ABOUT,
SPICY FOODS, THAT SEEMS TO BE A
PROBLEM FOR SOME PEOPLE.
CHOCOLATE CAN BE A PROBLEM,
CAFFEINE, CARBONATED BEVERAGES.
THOSE ARE ALL THINGS WE ASK THE
PATIENT ABOUT AND TRY TO FIND
OUT IF THOSE THINGS -- IF THEY
CAN FIGURE OUT IF THAT'S A
TRIGGER FOR THEM.
AS FAR AS THINGS THAT CAN HELP,
SMALLER MEALS, EATING SMALLER,
FOR FREQUENT MEALS CAN SOMETIMES
HELP WITH REFLUX AND
INDIVIDUALIZING WHAT WORKS FOR
YOU.
WE HAVE SOME HANDOUTS AND TOOLS,
BUT WHAT WORKS FOR ONE PERSON
DOESN'T ALWAYS WORK FOR THE NEXT
PERSON.
SO TRYING TO JUST GET THEM ON A
HEALTHY DIET AND APPROPRIATE
WEIGHT AND WORKING WITH THAT
PATIENT INDIVIDUALLY.
>> TO WORKING WITH YOUR DOCTOR
AND DIETITIAN CAN COME INTO
PLAY.
AND THERE ARE ASOME GREAT
OVER-THE-COUNTER PRODUCTS THAT
CAN TREAT AS ACID REFLUX OR
HEARTBURN AS WE KNOW IT.
SOME THINGS THAT USED TO BE
PRESCRIBED THAT ARE NOW OVER THE
COUNTER.
>> ELMEPROZOL OR PROTON PUMP
INHIBITORS AND OVER THE COUNTER
THEY ARE JUST AS GOOD AGO
ANYTHING WE CAN PRESCRIBE.
>> LET'S GO TO IRRITABLE BOWEL
SYNDROME, I.B.S. HAS BEEN A BUZZ
PLAY AND THAT CAN BE ANYTHING
BEING EXTREMELY CONSTIPATED TO
BOUTS OF DIARRHEA.
EXPLAIN WHAT HAPPENS WITH I.B.S.
>> OR ALTERNATING.
THERE ARE SOME PATIENTS, IN
FACT, THE MOST DIFFICULT
PATIENTS TO HELP ARE THE ONES
THAT SOMETIMES WILL GO FROM
BEING CONSTIPATED TO HAVING
SEVERE BOUTS OF DIARRHEA.
I THINK ONE OF THE INTERESTING
THINGS THAT'S COME UP IN THIS
WHOLE AREA IS THE RELATIONSHIP
OF GLUTEN.
WE HAVE ALWAYS KNOWN THAT GLUTEN
WAS THE CULPRIT IN CAUSING
CELIAC DISEASE BUT A LOT OF
PEOPLE ARE NOW FINDING THAT
ELIMINATING CERTAIN TYPES OF
FLOODS FROM THEIR DIET IS
HELPING QUITE A LOT WITH
IRRITABLE BOWEL SYNDROME.
AND ONE OF THE NEW ACRONYMS
THAT'S BEEN PUT FORWARD IS
SOMETHING CALLED FOGMAPS WHICH
STANDS FOR FERMENTABLE DYES.
IT TURNS OUT THAT ELIMINATING
THESE SORTS OF SUGARS FROM YOUR
DIET ARE VERY HELPFUL IN SOME
PEOPLE WITH CELIAC -- SORRY,
WITH IRRITABLE BOWEL SYNDROME,
AND MIGHT BE ONE OF THE THINGS
THAT HAPPENS WHEN YOU ACTUALLY
ELIMINATE GUTEN FROM YOUR DIET.
IS YOU ARE BY THE WAY,
ELIMINATING A LOT OF THESE OTHER
COMPONENTS THAT TRIGGER
SYMPTOMS.
>> WHICH LEADS US INTO THAT
DISCUSSION ABOUT CELIAC DISEASE
AND THE OTHER HOT TOPIC BEING
GOING ON GLUTEN-FREE DIETS AND
WHAT IS CELIAC DISEASE?
>> IT'S A TYPE OF ALLERGIC
REACTION TO A PROTEIN FOUND IN
WHEAT, AND RELATED GRAINS.
IT OCCURS IN ABOUT ONE IN 100
PEOPLE.
IT'S NOT PROBABLY ANY MORE
COMMON NOW THAN IT HAS BEEN 100
YEARS AGO, BUT WE HAVE GOOD
TESTS FOR IT NOW, AND DOCTORS
ARE VERY CLUED INTO TAKING IT,
OR INTO EVALUATING FOR IT,
SIMPLE BLOOD TEST IS REALLY VERY
GOOD.
>> THERE IS A BLOOD TEST NOW?
>> THERE IS A BLOOD TEST.
AND IT'S CALLED TISSUE
TRANSGLUTAMINASE, IT'S 90%
ACCURATE IN SAYING WHETHER YOU
DO OR DO NOT HAVE CELIAC
DISEASE.
THE BEST TEST IS TO GET A LITTLE
SAMPLE OF THE SMALL BOW HEALTH
WE DO WITH ENDOSCOPY, BUT A TTG
IS A GREAT SCREENING TEST.
>> I WANT TO TALK MORE ABOUT
DIET AND CELIAC DISEASE AND
GOING GLUTEN-FREE WITH ALLI.
FIRST, THE
NEXT TIME YOU DINE OUT AT A
RESTAURANT, TAKE A CLOSER LOOK
AT THE MENU.
YOU MIGHT JUST SEE THE WORDS
"GLUTEN FREE."
IT'S AN OPTION THAT IS BECOMING
EASIER TO FIND.
BUT GLUTEN FREE IS MORE THAN A
TREND.
FOR PEOPLE WITH CELIAC DISEASE,
IT MEANS FOOD THAT WON'T MAKE
THEM SICK.
>> HOLLY FRAZIER IS A TYPICAL
COLLEGE STUDENT, BUT THERE IS
ONE COLLEGE STAPLE SHE CAN'T
HAVE.
>> I REALLY MISS PIZZA.
>> HOLLY HAS CELIAC DISEASE.
>> IT'S KIND OF LIKE AN ACID
FEELING THAT'S ALWAYS THERE,
THAT NEVER GOES AWAY FOR ME.
>> THIS AUTOIMMUNE DISORDER
MEANS HOLLY GETS ILL WHEN SHE
EATS FOOD WITH GLUTEN FOUND IN
WHEAT, BARLEY AND RYE.
>> IT'S KIND OF LIKE A BOILING
FEELING IN MY INTESTINES WHEN I
ACTUALLY EATS GLUTEN.
>> IT ALSO MAKES HER TIRED.
AT TIMES, HOLLY CAN BARELY GET
OUT OF BED.
>> IT'S VERY EXHAUSTING ACTUALLY
AND IT TAKES ABOUT TWO TO THREE
DAYS TO GO AWAY.
>> THOSE DAYS ARE BEHIND HER NOW
THAT HOLLY KNOWS WHY SHE GETS SO
SICK.
>> IT BOOK A YEAR BEFORE THEY
FIGURED IT OUT.
>> BUT KEEPING HEALTHY MEANS
KEEPING A CLOSE EYE ON WHAT SHE
EATS.
>> IT DEFINITELY MAKES MY LIFE
DIFFICULT BECAUSE I'M A COLLEGE
STUDENT, AND IT'S EASIER TO BUY
TOP RAMEN AND MAC AND CHEESE.
>> MORE AND MORE PLACES LIKE
SPOKANE'S MAIN MARKET ARE MAKING
IT EASIER FOR HOLLY TO SHOP,
PROVIDING CUSTOMERS WITH A
VARIETY OF GLUTEN FREE OPTIONS.
EVEN RESTAURANTS ARE GETTING
INTO THE GLUTEN FREE GAME.
>> IT'S NICE.
IT MAKES IT EASIER FOR ME TO GO
OUT WITH MY FRIENDS.
>> FOR HOLLY, GOING GLUTEN FREE
WILL ALWAYS BE PART OF HER LIFE.
AND FOR THOSE WHO THINK IT IS A
FAD, SHE HAS THIS TO SAY.
>> IT'S DEFINITELY A REAL
DISEASE, AND IT REALLY BUGS ME
-- IT REALLY BOTHERS ME WHEN
PEOPLE THINK IT'S NOT A BIG
DEAL.
BECAUSE IT IS NOT.
IT'S AN AUTOIMMUNE DISEASE.
IT'S LIKE RHEUMATOID ARTHRITIS.
>> IT SOUNDS LIKE HOLLY HEARS
THAT A LOT.
YOU DON'T REALLY HAVE A DISEASE.
YOU JUST GO GLUTEN FREE.
IT'S THE TREND NOW.
INDEED, IT'S VERY SERIOUS.
>> THERE ARE A LOT OF PEOPLE WHO
ARE VERY DEBILITATED FROM CELIAC
DISEASE IF THEY HAVE NOT BEEN
DIAGNOSED OR TREATED.
>> HOW IMPORTANT IS DIET WHEN IT
COMES TO CELIAC?
>> DIET IS 100% OF THE TREATMENT
WHEN IT COMES TO CELIAC.
IT'S ABSOLUTELY ESSENTIAL THAT
YOU GO GLUTEN FREE.
THAT DOESN'T MEAN CUTTING OUT
WHEAT AND BREAD.
SOY SAUCE, LUNCH MEATS, YOU
REALLY HAVE TO SCRUTINIZE THE
FOOD LABELS.
THERE'S NO CHEAT DAYS WHEN IT
COMES TO BEING GLUTEN FREE.
IF YOU HAVE CELIAC, IT'S 100% OF
THE TIME.
>> AS A DIETITIAN, YOU ARE
PROBABLY VERY HAPPY TO SEE ALL
OF THE PRODUCTS THAT ARE COMING
OUT AND THE RESTAURANTS OFFERING
THOSE CHOICES?
>> ABSOLUTELY.
FOR SOMEONE WITH CELIAC DISEASE,
IT'S A HUGE LIFESTYLE CHANGE AND
IT'S HUGE TO HAVE MORE OPTIONS
AS FAR AS WHEN THEY ARE GOING
OUT AND GROCERY SHOPPING.
A LOT OF PEOPLE IN THE PUBLIC
ARE TRYING GLUTEN-FREE DIETS FOR
WHATEVER REASON.
BUT FOR PEOPLE WITH CELIAC
DISEASE, IT'S LIKE A MEDICINE
FOR THEM.
THEY HAVE TO HAVE A GLUTEN-FREE
DIET IN ORDER TO TREAT THEIR
DISEASE.
>> CAN I FEEL BETTER GOING
GLUTEN-FREE IF I DON'T HAVE
CELIAC DISEASE OR THE ALLERGY?
>> SOME PEOPLE SAY THEY FEEL
BETTER GOING GLUTEN-FREE, AND IF
YOU FEEL BETTER, I SAY OKAY,
THAT'S FINE BUT I ALSO LIKE TO
ASK PEOPLE WHY THEY FEEL BETTER.
WHAT ARE YOU TAKING OUT OF YOUR
DIET THAT IS MAKING YOU FEEL
BETTER?
ARE YOU TAKING OUT COOKIES AND
REFINED CARBOHYDRATES AND
REPLACING THEM WITH FRUITS AND
VEGETABLES?
THAT'S PRETTY MUCH A GIVEN THAT
YOU WILL FEEL BETTER.
AND ALSO NOT EVERY GLUTEN-FREE
PRODUCT IS A HEALTHY
ALTERNATIVE.
A LOT OF THEM ARE LOW IN FIBER,
VITAMINS, MINERALS BECAUSE THEY
ARE NOT MADE WITH WHOLE GRAINS.
IT'S NOT ALWAYS HEALTHY, THEY
MAKE GLUTEN-FREE COOKIE AND CAKE
AND THAT'S SOMETHING WE SHOULD
EAT IN MODERATION, REGARDLESS OF
GLUTEN OR NOT.
>> I THINK THERE'S A CAUTIONARY
TALE HERE, ALTHOUGH IT'S BECOME
A LOT EASIER FOR THE CELIAC
PATIENT TO FIND GLUTEN-FREE
ALTERNATIVES BECAUSE IT BECOME
SUCH A TREND, THERE IS A DANGER
OF GOING ON A GLUTEN-FREE DIET
BECAUSE OF THE IMPLICATIONS THAT
MIGHT HAVE.
I MEAN, IT CAN BE SOCIALLY
ISOLATING, AND IT LIMITS YOUR
OPTIONS EVEN THOUGH WE HAVE A
LOT MORE AVAILABLE.
I THINK IT'S PARTICULARLY
IMPORTANT FOR CHILDREN, FOR
INSTANCE, YOUR -- YOU KNOW, NO
PIZZA FOR YOU.
IT'S REALLY NOT A TRIVIAL CHANGE
TO MAKE IN YOUR DIET, WHICH IS
WHY SOME PEOPLE, WHILE THEY TAKE
OUT GLUTEN MAY ACTUALLY FEEL
BETTER BECAUSE OF SOME OF THE
OTHER THINGS THAT COME OUT WITH
THE GLUTEN.
IT ALSO UNDERSCORES THE
IMPORTANCE OF GETTING AN
ACCURATE DIAGNOSIS AND THAT
DIAGNOSIS IS BETTER MADE IN THE
TRUE CELIAC PATIENT WHILE THERE
THEY ARE STILL GETTING GLUTEN.
SO HAVING PATIENTS TO US WHEN
THEY ARE ON A GLUTEN-FREE DIET
AND WONDERING IF THEY HAVE
CELIAC DISEASE, MAKES IT
CHALLENGING.
WE HAVE TO ASK THEM TO RETURN TO
A GLUTEN CONTAINING DIET --
>> YOU HAVE TO FEEL CRUMMY FOR A
WHILE.
>> EXACTLY.
BONE HEALTH, REPRODUCTIVE
HEALTH.
WE RECOMMEND THAT PEOPLE WHO
HAVE CELIAC DISEASE, A PROVEN
DIAGNOSIS, ALL OF THEIR
FIRST-DEGREE RELATIVES SHOULD BE
SCREENED FOR CELIAC DISEASE AS
WELL.
VERY NOW BECOME A WEAR THAT
THERE'S A LARGE RANGE OF
MANIFESTATIONS OF CELIAC DISEASE
THAT ARE NO LONGER, WE USED TO
THINK OF AS JUST THE YOUNG CHILD
WITH DIARRHEA WHO IS NOT
GROWING.
WE NOW SEE IT THIBLE TIRE AGE
SPECTRUM AND MANIFESTING IN MANY
DIFFERENT WAYS.
>> THAT'S INTERESTING.
>> I WORK PRIMARILY IN
PEDIATRICS.
WE RECOMMEND THAT THE WHOLE
FAMILY GETS TESTED, AS YOU WERE
SAYING BUT WE ALSO DO RECOMMEND
THAT THE HOUSEHOLD STAY
GLUTEN-FREE FOR PEOPLE THAT HAVE
CHILDREN WITH CELIAC DISEASE
BECAUSE YOU DON'T KNOW WHAT YOUR
KIDS ARE GOING TO GET INTO AND
CROSS CONTAMINATION IN THE HOME
CAN BE A CONCERN AS WELL.
SO WE ENCOURAGE PARENTS TO EAT
WHAT YOU CHOOSE WHEN YOU ARE
OUTSIDE OF THE HOME WITHOUT YOUR
CHILD BUT MAKE THE HOUSEHOLD
GLUTEN-FREE AND THAT CAN BE A
CHALLENGE FOR FAMILIES.
>> WE ARE ENCOURAGING YOUR PHONE
CALLS AND EMAILS.
WE HAVE RYAN CALLING IN FROM
SPOKANE THIS EVENING.
HELLO, RYAN.
>> Caller: HI, THERE.
>> YOU HAVE A QUESTION FOR OUR
PANELISTS?
>> Caller: SORRY.
I HAVE A 4-YEAR-OLD WITH
CEREBRAL PALSY WHO GETS VERY
CONSTIPATED AND WE DO DAILY
MERILAX AND CHILDREN'S EX-LAX.
IS THERE ANY TYPE OF REGIMEN
THAT WOULD BE BETTER FOR HIM TO
BE MORE REGULAR?
>> OKAY.
EXCELLENT QUESTION, RYAN.
RYAN, ARE YOU STILL THERE?
>> Caller: I AM.
>> WHAT KIND OF DIET DO YOU HAVE
YOUR LITTLE GUY ON?
>> YOU KNOW, HE'S EATING
NORMAL --
>> WHAT 4-YEAR-OLDS EAT?
>> WELL, YEAH, THEY HAVE THE
SAME DINNER WE HAVE AND CHICKEN
AND RICE, IS WHAT WE ARE EATING
RIGHT NOW.
>> OKAY.
>> THANK YOU SO MUCH.
>> YOGURTS, THINGS LIKE THAT.
>> ALL RIGHT.
>> THAT'S A TOUGH ONE.
>> I'M NOT A PEDIATRIC
GASTROENTEROLOGIST, I'M AN ADULT
ONE AND THERE MAY BE A BIG
DIFFERENCE.
I KNOW IN AN ADULT, THE
FUNDAMENTAL PRINCIPLE THAT I
WOULD OFFER TO RYAN IS THAT HIS
CHILD SHOULD HAVE, YOU KNOW,
HIS -- HIS CHILD'S COLON SHOULD
SEE THE SAME THING EVERY DAY.
SO TRY TO GET INTO A REGULAR
ROUTINE.
AND IN MY PATIENTS WITH
CONSTIPATION, FIBER IS THE KEY
COMPONENT.
YOU WANT TO MAKE SURE YOU ARE
GETTING PLENTY OF FIBER, AND IF
IT'S HARD TO GET TO THE STORE,
TAKE A FIBER SUPPLEMENT THAT'S
EASY EVERY DAY.
AND THEN YOU CAN ADD MEROLAX ON
TOP OF THAT, WHICH IS A CHEMICAL
THAT MIXES IN THE STOOL AND
KEEPS IT SOFT.
>> ARE THERE ANY CONCERNS
GETTING HIM ON THAT AND THEN
BEING DEPENDENT UPON THAT?
>> NOT WITH FIBER OR MEROLAX.
THERE ARE WITH STIMULANT
LAXATIVES SUCH AS EX-LAX.
PEOPLE CAN DEVELOP AN DEPENDENCE
AND IT CAN WEAKEN YOUR COLON
LONG TERM BUT THERE WOULD NOT BE
LONG-TERM SIDE EFFECTS WITH THE
MEROLAX OR WITH FIBER.
AND THEN THERE ARE ADDITIONAL --
WE HAVE TWO ADDITIONAL
PRESCRIPTION MEDICATIONS WE CAN
USE.
BUT I DON'T KNOW IF THEY ARE
USED IN CHILDREN OR NOT.
>> ALLI.
>> SOMETHING IN THE PEDS WORLD
THAT WE RECOMMEND ARE FRUITS
THAT ARE HIGH IN SORBITAL,
PRUNES, PEA RS, PEACHES, PLUMS
AND THE ONES WITH THE P.
IT SOFTENS THE STOOL AND IT
MAKES IT EASY FOR THE CHILD TO
PASS THE STOOL.
SOMETIMES THEY HOLD ON AND IT
GETS HARDER AND IT'S MORE
UNCOMFORTABLE AND IT CREATES A
CONTINUAL PROBLEM.
SO IN THE PEDS G.I. CLINICS WE
RECOMMEND THREE TO FIVE SERVINGS
OF THOSE FRUITS.
>> WOULD HIS CEREBRAL PALSY HAVE
ANYTHING RELATED TO THAT?
>> I'M NOT A PEDIATRIC
GASTROENTEROLOGIST, BUT THERE'S
SUCH A LARGE AREA OF CEREBRAL
PALSY.
>> ONE OF THE KEYS TO KEEPING
CONSTIPATION AT ANY AGE IS
HAVING THAT REGULAR PROGRAM, AND
WHAT SOME PEOPLE DO IS THEY ARE
AFRAID OF LAXATIVES BECAUSE THEY
ARE CONCERNED THAT THEY MIGHT BE
HABIT FORMING AND SO ON.
SO THEY WILL WAIT UNTIL THEY ARE
REALLY UNCOMFORTABLE CONSTIPATED
AND THEN DO THE BIG CLEANOUT, SO
TO SPEAK, AND THAT -- IN MAKING
THAT SORT OF A CYCLE IS NOT
PROBABLY A GOOD WAY TO ENJOY
YOUR LIFESTYLE, CERTAINLY.
AND SO I ENCOURAGE MY PATIENTS
TO USE FIBER SUPPLEMENTS,
OSMOTIC SUPPLEMENTS AND USE THE
MORE STIMULANT LAXATIVES.
OKAY, IF YOU HAVEN'T HAD AN
ADEQUATE BOWEL MOVEMENT IN THREE
OR FOUR DAYS, THEN USE THE
RESCUE LAXATIVE BUT THEN RETURN
TO THE REGULAR PROGRAM.
>> HOW IMPORTANT IS IT TO OUR
OVERALL HEALTH TO STAY REGULAR?
TO GO ONCE A DAY?
TWICE A DAY?
HOW OFTEN SHOULD WE BE HAVING A
BOWEL MOVEMENT TO KEEP OUR
OVERALL HEALTH IN CHECK?
>> WELL, PEOPLE VARY A LOT.
AND THE NORMAL RANGE FOR BOWEL
MOVEMENTS IS THREE TIMES A DAY,
TO ONCE EVERY THREE DAYS.
IF YOU ARE GOING OUTSIDE THAT
RANGE, YOU SHOULD BE EVALUATED
TO MAKE SURE THAT NOTHING ELSE
IS GOING ON.
>> LET'S TAKE A PHONE CALL FROM
LINDA IN LEWISSTON.
>> Caller: HI, HOW ARE YOU
DOING?
I'M CALLING ABOUT MY 31-YEAR-OLD
DAUGHTER.
SHE HAS STRUGGLED WITH THE
SYMPTOMS THAT YOU GUYS ARE
DESCRIBING SINCE SHE WAS 18.
SHE TOOK HER GALLBLADDER OUT.
SHE'S BEEN TESTED FOR I.B.S.
SHE'S BEEN TESTED FOR CELIAC
DISEASE.
THEY HAVE DONE EVERYTHING.
SHE IS A MOM OF THREE.
SHE HAS DAYS SHE LITERALLY
CANNOT FUNCTION.
SHE DID THE BLOOD TEST FOR THE
WHEAT, THE GLUCOSE OR WHATEVER.
THEY SAID SHE'S NOT ALLERGIC TO
IT.
THEY PUT HER ON A MEDICATION.
SHE TAKES A HALF A TABLET A DAY
AND SHE CAN'T FUNCTION.
IT PUTS HER INSTANTLY TO SLEEP
BUT SHE CANNOT GET ANY ANSWERS
OF WHAT IS GOING ON WITH HER.
>> LINDA, BESIDES THE FATIGUE,
WHAT OTHER SYMPTOMS DOES SHE
HAVE?
>> THE EXTREME PAIN, THE
BURNING, SEVERE DIARRHEA, TO
WHERE SHE'S PASS OUT.
AND THEN SHE'LL GET CONSTIPATED.
SHE HAS CUT OUT ALL THE SUGARS.
SHE HAS CUT OUT ALL THE WHEAT
PRODUCTS.
NOTHING IS WORKING.
SHE'S HAD THE COLONOSCOPY.
THEY'VE DONE THE -- I DON'T KNOW
WHAT IT IS, THE TEST THEY PUT
THE TUBE DOWN HER THROAT, THEY
HAVE DONE EVERYTHING.
>> WOW!
THAT SOUNDS LIKE A CHALLENGING
CASE.
ANY THOUGHTS TOWARDS WHAT
LINDA'S DAUGHTER MIGHT BE GOING
THROUGH?
>> IT CERTAINLY SOUNDS LIKE A
CHALLENGING CASE AND
UNFORTUNATELY, IT'S NOT THAT
ATYPICAL TO SEE PATIENTS WHO
REALLY OVER TIME DEVELOP VERY
INTRACTABLE AND SEVERE ABDOMINAL
SYMPTOMS.
THERE ARE NO SPECIFIC TESTS TO
DIAGNOSE IRRITABLE BOWEL
SYNDROME.
IT'S A CLINICAL DIAGNOSIS AND I
THINK IN SOME CIRCUMSTANCES,
IT'S REASONABLE TO LOOK FOR
OTHER CONDITIONS THAT MIGHT BE
CAUSING THOSE SYMPTOMS, BUT --
BUT THERE IS NOT A SPECIFIC TEST
THAT WE CAN DO AND SAY THIS IS
IRRITABLE BOWEL SYNDROME.
THE DIAGNOSIS IS BASED ON THE
ABSENCE OF OTHER CONDITIONS AND
PARTICULAR MANIFESTATION,
ABDOMINAL PAIN, DIARRHEA
ALTERNATING WITH CONSTIPATION
SOUNDS LIKE DIFFICULT IRRITABLE
BOWEL SYNDROME.
>> SO SHE PROBABLY NEEDS TO SEEK
MORE MEDICAL ADVICE?
>> WELL, IRRITABLE BOWEL
SYNDROME, EVEN THOUGH SOME
PEOPLE, INCLUDING PHYSICIANS USE
IT AS KIND OF A BASKET TO HOLD
PATIENTS IN, IT CAN REALLY
RUIN'S SOMEBODY LIFE.
THEY TOOK 100 I.B.S. PATIENTS
AND ASKED THEM TO RANK THEIR
LIFE AND THEIR PAIN AND THEY
TOOK 100 PATIENTS WITH
METASTATIC PANCREATIC CANCER AND
THE PEOPLE WITH I.B.S. HAD A
WORSE LIFE AND MORE PAIN THAN
THE PEOPLE WITH PANCREATIC
CANCER.
IT CAN REALLY -- IT CAN REALLY
RUIN YOUR LIFE.
OUR GOAL IS, YOU KNOW, WHEN I
SEE SOMEONE LIKE THIS IN MY
OFFICE, AND IT SOUNDS LIKE SHE
HAS GOOD DOCTORS TAKING CARE OF
HER.
THEY HAVE BEEN VERY THOROUGH BUT
WHEN I SEE SOMEBODY LIKE THIS MY
GOAL IS, MAKE THEIR LIFE MORE
MANAGEABLE.
AND THE WAY I DO THAT IS, YOU
KNOW, MODERATE DIET WITH LOTS OF
FIBER IN IT, A FIBER SUPPLEMENT,
REGULAR EXERCISE IS REALLY KEY.
LIMIT STRESS IN YOUR LIFE TO THE
EXTENT YOU CAN, AND GET PLENTY
OF SLEEP.
AND THAT'S PROBABLY GOING TO BE
9 BEST YOU ARE GO -- THE BEST
YOU ARE GOING TO BE ABLE TO DO.
>> AND CHANGE YOUR DIET.
>> SHE MAY WANT TO LOOK INTO THE
LOW FOGMAP DIE THAT THE DR. P
WAS SPEAKING ABOUT EARLIER.
IT'S NOT JUST AVOIDING WHEAT.
>> WHERE IS A GOOD PLACE FOR HER
TO SEEK THAT INFORMATION?
IS THERE INFORMATION ONLINE?
>> I HAVE SEEN OUT OF STANFORD
UNIVERSITY, I BELIEVE A LOT OF
IT HAS COME FROM AUSTRALIA.
>> A LOT OF STUDIES FROM
AUSTRALIA, THAT'S RIGHT.
>> WORTH AN INTERNET CHECK ON
THAT ONE.
>> FOR SURE.
>> LET'S TAKE ANOTHER PHONE
CALL.
WOLF, YOU HAVE A QUESTION FOR
OUR PANEL THIS EVENING?
>> Caller: YEAH, ACTUALLY, I
JUST WANT TO COMMENT ABOUT THE
SUBJECT OF GLUTEN.
I HAVE A DAUGHTER THAT HAS SOME
SPECIAL NEEDS AND SHE'S ALSO
GLUTEN INTOLERANCE FROM THE TIME
SHE --
>> DID WE LOSE -- OKAY.
ROLF, IF YOU ARE LISTENING,
PLEASE GO AHEAD AND CALL THE
PHONE NUMBER BACK.
WE WILL BE HAPPY TO TAKE YOUR
PHONE CALL TONIGHT AND GET YOUR
QUESTION INTO OUR PANEL.
IN THE MEANTIME, LET'S TALK
ABOUT LACTOSE INTOLERANCE.
THIS FITS IN WITH THE TREND OF
GLUTEN FREE, I GUESS, BUT A FEW
YEARS AGO IT BECAME THE PHRASE
WE WERE HEARING A LOT.
AND THERE WERE MILK AND ALL
KINDS OF DAIRY PRODUCTS THAT
WERE COMING INTO PLAY THAT WERE
LACTOSE-FREE.
WHAT IS THIS LACTOSE INTOLERANCE
AND HOW CAN THAT AFFECT MY
HEALTH?
>> WELL, IT'S ACTUALLY THE SAME
PATH OF PHYSIOLOGY THAT PLAYS
INTO LACTOSE INTOLLersANCE
THAT WE HAVE BEEN TALKING ABOUT.
BASICALLY OUR SMALL INTESTINE IS
THE PART OF OUR GASTROINTESTINAL
TRACT WHERE WE ABSORB A LOT OF
THESE SUGARS AND WHAT WE HAVE
COME TO REALIZE IS THAT OUR
EFFICIENCY IN ABSORBING THESE
VARIOUS SUGARS, INCLUDING
LACTOSE VARIES FROM INDIVIDUAL
TO INDIVIDUAL, AND ALSO VARIES
DEPENDING ON WHAT SUGARS YOU
INGEST AND CERTAIN PEOPLE LOSE
THE ABILITY, AS THEY AGE, TO
DIAGNOSE LACTOSE.
THE LACTOSE, OR ANY POORLY
DIGESTED SUGAR GOES THROUGH TO
THE LARGE INTESTINE, WHICH IS
INHABITED BY BACTERIA, WHICH ARE
THERE AS PART OF OUR NORMAL
PHYSIOLOGY.
AND THOSE BACTERIA FEAST ON THE
LACTOSE, BASICALLY AND TURN IT
INTO GAS AND SMALL PARTICLES
WHICH WE CAUSE OSMOLES AND THAT
CAN RESULT IN FLATULENCE AND
BLOATING, AND SYMPTOMS OF
IRRITABLE BOWEL SYNDROME.
OTHER SUGARS THAT WE BECAME
AWARE OF, FRUCTOSE, THAT'S BEEN
SUPERSEDED BY THE FACT THAT WE
RECOGNIZE A LOT OF THESE THINGS,
HENCE THE FOGMAPS CAN BE
ABSORBED POORLY AND CAN CAUSE
SYMPTOMS IN SOME PATIENTS.
>> WOW, THAT'S SO INTERESTING.
AGAIN, THAT COMES DOWN TO DIET
AND CUTTING OUT A LOT OF DAIRY
PRODUCTS, UNFORTUNATELY, THERE
ARE PRODUCTS ON THE MARKET THAT
YOU CAN SUBSTITUTE WITH.
>> SOME PEOPLE CAN HAVE A SMALL
AMOUNT OF LACTOSE.
SOMETIMES YOU CAN BUILD UP YOUR
TOLERANCE.
AND SOME CAN'T DRINK COWS MILK,
BUT THEY CAN HAVE THE OTHER
DAIRY PRODUCTS AND IT'S BASED ON
A PERSON'S SENSITIVITY.
THERE'S CERTAINLY A LOT OF
ALTERNATIVE PRODUCTS OUT THERE
NOWADAYS.
>> WE HAVE ANOTHER PHONE CALL,
DIANE CALLING FROM SPOKANE.
HELLO, DIANE.
>> Caller: HI, HI.
I FOR THE LAST TWO YEARS, I HAVE
HAD BOUTS OF INTESTINAL PAIN.
IT DOESN'T HAPPEN ALL THE TIME.
JUST EVERY SO OFTEN AND IT
DOUBLES ME UP, BUT I DON'T HAVE
THE DIARRHEA OR CONSTIPATION.
I HAVE NORMAL BOWEL MOVEMENTS
AND I HAVE DONE A LOT OF
RESEARCH ONLINE FOR ALL THE
DIFFERENT INTESTINAL MALDID IS
AND -- MALL DID IS AND I COULD
NOT FIGURE OUT WHY I DIDN'T HAVE
THESE THINGS.
MY DAD HAD COLITIS REAL BAD AND
I REMEMBER AS A KID HE WOULD
SUFFER WITH THAT.
>> CAN YOU RELATE IT, DIANE TO
ANYTHING YOU HAVE EATEN OR A
CERTAIN TIME OF OR SOMETHING
ELSE THAT MIGHT BE HELPFUL
INFORMATION?
>> I PRETTY MUCH -- I'M A PRETTY
NATURAL TYPE OF PERSON AND I
WATCH MY DIET AND I REALLY HAVE
NEVER RELATED TO ANYTHING.
IT JUST HITS ME.
AND -- BUT WHAT I COULD NEVER
FIGURE OUT IS WHY I NEVER HAD
THE -- LIKE THE DIARRHEA OR
CONSTIPATION BECAUSE THAT SEEMS
TO BE THE THING THAT GOES WITH
ALL OF THESE INTESTINAL
PROBLEMS.
>> HMM.
AND IT'S A STABBING PAIN THAT
HITS YOU OUT OF NOWHERE?
>> YEAH.
>> Caller: AND IT LASTS FOR
ABOUT A WEEK.
>> OH, REALLY?
THAT LONG.
IT'S SHOT SHORT TERM.
>> Caller: AND THEN IT JUST GOES
AWAY.
>> OKAY.
ANY ADVICE FOR DIANE THIS
EVENING?
>> WELL, I GUESS SHE CAN BE
HAPPY THAT IT GOES AWAY.
>> IT DOES GO AWAY.
>> HOW CONCERNED SHOULD SHE BE
TOO, IF IT'S LASTING FOR A WEEK
AT A TIME.
>> BUT SHE'S HAD IT FOR TWO
YEARS.
SO IN TERMS OF CONCERN, THIS IS
NOT LIKELY TO BE SOMETHING
THAT'S PROGRESSIVE OR -- I'M
SURE IT'S A BIG NUISANCE FOR
HER, AND -- BUT PROBABLY NOT --
NOT INDICATIVE OF MORE WORRY
UNDERLYING PATHOLOGY.
ONE WOULD HOPE THAT SHE HAD BEEN
CHECKED OUT CAREFULLY BY A
GASTROENTEROLOGIST OR AT LEAST
BY HER INTERNIST, AND I THINK
PART OF WHAT WE ARE SEEING HERE
WITH COMPLAINTS OF THIS TYPE,
IT'S A BIGGER BASKET THAN WHAT
WE WERE TALKING ABOUT.
AND THE BASKET INCLUDES
IRRITABLE BOWEL SYNDROME BUT
FUNCTIONAL GASTROINTESTINAL
DISORDERS WHICH MEANS WE
RECOGNIZE THAT IT'S A PROBLEM
THAT THERE ARE SYMPTOMS
ASSOCIATED PAIN OR WHAT HAVE
YOU, BUT WE CONDITION FIND THE
SPECIFIC PIECE THAT HAS TO BE
REMOVED OR SPECIFIC MEDICINE
THAT HAS TO BE NECESSARILY GIVEN
TO FIND THE CURE FOR THAT.
IT MIGHT JUST BE PART OF NORMAL
PHYSIOLOGICAL FUNCTION THAT'S
PERCEIVED AS BEING PAINFUL BY
SOME PEOPLE FOR SOME REASON.
>> AS I WAS DOING MY RESEARCH
FOR TONIGHT'S TOPIC, I WAS
FINING THINGS LIKE THYROID
DISEASE ASSOCIATED WITH THINGS
THAT CAN BE GOING ON IN YOUR
STOMACH AND ABDOMEN AND ALL OF
THESE DIFFERENT RELATED -- YOU
KNOW, HOW IMPORTANT IT IS TO,
YOU KNOW, FOR OUR GUTS TO BE
HEALTHY.
AND ANOTHER THING I HAVE BEEN
FASCINATED WITH LATELY IS THE
PROBIOTICS.
AND THE FACT THAT WE ARE SEEING
NOW A LOT OF PRODUCTS WITH
PROBIOTICS IN KEEPING OUR GUT
HEALTHY.
ALLI, I EAT YOGURT EVERY DAY, AM
PROBIOTICS, OR DO I
NEED TO BUY A SPECIAL YOGURT.
>> IT'S THE GOOD BACTERIA.
WE WILL GIVE THEM THE GOOD
BACTERIA TO CALM THE DIARRHEA.
YOU PROBABLY DON'T NEED TO GO
OVERDOSING ON THEM, BUT YOU HAVE
A FUNCTION OUT THERE FOR CERTAIN
POPULATIONS.
>> LET'S TAKE A PHONE CALL FROM
SUSAN IN SPOKANE.
>> I HAVE A FRIEND WHO HAS A
BOWEL MOVEMENT MAYBE ONCE A WEEK
AND THIS HAS BEEN GOING ON FOR
YEARS AND THEY HAVE NOT -- NEVER
DIAGNOSED ANYTHING.
>> SHE HAS A REGULAR DIET AND
DOESN'T SEEM TO HAVE ANY
ASSOCIATED SYMPTOMS WITH THAT?
>> NO.
EXERCISES REGULAR.
EATS A GOOD DIET, AND JUST
NEVER, EVER, WANTS TO GO BEFORE
THEN AND THEN IT'S A BIG ONE
THAT IS NOT HEALTHY.
>> OKAY.
WELL, AGAIN, OUR SYSTEMS ARE
DIFFERENT, BUT A WEEK, ONCE A
WEEK IS THAT --
>> THAT'S OUTSIDE THE NORM.
AND, YOU KNOW, I'M GLAD SHE'S
HAD A COLONOSCOPY AT LEAST, AND
HOPEFULLY SHE'S HAD HER THYROID
LOOKED AT.
THERE ARE A COUPLE OF THINGS
THAT I WOULD IMMEDIATELY DO WHEN
SOMEONE CAME INTO MY OFFICE.
>> IT SOUNDS LIKE HER FRIEND IS
MORE TROUBLED BY IT THAN THE
PATIENT IS.
>> IT COULD BE.
IT'S A LITTLE CAUSE FOR CONCERN,
I GUESS.
>> ALL RIGHT, LET'S TOUCH ON A
FEW OTHER THINGS WHEN WE TALK
ABOUT TUMMY TROUBLE.
WE HAVE TALKED ABOUT CELIAC
DISEASE BUT WHAT ABOUT COLITIS
WHICH CAN BE A FAIRLY SERIOUS
CONDITION ALSO.
>> WELL, COLITIS IS A VERY BROAD
TERM.
WHAT IT SPECIFICALLY MEANS IS
INFLAMMATION OF THE COLON AND
THERE ARE MANY THINGS THAT CAN
CAUSE INFLAMMATION OF THE COLON,
ACUTE INFECTION, AND TO MORE
CHRONIC DISORDERS SUCH AS
CROHN'S DISEASE.
WHAT MAKES THE TERM COLITIS MORE
CONFUSING IS IRRITABLE BOWEL
SYNDROME USED TO BE REFERRED TO
AS COLITIS AND IT WAS A TERM
THAT HAS BEEN USED TO DESCRIBE A
LOT OF INTESTINAL DISORDERS.
SO IT'S REALLY A VERY VAGUE
TERM.
SO TO BE MORE PRECISE ABOUT IT,
I MEAN, THE WORRISOME-TYPE OF
COLITIS WOULD BE INFLAMMATORY
BOWEL DISEASE, MAINLY ULCERATIVE
COLITIS AND CROHN'S DISEASE.
INFECTIOUS COLITIS CAN HAPPEN.
THERE'S ANOTHER ONE THAT'S A BIG
CONCERN.
IT WAS A CONCERN IN HOSPITALIZED
PATIENTS BUT WE ARE SEEING MORE
AND MORE OF IT IN THE COMMUNITY.
AND THEN THERE ARE FORMS OF WHAT
WE CALL MICROSCOPIC COLITIS
WHICH CAN RESULT IN DIARRHEA AND
PROBLEMS THAT ARE HELPED BY A
SPECIFIC DIAGNOSIS AND
TREATMENT.
>> ALL RIGHT.
WE HAVE AN EMAIL TO ADDRESS THIS
EVENING, AND THIS PERSON IS
ASKING, PLEASE ADDRESS THE
DIFFERENCE BETWEEN FOOD
INTOLERANCE AND FOOD ALLERGY.
THAT'S AN EXCELLENT QUESTION.
ALLI, YOU WOULD LIKE TO TAKE
THAT?
>> THEY CAN PROBABLY GIVE YOU A
MORE SCIENTIFIC DIAGNOSIS THAN I
CAN.
IF YOU HAVE A FOOD ALLERGY, YOUR
BODY HAS A TRUE REACTION TO THAT
PROTEIN AND IF YOU HAVE A FOOD
ALLERGY, YOU SHOULD HAVE 100%
AVOIDANCE.
WHEREAS A FOOD INTOLERANCE, IT'S
MORE LIKE SIGNS AND SYMPTOMS
MAYBE OF BLOATING, ABDOMINAL
DISTENTION, DISCOMFORT, SUCH AS
WITH THE LACTOSE INTOLERANCE,
BUT YOU CAN DIGEST SOME OF THAT
FOOD.
SO SOME PEOPLE WILL SAY THEY
HAVE LACTOSE INTOLERANCE AND
THEY CAN STILL TOLERATE SOME
SMALL QUANTITIES OF MILK.
BUT IF YOU HAVE A TRUE MILK
ALLERGY, YOU ARE ALLERGIC TO THE
PROTEIN AND YOU COULDN'T
TOLERATE ANY MILK OR CHEESE, OR
DAIRY PRODUCTS AT ALL.
>> THAT'S AN EXCELLENT
DESCRIPTION.
DO YOU WANT TO PIGGYBACK ON
THAT.
>> I AGREE 100%, THAT FOOD
ALLERGIES ARE TRULY DANGEROUS
THINGS.
PEANUT ALLERGY, FOR INSTANCE,
CAN BE LIFE THREATENING AS CAN
OTHER FOOD ALLERGIES.
A FOOD INTOLERANCE, FOR
INSTANCE, LACTOSE INTOLERANCE,
IT MIGHT MAKE YOU MISERABLE BUT
IT'S NOT GOING TO SHORTEN YOUR
LIFE OR CAUSE MAJOR PROBLEMS FOR
YOU.
YOU WILL GET OVER THAT BOUT AND,
YOU KNOW, NEXT TIME YOU WANT TO
TREAT YOURSELF TO ICE CREAM, YOU
WILL PAY THE CONSEQUENCES, BUT
IT'S NOT -- IT DOESN'T HAVE THE
DIRE CONSEQUENCES THAT A TRUE
FOOD AL HER
ALLERGY DOES HAVE.
>> YOU WILL DISCOVER YOU HAVE AN
INTOLERANCE AFTER YOU EAT A
CERTAIN GROUP OF FOODS.
>> THERE'S NOT A LOT OF TESTING
THAT YOU CAN ALWAYS DO BUT FOOD
ALLERGIES YOU CAN DO TESTING FOR
TO SEE IF YOU HAVE A TRUE
ALLERGY.
>> LET'S TAKE ANOTHER PHONE CALL
THIS EVENING FROM SHARON.
HI, SHARON IN SPOKANE.
>> Caller: HI, HOW IS EVERYONE
THERE?
>> WE ARE GREAT.
DO YOU HAVE A QUESTION?
>> Caller: I DO AND IT'S A
TWO-PART QUESTION.
ABOUT TWO AN A HALF YEARS AGO, I
WAS DIAGNOSED WITH PLONIC
INERTIA.
I WANTED TO FIND OUT MORE ABOUT
IT, IS IT DUE TO HEREDITARY
INFLUENCES?
I TAKE MIRALAX EVERY DAY, AND
IT'S WORKING.
I'M WORRIED AT SOME POINT THAT
IT WILL STOP WORKING S. THAT A
PROBLEM?
>> THAT MEANS THAT THE COLON IS
SLOW.
AND THERE CAN BE A NUMBER OF
REASONS FOR THAT.
THERE COULD BE A NEUROLOGIC
CONDITION AND GENERALLY THOSE
PEOPLE HAVE HAD SLOW COLONS
SINCE BIRTH.
THE COLON GENERALLY SLOWS DOWN
AS WE GET OLDER, AND SHE MIGHT
HAVE BEEN BORN WITH A COLON THAT
WAS A LITTLE BIT SLOWER THAN
AVERAGE, AND IT MIGHT BE SLOWING
DOWN MORE SINCE THEN.
HYPOTHYROIDISM CAN CAUSE A SLOW
COLON.
I SUPPOSE PROBABLY THE BIGGEST
CATEGORY JUST IDIOPATHIC SLOW
COLONS.
SHE WILL ALWAYS BE BETTER OFF
WITH MIRALAX THAN WITHOUT IT,
BUT IN 20 YEARS IF HER COLON
SLOWS DOWN MORE, SHE MAY NEED
ADDITIONAL MEDICATIONS TO TAKE
ON TOP OF THAT.
>> AND SHE WAS CONCERNED THAT IT
COULD STOP WORKING AT SOME
POINT.
IS THAT SOMETHING SHE SHOULD BE
WORRIED ABOUT?
>> NO, MIRALAX IS A CHEMICAL
THAT MIXES IN WITH THE STOOL.
IT'S NOT ABSORBED AND IT KEEPS
THE STOOL FROM GETTING HARD.
>> THE OTHER THING SHE WAS
CURIOUS ABOUT, WAS IT
HEREDITARY?
>> THERE ARE SOME TYPES OF
COLONIC INERTIAL THAT ARE
HEREDITARY.
IF THEY DON'T HAVE A BOWEL
MOVEMENT FOR A WEEK, PEOPLE ARE
ALWAYS AWARE OF THAT.
IT MIGHT BE A LITTLE BIT MORE
LIKELY, BUT IT'S THE SORT OF
THING THAT IF THE PROBLEM COMES
UP, DEAL WITH IT THEN.
YOU WOULDN'T HAVE TO DO ANYTHING
PROACTIVELY TO LOOK OUT FOR
THAT.
>> OKAY.
OKAY.
VERY GOOD.
WE TALKED ABOUT A CONTRIBUTOR TO
SOME OF THESE ISSUES BEING
STRESS AND THAT'S WHERE WE ARE
SEEING MORE ULCERS TOO.
WHAT IS AN ULCER AND HOW IS IT
TREATED AND ARE WE SEEING MORE
OF THEM?
>> WELL, I PRESUME WE ARE
TALKING ABOUT PEPTIC ULCER
DISEASE BECAUSE ULCERS CAN OCCUR
ANY PLACE IN THE INTESTINE.
AND ONE OF THE THINGS THAT WE
HAVE LEARNED OVER THE LAST
DECADE OR MORE, IS THAT STRESS
PROBABLY ISN'T SUCH A BIG FACTOR
AS ONE WOULD THINK IN TERMS OF
THE CAUSING ULCERS.
IN FACT, MOST ULCERS ARE CAUSED
BY 9 PRESENCE OF A BACTERIA IN
THE SYMPTOMATIC CALLED HELOB
ATERCO CALORI, IT'S ONE OF THE
MAIN RISK FACTORS FOR GASTRIC
CANCER.
THE OTHER BIG, BIG, CAUSE OF
PEPTIC ULCER DISEASE IS THE USE
OF ASPIRIN, AND NSAID DRUGS, I
BEAU PROFENN.
>> AND WE SEE THE WARNING LABELS
NOW.
>> WE DO.
WE CERTAINLY SEE A LOT OF
PATIENTS WHO COME IN WITH
COMPLICATIONS OF ULCER DISEASE,
ESPECIALLY BLEEDING WHO HAVE
BEEN TAKING NSAID DRUGS.
SOMETIMES TAKING THEM ON TOP OF
OTHER NSAID DRUGS.
FOR INSTANCE, THEY MIGHT BE ON A
PRESCRIBED NSAID AND NOT
KNOWINGLY TAKE ADVIL OR ALEVE IN
ADDITION TO THAT, WHICH REALLY
CAN GET YOU INTO MAJOR TROUBLE
WITH PEPTIC ULCER DISEASE AND
COMPLICATIONS.
>> CAN ACID REFLUX, LETTING
SOMETHING LIKE THAT GO TOO LONG,
LEAD TO AN ULCER?
ARE THEY TWO UNRELATED ISSUES.
>> WELL, THEY ARE REALLY
DIFFERENT DISEASES.
THE ACID COMPONENT IS PART OF
BOTH OF THEM, BUT MOST RELUX
DISEASE, GASTRO REFLUX DISEASE
HAS TO DO WITH THE ACID IN THE
WRONG PLACE.
PEPTIC ACID DISEASE IS THE LOSS
OF THE STOMACH OR DUODENUM TO
PROTECT ITSELF WHICH IT
NATURALLY DOES THAT'S PRESENT
NORMALLY IN OUR G. I. TRACTS.
FORTUNATELY WE HAVE GREAT
MEDICATIONS TO TREAT THESE
THINGS NOW AND ONE OF THE
IMPORTANT THINGS IS AVOIDANCE OF
NSAIDS, ESPECIALLY IF YOU ARE AT
RISK.
>> ALL RIGHT.
WE HAVE SUE CALLING FROM
NEWPORT.
HELLO, SUE.
>> Caller: HI.
I HAVE A QUESTION ABOUT
IRRITABLE BOWEL SYNDROME,
CROHN'S DISEASE AND I'M DIABETIC
AND MY GRANDFATHER HAD CANCER
THE BOWEL.
>> YOU ARE CONCERNED THAT THAT
COULD BE SOMETHING THAT YOU ARE
GOING TO SUFFER WITH TOO?
>> Caller: WELL, I THINK I HAVE
IRRITABLE BOWEL SYNDROME RIGHT
NOW.
I AM GOING TO SEE MY DOCTOR NEXT
WEEK ABOUT IT.
>> OKAY.
AGAIN, THERE'S SOME CANCER IN
THE FAMILY.
SHOULD SHE BE CONCERNED
CONSIDERING SHE BELIEVES SHE
IRRITABLE BOWEL SYNDROME?
>> WELL, I THINK WE ALL NEED TO
BE CONCERNED ABOUT THE HEALTH OF
OUR COLON.
AS A GASTROENTEROLOGIST, I SAVE
MORE LIVES WITH A COLONOSCOPE
THAN I DO ANYTHING ELSE --
EVERYTHING ELSE I DO COMBINED.
AND IT'S, YOU KNOW, COLON CANCER
AWARENESS MONTH.
I WANT TO MAKE THAT KNOWN TO
YOUR VIEWERS.
AND HER ISSUES WOULD BE, YOU
KNOW, TOTALLY CLARIFIED BY A
COLONOSCOPY.
>> 90% TREATABLE AND 95%
PREVENTIBLE?
I THINK I JUST READ THAT
SOMEWHERE.
IF YOU ARE DIAGNOSED?
>> IF YOU LOOK AT THE DATA A
CERTAIN WAY, I THINK -- I THINK
YOU COULD SUPPORT THOSE NUMBERS.
>> OKAY.
VERY GOOD.
SO ANOTHER GOOD THING TO KEEP AN
EYE OUT AND GOOD REMINDER TO GET
OUR COLONOSCOPES THIS MONTH AND
THE MONTH OF MARCH.
>> ALL RIGHT.
WE HAVE AN EMAIL WE WANT TO
ADDRESS.
I HEAR THE BENEFITS AND WARNINGS
OF CLEANSES.
THIS IS A GREAT TOPIC.
WHAT ARE THE DOCTORS'
PROFESSIONAL OPINIONS ON
SHORT-TERM AND LONG-TERM EFFECTS
OF CLEANSES?
ARE THEY SAFE?
THIS IS COMING IN FROM SAM.
THIS IS SOMETHING I WANTED TO
ADDRESS.
SO THANK YOU SO MUCH, SAM.
WE ARE HEARING JUICE CLEANSE.
WE ARE LEARING ANY NUMBER OF
DIFFERENT CLEANSES.
WHAT IS YOUR TAKE?
>> I WISH I KNEW THE ANSWER.
WHAT I CAN TELL YOU IS THAT 9
WHOLE ISSUE OF WHAT WE CALL THE
HUMAN MICROBIOM, WE FIND THEY
ARE IMPORTANT TO KEEP US
HEALTHY, WE ARE STARTING TO
UNDERSTAND HOW THAT WORKS.
WE ARE ALSO STARTING TO
UNDERSTAND THAT NOT ALL
MICROBIOMES ARE EQUAL AND BY
CHANGING A PERSON'S MICRO BIOM,
YOU MAY IMPROVE THEIR HEALTH OR
CHANGE THEIR HEALTH.
I HAVE NOT SEEN A RASH OF
PATIENTS WHO HAVE COME TO SEE ME
WITH PROBLEMS BECAUSE THEY HAVE
BEEN GOING THROUGH CLEANSES, AND
I THINK THERE'S A LOT ABOUT THAT
MANIPULATION OF THE G.I. TRACT
THAT WE DON'T UNDERSTAND YET,
BUT WE SHOULD HAVE MORE
INFORMATION ABOUT IT DOWN THE
ROAD.
BUT I HAVE NOT SEEN ANY MAJOR
PROBLEMS ASSOCIATED WITH THAT IN
MY PRACTICE.
>> AND WE HAVE HEARD ABOUT
PEOPLE DOING CLEANSES FOR ANY
NUMBER OF REASONS TO LOSE WEIGH
OR SOME PEOPLE SAY THAT IT CAN
ACTUALLY REMOVE TOXINS FROM YOUR
SYSTEM, THOSE SORT OF THINGS.
IS THERE ANYTHING TO
SUBSTANTIATE THAT?
I MEAN OBVIOUSLY YOU WILL LOSE
WEIGHT IF YOU ARE JUST DOING A
JUICE CLEANSE FOR A FEW DAYS.
>> I HAVE PEOPLE ASK ME ABOUT
DOING CLEANSES AND IT'S
PRIMARILY FOR WEIGH LOSS.
SOME PEOPLE SAY THEY WANT TO GET
HEALTHIER AND I REMIND THEM THAT
WE HAVE A LIVER AND THAT DOES
NATURALLY CLEANSE OUR BODY AND
FILLER OUT TOXINS.
FOR THE MOST PART, IT'S NOT A
GOOD WAY TO LOSE WEIGHT.
WHAT YOU WILL LOSE IS VERY SHORT
TERM AND AS SOON AS YOU START
EATING A REGULAR DIET AGAIN, YOU
WILL GAIN IT BACK.
SO I DON'T THINK ENCOURAGE THEM
FOR MOST PEOPLE FOR WEIGHT LOSS.
THEY ARE NOT USUALLY
NUTRITIONALLY COMPLETE EITHER
BUT FOR THE NORMAL HEALTHY
PERSON, IF THEY DO ONE FOR TWO
TO THREE DAYS, THEY SHOULDN'T
HAVE ANY LONG-TERM HEALTH
CONSEQUENCES FROM THAT.
>> WE HAVE AL WITH A PHONE CALL
THIS EVENING.
HELLO, AL.
>> Caller: HI, HEY, DON'T LAUGH
AT THE QUESTION.
BUT AS I'M GETTING OLDER, AND I
LOOK BACK AT THE ACTIVITIES OF
YOUNG CHILDREN AND YOUNG ADULTS,
OF SOMER SALTS SOMERSAULTS AND
STANDING ON THEIR HEAD AND
WALKING THEIR ON THEIR HANDS IS
THERE ANYTHING RELATED TO THE
LITTLE KIDS HAVE SOMETHING
THERE.
AS I GET OLDER AND I LOOK AT MY
PEERS, I SEE ALL SORTS OF
INTERNAL PROBLEMS.
AND I'M JUST WONDERING, HEY,
MAYBE THERE SHOULD BE SOME KIND
OF A THERAPY WHERE YOU CAN GO IN
AND HANG UPSIDE DOWN FOR A WHILE
OR WHATEVER.
IF YOU COULD HELP ME WITH THAT
QUESTION, I WOULD APPRECIATE IT.
>> ALL RIGHT, AL.
THANK YOU SO MUCH.
NOTHING OFF THE TABLE TONIGHT,
AL.
THERE ARE ACTUALLY SOME
PRODUCTS, NOW THAT PEOPLE ARE
PURCHASING TO DO THE INVERSION,
TO HANG UPSIDE DOWN.
CAN IT HELP OUR OVERALL HEALTH
OR INTESTINAL --
>> WELL, I CERTAINLY WOULDN'T
RECOMMEND IT FOR ANYONE WHO
SUFFERS FROM GASTROESOPHAGEAL
REFLUX DISEASE BECAUSE THAT WILL
BE A CATASTROPHE.
I THOUGHT WE WERE GOING TO HEAR
ABOUT KIDS BEING MORE ACTIVE TO
IMPROVE THEIR PHYSICAL WELL
BEING AND CUT DOWN ON
PEDIATRIC -- CHILDREN AND THE
OBESITY PROBLEMS, BUT I DON'T
THINK THAT HANGING IN A
PARTICULAR POSITION IS GOING TO
HAVE BENEFICIAL IMPACT ON YOUR
INTESTINE.
>> OKAY.
IT'S NOT MOVING THINGS AROUND?
IT'S NOT SORT OF REPURPOSING
YOUR ORGANS OR ANYTHING LIKE
THAT WHEN YOU HANG UPSIDE DOWN?
>> IT REMANDS ME I HAD A FRIEND
WHO WAS A CARDIOLOGIST WHO
WANTED TO TRY OUT FOR THE SPACE
PROGRAM AND DID TRY OUT FOR IT.
HE WOULD ALWAYS ASK OUR
PROFESSORS IN MEDICAL SCHOOL HOW
A SYSTEM WOULD FUNCTION UNDER
ZERO GRAVITY.
IT ALWAYS THROUGH FOR THE
PROFESSOR TO A LOOP.
I'M NOT AWARE THE ASTRONAUTS
REALLY HAD TO DO ANYTHING
SPECIAL TO TAKE CARE OF THEIR
G.I. TRACT, NOR DID THEY SUFFER
ANY ILL CONSEQUENCES OF IT.
>> SO MAYBE AL IS JUST GOING
THROUGH WHAT WE CALL GO THROUGH
IN THE AGING PROCESS AND HANGING
UPSIDE DOWN MIGHT NOT HELP THAT.
WELL, LET'S GO AROUND AND JUST
GET SOME LAST THOUGHTS ON
KEEPING OUR GUTS HEALTHY AND
OVERALL HEALTH WHEN IT COMES TO
OUR DIGESTIVE SYSTEM.
ALLI, WHAT WOULD YOU RECOMMEND
OVERALL?
>> YOU KNOW, I THINK ONE OF THE
MOST IMPORTANT THINGS THAT
PEOPLE CAN DO FOR THEIR OVERALL
G.I. HEALTH IS PLAIN TAKEN A
HEALTHY WEIGH AND MINIMIZE YOUR
INTAKE OF PROCESSED FOODS.
I THINK PROCESSED FOODS REALLY
FOR THE MOST PART ARE NOT
HEALTHY FOR A LOT OF PEOPLE.
THEY HAVE A LOT OF HIDDEN
INGREDIENTS THEM.
IF YOU EAT MORE FRESH PRODUCE,
DAIRY PRODUCTS WHOLE GRAINS ARE
NATURAL, I THINK MOST OF US
WOULD BE HEALTHIER AND AVOID THE
INNER AISLES OF GROCERY STORE
WHERE ALL THE PROCESSED,
PACKAGED FOODS ARE HIDDEN WITH
ALL THE PROBLEMS THAT THEY COME
WITH.
>> DR. FERRIN?
>> WELL, WHAT I OFTEN TELL MY
PATIENTS IS THAT THE G.I. TRACT
CAN REALLY TAKE A JOKE.
YOU CAN PUT A PEPPERONI PIZZA IN
THE G.I. TRACT AND HANDLE IT
FINE.
9 PART OF YOUR BODY THAT CAN'T
TAKE A JOKE IS YOUR HEART.
SO LIVE A HEART HEALTHY
LIFESTYLE.
DON'T EAT TOO MANY CALORIES.
EAT A BALANCED DIET AND, YOU
KNOW, IF YOU SMOKE STOP SMOKING
BECAUSE YOUR G.I. TRACT WILL DO
FINE.
AND BY AND LARGE, PEOPLE DON'T
DIE OF CONDITIONS OF THE G.I.
TRACT COMPARED TO, YOU KNOW,
BEING HURT BY HEART CONDITIONS.
>> ALL RIGHT.
AND DR. P, SOME FINAL THOUGHTS
IN THE NEXT FEW SECONDS.
>> COLONOSCOPY.
IF YOU ARE AGE --
>> ONE WORD.
>> IF YOU ARE AGE 50, OR MORE,
HAVE A COLONOSCOPY, WHICH YOU
HAVE SYMPTOMS OR NOT, WHETHER
YOU HAVE A FAMILY HISTORY NOT.
IF YOU ARE AN AFRICAN-AMERICAN,
IT SHOULD BE AGE 45.
>> VERY GOOD.
GREAT DISCUSSION THIS EVENING.
I WANT TO THANK YOU ALL FOR
BEING HERE TONIGHT.
OUR THANKS WITH EVERYONE WOULD
CALLED IN WITH THEIR QUESTIONS
AND EMAILED.
WHEN WE COME BACK, AN UPDATE ON
THE AFFORDABLE CARE ACT.
YOU HAVE JUST 12 DAYS LEFT TO
SIGN UP FOR HEALTH INSURANCE
UNDER THE AFFORDABLE CARE ACT.
OPEN ENROLLMENT ENDS ON MARCH
31.
IF YOU WANT COVERAGE, BUT MAYBE
NEED SOME HELP, THERE ARE PEOPLE
LOCALLY WHO CAN HELP YOU.
JOINING ME NOW, WITH MORE IS RAY
WHITE, WITH COMMUNITY-MINDED
ENTERPRISES, HE HELPS
COORDINATES THE IN-PERSON
ASSISTORS PROGRAM HERE IN
SPOKANE.
RAY, THANKS SO MUCH FOR BEING
HERE.
>> I'M HAPPY TO BE HERE.
>> THIS IS A BIG JOB CORD
NAILING ALL THE FOLKS WHO GET ON
THE PHONE OR THE COMPUTER WHO
SIGN UP FOR THE COVERAGE.
IT'S GOING WELL BUT THERE ARE
STILL A LOT OF PEOPLE WITH
QUESTIONS.
WHAT KIND OF THINGS ARE YOU
HEARING AT THIS POINT?
>> ACTUALLY, A LOT OF WHAT WE
ARE HEARING IS A LOT OF PEOPLE
REALLY HAVE NOT REALLY BEEN --
THEY HAVE NOT REALLY RESPONDED
TO THE ADVERTISING RELATED TO
THE ACT, AND I THINK I SAW A
POLL LAST WEEK THAT SOMETHING
LIKE 23% OF ALL AMERICANS ARE
TOTALLY UNAWARE THAT THERE EVEN
IS AN AFFORDABLE CARE ACT.
WHEN YOU ADD THAT TO 509 HIGH
PERCENTAGE OF PEOPLE WHO KIND OF
KNOW WHAT IT IS, BUT DON'T
REALLY KNOW IF THERE'S GOING TO
BE ANY IMPACT TO THEM
PERSONALLY, THEN THERE'S REALLY
A MUCH SMALLER GROUP OF PEOPLE,
I THINK THAT REALLY ARE ON TOP
OF WHAT'S GOING ON AND
UNDERSTAND THAT NOT ONLY
OPPORTUNITIES BUT ALSO
UNDERSTAND THAT THERE ARE SOME
TAX PENALTIES THAT UNFORTUNATELY
MIGHT BE APPLIED TO PEOPLE THAT
DON'T HAVE HEALTH INSURANCE
AFTER MARCH 31st.
>> SO WHEN THAT DATE COMES AND
GOES, YOU WILL BE PENALIZED FOR
IT IF YOU ARE NOT SIGNED UP?
>> RIGHT.
IT WILL BE A TAX PENALTY ON 9 --
WHEN YOU FILE YOUR TAXES IN THE
NEXT -- DURING THE NEXT YEAR.
>> WHAT OTHER KIND OF THINGS ARE
PEOPLE KIND OF CONFUSED ABOUT OR
WHAT KIND OF QUESTIONS ARE THE
IN-PERSON ASSISTORS HEARING
RIGHT NOW ABOUT SIGNING UP, THE
CONFUSION MAY BE THAT IS APPLIED
TO IT?
>> WELL, I THINK PEOPLE HAVE
BEEN REALLY GOOD AT -- ONCE THEY
KNOW WHERE THE WEBSITE, IS AND
ACTUALLY GOING THERE AND TAKING
A LOOK.
I THINK WHEN THE HEALTH BENEFIT
EXCHANGE THAT RUNS WASHINGTON
EASEFUL CHANGE WHEN THEY PUT
TOGETHER THE PROGRAM, I THERE
WAS AN ASSUMPTION NOT ONLY HERE
BUT ALSO NATIONALLY THAT MOST
PEOPLE WOULD BE ABLE TO GO ON TO
THE WEBSITE AND PURCHASE THE
INSURANCE VERY EASILY IF YOU
WERE USED TO GOING TO THE
INTERNET, FOR EXAMPLE, POSSIBLY
BUYING AIRLINE TICKETS, YOU
KNOW, RESERVING HOTEL ROOMS.
>> THAT ANALOGY WAS USED A FEW
TIMES.
>> I'M IN THERE QUITE A BIT AND
IT'S A LITTLE MORE DIFFICULT
THAN THAT.
IT'S, YOU KNOW, SEQUENTIAL.
IT WORKS VERY, VERY WELL, PAGE
TO PAGE TO PAGE, BUT IT BUILDS
ON SOME KIND OF A LOGIC MODEL
THAT FORCES THEM TO ASK
QUESTIONS THAT WOULD REALLY TAKE
PEOPLE BY SURPRISE.
AND IF THEY ANSWER A QUESTION
WRONG, SOMETIMES THIS WILL STOP
THEIR PROCESS AND YOU GET A LOT
OF CALLS FROM PEOPLE WHO
ACTUALLY ENTERED INTO THE
PROCESS AND HAVE BEEN UNABLE TO
GO FURTHER.
AND A LOT OF TIMES THEY WILL
CALL THE CALL CENTER.
THIS' A STATEWIDE CALL CENTER
WHICH HAPPENS TO BE LOCATED IN
SPOKANE, BUT THE TRAFFIC THERE
IS MUCH HIGHER THAN THEY THOUGHT
IT WOULD BE AS WELL.
SO PEOPLE ARE EXPERIENCING
LONGER WAIT TIMES.
THE ADVICE I GIVE PEOPLE IF THEY
ARE REFERRED BY A FRIEND OR IF
THEY CALL ME, OR SEND ME AN
EMAIL, IT'S TO TRY TO FIND SOME
HELP FROM ONE OF THE
ORGANIZATIONS AND THERE ARE IN
SPOKANE.
THERE'S PROBABLY WELL OVER 100,
MAYBE 150 IN SPOKANE COUNTY
ALONE THAT HAVE PEOPLE THAT ARE
IN-PERSON ASSISTORS OR
NAVIGATORS IS ANOTHER WORD FOR
WHAT WE DO.
THEY HAVE SOMEONE THAT CAN SIT
DOWN WITH YOU AND GUIDE YOU
THROUGH THE PROCESS.
>> AND WHAT KIND OF INFORMATION,
AGAIN, DO THEY NEED TO HAVE WHEN
THEY SIT DOWN TO START THE
PROCESS, EVEN IF THEY ARE
WORKING WITH ONE OF THE
IN-PERSON ASSISTORS?
YOU NEED SOME VITAL INFORMATION
THAT IS GOING TO NEED TO BE
AVAILABLE SO THAT YOU CAN GET
SIGNED UP.
>> SURE.
AND THE FIRST THING WE NEED TO
DO WE NEED TO VERIFY THEIR
IDENTITY.
SO WHAT A PERSON WOULD NEED TO
DO IS TO MAKE SURE THEY HAVE
THEIR DRIVER'S LICENSE, MAKE
SURE THEY HAVE -- IF POSSIBLE, A
SOCIAL SECURITY CARD.
I KNOW A LOT OF PEOPLE DON'T
CARRY THEM AROUND, BUT IF AT ALL
POSSIBLE, IT WOULD BE A GOOD
THING TO BRING.
WE RECOMMEND THAT PEOPLE BRING
COPIES OF THEIR LAST YEAR'S
TAXES BECAUSE YOU ARE REQUIRED
TO ESTIMATE YOUR INCOME, AND
ALSO -- AND ALSO TO IDENTIFY ALL
THE HOUSEHOLD MEMBERS BY NOT
ONLY NAME BUT ALSO BY SOCIAL
SECURITY NUMBER, SO THAT'S
TYPICALLY PRETTY CONVENIENTLY
LOCATED ON YOUR TAXES,
ESPECIALLY IF YOU HAVE CHILDREN
AS DEPENDENTS.
WE ASK PEOPLE TO BRING THOSE
KINDS OF THINGS.
THE AFFORDABLE CARE ACT IS
AVAILABLE TO NOT ONLY REGULAR
CITIZENS BUT ALSO PEOPLE WHO ARE
HERE ON A LEGAL BASIS.
IF PEOPLE ARE HERE ON CERTAIN
TYPES OF VISAS, WE MIGHT
RECOMMEND THAT THEY BRING A COPY
OF A VISA.
SOMETIMES THE SYSTEM WILL ASK
YOU TO VERIFY YOUR STATUSES IN A
CERTAIN WAY OF SOCIAL SECURITY
NUMBER, YOU KNOW, A VISA NUMBER
OR SOMETHING LIKE.
LIKETHAT.
SO WE HAVE THE ABILITY TO
ACTUALLY UPLOAD THEM TO THE
SYSTEM AND MAKE THEIR JOURNEY
THROUGH THE PROCESS EASTIER.
>> WHAT IS THE BEST WAY TO
CONTACT AN IN-PERSON ASSISTOR TO
GET THAT HELP, YOU SAY WHEN THEY
COME?
IS THERE A LOCATION THAT THEY
CAN ACTUALLY PHYSICALLY GO TO OR
SET UP AN APPOINTMENT TO GO TO?
>> WELL, THERE ARE MANY.
AS I SAID EARLIER, WE ARE ONE OF
MANY ORGANIZATIONS IN SPOKANE
THAT DO THIS WORK.
I WOULD RECOMMEND THAT THEY
COULD START BY CALLING OUR
ORGANIZATION, AND WE HAVE AN
APPOINTMENT LINE NUMBER.
IT'S 444-3066.
AND WE ALSO HAVE A GREAT PRIMARY
PARTNER WITH THE SPOKANE COUNTY
LIBRARY DISTRICT AND THEY HAVE
EIGHT NAVIGATORS ON THEIR STAFF
THAT IS 893-8400.
>> 893-8400?
>> YES AND YOU CAN GO TO THE
HEALTH PLAN, THE WA
HEALTHPLAN.ORG AND YOU CAN
ACCESS A LIST OF NAVIGATORS NOT
ONLY -- THROUGHOUT THE STATE
ACTUALLY BY NAME AND ZIP CODE,
ORGANIZATION.
>> DO YOU ANTICIPATE, RAY, THAT
IT WILL GET QUITE BUSY IN THE
NEXT WEEK?
>> WELL, ACTUALLY, IT'S BEEN
QUITE BUSY FOR A WHILE.
BECAUSE EVEN THOUGH, AS I STATED
EARLIER, A HIGH PERCENTAGE OF
PEOPLE REALLY DON'T KNOW HOW IT
AFFECTS THEM OR IF IT AFFECTS
THEM.
A LOT OF PEOPLE DO AND WORD OF
MOUTH FROM PEOPLE'S EARLIER
EFFORTS ARE STARTING TO DRIVE
PEOPLE TO NOT ONLY OURSELVES BUT
MOST OF THE MEDICAL CLINICS
HAVE -- IN TOWN HERE HAVE
IN-PERSON ASSISTORS, THE
HOSPITALS DO.
THERE'S AN ORGANIZATION CALLED
BETTER HEALTH TOGETHER, WHICH
ACTUALLY IS 9 -- KIND OF A
CLEARINGHOUSE OF THE OVERALL
ORGANIZATION THAT WE ALL REPORT
TO AND REPORT THROUGH.
THERE'S JUST A NUMBER OF
DIFFERENT PLACES THAT PEOPLE CAN
GO.
SO IT'S NOT A LACK OF RESOURCES.
I THINK -- MAYBE NOT NECESSARILY
BEEN A LACK OF INFORMATION, BUT
SOME PEOPLE JUST HAVEN'T REALLY
LOOKED IN THE RIGHT PLACE TO SEE
THE INFORMATION THAT'S OUT THERE
ABOUT THE RESOURCES THAT ARE
AVAILABLE.
>> AND, OF COURSE, A LOT OF
PEOPLE ANTICIPATING THAT THE
YOUNG ARE NOT SIGNING UP AND MAY
JUST TAKE THE PENALTY AND
PERHAPS WAIT THE NEXT YEAR AND
SEE SORT OF HOW THINGS GO.
IT'S JUST SORT OF HARD TO SAY
WHAT THEY ARE THINKING, THE
YOUNG AND HEALTHY AS THEY ARE
CALLING THEM.
>> RIGHT AND ONE THING I WOULD
SAY TO ANYONE WHO MIGHT BE
LISTENING, IS THAT A LOT OF
PEOPLE ARE ALSO UNAWARE THAT THE
STATE OF WASHINGTON CHOSE TO
EXPAND THEIR MEDICAID PROGRAM.
STATES HAD THE OPTION AND
WASHINGTON CHOSE TO DO THAT.
AND WHAT THAT MEANS IS THAT NOW
YOU CAN ACTUALLY HAVE MUCH MORE
INCOME AND BE ELIGIBLE FOR
ABSOLUTELY FREE HEALTH
INSURANCE.
AND WE WORKED WITH A NUMBER OF
YOUNG PEOPLE, PARTICULARLY
STUDENTS, FOR EXAMPLE, AND THEY
MAY THINK, WELL -- IF THEY DON'T
KNOW ANYTHING ABOUT MEDICAID,
YOU KNOW, NOT TOO LONG AGO, YOU
COULD ONLY MAKE JUST A FEW
HUNDRED DOLLARS A MONTH AND BE
ELIGIBLE FOR MEDICAID.
THEY EXPANDED THAT TO ALMOST
$16,000 A YEAR.
SO A LOT OF MINIMUM AGE WORKERS
AND COLLEGE STUDENTS WORKING
PART TIME COULD BE ELIGIBLE FOR
THE FREE HEALTH INSURANCE AND
IT'S GOOD COVERAGE AND IT IS
HEALTH INSURANCE, AND IT
SATISFIES THE MANDATE.
A LOT OF PEOPLE DON'T KNOW THAT
EITHER.
AND IT'S REALLY SOMETHING THAT'S
BEEN REALLY GOOD IN WASHINGTON
STATE.
I WOULD SAY THAT WASHINGTON
STATE'S EXPERIENCE, FROM WHAT I
HAVE OBSERVED, AS USUAL, IS
ALWAYS, YOU KNOW, RIGHT ON AND
VERY GOOD RELATED TO, YOU KNOW,
HEALTH, BUT ALL SOCIAL SERVICES
IT SEEMS LIKE WASHINGTON IS ON
THE CUTTING SMEENGE VERY GOOD
INFORMATION AND LOTS OF HELP
AVAILABLE.
THE DEADLINE IS MARCH 31st,
OPEN ENROLLMENT WON'T BEGIN
AGAIN UNTIL NOVEMBER OF 2014.
SO THERE'S A GAP IN THERE BEFORE
YOU CAN GO THROUGH OPEN
ENROLLMENT AGAIN.
>> RIGHT, HOWEVER, PEOPLE CAN
SIGN UP FOR MEDICAID ALL YEAR
ROUND.
>> THAT'S AN EXCELLENT POINT.
>> AND ALSO PEOPLE WHO MAY
HAVE -- WHAT THEY ARE CALLING
QUALIFYING EVENTS.
FOR EXAMPLE, IF YOU ALL OF A
SUDDEN BECOME UNEMPLOYED HALFWAY
THROUGH THE YEAR, YOU CAN GO
INTO THE HEALTH PLAN FINDER WITH
THE HELP OF SOMEONE AND ACTUALLY
PURCHASE A PLAN.
>> VERY GOOD.
RAY WHITE THANK YOU SO MUCH.
IF YOU WANT TO SCHEDULE AN
APPOINTMENT WE HAVE TWO NUMBERS
THAT YOU CAN CALL, THEY ARE ON
YOUR SCREEN.
(509) 444-3066 OR
1-(855)-487-7686.
RAY WHITE, THANK YOU SO MUCH FOR
YOUR KNOWLEDGE AND WITH THE
LOOMING DEADLINE COMING UP ON
MARCH 31st.
WE'RE BACK ON APRIL 17TH WHEN
OUR TOPIC WILL BE ALLERGIES.
UNTIL THEN, THANK YOU FOR
WATCHING.
I'M TERESA LUKENS.
GOOD NIGHT.
>> "HEALTH MATTERS" IS MADE
POSSIBLE BY OUR VIEWERS, THE
FRIENDS OF KSPS.
AND BY PROVIDENCE HEALTH CARE.
PROVIDENCE'S MOTTO IS KNOW ME.
CARE FOR ME.
EASY MY WAY.
AND PROVIDENCE DOES THAT I'VE
SEEN IT OVER AND OVER AGAIN.
I'M DR. STEPHEN MURRAY AND I
CHOSE PROVIDENCE BECAUSE I
BELIEVE IN THE MISSION
STATEMENT.
AND WORKING TOGETHER WITH OTHERS
OF LIKE MIND IS A VERY POWERFUL
WAY TO TAKE CARE OF PATIENTS.
>> MY NAME IS BETH PEREZ AND I
AM A REGISTERED NURSE, AND I
WORK AT HOLY FAMILY HOSPITAL ON
THE LABOR AND DELIVERY UNIT.
I'M ABOUT TO HAVE MY SECOND
CHILD, AND I CHOSE PROVIDENCE
BECAUSE I LOVE AND TRUST THE
PEOPLE THAT I WORK WITH, AND WHY
WOULDN'T I SEEK CARE FROM PEOPLE
I LOVE AND TRUST.
CLOSED CAPTION PRODUCTIONS
www.ccproductions.com