Gastroenterology

DMC Detroit Receiving Hospital enjoys the services of leading gastroenterologists, who conduct research and use cutting-edge techniques and procedures to bring comfort and quality of life to their patients.

The Gastroenterology Division provides evaluation, treatment and education about digestion problems people experience.

Common reasons people come to us include: difficulty swallowing, unexplained abdominal pain, heartburn and reflux, screening for colon cancer, diarrhea, constipation, weight loss and bleeding with bowel movements. We see patients in clinic and in the hospital.

We use fiberoptic endoscopy to view the esophagus, stomach, small bowel, pancreas, colon, rectum and anus. We are able to take samples, remove polyps, remove cancer, fix hemorrhoids, and stop bleeding inside during an endoscopy. We use video capsule testing to photograph parts of the small intestine not easy to reach. We supervise intravenous nutrition called Total Parenteral Nutrition (TPN).

Our expertise includes gall bladder and liver, because these are digestion organs. We teach colleagues, nurses, medical students, residents, fellows, patients, their families and on request the public about digestion matters.

Our research centers around unanswered questions in digestion. We currently study the role of the terminal ileum in diarrhea, the safety and success of Hepatitis C treatment in African American patients, the role of nutrients in colon cancer to name just a few.

Dr. Elizabeth May is one of the leading physicians in the group. Below are two articles she wrote for the Detroit Receiving magazine, Receiving Seniors.

Dr. Elizabeth May
Geriatric Gastroenterologist

We really do have to talk about this.

Bowel movements. Specifically the lack of them.

Many older women and men have constipation, but it’s overlooked as more pressing issues take the center stage in our lives and in our conversations with our doctors. I see many cases at Detroit Receiving Hospital’s Rosa Parks Geriatric Clinic.

So how do you know if you officially are constipated? You have fewer than three bowel movements a week, you may strain, your stool may be lumpy or hard or you may feel like you haven’t “gone” completely.

Patients can be so self-conscious about bringing this up. When they’re talking with their doctor, they feel like they’ve already taken up enough time and just want to bother us with what seems like a minor problem. But the way you feel overall is affected by having a daily bowel movement. Constipation may be accompanied by indigestion, heart burn and a loss of appetite.

What factors increase your risk for constipation? In this country, people who are over age 65, females, people of color and those with little physical activity have a greater risk.

Some medications, like prescription pain killers and diuretics, cause constipation.

There are a number of very simple ways that you can improve your digestive performance:

Drink six to eight glasses of non-caffeinated fluids -- preferably water – every day
Fill your plate with fiber, such as fruits and vegetables, nuts, whole grains and legumes (beans and lentils)
Movement -- Even just working around the house or walking will help
Be careful with pain medications. Over-the-counter pain medications, like aspirin or ibuprofen, are usually OK, but prescription pain medicines may cause constipation

Constipation can be debilitating and, rarely, can lead to impaction, where stool collects in the colon, or it can be a sign of a bowel obstruction.

While constipation rarely causes cancer, changes in bowel activity may suggest the need for a colonoscopy, which we in the medical community recommends every 10 years for people over the age of 50. Studies show that African Americans, especially men, should begin at the age of 45.

Enjoying the Holiday Feast

The holidays bring so many opportunities for food, friends and family that many seniors suffer their way through the fabulous meals.

The average meal leaves your stomach in about two hours, but a high-fat meal can take four hours or more, because fat takes longer to digest than protein or carbohydrates. This triggers bloating or heartburn, caused by an overfull stomach pushing digestive acids upward into the esophagus. For people with underlying cardiovascular disease, the consequences of a high-fat meal can be even more serious. Fortunately, it's possible to avoid gastrointestinal holiday distress and still enjoy the delights of the season. Here's how.

Divide and conquer.

Shoot for an hour-long break between each course, if possible. Your stomach is like a little balloon, and when you eat too much at one time, it stretches too far and feels uncomfortable. If you give your stomach time to get rid of some of the food, you’ll decrease the likelihood of indigestion and heartburn.

No super sizing!

Focus on enjoying the flavors of all the foods and you may find that you're satisfied, not stuffed, at the end of the meal. You can always go back for more if you're still hungry. Drink lots of water.

New research suggests that dehydration slows your metabolism, causing you to burn calories less efficiently. Another benefit of water: You will feel full more quickly, making it less likely that you'll go back for seconds.

Skip the after-dinner cocktail.

Alcohol is a muscle relaxant, so it also relaxes the sphincter at the bottom of your esophagus, making acid reflux [stomach acid backing up into your esophagus and causing burning in your chest and abdomen] more likely...especially when combined with a larger meal. Opt for a more healthful post-meal beverage, such as tea.

Forego the fizz.

Stay away from carbonated beverages after lunch or dinner. Although sodas can help settle your stomach when you're under the weather, bubbles can make you feel even more bloated when your belly is jam-packed.

Stroll around the block.

Take a moderate-paced walk an hour or two after eating. "Although we don't know the exact mechanism by which it works, walking seems to promote digestion," says Dr. May. “Avoid any intense cardiovascular exercise, high-impact moves, crunches or any stretches that involve bending over at the waist for the day after your feast. These activities can all aggravate heartburn.”

Call in the reinforcements.

Although nothing but time will make that overstuffed stomach feel like its old self again, an over-the-counter antacid, such as Tums, can help relieve the symptoms of heartburn. For a more severe case of reflux, try an acid-blocking drug, such as Pepcid AC.

Stay upright.

Don't lie down or recline in a chair at an angle greater than 45 degrees within four hours of eating; those positions can cause the acid from your stomach to flow backward into your esophagus, causing heartburn.