November 30, 2025 • 43 mins
Tonight, on Your Health First, Dr. Galati starts by talking about his Kodiak Pancakes for breakfast. He also has Gastroenterologist Dr. Adeeb Dwairy join the show to explain the common GI complaints and how often he sees late cases. Dr. Galati also takes a few minutes to discuss the key things to be aware of in projecting for 2026.
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Episode Transcript
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Speaker 1 (00:01):
Initial life sequence.
Speaker 2 (00:04):
Coming to you live from Houston, Texas, home to the
world's largest medical center, and.
Speaker 3 (00:08):
The approach rays everything looking at.
Speaker 2 (00:19):
This is your Health First, the most beneficial health program
on radio with doctor Joe Galotti. During the next hour,
you'll learn about health, wellness and the provention of disease.
Speaker 1 (00:30):
Now here's your host, doctor Joe Galotti. Well a good
Sunday evening to everybody, Doctor Joe Galotti. The name of
the program you tune into tonight for the next hour
(00:52):
is your Health First. And that is exactly what we
are trying to do, putting your hell first, not third,
not fourth, not tenth, but number one. Our website is
doctor Jogalotti dot com. Signer for our newsletter, send me
(01:16):
a message. All of our social media is available there
for you to communicate back and forth with us. You
could send us a message and some of the information
tonight that will be sharing with everybody will be on
our Facebook page at doctor Joe Galotti. It's all that,
(01:38):
but you have to go to doctor Joeglotti dot com
get all those links tonight on the program. Doctor Adeeb Dowarry.
He is a gastronurologist. His practice is Houston Regional gastro
Neurology Institute. Their website is hrgastro dot com. And it's
his first time on the program tonight. We'll see how
(02:01):
he does. But he is a very articulate physician and
has put together a really fantastic practice here serving the
greater Houston area. I guess that's why they call it
Houston Regional gast Neurology Institute, and so where you know,
(02:21):
I really don't have a set agenda because I'm also
a gast neurologist. I'm a hepatologist deliver specialist. It's always
great to have another colleague on with you, but really
what I'm always interested in what are people coming in with?
What kind of abdominal symptoms? Diarrhea? Hey, we hate to
you know, I know it's seven o'clock on a Sunday evening,
(02:41):
but talking about diarrhea, constipation, blood your stool, nausea, vomiting, heartburn, indigestion,
sour stomach, all these things. And as you've all seen
as consumers, there are so many of these products. You're
watching TV in the evening, and they're there are symptoms,
(03:02):
there are there are there are supplements for various gi symptoms,
so I think buyer beware and having somebody like doctor
Duarion is really key. So he'll be coming up shortly.
Hope you had all a great Thanksgiving. I was with family.
It was a lovely day together. Kids were in town.
(03:23):
And of course a little bit of time to recharge,
recharge your battery. Taking four days off, I was lucky
to have four days off, and it was all it
was all very good. We have to be thankful for
all that we have, all right, So a couple of things.
Let's talk about breakfast. So this this morning, I got up,
(03:46):
but it was you know, as you know, it was
a bit of a gray day today, sort of fall
showing its colors even here in the Gulf Coast area.
Certainly other parts of the country Chicago snow. So it is,
you know, we can't forget it's almost tomorrow's December one.
We can't forget winter is just around the corner here.
(04:07):
But anyway, so my wife and I got up, and
you know, typically we would have oatmeal. I may make
a fruit with Greek yogurt, some nuts thrown in, may
have scrambled egg or an egg white omelet. But we're
really not into pancakes and waffles, all right, sort of
(04:31):
the American staple for breakfast. Let's have waffles, let's have pancakes.
But anyway, in our cabinet were these Kodiac pancake mix
and I looked at it and I said, well, it's
sort of a gray Sunday morning, it's sort of a
holiday weekend. Let's make Kodiac pancakes.
Speaker 3 (04:54):
Now.
Speaker 1 (04:55):
Their big selling point is that your going to get
fifteen to twenty one grams of protein, and that is
good for you. And I think people will be shopping
and saying, Achemima, that stuff is garbage. I'm going to
get these Kodiac cakes with fifteen eighteen twenty one grams
(05:19):
of protein because that's good for me. I'm putting my
health first. But the reality is, where is this protein
coming from. Well, if you just mix it with water,
you get fifteen grams of protein. It is because in
the ingredients it is way protein is added in there.
(05:39):
If you add milk instead of water, you get eighteen
grams of protein, and if you add milk and an
egg you get the twenty one. So it's really no
surprise that you're getting extra protein. Now I look at
it in my own sinister way, and I say, why
(06:04):
do we have to have this? Come on? To get
added protein by adding by eating a pancake or a waffle,
it sort of makes you feel good about yourself. Yeah,
I'm really eating crap for breakfast. But man, honey, we're
getting fifteen grams of protein. So let's let's take this apart.
(06:28):
How can you get fifteen grams of protein? Forget about
the pancakes. Well, have a serving of Greek yogurt. Now,
the Greek yogurt is going to give you far more
nutritional kick for your dollar than these kodiac cakes. Have
a piece of lean chicken breast, have a small serving
(06:52):
of black beans. You go to some more I don't
want to say Mexican restaurant for breatreakfast. You're going to
get a side of black beans with your breakfast burrito.
Which I'm not saying, go have a breakfast burrito just
to get that black beans. But there's nothing wrong with
(07:13):
you having an egg or some oatmeal or something and
having a side of some beans to get your added protein.
But you're with all of these other foods, be it
the beans, be it the Greek yogurt. You're getting far
more nutritional value then you're getting from a carbohydrate loaded
(07:39):
no fiber Kodiac cake. But we feel good because we're
getting that added protein. There is a great book to
read a friend of the program, doctor Garth Davis. He's
a very very well known bariatric surgeon for weight loss surgery.
He wrote a book it's got to be maybe ten
(08:01):
years by now, called Protein Halic, Protein Halic. I would
recommend getting that because he talks about the absurdity and
this fascination that we all have with getting protein protein, protein,
protein bars, protein snacks, eat beef jerky to get more protein.
(08:23):
It's crazy. We could get all the protein we need
naturally through a whole food, plant based diet. And he
talks about this very well, and we've had him on
the radio. You can look at some of the archives,
doctor Garth Davis, but certainly come the new year he'll
be on the program on a regular basis. So anyway,
take a look at these Kodiak cakes. I don't think
(08:44):
you need to get them now. Is it a better
alternative than Bisquick or Anchemima or any of these other
generic pancake mixes. Maybe because you're getting the protein. But
I would say, challenge yourself and figure out how you
can get added protein in your diet without having to
(09:08):
resort to somewhat you know, artificial intake. How about that?
All right? Doctor Adeeb Dowarr is coming up in a minute.
Doctor Joglotti dot com is our website. I am doctor
Joe Galotti. Every Sunday, and don't forget if you're traveling
over the holidays, the iHeartRadio app. We got you covered
(09:31):
every corner of the world. Stay tuned. We'll bright back
every Sunday evening. As you all know, we're here bringing
everybody the best in health and wellness and we are
raising your Health IQ, one listener at a time. I'm
doctor Joe Golotti. This is your Health First. And as
(09:51):
I was saying a little earlier in the program, one condition.
Speaker 3 (09:59):
That is.
Speaker 1 (10:03):
A big problem is GI problems. And if you watch TV,
there are all these products that people can buy and
people don't know what to do. I get phone calls
all the time about should I take this supplement or
that supplement, And I think the understanding of gastro and
testinal disorders is very confused. So on the line tonight
(10:25):
making his Your Health First debut is doctor Adeeb Dowarri.
He's the founder of Houston Regional Gastroneurology Institute here in Houston, Texas. Adeed,
welcome to the program and glad you have a few
minutes for tonight.
Speaker 4 (10:39):
Thanks doctor Glatty, and I appreciate having me on for
this radio debut for me.
Speaker 1 (10:44):
All right, well, it's an important topic. So first, just
since you're new to the program, just give a brief
thumbnail of who you are, your practice, where you're from,
and where you went to school, things like that.
Speaker 3 (10:59):
Yeah.
Speaker 4 (11:00):
So I'm a native Houstonian, you know, born and raised
here in Houston. You know, I did my university training
up at Baylor University traditional pre med.
Speaker 3 (11:08):
I got a degree in biology.
Speaker 4 (11:11):
Came back to Houston at the Center, completed my entire
medical training through medical medical school residency my G I
fellowship all at the University of Texas Health SCIDE Center,
and then I set a base here in Houston and
I started hr G. I. You know, I know, you
introduced it as Houston Regional Gasherology Institute, which is the
long name, and now we're eight Houston area locations and
(11:35):
a team of doctors around Houston.
Speaker 3 (11:37):
So uh yeah, G I G I is are bread
and butter and we love it.
Speaker 1 (11:41):
Yeah, Now tell me, in a typical day or week,
what would you say are the two or three most
common GI complaints that people come in with. Because the
way the way I look at this, and and and
the value of the program. There are people sitting home
tonight driving in the are coming home from Grandma's house
(12:03):
that is saying, you know, I have chronic abdominal pain,
I have heartburn, I have constipations. So in a in
a real world situation, what are you actually seeing?
Speaker 4 (12:14):
So you know, you hit you hit the top ones
pretty well. You know, I think people come to us,
you know, for complaints. You you covered them. Abdominal does comfort,
you know, whether it's upper right sided, lower gird, you know,
acid reflex, heartburn which is what they're commonly known as.
Speaker 3 (12:31):
Our altered vowel habits, you know, diarry or constipation.
Speaker 4 (12:34):
Those are probably the most common complaints, you know, but
probably the most common reason is really with the rise
of cancer is probably calling cancer screening, so that probably
encompasses what people come and see us for the most.
Speaker 1 (12:46):
Yeah, when when you look at patients and they come
in and they say, hey, I have heartburn. Do you
find that they've already seen their primary care physician, they
have to maybe self medicate because there are a lot
of over the counter products that are our geared towards
(13:08):
a GI complaint, be it and to acids. People are taking,
you know, zantac, they're taking increased fiber supplements. Do you
find that people come sort of trying to have a
do it yourself at home remedy to get started, and
when they they find out that they've been on something
(13:29):
for a week or a month, they say, wait a second,
I have to see somebody.
Speaker 4 (13:32):
Yeah, you know, with the you know, obviously with internet
and then the revolution of AI, the convenience of self treatment. Yeah,
you know, I think doctor Google is so convenient for
so many people. But you know, undertreated or poorly treated
heartburn leads to complications down the road, and I think
that's what's oftentimes unrecognized, which is where we really come
(13:55):
into play.
Speaker 3 (13:56):
You know.
Speaker 4 (13:56):
The labeling says, you know, if symptoms are unresolved after
fourteen days, really seek medical advice. And it's and it's
critical for a lot of reasons, and you can go
into those those complications. You know, for us it's the
common term is chronic esophagitis, which is that inflammation that's
left untreated, it could lead to you know, scarring, which
could cause strictures, which is narrowing in the estic yet sure,
(14:18):
it could lead to pre pre cancerous conditions like barret
and then obviously that can lead to add no carcinoma,
which is you know, softagal cancer. And then you know
a lot of people can deal with you know, even
upper symptoms, so you know, it can it can affect
the throat, so like laryngitis which leads to chronic cough,
it can affect their pulmonary system, so asthmatics can have
issues with it. So yeah, untreated or poorly treated heartburn
(14:43):
could have lots of chronic complications.
Speaker 1 (14:45):
So yeah, you know, going back and I don't have
the exact year, but it was probably a good twenty
years ago when the you know, my initial training in
medical school, the big breakthrough in medical therapy for GI
issues were the H two blockers. You know, zantac. Everybody
knows about zantac rinitidine and that was strictly by prescription,
(15:10):
and then that went over the counter and then the newer,
more effective and potent drugs, the proton pump and inhibitors
which were heavily heavily commercialized. Everybody got to know the
purple pill, and they were prescription as well. But about
it must have been fifteen to twenty years ago they
went over the counter. You did not need a prescription.
(15:32):
And I had said even back then that people are
going to self medicate themselves, and as you mentioned, potential
complications are not getting seen. These medicines look absolutely correct.
Fourteen days an NCAA dooctor. What do you when people
come and they've been on these medicines for years? What
do you say to them? And of course a very
(15:53):
cordial way, but what do you say to them?
Speaker 4 (15:55):
Yeah, so twenty also hit the timeframe appropriately, So it
was around two thousand and three where the I think
the first otc PPI went over the counter. So it
has been about twenty years where people have been able
to self medicate, right, you know, And it's and it's
so critical to recognize your symptoms. So so let's say
(16:15):
they have that stricture, that narrowing that that's causing their symptoms.
That could be from just you know, that scarring, or
it could be from cancer. So if patients are feeling
you know, food getting stuck, which is what we call
is phasia, or painful swallowing, which what we call a dinophasia. Uh,
they might be having unintentional weight loss. You know, I
know everyone wants to lose weight and stay in age,
(16:38):
not this way. You know, seeking seeking care is critical
because you know we you know, announce of prevention is
worth a pound of cure. You know Benjamin Franklin's you know,
one of his most famous proverbs or quotes. Uh, we
got to catch it early so we can prevent long
term problems down the road.
Speaker 1 (16:52):
Yeah. And I think there's a certain mentality that has
developed that everybody has heart, everybody has reflux, and I
have to tell thirty year olds or seventy year olds
that is not normal. You should not be walking around
with these symptoms. Do you do you find the same
(17:14):
sort of scenario with the patients you see every day.
Speaker 3 (17:18):
That's true.
Speaker 4 (17:19):
You know, there are a lot of treatment options, and
you know, now with the side effects or potential correlation
of long term uses of PPI used, we should be
managing it with some of the other options that we have.
Speaker 3 (17:35):
So you know, they're there.
Speaker 4 (17:37):
Oftentimes a patient might have a hidle hernia, and we
do now have minimally invasive options to fix the hidle
hernia and theoretically get you off of a proton pump
inhibitor which could have long term side effects. So there
are good options to get patients off PPIs and resolve
their heartburn.
Speaker 1 (17:56):
Yeah, and I've I've been known to say that hill
mentality where people simply they go see you and they say, doctor,
do Werry, I've got heartburn. No, I don't want to
get into all this testing, Just give me a prescription.
And that's the wrong thing. The other thing is the
rise in heartburn. The rise in these complications of soophagitis
(18:18):
and cancer is directly correlated with obesity. The rise in
obesity is just a major driver for heartburn. Now, does
when you're seeing somebody with heartburn and indigestion, does the
obesity discussion come up as well?
Speaker 3 (18:35):
It does?
Speaker 4 (18:35):
You know how funny enough, I don't feel like I'm
entirely overweight. But when I had my first endoscopy, I
had a small high to hernia and before we talked
about repair, one of the first things my gosh just
told me was to lose ten pounds because it is
life changing and symptom resolving. So you know, before the pill,
(18:57):
lifestyle changes make a huge difference.
Speaker 1 (18:59):
All Right, you know we're going to we're gonna take
a quick break here. We are honor tonight to have
doctor adib Dwari. He's the founder of Houston Regional Gastronurology Institute.
The website there for more information is Hrgastro dot com.
Our website Doctor Joegalotti dot com. You're tuned into your
Health First, Stay tuned. We will be right back. Welcome
(19:21):
back everybody, Doctor Joe Galotti, thanks for tuning into your
health first tonight every Sunday, every single Sunday between seven
and eight pm Central, broadcasting from our world headquarters here
in Houston seven forty KTRH and heard around the globe
on the iHeart app, iHeartRadio Network. So happy to have
(19:43):
doctor adib Dwari. He is a gastro and terrologist. He's
the founder of Houston Regional Gastroentrology Institute here in Houston, Texas.
And we've been chatting about various GI complaints, but one
of my I don't want to say it's a pet
peeve because it's not like I'm annoyed at it at all.
(20:03):
But patients come late with symptoms. They have chronic constipation,
they have diarrhea, they may see bloodness stools, and either
they're just simply embarrassed or in denial. But many times
we see patients late and we look to ourselves and say, man,
(20:26):
if you only got here a week, a month, six
months earlier. So how often in your daily practice with
you and your partners do you see these late cases,
either patients that refer to themselves laid or their primary
care physician doesn't quite have a timely referral. What's the
(20:47):
real world story out there?
Speaker 4 (20:50):
Yeah, you know, speaking to colon cancer specifically, it's one
of the most preventable cancers right. Absolutely, it comes with
early screening and so if we find that pollup early,
we remove it.
Speaker 3 (21:02):
We literally eliminate that cancer from forming.
Speaker 4 (21:04):
So a delayed care really is a is a huge issue. So,
you know, yes to your points, was it something else
that we thought was the cause?
Speaker 3 (21:14):
And you know, hoping that time will heal.
Speaker 4 (21:17):
You know, I am a believer in that based on
the circumstance that the time and the body will heal.
But for example, let's say you're having a cardiac event.
You know, you might not have your body or time
to heal down the road. So you know, you know,
you got to take it seriously. So I always, you know,
tell the you know, you know, think I'm a patient myself,
So thinking about the circumstance. If something doesn't seem right
or doesn't add up, you know, for everyone listening tonight,
(21:39):
you seek care. It might be elective where you can
schedule it down the road, and it might be urgent
where you need you need to go to your er
or your urgent care urgently. But if it, if it
doesn't add up, you know, your body best seat care.
Speaker 3 (21:52):
Yeah yeah.
Speaker 1 (21:52):
And you know the other thing with regard to colon
cancer and and so the American Cancer Society and other
organists as have dropped down the age where screening should start.
So your typical no family history of colon cancer polyps
forty five years old. It used to be fifty and
(22:13):
that was sort of the you know, part of your
fiftieth birthday was you'd get some gag gift about having
to get your colonoscoby. Of course, but now it's forty five,
and you know, patients still are somewhat I think it's
getting better. I think the current group of forty five
year olds and fifty year olds are getting a little
(22:33):
bit more in tune with what they need to do.
But they will always say is there or an alternative?
What else can I do? And I know colon guard
is again heavily promoted on TV in print. How do
you talk to patients about colon guard rather than a colonoscoby?
Speaker 4 (22:52):
So this one's very personal, so you know, to your point,
the American Cancer Society changed the recommendations in twenty eighteen,
and it took a couple of years later where the
United States Service Task Force in twenty twenty one changed
the screening age where the forty five is the new fifty.
Speaker 3 (23:10):
But for me personally, that wouldn't have worked.
Speaker 4 (23:12):
And I say that, you know, to our point previously
that delaying care would would have been an issue. My
wife and I had traveled overseas. I was thirty years
thirty years old at the time, and I thought I
had eaten some undercook ground beef and I had some
gi symptoms that I was underplaying, and you know, being
a gastroologist myself, I thought it was infectious. I wasn't
(23:33):
really worried about it. I was going to take some
antabotics and let it pass. My wife wanted me to
get a colonoscopy, and you know, she's an attorney, not
a physician, but was insisting I did, and so I did.
With no family history of colon cancer or colon polyps
at the time, I proceeded to get one and I
had a very large pre cancer's colon polyp.
Speaker 3 (23:52):
Wow.
Speaker 4 (23:53):
Now in forty three, have have had four colonoscopies and
pending my fifth one now and I wouldn't be here
today if it wasn't for that colonoscopy at thirty not
meeting guidelines. So why did they change the guidelines from
fifty to forty five Is we were missing fifteen percent
of colon cancers by making the general population or recommending
(24:14):
the general population to wait till fifty, and that was
just too much. We also noticed that the patients born
in the nineties, in comparison to patients born in people
born in the nineties and in comparison to people born
in the fifties had a two times risk of callon cancer,
and the incidents of callon cancer in the last two
decades have also doubled and advanced colon cancers for patients
(24:36):
under the age of fifty five, and so there's almost
been a cancer pandemic and early screening is credential as critical,
which is why we lowered the age to forty five.
And to answer your question, what's the difference between holi
guard or kolonoscopies? If the best screening test is just
the one that the patient will do, and so we're
(24:58):
just pushing for screening because if we can just identify
the lesion sooner, we're hoping that we can prevent colon
cancer from forming. Right now, if you're gonna if you're
gonna break down the different types of screening tests, colonoscopy
is still the gold standard and the reason why it's
not only diagnostic, but it's also therapeutic. So while we're
doing the diagnostic test, we can therapeut therapeutically remove the
(25:20):
pre cancerous polyps. All the other tests, whether that's colon
guard which is the stool based test, or SHIELD which
is the blood test, the blood based test, screening tests,
you know, those are still just diagnostics. You still have
your your fecal cold blood test, which is a stool
based test, which is just looking for you know, bl
blood in the stool.
Speaker 3 (25:41):
Uh.
Speaker 4 (25:41):
You have your CT colonography, which is just an imaging
scan of the the colon.
Speaker 3 (25:46):
Uh.
Speaker 4 (25:46):
You have your your short form of the kolonoscity, which
is a flexible sigmoidoscopy. But once again, nothing meets to them,
to the standard of the colonoscopy. So if you're gonna
get screened once again, choose the one that you'll do.
Speaker 3 (25:59):
But a gold standard is the colonoscopy.
Speaker 4 (26:02):
You know.
Speaker 1 (26:02):
That's that's great.
Speaker 3 (26:03):
Now.
Speaker 1 (26:04):
The one thing that the public needs to be clear
on is we are saying screening for in this particular case,
colon cancer, but for colon guard just just to just
to isolate colar guard. That is for people that have
(26:25):
no symptoms. And I believe the fine print says no
family history of colon cancer. Is that right?
Speaker 3 (26:33):
So you're right.
Speaker 4 (26:35):
So when it comes to those screening tests, you're not
supposed to have red flag. So if you have a
previous history yourself or family history those type of screening tests,
whether that colar guard or the blood test runs like shield,
you're not really a candidate for that type of screening
test because you're already potentially a high risk candidate, and
so the likelihood of that test being positive is higher
(26:58):
or you will end up getting a colonoscar anyways, right,
And why that's important is you know, with your with
your with your healthcare plan, you qualify for a screening test.
Speaker 3 (27:08):
And that's just one screening test.
Speaker 4 (27:10):
And so if you choose colon guard or shield or
any of the other ones and it comes back positive,
your colonoscopy that would have been covered on your first
round will no longer be covered because no longer is
your colonos be considered screening.
Speaker 3 (27:24):
It's now considered diagnostic.
Speaker 4 (27:26):
Right, And so if you had chosen your kolonosopy to
be your first screening test, that that initial test, which
was once again not only screening on diagnostic I am
you know sorry, screening and therapeutic, it is now going
to be considered subject to your deductible.
Speaker 3 (27:41):
So there's a financial implication if it's not your first choice.
Speaker 1 (27:44):
Yeah, and it's unfortunate that the the the maze of
the insurance where if and and patients will come to
they and and they'll get a bill from from our
center or from the insurance company saying hey, I thought
this was covered and I'm like, no, the coding is
you have symptoms, you have blood in your stool, it's
not screening anymore. So again, my big take home is
(28:07):
you don't want to have this false sense of security
where somebody will come in and say, I have cramps,
I see a little blood in my stool, I have diarrhea.
But doctor Galotti or doctor or doctor do worry. My
color guard was negative, so they think they're off the hook.
But I would say, no, this still needs to be investigated.
(28:29):
What do you say exactly?
Speaker 4 (28:31):
I mean, we've had many false negative colon guards that
lead to a diagnosis on colonoscopy. And then there's also
the anxiety with positive colon guards, right, and that is
a colon cancer screening test where so patients come to
us where they have a positive test and then automatically
deferred without a great explanation. Right, are now in our
(28:52):
hands with the anxiety of a colonosopy pending, right that
we have to work them through those emotions.
Speaker 3 (28:56):
So you know, once again, kolonosky is your stop shop.
Speaker 4 (29:00):
It's your gold standard, absolutely, and if it's your first test,
you're the likelihood of having that one fully financially covered
is much higher than if you had a preceded test.
Speaker 1 (29:09):
Right, Okay, final final sort of thought before we let
you go for tonight. Obesity, Now obesity. We both know
that obesity and fatty liver. Our major concern is the
development of soorrhosis. We're talking about this all the time.
You and I are both affiliated in various research studies
(29:33):
that we are doing together. But again, I want your
your viewpoint. A patient comes in be it with heartburn, indigestion,
and they have these mildly elevated liver chemistries, they have
an ultrasound that's been done for whatever reason that shows
a fatty liver. What's the conversation that you have with them?
Speaker 3 (29:57):
Take it seriously, you know.
Speaker 4 (30:00):
So when we we identify those elevated LFTs and we
proceed with the work up, it's not just something that
we can kind of put off on the back burner.
It's to dig in a little bit deeper, especially in
this day and age. You know, when we talk about cirrhosis,
everybody automatically thinks of alcohol as the cause or viral hepatitis.
But in the States, fatty liver is just as much
(30:22):
of a cause as those other two conditions. Which we've
really eliminated through education or minimize so you know, with
the with the you know, the cures for hepatitis c
H and the treatment for hepatitis B, and then the
support systems for alcohol. You know, we've been able to
manage those two causes for cirhosis, but fatty liver is
just growing, uh in our in our population. Thankfully, with
(30:45):
you know, education and acknowledgment, we're able to you know,
build support networks and then now with new therapies coming
on the horizon, hopefully we can we can bring this
condition under control as well.
Speaker 1 (30:55):
Yeah, it really is. It is a my opinion, since
that you know, I am in you know, live disease.
This is public health crisis number one. Fatty livid disease
again tied in with diabetes and metabolic syndrome. And again
we cannot discount the idea that so many of these
GI complaints that you see are somehow obesity related. We
(31:18):
have to make make that connection. So what I would
what I would say now, doctor, do worry? We have
to definitely get you back. You've been fantastic tonight. What
would you say for the next time? Topics that you
you think we need to cover uh in an effort
as I like to say, raise everybody's health, IQ. What
(31:40):
what are the one or two things that that we
should talk about next time?
Speaker 4 (31:44):
So, I mean, I know we talked about, you know,
the three most common presentations for GI you know, being
altered batol, habits.
Speaker 3 (31:50):
We didn't really get into it this time. I mean,
that's one for next time.
Speaker 4 (31:53):
I'd still like to dig in more on con cancer awareness,
just because I don't want that to be forgotten. Maybe
we can save that from March when it's cancer awareness mine, right,
And then you know, one of the causes of you know,
gatrick cancer is H pylori. Yes, yes, it's oftentimes asymptomatic,
so people don't even know they have it, and it's
just a simple test that we can identify and actually
(32:14):
treating cure.
Speaker 1 (32:14):
So all right, I say, next visit H pylori, we're
gonna be talking about that. Doctor Adeeb. It's been fantastic
having you on and we just have to get you back.
That's as simple as it is.
Speaker 3 (32:28):
Sounds great. Thanks for having me, This was wonderful, all right, thank.
Speaker 1 (32:31):
You, Welcome back everybody. Doctor Joglati. Final segment on this
post Thanksgiving Sunday night. I want to thank doctor Adeb
Dowarri for coming on. He made a lot of sense
in his approach to GI disorders colon cancer screening. And
(32:56):
the bottom line for all of this is is you
have to be in tune with your your body. That's
what it comes down to. We don't have gauges and
other flashing lights that will go off if something is wrong.
(33:21):
You basically have to take the responsibility to say or
have a sense of what normal is. You should not
be having chronic abdominal pain every day and think that
this is part of being fifty, or having chronic diarrhea
or chronic nausea or a little bit of blood in
(33:44):
the stool because you know I've got hemorrhoids. Well, I
can't tell you how many cases of alleged hemorrhoids I've
seen over the past thirty five years that have turned
out to be anything but a hemorrhoid. And people sit
on this too long, and so you have to really
be careful to get more information on doctor Dowary and
(34:04):
his really fantastic team, which I fully endorse, knowing him well.
And it's it's both the you know, the the person,
the physician that is ethical as well as his mission.
Contact him. It's hr Gastro dot com. Hr gastro dot
(34:27):
com to get in touch with doctor Dowarri and his team.
All right, so final, final, few minutes here. So it
is the holiday season and it is stressful. It should
be full of love, faith and family, but sometimes we
(34:52):
all get a little derailed and lose sight of you know,
what we're doing here. But with regard to your health
and wellness, which I would I would say, and it's
so so trait. Everybody has heard this. If you have
your health, you have everything. And that is true because
(35:16):
when for someone like me, I deal with very very
sick patients with liver disease. And when you are chronically ill,
you're not able to work, You're not able to take
care of yourself fully. You're always visiting the doctor. You
have a handful of medicines you're on that is giving
(35:37):
you side effects in one of a hundred different ways.
You don't have energy, you're fatigued, your mood goes down,
you don't enjoy life, you can't enjoy your family, you
can't enjoy your grandkids. And so you can have all
the money in the world, have the biggest house anywhere.
(36:01):
But if you're not healthy and you don't have a
sense of wellness, you might as well just flush it
all down the toilet. Because you can't buy yourself health.
It's something that you have to really earn in a way.
And as I said every week on the radio here
(36:21):
and I tell this to patients just about every single day,
it's no accident when you come across people that are
really healthy even later in life. These are people that
are committed to exercising, they're committed to a good diet.
They have never had a period in their life where
they drank excessively, smoked, did drugs, ran the hard life.
(36:48):
It will catch up with you, all right. So with
that said, in projecting for twenty twenty six, now, I
know it's tomorrow's December one, and you've got all of
December to get up to December thirty first, but let's
start thinking about this now, what are the key things
(37:09):
that you need to be aware of. Start to think
about not just about you, but your family, your spouse,
your children, your significant other, those people that are closest
around you, that circle of trust that we all have,
the people that are closest to us, and maybe an employee,
and may be a best friend, could be a neighbor,
(37:31):
whoever it is in your life. These are the punch
list things that you need to really think about. Number One,
take an honest look at your weight. Take an honest
look at your weight. Jump on the scale tomorrow morning,
see what your weight is. Calculate your body mass index.
(37:54):
Now this is not the perfect indicator of normal weight
or or being overweight or obesity, but it is a
good start and you have to look at it. And
there are one hundred and one BMI body mass index
calculators on your smartphone. So you take your weight and
(38:18):
your height, plug it in BMI and see if you're
in the normal range, your overweight, or you obese or
god forbid, if your BMI is over forty, you're morbidly obese.
And look at strategies to get your weight down. But
you really have to take inventory as to what you're doing.
(38:38):
Am I exercising yes?
Speaker 3 (38:40):
Or no?
Speaker 1 (38:40):
Am I eating out too much? Am I eating processed foods?
When was the last time I made a scratch meal?
Meaning you took the raw ingredients, chopped up the vegetables,
chopped up some protein fish whatever it was, and you
cooked it from scratch. So take a look at your
weight number two And I was talking about this a
(39:01):
couple of weeks ago. No, you're blood pressure. Know your
blood pressure. Having high blood pressure is no good, leads
to heart disease, put you at risk of stroke, kidney disease,
heart failure. It's silent. You will not be sitting there
tonight nearly eight o'clock and say, oh, man, I think
(39:23):
I've got high blood pressure. Most of the time, unless
it is really high, you're not going to have headaches,
any other chest pain, things like that. But you want
to know what your blood pressure is. If you don't
have a blood pressure cuff, go pick one up. Next
thing is exercise. Our bodies were meant to move, and
so you have to at least think about some sort
(39:47):
of exercise schedule or strategy, even if it is just walking.
I would be happy. Get a good pair of sneakers,
some good socks, stretch before you go on walk, make
sure it's safe outside. Or if you walk on a
treadmill at the gym and try to start to incrementally
(40:07):
increasing the amount of time you spend on walking. You
could add in resistance training with weights, bands. They have
all kinds of gadgets machines at the gym. You could
just buy a five or ten pound dumbbell and do
a full body workout with one single dumbbell. You don't
(40:27):
have to invest hundreds and thousands of dollars. The next
thing is know your family history. We again, these are
things that we've talked about, but very very worthwhile bringing up.
You want to know your family history with regard to cancer.
We talked about colon cancer earlier with doctor Dwari. Colon
(40:48):
cancer unfortunately runs in families, and so you want to know,
did your brother, did your sister, did one of your aunts?
Did a parent or a grandparent have colding care? Answer
ditto on the presence of polyps. Just having polyps increases
(41:08):
your risk of having polyps and or colon cancer, so
you want to keep on top of that. Then we
have breast cancer, pancreated cancer, prostate cancer, all of these
things you want to know the family history, diabetes, heart failure,
There are certain types of liver disease that are hereditary
and tend to run in families. You know, did you
(41:30):
have aunt Sue that died at forty five? Of prhosis,
but she never drink. That should be an eye opener
to everybody. What did you have? Did she have something genetic?
That's your family history. So I think if you start
really taking inventory on all of these different points, you
(41:52):
can start to make an impact. The other point, which
we've been saying Old Evening tonight, you have to listen
to your body aches and pains. Yes, some aches and
pains go with getting older, usually in the form of arthritis,
stiff hip, stiff back, shoulder, neck, things like that. But
(42:15):
when you're having shortness of breath, cough, chronic headache, visual changes,
chest pain, palpitations, your hardest skipping beats, all of the
digestive and GI symptoms, trouble swallowing, nausea, reflux, heartburn, vomiting,
(42:36):
bloating blood in your stool, constipation, diarrhea, weight loss, unexplained
weight loss. These are things that you have to be,
you know, really dialed into and have a sense of
you know, what is it that I need to be
aware of? And I think that you know speaks volumes,
(43:03):
all right, So with that said, we're going to close
out this Sunday Evening. Thanks again to doctor Dewari and
his team at Houston Regional Gastronurology Institute hr Gastro dot
com don't forget doctor Jogalotti dot com is a way
to get in touch with me. All of our social
media is there. Send me a message, let me know
(43:23):
what's on your mind, and we'll be back next Sunday evening.
Take care, everybody,
Initial life sequence.
Speaker 2 (00:04):
Coming to you live from Houston, Texas, home to the
world's largest medical center, and.
Speaker 3 (00:08):
The approach rays everything looking at.
Speaker 2 (00:19):
This is your Health First, the most beneficial health program
on radio with doctor Joe Galotti. During the next hour,
you'll learn about health, wellness and the provention of disease.
Speaker 1 (00:30):
Now here's your host, doctor Joe Galotti. Well a good
Sunday evening to everybody, Doctor Joe Galotti. The name of
the program you tune into tonight for the next hour
(00:52):
is your Health First. And that is exactly what we
are trying to do, putting your hell first, not third,
not fourth, not tenth, but number one. Our website is
doctor Jogalotti dot com. Signer for our newsletter, send me
(01:16):
a message. All of our social media is available there
for you to communicate back and forth with us. You
could send us a message and some of the information
tonight that will be sharing with everybody will be on
our Facebook page at doctor Joe Galotti. It's all that,
(01:38):
but you have to go to doctor Joeglotti dot com
get all those links tonight on the program. Doctor Adeeb Dowarry.
He is a gastronurologist. His practice is Houston Regional gastro
Neurology Institute. Their website is hrgastro dot com. And it's
his first time on the program tonight. We'll see how
(02:01):
he does. But he is a very articulate physician and
has put together a really fantastic practice here serving the
greater Houston area. I guess that's why they call it
Houston Regional gast Neurology Institute, and so where you know,
(02:21):
I really don't have a set agenda because I'm also
a gast neurologist. I'm a hepatologist deliver specialist. It's always
great to have another colleague on with you, but really
what I'm always interested in what are people coming in with?
What kind of abdominal symptoms? Diarrhea? Hey, we hate to
you know, I know it's seven o'clock on a Sunday evening,
(02:41):
but talking about diarrhea, constipation, blood your stool, nausea, vomiting, heartburn, indigestion,
sour stomach, all these things. And as you've all seen
as consumers, there are so many of these products. You're
watching TV in the evening, and they're there are symptoms,
(03:02):
there are there are there are supplements for various gi symptoms,
so I think buyer beware and having somebody like doctor
Duarion is really key. So he'll be coming up shortly.
Hope you had all a great Thanksgiving. I was with family.
It was a lovely day together. Kids were in town.
(03:23):
And of course a little bit of time to recharge,
recharge your battery. Taking four days off, I was lucky
to have four days off, and it was all it
was all very good. We have to be thankful for
all that we have, all right, So a couple of things.
Let's talk about breakfast. So this this morning, I got up,
(03:46):
but it was you know, as you know, it was
a bit of a gray day today, sort of fall
showing its colors even here in the Gulf Coast area.
Certainly other parts of the country Chicago snow. So it is,
you know, we can't forget it's almost tomorrow's December one.
We can't forget winter is just around the corner here.
(04:07):
But anyway, so my wife and I got up, and
you know, typically we would have oatmeal. I may make
a fruit with Greek yogurt, some nuts thrown in, may
have scrambled egg or an egg white omelet. But we're
really not into pancakes and waffles, all right, sort of
(04:31):
the American staple for breakfast. Let's have waffles, let's have pancakes.
But anyway, in our cabinet were these Kodiac pancake mix
and I looked at it and I said, well, it's
sort of a gray Sunday morning, it's sort of a
holiday weekend. Let's make Kodiac pancakes.
Speaker 3 (04:54):
Now.
Speaker 1 (04:55):
Their big selling point is that your going to get
fifteen to twenty one grams of protein, and that is
good for you. And I think people will be shopping
and saying, Achemima, that stuff is garbage. I'm going to
get these Kodiac cakes with fifteen eighteen twenty one grams
(05:19):
of protein because that's good for me. I'm putting my
health first. But the reality is, where is this protein
coming from. Well, if you just mix it with water,
you get fifteen grams of protein. It is because in
the ingredients it is way protein is added in there.
(05:39):
If you add milk instead of water, you get eighteen
grams of protein, and if you add milk and an
egg you get the twenty one. So it's really no
surprise that you're getting extra protein. Now I look at
it in my own sinister way, and I say, why
(06:04):
do we have to have this? Come on? To get
added protein by adding by eating a pancake or a waffle,
it sort of makes you feel good about yourself. Yeah,
I'm really eating crap for breakfast. But man, honey, we're
getting fifteen grams of protein. So let's let's take this apart.
(06:28):
How can you get fifteen grams of protein? Forget about
the pancakes. Well, have a serving of Greek yogurt. Now,
the Greek yogurt is going to give you far more
nutritional kick for your dollar than these kodiac cakes. Have
a piece of lean chicken breast, have a small serving
(06:52):
of black beans. You go to some more I don't
want to say Mexican restaurant for breatreakfast. You're going to
get a side of black beans with your breakfast burrito.
Which I'm not saying, go have a breakfast burrito just
to get that black beans. But there's nothing wrong with
(07:13):
you having an egg or some oatmeal or something and
having a side of some beans to get your added protein.
But you're with all of these other foods, be it
the beans, be it the Greek yogurt. You're getting far
more nutritional value then you're getting from a carbohydrate loaded
(07:39):
no fiber Kodiac cake. But we feel good because we're
getting that added protein. There is a great book to
read a friend of the program, doctor Garth Davis. He's
a very very well known bariatric surgeon for weight loss surgery.
He wrote a book it's got to be maybe ten
(08:01):
years by now, called Protein Halic, Protein Halic. I would
recommend getting that because he talks about the absurdity and
this fascination that we all have with getting protein protein, protein,
protein bars, protein snacks, eat beef jerky to get more protein.
(08:23):
It's crazy. We could get all the protein we need
naturally through a whole food, plant based diet. And he
talks about this very well, and we've had him on
the radio. You can look at some of the archives,
doctor Garth Davis, but certainly come the new year he'll
be on the program on a regular basis. So anyway,
take a look at these Kodiak cakes. I don't think
(08:44):
you need to get them now. Is it a better
alternative than Bisquick or Anchemima or any of these other
generic pancake mixes. Maybe because you're getting the protein. But
I would say, challenge yourself and figure out how you
can get added protein in your diet without having to
(09:08):
resort to somewhat you know, artificial intake. How about that?
All right? Doctor Adeeb Dowarr is coming up in a minute.
Doctor Joglotti dot com is our website. I am doctor
Joe Galotti. Every Sunday, and don't forget if you're traveling
over the holidays, the iHeartRadio app. We got you covered
(09:31):
every corner of the world. Stay tuned. We'll bright back
every Sunday evening. As you all know, we're here bringing
everybody the best in health and wellness and we are
raising your Health IQ, one listener at a time. I'm
doctor Joe Golotti. This is your Health First. And as
(09:51):
I was saying a little earlier in the program, one condition.
Speaker 3 (09:59):
That is.
Speaker 1 (10:03):
A big problem is GI problems. And if you watch TV,
there are all these products that people can buy and
people don't know what to do. I get phone calls
all the time about should I take this supplement or
that supplement, And I think the understanding of gastro and
testinal disorders is very confused. So on the line tonight
(10:25):
making his Your Health First debut is doctor Adeeb Dowarri.
He's the founder of Houston Regional Gastroneurology Institute here in Houston, Texas. Adeed,
welcome to the program and glad you have a few
minutes for tonight.
Speaker 4 (10:39):
Thanks doctor Glatty, and I appreciate having me on for
this radio debut for me.
Speaker 1 (10:44):
All right, well, it's an important topic. So first, just
since you're new to the program, just give a brief
thumbnail of who you are, your practice, where you're from,
and where you went to school, things like that.
Speaker 3 (10:59):
Yeah.
Speaker 4 (11:00):
So I'm a native Houstonian, you know, born and raised
here in Houston. You know, I did my university training
up at Baylor University traditional pre med.
Speaker 3 (11:08):
I got a degree in biology.
Speaker 4 (11:11):
Came back to Houston at the Center, completed my entire
medical training through medical medical school residency my G I
fellowship all at the University of Texas Health SCIDE Center,
and then I set a base here in Houston and
I started hr G. I. You know, I know, you
introduced it as Houston Regional Gasherology Institute, which is the
long name, and now we're eight Houston area locations and
(11:35):
a team of doctors around Houston.
Speaker 3 (11:37):
So uh yeah, G I G I is are bread
and butter and we love it.
Speaker 1 (11:41):
Yeah, Now tell me, in a typical day or week,
what would you say are the two or three most
common GI complaints that people come in with. Because the
way the way I look at this, and and and
the value of the program. There are people sitting home
tonight driving in the are coming home from Grandma's house
(12:03):
that is saying, you know, I have chronic abdominal pain,
I have heartburn, I have constipations. So in a in
a real world situation, what are you actually seeing?
Speaker 4 (12:14):
So you know, you hit you hit the top ones
pretty well. You know, I think people come to us,
you know, for complaints. You you covered them. Abdominal does comfort,
you know, whether it's upper right sided, lower gird, you know,
acid reflex, heartburn which is what they're commonly known as.
Speaker 3 (12:31):
Our altered vowel habits, you know, diarry or constipation.
Speaker 4 (12:34):
Those are probably the most common complaints, you know, but
probably the most common reason is really with the rise
of cancer is probably calling cancer screening, so that probably
encompasses what people come and see us for the most.
Speaker 1 (12:46):
Yeah, when when you look at patients and they come
in and they say, hey, I have heartburn. Do you
find that they've already seen their primary care physician, they
have to maybe self medicate because there are a lot
of over the counter products that are our geared towards
(13:08):
a GI complaint, be it and to acids. People are taking,
you know, zantac, they're taking increased fiber supplements. Do you
find that people come sort of trying to have a
do it yourself at home remedy to get started, and
when they they find out that they've been on something
(13:29):
for a week or a month, they say, wait a second,
I have to see somebody.
Speaker 4 (13:32):
Yeah, you know, with the you know, obviously with internet
and then the revolution of AI, the convenience of self treatment. Yeah,
you know, I think doctor Google is so convenient for
so many people. But you know, undertreated or poorly treated
heartburn leads to complications down the road, and I think
that's what's oftentimes unrecognized, which is where we really come
(13:55):
into play.
Speaker 3 (13:56):
You know.
Speaker 4 (13:56):
The labeling says, you know, if symptoms are unresolved after
fourteen days, really seek medical advice. And it's and it's
critical for a lot of reasons, and you can go
into those those complications. You know, for us it's the
common term is chronic esophagitis, which is that inflammation that's
left untreated, it could lead to you know, scarring, which
could cause strictures, which is narrowing in the estic yet sure,
(14:18):
it could lead to pre pre cancerous conditions like barret
and then obviously that can lead to add no carcinoma,
which is you know, softagal cancer. And then you know
a lot of people can deal with you know, even
upper symptoms, so you know, it can it can affect
the throat, so like laryngitis which leads to chronic cough,
it can affect their pulmonary system, so asthmatics can have
issues with it. So yeah, untreated or poorly treated heartburn
(14:43):
could have lots of chronic complications.
Speaker 1 (14:45):
So yeah, you know, going back and I don't have
the exact year, but it was probably a good twenty
years ago when the you know, my initial training in
medical school, the big breakthrough in medical therapy for GI
issues were the H two blockers. You know, zantac. Everybody
knows about zantac rinitidine and that was strictly by prescription,
(15:10):
and then that went over the counter and then the newer,
more effective and potent drugs, the proton pump and inhibitors
which were heavily heavily commercialized. Everybody got to know the
purple pill, and they were prescription as well. But about
it must have been fifteen to twenty years ago they
went over the counter. You did not need a prescription.
(15:32):
And I had said even back then that people are
going to self medicate themselves, and as you mentioned, potential
complications are not getting seen. These medicines look absolutely correct.
Fourteen days an NCAA dooctor. What do you when people
come and they've been on these medicines for years? What
do you say to them? And of course a very
(15:53):
cordial way, but what do you say to them?
Speaker 4 (15:55):
Yeah, so twenty also hit the timeframe appropriately, So it
was around two thousand and three where the I think
the first otc PPI went over the counter. So it
has been about twenty years where people have been able
to self medicate, right, you know, And it's and it's
so critical to recognize your symptoms. So so let's say
(16:15):
they have that stricture, that narrowing that that's causing their symptoms.
That could be from just you know, that scarring, or
it could be from cancer. So if patients are feeling
you know, food getting stuck, which is what we call
is phasia, or painful swallowing, which what we call a dinophasia. Uh,
they might be having unintentional weight loss. You know, I
know everyone wants to lose weight and stay in age,
(16:38):
not this way. You know, seeking seeking care is critical
because you know we you know, announce of prevention is
worth a pound of cure. You know Benjamin Franklin's you know,
one of his most famous proverbs or quotes. Uh, we
got to catch it early so we can prevent long
term problems down the road.
Speaker 1 (16:52):
Yeah. And I think there's a certain mentality that has
developed that everybody has heart, everybody has reflux, and I
have to tell thirty year olds or seventy year olds
that is not normal. You should not be walking around
with these symptoms. Do you do you find the same
(17:14):
sort of scenario with the patients you see every day.
Speaker 3 (17:18):
That's true.
Speaker 4 (17:19):
You know, there are a lot of treatment options, and
you know, now with the side effects or potential correlation
of long term uses of PPI used, we should be
managing it with some of the other options that we have.
Speaker 3 (17:35):
So you know, they're there.
Speaker 4 (17:37):
Oftentimes a patient might have a hidle hernia, and we
do now have minimally invasive options to fix the hidle
hernia and theoretically get you off of a proton pump
inhibitor which could have long term side effects. So there
are good options to get patients off PPIs and resolve
their heartburn.
Speaker 1 (17:56):
Yeah, and I've I've been known to say that hill
mentality where people simply they go see you and they say, doctor,
do Werry, I've got heartburn. No, I don't want to
get into all this testing, Just give me a prescription.
And that's the wrong thing. The other thing is the
rise in heartburn. The rise in these complications of soophagitis
(18:18):
and cancer is directly correlated with obesity. The rise in
obesity is just a major driver for heartburn. Now, does
when you're seeing somebody with heartburn and indigestion, does the
obesity discussion come up as well?
Speaker 3 (18:35):
It does?
Speaker 4 (18:35):
You know how funny enough, I don't feel like I'm
entirely overweight. But when I had my first endoscopy, I
had a small high to hernia and before we talked
about repair, one of the first things my gosh just
told me was to lose ten pounds because it is
life changing and symptom resolving. So you know, before the pill,
(18:57):
lifestyle changes make a huge difference.
Speaker 1 (18:59):
All Right, you know we're going to we're gonna take
a quick break here. We are honor tonight to have
doctor adib Dwari. He's the founder of Houston Regional Gastronurology Institute.
The website there for more information is Hrgastro dot com.
Our website Doctor Joegalotti dot com. You're tuned into your
Health First, Stay tuned. We will be right back. Welcome
(19:21):
back everybody, Doctor Joe Galotti, thanks for tuning into your
health first tonight every Sunday, every single Sunday between seven
and eight pm Central, broadcasting from our world headquarters here
in Houston seven forty KTRH and heard around the globe
on the iHeart app, iHeartRadio Network. So happy to have
(19:43):
doctor adib Dwari. He is a gastro and terrologist. He's
the founder of Houston Regional Gastroentrology Institute here in Houston, Texas.
And we've been chatting about various GI complaints, but one
of my I don't want to say it's a pet
peeve because it's not like I'm annoyed at it at all.
(20:03):
But patients come late with symptoms. They have chronic constipation,
they have diarrhea, they may see bloodness stools, and either
they're just simply embarrassed or in denial. But many times
we see patients late and we look to ourselves and say, man,
(20:26):
if you only got here a week, a month, six
months earlier. So how often in your daily practice with
you and your partners do you see these late cases,
either patients that refer to themselves laid or their primary
care physician doesn't quite have a timely referral. What's the
(20:47):
real world story out there?
Speaker 4 (20:50):
Yeah, you know, speaking to colon cancer specifically, it's one
of the most preventable cancers right. Absolutely, it comes with
early screening and so if we find that pollup early,
we remove it.
Speaker 3 (21:02):
We literally eliminate that cancer from forming.
Speaker 4 (21:04):
So a delayed care really is a is a huge issue. So,
you know, yes to your points, was it something else
that we thought was the cause?
Speaker 3 (21:14):
And you know, hoping that time will heal.
Speaker 4 (21:17):
You know, I am a believer in that based on
the circumstance that the time and the body will heal.
But for example, let's say you're having a cardiac event.
You know, you might not have your body or time
to heal down the road. So you know, you know,
you got to take it seriously. So I always, you know,
tell the you know, you know, think I'm a patient myself,
So thinking about the circumstance. If something doesn't seem right
or doesn't add up, you know, for everyone listening tonight,
(21:39):
you seek care. It might be elective where you can
schedule it down the road, and it might be urgent
where you need you need to go to your er
or your urgent care urgently. But if it, if it
doesn't add up, you know, your body best seat care.
Speaker 3 (21:52):
Yeah yeah.
Speaker 1 (21:52):
And you know the other thing with regard to colon
cancer and and so the American Cancer Society and other
organists as have dropped down the age where screening should start.
So your typical no family history of colon cancer polyps
forty five years old. It used to be fifty and
(22:13):
that was sort of the you know, part of your
fiftieth birthday was you'd get some gag gift about having
to get your colonoscoby. Of course, but now it's forty five,
and you know, patients still are somewhat I think it's
getting better. I think the current group of forty five
year olds and fifty year olds are getting a little
(22:33):
bit more in tune with what they need to do.
But they will always say is there or an alternative?
What else can I do? And I know colon guard
is again heavily promoted on TV in print. How do
you talk to patients about colon guard rather than a colonoscoby?
Speaker 4 (22:52):
So this one's very personal, so you know, to your point,
the American Cancer Society changed the recommendations in twenty eighteen,
and it took a couple of years later where the
United States Service Task Force in twenty twenty one changed
the screening age where the forty five is the new fifty.
Speaker 3 (23:10):
But for me personally, that wouldn't have worked.
Speaker 4 (23:12):
And I say that, you know, to our point previously
that delaying care would would have been an issue. My
wife and I had traveled overseas. I was thirty years
thirty years old at the time, and I thought I
had eaten some undercook ground beef and I had some
gi symptoms that I was underplaying, and you know, being
a gastroologist myself, I thought it was infectious. I wasn't
(23:33):
really worried about it. I was going to take some
antabotics and let it pass. My wife wanted me to
get a colonoscopy, and you know, she's an attorney, not
a physician, but was insisting I did, and so I did.
With no family history of colon cancer or colon polyps
at the time, I proceeded to get one and I
had a very large pre cancer's colon polyp.
Speaker 3 (23:52):
Wow.
Speaker 4 (23:53):
Now in forty three, have have had four colonoscopies and
pending my fifth one now and I wouldn't be here
today if it wasn't for that colonoscopy at thirty not
meeting guidelines. So why did they change the guidelines from
fifty to forty five Is we were missing fifteen percent
of colon cancers by making the general population or recommending
(24:14):
the general population to wait till fifty, and that was
just too much. We also noticed that the patients born
in the nineties, in comparison to patients born in people
born in the nineties and in comparison to people born
in the fifties had a two times risk of callon cancer,
and the incidents of callon cancer in the last two
decades have also doubled and advanced colon cancers for patients
(24:36):
under the age of fifty five, and so there's almost
been a cancer pandemic and early screening is credential as critical,
which is why we lowered the age to forty five.
And to answer your question, what's the difference between holi
guard or kolonoscopies? If the best screening test is just
the one that the patient will do, and so we're
(24:58):
just pushing for screening because if we can just identify
the lesion sooner, we're hoping that we can prevent colon
cancer from forming. Right now, if you're gonna if you're
gonna break down the different types of screening tests, colonoscopy
is still the gold standard and the reason why it's
not only diagnostic, but it's also therapeutic. So while we're
doing the diagnostic test, we can therapeut therapeutically remove the
(25:20):
pre cancerous polyps. All the other tests, whether that's colon
guard which is the stool based test, or SHIELD which
is the blood test, the blood based test, screening tests,
you know, those are still just diagnostics. You still have
your your fecal cold blood test, which is a stool
based test, which is just looking for you know, bl
blood in the stool.
Speaker 3 (25:41):
Uh.
Speaker 4 (25:41):
You have your CT colonography, which is just an imaging
scan of the the colon.
Speaker 3 (25:46):
Uh.
Speaker 4 (25:46):
You have your your short form of the kolonoscity, which
is a flexible sigmoidoscopy. But once again, nothing meets to them,
to the standard of the colonoscopy. So if you're gonna
get screened once again, choose the one that you'll do.
Speaker 3 (25:59):
But a gold standard is the colonoscopy.
Speaker 4 (26:02):
You know.
Speaker 1 (26:02):
That's that's great.
Speaker 3 (26:03):
Now.
Speaker 1 (26:04):
The one thing that the public needs to be clear
on is we are saying screening for in this particular case,
colon cancer, but for colon guard just just to just
to isolate colar guard. That is for people that have
(26:25):
no symptoms. And I believe the fine print says no
family history of colon cancer. Is that right?
Speaker 3 (26:33):
So you're right.
Speaker 4 (26:35):
So when it comes to those screening tests, you're not
supposed to have red flag. So if you have a
previous history yourself or family history those type of screening tests,
whether that colar guard or the blood test runs like shield,
you're not really a candidate for that type of screening
test because you're already potentially a high risk candidate, and
so the likelihood of that test being positive is higher
(26:58):
or you will end up getting a colonoscar anyways, right,
And why that's important is you know, with your with
your with your healthcare plan, you qualify for a screening test.
Speaker 3 (27:08):
And that's just one screening test.
Speaker 4 (27:10):
And so if you choose colon guard or shield or
any of the other ones and it comes back positive,
your colonoscopy that would have been covered on your first
round will no longer be covered because no longer is
your colonos be considered screening.
Speaker 3 (27:24):
It's now considered diagnostic.
Speaker 4 (27:26):
Right, And so if you had chosen your kolonosopy to
be your first screening test, that that initial test, which
was once again not only screening on diagnostic I am
you know sorry, screening and therapeutic, it is now going
to be considered subject to your deductible.
Speaker 3 (27:41):
So there's a financial implication if it's not your first choice.
Speaker 1 (27:44):
Yeah, and it's unfortunate that the the the maze of
the insurance where if and and patients will come to
they and and they'll get a bill from from our
center or from the insurance company saying hey, I thought
this was covered and I'm like, no, the coding is
you have symptoms, you have blood in your stool, it's
not screening anymore. So again, my big take home is
(28:07):
you don't want to have this false sense of security
where somebody will come in and say, I have cramps,
I see a little blood in my stool, I have diarrhea.
But doctor Galotti or doctor or doctor do worry. My
color guard was negative, so they think they're off the hook.
But I would say, no, this still needs to be investigated.
(28:29):
What do you say exactly?
Speaker 4 (28:31):
I mean, we've had many false negative colon guards that
lead to a diagnosis on colonoscopy. And then there's also
the anxiety with positive colon guards, right, and that is
a colon cancer screening test where so patients come to
us where they have a positive test and then automatically
deferred without a great explanation. Right, are now in our
(28:52):
hands with the anxiety of a colonosopy pending, right that
we have to work them through those emotions.
Speaker 3 (28:56):
So you know, once again, kolonosky is your stop shop.
Speaker 4 (29:00):
It's your gold standard, absolutely, and if it's your first test,
you're the likelihood of having that one fully financially covered
is much higher than if you had a preceded test.
Speaker 1 (29:09):
Right, Okay, final final sort of thought before we let
you go for tonight. Obesity, Now obesity. We both know
that obesity and fatty liver. Our major concern is the
development of soorrhosis. We're talking about this all the time.
You and I are both affiliated in various research studies
(29:33):
that we are doing together. But again, I want your
your viewpoint. A patient comes in be it with heartburn, indigestion,
and they have these mildly elevated liver chemistries, they have
an ultrasound that's been done for whatever reason that shows
a fatty liver. What's the conversation that you have with them?
Speaker 3 (29:57):
Take it seriously, you know.
Speaker 4 (30:00):
So when we we identify those elevated LFTs and we
proceed with the work up, it's not just something that
we can kind of put off on the back burner.
It's to dig in a little bit deeper, especially in
this day and age. You know, when we talk about cirrhosis,
everybody automatically thinks of alcohol as the cause or viral hepatitis.
But in the States, fatty liver is just as much
(30:22):
of a cause as those other two conditions. Which we've
really eliminated through education or minimize so you know, with
the with the you know, the cures for hepatitis c
H and the treatment for hepatitis B, and then the
support systems for alcohol. You know, we've been able to
manage those two causes for cirhosis, but fatty liver is
just growing, uh in our in our population. Thankfully, with
(30:45):
you know, education and acknowledgment, we're able to you know,
build support networks and then now with new therapies coming
on the horizon, hopefully we can we can bring this
condition under control as well.
Speaker 1 (30:55):
Yeah, it really is. It is a my opinion, since
that you know, I am in you know, live disease.
This is public health crisis number one. Fatty livid disease
again tied in with diabetes and metabolic syndrome. And again
we cannot discount the idea that so many of these
GI complaints that you see are somehow obesity related. We
(31:18):
have to make make that connection. So what I would
what I would say now, doctor, do worry? We have
to definitely get you back. You've been fantastic tonight. What
would you say for the next time? Topics that you
you think we need to cover uh in an effort
as I like to say, raise everybody's health, IQ. What
(31:40):
what are the one or two things that that we
should talk about next time?
Speaker 4 (31:44):
So, I mean, I know we talked about, you know,
the three most common presentations for GI you know, being
altered batol, habits.
Speaker 3 (31:50):
We didn't really get into it this time. I mean,
that's one for next time.
Speaker 4 (31:53):
I'd still like to dig in more on con cancer awareness,
just because I don't want that to be forgotten. Maybe
we can save that from March when it's cancer awareness mine, right,
And then you know, one of the causes of you know,
gatrick cancer is H pylori. Yes, yes, it's oftentimes asymptomatic,
so people don't even know they have it, and it's
just a simple test that we can identify and actually
(32:14):
treating cure.
Speaker 1 (32:14):
So all right, I say, next visit H pylori, we're
gonna be talking about that. Doctor Adeeb. It's been fantastic
having you on and we just have to get you back.
That's as simple as it is.
Speaker 3 (32:28):
Sounds great. Thanks for having me, This was wonderful, all right, thank.
Speaker 1 (32:31):
You, Welcome back everybody. Doctor Joglati. Final segment on this
post Thanksgiving Sunday night. I want to thank doctor Adeb
Dowarri for coming on. He made a lot of sense
in his approach to GI disorders colon cancer screening. And
(32:56):
the bottom line for all of this is is you
have to be in tune with your your body. That's
what it comes down to. We don't have gauges and
other flashing lights that will go off if something is wrong.
(33:21):
You basically have to take the responsibility to say or
have a sense of what normal is. You should not
be having chronic abdominal pain every day and think that
this is part of being fifty, or having chronic diarrhea
or chronic nausea or a little bit of blood in
(33:44):
the stool because you know I've got hemorrhoids. Well, I
can't tell you how many cases of alleged hemorrhoids I've
seen over the past thirty five years that have turned
out to be anything but a hemorrhoid. And people sit
on this too long, and so you have to really
be careful to get more information on doctor Dowary and
(34:04):
his really fantastic team, which I fully endorse, knowing him well.
And it's it's both the you know, the the person,
the physician that is ethical as well as his mission.
Contact him. It's hr Gastro dot com. Hr gastro dot
(34:27):
com to get in touch with doctor Dowarri and his team.
All right, so final, final, few minutes here. So it
is the holiday season and it is stressful. It should
be full of love, faith and family, but sometimes we
(34:52):
all get a little derailed and lose sight of you know,
what we're doing here. But with regard to your health
and wellness, which I would I would say, and it's
so so trait. Everybody has heard this. If you have
your health, you have everything. And that is true because
(35:16):
when for someone like me, I deal with very very
sick patients with liver disease. And when you are chronically ill,
you're not able to work, You're not able to take
care of yourself fully. You're always visiting the doctor. You
have a handful of medicines you're on that is giving
(35:37):
you side effects in one of a hundred different ways.
You don't have energy, you're fatigued, your mood goes down,
you don't enjoy life, you can't enjoy your family, you
can't enjoy your grandkids. And so you can have all
the money in the world, have the biggest house anywhere.
(36:01):
But if you're not healthy and you don't have a
sense of wellness, you might as well just flush it
all down the toilet. Because you can't buy yourself health.
It's something that you have to really earn in a way.
And as I said every week on the radio here
(36:21):
and I tell this to patients just about every single day,
it's no accident when you come across people that are
really healthy even later in life. These are people that
are committed to exercising, they're committed to a good diet.
They have never had a period in their life where
they drank excessively, smoked, did drugs, ran the hard life.
(36:48):
It will catch up with you, all right. So with
that said, in projecting for twenty twenty six, now, I
know it's tomorrow's December one, and you've got all of
December to get up to December thirty first, but let's
start thinking about this now, what are the key things
(37:09):
that you need to be aware of. Start to think
about not just about you, but your family, your spouse,
your children, your significant other, those people that are closest
around you, that circle of trust that we all have,
the people that are closest to us, and maybe an employee,
and may be a best friend, could be a neighbor,
(37:31):
whoever it is in your life. These are the punch
list things that you need to really think about. Number One,
take an honest look at your weight. Take an honest
look at your weight. Jump on the scale tomorrow morning,
see what your weight is. Calculate your body mass index.
(37:54):
Now this is not the perfect indicator of normal weight
or or being overweight or obesity, but it is a
good start and you have to look at it. And
there are one hundred and one BMI body mass index
calculators on your smartphone. So you take your weight and
(38:18):
your height, plug it in BMI and see if you're
in the normal range, your overweight, or you obese or
god forbid, if your BMI is over forty, you're morbidly obese.
And look at strategies to get your weight down. But
you really have to take inventory as to what you're doing.
(38:38):
Am I exercising yes?
Speaker 3 (38:40):
Or no?
Speaker 1 (38:40):
Am I eating out too much? Am I eating processed foods?
When was the last time I made a scratch meal?
Meaning you took the raw ingredients, chopped up the vegetables,
chopped up some protein fish whatever it was, and you
cooked it from scratch. So take a look at your
weight number two And I was talking about this a
(39:01):
couple of weeks ago. No, you're blood pressure. Know your
blood pressure. Having high blood pressure is no good, leads
to heart disease, put you at risk of stroke, kidney disease,
heart failure. It's silent. You will not be sitting there
tonight nearly eight o'clock and say, oh, man, I think
(39:23):
I've got high blood pressure. Most of the time, unless
it is really high, you're not going to have headaches,
any other chest pain, things like that. But you want
to know what your blood pressure is. If you don't
have a blood pressure cuff, go pick one up. Next
thing is exercise. Our bodies were meant to move, and
so you have to at least think about some sort
(39:47):
of exercise schedule or strategy, even if it is just walking.
I would be happy. Get a good pair of sneakers,
some good socks, stretch before you go on walk, make
sure it's safe outside. Or if you walk on a
treadmill at the gym and try to start to incrementally
(40:07):
increasing the amount of time you spend on walking. You
could add in resistance training with weights, bands. They have
all kinds of gadgets machines at the gym. You could
just buy a five or ten pound dumbbell and do
a full body workout with one single dumbbell. You don't
(40:27):
have to invest hundreds and thousands of dollars. The next
thing is know your family history. We again, these are
things that we've talked about, but very very worthwhile bringing up.
You want to know your family history with regard to cancer.
We talked about colon cancer earlier with doctor Dwari. Colon
(40:48):
cancer unfortunately runs in families, and so you want to know,
did your brother, did your sister, did one of your aunts?
Did a parent or a grandparent have colding care? Answer
ditto on the presence of polyps. Just having polyps increases
(41:08):
your risk of having polyps and or colon cancer, so
you want to keep on top of that. Then we
have breast cancer, pancreated cancer, prostate cancer, all of these
things you want to know the family history, diabetes, heart failure,
There are certain types of liver disease that are hereditary
and tend to run in families. You know, did you
(41:30):
have aunt Sue that died at forty five? Of prhosis,
but she never drink. That should be an eye opener
to everybody. What did you have? Did she have something genetic?
That's your family history. So I think if you start
really taking inventory on all of these different points, you
(41:52):
can start to make an impact. The other point, which
we've been saying Old Evening tonight, you have to listen
to your body aches and pains. Yes, some aches and
pains go with getting older, usually in the form of arthritis,
stiff hip, stiff back, shoulder, neck, things like that. But
(42:15):
when you're having shortness of breath, cough, chronic headache, visual changes,
chest pain, palpitations, your hardest skipping beats, all of the
digestive and GI symptoms, trouble swallowing, nausea, reflux, heartburn, vomiting,
(42:36):
bloating blood in your stool, constipation, diarrhea, weight loss, unexplained
weight loss. These are things that you have to be,
you know, really dialed into and have a sense of
you know, what is it that I need to be
aware of? And I think that you know speaks volumes,
(43:03):
all right, So with that said, we're going to close
out this Sunday Evening. Thanks again to doctor Dewari and
his team at Houston Regional Gastronurology Institute hr Gastro dot
com don't forget doctor Jogalotti dot com is a way
to get in touch with me. All of our social
media is there. Send me a message, let me know
(43:23):
what's on your mind, and we'll be back next Sunday evening.
Take care, everybody,
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