The Benefits of a High Fiber Diet

A high-fiber diet can provide many health benefits. Firstly, it may help treat chronic constipation and improve the quality of stool. Moreover, a high-fiber diet may also decrease the incidence of colon cancer while also improving markers of fecal inflammation and intestinal symbiosis in parties with Inflammatory Bowel Disease.

The Benefits of a High Fiber Diet
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A consultation with a gastroenterologist will provide more insight into the benefits of a high-fiber diet, specifically how it can benefit you. A study recently compared Kiwi fruit, prunes, and psyllium for the treatment of chronic constipation. The study found that consuming kiwi results in less bloating. Moreover, kiwi offers the greatest improvement in stool quality in comparison to the other options.

The Benefits of a High Fiber Diet
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If you have recently started struggling with constipation then a consultation with a gastroenterologist would be best. A consultation allows for further evaluation of possible causes including colon cancer and other obstructive lessons. In the absence of any findings, a high-fiber diet is usually recommended. Most dietary fiber and fiber supplements result in gas and bloating. According to the previously mentioned study, kiwi appears to be more tolerable. If you’d like to schedule a consultation with an experienced and trusted gastroenterologist, contact Katy Stomach Doctor today.

Options for Obesity Managements


There are multiple treatment options available for managing obesity. This is due to an estimate of 60% of the US population suffering from some degree of obesity. Before exploring options, a baseline assessment of nutritional and medical status should be complete. There is an increased risk of diabetes, hypertension, and cardiovascular disease in patients who suffer from obesity. Other risk factors include an increased risk of liver cancer, colon cancer, and pancreatic cancer.

Before you explore treatment options, you should receive an evaluation by a gastroenterologist. NAFLD (fatty liver) is now the most common cause of end-stage liver disease in the U.S. This disease occurs in the pediatric age group as well as young adults. Since the findings on laboratory evaluations and physical examination are often very subtle. Again, a consultation with a gastroenterologist would be helpful.

Options for Obesity Management
A balanced diet is the first step to overcoming obesity.

Treatment Options & Food Plans

Specific options for the treatment of weight loss include the following: lifestyle modifications, medications, and bariatric surgery. The cornerstone of any treatment regimen is caloric restriction and exercise. Calorie restriction of 1200-15000 calories per day is essential to managing your weight. Most patients who do not lose weight with intake restrictions are underestimating calorie intake.

Food plans are a highly effective method for maintaining and improving weight loss. To ensure your food plan is as effective a possible, you should weigh and measure your food intake. Four ounces of chicken after cooking is about 2 good bites. Although multiple different diets have been promoted, no one diet has been found to be superior. There are no studies that suggest the keto diet is better than the Mediterranean and vice versa.

Whatever diet you chose, it has to be palatable. Since calorie restriction is indefinite, the diet also has to be something reasonably sustainable. In addition to calorie restriction, weekly physical exercise is essential. 150 hours a week of aerobic exercise plus resistance training is just one of many options for physical exercise. It should be noted that exercise alone will not result in significant weight loss. However, it will help maintain weight loss.

Options for Obesity Management
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Managing Obesity with Medication

Several different medications have been FDA approved for weight loss. This includes phentermine, orlistat, naltrexone/bupropion, and liraglutide. The choice of drug therapy is a balance between efficacy, adverse effects, and patients’ other medical problems. Consulting with a nutritionist and gastroenterologist will help determine the best option for you. If 5% or more weight loss doesn’t occur within three months, you should discontinue your medication.

The last option is bariatric surgery. Gastric balloons have become increasingly popular and offer varying success. Gastric balloons can result in obstruction, gastric ulcerations, and abdominal pain. Endoscopic remodeling results in a type of restrictive surgery with varying degrees of success.

With that in mind, bariatric surgery is an option strictly for patients with a BMI greater than 40 or over 35 with medical problems associated with obesity. Two operations are commonly available; the gastric sleeve and the Roux-en-y. The gastric sleeve removes a portion of the stomach, while the Roux-en-y gastric bypass is more invasive with a 12% complication rate. Although there is a higher complication rate, it results in a significantly higher weight loss.

Obesity is a national epidemic affecting all age groups and genders. Aggressive lifestyle medication associated with calorie restriction is the basis of any program. An aggressive approach with a consultation should be considered. Consult with Dr. James Maher today to learn the best option for you.

Famotidine Use in Covid -19 Patients

In an observational study, the use of Famotidine (Pepcid) was associated with a lower incidence of mortality, a lower chance of intubation, and lower inflammatory markers. The reason for this association is unclear. Famotidine inhibits histamine release which is found in most tissue. The release of histamine causes a cascade of other inflammatory cytokines and proteases to be release.

 Famotidine Use in Covid -19 Patients
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Viruses, including COVID, act on cells in the lung to cause histamine release. It is postulated that blocking histamine release, reduces the inflammatory response to this viral infection. It appears that PPIs (Proton pump inhibitors) have the opposite effect. By taking PPIs, you can increase the risk of COVID positivity. However, the increased risk is dose dependant.

You should take the medication once a day as two daily doses could increase the chance of COVID positivity. The PPIs decrease stomach acid secretion. Stomach acid plants an important role in destroying ingested bacteria and viruses. Without gastric acid, patients are at an increased risk for enteric infections including COVID 19. The GI tract is a major conduit for COVID infections invading the small bowel cells which can result in the inflammation of the stomach, small bowel, and colon.

 Famotidine Use in Covid -19 Patients
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PPIs are immensely popular drugs. It seems that everyone takes these medications. However, the medications usually don’t require chronic use. Most GI conditions require three months of treatment then taper off. Due to the rebound hyperacidity, the longer the drug is taken, the more difficult it is to stop. Consultation with a GI specialist will assist in determining the appropriate use of these medications.

Nonalcoholic Liver Disease

Non-alcoholic liver disease (NALD) refers to a range of liver conditions that affect people who consume little to no alcohol. It is characterized by an increase in fat accumulation in the liver without a significant alcohol presence. NALD is associated with Type 2 diabetes, hypertension, and hyperlipidemia.

This disease is present in at least 80% of patients who have a BMI of more than 35. Additionally, it is more common in women who have a waist circumference over 80 cm and in men whose waist circumference is more than 102 cm. Insulin resistance is the central feature of metabolic syndrome. 

Nonalcoholic Liver Disease
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Macrophages in fat produce inflammatory enzymes that break down fat in tissue used predominantly by muscle and other tissue. This inhibits sugar utilization resulting in hyperglycemia, leading to elevated insulin levels. As a result, fatty acid production in the body will further increase.

The over-production of fatty acids leads to elevated triglyceride levels with increased liver fat. This will progressively lead to increased fat in the liver and the development of fibrosis and NASH. 

Fibrosis can lead to worsening liver disease and eventually cirrhosis. Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in this country. The disease is very common in children 12-18 years old and can also affect young adults and pregnant women.

Nonalcoholic Liver Disease
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Studies & Screening Options

In a recent study, the disease was progressive in 23% of children, even those with dietary therapy. Obesity and elevated liver enzymes alone underestimate the presence of NAFLD.  A liver biopsy is accurate but invasive. A Fibro scan, which measures liver stiffness, has limitations but is currently used for screening.

 In the presence of obesity, elevated liver enzymes, or upper abdominal pain, a consultation with a gastroenterologist familiar with this disease is recommended. Multiple drug research trials are currently in progress. If qualified, a referral for a drug trial can easily be done if a patient qualifies. A gastroenterologist can monitor for disease progression and the development of liver cancer.