If you have a digestive disorder, you may need to visit a gastroenterologist. There are numerous digestive disorders that affect the digestive tract of adults and children, including lactose intolerance, constipation, Crohn’s disease, diarrhea, colon cancer, irritable bowel syndrome (IBS), ulcerative colitis and peptic ulcers.

Constipation is a big problem that patients just don’t want to talk about with their doctor. It’s often embarrassing and they just don’t know how to bring it up. Based on some new studies on patient self-reporting, the prevalence of chronic constipation can be anywhere from 10-20 percent. Chronic constipation is a challenging problem because it affects one’s quality of life. It can cause emotions such as frustration, anxiety, embarrassment and stress. I think that chronic constipation definitely is important to speak about with your family doctor.

As patients and as doctors, we can often define the normal spectrum of normal bowel movements. Many times, we think normal is three spontaneous, complete bowel movements per week. But according to the American College of Gastroenterology, chronic constipation is defined as unsatisfactory defecation characterized by infrequent stools, difficult passage of stools, or both.

Patients often think about difficult bowel movements as being straining, having hard, lumpy bowel movements. Trying very hard or having a difficult time passing the bowel movement and also spending an exorbitant amount of time trying to have a bowel movement.

When you see your  local family doctor and talk about chronic constipation, it’s important that you don’t feel shy or embarrassed. It’s important that you bring up your history, as your family doctor will do their best to find out what’s going on.

When you see your local  family doctor, what they’ll do is talk to you about your history. What medical conditions you have, what medications you’re taking that can affect you. They are going to look for red flags or danger signs. The red flags can include weight loss, anemia, pain, problems with blood in the stool, or even new symptomatology that occurs in patients over 50 years of age.

These are all red flags that your family doctor will be listening to. During the visit, they’ll ask you about your family history of colon cancer or any inflammatory bowel diseases. During your visit, there may be a physical exam examining the abdomen or doing a rectal exam and they will offer you some tests. These tests will include blood tests to check for anemia, your thyroid, but also may include a referral for colonoscopy if there is a concern.

It’s important when you speak to your family doctor about treatment options for chronic constipation that they provide education about fluid and fibre. It has to be adequate combined with exercise to allow the body to deal with this naturally. Luckily, we have many over-the-counter products that can help with chronic constipation.Often seeing a local family physician or a physiotherapist in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition.Smart Food Now and exercise is also optimal for overall health.   

If there’s an adequate trial, and if you’ve tried your best as a patient and it’s not working, don’t be afraid to speak to your doctor because besides over-the-counters, there are prescription medications – prokinetic agents that can help you. It’s important you speak to your local  family doctor about treatment options for chronic constipation.  Presenter: Dr. Daniel Ngui, Family Doctor, Vancouver, BC

Local Practitioners: Family Doctor

As a patient with inflammatory bowel disease, you may already be having discussions with your gastroenterologist or other allied health care professionals regarding this new opportunity, that being the biosimilar version of infliximab.

If given the opportunity to be on the biosimilar version of infliximab, the expectation or the benefit to you would be two: one – and most importantly, it would be that the likelihood of success, the likelihood of this drug working, would be similar to whether you’re on the original version of infliximab. And furthermore the safety of this drug would be similar to if you’re on the original version of infliximab.

But then another benefit that one should potentially consider is the cost of this medication, and for certain patients that is a big deal, that this drug is coming out at a much-reduced cost, to the original infliximab cost, and whether that may impact your insurance premiums or other aspects of the care of your health, may be something that could be a very important issue for you to consider.

An important consideration when understanding whether indeed the biosimilar version of infliximab should be an opportunity that you would endorse or you would use, is the amount of science that has gone behind the approval that Health Canada has given this biosimilar version of infliximab to be used in the same way as the original version. This concept is new, and because of that I would strongly consider you going to speak to your gastroenterologist really to learn more about this opportunity.  Presenter: Dr. Brian Bressler, Gastroenterologist, Vancouver, BC

Local Practitioners: local family physicians