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.

Guidelines for the Diagnosis and Management of Barrett’s Esophagus

by Dr. Christopher Cutler

In 2015, the American College of Gastroenterology published clinical guidelines for the diagnosis and management of Barrett’s esophagus (BE). The following is a summary of this guideline which the physicians at Granite Peaks Gastroenterology would like to share with you:

  • —Screening of the general population for BE is not recommended.
  • —Screening for BE may be considered in men with chronic (>5 years) and/or frequent (weekly or more) symptoms of gastroesophageal reflux (heartburn or acid regurgitation) and two or more risk factors for BE. These risk factors include: age >50 years, Caucasian race, central obesity, current or past history of smoking, and a confirmed family history of BE or esophageal cancer (in a first degree relative).
  • —Screening for BE in females is not recommended. However, individualized screening could be considered in a woman with multiple risk factors for BE including: age>50, Caucasian race, chronic and/or frequent reflux symptoms, central obesity, current or past history of smoking, and a confirmed family history of BE or esophageal cancer (in a first degree relative).
  • —If the initial endoscopy is negative for BE, repeating an endoscopy to look for BE is not recommended. If the endoscopy reveals significant esophagitis, a repeat endoscopy after PPI (Prilosec) therapy for 8-12 weeks is recommended to ensure healing of esophagitis and exclude the presence of underlying BE.
  • —For BE patients without dysplasia (pre-cancerous cells), endoscopic surveillance should be performed every 3-5 years.
  • —For BE patients with dysplasia of any grade, the biopsies should be read by two pathologists, at least one of whom has expertise in GI pathology.
  • —For patients whose biopsies are indefinite for dysplasia, a repeat endoscopy after 3-6 months of optimized PPI therapy should be performed. If this endoscopy confirms the diagnosis of indefinite for dysplasia, a surveillance interval of 12 months is recommended.
  • —For patients with BE and confirmed low-grade dysplasia, endoscopic therapy (radiofrequency ablation) is considered the preferred treatment, although endoscopic surveillance every 12 months is an acceptable alternative.

—Patients with BE and confirmed high-grade dysplasia should be managed with endoscopic therapy (radiofrequency ablation +/- endoscopic mucosal resection).

—Endoscopic ablative therapies should not be routinely applied to patients with nondysplastic BE because of their low risk of progression to esophageal cancer.

—Patients with BE should receive once-daily PPI therapy. Routine use of twice-daily dosing is not recommended, unless necessitated because of poor control of reflux symptoms or esophagitis.

—Anti-reflux surgery should not be pursued in patient with BE to prevent cancer. However this surgery should be considered in those with incomplete control of reflux symptoms on optimized medical therapy.

—Endoscopic surveillance following elimination of BE for patients with low-grade dysplasia is recommended every 6 months for the first year, and annually thereafter.

—Endoscopic surveillance following elimination of BE for patients with high-grade dysplasia or intramucosal carcinoma is recommended every 3 months for the first year, every 6 months for the second year, and annually thereafter.

If you have any questions about Barrett’s esophagus or your reflux symptoms, please contact your physician at Granite Peaks Gastroenterology.

The World’s Emergency Room

By Dr. Christopher Cutler

As a doctor here at Granite Peaks Gastroenterology, I reflect on Humanitarianism: the promotion of human welfare; making other people’s lives better, regardless of their gender, race or religion. Dr. Michael VanRooyen personifies humanitarianism. For him, providing for the health and welfare of the world’s oppressed and suffering is not a political issue, it is an international imperative. In his captivating new book, The World’s Emergency Room: The Growing Threat to Doctors, Nurses, and Humanitarian Workers, Dr. VanRooyen takes readers on his journeys from the Rwandan genocide to earthquake-ravaged Haiti to the Syrian refugee crisis. As an emergency physician and leader in the relatively new field of humanitarian medicine, Dr. VanRooyen has helped thousands of people worldwide who have been displaced by war, natural disasters, and disease. His riveting personal account of these public health emergencies, and the humanitarians who put themselves in harm’s way to help, provides a fresh, new perspective on global health crises and the challenges faced by aid workers and non-governmental organizations.

The breadth of Dr. VanRooyen’s credentials is impressive. He is a professor at Harvard Medical School and the Harvard School of Public Health, the chairman of Emergency Medicine at Brigham and Women’s Hospital in Boston, and the co-founder and director of the Harvard Humanitarian Initiative. Full disclosure: he was my roommate during our medical residencies in Chicago and a groomsman in my wedding, and he remains one of my closest friends.

Long before my days at Granite Peaks Gastroenterology, I first met Mike during medical school, and even then his altruism was evident. After the fourth year of medical school, many students take time off before commencing the grueling schedule of residency. But not Mike. He used the time to work with the Indian Red Cross in Delhi, help priests in war-torn El Salvador, and travel to Geneva to learn the intricacies of the international relief agencies located there. Over the past 25 years, Mike and his wife Julie, a prominent gynecologic surgeon herself, have provided care in over 30 countries including the Democratic Republic of Congo, Somalia, Bosnia, Chad, Sudan, and Iraq. Mike also travelled to NYC to offer his assistance in the aftermath of 9/11. The atrocities that Mike has witnessed are incomprehensible to the average American. In The World’s Emergency Room, Dr. VanRooyen takes us into these disaster zones with a gripping narrative, and proposes solutions on how to better serve people and populations in need, while safeguarding the lives of aid workers and humanitarians faced with increasing threats while working in the field.

The World’s Emergency Room is a truly inspirational book. The humanitarian work being carried out by Dr. VanRooyen and his colleagues brings to mind the famous quote by Mahatma Gandhi, “Be the change you wish to see in the world.”

To learn more about the Harvard Humanitarian Initiative, please visit hhi.harvard.edu.

Announcing the Launch of Our New Online Home!

We’re thrilled to announce the launch of our new website! The fresh design was built to provide our current and potential patients with increased ease of use, sufficient location/condition information, and quick access to assistance from Granite Peaks GI (GPG) staff. Learn more about the new features below for Granite Peaks GI!

Patient Portal

granite peaks gi

Creating and logging into your personal Patient Portal account allows you to discuss your condition and procedure privately with your physician. You may also use this platform to request appointments, renew medications, and access your personal health record. The system provides a secure place for you to store information and discuss your needs. You can access Patient Portal by clicking the “Patient Login” tab located within the white text on the second row of the navigation.

Book an Appointment

granite peaks gi

Booking an appointment with a GPG professional is simple using the new website. Just click the “Book Appointment” tab in the top right corner of the screen. Here, you can click the “Book Online” button to begin the process of securely booking your appointment online. This page also provides contact, location, and physician information.

Resources

granite peaks gi

Required forms for your office visit can be found on the Resources page. You can access this page by clicking the “Resources” tab located within the white text on the second row of the navigation. This will allow you to review, download, and print each form you will need for your first visit with GPG.

Provider Information

granite peaks gi

If you’d like to learn more about the providers at GPG, click the “Providers” tab to find a full page of bios. Information regarding each physician can be found by clicking on their image located on this page.

Procedure and Service Information

granite peaks gi

Whether you’re new to our facility or a returning patient, it’s likely that you’ll have questions regarding your care. Although our physicians and staff will be available to answer any and all questions you may have, our procedure and service information pages are a great place to find quick answers. You can find informative pages in the white text on the second row of the navigation as well. These will be located under the “GI Conditions” and “Services” tabs.

Questions?

granite peaks gi

Should you run into any questions while using the new website, our team will be happy to help you find your way! For site assistance, facility information, over-the-phone booking, or general questions regarding your care, please feel free to give our offices a call at 801-619-9000. You may also visit our contact page to request information.

Granite Peaks Welcomes James M. Stewart, MD

James M. Stewart, MD:  “As a gastroenterologist, I believe that gastrointestinal health and well-being are critical to enjoying a healthy lifestyle, and all that Utah has to offer. After completing my gastroenterology training at Banner Good Samaritan/ VA program in Phoenix, Arizona, I am pleased to start practicing at Granite Peaks Gastroenterology in Sandy, Utah and will be serving patients from across the Wasatch Front. My special interests include colorectal cancer prevention, GERD, Inflammatory Bowel Disease, and I’ve done research in obesity-related liver disease and other gastrointestinal cancers. After losing family to gastrointestinal cancers, I am dedicated to promoting screenings for early detection of colorectal and esophageal cancer.”

James M. Stewart, MD will be accepting new patients and provides same and next day availability. Stewart sees patients in our Sandy office, and has procedure time every week. Visit Dr. Stewart’s bio on our Meet the Team page by clicking here.

Fellowship: Gastroenterology, Banner Good Samaritan/ VA Hospital-Phoenix, AZ
Residency: Internal Medicine, University of California, San Diego, CA
Internship: Internal Medicine, Residency Program, University of California, San Diego, CA
Doctor of Medicine: University of Utah, Salt Lake City, UT

 

Digestive Friendly & Not-So-Friendly Foods

Summer is notorious for bringing people together, whether it’s a barbecue, July 4th & July 24th celebrations, birthdays, and even weddings.  You can almost always expect a smorgasbord of foods that may or may not agree with your digestive system. The following is a list of friendly and not so friendly food choices that could leave you partying with your friends and family, or spending the event uncomfortable and aggravated with GERD heartburn or other related concerns.

Worst:

  • High-Fat/ Fried Foods: for many, high-fat foods and fried foods produce acid reflux and heart-burn. This can cause a pale-colored stool called steatorrhea which is excess fat in the feces.
  • Spicy Food: can often cause heartburn pain
  • Diary: Those who are lactose intolerant should steer clear from many diary items because they don’t usually have lactase, an enzyme that breaks down lactose, which is the sugar in milk. If diary causes gas, bloating, diarrhea, or other GI issues, consult with your primary care provider.
  • Alcohol: This relaxes the esophageal sphincter, causing acid reflux and heartburn, especially if combined with spicy and fatty foods. Alcohol can also inflame the stomach lining, impairing enzymes and preventing nutrients from being absorbed.
  • Berries: Berries are a great source of antioxidants, but can cause problems for people with diverticulitis, which are pockets in the large intestine. Seeds can get stuck in these pockets and may cause infection.

  • Chocolate:
    This could cause problems for people with Irritable Bowel Syndrome, and since chocolate contains milk, those with a lactose intolerance could also find gas, bloating and other symptoms after eating this tasty treat.
  • Coffee, Tea, Soft Drinks: These beverages can act as a diuretic and can over-relax the esophageal sphincter, causing acid reflux and heartburn.

Best:

  • Yogurt: Our GI tract contains trillions of bacteria that help break down and digest food. Yogurt contains some good bacteria to promote a healthy system. Look for products that say “Live & active cultures”.
  • Lean Meat & Fish: Easier for your body to digest than high-fat red meats and is not associated with colon cancer.
  • Whole grains: Americans need 20-30 grams of whole grains, but the average consumption is around 12 grams. Whole grains help you feel full longer and can help lower cholesterol. However, those with Celiac Disease must stay away from the whole grains which contain gluten.
  • Bananas: “A Banana A Day is a Healthy Way” and can restore normal bowel functions, electrolytes, and potassium.
  • Ginger: Ginger can relieve nausea, vomiting, motion sickness, morning sickness, gas, colic, and lack of appetite.

Go forth, and have a healthy and happy gastrointestinal tract through the summer. If you have uncomfortable reactions to foods, but you’re unsure why, call 801-619-9000 to schedule an appointment with one of our specialists. Granite Peaks can help get you back on track and enjoying your summer without discomfort.

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.

What are Gallstones?

The gallbladder stores bile, a fluid made by the liver. Bile helps digest fats in the foods you eat. Gallstones form when certain substances in the bile crystallize and become solid. In some cases, the stones don’t cause any symptoms. In  others, they irritate the walls of the gallbladder. More serious problems can occur if stones move into nearby ducts- such as the common bile duct- and case blockages. This stops the flow of bile and can lead to pain, nausea, and infection.

According to the Mayo Clinic, ‘Gallstones range in size from as small as a grain of sand to as large as a golf ball.’

Common Symptoms

Gallbladder problems can cause painful attacks, often after a meal. Some people have only one attack, and possibly a single stone, while others may have multiple stones:

  • Severe pain or aching in the upper abdomen, back, or right shoulder blade
  • A dull ache beneath the ribs or breastbone
  • Nausea, upset stomach, or vomiting
  • Jaundice (a buildup of bile chemicals in the blood), which causes yellowing of the skin, eyes, dark urine, and itching

Treating Gallstones

If your stones are not causing symptoms, you may choose to delay treatment. But if you’ve had one or more painful attacks, your doctor will likely recommend removing your gallbladder. This prevents more stones from forming and causing attacks. It also helps prevent complications, such as stones passing into the ducts and causing infection or pancreatitis. After the gallbladder is removed, your liver will still make bile to aid digestion.

Diet for Gallbladder health & during Gallbladder problems

According to WebMD, healthy foods for your Gallbladder include, “fresh fruits and vegetables; whole grains  (whole-wheat bread, brown rice, oats, bran cereal); lean meat, poultry, and fish; low-fat dairy products.” The following is a list of foods to avoid if you’re experiencing Gallbladder problems, provided by WebMD: “Fried foods; highly processes foods (doughnuts, pie, cookies); whole-milk dairy products (cheese, ice cream, butter); Fatty red meat.”

If you’d like to schedule an appointment to check on your Gallbladder health, click here. Granite Peaks is able to see patients within one week if the needs are non-emergent.  No referral is necessary. Please call our offices at, (801) 619-9000 with additional questions.

April & May Health Observance

As you know, March was Colorectal Cancer Awareness Month, AKA the Blue Campaign. Granite Peaks Gastroenterology had a great campaign with several interviews on Channels 2, 4, and 5. Granite Peaks knows the importance of raising colon cancer awareness because a simple screening procedure could save your life, and the lives of those you love.

The following are some health observances in April and May:

  • April 1-30: Hepatitis Awareness Month- ‘The Hepatitis Foundation International (HFI) provides information and educational material to providers and the public. The HFI is dedicated to promoting liver wellness and reducing the incidence of preventable, liver-related, chronic diseases and lifestyle choices that negatively impact the liver.
  • May 1-30: Employee Health & Fitness Month- Granite Peaks promotes a healthy lifestyle with a good diet and exercise. Several employees participate in half and full marathons, and others love hiking, bicycling, swimming, and participate in many activities. A healthy lifestyle can also translate into a healthy Gastrointestinal tract.
  • May 1-30: ‘Liver Awareness Month: Liver Awareness Month focuses attention on the need to maintain a healthy liver through a healthy lifestyle, the types of seriousness of liver disease, and the urgency to be tested for liver disease.’ Follow these links to learn more about Liver Health: www.liverfoundation.org, HepC123.liverfoundation.org 
  • May 11-17: Food Allergy Awareness Week: ‘In 1997, the Food Allergy and Anaphylaxis Network (FAAN) created Food Allergy Awareness Week, including gluten allergy awareness, to educate others about food allergies, which include potentially life-threatening medical conditions affecting 15 million Americans.’ Food allergies can forever change one’s lifestyle. Whether it be a nut allergy, which is one of the most common food allergies, gluten, diary, etc. it’s very important to read food labels. For more information, select the following links: www.foodallergy.org; if you or someone you know feels they may have a gluten intolerance, call (801) 619-9000 to schedule an appointment, or click here to book an appointment.

March 31, 2014 and Beyond…

Today is the last day of Colon Cancer Awareness Month, but that doesn’t mean the fight against colon cancer stops today. Here are some things you can do to help yourself, your family, and your friends:

  • Get Screened!  If you’re 50 and over, schedule your screening colonoscopy today.  It could save your life.
  • If you have a family history of colon cancer, the US Preventative Services Task Force recommends screening starting at age 40 for those with a high-risk, or 10 years earlier than the youngest age of colon cancer diagnosis for any affected relative.
  • Colon Cancer is 80% preventable when detected early, but is still the 2nd leading cause of cancer deaths in the U.S.
  • If you’ve been screened, good job! Now spread the word through social media, blogs and word of mouth. We need your help to inform others.

Learn about the symptoms:

Colon Cancer typically has no symptoms.  If you have any two of the following symptoms, call your gastroenterologist immediately to discuss screening and other options:

  • Rectal bleeding
  • Weight loss with no known reason
  • Weakness and fatigue
  • Nausea or vomiting
  • Diarrhea, constipation or narrower stools than usual
  • Bowel never feels empty
  • Blood in stool (bright red or very dark)
  • Persistent cramps, gas, pain, or feeling full or bloated.

Contact Granite Peaks to schedule your appointment!  Follow this link (https://www.granitepeaksgi.com/service/colonoscopy-screening/) and select “Book Appointment” at the top of the page to schedule your colon cancer screenings.  You may also call us at (801) 619-9000. If you have questions or need more information, here are additional resources for you:

Screening Colonoscopy Information (Granite Peaks)

Colon Cancer Alliance

 

Honoring Patient Safety: Infection Prevention Day

In honor of GI Nurses and Associates Appreciation Week, are observing and honoring today being all about patient safety. Granite Peaks goes above and beyond to ensure each and every patient is safe before, during and after their procedure and office consultation. The Granite Peaks Endoscopy Center is state-of-the-art and fully equipped with the latest equipment.  This facility is one of Salt Lake’s most modern state-licensed, freestanding endoscopy facilities with five board-certified Gastroenterologists. The endoscopy center is also Medicare-certified and accredited by the Accreditation Association for Ambulatory Health Care, which gave us its highest recommendation. Most importantly, our endoscopy center is designed not just for quality care but also for your safety, convenience, privacy, and comfort.

If you’d like to schedule an appointment at Granite Peaks Endoscopy Center and other locations, please call (801) 619-9000 or click here to request and appointment.

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