In this Q&A episode, Dr. Fred Gandolfo addresses a listener's concern about the risk of pancreatic cancer, especially in the context of family history. Dr. Gandolfo dives deep into understanding pancreatic cancer, its symptoms, and the importance of early detection. He explains who should consider screening, the methods used for screening, and the balance between the benefits and potential harms of such screenings.

Topics covered in this episode:

- The role and function of the pancreas. - Why pancreatic cancer is often diagnosed late. - Symptoms and risk factors for pancreatic cancer. - Statistics on the prevalence and survival rates of pancreatic cancer. - Who should be screened for pancreatic cancer. - Genetic syndromes and their link to pancreatic cancer. - Screening methods: MRI and Endoscopic Ultrasound (EUS). - Modifiable risk factors: Smoking, chronic pancreatitis, obesity, and diet. - Importance of consulting with a healthcare provider for personalized advice.

Referenced in today's episode: AGA Clinical Practice Update on Pancreas Cancer Screening

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In this episode, Dr. Fred Gandolfo tackles a pressing question: Is your doctor's time valued in today's fast-paced, on-demand world?

Drawing from a recent patient case involving a bad review, Dr. Gandolfo delves into the complexities of managing patient expectations, the pressures of private practice, and the true cost of follow-up phone calls.

Dr. Gandolfo shares his candid thoughts on the challenges faced by doctors in balancing patient care with personal time, especially in a private practice setting where patient satisfaction is paramount.

Topics covered in this episode:

- The value of a doctor's time in the age of immediate gratification. - Challenges of managing patient expectations and satisfaction in private practice. - The inefficiencies and frustrations of follow-up phone calls. - The importance of follow-up visits for comprehensive patient care. - The impact of online reviews on medical practices. - Comparing the value of time between doctors and other professionals like lawyers. - The personal cost of after-hours calls and maintaining work-life balance. - Legal and ethical considerations for patient privacy and follow-up care.

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

In this episode, we cover the relationship between food and gut inflammation. Using a case of diverticular disease, Dr. Gandolfo and guest Stephanie Schiff, RDN discuss the best way to start eating an anti-inflammatory diet.

Registered Dietitian Stephanie Schiff explores how dietary choices can influence the onset and recurrence of diverticulitis, a common yet often misunderstood condition. Through a real patient case, Dr. Gandolfo illustrates the challenges and treatment strategies for managing diverticulitis. Stephanie provides invaluable insights into the Mediterranean diet and its benefits on reducing gastrointestinal inflammation, debunking myths about seeds and nuts, and offering practical advice for incorporating high-fiber foods into your diet.

Topics covered in this episode:

- Introduction to diverticular disease and diverticulitis. - Case study of a 59-year-old woman with recurrent diverticulitis. - Risk factors for developing diverticular disease. - The role of diet in preventing and managing diverticulitis. - Debunking myths about seeds and nuts in diverticular disease. - The benefits of the Mediterranean diet and its anti-inflammatory properties. - Practical tips for increasing dietary fiber intake safely. - The impact of processed foods and lifestyle choices on gut health. - Supplements and other considerations for managing diverticulitis.

Referenced in today's show:

Review article on diverticular disease in Gastroenterology

Seeds and nuts in diverticular disease in JAMA

Dietary fiber and diverticulitis in Nutrients

AGA guidelines on diverticular disease

Follow Stephanie Schiff, RDN on Facebook, Instagram, TikTok, X, and LinkedIn

Read Stephanie's articles about healthy lifestyle and nutrition on medium.com

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Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

In this episode, Dr. Gandolfo covers the essential yet often dreaded topic of colonoscopy preparation, aka cleaning out your colon. With a mix of humor and expert advice, Dr. Gandolfo demystifies the process, emphasizing the importance of a thorough prep to ensure a successful colonoscopy. He shares practical tips and personal anecdotes to help you navigate the prep with ease, making sure you're well-prepared for this crucial cancer screening procedure.

Topics covered in this episode:

- The importance of colonoscopy prep for effective screening.

- Colorectal cancer statistics and the significance of early detection.

- The process of finding and consulting with a gastroenterologist.

- The role of polyps in the development of colorectal cancer and how colonoscopy can prevent cancer.

- Different types of bowel preps: liquid, pill, and over-the-counter options.

- Practical tips for a successful bowel prep, including dietary adjustments, medication management, and logistical considerations.

- Troubleshooting common issues with bowel prep, such as nausea and an incomplete cleanout.

- The benefits of split-dose prep and the importance of following instructions.

- The impact of insurance policies on pre-procedure consultations and prep coverage.

Referenced in today's show:

- Dr. Gandolfo's YouTube channel for detailed prep instructions and troubleshooting tips.

- The Real GI Doc Show Episode 15 on non-invasive colorectal cancer screening options.

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Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

In this episode, Dr. Gandolfo dives into a recent and rather sensational news story about a colonoscopy that took a troubling turn. The case involves an 84-year-old doctor in Florida who allegedly performed a colonoscopy without wearing his hearing aids, resulting in the patient screaming in pain without the doctor's knowledge.

Dr. Gandolfo provides his expert insights and thoughts on this unusual situation, discussing the importance of proper sedation, communication in the operating room, and the potential consequences of such incidents on the reputation of critical medical procedures like colonoscopies.

Topics covered in this episode:

- Overview of the Florida colonoscopy incident. - The importance of sedation during colonoscopy. - Communication and teamwork in the endoscopy suite. - Implications of sensational news stories on public perception of medical procedures. - Proper protocols and practices for performing colonoscopies. - The role of age and physical condition in a doctor's ability to perform procedures. - Encouragement for proper colorectal cancer screening.

Referenced in this episode: Fox News article "Tampa doctor couldn't hear colonoscopy patient scream because he wasn't wearing hearing aids, board finds"

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

In this episode, Dr. Gandolfo explores the latest advancements in non-invasive colorectal cancer screening, including the new FDA-approved "Shield" blood test and the updated Cologuard stool test. With only 60% of eligible individuals getting screened in the US, these new tests offer alternatives for those who are unable or unwilling to undergo a colonoscopy. Dr. Gandolfo dives into the pros and cons of these non-invasive tests and discusses their effectiveness compared to the gold standard of colonoscopy.

Topics covered in this episode:

- Introduction to non-invasive colorectal cancer screening options.

- Detailed explanation of the Shield blood test and its recent FDA approval.

- Overview of the updated Cologuard stool test and its improvements.

- Case study of a 73-year-old patient with undiagnosed colon cancer.

- The importance of early detection and screening for colorectal cancer.

- Sensitivity and specificity of non-invasive tests versus colonoscopy.

- Practical advice on choosing the right screening method based on age, health, and risk factors.

- The role of non-invasive tests in increasing screening rates among the unscreened population.

Referenced in today's show:

- Study on the new generation of Cologuard

- New England Journal of Medicine article on the Shield blood test

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Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

Dr. Gandolfo dives deep into the common yet often misunderstood issues of constipation and bloating. Drawing from real-life clinical experiences, Dr. Gandolfo provides valuable insights and practical advice for managing these prevalent gastrointestinal concerns.

Topics covered in this episode:

- A detailed case study of a 34-year-old woman with chronic bloating and constipation.

- The differential diagnosis process for bloating, including ruling out serious conditions.

- The difference between bloating and abdominal distension.

- Understanding the causes of bloating and constipation.

- Practical dietary and lifestyle changes to improve bowel movements.

- The role of fiber, water, and exercise in promoting digestive health.

- Effective use of over-the-counter remedies like psyllium husk and Miralax.

- The importance of bowel hygiene and daily routines to facilitate regular bowel movements.

- When to consider medical evaluation and prescription medications for chronic constipation and bloating.

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

In this episode, Dr. Fred Gandolfo explores the importance of taking action when faced with complicated health issues, drawing parallels between medical treatment and business management. Dr. Gandolfo emphasizes the need to start somewhere, even if everything isn't perfectly understood or optimized, and discusses how to avoid the pitfalls of over-researching and under-acting.

Topics covered in this episode:

- Understanding the urgency of addressing immediate health problems.

- The value and limitations of using the internet for medical research.

- Finding a trusted medical team and making informed decisions.

- The concept of "paralysis by analysis" and how to overcome it.

- Creating actionable plans with realistic timelines for health improvements.

- Breaking down long-term goals into daily, weekly, and monthly tasks.

- The importance of continuous action and adjustment in achieving health goals.

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Referenced in today's show- Episode 12: When the House is on Fire: Prioritizing Health Emergencies Over Root Causes

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