Cedar Valley Gastroenterology offers area patients an interdisciplinary approach in the diagnosis and treatment of a wide range of digestive disorders.

Gastroenterology is the specialty dealing with all the organs associated with digestion, from the time we eat to the time the digested food leaves the body — the esophagus, stomach and colon. Disorders can happen because of any problems with digestion, either the movement, or the digestion itself, the elimination, or because of cancers or infections.

Diseases commonly treated include hepatitis B and C, reflux, Barrett’s esophagus, peptic ulcer, Crohn’s, ulcerative colitis, irritable bowel syndrome, pancreatitis and issues with nutrition. Dr. Ravindra Mallavarapu, one of three gastroenterologists under Cedar Valley Medical Specialists (CVMS)’ umbrella, says three to four million Americans are infected by hepatitis C, a chronic infection of the liver.

“It is contracted either through IV drugs, inhaled drugs or blood transfusions before the testing came about,” he explains. “If it remains in the body, it can cause damage, such as cirrhosis, the scarring of the liver. The Centers for Disease Control and Prevention recommends persons 45 to 60 be tested for hepatitis C.” CVMS’ doctors are the primary providers in the Cedar Valley that treat hepatitis C. “Treating hepatitis C requires some experience first, and not everyone is interested. I had some background training in liver diseases that I brought with me here. The regimens are complex,” Dr. Mallavarapu says.

Additionally, reflux is a common disease which affects quality of life for sufferers. “Reflux is a chronic condition that can put a person at risk for a condition called Barrett’s, which is a change in the lining of the esophagus that can lead to cancer. The treatment involves changes in lifestyle and medication. For example, reflux can be treated with medications, by losing weight, eating smaller meals, and not eating foods that trigger reflux, such as tomato-based sauces. The medications are really effective,” he says. “They have minimal side effects.”

Inflammatory bowel diseases such as Crohn’s or ulcerative colitis can affect the lining of the gut, colon or small bowel. It is believed that an abnormal immune response is what results in the damaging inflammation of the digestive tract. If the immune system reaction can be controlled with medication, surgery may not be necessary.

A number of digestive conditions can also be related to diet. People may be intolerant to gluten, lactose or fructose. A staff dietitian advises these patients, under the care of the provider.

“We’ve made great strides in the detection of colon cancer, which may require the removal of pre-cancerous polyps. Also, the advancement in colonoscopy preparations requiring less liquid to be consumed is a great benefit to the patients,” says Dr. Mallavarapu.

Other technological advancements include a camera inside a pill that can take pictures of the small bowel, and upgraded ways to control bleeding and open tumors using stents. In the near future, an instrument with a camera inside of another camera will allow viewing inside the bile duct. Dr. Mallavarapu’s practice recently obtained a new form of ultrasound that can tell if the liver is scarred.

Most beneficial to patients is that Cedar Valley Gastroenterology and the Allen Digestive Health Center offer full service, patient-focused satisfaction and customer service, he says. “We have a comprehensive range of services available that makes it highly unlikely that our patients will need to go outside the area for diagnosis and treatment.

“Our primary care team has grown to include the highest-quality care from world-class professionals, including Dr. Srinivas Kalala and Dr. Ana Huerta Alardin. We also have two outstanding nurse practitioners on our team. Barb Burkle, MSN, ARNP, FNP-BC, has been practicing digestive health for twelve years, and specializes in general gastrointestinal health, inflammatory bowel disease and liver disease. Tracy Elliott, ARNP, has been practicing digestive health for four years, and focuses on a holistic approach to patient care through nutritional education, exercise and natural supplementation,” says Dr. Mallavarapu.

“We stay up to date. We have designed a new website to assist in educating patients regarding many aspects of their health care. We are the second line of care after the primary physicians and we collaborate with general surgery, radiology, and other disciplines.”

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