If you feel ill with fever, flu-like symptoms or respiratory illness, please call us to reschedule your appointment. Please Do Not Bring Children Under age 16 to Appointments.

Liver Disease in Pregnancy

By R. Kyle Barnett, MD

Abnormal liver tests occur in approximately 3-5% of pregnant women. For some women, test results that would otherwise suggest liver or gallbladder dysfunction in a non-pregnant woman may, in fact, be normal in a pregnant woman. Abnormal test results should be evaluated by a specialist since some diseases, newly diagnosed in pregnancy, may require more immediate intervention for the expectant mother or unborn fetus.

Additional Testing

Managing a pregnant woman with liver disease is a common medical scenario that involves unique challenges, since the mother AND fetus must be considered in any clinical treatment decisions. Pregnant patients who have had abnormal liver tests can expect to undergo some level of additional testing, to address initial testing results.

A standard workup, just as any non-pregnant individual with similar results would have, is the first step. Most liver test results remain the same during pregnancy, except for those produced by the placenta. Abnormalities seen with certain liver tests require further evaluation.

Ultrasound testing is safe and is the preferred imaging type in abnormal liver assessment that suggests gallbladder disease. MRI and CT scans may be used but only under certain conditions in later pregnancy.

Endoscopy may be necessary during pregnancy, but if possible, not until after the second trimester. Sedation with propofol is acceptable for pregnant patients.

Liver Diseases Unique to Pregnancy

Hyperemesis gravidarum (HG), is a condition which includes severe morning sickness, with symptoms which can include nausea, vomiting, jaundice, weight loss and dehydration which can affect liver function, urine output, blood pressure, cognition and heart rate. Treatment for HG may require hospitalization to ensure the pregnant woman receives fluids and nutrients necessary for her own health as well as that of the fetus, usually followed by bedrest.

Preeclampsia with liver involvement can progress to the level of Severe Preeclampsia, prompting delivery after 36 weeks to limit maternal and fetal complications.

HELLP syndrome, is an unusual set of symptoms that may be related to preeclampsia. It affects liver function, causes the breakdown of red blood cells and produces a low platelet count, which negatively affects blood clotting ability. Immediate delivery is recommended (especially after 34 weeks).

Other Condition That Can Occur

Gallbladder and Biliary System

If symptoms indicate, gall bladder removal is possible during pregnancy using laparoscopic surgical techniques.

Patients with liver masses should be treated prior to pregnancy when possible. Most conditions do not require routine imaging, but those with certain lesions should be monitored by ultrasound to track growth.

Hepatitis

Current recommendations for pregnant women with chronic hepatitis B virus infection include vaccinating infants born to HBV-infected mothers and antiviral medication given during the third trimester to reduce transmission to the newborn. At present, chronically hepatitis B-infected women can still breastfeed, as no strong evidence indicates otherwise.

Women with risk factors for hepatitis C should be screened with blood tests, but screening is not indicated in women without risk factors. Invasive procedures, including an elective C-section, should be avoided if possible in women with chronic hepatitis C, to prevent transmission of hepatitis C to the fetus.

Women with acute hepatitis should be tested for common causes of acute liver injury including viral hepatitis and herpes hepatitis. Those with acute hepatitis suspected to be caused by herpes virus should be treated with antiviral medication.

Women suspected of cirrhosis should have an upper endoscopy to screen for esophageal varices in the second trimester. Those with large esophageal varices should be treated accordingly.

More

There are more liver conditions that could be present during pregnancy for certain at-risk patients. Pregnant women under a doctor’s care will be able to address any health concerns that could affect the mother or fetus.

Patients who know they have hepatitis or feel there is a risk of exposure, have liver conditions that require medical care or have hereditary factors that may indicate liver problems, should consult with their doctor prior to becoming pregnant to ensure the healthiest start for themselves and their baby.

Get to know your doctors!

At Granite Peaks, we believe it’s very important to learn about your provider, and their goals that are aimed at creating the best patient care possible.

Granite Peaks Gastroenterology brings a new dimension to healthcare in Utah. Formed in Sandy, Utah, Granite Peaks brings together a team of well-established physicians and staff with the common goal of creating a fully integrated digestive health center of excellence. The physicians are board-certified in gastroenterology and fully trained in all modalities of GI care. Granite Peaks Gastroenterology is committed to providing exceptional quality of care through medical excellence, impeccable service, compassion and the use of state-of-the-art technology in a welcoming environment.

Dr. R. Kyle Barnett

Dr. Barnett attended Texas Tech University for his undergraduate studies and then graduated from Texas Tech University School of Medicine with his medical degree in 1987. He completed his internship and residency with board certification in the field of internal medicine at the University of Utah School of Medicine in 1990. He is involved in GI research as well as the inpatient and outpatient practice of gastroenterology- including gastrointestinal, biliary, liver and pancreatic disorders. He is on the active staff at Alta View and Lone Peak hospital and is on all insurance panels in Utah. “Gastroenterologists face a number of challenges in their daily routine, and that certainly contributed to my wanting to become a GI specialist. I enjoy a good challenge… and the rewards of being able to have a direct and positive impact on how people feel and on the quality of the lives they lead. For more than a decade and a half, I’ve enjoyed what I do. A big part of this is knowing that it is important and does make a difference, which is why I strive always to provide the very highest level of care of each and every person I see. I try to understand what each individual is dealing with. Then I start building a relationship of trust and genuine compassion.  The best care and outcomes depend on both physician and patient being personally invested in making sure things are done thoroughly, conscientiously an correctly.”

Dr. Christopher Cutler

Dr. Cutler received a B.S. in psychology from the University of Michigan in 1984. He completed his gastroenterology fellowship in 1995 at Indiana University of Indianapolis. He is board certified in internal medicine and gastroenterology. Dr. Cutler has been practicing gastroenterology in Utah since 1995 and is experienced in all aspects of gastroenterology, digestive diseases and digestive health. He is on the staff at Alta View Hospital, Lone Peak Hospital, and is a participating physician on all insurance panels in Utah. “Your digestive health is a vital component of your overall health, comfort, and physical and mental well-being. Whether a patient feels perfectly healthy and visits me for a screening colonoscopy or has digestive difficulties, as a Board-Certified Gastroenterologist, I apply my extensive experience, training, and expertise and the most recent advances in my field to a thoughtful assessment and diagnosis of each individual. We will discuss “conventional” medical approaches and complementary “alternative” approaches to determine the best options for you. In many cases- as in colon disease screening with colonoscopy- early intervention and treatment can prevent the development of disease. Gastroenterology is especially rewarding because my patients benefit from my knowledge, experience, and use of the latest research and technology in this quickly-evolving medical specialty. For my patients with digestive disorders, I can prescribe a course of action which provides immediate relief, often restoring patients to symptom-free, normal lives. It is gratifying for me when, several times each day, patients say to me, “If only I had known the exam (or treatment) would be this easy, I would have made an appointment with you a long time ago.”

Dr. Steven Desautels

Dr. Steven Desautels received his bachelor’s degree in microbiology from the University of Florida in 1986. He is board certified in internal medicine and gastroenterology. He has been participating in GI research, as well as the inpatient and outpatient practice of gastroenterology in Utah since 1997. He is highly experienced in all aspects of gastroenterology and liver disease. He is active on the staff of Alta View Hospital, Riverton Hospital, and is a participating physician on all insurance panels in Utah. “I became a physician for the simple reason that I wanted to do something for others, to make a difference in their lives. With disorders of the digestive tract, people’s lives are changed in a very fundamental way. Pain. Discomfort. Irregular habits. And a wide variety of symptoms that range from unpleasant and embarrassing to disruptive and debilitating. These are people who truly need help… and an improved quality of life. This is my motivation as a physician, and it’s the commitment I make to everyone in my care.”

Dr. Andrew Heiner

Dr. Heiner attended UCLA and BYU, receiving a B.S. in zoology in 1983. In 1987, he earned his medical degree from the University of Texas Medical Branch. He then completed his internal medicine training at the University of Utah and stayed here to complete his gastroenterology and has been practicing gastroenterology in Salt Lake City since 1992. He is active on the staff of Alta View Hospital, and Lone Peak Hospital, and is a participating physician on all insurance panels in Utah. “After nearly 20 years of practicing GI medicine, what I enjoy most is that I’m able to achieve my goal of providing meaningful help to people in need. Quite often, people are surprised that relief and improvement in significant improvement in their GI symptoms. But providing that difference means being dedicated to doing things as well as they can be done. I approach every person who puts their trust in me as I would a loved one. I pay attention to the details. I help put them at east. And I truly listen. Experience has shown me that patients will almost always tell me enough to make an accurate diagnosis, which is where medical excellence- and appropriate and successful care- begin.”

Dr. J. David Schmidt

Dr. Schmidt received his B.A. in biology from the University of Vermont in 1996. In 2000, he received his medical degree from Jefferson Medical College of Thomas Jefferson University in Philadelphia. He completed his internship and residency at the Lankenau Hospital in 2004 in Wynnewood, PA, where he also served as chief medical resident. He is active on the staff of Lone Peak Hospital, Riverton Hospital, and is a participating physician on all insurance panels in Utah. “My goal as a physician is to provide the highest quality of care to every one of my patients. There is, of course, much that goes into achieving this objective. Skill. Knowledge. Capability. And dedication. I believe the best care is that which is delivered with a genuine compassion for each person’s individual needs, health and life. For me, this starts by listening. I need to know what’s going on, how it affects you, what your concerns and sensibilities are and all the other things that are intertwined with your gastrointestinal problems. But it’s also key to being truly present and involved in your care and to being a partner in helping you get back to what’s important: living- and enjoying- your life.”

May Marschner, PA-C

“As a PA working in Gastroenterology, my goal is to work with the doctors, medical staff, and our patients to help deliver the best care possible. I think there is a lot of overlap between GI and other areas of medicine, so while I focus on GI complaints, I still try to keep the big picture in mind for overall health and wellness. I strive to educate patients, answering their questions, and make sure they are up to date on preventative screenings, like colonoscopies. I also consult with my supervising physicians on a daily basis, and as a team; we work together to come up with individual plans for each patient. Lastly, I like to connect with our patients to make sure they are happier when they leave, than when they arrived.”

May has an undergraduate degree from Rhodes College in Memphis Tennessee, Post-Bachelor Study from University of New Orleans, in Louisiana,  and a Graduate Degree from the University of Utah in Physician Assistant Studies. May is accepting new patients and can be seen at the Granite Peaks clinic at 9829 South 1300 East in Sandy, Utah.

GI Nurses & Associates Appreciation Week

March 24th-28th is National Gastroenterology Nurses & Associates Appreciation Week!

Monday, March 24th: Spreading the Word: Awareness Day

Tuesday, March 25th: Time out for Education Day

Wednesday, March 26th: Celebrating You: GI Nurses and Associates Day

Thursday, March 27th: Honoring Patient Safety: Infection Prevention Day

Friday, March 28th: Building a Stronger Future: Evidence-based Practice Day

Granite Peaks GI.com would like to thank all of our staff for all of the hard work they do every day. Our physicians are Dr. Kyle Barnett, Dr. Christopher Cutler, Dr. Steven Desautels, Dr. Andrew Heiner, and Dr. David Schmidt.  Our new Physician Assistant, May Marschner PA-C has been a wonderful addition to our team!

 

Dr. Barnett Lecture Notes and Photos

To follow up from our last blog post, Dr. Barnett’s lecture was a great success!  With over 200 attendants to the Snowbird CME Conference, the majority attended Barnett’s lecture on Gastritis versus Ulcers.

 

Dr. Barnett, Speaker at Snowbird CME Conference

Dr. R. Kyle Barnett will speak at the 37th annual Snowbird CME Conference on August 8th, at 9:30am.

Topic: Gastritis vs. Ulcers

Visit their website for more information about Dr. Barnett and the Conference: http://snowbirdcme.org/
The conference starts August 7th and goes through August 9th.

 

Dr. Barnett Lecture March 26 @ 7:00pm

Legacy Lecture Series
Tuesday, March 26th, 2013 at 7:00 PM
Legacy Retirement in the Activity Room
1617 West Temple Lane
South Jordan, UT 84095

 

Subject:  Gastrointestinal Health
Presented by Dr. Kyle Barnett

Dr. R. Kyle Barnett is a Board Certified Gastroenterologist and has been practicing for nearly 20 years.  In 2008, he partnered with four other GI specialists and is currently practicing for Granite Peaks Gastroenterology in Sandy, Utah. ” Gastroenterologists face a number of challenges in their daily routine, and that certainly contributed to my wanting to be a GI specialist.  I enjoy a good challenge and the rewards of being able to have a direct and positive impact on how people feel and on the quality of the lives they lead.”  Dr. Barnett feels it’s important to build a solid relationship with each of his patients with trust and genuine compassion.  Dr. Barnett is one of the highest ranked Gastroenterologists in Utah and serves all communities along the Wasatch Front.  “The best care and outcomes depend on both physician and patient being personally invested in making sure things are done thoroughly, conscientiously and correctly.”

Top Questions to Ask Your Gastroenterologist:

 

  1. When should I have a colonoscopy?
  2. My family member has a history of cancer, when should I have my colonoscopy?
  3. I have a lot of gas/ bloating and pain-is it my diet?
  4. Could my medications be causing stomach aches, constipation, gas/ bloating?
  5. I continually have hemorrhoids and can’t seem to get rid of them. Any suggestions? How can you help me?

Granite Peaks Media March!

Granite Peaks Commercial

Dr. R. Kyle’s Live TV Interviews:Granite Peaks Commercial Dr. Barnett
Granite Peaks has a local celebrity! Dr. Kyle Barnett, a Granite Peaks GI specialist, has been featured on several news stations and will have another live interview tomorrow, March 5th at 11:30am on Studio 5 (Channel 5). Be sure to tune in as Dr. Barnett answers colonoscopy myths.

Granite Peaks has also filmed a commercial! The big debut is tonight during the 6:30pm news on KSL 5 tonight, March 4th and will air all month long on ABC 4 and KSL 5.
The Spring Edition of ‘Your Health Matters’ Newsletter has been posted to our website and sent via email. If you’d to receive future newsletters by email, please click the link below!

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Welcome to Granite Peaks GI Blog!

For specialized problems, trust specialized care.

For cardiac concerns, you trust a cardiologist. For a broken bone, you see an orthopedic surgeon. Similarly, your GI concerns and digestive tract health are best-entrusted to a Granite Peaks GI specialist. Unlike doctors from other specialties who perform GI procedures without true specialty training, gastroenterologists train for years on endoscopy and the problems being evaluated. With colonoscopy, for example, research shows that gastroenterologists are more likely to evaluate the entire colon for colon disease and detect what’s wrong, and their patients experience fewer complications.

Compassionate care & impeccable service.

We believe caring is essential in healthcare, and it shows. We give you the personal care and attentive service we expect for ourselves and our loved ones. We provide a comfortable environment and make sure you’re seen by one of our physicians each time you’re here. We’re also accustomed and sensitive to patients who are nervous or upset. And we take pride in treating everyone with the kindness, honesty and respect they deserve.

An approach that’s focused on relief & resolution, not procedures.

A complex system, the gastrointestinal tract can be affected by a number of disorders. And they are often subtle and difficult to understand. So we focus not on a particular procedure or treatment but on understanding and resolving your unique problem. This starts by listening to you carefully and investigating things thoroughly. While we do perform procedures, we look for the treatment that’s best for you, not for us. Because one-of-a-kind problems don’t benefit from one-size-fits-all care.

To schedule an appointment with one of our doctors, please call our office at (801) 619-9000 or use our online Request an Appointment form.

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