“As you know, most brands of magnesium citrate were recalled in July of last year, leaving patients with virtually no options of obtaining this product. This product is used for constipation and for certain bowel preps for colonoscopies.

There now appears to be certain locations where the product can again be purchased over the counter. Two of these locations are CVS stores (Freskaro brands) and Walgreens stores (Walgreen brand). They may be sold out at certain stores, but you can ask the pharmacist when they will be back in stock.

If you know of other locations that magnesium citrate can be purchased, please post them here.

Be well!

At SOMC Gastroenterology Associates we greatly appreciate the trust and support of our patients and referring providers. Along with this trust and support, comes an increase in the number of patients waiting for appointments. We understand the wait times for office visits and procedure (endoscopy and colonoscopy) appointments are very long, and we are doing everything we can to address this. To this end, we are actively looking to hire another Gastroenterologist to join our team, which will make a big difference toward this goal.

The inaugural word is TACHYPHYLAXIS (pronounced tackee-fil-axis).

Does this mean?:
A. An allergic reaction to penicillin
B. Loss of effect of a medication
C. Fast heart beat
D. A certain type of laxative

Tachy meaning “rapid”, and Phylaxis meaning “protection”. Tachyphylaxis means the rapid loss of the effects of a medication after repeated doses. It is similar to medication “tolerance”, however in general tolerance to medications occurs more slowly over time.

Tachyphylaxis can occur with many difference classes of medications, including anti-depressants, blood pressure meds, steroid creams. The classic GI class of medications that can result in tachyphylaxis are the H2 stomach acid blockers, such as ranitidine (used to be Zantac), famotidine (Pepcid), cimetidine (Tagamet).
Be well!

The word is “Diapedesis”.

Does this mean?
A) A baby’s ability to begin to walk
B) Having problems with urinating at night
C) The movement of a cell out of the bloodstream
D) Diarrhea causing dehydration

The answer is C: Diapedesis is the term for a cell (usually a white blood cell) moving out of the bloodstream, through the microscopic gaps in the wall of the blood vessel, and into the tissues. This is an intentional movement of the cell, most often associated with the inflammatory response or immune response of the particular tissue or organ. The circulating white blood cell is essentially being recruited to join the inflammatory response of that area.

The word is THROMBOCYTOPENIA (pronounced thrombo-syto-peenya).

Does this mean?
A) A condition that increases the risk for blood clots.
B) A low platelet count.
C) A precancerous condition of the bone marrow.
D) An elevated white blood cell count.

The answer is B: The normal range for platelet count is 150-400 (thousands). So, thrombocytopenia is any platelet count below 150,000. Some of the more common conditions that can cause this to happen include ITP, any bone marrow disease (since platelets are produced in the bone marrow), cirrhosis, and certain medications (such as heparin). The platelet count can sometimes drop to the single digits in these conditions. As long as the platelet count is above 20,000, we usually don’t need to transfuse platelets. Surgical procedures usually require the platelet count to be above 50,000.

March is colon (colorectal) cancer awareness month.

As part of raising awareness for this disease, I thought that I would post some common misconceptions regarding screening for this cancer.

“I feel fine without any symptoms, so I don’t need to be screened.”

False: With precancerous polyps and early colon cancer, you will not have any symptoms at all. Symptoms such as visible rectal bleeding and change in bowel habits only occur (if at all) when the cancer has been growing for a long time.

“I don’t have a family history of colon cancer so I don’t have to worry.”

False: 70% of people who develop colon cancer do NOT have any family history of colon cancer.

While colonoscopy is the preferred way to screen for colon and rectal cancer, acceptable options include stool DNA testing (Cologuard) and checking for hidden (occult) blood in the stool (FIT test).

The general public should start screening at age 45. Cologuard should NOT be used if you have a family history of colon cancer, have had polyps on previous colonoscopies, or if you have any symptoms. In these situations a colonoscopy is needed.

Remember to get screened if you are over age 45! Be well.

This trivia term is two words. The term is INTESTINAL METAPLASIA.

Does this mean….?

A) Blockage of the intestine with mucus

B) Weakness of the walls of the intestine

C) Change in the lining of the lower esophagus

D) A congenital deformity of the stomach

The correct answer is “C”, a change in the lining of the lower esophagus.

In this case, intestinal metaplasia refers to a change in the lining of the area of the esophagus where it connects to the stomach. This occurs as a result of chronic acid reflux over many years. Intestinal metaplasia is the medical term for Barrett’s esophagus, a pre-cancerous condition of the lower esophagus.

The reason for the term “intestinal” is due to the fact that the lining changes from normal esophagus mucosa to a more intestinal type lining.