From checking a patient’s gut to scoping out a stomach and more, the gastroenterology department at Kansas Medical Clinic in Topeka is often the first in the state and sometimes the region to offer the latest diagnostics and procedures for gastrointestinal and related conditions.
KMC was founded more than 30 years ago by Shekhar Challa, MD, a board-certified gastroenterologist. It now has clinics in five Kansas communities and includes dermatology, plastic surgery, hair transplants and cosmetic procedures.
But diagnosing and treating gastroenterology conditions remains at the core of the practice, and it’s been marked by considerable advances in the past decade, Dr. Challa says.
Here’s a look at some of those advances.
New hepatitis C drugs. During his residency in the 1980s, Dr. Challa recalls, hepatitis C hadn’t yet been discovered or named. Until this decade, treatment was difficult, consisting of limited pharmacological options with about a 50 percent success rate. With newer protease inhibitors, which stop the virus from infecting more cells and replicating itself, “now, we have a 95 percent cure rate,” Dr. Challa says. Along with a high rate of efficacy, the newer drugs are helping reduce a patient’s risk for developing liver cancer. Nearly 50 percent of liver cancer cases in the U.S. can be attributed to hepatitis C, according to a 2016 report by the Centers for Disease Control and Prevention.
New weight-loss option. Obesity is on the rise in America, with many patients looking for weight-loss solutions. Within months of the FDA approving nonsurgical gastric balloon procedures in August 2015, KMC started offering the ORBERA intragastric balloon for qualifying, moderately obese patients. The deflated balloon is placed in the patient’s stomach with an endoscope and inflated with a saline solution until it’s about the size of a grapefruit. Patients start a 12-month program with coaching and education to make dietary and lifestyle changes. After six months, the balloon is deflated and removed, while the coaching continues. Since approving the balloon, the FDA has advised physicians closely monitor patients who have the balloon procedure for any adverse risks.
New liver scan. For years, a liver biopsy — conducted with a 6-inch needle in one section of the organ — was the gold standard to test the health of a liver and evaluate patients with hepatitis infections, fibrosis and cirrhosis. In 2014, KMC began offering the FibroScan procedure, after investing in the $165,000 system in which a probe placed on the skin sends vibrations into the liver and measures how long it takes for the vibrations to travel through the organ. Dr. Challa calls the noninvasive FibroScan a “game changer” for diagnosing liver conditions.
New detection systems. For patients with symptoms ranging from heartburn to bloating, the Kansas Medical Center offers procedures to measure for acid reflux and small intestinal bacterial overgrowth (SIBO). With an EGD, or upper endoscopy, with BRAVO pH test, a monitoring device is attached to the patient’s esophagus to measure and record the pH levels to determine if the patient suffers from gastroesophageal reflux disease. To detect and measure abnormal bacteria in the gut, KMC offers the noninvasive lactulose breath tests, in which a nonabsorbable sugar solution is swallowed and the hydrogen and methane gases, produced by the bacteria, are measured. SIBO can cause a variety of symptoms and conditions, including abdominal pain, bloating and weight loss. Dr. Challa has written a book about probiotics and gut health. The Kansas Medical Clinic also uses the SmartPill monitoring system to detect gastroparesis. With the SmartPill, a patient swallows a capsule that travels through the GI tract and wirelessly transmits data to a recording device worn by the patient. The capsule eventually passes with a regular bowel movement.