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Acid Reflux Zero Gravity

Gtgtgt ON HEALTH MATTERS, TELEVISION FOR LIFE, WHEN A TUMMY ACHE BECOMES A LOT WORST IT’S TIME TO CALL A DOCTOR. gtgt IT TOOK ABOUT A YEAR FOR THEM TO FIGURE IT OUT. gtgt A COLLEGE STUDENT COPES WITH CELIAC DISEASE. gtgt CELIAC CAN ACTUALLY KILL SOMEONE. gtgt HOW CHANGING HER DIET MADE A WORLD OF DIFFERENCE. PLUS ANSWERS TO YOUR QUESTIONS ON GASTROINTESTINAL ILLNESSES. RIGHT NOW, ON HEALTH MATTERS. gtgt HEALTH MATTERS IS MADE POSSIBLE BY OUR VIEWERS, THE FRIENDS OF KSPS. AND BY PROVIDENCE HEALTH CARE. gtgt 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. gtgt 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. gtgt 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.

HEALTH MATTERS Tummy Troubles

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. gtgt 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. gtgt 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.

Gtgt 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. gtgt ARE YOU SEEING MORE OF IT gtgt 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. gtgt MMHMM. AND THAT CAN BE SOMETHING LIKE ACID REFLUX WHICH WHAT IS ACID REFLUX gtgt 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. gtgt 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. gtgt 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. gtgt 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 gtgt 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. gtgt TO WORKING WITH YOUR DOCTOR AND DIETITIAN CAN COME INTO PLAY. AND THERE ARE ASOME GREAT OVERTHECOUNTER 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. gtgt ELMEPROZOL OR PROTON PUMP INHIBITORS AND OVER THE COUNTER THEY ARE JUST AS GOOD AGO ANYTHING WE CAN PRESCRIBE. gtgt 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. gtgt 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. gtgt WHICH LEADS US INTO THAT DISCUSSION ABOUT CELIAC DISEASE AND THE OTHER HOT TOPIC BEING GOING ON GLUTENFREE DIETS AND WHAT IS CELIAC DISEASE gtgt 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. gtgt THERE IS A BLOOD TEST NOW gtgt 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. gtgt I WANT TO TALK MORE ABOUT DIET AND CELIAC DISEASE AND GOING GLUTENFREE 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. gtgt HOLLY FRAZIER IS A TYPICAL.

COLLEGE STUDENT, BUT THERE IS ONE COLLEGE STAPLE SHE CAN’T HAVE. gtgt I REALLY MISS PIZZA. gtgt HOLLY HAS CELIAC DISEASE. gtgt IT’S KIND OF LIKE AN ACID FEELING THAT’S ALWAYS THERE, THAT NEVER GOES AWAY FOR ME. gtgt THIS AUTOIMMUNE DISORDER MEANS HOLLY GETS ILL WHEN SHE EATS FOOD WITH GLUTEN FOUND IN WHEAT, BARLEY AND RYE. gtgt IT’S KIND OF LIKE A BOILING FEELING IN MY INTESTINES WHEN I ACTUALLY EATS GLUTEN. gtgt IT ALSO MAKES HER TIRED. AT TIMES, HOLLY CAN BARELY GET OUT OF BED. gtgt IT’S VERY EXHAUSTING ACTUALLY.

AND IT TAKES ABOUT TWO TO THREE DAYS TO GO AWAY. gtgt THOSE DAYS ARE BEHIND HER NOW THAT HOLLY KNOWS WHY SHE GETS SO SICK. gtgt IT BOOK A YEAR BEFORE THEY FIGURED IT OUT. gtgt BUT KEEPING HEALTHY MEANS KEEPING A CLOSE EYE ON WHAT SHE EATS. gtgt IT DEFINITELY MAKES MY LIFE DIFFICULT BECAUSE I’M A COLLEGE STUDENT, AND IT’S EASIER TO BUY TOP RAMEN AND MAC AND CHEESE. gtgt 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. gtgt IT’S NICE. IT MAKES IT EASIER FOR ME TO GO OUT WITH MY FRIENDS. gtgt 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. gtgt 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.

Gtgt 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. gtgt THERE ARE A LOT OF PEOPLE WHO ARE VERY DEBILITATED FROM CELIAC DISEASE IF THEY HAVE NOT BEEN DIAGNOSED OR TREATED. gtgt HOW IMPORTANT IS DIET WHEN IT COMES TO CELIAC gtgt 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. gtgt AS A DIETITIAN, YOU ARE PROBABLY VERY HAPPY TO SEE ALL OF THE PRODUCTS THAT ARE COMING OUT AND THE RESTAURANTS OFFERING THOSE CHOICES gtgt 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 GLUTENFREE DIETS FOR.

WHATEVER REASON. BUT FOR PEOPLE WITH CELIAC DISEASE, IT’S LIKE A MEDICINE FOR THEM. THEY HAVE TO HAVE A GLUTENFREE DIET IN ORDER TO TREAT THEIR DISEASE. gtgt CAN I FEEL BETTER GOING GLUTENFREE IF I DON’T HAVE CELIAC DISEASE OR THE ALLERGY gtgt SOME PEOPLE SAY THEY FEEL BETTER GOING GLUTENFREE, 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 GLUTENFREE 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 GLUTENFREE COOKIE AND CAKE AND THAT’S SOMETHING WE SHOULD EAT IN MODERATION, REGARDLESS OF GLUTEN OR NOT. gtgt I THINK THERE’S A CAUTIONARY TALE HERE, ALTHOUGH IT’S BECOME A LOT EASIER FOR THE CELIAC PATIENT TO FIND GLUTENFREE.

ALTERNATIVES BECAUSE IT BECOME SUCH A TREND, THERE IS A DANGER OF GOING ON A GLUTENFREE 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 GLUTENFREE DIET AND WONDERING IF THEY HAVE CELIAC DISEASE, MAKES IT CHALLENGING. WE HAVE TO ASK THEM TO RETURN TO A GLUTEN CONTAINING DIET gtgt YOU HAVE TO FEEL CRUMMY FOR A WHILE. gtgt EXACTLY. BONE HEALTH, REPRODUCTIVE HEALTH. WE RECOMMEND THAT PEOPLE WHO.

HAVE CELIAC DISEASE, A PROVEN DIAGNOSIS, ALL OF THEIR FIRSTDEGREE 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. gtgt THAT’S INTERESTING. gtgt 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 GLUTENFREE 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 GLUTENFREE AND THAT CAN BE A CHALLENGE FOR FAMILIES. gtgt WE ARE ENCOURAGING YOUR PHONE CALLS AND EMAILS. WE HAVE RYAN CALLING IN FROM SPOKANE THIS EVENING. HELLO, RYAN. gtgt Caller HI, THERE.

Gtgt YOU HAVE A QUESTION FOR OUR PANELISTS gtgt Caller SORRY. I HAVE A 4YEAROLD WITH CEREBRAL PALSY WHO GETS VERY CONSTIPATED AND WE DO DAILY MERILAX AND CHILDREN’S EXLAX. IS THERE ANY TYPE OF REGIMEN THAT WOULD BE BETTER FOR HIM TO BE MORE REGULAR gtgt OKAY. EXCELLENT QUESTION, RYAN. RYAN, ARE YOU STILL THERE gtgt Caller I AM. gtgt WHAT KIND OF DIET DO YOU HAVE YOUR LITTLE GUY ON gtgt YOU KNOW, HE’S EATING NORMAL gtgt WHAT 4YEAROLDS EAT gtgt WELL, YEAH, THEY HAVE THE SAME DINNER WE HAVE AND CHICKEN.

AND RICE, IS WHAT WE ARE EATING RIGHT NOW. gtgt OKAY. gtgt THANK YOU SO MUCH. gtgt YOGURTS, THINGS LIKE THAT. gtgt ALL RIGHT. gtgt THAT’S A TOUGH ONE. gtgt 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. gtgt ARE THERE ANY CONCERNS GETTING HIM ON THAT AND THEN BEING DEPENDENT UPON THAT gtgt NOT WITH FIBER OR MEROLAX. THERE ARE WITH STIMULANT LAXATIVES SUCH AS EXLAX. PEOPLE CAN DEVELOP AN DEPENDENCE.

AND IT CAN WEAKEN YOUR COLON LONG TERM BUT THERE WOULD NOT BE LONGTERM 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. gtgt ALLI. gtgt 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. gtgt WOULD HIS CEREBRAL PALSY HAVE ANYTHING RELATED TO THAT gtgt I’M NOT A PEDIATRIC GASTROENTEROLOGIST, BUT THERE’S SUCH A LARGE AREA OF CEREBRAL PALSY. gtgt 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. gtgt 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 gtgt 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. gtgt LET’S TAKE A PHONE CALL FROM LINDA IN LEWISSTON. gtgt Caller HI, HOW ARE YOU DOING I’M CALLING ABOUT MY 31YEAROLD.

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. gtgt LINDA, BESIDES THE FATIGUE, WHAT OTHER SYMPTOMS DOES SHE HAVE gtgt 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. gtgt WOW! THAT SOUNDS LIKE A CHALLENGING.

CASE. ANY THOUGHTS TOWARDS WHAT LINDA’S DAUGHTER MIGHT BE GOING THROUGH gtgt 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. gtgt SO SHE PROBABLY NEEDS TO SEEK MORE MEDICAL ADVICE gtgt 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. gtgt AND CHANGE YOUR DIET. gtgt SHE MAY WANT TO LOOK INTO THE LOW FOGMAP DIE THAT THE DR. P WAS SPEAKING ABOUT EARLIER. IT’S NOT JUST AVOIDING WHEAT. gtgt WHERE IS A GOOD PLACE FOR HER TO SEEK THAT INFORMATION IS THERE INFORMATION ONLINE gtgt I HAVE SEEN OUT OF STANFORD UNIVERSITY, I BELIEVE A LOT OF.

IT HAS COME FROM AUSTRALIA. gtgt A LOT OF STUDIES FROM AUSTRALIA, THAT’S RIGHT. gtgt WORTH AN INTERNET CHECK ON THAT ONE. gtgt FOR SURE. gtgt LET’S TAKE ANOTHER PHONE CALL. WOLF, YOU HAVE A QUESTION FOR OUR PANEL THIS EVENING gtgt 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 gtgt 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 LACTOSEFREE. WHAT IS THIS LACTOSE INTOLERANCE AND HOW CAN THAT AFFECT MY HEALTH gtgt 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. gtgt 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. gtgt 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. gtgt WE HAVE ANOTHER PHONE CALL, DIANE CALLING FROM SPOKANE. HELLO, DIANE. gtgt 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. gtgt CAN YOU RELATE IT, DIANE TO ANYTHING YOU HAVE EATEN OR A CERTAIN TIME OF OR SOMETHING ELSE THAT MIGHT BE HELPFUL.

INFORMATION gtgt 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. gtgt HMM. AND IT’S A STABBING PAIN THAT HITS YOU OUT OF NOWHERE gtgt YEAH. gtgt Caller AND IT LASTS FOR ABOUT A WEEK. gtgt OH, REALLY.

THAT LONG. IT’S SHOT SHORT TERM. gtgt Caller AND THEN IT JUST GOES AWAY. gtgt OKAY. ANY ADVICE FOR DIANE THIS EVENING gtgt WELL, I GUESS SHE CAN BE HAPPY THAT IT GOES AWAY. gtgt IT DOES GO AWAY. gtgt HOW CONCERNED SHOULD SHE BE TOO, IF IT’S LASTING FOR A WEEK AT A TIME. gtgt 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. gtgt 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. gtgt 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. gtgt LET’S TAKE A PHONE CALL FROM SUSAN IN SPOKANE. gtgt 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. gtgt SHE HAS A REGULAR DIET AND DOESN’T SEEM TO HAVE ANY ASSOCIATED SYMPTOMS WITH THAT gtgt 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. gtgt OKAY. WELL, AGAIN, OUR SYSTEMS ARE DIFFERENT, BUT A WEEK, ONCE A WEEK IS THAT gtgt 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. gtgt IT SOUNDS LIKE HER FRIEND IS MORE TROUBLED BY IT THAN THE PATIENT IS. gtgt IT COULD BE. IT’S A LITTLE CAUSE FOR CONCERN, I GUESS. gtgt 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.

Gtgt 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 WORRISOMETYPE 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. gtgt 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 gtgt 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. gtgt THAT’S AN EXCELLENT DESCRIPTION. DO YOU WANT TO PIGGYBACK ON THAT. gtgt 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. gtgt YOU WILL DISCOVER YOU HAVE AN INTOLERANCE AFTER YOU EAT A CERTAIN GROUP OF FOODS. gtgt 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. gtgt LET’S TAKE ANOTHER PHONE CALL THIS EVENING FROM SHARON. HI, SHARON IN SPOKANE. gtgt Caller HI, HOW IS EVERYONE THERE gtgt WE ARE GREAT. DO YOU HAVE A QUESTION gtgt Caller I DO AND IT’S A TWOPART 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 gtgt 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. gtgt AND SHE WAS CONCERNED THAT IT COULD STOP WORKING AT SOME POINT. IS THAT SOMETHING SHE SHOULD BE WORRIED ABOUT gtgt NO, MIRALAX IS A CHEMICAL THAT MIXES IN WITH THE STOOL. IT’S NOT ABSORBED AND IT KEEPS THE STOOL FROM GETTING HARD. gtgt THE OTHER THING SHE WAS CURIOUS ABOUT, WAS IT HEREDITARY gtgt 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. gtgt 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 gtgt 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. gtgt AND WE SEE THE WARNING LABELS NOW. gtgt 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. gtgt CAN ACID REFLUX, LETTING SOMETHING LIKE THAT GO TOO LONG, LEAD TO AN ULCER.

ARE THEY TWO UNRELATED ISSUES. gtgt 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. gtgt ALL RIGHT.

WE HAVE SUE CALLING FROM NEWPORT. HELLO, SUE. gtgt Caller HI. I HAVE A QUESTION ABOUT IRRITABLE BOWEL SYNDROME, CROHN’S DISEASE AND I’M DIABETIC AND MY GRANDFATHER HAD CANCER THE BOWEL. gtgt YOU ARE CONCERNED THAT THAT COULD BE SOMETHING THAT YOU ARE GOING TO SUFFER WITH TOO gtgt Caller WELL, I THINK I HAVE IRRITABLE BOWEL SYNDROME RIGHT NOW. I AM GOING TO SEE MY DOCTOR NEXT WEEK ABOUT IT. gtgt OKAY. AGAIN, THERE’S SOME CANCER IN THE FAMILY. SHOULD SHE BE CONCERNED CONSIDERING SHE BELIEVES SHE IRRITABLE BOWEL SYNDROME.

Gtgt 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. gtgt 90 TREATABLE AND 95 PREVENTIBLE I THINK I JUST READ THAT SOMEWHERE. IF YOU ARE DIAGNOSED gtgt IF YOU LOOK AT THE DATA A.

CERTAIN WAY, I THINK I THINK YOU COULD SUPPORT THOSE NUMBERS. gtgt 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. gtgt 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 SHORTTERM AND LONGTERM 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 gtgt 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. gtgt 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. gtgt 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 LONGTERM HEALTH CONSEQUENCES FROM THAT. gtgt WE HAVE AL WITH A PHONE CALL THIS EVENING. HELLO, AL. gtgt 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. gtgt 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 gtgt 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. gtgt OKAY. IT’S NOT MOVING THINGS AROUND IT’S NOT SORT OF REPURPOSING YOUR ORGANS OR ANYTHING LIKE THAT WHEN YOU HANG UPSIDE DOWN gtgt 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. gtgt 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 gtgt 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. gtgt DR. FERRIN gtgt 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. gtgt ALL RIGHT.

AND DR. P, SOME FINAL THOUGHTS IN THE NEXT FEW SECONDS. gtgt COLONOSCOPY. IF YOU ARE AGE gtgt ONE WORD. gtgt 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 AFRICANAMERICAN, IT SHOULD BE AGE 45. gtgt 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 COMMUNITYMINDED ENTERPRISES, HE HELPS COORDINATES THE INPERSON ASSISTORS PROGRAM HERE IN SPOKANE. RAY, THANKS SO MUCH FOR BEING HERE. gtgt I’M HAPPY TO BE HERE. gtgt 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 gtgt 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. gtgt SO WHEN THAT DATE COMES AND GOES, YOU WILL BE PENALIZED FOR.

IT IF YOU ARE NOT SIGNED UP gtgt RIGHT. IT WILL BE A TAX PENALTY ON 9 WHEN YOU FILE YOUR TAXES IN THE NEXT DURING THE NEXT YEAR. gtgt WHAT OTHER KIND OF THINGS ARE PEOPLE KIND OF CONFUSED ABOUT OR WHAT KIND OF QUESTIONS ARE THE INPERSON ASSISTORS HEARING RIGHT NOW ABOUT SIGNING UP, THE CONFUSION MAY BE THAT IS APPLIED TO IT gtgt 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. gtgt THAT ANALOGY WAS USED A FEW TIMES. gtgt 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 INPERSON 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. gtgt 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 INPERSON ASSISTORS YOU NEED SOME VITAL INFORMATION THAT IS GOING TO NEED TO BE AVAILABLE SO THAT YOU CAN GET SIGNED UP. gtgt 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.

Gtgt WHAT IS THE BEST WAY TO CONTACT AN INPERSON 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 gtgt 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 4443066. AND WE ALSO HAVE A GREAT PRIMARY PARTNER WITH THE SPOKANE COUNTY.

LIBRARY DISTRICT AND THEY HAVE EIGHT NAVIGATORS ON THEIR STAFF THAT IS 8938400. gtgt 8938400 gtgt 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. gtgt DO YOU ANTICIPATE, RAY, THAT IT WILL GET QUITE BUSY IN THE NEXT WEEK gtgt 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 INPERSON 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. gtgt 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. gtgt 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. gtgt RIGHT, HOWEVER, PEOPLE CAN SIGN UP FOR MEDICAID ALL YEAR ROUND. gtgt THAT’S AN EXCELLENT POINT. gtgt 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. gtgt 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 4443066 OR 18554877686. 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. gtgt 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. gtgt MY NAME IS BETH PEREZ AND I.

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