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Gastroenterology Associates of Western Colorado is a single specialty center, dedicated solely to the care of Gastroenterology patients. Colo-rectal Cancer is the third most common cancer diagnosed in both men and women in the United States. It is preventable and beatable. Our mission is early detection and prevention.
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Going forward WWMG will continue the use of our EZAccess patient portal. If you have not already signed up for EZAccess, and you are an existing patient, you can call your clinic to register, or you can click on the link below and follow the instructions on the right hand side of the screen to register yourself.
Gastroenterology Associates is a medical group practice located in Ithaca, NY that specializes in Internal Medicine and Gastroenterology.
What To Expect. Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It will also help alleviate any unnecessary anxiety you may be feeling prior to your first appointment.
Flexible Sigmoidoscopy. Examine the large intestine. This 10 to 20 minute procedure allows your physician to examine the inside of the large intestine. Doctors may use flexible sigmoidoscopy to determine the cause of diarrhea, abdominal pain, constipation or look for signs of cancer. Fecal Microbiota Transplant.
If you have pain in your upper abdomen, swallowing difficulty, nausea or vomiting, an upper endoscopy may help your doctor diagnose your symptoms…. Remicade Infusion Therapy. Minimally Invasive. Remicade is a prescription medicine that is approved for patients with Crohn’s Disease and Ulcerative Colitis.
The PillCam is an easily swallowed video capsule with its own camera and light source, it transmits images of the small bowel to a data recorder that you wear for approximately 8 hours. Hemorroid Banding. End discomfort. Banding is a fast, painless and proven non surgical hemorrhoid treatment.
Those who have visited our top-of-the-line endoscopy centers will tell you that it is far more comfortable and inviting than a hospital. Beyond that, unique offerings like our Open Access Colonoscopies save you time by eliminating the need for an initial office consultation.
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Westchester Health will access and use your information on the Patient Portal in accordance with the Westchester Health Patient Portal Consent Form which you must complete in order to access the portal and Westchester Health’s Notice of Privacy Practices . As a summary, Westchester Health may use your information in order to facilitate scheduling, billing, and your treatment, as well as to communicate with you about your care.
The Patient Portal is a secure, confidential and easy to use website that gives patients 24 hour access to their medical records. It uses the latest encryption technology to deliver secure communication between patients and providers. The Patient Portal is administered and maintained by NextGen Healthcare Information Systems, LLC (“NextGen”) on behalf of Westchester Health.
Due to the sensitive nature of medical information each adult patient must complete and sign our Patient Portal Care Manager Form for Adults to grant access to each other’s Portal accounts.
The Patient Portal Support Team can be contacted during normal business hours at (914) 232-1919 Option #3 for assistance in any of your questions regarding the Patient Portal.
For any questions please contact the portal support team at:#N#(914) 232-1919 - Option 3, during our business hours Monday thru Friday 8:00 am – 4:30 pm or#N#email us at WHM-Portal@northwell.edu
Lab results are automatically sent to the portal only after they have been reviewed and signed off by the provider. If you do not see your labs you should send your provider a secure message from the NextGen Patient Portal account asking for the status of a recent lab result. When your provider sends you an electronic copy of the lab result, you will receive an email notification indicating a document is available in the Inbox.
Access to information for patients under the age of 12 is permitted by the child’s personal representative. Access to information for children ages 12 to 18 is also permitted by a child’s representative, but is limited to appointment requests only. Access to another adult’s information (18 or older) can only be done under the following conditions:
The prevalence of PHG in patients with portal hypertension has been reported to vary between 20% and 80% 1, 9-12. The wide variation in the reported prevalence is most likely due to differences in the study population specifically, the proportion of patients with non-cirrhotic portal hypertension, the severity of the underlying liver disease, and the proportion of patients with previous endoscopic treatment. A higher rate of PHG is observed in patients with more severe liver disease 10, 11and in patients who have had previous endoscopic treatment with sclerotherapy or endoscopic variceal ligation 1, 9, 12There is controversy regarding the specific endoscopic technique used for variceal eradication that leads to a higher prevalence of PHG, with some studies showing a higher incidence after sclerotherapy than after ligation and other studies showing a similar incidence with both techniques 13-15. Although many studies have concluded that the presence of PHG is associated with indirect signs of portal hypertension such as the presence of larger varices 1, 11, splenomegaly 10, 11and low platelet count 11, the studies that evaluated the association between the hepatic venous pressure gradient, a well established method to measure portal pressure 16, and PHG have lead to controversial results. Two studies found no clear relationship between HVPG and PHG 17, 18, while another study found that patients with more severe gastropathy had a higher HVPG than patients with mild or no gastropathy19. These controversial results may be due to selection bias, as all patients who were included in these studies had clinically significant portal hypertension 17, 18. The issue would be clearer if it could be demonstrated that PHG presents only in patients with cirrhosis and portal hypertension (HVPG ≥ 6mmHg) or only in those with clinically significant portal hypertension (HVPG ≥ 10mmHg). However, such studies are still lacking.
PHG may change with time in an individual patient. Studies that have evaluated the natural history of PHG have described controversial results, possibly due to differences in study population. If only patients with cirrhosis who do not require primary or secondary prophylaxis are included, approximately 30% of patients with mild PHG develop severe PHG during a follow up period ranging from 12 to 103 months11. Only a few cases of improvement in PHG are described. Most of the cases that bleed from PHG occur in patients with de novoPHG or in those with worsening of previous PHG 9, 11. Patients with diffuse lesions are more likely to bleed 9, 12. Patients who have PHG associated to cirrhosis-related portal hypertension have more frequently persistent and progressive PHG (which is more likely to bleed) than patients with PHG related to non-cirrhotic portal hypertension 9. Although, as mentioned above, patients with previous endoscopic therapy (sclerotherapy or endoscopic variceal ligation) have a higher prevalence of PHG 1, 9, 12, the clinical course of the PHG in this context, particularly in non cirrhotic portal hypertension, may be milder and transient 9, 14. Studies that have focused on patients with cirrhosis have not observed differences in severity or course of PHG in patients who develop it spontaneously or after endoscopic therapy 1.
Portal hypertenisive gastropathy (PHG) and GAVE syndrome are recently discovered entities who can be associated with bloodloss from gastrointestinal tract at patients with or without liver cirrhosis. PHG will be developed at 65% of patients with portal hypertension caused by liver cirrhosis but it could be developed at portal hypertension which is not caused by the liver cirrhosis. PHG is often assosiated with portal hypertension patients and presence of esofageal and /or gastric varices. Mechanism of pathogenesis PHG is still not completely cleared up, but regulation of gastric nitric oxide level, postaglandins, tumor necrosis factor (TNF) and epidermal growth factor production could be important factors in development of portal hypertensive gastropathy. Mechanisms who participate in originating of Gastric Antral Vascular Ectasia (GAVE) are also not completly clear. Classic characteristics of this syndrome are red, often haemorrhagic lesions most often located in stomach antrum, and who could result in blood loss. More than 70% of patients with GAVE syndrome have no cirrhosis or portal hypertension. But when liver cirrhosis is present, it is very difficult to make difference between GAVE and PHG. This review will be focused on incidence, clinical importance, etiology, pathofisiology and treatment of PHG, and how to differentiate between GAVE syndrom and PHG in a case that there exists.
Nonalcoholic Fatty Liver Disease (NAFLD) is the term used for the buildup of extra fat within liver cells in individuals who consume little or no alcohol.
Gastric antral vascular ectasia (GAVE) is characterized by the presence of red spots without a background mosaic pattern that are typically located in the gastric antrum. GAVE is most frequently observed in patients with cirrhosis and portal hypertension, although they have also been observed in patients without cirrhosis such as autoinmune connective tissue disorders, bone marrow transplantation or chronic renal failure 54-57. Seemingly, patients with cirrhosis have more often diffuse disease 58while in non-cirrhotic patients the disease is most frequently limited to the antrum 59, 60. In contrast to PHG, GAVE is only observed in the stomach and not in other parts of the gastrointestinal tract. The prevalence of GAVE in cirrhosis is very low. In a recent study performed in patients awaiting liver transplantation, GAVE was observed in only 8/345 (2%) of the patients 61. A similar prevalence has been described in patients with HCV and advanced fibrosis 10.
The pathophysiology of GAVE is not fully understood. In patients with cirrhosis, portal hypertension appears not to be essential in its development as patients do not respond to portal pressure-reducing therapies, such as TIPS or surgical shunt 40, 62. Liver insufficiency seems to play a significant role in the development of GAVE because it develops in patients with more severe liver dysfunction 59and it has been shown to resolve after liver transplantation 61, 63. Speculation regarding an accumulation of substances not metabolized by the liver which may induce vasodilatation and/or angiogenesis has been suggested as a posible mechanism 62. The association between GAVE and hormones with vasodilating properties such as gastrin 18, 54, 59and prostaglandin E264has also been suggested. Finally abnormal antral motility 65and mechanical stress 18have also been associated to the pathogenesis of GAVE which is further supported by the antral distribution of the lesions.
Non response to medical treatment in the acute setting may be defined according to the standards of non response to variceal bleeding 27, as both are associated to portal hypertension and require a change of therapy. Treatment failure is considered when there is a new hematemesis after at least 2 hours of treatment initiation, or a 3 gr drop in hemoglobin in the absence of transfusion of packed red blood cells or an inadequate hemoglobin increase in response to blood transfusions, or death 27.
Contact Dr. Masi Khaja by phone: (970) 245-0990 for verification, detailed information, or booking an appointment before going to.
Dr Shields is a native of Colorado. He attended Western State Colorado University with a degree in biology followed by medical school at Kansas City University of Medicine and Biosciences. He completed Internal Medicine Residency and Gastroenterology Fellowship at the Naval Medical Center in San Diego, CA and Hepatology training at the Scripps Clinic in La Jolla, CA. He stayed on faculty at the Naval Medical Center and was an Assistant Professor of Medicine at the Uniformed Services University of Health Sciences for five years before joining Grand Junction Gastroenterology in 2014. He is board certified in Gastroenterology. He is a Fellow of the American College of Physicians and American College of Gastroenterology.
Electronic health records are important because they may improve a health care professional's ability to make well-informed treatment decisions.
Dr. Masi Khaja, MD, is a Gastroenterology specialist in Grand Junction, Colorado. He attended and graduated from medical school in 1999, having over 22 years of diverse experience, especially in Gastroenterology. He is affiliated with many hospitals including Cedar Park Regional Medical Center, Family Health West Hospital, Community Hospital, Delta County Memorial Hospital, St Marys Hospital And Medical Center. Dr. Masi Khaja also cooperates with other doctors and physicians in medical groups including Gastroenterology Associates Of Western Colorado, P C. Dr. Masi Khaja accepts Medicare-approved amount as payment in full. Call (970) 245-0990 to request Dr. Masi Khaja the information (Medicare information, advice, payment, ...) or simply to book an appointment.
From Business: Grand Junction Gastroenterology is one of the largest gastroenterology groups in Colorado serving western Colorado, southwestern Wyoming and eastern Utah. Its…
Hannah is a native of Grand Junction, Colorado. She is excited to be back in the Grand Valley with her family. Hannah received her Bachelor of Science in biology from the University of Denver.
MOC - He does not participate in the Medicare Maintenance of Certification Program. A "Maintenance of Certification Program" encourages board certified physicians to continue learning and self-evaluating throughout their medical career.
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Patients and their legal guardians can sign up for Patient Portal in accordance with the Terms and Conditions of the website . We respect your privacy. When there is important information awaiting you in your Patient Portal account, you’ll receive a notice in your personal email.
Dr Shields is a native of Colorado. He attended Western State Colorado University with a degree in biology followed by medical school at Kansas City University of Medicine and Biosciences. He completed Internal Medicine Residency and Gastroenterology Fellowship at the Naval Medical Center in San Diego, CA and Hepatology training at the Scripps Clinic in La Jolla, CA. He stayed on faculty at the Naval Medical Center and was an Assistant Professor of Medicine at the Uniformed Services University of Health Sciences for five years before joining Grand Junction Gastroenterology in 2014. He is board certified in Gastroenterology. He is a Fellow of the American College of Physicians and American College of Gastroenterology.
Hannah is a native of Grand Junction, Colorado. She is excited to be back in the Grand Valley with her family. Hannah received her Bachelor of Science in biology from the University of Denver.
WWMG Nephrology is dedicated to the diagnosis and treatment of diseases of the kidney. Our goal at all times is the preservation of the patient’s kidney function by the early recognition of conditions which will threaten it, and by prompt intervention designed to save kidney function. Such treatment postpones or completely abolishes the future need for dialysis in most cases.
Dr. Neral is a fellowship-trained Orthopedic and Sports Medicine Surgeon at Western Washington Medical Group in Everett, Washington. He specializes in the full spectrum of care for the shoulder, hip, and knee. “My goal is to create an individual plan for each patient utilizing the most conservative treatments available. I will provide you with a clear understanding of your condition so we can work together to restore your function.” You can learn more about Dr. Neral here.
You deserve excellence. That’s why Western Washington Medical Group requires all of our providers to be board-certified/eligible in their specialty.
Do you need to see a provider right away? Western Washington Medical Group has two walk-in clinics: Lake Serene Clinic in Lynnwood and Snohomish Family Medicine. Both have extended hours for your convenience, including weekends, evenings and holidays. Weekend hours are also available at Marysville Family Medicine