Gallstones and Gallbladder Disease

Some people think of their gallbladder as being “expendable”. Not that anybody wants any of their organs to be removed, but since many people live a seemingly normal life after getting their gallbladder removed, many people don’t think their gallbladder plays an important role in their overall health. After all, how important can your gallbladder be if you can do just fine after it’s surgically removed? The gallbladder actually plays a very important role in your body. It is an essential part of the digestive system.

In the United States, about a million new cases of gallstone disease are diagnosed each year, and some 800,000 operations are performed to treat gallstones, making it the most common gastrointestinal disorder requiring hospitalization. Gallstones or gallbladder disease can quickly turn a great meal into a period of misery.

Gallstone disease is the most common disorder affecting the body’s biliary system, the network of organs and ducts that create, transport, store, and release bile. Bile is a thick fluid, made in the liver and stored in the gallbladder, which acts in the small intestine to digest fat. Bile contains cholesterol, water, proteins, bilirubin (a breakdown product from blood cells), bile salts (the chemicals necessary to digest fat), and small amounts of copper or other materials. If the chemical balance of bile contains too much of any of these components, particularly of cholesterol, crystals form and can harden into stones.

Bile is stored in the Gallbladder and is concentrated up to five times by the removal of water. Gallstones form when liquid stored in the gallbladder hardens into pieces of stone-like material. Bile contains water, cholesterol, bilirubin and other substances. Ideally these minerals remain in liquid form until they are passed out of the body. However, excessive amounts of these minerals in bile can cause them to crystallize.

These small crystals that form out of the saturated bile may begin to clump together. Any existing crystals makes it easier for other crystals to form. If they stay in the gallbladder too long, the crystals gradually grow larger until they become a gallstone so large that it cannot pass through the biliary ducts.

In terms of size, gallstones can be as small as a grain of sand or as large as a golf ball. A person can form one large stone in his or her gallbladder, or hundreds! About 10 percent of the population has gallstones, but the vast majority experiences no symptoms and need no treatment. However, in 1 percent to 2 percent of these people, gallstones can cause problems by lodging in bile ducts, stopping the flow of bile or digestive enzymes, and leading to severe abdominal pain, vomiting, inflammation, and even life-threatening infection.

Gallstone attack has some classic symptoms:

The most agonizing pain is experienced in the upper right part of the abdomen under the ribs. Usually it appears suddenly, sometimes an hour or two after eating a fatty meal. The pain may get worse quickly, and then last for several hours. Many times the pain may radiate to the back between the shoulder blades or under the right shoulder. Inhaling deeply, or moving, often makes the pain worse. The primary therapy for gallstones that are causing pain, inflammation, or infection is removal of the gallbladder.

A number of factors put people at higher risk of gallstones:

  • Gender: Women between the ages of 20 and 60 are 3 times more likely to develop gallstones than are men in the same age group. By age 60, 20 percent of American women have gallstones.
  • Age: The incidence of gallstone disease increases with age.
  • Genetics: Family history and ethnicity are critical risk factors in development of gallstones, though no gene responsible for gallstone formation has yet been discovered. African-Americans seem to have lower rates of gallstone disease than American Indians, whites, or Hispanics.
  • Obesity: Obesity is a significant risk factor, particularly for women. Obesity also slows down the emptying of the gallbladder.
  • Location of body fat: Belly fat, that spare tire around the middle, dramatically increases the chance of developing stones.
  • Diabetes: People with diabetes often have high levels of triglycerides in their blood, and these fatty acids tend to increase the risk of gallstones.

Even if you’re not at risk for gallstones, it is wise to maintain a healthy body weight, by among other things, sticking to a diet that is low in fat and cholesterol and high in fiber.

If you are in the Las Vegas area and suffering with gallstones or gallbladder disease, schedule a consultation with Dr. Shawn Tsuda.

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What you Need to Know about Protein

You probably know you need to eat protein, but what is it and where exactly do you find it? The answer is – everywhere – if you’re talking about the body. Proteins make up about 42% of the dry weight of our bodies. The protein collagen—which holds our skin, tendons, muscles, and bones together—makes up about a quarter of the body’s total protein. Protein builds, maintains, and replaces the tissues in your body. Your muscles, your organs, and your immune system are made up mostly of protein. All of our cells and even blood are packed with protein molecules.

Proteins, along with fats and carbohydrates, are the macronutrients that form the basis of our diets. Once consumed, some people associate protein only with helping to build muscle, but keep in mind that’s not all it does for us. In our bodies, protein performs a range of duties, from building new cells to regulating metabolism to helping cells communicate. Proteins help shuttle oxygen throughout the body in the form of hemoglobin, as well as build muscle.

When you eat foods that contain protein, the digestive juices in your stomach and intestine go to work. They break down the protein in food into basic units, called amino acids. The amino acids then can be reused to make the proteins your body needs to maintain muscles, bones, blood, and body organs.

Amino acids are the building blocks of proteins. Our DNA directs the body to join various combinations of amino acids into a variety of sequences and three-dimensional shapes for an arsenal of over 2 million different proteins, each serving a unique function. Our bodies can make some of these amino acids, but there are nine that are considered “essential amino acids” because we must consume these through our diet.

Many foods contain protein, but the best sources are:

  • Beef
  • Poultry
  • Fish
  • Eggs
  • dairy products
  • Nuts
  • Seeds
  • legumes like black beans and lentils

While our bodies can store fats and carbohydrates to draw on when needed, we do not have a storage pool of amino acids. We need a fresh source each day in order to build the body proteins we need. If the body is missing a particular amino acid to form the protein it needs, it will pull that amino acid by breaking down existing muscle protein. If we consistently lack certain amino acids we will lose muscle weight, energy and, eventually, fundamental functions.

The amount of protein you need depends on your weight and health. The Recommended Daily Allowance (RDA) for protein for the healthy individual is 0.8 grams of protein per kilogram of body weight or 3 to 4 grams per 10 pounds, and two to three servings of protein-rich food will meet the daily needs of most adults. Athlete’s protein intake recommendations may be higher.

The good news is that you don’t have to eat all the essential amino acids in every meal. As long as you have a variety of protein sources throughout the day, your body will grab what it needs from each meal.

You can look at a food label to find out how many protein grams are in a serving, but if you’re eating a balanced diet, you don’t need to keep track of it. It’s pretty easy to get enough protein.

*Dr. Shawn Tsuda is a General Surgeon specializing in robotic bariatric surgery. Schedule a consultation to learn more.
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Your Chemical Romance

It’s no secret that many of us eat for emotional reasons, but did you know that research suggests that the brain circuit for eating overlaps with the brain circuit for interpersonal relationships? The neurobiology suggests that improving social relationships can actually help you lose weight. There may even be a few ways to trick the brain to achieve the same effect.

The neurotransmitter responsible for close, trusting relationships is oxytocin. Oxytocin is released by physical contact and supportive interactions with other people. Release of oxytocin increases feelings of trust and generosity. It also reduces feelings of stress and anxiety.

Amazingly, the act of eating actually releases oxytocin. In fact, eating releases oxytocin in dopamine rich brain areas, which helps explain why eating can be soothing and pleasurable. After all, part of the reason we’re drawn to emotional eating is that eating mimics the same feelings of comfort we get from close friends and family.

If you’re trying to lose weight, try boosting your oxytocin. Luckily, the best way to do that is to improve the quality and closeness of your relationships with family, friends, and significant others.

It seems like a simple suggestion, but unfortunately, problems with these relationships are often what triggers emotional eating in the first place. As a temporary measure — while you’re working on your relationships — here are a few ways to boost your oxytocin that don’t involve snacking:

  • Get a massage. Physical contact with another person is the surest way of boosting oxytocin. If you’re not in a relationship, it can be difficult to accomplish that. If you are in a relationship, then yes, your partner is a great source of oxytocin, but don’t rely on getting all your oxytocin from one person. Getting a massage releases large amounts of oxytocin, and will help you de-stress.
  • Say or do something nice for a friend. When other people trust and rely on you it boosts your oxytocin. Showing support for someone else helps that happen.
  • Pet a pet. Petting furry pets, whether it’s yours or someone else’s can help increase oxytocin. Part of it is their furry warmth, and part of it, particularly with dogs, is their trust in you. Being trusted helps increase oxytocin whether it’s a person or a dog.
  • Hug a friend. Ask a friend for a long hug, or ask them if they would like a hug. Hugs, particularly long ones, release oxytocin. In fact frequent hugging not only increases oxytocin, it also decreases blood pressure.
  • Have a conversation (in person or on the phone). The human voice can release oxytocin in ways that the written (or texted word) doesn’t.
  • Have a warm cup of tea while wrapped in a blanket. Physical warmth helps promote feelings of trust and generosity.

If you live in the Las Vegas area and are looking for ways to treat your obesity and the diseases that often accompany it, schedule an appointment with Dr. Shawn Tsuda. He and his expert team can help you find the best treatment for your unique situation.

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Fitness Trends for 2017

We’re more than a month into 2017, but you still might be wondering what’s trending in the fitness world this year. While the following certainly aren’t “new,” and this list includes only few of many options, these trends will be huge this year according to an annual report published by the American College of Sports Medicine (ACSM).

  • wearable tech
    • Fitness trackers and smartwatches have been hot holiday gifts for the last few years, and the ACSM says that trend won’t be going anywhere in 2017—and in fact, it will only get bigger. Today’s wearables track distance, and also provide heart rate readings, GPS route tracking, move reminders, and much more. Recent updates from brands like Garmin, Apple, and Fitbit have sent the trend to number one for this year.
  • body weight training
    • It’s easy to see why no-equipment workouts are popular. They’re relatively easy to learn, they can be modified to suit any ability level, and they can be done just about anywhere. Plus, body weight exercises are an efficient way to get fit for free. Pushups and pull-ups are classic bodyweight moves, but there are plenty more to choose from, like squats, lunges, and planks, just to name a few.
  • high-intensity interval training (HIIT)
    • HIIT helps torch calories fast by alternating quick bursts of high-intensity exercise with short rest periods. It can be found in all types of workouts, from Pilates to CrossFit and boot camp classes. To try a high-intensity interval training workout yourself, spend 20 to 30 minutes total combining repeated short bursts of work with short break periods, like 45 seconds of burpees with 15 seconds of rest followed by 45 seconds of squats.

Keep in mind that in addition to helping to maintain a healthy weight, regular exercise lowers your risk of heart disease, stroke, cancer, dementia, and other chronic diseases, and serves as a powerful stress-reducer and mood-booster. With obesity and its accompanying health problem on the rise, using exercise as a preventive health tool is perhaps more important than ever.

If you live in the Las Vegas area and are looking for ways to treat obesity and metabolic disorder, schedule an appointment with Dr. Shawn Tsuda. He and his expert team can help find the right treatment for you.

 

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Obesity: The Disease that Keeps on Growing

A number of studies have shown that individuals who are obese are often stereotyped as “lazy” or “lacking in willpower.” However, obesity is no longer considered a cosmetic issue that is caused by overeating and a lack of self-control. The World Health Organization (W.H.O.), along with National and International medical and scientific societies, now recognize obesity as a chronic progressive disease resulting from multiple environmental and genetic factors.

In the United States, epidemiological data from a study that measured the actual body size of thousands of Americans, showed that 34 percent of adults more than 20 years old are affected by obesity and 68 percent are overweight (2007-2008 data). Obesity affected 10 percent of children between two and five years of age, 2 percent of those between 6 to 11 years old, and 18 percent of adolescents.

Throughout the last 3 decades, the prevalence of obesity has been increasing at an alarming rate. Since 1985, the Center for Disease Control (CDC) has supported an ongoing study, conducted on a yearly basis by state health departments, to examine changes in obesity prevalence state-to-state, and has found the following:

  • In 1990, the obesity prevalence for most of the states was 10 percent or less.
  • By 1995, more than half the states had a prevalence of 15 percent.
  • By 2000, nearly half the states had a prevalence of 20 percent or higher.
  • Five years later (2005), all but three states had a prevalence greater than 20 percent and nearly a third had a prevalence of 25 percent or more.
  • By 2010, the data show that most of U.S. states had a prevalence of 25 percent and many had a prevalence of 30 percent or higher.

Obesity is considered a multifactorial disease with a strong genetic component. Acting upon a genetic background are a number of hormonal, metabolic, psychological, cultural and behavioral factors that promote fat accumulation and weight gain.

Many other conditions associated with obesity contribute to the progression of the AdobeStock_69574863 (2).jpgdisease. Obesity reduces mobility and the number of calories that would be burned in the performance of activity. Weight gain may also cause psychological or emotional distress which, in turn, produces hormonal changes that may cause further weight gain by stimulating appetite and by increasing fat uptake into fat storage depots.

Sleep duration is reduced by weight gain due to a number of conditions that impair sleep quality such as pain, sleep apnea and other breathing problems, a need to urinate more frequently, use of certain medications, and altered regulation of body temperature. Shortened sleep duration, in turn, produces certain hormones that both stimulate appetite and increase the uptake of fat into fat storage depots.

Weight gain also contributes to the development of other diseases such as hypertension, diabetes, heart disease, osteoarthritis and depression, and these conditions are often treated with medications that contribute to even further weight gain. In all of these ways and more, obesity ’begets’ obesity, trapping the individual in a vicious weight gain cycle.

Multiple factors acting upon a genetic background cause weight gain and obesity. Conditions associated with weight gain and biological changes in the body that occur as a result of weight gain contribute to progression of the disease, often trapping the individual in a vicious weight gain cycle. Obesity is a complex disease influenced by several issues, including genetic, physiological, environmental, and behavioral.

If you live in the Las Vegas area and are concerned about your weight, schedule an appointment with Dr. Shawn Tsuda to learn more about how to improve your weight and health.

 

Eliminate the Need for Potentially Harmful Acid Reflux Meds

Nearly 20 percent of Americans suffer from regular bouts of heartburn, acid indigestion and other symptoms of chronic gastroesophageal reflux disease (GERD). GERD is a severe, chronic acid reflux condition in which acidic stomach contents back up into your esophagus. The muscle connecting the stomach to the esophagus is weak or relaxes abnormally, allowing this abnormal movement.

Over the last 20 years, the most popular and effective GERD medications on the market, both prescription and over-the-counter, have been a class of drugs called proton pump inhibitors (PPIs). However, long-term use of PPIs have been found to harmful to the body.

Over the last few years, there have been many studies looking at whether long-term PPI use contributes to gut infections, bone loss, chronic kidney disease,  and even dementia. As a precaution, experts recommend that people who have been taking more than one PPI a day for many years seek a medical re-evaluation to see if they still need and are benefitting from the medication.

Here are a few classic symptoms of GERD to look out for:

  • Heartburn: For many people, acid indigestion (known as heartburn) is more than an occasional annoyance after eating a greasy meal. Research shows that more than 60 million people suffer from this burning sensation that can extend from the breastbone to the neck and throat. Heartburn sufferers may also experience a sore throat, hoarseness, chronic cough, asthma, or a feeling of a lump in the throat. Because there can be chest pain associated with GERD, heartburn sometimes is mistaken for heart attack.
  • Regurgitation: a sensation of acid backed up in the esophagus. Other common symptoms are: feeling that food may be trapped behind the breastbone, heartburn or a burning pain in the chest (under the breastbone), increased by bending, stooping, lying down, or eating, more likely or worse at night, relieved by antacids, nausea after eating

Untreated GERD can damage the food pipe, and contribute to Barrett’s esophagus, a risk anatomy-demon-3factor for esophageal cancer, so it’s important not to ignore.

Fortunately, there is a simple, minimally invasive laparoscopic procedure that starts to have a positive impact from day one and eliminates the need for medications for GERD.  LINX is easy to understand and love because it is a simple, quarter-sized device that does exactly what your failing Reflux Barrier is supposed to do — prevent stomach acid from entering your esophagus. LINX is designed to start working the moment the device is implanted.

If you’re interested in learning more, schedule an appointment with Dr. Shawn Tsuda. He can help you decide if LINX is a good option for you.

Exercise for Weight Loss

Being active is an important part of any weight-loss or weight-maintenance program. When you’re active, your body uses more energy (calories), and when you burn more calories than you consume, you lose weight.

Diet and exercise are both important to weight loss efforts. However, while diet has a stronger effect on weight loss than physical activity does, physical activity, including exercise, has a stronger effect in preventing weight regain after weight loss.

For most healthy adults, the Department of Health and Human Services recommends these exercise guidelines:

  • Aerobic activity. Get at least 150 minutes a week of moderate aerobic activity or 75 AdobeStock_116731872.jpegminutes a week of vigorous aerobic activity. However, to effectively lose or maintain weight, some people may need up to 300 minutes a week of moderate physical activity. You can do a combination of moderate and vigorous activity. The guidelines suggest that you spread out this exercise during the course of a week, and sessions of activity should be at least 10 minutes long.
  • Strength training. Do strength training exercises at least twice a week. No specific amount of time for each strength training session is included in the guidelines.

Moderate aerobic exercise includes such activities as brisk walking, swimming and mowing the lawn. Vigorous aerobic exercise includes such activities as running and aerobic dancing. Strength training can include use of weight machines, or activities such as carrying groceries or heavy gardening. As a general goal, aim for at least 30 minutes of overall physical activity every day.

The American College of Sports Medicine reports that you can elevate your metabolism for up to 24 hours post-exercise by adding just one little twist to your exercise routine: intervals. All you have to do is inject brief periods of intense effort into your regular walks (or runs, swims, bicycling, elliptical sessions, etc.) The intensity effectively resets your metabolism to a slightly higher rate during your workout, and it takes hours for it to slow down again. That equals ongoing calorie burn long after you’ve showered and toweled off.

If you’re a walker and you typically exercise for 30 minutes, try adding a burst of jogging for 30 seconds every 5 minutes. As you become more fit, you can increase the interval length to a minute, and decrease the walking segments to 4 minutes. For the biggest metabolism boost, you’ll want to make sure that the interval portion leaves you breathing hard.

While your heart and other organs demand fuel around the clock, there’s little you can do to increase their metabolic needs. However, your muscles—which also require constant feeding—are changeable. Make them bigger, and they will demand more calories day and night. With essential moves, adapted from findings by the American College of Sports Medicine, you can target all the major muscle groups in your body. You should be able to get through the entire routine in less than 30 minutes. Do this 2 to 3 times a week and your muscles will turn into furnaces that burn up extra calories before your body can convert them to fat.

If you live in the Las Vegas area and are struggling with obesity and considering bariatric surgery, contact Dr. Shawn Tsuda. He and his team of experts will find the right treatment for you.