Top Doctors 2010: The Evolution
Medicine keeps moving forward, thanks to practitioners such as these.
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Marciana Filippone’s patients often visit her because of abdominal pain and bowel discomfort or irregularities. Such vague symptoms require Filippone to play detective by questioning her patients “to tease out the underlying reason he or she is presenting with these symptoms” and to identify the most appropriate course of evaluation and treatment.
Filippone sees many patients who suffer from gastroesophageal reflux disease, which is commonly known as heartburn or acid indigestion. Though treatment with acid-reducing drugs known as PPIs and H2 blockers is usually effective, GERD is an illness that in many cases can be controlled or avoided by eating a heart-healthy, low-fat diet, maintaining an appropriate weight, and avoiding the excess use of alcohol and anti-inflammatory drugs.
Filippone spends more time educating patients these days, especially those who have done reading on their own that raises concerns or anxieties about their illnesses and medications. “I try to dispel misconceptions and put their disease and treatment risks in perspective,” she says.
She is seeing a welcome upswing in patients being proactive about colon-cancer screening and colonoscopies, a trend she attributes in part to improvements in methods of sedation for the procedure.
She notes several other advances in the testing and treating of gastrointestinal disorders. For example, laboratory blood testing for celiac disease (an intolerance to gluten) is now more reliable and readily available. Virtual colonoscopy, which examines the colon by CT scan, is now available for cancer screening in selected patients who cannot or choose not to undergo traditional colonoscopy.
Wireless capsule endoscopy, also known as a capsule camera, is a new alternative to traditional endoscopy for looking into a patient’s small bowel.
People who suffer from moderate to severe inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis are benefiting from biologic therapy drugs introduced in the past decade, including the intravenous drug Remicade and new self-injectable drugs such as Humira and Cimzia.
“These drugs have really improved the quality of life for significant numbers of patients and allowed them to avoid surgery in many cases,” she says.
Page 4: Janis Chester | Psychiatry