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Endoscopic Ultrasound Electronic Medical Records Live a Healthy Lifestyle TDDC takes your health seriously. We do our best to be at the cutting edge of our discipline in technology while bringing you the crème de la crème of physicians to care for your digestive health. TDDC has become a model for other centralized medical organizations Reasons to have your colonoscopy performed by a gastroenterologist How do patients benefit from EMR? How can you stay digestively healthy? A publication from

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TDDC Today is an educational and informativeresource for referring physicians, providers,and other related health care professionals, aswell as the general public. This publication willfocus on providing up-to-date information oninnovative and evolving treatments for gastro-enterology-related disorders and diseases.

The information contained in this publication isnot intended to replace a physician’s profes-sional consultation and assessment. Pleaseconsult your physician on matters related toyour personal health.

Contributing WritersKarrie WelbornChuck Colley

A publication from

Texas Digestive Disease Consultants1420 W. Mockingbird Ln.,#340

Dallas, TX 75247(214) 424-2200

(214) 424-2220 Faxwww.tddctx.com

For additionaloffice locations, visit our web site.

President James J. Weber, MDCFO Allen W. Rubin, MD

Administrator Peggy SeilerVice President Steven Wilkofsky, MDVice President Michael Nunez, MD

Vice President Osvaldo Fajardo, MDVice President S Neil Mehta, MD

Vice President Esmail Elwazir, MDVice President Stephen Lacey, MDVice President German Oliver, MDVice President Waldo Bracy, MD

Opening RemarksWelcome to this, our third issue of TDDC Today!

In this issue you will find a little history on how TDDC came to be;“how” it works, and why it benefits you, our patients. We’ve includedsome informative articles on digestive health issues as well as anarticle on why electronic medical records (EMR) are more than “just”a digital versions of the old paper records.

TDDC takes your health seriously. We do our best to be at the cuttingedge of our discipline in technology while bringing you the crème de

la crème of physicians to care for your digestive health.

TDDC’s staff hopes you will enjoy the information in this issue. Please feel free toshare your comments with us.

Sincerely,James J. Weber, MDPresident

TDDC Today 3

TDDC Today is published by Oser-Bentley Custom Publishers, LLC, adivision of Oser Communications Group, Inc., 1877 N. Kolb Road,Tucson, AZ 85715. Phone (972) 687-9035 or (520) 721-1300, fax(520) 721-6300, www.oser.com. Oser-Bentley Custom Publishers,LLC specializes in creating and publishing custom magazines.Inquiries: Tina Bentley, [email protected]. Editorial comments:Karrie Welborn, [email protected]. Please call or fax for a newsubscription, change of address, or single copy. This publication maynot be reproduced in part or in whole without the express writtenpermission of Oser-Bentley Custom Publishers, LLC. To advertise inan upcoming issue of this publication, please contact us at (972)687-9035 or (520) 721-1300 or visit us on the Web at www.oser-bentley.com. March 2009

Contents Volume 1 • Issue 3

TDDC …A Model for GrowthTDDC has become a model for other centralized medical organizations

Why GastroenterologistsReasons to have your colonoscopyperformed by a gastroenterologist

Electronic Medical RecordsHow do patients benefit from EMR?

Endoscopic UltrasoundWhat is this procedure and how can it help you?

Live a Healthy LifestyleHow can you stay digestively healthy?

4

6

810

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TDDC . . .A Model for GrowthFor fourteen years Texas Digestive DiseaseConsultants (TDDC) has been providingexcellent digestive health care, even as they(without necessarily planning it) became asuccessful model for a centralized medicalorganization. TDDC’s reputation among themedical community is one that has newphysicians champing at the bit to become apart of the organization. To be accepted asone of the TDDC’s physicians is consideredan honor in the medical community. Adynamic rather than static model for bothbusiness practices and medical providers,the organization is strongly founded inforward thinking and prides itself on beingopen to new concepts and new technologies.Perhaps though, what TDDC does best is to

bring together the convenience of a largecorporate structure with the autonomy andindependence of a private practice.

In 1995 the impetus for what evolved intoTDDC included a quest to lower costsand a way to provide common coverage.TDDC has grown from that initialenterprise to one of a multi-center, 17-officeorganization providing top level care topatients and centralized resources for allmedical personnel.

According to founder and President James J.Weber, MD, it all “just happened.” He notesthat since 1995 the organization has tripledin size. Currently there are 44 physicians

across the geography of the Dallas-Ft. WorthMetroplex. What is truly impressive is thatthe growth occurred without any advertisingor attempt to “market” the organization.The offices / centers that joined after theoriginal phase, have all come to TDDC andrequested an opportunity to join.

The model not only works, it continues todraw more physicians and centers into itsfold simply because it is the best of twoworlds—private practice and a larger,centralized organization. There are certainlyother centralized medical organizations inTexas and the country, what makes TDDCunique is that the physicians to not have topay to belong. The organization is more like

A Successful Model for a Centralized Medical Organizationwith James Weber, MD

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an extended family in structure than amany-tiered or rigid corporation.

How Does It Work?Centers are admitted to the TDDC family ofphysicians without the requirement of an on-going financial “partnership” commitmentthat locks them to the organization. Anydoctor or center is able to withdraw from thegroup at any time. Each office is able to createand maintain their own “ambience” andcomfortable way of working while still beingable to access the centralized hub of digitallybased billing, medical records and otherbusiness-focused information. Each officebenefits from the corporate ability tonegotiate lower insurance rates and otherbusiness expenses as well as uniform access tobilling, medical records and other companycommunication processes. The businessaspect is concrete and secure, yet removedfrom the desk of the physician so he or shecan concentrate on the patients. All this inaddition to having access to a histology lab, apharmacy within the organization, and othercomponents of a large medical facility that arenormally too expensive for a small privatepractice to afford.

Equally beneficial across the organization isthe connection to the other physicians.There is a monthly board meeting whererepresentatives from each center meet todiscuss major decision, ideas, and possibleapplicants. Also, any member of the

organization can contact any other memberto discuss new procedures, research, or toconsult with any member regarding apatient. This ability to communicate acrossoffices and centers becomes an intrinsicsupport system for all concerned.

A perfect analogy for the organization is awagon wheel.

Each spoke of the wheel hasspace between it andthe other spokes,while beingconnectedto thebusinessrealityat theinnercircle(thehub)and thecommunityof ideas andknowledge at theouter circle (the rim).

With quality, professionalism, compassion,and dedication working together to createa cohesive functionality (accented byindividual grace and style) the “wheel”that is TDDC, continues its dynamicmovement forward.

Dr. James Weber received a

degree in biomedical science

from Texas A&M University

in 1983. He obtained

his medical degree from

the University of Texas

Southwestern Medical School

in Dallas in 1987. His

internship and residency were

in internal medicine at Parkland Memorial

Hospital. Dr. Weber then completed

his gastroenterology fellowship at

Baylor University Medical Center

in 1992 and is board certified

in Gastroenterology. He

opened his gastroenterology

practice in 1992 at Baylor

Regional Medical Center

at Grapevine where he

has been president of

the medical staff, Chief

of Gastroenterology, and

on the Board of Trustees. He

is the President of Texas

Digestive Disease Consultants

and an active member of

the American Gastroenterology

Association, American College of

Gastroenterology, American Society for

Gastrointestinal Endoscopy, as well as the Texas

and Tarrant County Medical Associations. His

areas of special interest include colorectal cancer

prevention and inflammatory bowel disease.

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Why Gastroenterologists Should Perform ColonoscopyRaj Putcha, MD, Chief of Gastroenterologyat the Medical Center of McKinney, offersthree compelling reasons why it is better forgastroenterologists to perform colonoscopyrather than other specialists.

Training From the time gastroenterologists HiromiShinya, MD and William Wolff, MD

pioneered colonoscopy in the late1960s, there has been on-going researchand technological advancements in thediscipline—not only in the far-sightednessof this medical specialty, but in thetraining and experience of its practitioners.In the course of their specializedtraining, gastroenterologists complete athree-year fellowship. During this

fellowship, which is in part dedicatedto colonoscopy, each doctor typicallycompletes well over 1,000 procedures.While other medical practitioners maybe trained in colonoscopy, they are requiredto learn/perform only 25 colonoscopies.Dr. Putcha believes that to truly learnthe “art” of the colonoscopy, a physicianneeds the full three years of study and

Training, Experience & Educationwith Raj Putcha, MD

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the breadth of experience that thefellowship provides. Through this dedicatedtraining, a patient feels confident thattheir colonoscopy is being performed bythe expert, a gastroenterologist.

“Gastroenterologists,” says Dr. Putcha,“are not just technicians; they are thespecialists trained to treat disorders ofthe gut.”

Experience / Procedure Volume Once beyond the initial years ofstudy, gastroenterologists perform over1,000 colonoscopies each year. Otherpractitioners, including colorectal surgeons,may average only 100. It stands to reasonthat the physician who has a largervolume of cases will have a greater easewith the procedure. Dr. Putcha notesthat “The more procedures you do, thebetter you are. The better you become, thesafer the procedure is.”

Studies back up the doctor’s comments andshow that the volume of procedurescompleted result in better outcomes.For example, a recent Canadian study,published in the January 2009 issue ofthe Annals of Internal Medicine1, foundthat colonoscopy missed almost everycancer in the right side of the colon anda third of cancers in the left side of thecolon. That could be a very scary statement,but what is not delineated in the study,is that approximately 70 percent ofthe procedures cited in the study werenot done by a gastroenterologist. “Agastroenterologist” states Dr. Putcha,“would more successfully have foundthese indications and therefore therewould have been more potential forsaved lives. This is why it’s important tomake sure you find a physician who has awealth of training and experience. The factis, no one does more colonoscopies thana gastroenterologist.”

Ongoing EducationGastroenterologists are continually researchingbetter ways to screen for colon cancer, many ofwhich do not involve undergoing a colonoscopy.They review on-going research and study thelatest techniques for removing polyps andavoiding or resolving possible complications.

Recent studies show that gastroenterologistsare better at finding polyps, removingthem2, and with fewer complications.Recent studies have also indicated thatgastroenterologists are better atfollowing the appropriate guidelinesregarding when your next colonoscopyshould be; that is, they do notunnecessarily perform colonoscopy atinappropriate intervals.

“At the end of the day,” says Dr. Putcha,“remember that your body is yourone automobile for life. Keep it servicedby the best. Visit with a board certifiedgastroenterologist about having yourcolonoscopy.”

Dr. Putcha is Chief of

Gastroenterology at the

Medical Center of

McKinney as well as being

on the Medical Executive

Committee. He obtained

his Bachelor of Science

with University Honors

in Chemical Engineering

from Carnegie Mellon University in 1992,

and his Doctorate of Medicine from the

University of Miami School of Medicine in

Miami, Florida in 1996. He credits his

initial interest in Gastroenterology to his

mentors in medical school. Dr. Putcha’s

internship and residency in Internal

Medicine were completed at the University

of Texas Southwestern Medical Center

at Dallas as was his Fellowship in

Gastroenterology in the Division of

Digestive and Liver Diseases. Dr. Putcha is

Board Certified in both Internal Medicine

and Gastroenterology.

Gastroenterologists invented and havemodified colonoscopy

Gastroenterologists undergo three years offellowship training dedicated to colonoscopy

Gastroenterologists learn “the art” ofcolonoscopy not just the basic procedure.

Gastroenterologists are trained in the theory of how the “gut” works.

Many practicing gastroenterologists average1,000 colonoscopies/year

Other physicians average significantlyless/year

Why Gastroenterologists

Through this dedicated training, a patient feels confident that their colonoscopy is being performed by the expert, a gastroenterologist.

1 Nancy N. Baxter, MD, PhD; Meredith A. Goldwasser, ScD; Lawrence F. Paszat, MD,MS; Refik Saskin, MSc; David R. Urbach, MD, MSc; and Linda Rabeneck, MD, MP;“Association of Colonoscopy and Death From Colorectal Cancer,” 6 Jan. 2009Annals of Internal Medicine (volume 150, pages 1-8) www.annals.org

2 Cynthia Ko MD “Colonoscopy Quality Varies By Physician Specialty” DamianMcnamara “GI and Hepatology News” (volume 3, No. 1, Jan. 2009 pages 1, 4.)

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I'm not a doctor, but I play one at home. Ifsomething doesn’t feel right or “it hurtswhen I do this,” I jump on the Internet todiagnose my real or perceived issue andthen decide on treatment. I’ll wager I’m notunique in this regard and I’m sure themedical profession would, rightfully,caution me about the dangers of incorrector invalid information. We should all beskeptical about any information we find onthe Internet and never self-diagnosis basedon it.

The point of this article is the fact all thisinformation is available in a researchable,

electronic format today, and how we allbenefit from its proper use. The Internetmay provide general diagnostic andtreatment information but it cannot, andmust not ever, allow the web surfer accessto specific patient records.

The traditional medical record, or chart, ispaper based with colored, numbered andtabbed folders containing pages of healthhistory, current health problems, diagnostic,treatment, and other information relatingvisits or encounters with a specific provider.Providers may be an individual doctor,hospital, clinic, or medical group. Each

provider we visit will likely maintain aseparate chart for us, resulting in manycharts located in many places with someportion of the information duplicated in allthose folders. Remember all the forms wefill out with the same information everytime we see a new doctor!

It would be reasonable to expect that ourmedical records be computerized, especiallygiven the many recent advances in dataprocessing and data communicationstechnologies. Like the paper version of themedical record, the electronic chart orEMR, serves the same purpose; a system to

Electronic Medical RecordsPatients Benefit from TDDC’s EMRBy Chuck Colley

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document, share and store informationrelating to a patient’s encounter with theirhealth care provider(s). Encounterinformation entered into the electronicchart may include data relating to visitsfrom routine examinations to majorsurgery, all organized in a manner suitablefor post visit referral and cross-referencingwith other data.

The EMR’s benefit to the doctor may bemore obvious than to the patient but, thepatient is definitely better served when theirprovider(s) employ such systems. We’llexplore some EMR features and benefits inthe following list.

LegibilityI’ve worked with doctors long enough toknow it’s really true; you really can’t readtheir handwriting! Illegible handwriting byclinicians, a common, chronic issue withpaper records, is eliminated in the EMR.Legible notes are a welcome change for anyclinician researching patient information.Medical errors may be greatly reducedsimply by the ability to correctly interpretorders and other information in the EMR.

Accessibility and AvailabilityAnother of the EMR’s benefits is itsaccessibility. Depending on how the systemis designed, it can be accessed fromanywhere, securely, at any time, insideor outside the provider’s facility. Thepatient need not wait for office hours toacquire potentially critical informationfrom their chart.

Chart OrganizationWith the most organized paper based chart,the provider must still perform page-by-page searches for the specific informationthey seek, such as lab or radiology results. Awell designed EMR is organized forintuitive and effortless information retrievalwhich allows targeted, current episoderelated data to stand out, reducing timedelays in diagnosis and treatment.

CommunicationVisits to the doctor for many illnesses result inpatient referrals to other specialists. The refer-ral for a radiological exam, for example, will

typically result in a radiologist’s report of theirfindings along with the images created for theexam. If both the referring doctor and the spe-cialist employ EMR systems, the data couldflow automatically and securely to all partiesconsulting on the illness. I remember walkingmy X-rays back to my doctor (I think this isnow called the sneaker-net) and waiting forthe official report to arrive by mail at his of-fice. The electronic communications not onlysaves time but potentially may save lives aswell, in emergent situations. Continuity of careis another major benefit of EMR electroniccommunication systems. A patient may visit

their doctor and outside specialists multipletimes for the same illness. Accurate, organizedand timely information helps insure there areno gaps or missed opportunities over thecourse of treatment

Information Security and PrivacyThe Health Information Portability andAccessibility Act (HIPAA) mandate

safeguards for the protection of patientmedical information. The EMR, as apassword-protected system, controls accessto patients’ confidential records andprovides several additional protections forthe records. Privacy is further assured withsecurity controls that track access to thepatient’s information.

I’ve named but a few of today’s benefits ofthe EMR with the future promise of evengreater advantages to the patient as moreand more providers embrace thistechnology. Your doctors and staff

understand how to maximize the TDDCEMR system to provide the most benefit toyou, the patient. After all, you’re the reasonwe’re here!

Chuck Colley is the CEO of the 7Sigma Corp.

Chuck assists TDDC with many aspects

of the the TDDC technology infrastructure.

Like the paper version of the medical record, the electronic chart or EMR,serves the same purpose; a system to document, share and store information

relating to a patient’s encounter with their health care provider(s).

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Why… and when… do endoscopy andultrasound go together? To understandthat, it is necessary to understand what eachone is separately.

Endoscopy is a procedure whereby aphysician inserts a long, thin flexible tube(endoscope) into the body via the mouth oranus to further evaluate the GI tract.

Ultrasonography is an ultrasound basedimaging technology that uses high-frequencysound waves to create images of the organs,tissues and structures within the body—liver, gallbladder, pancreas, ovaries, uterusand others.

Since the 1980s the combination of a tinyultrasound camera attached to the tube usedin endoscopic procedures has allowedphysicians to better image the lining of theGI tract (esophagus, stomach, intestine andcolon) and adjacent organs such as thegallbladder, bile duct and pancreas in amanner that creates highly refined images

for the physicians to utilize to determineabnormalities. This procedure is called EUS(Endoscopic Ultrasound).

Endoscopic ultrasound can be used to furtherevaluate growths noted on routine endoscopyor X-rays. EUS allows the physician to getmore detailed images to help define theextent/depth of the abnormality and guidefurther treatment. The procedure also aidsthe evaluation of those patients who haveacute pancreatitis by being able to furtherevaluate the gallbladder and bile duct forstones and debris. Since the pancreas lies nextto the stomach and intestine, EUS providesphysicians much clearer images than otherX-rays to evaluate the texture of the pancreasto evaluate for inflammation, cysts andcancer. It is also possible to perform a fineneedle aspiration with a very tiny needle,which is passed through the endoscopic tube,under ultrasound guidance to obtain a tissuesample. Because EUS is a far less invasiveprocedure to obtain tissue than surgery, it hasbecome a very positive, outpatient technique.

EUS is a wonderful diagnostic tool,allowing physicians to observe, diagnoseand treat in a manner that clarifies causesby eliminating diagnostic questions throughaccurate view of organs and thus allow forthe best possible treatment plans.

Dr. Bhavani Mopartygraduated from Tulane

Medical School. She

completed an Internal

Medicine residency at

Rush Presbyterian/St Luke’s

hospital in Chicago and

a Gastroenterology

fellowship at the

University of Texas Medical Branch in

Galveston. Additionally, she received a year

of formal training in EUS, ERCP and

advanced therapeutic procedures at the

combined Massachusetts General/ Brigham

& Women’s Harvard program. She is board

certified in Gastroenterology.

Endoscopic UltrasoundAnother Dimension to Endoscopywith Bhavani Moparty, MD

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Test your nutrition IQ1. How many fruit and vegetable servings

do you eat a day?■ 0-1

■ 1-3

■ 3-5

■ NoneRecommendation: Nutritionists recommendat least three to five servings each day. Aserving can be a small glass of 100 percentfruit juice or a piece of fruit.

2. Do you follow the food pyramid?■ Yes

■ NoRecommendation: The food pyramid is aperfect guide to maintain a balanced dietand get the daily nutritional allowancesrecommended for optimal health.

3. How often do you eat fast food?■ Once a week

■ Once a month

■ Three to five times a week

■ NeverRecommendation: Aim to eat at fast foodrestaurants as seldom as possible. Fastfood is packed with saturated fat andcholesterol, which can lead to unhealthyweight gain. If you must eat at a fastfood restaurant for convenience, choosegrilled chicken or fish sandwiches, minusthe mayo, or salad with low-fat dressing.

4. Do you shop along the perimeter ofthe grocery store?■ Yes

■ NoRecommendation: The outer areas in agrocery store tend to carry the healthieritems — fresh produce and dairy. Centeraisles are stocked with processed foodsand goods with refined sugars. The moreyou avoid these items, the better you canmanage your weight.

Sources: Webmd.com, Sixwise.com

You arewhatyou eat!A balanced diet

is fuel your body needs

•Beware of dietary supple-ments. Supplements are notregulated or recommendedfor children younger than 18.

•Consider the type offuel being put into yourbody. Proper nutritionand a balanced diet areessential for energy andphysical output.

• Obtain the proper amountof rest after exerting largeamounts of energy. Studiesshow you need approxi-mately eight-and-a-half tomore than nine hours of sleepeach night to rejuvenate thebody, physically and mentally.

The key to nutrition is balance. The body needs a healthy combination of carbohy-drates, protein, and fat to be properly fueled, especially when physically active. Althoughit’s been around a long time, the food pyramid is still helpful in determining what kindsof foods our body needs. Vitamins such as B6, D, iron, calcium, magnesium, zinc, andchromium are essential to a balanced diet.

A balanced diet never goes out of style, and that it is the only proven method forproperly fueling the body. It is recommend to eat five to six meals a day with a propercombination of protein, carbohydrates, and fat.

For athletes, hard-working muscles need protein to replace what’s been depleted. So itis best to eat a well-balanced meal two to three hours before a game or rigorous activity.

For longer events requiring intense physical activity, protein bars, bananas, or energydrinks are effective. And don’t forget, hydration is essential to any workout.

You should know:

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Live a Healthy LifesyleDiet, Exercise & Digestive Healthwith Kimberly Persley, MD

“The three great essentials

to achieve anything worth

while are first, hard work;

second, stick-to-itiveness;

third, common sense.”

–Thomas A. Edison

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If you want to be healthy it is not a bad planto follow the advice of Thomas Alva Edison.Whether the achievement you are workingtowards is the resolution of a health issue,a relationship, or aproject, the samethree things apply:work at it, stick toit, and use yourcommon sense inthe process.

In terms of a healthylifestyle, the quote isparticularly apt. Inour culture, beingable to eat healthyis actually moredifficult than eatingpoorly. With acultural reality thatpromotes fast and/orpackaged foods, anddoes not push past ageneralized inertiaregarding regular exercise, it is nowonder we are a nation of… well,often less than healthy folks. Add to thecultural dysfunction a desire to simplytake a pill in order to ease the symptomsof a problem rather than working todetermine cause, effect, and solution andyou clearly have a world that is ignoring itsbest health interests.

When Dr. Kimberly Persley was asked ifthere was a particular diet and exercise planfor digestive health, her response was no,there is no particular diet nor is there anexercise program created and directedespecially to individuals with digestive

issues. “What you can do, to be digestivelyhealthy,” she said, “is to eat as naturally aspossible; choose an exercise that pleasesyou, and then… keep doing it!” Shesuggested, drink more water, eat plenty ofgood, colorful fruits and vegetables,increase whole grains, avoid soda andcaffeinated beverages—and add an exercise

routine that includes at least thirty minutesa day, five days a week. Sixty minutes ofexercise most days of the week will tomanage body weight. “The actual exercise,”

she added, “should besomething that you findenjoyable. Walking,dancing, biking, hiking,swimming, yoga, ormore involved work-outs —it really doesn’tmatter what it is you doas long as you areenjoying it andexperiencing it at least30 minutes daily, fivedays a week. Movementof the body also aids indigestion. A sluggishlifestyle can lead to asluggish digestivesystem. If,” she adds,“the exercise nourishesyour mind and spirit as

much as it does yourbody, so much the better.”

Dr. Persley offered some guidelinesregarding what to avoid if a healthy life-style with excellent nutrition is desired. Shestated that caffeine intake can beparticularly harmful if one already hasdigestive issues. She added that for manypeople, simply reducing their caffeine intakefrom six or seven cups of coffee (or tea, orsoda) each day to one—or better yet, none,produces a healthier body. Drink morewater and keep the body well hydrated.Going to bed directly after a meal is not thehealthiest plan for our bodies; according toDr. Persley. She suggested that it is healthier

to wait at least several hours between foodintake and going to bed. Increased refluxsymptoms may develop because of food stillleft in the stomach.

To be healthy then, digestively or otherwise,means eating well, sticking to a diet that isas organic (natural) as possible, and most of

all, using your intrinsic common sense whenmaking nutrition choices.

Dr. Kimberly MoniquePersley graduated Magna

Cum Laude from Texas

Wesleyan University in

1989 and received her

medical degree from

the University of Texas

Southwestern Medical

School in 1993. She

continued her studies at the University of

Texas Southwestern Medical School,

completing her internship there and

then serving as Chief Resident for

Internal Medicine. She completed her

gastroenterology Fellowship in 2000, and

went on to further studies with a Present-

Levinson Inflammatory Bowel Disease

Fellowship completed in 2001 at Mount

Sinai Medical Center in New York. Dr.

Persley served as an Assistant Clinical

Professor of Medicine at the University of

Texas Southwestern Medical School. She

is currently on staff at Presbyterian

Hospital, and is board certified in both

Gastroenterology and Internal Medicine.

“What you can do, to be digestively healthy, is to eat as naturally as possible;choose an exercise that pleases you, and then… keep doing it!”

– Dr. Kimberly Monique Persley

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18 TDDC Today

Charles Richardson, MDW. Gregory Hodges, MD

Esmail Elwazir, MDBhavani Moparty, MD

3409 Worth St #700 Sammons TowerDallas, TX 75246

Telephone: 214-820-2266

9101 N Central Expwy #300Dallas, TX 75231

Telephone: 214-820-2266

James Weber, MDTimothy Ritter, MDStephen Lacey, MDJeffrey Smith, MDDavid Spady, MD

David Levitan, MDJody Houston, MD

2020 W State Hwy 114 #300Grapevine, Texas 76051

Telephone: 817-424-1525

601 S. Main StKeller, TX 76248

Telephone: 817-741-4347

Steven Katzman, MDSteven Wilkofsky, MD

Allen Rubin, MDRaymond Vallera, MDNeville Fernandes, MD

Paulino Rivera-Torres, MD701 Tuscan #110 Dr

Irving, TX 75039Telephone: 214-496-1100

James Cox, MDS. Neil Mehta, MD

1850 Lakepointe Dr #400Lewisville, TX 75057

Telephone: 972-316-0262

Andrew Holt, MDAnita Steephen, MD

2321 Olympia Dr #100Flower Mound, TX 75028Telephone: 972-691-3777

Osvaldo Fajardo, MDRajesh Putcha, MD

4510 Medical Center Dr #318McKinney, TX 75069

Telephone: 972-562-4430

4500 Hillcrest #180Frisco, TX 75035

Telephone: 972-832-4294

1105 N Central Expwy #370Allen, TX 75013

Telephone: 972-495-6464

Jason Edling, MDGrace Vanesko, MD

David Park, MDDaniel Friedman, MD

6124 W. Parker Rd #536Plano, TX 75093

Telephone: 972-943-8440

5425 W Spring Creek #205 PkwyPlano, TX 75024

Telephone 972-526-5860

Christopher Vesy, MD3600 Gaston Ave

Barnett Tower #809Dallas, TX 75246

Telephone: 214-818-0948

Peter Loeb, MDMichael Nunez, MD

William Stevens, MDKimberly Persley, MD

Rajeev Jain, MD8230 Walnut Hill Ln #610

Dallas, TX 75231Telephone: 214-345-7398

Michael Mendelson, MDWaldo Bracy, MDKim Gentry, MD

Charles Owen, MDM. Tarek Al-Assi, MDS. Mohsin Shah, MD

1001 N Waldrop Dr #509Arlington, TX 76012

Telephone: 817-394-4300

German Oliver, MDPaul Wright, MDFayez Seif, MD

Robert Miller, MD32694 N Galloway #501Mesquite, TX 75150

Telephone: 972-681-2226

4501 Joe Ramsey #220Greenville, TX 75401

Telephone: 903-454-6300

1005 W Ralph Hall Pkwy #125Rockwall, TX 75032

Telephone: 972-475-1277

Compassionate, Professional, Dedicated Quality Physicians & Staff

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20 TDDC Today

Many diseases that affect the digestive system are associated withfolklore, old wives’ tales, and rumors about their causes andtreatments. Some folklore is harmless, yet some can be dangerousif it keeps a person from correctly preventing or treating an illness.Call your TDDC Physician today if you have questions.

Myth #1 – Food combining diets really work.There are plenty of diets based on the belief that the digestivesystem can’t tackle a combination of foods or nutrients.Commonly, carbohydrates and proteins are said to ‘clash,’ leadingto digestive problems and weight gain. The opposite is often true.Foods eaten together can help the digestive system. For example,vitamin C in orange juice can increase iron absorption from a meallike chicken or beef.

Very few foods are purely carbohydrate or purely protein; most are amixture of both. The digestive system contains enzymes that areperfectly capable of breaking down all the foods we eat. Foodcombining diets should be avoided.

Source: Better Health Channel

Myth #2 – Diverticulosis is an uncommon and serious problem. Actually, the majority of Americans over age 60 havediverticulosis, but only a small percentage have symptomsor complications. Diverticulosis is a condition in which littlesacs--or out-pouchings--called diverticula, develop in the wallof the colon. These tend to appear and increase in number withage. Most people do not have symptoms and would not knowthat they had diverticula unless X-ray or intestinal examinationwere done. Less than 10% of people with diverticulosis everdevelop complications such as infection

Source: About.com Women’s Health

Busting MythsDetermining the Validity of Common Beliefs

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Myth #3 – Celiac disease is a rare childhood disease.Celiac disease affects children and adults. At least 1 in 1,000people and, in some populations, 1 in 200 people have celiacdisease. Most often, celiac disease first causes symptoms duringchildhood, usually diarrhea, growth failure, and failure to thrive.But the disease can also first cause symptoms in adults. Thesesymptoms may be vague and therefore attributed to otherconditions. Symptoms can include bloating, diarrhea, abdominalpain, skin rash, anemia, and thinning of the bones (osteoporosis).Celiac disease may cause such nonspecific symptoms for severalyears before being correctly diagnosed and treated.

People with celiac disease should not eat any foodscontaining gluten, a protein in wheat, rye, barley, andpossibly oats, regardless of whether or not they have symptoms.In these people, gluten destroys part of the lining of the smallintestine, which interferes with the absorption of nutrients. Thedamage can occur from even a small amount of gluten, and noteveryone has symptoms of damage.

Source: Remaining Healthy and The National Digestive DiseasesInformation Clearinghouse (NDDIC)

Myth #4 – Cirrhosis is only caused by alcoholism. Alcoholism is just one of many causes of cirrhosis. Cirrhosis is scarringand decreased function of the liver. In theUnited States, alcohol causes less thanone-half of cirrhosis cases. Theremaining cases are from otherdiseases that cause liver damage. Forexample, in children, cirrhosis mayresult from cystic fibrosis, alpha-1antitrypsin deficiency, biliary atresia,glycogen storage disease, and otherrare diseases. In adults, cirrhosis maybe caused by hepatitis B or C,primary biliary cirrhosis, diseases of

abnormal storage ofmetals like iron or copper

in the body, severe reactions to prescription drugs,or injury to the ducts that drain bile from the liver.

Source: About.com Women’s Health(About.com Health's Disease and Condition

content is reviewed by the MedicalReview Board)

Myth #5 – Spicy food and stress cause stomach ulcers.Almost all stomach ulcers are caused either by

infection with a bacterium calledHelicobacter pylori (H.

pylori) or by use ofpain medicationssuch as aspirin,ibuprofen, or

naproxen, the socalled nonsteroidal anti

inflammatory drugs (NSAIDs).Most H. pylori related ulcers can be cured with antibiotics. NSAIDinduced ulcers can be cured with time, stomach protectivemedications, antacids, and avoidance of NSAIDs. Spicy food andstress may aggravate ulcer symptoms in some people, but they donot cause ulcers.

Myth #6 – Smoking a cigarette helps relieve heartburn. Actually, cigarette smoking contributes to heartburn. Heartburnoccurs when the lower esophageal sphincter (LES) (a musclebetween the esophagus and stomach) relaxes, allowing the acidiccontents of the stomach to splash back into the esophagus.Cigarette smoking causes the LES to relax.

Source: Myths and Facts About Digestive Diseases

Disclaimer: The information discussed above is a general overview of informationthat can be found on the internet. If you have questions or concerns, please contactyour TDDC Physician.

MYTHSBUSTED

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