09 cover outlined.indd - Ohio Gastroenterology and Liver Institute

Transcription

CONTACT US
Patient Referrals
Ohio GI Administration
Please see our map on the back cover.
Dan Walker - Chief Operating Officer
Phone - 513-569-1310
Email: [email protected]
RoseAnn Maher - Office Manager
Phone - 513-569-1300
Research Division
Billing
Consultants for Clinical Research
Phone - 513-872-4549
www.ccrstudy.com
Phone - 513-872-4555
Table of Contents
Our Work
OHIO GI LEADERSHIP
AND QUALITY REPORT
Outpatient
Inpatient
Hospital Coverage
Endoscopic/Therapeutic Services
Clinical Research
Education
Leadership
Our Patients
Patient Encounters
Specific Disease Encounters
Our Endoscopy Centers
Our Commitment to Quality
www.ohiogi.com
Endoscopy Center Complication Rate
Colorectal Cancer Prevention Studies
Patient Satisfaction Surveys
Inflammatory Bowel Disease
Irritable Bowel Syndrome
Liver Disease
Women’s Digestive Health
Endoscopic Ultrasound
Endoscopic Retrograde Cholangiopancreatography
Esophageal Disorders
Small Bowel Evaluation
Pancreatic Disorders
Endoscopic Mucosal Resection
Our Research Division
Our Physicians
2925 Vernon Place • Suite 100 • Cincinnati, Ohio 45219
www.ohiogi.com
Physicians
Physician Assistants
Contact Us
OUR WORK
PHYSICIAN ASSISTANTS
Outpatient
Convenient locations
Individualized care
Expedited visits
Close communication with referring doctors
With offices located throughout Cincinnati, Fairfield and surrounding suburbs and counties, we are able
to offer convenience to our patients. We provide outpatient consultation and follow-up care and see
patients on a timely basis. For urgent outpatient care, appointments with our physicians and physician
assistants can usually be made within 24 hours. We emphasize close communication with referring
physicians by direct discussion for more urgent or serious conditions and always with prompt written
reports of patient encounters. Other modalities such as voice mail, fax referral forms, and email have
also been developed to enhance communication.
Inpatient
Always available
Rapid consultation and endoscopic response
Ohio GI physicians work at most hospitals within the Greater Cincinnati area where we provide inpatient
services and are available on a 24 hr/7 day per week/365 day per year basis. When we receive a
consultation request we see patients quickly and provide thoughtful and expedited endoscopic services.
We are the primary providers of GI services and our physicians are directors of the GI divisions or
endoscopy committees at many of the hospitals.
Jennifer Acosta, PA-C, MPAS
• Special Interest: Outpatient digestive care, Inflammatory Bowel Disease (IBD),
Irritable Bowel Syndrome (IBS), Hepatitis
Ms. Acosta graduated from South University with a Bachelor Degree in Physician Assistant Studies. She
received her Master’s Degree in PA Studies from the University of Nebraska. Jennifer is Board Certified
by the National Commission on Certification of Physician Assistants.
Laurie Einwald, PA-C, MPAS
• Special Interest: Inpatient and outpatient digestive care,
Inflammatory Bowel Disease (IBD), Irritable Bowel Syndrome (IBS), Hepatitis
Ms. Einwald graduated from the University of Dayton with a Bachelor Degree in pre-medicine. She
received her Master’s Degree in Physician Assistant Studies from Marquette University. Laurie is Board
Certified by the National Commission on Certification of Physician Assistants.
James Fry, PA-C, MS
Irritable Bowel Syndrome (IBS), Hepatitis, Clinical research
Mr. Fry received his Physician Assistant training while serving in the US Air Force and then obtained his
Master’s Degree from Alderson-Broaddus College. Prior to being recruited to Ohio GI, he was a professor
in the PA programs at the University of Kentucky and Marietta College. He has been chairman of the
education council of the American Academy of Physician Assistants and VP of the Ohio Association of
Physician Assistants. Jim is Board Certified by the National Commission on Certification of Physician
Assistants. Jim is a Distinguished Fellow of the American Academy of Physician Assistants.
Dr. Jeffrey D. Stotz
Consultative gastroenterology, endoscopy, colonoscopy
• Special Interest: Gastroesophageal reflux (GERD), Inflammatory bowel disease (IBD)
Dr. Stotz graduated from The Ohio State University College of Medicine and completed his Internal
Medicine Residency and his Gastroenterology Fellowship at University Hospitals of Cleveland/Case
Western Reserve University. Dr. Stotz has recently lectured to a medical audience on Celiac Disease. He
is Board Certified in Internal Medicine and Gastroenterology.
Dr. George Waissbluth
• Special Interest: Irritable bowel syndrome (IBS)
Dr. Waissbluth graduated from the Universidad de Chile in Santiago, Chile, and completed his Residency
in Internal Medicine at Jewish Hospital, Cincinnati. His Gastroenterology Fellowship was completed at
the University of Cincinnati. Dr. Waissbluth is Board Certified in Internal Medicine and Board Eligible in
Gastroenterology.
Hospital Coverage:
Bethesda Hospital
Children’s Hospital Medical Center*
Christ Hospital
Jewish Hospital
Mercy Fairfield Hospital
Mercy Western Hills Hospital
Mercy Mt Airy Hospital*
West Chester Medical Center
Adams County Hospital*
VA Hospital*
* Limited to outpatient coverage
Proven high standards and superior results
Experts with high volume of experience
All of our physicians are experts in the performance of endoscopy and colonoscopy. Additional
subspecialization within our group includes physicians who have had specific and extensive experience and
training in more advanced endoscopic procedures such as: endoscopic ultrasound (EUS) with fine needle
aspiration (FNA), Endoscopic Retrograde Cholangiopancreatography (ERCP), and endoscopic mucosal
resection (EMR). We were the first in the area to perform small bowel wireless capsule endoscopy with
the “Pillcam”. Liver biopsies are performed by one of our Hepatologists in our endoscopy centers. Experts
in esophageal disorders perform a variety of specialized esophageal testing. Our pathologist, an expert
in gastrointestinal pathology, evaluates biopsy material from our endoscopy centers.
Some of the procedures we perform:
• EGD with related therapies
• Colonoscopy with related therapies
• Endoscopic Ultrasound (EUS) for GI and non-GI (pulmonary) lesions
• Fine needle aspiration during EUS
• ERCP, sphincterotomy, pancreatic and biliary stent placement, manometry
• Choledochoscopy
• Esophageal, small bowel, pancreatobiliary, and colonic dilation
• Esophageal and colonic stenting
• Pancreatic pseudocyst drainage.
• Endoscopic mucosal resection (EMR)
• Celiac plexus block under endoscopic ultrasound guidance
• Argon plasma coagulation of polyps and vascular lesions
• Percutaneous endoscopic gastrostomy and jejunostomy
• Hydrogen breath testing for small bacterial overgrowth and carbohydrate intolerance
• Endoscopic banding for internal hemorrhoids
• Small bowel wireless capsule endoscopy “pill cam”
• Liver biopsy
• Esophageal Manometry
• Esophageal catheter and BRAVO pH testing
• Esophageal impedance
• Halo Ablation of Barrett’s esophagus
Dr. Alan V. Safdi, FACG
• Special Interest: Inflammatory Bowel Disease (IBD), Irritable Bowel Syndrome (IBS),
Clinical research
Dr. Alan Safdi graduated from the University of Cincinnati College of Medicine (with distinction being
nominated to the honorary medical society of AOA) and completed his Residency in Internal Medicine
at the University of California at San Diego. He did his undergraduate education at Northwestern
University and was inducted into the honorary society, Phi Beta Kappa. His Gastroenterology Fellowship
was completed at the University of Cincinnati. Dr. Safdi lectures nationally on IBD, colonoscopy
preparation, esophageal reflux, and a variety of gastrointestinal disorders. He has authored many
articles, reviews and updates related to Gastroenterology. He is actively involved in clinical research in
internal medicine and digestive disease disorders. Dr. Safdi has been awarded Cincinnati Magazine’s
“Top Doctor” recognition. He has been the director of the Gastroenterology section at Deaconess
Hospital and was past Chairman of the Cincinnati Crohn’s and Colitis Medical Advisory Committee. Dr.
Alan Safdi is a Fellow of the American College of Gastroenterology and is Board Certified in Internal
Medicine and Gastroenterology.
Dr. Michael A. Safdi, MACG, FACP
• Special Interest: Hemorrhoidal band ligation, Gastroesophageal Reflux (GERD),
Inflammatory Bowel Disease (IBD), Irritable Bowel Syndrome (IBS),
Peptic Ulcer Disease, Clinical research
Dr. Michael Safdi graduated from the University of Cincinnati College of Medicine and completed his
Residency in Internal Medicine at the University of California at San Diego. His Gastroenterology
Fellowship was also completed at the University of California at San Diego. He has served on numerous
local, regional and national boards and committees with the American College of Gastroenterology and
other organizations. He is actively involved in clinical research of new medications for digestive disorders
and with training young CCFA investigators. Dr. Safdi has been awarded Cincinnati Magazine’s “Top
Doctor” recognition. Dr. Safdi is a Master of the American College of Gastroenterology, a Fellow of the
American College of Physicians, and is Board Certified in Internal Medicine and Gastroenterology.
Dr. Kris Ramprasad
• Special Interest: Gastroesophageal Reflux Disease (GERD)
Dr. Ramprasad graduated from Madras Medical School, Madras, India. He completed his Residency
in Internal Medicine at the Veteran’s Administration Hospital and at Wright State University, both
in Dayton, Ohio. His Gastroenterology Fellowship was completed at the University of Cincinnati. Dr.
Ramprasad is the Gastroenterology section head at Mercy Hospital Western Hills. He is a clinical teacher
of Gastroenterology Fellows at the University of Cincinnati and has been awarded Cincinnati Magazine’s
“Top Doctor” recognition. Dr. Ramprasad is Board Certified in Internal Medicine and Gastroenterology.
Dr. Ravi Ravinuthala, Member of the Royal College of Physicians (UK)
• Special Interest: Hepatology, Mind-Body interaction
Clinical Research
Three decades experience
Involvement in the leading edge of GI therapies
Availability of alternative treatments for patients
We have been involved in clinical research for nearly thirty years. Our research division, Consultants
for Clinical Research (www.ccrstudy.com), has conducted over 350 gastroenterology and hepatology
clinical trials. We have participated in numerous pivotal clinical trials that now form the basis of advanced
treatment in many GI disorders such as: Crohn’s disease, ulcerative colitis, irritable bowel syndrome,
GERD, Hepatitis B, Hepatitis C, Peptic Ulcer Disease, eradication of Helicobacter pylori, and others. Our
involvement in clinical research trials provides us with an increased level of experience and knowledge
regarding new treatments and related pharmacology as well as the ability to offer treatment alternatives
to patients that would otherwise not be available to them.
Dr. Ravinuthala graduated from Rangaraya Medical College in India. He completed his Internal Medicine
Residency, Gastroenterology Fellowship and Transplant Hepatology Fellowship at Henry Ford Hospital,
Detroit, Michigan. He is Board Certified in Internal Medicine, Gastroenterology, and Transplant Hepatology
and is UNOS approved for liver transplantation.
Dr. Z. A. Saeed, FACG
• Special Interest: Pancreaticobiliary (ERCP) and therapeutic endoscopy, Endoscopic
ultrasound-guided biopsies (EUS), Hemorrhoidal band ligation,
Pancreatic and biliary disorders
Dr. Saeed graduated from King Edward Medical College, Lahore, Pakistan. He completed his Residency in
Internal Medicine at Texas Tech University, Amarillo. He received Fellowship training in Gastroenterology
and Hepatology at Georgetown University, Washington, D.C., followed by clinical and basic research
training at The National Institutes of Health, Bethesda, Maryland. He also completed a Fellowship in
Advanced Therapeutic Endoscopy and Endoscopic Research at Baylor College of Medicine, Houston,
Texas, and received formal training in endoscopic ultrasound procedures at Institut Paoli-Calmette,
Marseilles, France. Dr. Saeed is a Fellow of the American College of Gastroenterology and has been
awarded Cincinnati Magazine’s “Top Doctor” recognition. Dr. Saeed is Board Certified in Internal Medicine
and Gastroenterology.
Education
Patients and the public
Physicians
Medical students and residents
Nurses
With the enormous amount of medical information available, Ohio GI recognizes the importance of
educating physicians, students, medical residents, patients, and the public at large. Many of our
physicians present lectures to medical audiences on state-of-the-art topics during medical conferences
and hospital grand rounds in town and around the country. Ohio GI conducts an annual CME conference
(usually held in February) for approximately one hundred primary care providers to hear talks on the
latest breakthroughs in the field. We frequently provide lectures to community groups in a variety of
settings on requested topics, such as: inflammatory bowel disease, irritable bowel syndrome, reflux,
colon cancer prevention, liver disease, and others. Through our involvement with the American Cancer
Society, programs have been brought to the area reaching tens of thousands of people with information
and education about colon cancer prevention. We are involved in teaching GI fellows, medical residents,
family practice residents, medical students, nursing students, physician assistant students, and as
preceptors for undergraduate students who are considering a career in medicine.
On an individual patient level, we have developed a wide array of materials and information that focus
on specific diseases or symptoms for patient education. We believe a well informed patient is a healthier
patient. Our website (www.ohiogi.com) contains many additional informative resources for patients and
physicians.
Leadership
State of Ohio GI leadership
National GI Society Leadership
Ohio GI CME Conference
Ohio GI staff hold or have held leadership positions in the GI division and endoscopy departments at many
of our local hospitals. Leadership involvement in national, state, and local organizations has included:
National Board of Trustees of the American College of Gastroenterology, Southern Ohio Governors for
the American College of Gastroenterology, Practice Management Committee for the American Society
for Gastrointestinal Endoscopy, founding officer of the Gastroenterology Assembly for the Medical Group
Managers Association, National and State GI representative to the Medicare Carrier Advisory Committee,
Chairman of Colorectal Cancer Task Force at the Cincinnati Chapter of the American Cancer Society,
Chairman of the Medical Advisory Committee for the Cincinnati Crohn’s and Colitis Foundation chapter,
National CCFA young investigator training course , Medical Director of the Christ Hospital Center for
Swallowing Disorders, and many others.
Dr. Mangels graduated from the Medical College of Ohio in Toledo and completed his Residency in
Internal Medicine at the University of Cincinnati. His Gastroenterology Fellowship was also completed
at the University of Cincinnati. He is the co-chairman of the Gastroenterology Section at Bethesda
North Hospital and has been awarded Cincinnati Magazine’s “Top Doctor” recognition. He has presented
lectures at medical conferences on a variety of topics such as Gastrointestinal Bleeding. Dr. Mangels is a
Fellow of the American College of Gastroenterology and is Board Certified in Gastroenterology.
Dr. Stephen P. Martin
• Special Interest: Pancreaticobiliary (ERCP) and therapeutic endoscopy,
Capsule endoscopy “Pillcam”, Pancreatic and biliary disorders
Hospital GI leadership
Local Not-for-profit organization leadership
Dr. David Mangels, FACG
Dr. Martin graduated from the University of Cincinnati College of Medicine and completed his Residency
in Internal Medicine at the University Hospitals of Cleveland/Case Western Reserve University. His
Gastroenterology Fellowship, which was completed at the University of Pittsburgh, included a focused
year of pancreaticobiliary endoscopy and pancreatic physiology training. He is the Chief of Endoscopy at
Mercy Hospital Fairfield and has been awarded Cincinnati Magazine’s “Top Doctor” and Cincy Magazine’s
“Best Doctor” recognitions. Dr. Martin is Board Certified in Gastroenterology.
Dr. Terrance O’Toole
• Special Interest: Gastroesophageal Reflux Disease (GERD), Barrett’s therapy,
Clinical outcomes
Dr. O’Toole graduated from the Ohio University College of Osteopathic Medicine in Athens, Ohio. He
completed his Internal Medicine residency training at the University of Cincinnati. He continued his
training at the University of Cincinnati, where he completed his Gastroenterology Fellowship. Dr. O’Toole
has lectured on numerous topics such as Barrett’s, Gastroparesis, and Refractory celiac disease. Dr.
O’Toole is Board Certified in Internal Medicine and Gastroenterology.
Dr. Michael D. Kreines, FACG, FAGA, FACP
Gastroesophageal Reflux Disease (GERD), Esophageal Disorders
Dr. Kreines graduated from the University of Cincinnati College of Medicine and completed his Residency
in Internal Medicine at the University of Minnesota. His Gastroenterology Fellowship was performed at
the University of California in San Diego followed by an Inflammatory Bowel Disease Fellowship and
faculty position at the University of Chicago. He was a founding member and is a current board member
of the Cincinnati CCFA chapter and is an active participant in IBD clinical research trials. He was recently
appointed to the National Medical Scientific Advisory Committee of the Colon Cancer Alliance (CCA). He
is the chief of Gastroenterology and the Director of the Center for Swallowing Disorders at the Christ
Hospital and Co-chairman of the local Colorectal Task Force at the American Cancer Society. He is
actively involved in teaching medical students and internal medicine and family practice residents. Dr.
Kreines has been awarded Cincinnati Magazine’s “Top Doctor” recognition. He has lectured extensively
at medical and nursing and community conferences on a variety of topics such as: Inflammatory Bowel
Disease, Irritable Bowel Syndrome, Colon Cancer Prevention, and Esophageal Disorders. Dr Kreines is a
Fellow of the American College of Gastroenterology, the American Gastroenterology Association, and the
American College of Physicians and is Board Certified in Internal Medicine and Gastroenterology.
Dr. Lisa S. Lestina
• Special Interest: Gastroesophageal Reflux Disease (GERD), Women’s health
Dr. Lestina graduated from Northwestern University Medical School in Chicago. She subsequently
completed her Residency and Chief Residency in Internal Medicine at Dartmouth-Hitchcock Medical
Center in New Hampshire. Dr. Lestina continued her training at Dartmouth, completing her Fellowship
in Gastroenterology. Dr. Lestina has presented lectures to medical and nursing audiences on a variety
of topics such as: Celiac Disease, Helicobacter Pylori and Clostridium Difficile. She is Board Certified in
Internal Medicine and Gastroenterology.
OUR PATIENTS
Our mission is to provide outstanding and very personalized care to all patients within the broad range
of digestive disorders. Ohio GI is a large subspecialized practice to which a high volume of patients with
common and uncommon disorders are referred, resulting in unparalleled expertise in diagnostic and
therapeutic capabilities.
Annually, Ohio GI provides over 70,000 digestive services which include inpatient encounters,
outpatient encounters, and endoscopic procedures to patients mainly from Ohio, Kentucky,
and Indiana.
Numbers of patients seen in several diagnostic categories:
DIAGNOSIS
PATIENT VISITS
Crohn’s Disease.......................4,084
Ulcerative Colitis.....................1,869
Liver Disease............................1,734
Irritable Bowel Syndrome..........843
Pancreatic Disorders..............1,682
Esophageal Disorders.............6,228
Abdominal Pain*......................6,839
GI Bleeding................................3,694
Diarrhea*................................4,488
Constipation.............................1,488
*Includes some patients with IBS
OUR ENDOSCOPY CENTERS
We operate four state-of-the-art endoscopy centers that provide specialized services at convenient
locations in Clifton, Montgomery, Fairfield, and Norwood. These facilities provide a comfortable, friendly,
and personal environment. We have meticulous standards of high quality care and consistently receive
high ratings for patient satisfaction.
We have developed an in-house electronic medical record system (eMerge), specific to endoscopic
procedures, that is currently used at our primary endoscopy centers. This allows a detailed report
to be generated at the time of the procedure and immediately faxed to the primary physician. The
patient is also provided with a report for their personal records that helps to clearly convey the results,
recommendations, and follow-up. Patients can also access their reports and results on-line via a secure
patient portal. Additional educational materials are provided to enhance the understanding of the
underlying disease process and healthy lifestyle recommendations.
A computerized recall system is utilized to remind patients to schedule a follow-up visit. For example,
a patient who has had adenomatous colonic polyps will usually need follow-up colonoscopy in the
future. The recommended interval is entered into the computer and when the time arrives, a patient
letter is generated and sent to inform them that it is time to schedule a surveillance procedure. These
scheduling reminders are especially important in conditions where a premalignant state may occur, such
as preventing colon cancer by appropriate follow-up colonoscopy.
Dr. Kim R. Jurell
• Special Interest: Gastroesophageal Reflux Disease (GERD),
Inflammatory Bowel Disease (IBD)
Dr. Jurell graduated from the Indiana University College of Medicine and completed his Residency in
Internal Medicine at St. Vincent Hospital in Indianapolis. His Gastroenterology Fellowship was completed
at the Medical College of Wisconsin in Milwaukee. He has presented lectures at medical conferences on
a variety of topics such as Clostridium Difficile. He has been awarded Cincy Magazine’s “Best Doctor”
recognition. Dr. Jurell is Board Certified in Gastroenterology.
Dr. Terry R. Kaylor
• Special Interest: Barrett’s therapy, Peptic Ulcer Disease
Dr. Kaylor graduated from the University of Cincinnati College of Medicine and completed his Internal
Medicine Residency and Gastroenterology Fellowship at The Ohio State University. Dr. Kaylor is interested
in all areas of Gastroenterology and Hepatology. He has presented lectures at medical conferences on
a variety of topics such as Gastrointestinal Inflammatory Disorders. He is Board Certified in Internal
Dr. John P. Czarnecki
Dr. Czarnecki graduated from Northwestern University Medical School in Chicago and completed his
Residency in Internal Medicine at Dartmouth-Hitchcock Medical Center. He continued his training
at Dartmouth, where he completed his Gastroenterology Fellowship. He has presented lectures at
medical conferences on a variety of topics such as Colorectal Cancer Screening, GERD, Celiac Disease,
and Evaluation of Swallowing Disorders. Dr. Czarnecki is Board Certified in Internal Medicine and
Gastroenterology.
OUR COMMITMENT TO QUALITY
We are able to report quality data where information is measurable and available. In many areas there
are no established benchmark indicators of quality performance and we present highlights of numbers of
patient volume or descriptions of clinical areas of expertise. We believe, and studies have documented,
that seeing a high volume of patients with any given condition leads to expertise that correlates with
better outcomes.
Dr. Karen Haberthier
• Special Interest: Women’s health
When performing procedures on our patients, we strive to maximize accuracy and minimize risk and
complications. Complications can occur during any medical procedure and we track and compare our
data with nationally published complication rates.
Dr. Haberthier graduated from University of Medicine and Dentistry of New Jersey - New Jersey Medical
School and completed her residency in Internal Medicine at Boston University Medical Center Her
Gastroenterology fellowship was performed at University of Pittsburgh Medical Center, where she also
served as Chief GI Fellow. Dr. Haberthier is Board Certified in Internal Medicine and Gastroenterology.
In 2008, 15,303 patients underwent gastrointestinal endoscopy and/or colonoscopy in one of our
outpatient endoscopy facilities. The major complications that can occur include perforation, bleeding
from therapeutic maneuvers such as polypectomy, and death. An endoscopic complication occurred in
only 8 patients for a rate of 0.0005%. Bleeding accounted for 7 of the 8 events, all from polypectomy
sites. None of these patients required surgery and only one needed transfusion. One patient developed
an esophageal tear after dilation for which he was briefly hospitalized and medically treated. There were
no colonic perforations.
Dr. Mark E. Jonas
• Special Interest: Hepatology, Gastrointestinal bleeding, Capsule endoscopy “Pillcam”
Dr. Jonas graduated from the State of New York Health Sciences Center at the Brooklyn College of
Medicine. He completed his Residency in Internal Medicine at the Montefiore Medical Center of the
Albert Einstein College of Medicine. His Gastroenterology Fellowship was performed at the University of
Medicine and Dentistry of New Jersey - New Jersey Medical School. Dr. Jonas completed an additional
year of Fellowship in Hepatology and Liver Transplantation at the Mount Sinai Medical Center in New
York City. Dr. Jonas is the Internal Medicine residency program Education Director at Jewish Hospital.
Dr. Jonas has been awarded Cincinnati Magazine’s “Top Doctor” recognition. He is Board Certified
in Internal Medicine, Gastroenterology, and Transplant Hepatology and is UNOS approved for liver
transplantation.
The following data summarizes the complications and compares with national averages.
OHIO GI
Total complications
Perforation
Hemorrhage*
Death
0.0005%
0.00006%
0.00006%
0.0%
NATIONAL RATES
0.5%
0.09%
0.48%
0.0006%
*Requiring transfusion or hospitalization
Colonoscopy and EGD performed by Ohio GI physicians is as safe or safer than national averages.
Colonoscopy quality - Colorectal Cancer (CRC) Prevention
Colonoscopy with polypectomy is currently the best method of colorectal cancer (CRC) prevention. CRC
usually begins as an asymptomatic polyp. With time as the polyp grows, malignant degeneration can
occur. To prevent CRC, polyps need to be found and removed with colonoscopy.
Colonoscopy is highly effective but it has some limitations in that it does not identify all polyps and
cancers. To address this concern, studies have demonstrated three main parameters that correlate
with greater colonoscopic accuracy: high rate of complete colonoscopy with visualization into the base
of the cecum, inspection time during colonoscopy withdrawal of six minutes or greater, and quality
colonoscopy preparation to minimize “hidden lesions”. We routinely monitor these quality parameters and
our data demonstrates performance superior to the current recommendations and national standards, as
demonstrated in the following graphs:
1. Complete Colonoscopy Study:
To detect all lesions, the entire colon needs to be carefully examined. Given certain technical factors
such as adequacy of the bowel preparation, adhesions, and the tortuous nature of some colons, insertion
of the colonoscopy all the way into the cecum can present a challenge. Our experienced and skilled
colonoscopists do reach the cecum in almost all cases.
Cecal Intubation Rates
98.71%
Ohio GI
97
96
National*
95
95.0%
94
All of our physicians are expert in outpatient and inpatient consultative gastroenterology, hepatology,
endoscopy, colonoscopy, and colorectal cancer prevention. We all see patients spanning the spectrum of
digestive and liver disorders. Highlighted below is a brief synopsis of background information, mention
of specific leadership roles, and designation of additional area of focused expertise for each of our
physicians and physician assistants.
Dr. Pradeep K. Bekal
Endoscopic ultrasound-guided biopsies (EUS), Pancreatic and biliary disorders
Dr. Bekal graduated from Madras Medical School, Madras, India, and completed his Residency in Internal
Medicine at New York Methodist Hospital in Brooklyn, New York. His Gastroenterology Fellowship was
completed at the Brooklyn Hospital Medical Center. Dr. Bekal completed an Advanced Therapeutic
Endoscopy Fellowship at Allegheny General Hospital in Pittsburgh. Dr. Bekal is the Gastroenterology
Director at West Chester Medical Center and has been awarded Cincinnati Magazine’s “Top Doctor”
recognition. He is Board Certified in Gastroenterology.
Dr. Manish M. Chokshi
• Special Interest: Hemorrhoidal band ligation, Capsule endoscopy “Pillcam”,
Hydrogen breath testing, Esophageal studies
99
98
OUR PHYSICIANS
*American College of Gastroenterology 2009
93
1
Colonoscopy by Ohio GI Gastroenterologists reliably examines the entire colon, meeting or exceeding national standards.
Dr. Chokshi graduated from Case Western Reserve University School of Medicine and completed his
Internal Medicine Residency at Metro Health Medical Center, both in Cleveland. Dr. Chokshi then completed
his Fellowship in Gastroenterology at the University of Michigan Medical Center in Ann Arbor. He has
presented lectures at medical conferences on a variety of topics such as: Evaluation of Anemia from the
GI Prospective and Clinically Useful Pharmacology of GI Drugs. He is Board Certified in Internal Medicine
CONSULTANTS FOR CLINICAL RESEARCH
Consultants for Clinical Research (CCR) is a multi-specialty clinical research center. For over 25 years,
CCR has conducted clinical pharmaceutical trials and Investigator initiated clinical trials. CCR has
demonstrated a commitment to excellence in the clinical trials process by providing high quality data
collection while meeting strict ethical and professional standards for our patients and the industry. CCR
employs a dedicated experienced staff of Physician Assistants, Registered Nurses, Certified Medical
Assistants, administrators, and clerical staff in a 4,000 square foot facility plus satellite offices. Infusion
suites are utilized to administer investigational as well as commercially available therapies.
A national leading research center, Consultants for Clinical Research has participated in over 500 clinical
trials for medical conditions such as the following:
Ankle Sprain
Back Pain (Chronic)
Bronchitis
C. Difficile Toxin
Crohn’s Disease
Diabetes
Dyspepsia
Gastroparesis
Gastropathy (NSAID induced)
GERD (Erosive & non-erosive)
Hemorrhoids
Hepatitis B
Hepatitis C
Hyperlipidemia
Hypertension
Non Alcholic Steatohepatitis (NASH)
Osteoarthritis
Otitis Externa
Pain Management
Pancreatitis
Peptic Ulcer Disease
Pneumonia
Rheumatoid Arthritis
Strep Pharyngitis
Ulcerative Colitis
Contact
Call Linda Magaw (513-872-4549) for information about CCR, for patient referrals, or to receive
information on participating in clinical research trials (physicians).
2. Colonoscopy Withdrawal Time Study:
After reaching the cecum, the colonoscope should be slowly withdrawn during careful inspection for
polyps, cancer and other abnormalities. Studies have demonstrated and the American College of
Gastroenterology recommends that a withdrawal time of 6 minutes or greater correlates with a higher
likelihood of finding lesions.
Colonoscopy Withdrawal Time
12
10
11.2
Ohio GI
8
6
6.0
4
National*
2
0
Minutes
Colonoscopy by Ohio GI Gastroenterologists involves careful and deliberate inspection of the colon that
exceeds national standards.
3. Colonoscopy Bowel Preparation Study:
Thorough bowel cleansing is critically important to visualize abnormalities in the colon. There are many
different techniques available to purge the colon of debris. Patients repeatedly tell us that the colon
cleansing process is the “most difficult part” of colonoscopy. We review and reevaluate various bowel
cleansing methods for palatability and effectiveness. Recent data has indicated rare kidney toxicity from
a commonly used prep (phosphosoda), thus we are using other preps and tracking their effectiveness.
A study of these new bowel cleansing programs is currently in progress.
www.ccrstudy.com
4. Polyp Detection Rate Study:
As a more direct marker of quality, the rate at which adenomas are detected during screening
colonoscopies can also be measured and compared with nationally published rates and medical society
recommendations.
Adenoma Detection Rate - Males
35
30
31.7%
25
Ohio GI
25.0%
20
15
National*
10
5
0
Adenoma Detection Rate - Females
35
30
25
Ohio GI
29.3%
20
National*
15
10
15.0%
5
0
These graphs demonstrate superior performance by Ohio GI Gastroenterologists.
Ohio GI “pancreatologists” treat a variety of pancreatic diseases such as: acute, recurrent acute, and
chronic pancreatitis, pancreatic cancer, and pancreatic insufficiency with medical, dietary, and endoscopic
therapies. We remain actively involved with patients that require surgery as well. Subspecialized techniques
that our experts provide include endoscopic drainage of pancreatic cysts, thereby avoiding major surgery.
Sphincter of Oddi manometry and sphincterotomy and stent placement are ERCP techniques with which
we have extensive experience. Choledochoscopy allows the placement of a thin bore endoscope directly
up into the bile duct for visualization of pathology and application of a variety of therapies to detect and
treat stones or tumors.
Endoscopic Mucosal Resection (EMR)
EMR is a more aggressive technique of lesion removal involving submucosal injection of saline to raise
a lesion up from deeper tissue layers. The lesion is then removed with snare cautery or bands. In
appropriately selected patients, larger lesions can sometimes be removed with this specialized approach
by our experienced endoscopists, eliminating the need for surgical resection.
Patient Satisfaction Survey - Endoscopy Centers
Capsule Endoscopy Indications
After undergoing a procedure at one of our centers, patients are asked to fill out an evaluation form,
rating their experience from various perspectives. Questions address the spectrum of the encounter from
evaluation of registration and release to judging the level of respect, efficiency, and professional skills
of our staff and physicians. In all parameters, 95% or more of patients rated us as having either met or
exceeded their expectations.
Number of Patients
100
80
60
40
40
19
20
8
4
12
9
3
3
99%
100%
0
99%
99%
99%
99%
90%
80%
70%
60%
50%
40%
30%
Capsule Endoscopy Findings
20%
10%
Number of Patients
100
1%
1%
1%
1%
1%
0%
1
80
2
3
4
5
Survey Question (see below)
60
60
1. Our staff’s personal manner was clear, courteous, and respectful.
40
3
0
2. Our nurses’ professional skills were competent and efficient.
17
20
6
3
1
2
1
1
1
4
1
1
3. Our physicians’ professional skills were competent and efficient.
4. Our physicians’ effectiveness in answering questions, addressing treatments, needs
and concerns was clear.
5. Our physicians’ personal manner was clear, courteous, and respectful.
Patient Satisfaction Survey - Office
A prospective survey study was performed by an independent research group on randomly selected
patients coming to our offices. Patients were given a questionnaire that asked them to evaluate the
practice environment, staff communication, education of patients, physician communication, office
management, and physician/staff teamwork. Results were then compared to national and regional
responses to the identical questionnaire. The following table shows the results of the Ohio GI survey
indicating superiority for all parameters when compared to both national and regional results.
Routine endoscopy with EGD and colonoscopy (with retrograde cannulation of the terminal ileum) still
leaves approximately 15-20 feet of small intestine that has been challenging to visualize endoscopically.
We perform small bowel enteroscopy utilizing a fiberoptic push enteroscope that can reach into the
jejunum and balloon enteroscopy that can penetrate even further. Ohio GI was the first practice in our
area to utilize the “Pillcam”. This noninvasive device incorporates a camera in a mechanical pill format
that, after being swallowed, takes a video of the entire small intestine.
In 2008, we performed 268 small bowel Pillcam examinations. Indications for this test were often to
diagnose unexplained anemia or gastrointestinal bleeding or to evaluate for IBD/diarrhea. These patients
had already undergone other standard tests to evaluate their condition, without an answer. Pillcam
results did elucidate the condition in 40% of patients.
Patient Satisfaction for Ohio GI Practice
5.00
Ohio GI
4.00
National
Regional (Ohio)
3.00
Environment
Staff
Communication
Education
Patients
MD
Communications
Office
Management
MD/Staff
Teamwork
Pillcam
Small Intestine
Small Intestine
Large Polyp
Survey Categories
This technique is highly specialized requiring in-depth and extensive training. Our expert physicians who
have undergone this level of training were the first in our area to perform endoscopic ultrasound. Our
experience with fine needle aspiration, which greatly enhances the diagnostic accuracy of this procedure,
is unparalleled locally.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
ERCP is a highly specialized endoscopic procedure combining endoscopic and radiographic images to
evaluate the biliary tree and pancreas. ERCP is a tool for the diagnosis of liver, bile duct, and pancreatic
disorders. ERCP can also offer treatment such as sphincterotomy, stone removal, and stent placement in
the bile and pancreatic ducts. Studies have shown that physicians who perform a high volume of ERCP’s
experience lower rates of complications, such as pancreatitis. Among the physicians of Ohio GI, three are
super-specialized in ERCP techniques and thus maintain a high volume practice.
Ohio GI offers comprehensive testing, evaluation and recommendations regarding esophageal disorders.
Esophageal reflux testing modalities include the measurement of gastric acid reflux into the esophagus
with nasal catheter ambulatory 24 hour pH probes and attached Bravo 48 hour esophageal acid monitoring.
Through our leadership as the Director of the Swallowing Center, we introduced the newer technology
of esophageal impedance. This allows more sophisticated testing of esophageal symptoms that may be
related to reflux of nonacidic gastric contents. Patients with gastroesophageal reflux disease (GERD) are
treated with a comprehensive review of diet, medications, lifestyle, and other relevant factors.
Esophageal function is usually assessed with motility testing. In 2008 we performed 149 esophageal pH
and motility tests. Patients with esophageal motility disorders such as achalasia may undergo pneumatic
dilation, BoTox injection or be referred to a GI surgeon, as appropriate, for each individual circumstance
based on detailed consultation.
Barrett’s esophagus, a potentially precancerous complication of gastroesophageal reflux disease (GERD)
is sought out during every endoscopic exam of the UGI tract using standard white light video endoscopy.
In some cases Narrow Band Imaging (NBI) using blue light technology that highlights the appearance
of Barrett’s is utilized. Halo ablation of Barrett’s has recently been introduced by us to endoscopically
ablate Barrett’s esophagus with dysplasia.
Ohio GI is an acknowledged leader in the treatment of patients with inflammatory bowel disease. In
2008 we saw 5,953 patient visits with ulcerative colitis or Crohn’s disease. Many patients are seen in
consultation by us for a second opinion. We have been actively involved in IBD clinical research, leading
to publication of numerous journal articles and participation in many national conferences. Our patients
with IBD may choose to participate in clinical trials, availing themselves of treatments not otherwise
accessible. In Cincinnati, we helped form the local chapter of the Crohn’s & Colitis Foundation of America
(CCFA) and have remained active in its organization, research, fund raising, educational activities, and
chairing the medical advisory committee.
We strive to provide IBD patients with the most safe and effective therapies available including prescription
medications, over-the-counter products, dietary advice, life style support, and clinical research trials.
We have had great success in reducing the use of steroids which have many short and long-term side
effects. Our dedicated IBD nursing staff is responsible for administering and assisting in monitoring
biologic medications such as Remicade (Infliximab) and others. We utilize additional tools such as disease
activity indices to follow many patients to track their progress and provide objective information on each
patient’s status.
Crohn’s disease is a lifelong and potentially serious condition that has significant medical, economic,
and social impact. The use of expensive biologic therapies thus needs to be carefully evaluated in terms
of providing substantial benefits for our patients. We performed a study to examine and document the
response of patients with Crohn’s disease to biologic therapy with Remicade (Infliximab). A standardized
inflammatory bowel disease questionnaire (IBDQ) was used as the tool to measure the patient’s clinical
status. Patients entering this study were patients with moderate to severe Crohn’s disease, most of whom
had active disease in spite of treatment with other available modalities (typically steroids and immune
modulator therapies such as azathioprine or 6-mercaptopurine). After treatment with Remicade, the
IBDQ score improved in 72% of our patients, was unchanged in 8% and worsened in 20%. This study did
document improvement in a very significant percentage of our patients undergoing biologic treatment.
Irritable bowel syndrome is a chronic gastrointestinal disorder of unclear etiology. Recent studies have
suggested that in some patients, small bowel bacterial overgrowth (SBBO) may cause symptoms or be a
contributing factor. Thus, identification and treatment of SBBO may be potentially beneficial to patients
who have IBS. Ohio GI was the first adult GI practice in Greater Cincinnati to acquire equipment to test
for SBBO. The fairly simple test is performed by measuring the amount of hydrogen in a patient’s breath,
having the patient ingest a nonabsorbable sugar (lactulose) and retesting breath hydrogen over a period
of time looking for an “early peak” that may signify bacterial metabolism of the lactulose in the small
intestine due to an abnormal accumulation of bacteria.
We performed a study of our patients undergoing hydrogen breath testing to assess the performance
of this test and the response to therapy. Initially, out of 244 lactulose breath tests, 217 were positive
(89%). We then prospectively studied 64 patients who tested positive and were followed up 1 month
and 3 months after starting treatment with either rifaxamin 400mg TID or metronidazole 250mg TID
for one week. Patients had an average age of 48 years and 89% were female. Results showed that
approximately 90% experienced at least some relief of symptoms while on treatment. Patients were
asked to rate their overall relief of symptoms as poor, fair, good or excellent. At 1 month 39% rated
their relief as “good or excellent”. At 3 months 61% of patients rated their relief as “good or excellent”.
Patients presenting with symptoms of bloating and diarrhea reported the most improvement.
Liver Disease
Ohio Gastroenterology and Liver Institute is the largest hepatology practice in the greater Cincinnati
area. All Ohio GI physicians are trained in hepatology and several have a special interest in liver disease.
In fact, Ohio GI is the only private practice in the tristate area with physicians who are board certified
specifically in hepatology and liver transplantation.
Our doctors evaluate and treat adult patients with any type of liver disease at the specialist and
subspecialist level. Patients are seen at all stages of disease including those very ill who require liver
transplantation and those who are too ill to be considered for transplantation. Fortunately, progress
in hepatology over the years has allowed most liver patients to be treated successfully without need
for transplantation. Liver diseases we’ve treated include: viral hepatitis (A, B, and C), auto-immune
hepatitis, fatty liver/NASH, hemochromatosis, bile duct disorders, liver tumors, and diagnosing abnormal
liver blood tests. Ohio GI has the most fellowship trained interventional gastroenterologists in the
tristate area who perform the advanced procedures of endoscopic ultrasonography and ERCP to help
maximize healthcare delivery to our patients. Liver biopsies are performed in our endoscopy centers and
interpreted by our pathologists and hepatologists.
Our active research unit participates in many cutting edge trials involving different liver diseases. We are
frequently the only practice in this area participating in these research protocols. This type of research
in the past has led to new discoveries and advanced the treatment of many liver diseases.
Ohio Gastroenterology and Liver Institute is proud to include board certified female gastroenterologists
with special interests in women’s health, including but not limited to: Gastroesophageal Reflux Disease
(GERD), Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD), Gallbladder Disease, Colon
Cancer, Liver Disease, GI Disease during Pregnancy, Fecal Incontinence, and Hemorrhoids.
Patients need to feel comfortable seeking care for their gastrointestinal health. They seek doctors who
will listen to their concerns, spend time with them, and make them feel at ease, even when discussing
matters that may be embarrassing or unsettling. Additionally, there may be gender differences and
barriers to cancer prevention strategies for women. We ensure that women who prefer to see a female
physician for their screening colonoscopy and consultation can do so.
Endoscopic Ultrasound (EUS)
EUS has emerged as a highly sensitive and specific minimally invasive diagnostic tool. The procedure
involves insertion of an endoscope which has an ultrasound probe at its tip. The ultrasound beam can be
placed in close proximity to an area of interest, such as a tumor or cyst, to image its size and appearance
and to assess potential invasion into surrounding structures. Through the channel of the scope, a fine
needle aspiration (FNA) can be performed to obtain material for cytologic analysis. EUS can also be used
in the evaluation of upper GI and lower GI lesions, solid organs, IBD, vascular structures, and chest/
pulmonary lesions.
Irritable bowel syndrome is a chronic gastrointestinal disorder of unclear etiology. Recent studies have
suggested that in some patients, small bowel bacterial overgrowth (SBBO) may cause symptoms or be a
contributing factor. Thus, identification and treatment of SBBO may be potentially beneficial to patients
who have IBS. Ohio GI was the first adult GI practice in Greater Cincinnati to acquire equipment to test
for SBBO. The fairly simple test is performed by measuring the amount of hydrogen in a patient’s breath,
having the patient ingest a nonabsorbable sugar (lactulose) and retesting breath hydrogen over a period
of time looking for an “early peak” that may signify bacterial metabolism of the lactulose in the small
intestine due to an abnormal accumulation of bacteria.
We performed a study of our patients undergoing hydrogen breath testing to assess the performance
of this test and the response to therapy. Initially, out of 244 lactulose breath tests, 217 were positive
(89%). We then prospectively studied 64 patients who tested positive and were followed up 1 month
and 3 months after starting treatment with either rifaxamin 400mg TID or metronidazole 250mg TID
for one week. Patients had an average age of 48 years and 89% were female. Results showed that
approximately 90% experienced at least some relief of symptoms while on treatment. Patients were
asked to rate their overall relief of symptoms as poor, fair, good or excellent. At 1 month 39% rated
their relief as “good or excellent”. At 3 months 61% of patients rated their relief as “good or excellent”.
Patients presenting with symptoms of bloating and diarrhea reported the most improvement.
Liver Disease
Ohio Gastroenterology and Liver Institute is the largest hepatology practice in the greater Cincinnati
area. All Ohio GI physicians are trained in hepatology and several have a special interest in liver disease.
In fact, Ohio GI is the only private practice in the tristate area with physicians who are board certified
specifically in hepatology and liver transplantation.
Our doctors evaluate and treat adult patients with any type of liver disease at the specialist and
subspecialist level. Patients are seen at all stages of disease including those very ill who require liver
transplantation and those who are too ill to be considered for transplantation. Fortunately, progress
in hepatology over the years has allowed most liver patients to be treated successfully without need
for transplantation. Liver diseases we’ve treated include: viral hepatitis (A, B, and C), auto-immune
hepatitis, fatty liver/NASH, hemochromatosis, bile duct disorders, liver tumors, and diagnosing abnormal
liver blood tests. Ohio GI has the most fellowship trained interventional gastroenterologists in the
tristate area who perform the advanced procedures of endoscopic ultrasonography and ERCP to help
maximize healthcare delivery to our patients. Liver biopsies are performed in our endoscopy centers and
interpreted by our pathologists and hepatologists.
Our active research unit participates in many cutting edge trials involving different liver diseases. We are
frequently the only practice in this area participating in these research protocols. This type of research
in the past has led to new discoveries and advanced the treatment of many liver diseases.
Ohio Gastroenterology and Liver Institute is proud to include board certified female gastroenterologists
with special interests in women’s health, including but not limited to: Gastroesophageal Reflux Disease
(GERD), Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD), Gallbladder Disease, Colon
Cancer, Liver Disease, GI Disease during Pregnancy, Fecal Incontinence, and Hemorrhoids.
Patients need to feel comfortable seeking care for their gastrointestinal health. They seek doctors who
will listen to their concerns, spend time with them, and make them feel at ease, even when discussing
matters that may be embarrassing or unsettling. Additionally, there may be gender differences and
barriers to cancer prevention strategies for women. We ensure that women who prefer to see a female
physician for their screening colonoscopy and consultation can do so.
Endoscopic Ultrasound (EUS)
EUS has emerged as a highly sensitive and specific minimally invasive diagnostic tool. The procedure
involves insertion of an endoscope which has an ultrasound probe at its tip. The ultrasound beam can be
placed in close proximity to an area of interest, such as a tumor or cyst, to image its size and appearance
and to assess potential invasion into surrounding structures. Through the channel of the scope, a fine
needle aspiration (FNA) can be performed to obtain material for cytologic analysis. EUS can also be used
in the evaluation of upper GI and lower GI lesions, solid organs, IBD, vascular structures, and chest/
pulmonary lesions.
This technique is highly specialized requiring in-depth and extensive training. Our expert physicians who
have undergone this level of training were the first in our area to perform endoscopic ultrasound. Our
experience with fine needle aspiration, which greatly enhances the diagnostic accuracy of this procedure,
is unparalleled locally.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
ERCP is a highly specialized endoscopic procedure combining endoscopic and radiographic images to
evaluate the biliary tree and pancreas. ERCP is a tool for the diagnosis of liver, bile duct, and pancreatic
disorders. ERCP can also offer treatment such as sphincterotomy, stone removal, and stent placement in
the bile and pancreatic ducts. Studies have shown that physicians who perform a high volume of ERCP’s
experience lower rates of complications, such as pancreatitis. Among the physicians of Ohio GI, three are
super-specialized in ERCP techniques and thus maintain a high volume practice.
Ohio GI offers comprehensive testing, evaluation and recommendations regarding esophageal disorders.
Esophageal reflux testing modalities include the measurement of gastric acid reflux into the esophagus
with nasal catheter ambulatory 24 hour pH probes and attached Bravo 48 hour esophageal acid monitoring.
Through our leadership as the Director of the Swallowing Center, we introduced the newer technology
of esophageal impedance. This allows more sophisticated testing of esophageal symptoms that may be
related to reflux of nonacidic gastric contents. Patients with gastroesophageal reflux disease (GERD) are
treated with a comprehensive review of diet, medications, lifestyle, and other relevant factors.
Esophageal function is usually assessed with motility testing. In 2008 we performed 149 esophageal pH
and motility tests. Patients with esophageal motility disorders such as achalasia may undergo pneumatic
dilation, BoTox injection or be referred to a GI surgeon, as appropriate, for each individual circumstance
based on detailed consultation.
Barrett’s esophagus, a potentially precancerous complication of gastroesophageal reflux disease (GERD)
is sought out during every endoscopic exam of the UGI tract using standard white light video endoscopy.
In some cases Narrow Band Imaging (NBI) using blue light technology that highlights the appearance
of Barrett’s is utilized. Halo ablation of Barrett’s has recently been introduced by us to endoscopically
ablate Barrett’s esophagus with dysplasia.
Ohio GI is an acknowledged leader in the treatment of patients with inflammatory bowel disease. In
2008 we saw 5,953 patient visits with ulcerative colitis or Crohn’s disease. Many patients are seen in
consultation by us for a second opinion. We have been actively involved in IBD clinical research, leading
to publication of numerous journal articles and participation in many national conferences. Our patients
with IBD may choose to participate in clinical trials, availing themselves of treatments not otherwise
accessible. In Cincinnati, we helped form the local chapter of the Crohn’s & Colitis Foundation of America
(CCFA) and have remained active in its organization, research, fund raising, educational activities, and
chairing the medical advisory committee.
We strive to provide IBD patients with the most safe and effective therapies available including prescription
medications, over-the-counter products, dietary advice, life style support, and clinical research trials.
We have had great success in reducing the use of steroids which have many short and long-term side
effects. Our dedicated IBD nursing staff is responsible for administering and assisting in monitoring
biologic medications such as Remicade (Infliximab) and others. We utilize additional tools such as disease
activity indices to follow many patients to track their progress and provide objective information on each
patient’s status.
Crohn’s disease is a lifelong and potentially serious condition that has significant medical, economic,
and social impact. The use of expensive biologic therapies thus needs to be carefully evaluated in terms
of providing substantial benefits for our patients. We performed a study to examine and document the
response of patients with Crohn’s disease to biologic therapy with Remicade (Infliximab). A standardized
inflammatory bowel disease questionnaire (IBDQ) was used as the tool to measure the patient’s clinical
status. Patients entering this study were patients with moderate to severe Crohn’s disease, most of whom
had active disease in spite of treatment with other available modalities (typically steroids and immune
modulator therapies such as azathioprine or 6-mercaptopurine). After treatment with Remicade, the
IBDQ score improved in 72% of our patients, was unchanged in 8% and worsened in 20%. This study did
document improvement in a very significant percentage of our patients undergoing biologic treatment.
Patient Satisfaction Survey - Office
A prospective survey study was performed by an independent research group on randomly selected
patients coming to our offices. Patients were given a questionnaire that asked them to evaluate the
practice environment, staff communication, education of patients, physician communication, office
management, and physician/staff teamwork. Results were then compared to national and regional
responses to the identical questionnaire. The following table shows the results of the Ohio GI survey
indicating superiority for all parameters when compared to both national and regional results.
Routine endoscopy with EGD and colonoscopy (with retrograde cannulation of the terminal ileum) still
leaves approximately 15-20 feet of small intestine that has been challenging to visualize endoscopically.
We perform small bowel enteroscopy utilizing a fiberoptic push enteroscope that can reach into the
jejunum and balloon enteroscopy that can penetrate even further. Ohio GI was the first practice in our
area to utilize the “Pillcam”. This noninvasive device incorporates a camera in a mechanical pill format
that, after being swallowed, takes a video of the entire small intestine.
In 2008, we performed 268 small bowel Pillcam examinations. Indications for this test were often to
diagnose unexplained anemia or gastrointestinal bleeding or to evaluate for IBD/diarrhea. These patients
had already undergone other standard tests to evaluate their condition, without an answer. Pillcam
results did elucidate the condition in 40% of patients.
Patient Satisfaction for Ohio GI Practice
5.00
Ohio GI
4.00
National
Regional (Ohio)
3.00
Environment
Staff
Communication
Education
Patients
MD
Communications
Office
Management
MD/Staff
Teamwork
Pillcam
Small Intestine
Small Intestine
Large Polyp
Survey Categories
Patient Satisfaction Survey - Endoscopy Centers
Capsule Endoscopy Indications
After undergoing a procedure at one of our centers, patients are asked to fill out an evaluation form,
rating their experience from various perspectives. Questions address the spectrum of the encounter from
evaluation of registration and release to judging the level of respect, efficiency, and professional skills
of our staff and physicians. In all parameters, 95% or more of patients rated us as having either met or
exceeded their expectations.
Number of Patients
100
80
60
40
40
19
20
8
4
12
9
3
3
99%
100%
0
99%
99%
99%
99%
90%
80%
70%
60%
50%
40%
30%
Capsule Endoscopy Findings
20%
10%
Number of Patients
100
1%
1%
1%
1%
1%
0%
1
80
2
3
4
5
Survey Question (see below)
60
60
1. Our staff’s personal manner was clear, courteous, and respectful.
40
3
0
2. Our nurses’ professional skills were competent and efficient.
17
20
6
3
1
2
1
1
1
4
1
1
3. Our physicians’ professional skills were competent and efficient.
4. Our physicians’ effectiveness in answering questions, addressing treatments, needs
and concerns was clear.
5. Our physicians’ personal manner was clear, courteous, and respectful.
4. Polyp Detection Rate Study:
As a more direct marker of quality, the rate at which adenomas are detected during screening
colonoscopies can also be measured and compared with nationally published rates and medical society
recommendations.
Adenoma Detection Rate - Males
35
30
31.7%
25
Ohio GI
25.0%
20
15
National*
10
5
0
Adenoma Detection Rate - Females
35
30
25
Ohio GI
29.3%
20
National*
15
10
15.0%
5
0
These graphs demonstrate superior performance by Ohio GI Gastroenterologists.
Ohio GI “pancreatologists” treat a variety of pancreatic diseases such as: acute, recurrent acute, and
chronic pancreatitis, pancreatic cancer, and pancreatic insufficiency with medical, dietary, and endoscopic
therapies. We remain actively involved with patients that require surgery as well. Subspecialized techniques
that our experts provide include endoscopic drainage of pancreatic cysts, thereby avoiding major surgery.
Sphincter of Oddi manometry and sphincterotomy and stent placement are ERCP techniques with which
we have extensive experience. Choledochoscopy allows the placement of a thin bore endoscope directly
up into the bile duct for visualization of pathology and application of a variety of therapies to detect and
treat stones or tumors.
Endoscopic Mucosal Resection (EMR)
EMR is a more aggressive technique of lesion removal involving submucosal injection of saline to raise
a lesion up from deeper tissue layers. The lesion is then removed with snare cautery or bands. In
appropriately selected patients, larger lesions can sometimes be removed with this specialized approach
by our experienced endoscopists, eliminating the need for surgical resection.
CONSULTANTS FOR CLINICAL RESEARCH
Consultants for Clinical Research (CCR) is a multi-specialty clinical research center. For over 25 years,
CCR has conducted clinical pharmaceutical trials and Investigator initiated clinical trials. CCR has
demonstrated a commitment to excellence in the clinical trials process by providing high quality data
collection while meeting strict ethical and professional standards for our patients and the industry. CCR
employs a dedicated experienced staff of Physician Assistants, Registered Nurses, Certified Medical
Assistants, administrators, and clerical staff in a 4,000 square foot facility plus satellite offices. Infusion
suites are utilized to administer investigational as well as commercially available therapies.
A national leading research center, Consultants for Clinical Research has participated in over 500 clinical
trials for medical conditions such as the following:
Ankle Sprain
Back Pain (Chronic)
Bronchitis
C. Difficile Toxin
Crohn’s Disease
Diabetes
Dyspepsia
Gastroparesis
Gastropathy (NSAID induced)
GERD (Erosive & non-erosive)
Hemorrhoids
Hepatitis B
Hepatitis C
Hyperlipidemia
Hypertension
Non Alcholic Steatohepatitis (NASH)
Osteoarthritis
Otitis Externa
Pain Management
Pancreatitis
Peptic Ulcer Disease
Pneumonia
Rheumatoid Arthritis
Strep Pharyngitis
Ulcerative Colitis
Contact
Call Linda Magaw (513-872-4549) for information about CCR, for patient referrals, or to receive
information on participating in clinical research trials (physicians).
2. Colonoscopy Withdrawal Time Study:
After reaching the cecum, the colonoscope should be slowly withdrawn during careful inspection for
polyps, cancer and other abnormalities. Studies have demonstrated and the American College of
Gastroenterology recommends that a withdrawal time of 6 minutes or greater correlates with a higher
likelihood of finding lesions.
Colonoscopy Withdrawal Time
12
10
11.2
Ohio GI
8
6
6.0
4
National*
2
0
Minutes
Colonoscopy by Ohio GI Gastroenterologists involves careful and deliberate inspection of the colon that
exceeds national standards.
3. Colonoscopy Bowel Preparation Study:
Thorough bowel cleansing is critically important to visualize abnormalities in the colon. There are many
different techniques available to purge the colon of debris. Patients repeatedly tell us that the colon
cleansing process is the “most difficult part” of colonoscopy. We review and reevaluate various bowel
cleansing methods for palatability and effectiveness. Recent data has indicated rare kidney toxicity from
a commonly used prep (phosphosoda), thus we are using other preps and tracking their effectiveness.
A study of these new bowel cleansing programs is currently in progress.
www.ccrstudy.com
Colonoscopy quality - Colorectal Cancer (CRC) Prevention
Colonoscopy with polypectomy is currently the best method of colorectal cancer (CRC) prevention. CRC
usually begins as an asymptomatic polyp. With time as the polyp grows, malignant degeneration can
occur. To prevent CRC, polyps need to be found and removed with colonoscopy.
Colonoscopy is highly effective but it has some limitations in that it does not identify all polyps and
cancers. To address this concern, studies have demonstrated three main parameters that correlate
with greater colonoscopic accuracy: high rate of complete colonoscopy with visualization into the base
of the cecum, inspection time during colonoscopy withdrawal of six minutes or greater, and quality
colonoscopy preparation to minimize “hidden lesions”. We routinely monitor these quality parameters and
our data demonstrates performance superior to the current recommendations and national standards, as
demonstrated in the following graphs:
1. Complete Colonoscopy Study:
To detect all lesions, the entire colon needs to be carefully examined. Given certain technical factors
such as adequacy of the bowel preparation, adhesions, and the tortuous nature of some colons, insertion
of the colonoscopy all the way into the cecum can present a challenge. Our experienced and skilled
colonoscopists do reach the cecum in almost all cases.
Cecal Intubation Rates
98.71%
Ohio GI
97
96
National*
95
95.0%
94
All of our physicians are expert in outpatient and inpatient consultative gastroenterology, hepatology,
endoscopy, colonoscopy, and colorectal cancer prevention. We all see patients spanning the spectrum of
digestive and liver disorders. Highlighted below is a brief synopsis of background information, mention
of specific leadership roles, and designation of additional area of focused expertise for each of our
physicians and physician assistants.
Dr. Pradeep K. Bekal
Endoscopic ultrasound-guided biopsies (EUS), Pancreatic and biliary disorders
Dr. Bekal graduated from Madras Medical School, Madras, India, and completed his Residency in Internal
Medicine at New York Methodist Hospital in Brooklyn, New York. His Gastroenterology Fellowship was
completed at the Brooklyn Hospital Medical Center. Dr. Bekal completed an Advanced Therapeutic
Endoscopy Fellowship at Allegheny General Hospital in Pittsburgh. Dr. Bekal is the Gastroenterology
Director at West Chester Medical Center and has been awarded Cincinnati Magazine’s “Top Doctor”
recognition. He is Board Certified in Gastroenterology.
Dr. Manish M. Chokshi
• Special Interest: Hemorrhoidal band ligation, Capsule endoscopy “Pillcam”,
Hydrogen breath testing, Esophageal studies
99
98
OUR PHYSICIANS
93
1
Colonoscopy by Ohio GI Gastroenterologists reliably examines the entire colon, meeting or exceeding national standards.
Dr. Chokshi graduated from Case Western Reserve University School of Medicine and completed his
Internal Medicine Residency at Metro Health Medical Center, both in Cleveland. Dr. Chokshi then completed
his Fellowship in Gastroenterology at the University of Michigan Medical Center in Ann Arbor. He has
presented lectures at medical conferences on a variety of topics such as: Evaluation of Anemia from the
GI Prospective and Clinically Useful Pharmacology of GI Drugs. He is Board Certified in Internal Medicine
Dr. John P. Czarnecki
Dr. Czarnecki graduated from Northwestern University Medical School in Chicago and completed his
Residency in Internal Medicine at Dartmouth-Hitchcock Medical Center. He continued his training
at Dartmouth, where he completed his Gastroenterology Fellowship. He has presented lectures at
medical conferences on a variety of topics such as Colorectal Cancer Screening, GERD, Celiac Disease,
and Evaluation of Swallowing Disorders. Dr. Czarnecki is Board Certified in Internal Medicine and
Gastroenterology.
OUR COMMITMENT TO QUALITY
We are able to report quality data where information is measurable and available. In many areas there
are no established benchmark indicators of quality performance and we present highlights of numbers of
patient volume or descriptions of clinical areas of expertise. We believe, and studies have documented,
that seeing a high volume of patients with any given condition leads to expertise that correlates with
better outcomes.
Dr. Karen Haberthier
• Special Interest: Women’s health
When performing procedures on our patients, we strive to maximize accuracy and minimize risk and
complications. Complications can occur during any medical procedure and we track and compare our
data with nationally published complication rates.
Dr. Haberthier graduated from University of Medicine and Dentistry of New Jersey - New Jersey Medical
School and completed her residency in Internal Medicine at Boston University Medical Center Her
Gastroenterology fellowship was performed at University of Pittsburgh Medical Center, where she also
served as Chief GI Fellow. Dr. Haberthier is Board Certified in Internal Medicine and Gastroenterology.
In 2008, 15,303 patients underwent gastrointestinal endoscopy and/or colonoscopy in one of our
outpatient endoscopy facilities. The major complications that can occur include perforation, bleeding
from therapeutic maneuvers such as polypectomy, and death. An endoscopic complication occurred in
only 8 patients for a rate of 0.0005%. Bleeding accounted for 7 of the 8 events, all from polypectomy
sites. None of these patients required surgery and only one needed transfusion. One patient developed
an esophageal tear after dilation for which he was briefly hospitalized and medically treated. There were
no colonic perforations.
Dr. Mark E. Jonas
• Special Interest: Hepatology, Gastrointestinal bleeding, Capsule endoscopy “Pillcam”
Dr. Jonas graduated from the State of New York Health Sciences Center at the Brooklyn College of
Medicine. He completed his Residency in Internal Medicine at the Montefiore Medical Center of the
Albert Einstein College of Medicine. His Gastroenterology Fellowship was performed at the University of
Medicine and Dentistry of New Jersey - New Jersey Medical School. Dr. Jonas completed an additional
year of Fellowship in Hepatology and Liver Transplantation at the Mount Sinai Medical Center in New
York City. Dr. Jonas is the Internal Medicine residency program Education Director at Jewish Hospital.
Dr. Jonas has been awarded Cincinnati Magazine’s “Top Doctor” recognition. He is Board Certified
in Internal Medicine, Gastroenterology, and Transplant Hepatology and is UNOS approved for liver
transplantation.
The following data summarizes the complications and compares with national averages.
OHIO GI
Total complications
Perforation
Hemorrhage*
Death
0.0005%
0.00006%
0.00006%
0.0%
NATIONAL RATES
0.5%
0.09%
0.48%
0.0006%
*Requiring transfusion or hospitalization
Colonoscopy and EGD performed by Ohio GI physicians is as safe or safer than national averages.
OUR ENDOSCOPY CENTERS
We operate four state-of-the-art endoscopy centers that provide specialized services at convenient
locations in Clifton, Montgomery, Fairfield, and Norwood. These facilities provide a comfortable, friendly,
and personal environment. We have meticulous standards of high quality care and consistently receive
high ratings for patient satisfaction.
We have developed an in-house electronic medical record system (eMerge), specific to endoscopic
procedures, that is currently used at our primary endoscopy centers. This allows a detailed report
to be generated at the time of the procedure and immediately faxed to the primary physician. The
patient is also provided with a report for their personal records that helps to clearly convey the results,
recommendations, and follow-up. Patients can also access their reports and results on-line via a secure
patient portal. Additional educational materials are provided to enhance the understanding of the
underlying disease process and healthy lifestyle recommendations.
A computerized recall system is utilized to remind patients to schedule a follow-up visit. For example,
a patient who has had adenomatous colonic polyps will usually need follow-up colonoscopy in the
future. The recommended interval is entered into the computer and when the time arrives, a patient
letter is generated and sent to inform them that it is time to schedule a surveillance procedure. These
scheduling reminders are especially important in conditions where a premalignant state may occur, such
as preventing colon cancer by appropriate follow-up colonoscopy.
Dr. Kim R. Jurell
• Special Interest: Gastroesophageal Reflux Disease (GERD),
Inflammatory Bowel Disease (IBD)
Dr. Jurell graduated from the Indiana University College of Medicine and completed his Residency in
Internal Medicine at St. Vincent Hospital in Indianapolis. His Gastroenterology Fellowship was completed
at the Medical College of Wisconsin in Milwaukee. He has presented lectures at medical conferences on
a variety of topics such as Clostridium Difficile. He has been awarded Cincy Magazine’s “Best Doctor”
recognition. Dr. Jurell is Board Certified in Gastroenterology.
Dr. Terry R. Kaylor
• Special Interest: Barrett’s therapy, Peptic Ulcer Disease
Dr. Kaylor graduated from the University of Cincinnati College of Medicine and completed his Internal
Medicine Residency and Gastroenterology Fellowship at The Ohio State University. Dr. Kaylor is interested
in all areas of Gastroenterology and Hepatology. He has presented lectures at medical conferences on
a variety of topics such as Gastrointestinal Inflammatory Disorders. He is Board Certified in Internal
Dr. Michael D. Kreines, FACG, FAGA, FACP
Gastroesophageal Reflux Disease (GERD), Esophageal Disorders
Dr. Kreines graduated from the University of Cincinnati College of Medicine and completed his Residency
in Internal Medicine at the University of Minnesota. His Gastroenterology Fellowship was performed at
the University of California in San Diego followed by an Inflammatory Bowel Disease Fellowship and
faculty position at the University of Chicago. He was a founding member and is a current board member
of the Cincinnati CCFA chapter and is an active participant in IBD clinical research trials. He was recently
appointed to the National Medical Scientific Advisory Committee of the Colon Cancer Alliance (CCA). He
is the chief of Gastroenterology and the Director of the Center for Swallowing Disorders at the Christ
Hospital and Co-chairman of the local Colorectal Task Force at the American Cancer Society. He is
actively involved in teaching medical students and internal medicine and family practice residents. Dr.
Kreines has been awarded Cincinnati Magazine’s “Top Doctor” recognition. He has lectured extensively
at medical and nursing and community conferences on a variety of topics such as: Inflammatory Bowel
Disease, Irritable Bowel Syndrome, Colon Cancer Prevention, and Esophageal Disorders. Dr Kreines is a
Fellow of the American College of Gastroenterology, the American Gastroenterology Association, and the
American College of Physicians and is Board Certified in Internal Medicine and Gastroenterology.
Dr. Lisa S. Lestina
• Special Interest: Gastroesophageal Reflux Disease (GERD), Women’s health
Dr. Lestina graduated from Northwestern University Medical School in Chicago. She subsequently
completed her Residency and Chief Residency in Internal Medicine at Dartmouth-Hitchcock Medical
Center in New Hampshire. Dr. Lestina continued her training at Dartmouth, completing her Fellowship
in Gastroenterology. Dr. Lestina has presented lectures to medical and nursing audiences on a variety
of topics such as: Celiac Disease, Helicobacter Pylori and Clostridium Difficile. She is Board Certified in
Internal Medicine and Gastroenterology.
OUR PATIENTS
Our mission is to provide outstanding and very personalized care to all patients within the broad range
of digestive disorders. Ohio GI is a large subspecialized practice to which a high volume of patients with
common and uncommon disorders are referred, resulting in unparalleled expertise in diagnostic and
therapeutic capabilities.
Annually, Ohio GI provides over 70,000 digestive services which include inpatient encounters,
outpatient encounters, and endoscopic procedures to patients mainly from Ohio, Kentucky,
and Indiana.
Numbers of patients seen in several diagnostic categories:
DIAGNOSIS
PATIENT VISITS
Crohn’s Disease.......................4,084
Ulcerative Colitis.....................1,869
Liver Disease............................1,734
Irritable Bowel Syndrome..........843
Pancreatic Disorders..............1,682
Esophageal Disorders.............6,228
Abdominal Pain*......................6,839
GI Bleeding................................3,694
Diarrhea*................................4,488
Constipation.............................1,488
*Includes some patients with IBS
family practice residents, medical students, nursing students, physician assistant students, and as
preceptors for undergraduate students who are considering a career in medicine.
On an individual patient level, we have developed a wide array of materials and information that focus
on specific diseases or symptoms for patient education. We believe a well informed patient is a healthier
patient. Our website (www.ohiogi.com) contains many additional informative resources for patients and
physicians.
Leadership
State of Ohio GI leadership
National GI Society Leadership
Ohio GI CME Conference
Ohio GI staff hold or have held leadership positions in the GI division and endoscopy departments at many
of our local hospitals. Leadership involvement in national, state, and local organizations has included:
National Board of Trustees of the American College of Gastroenterology, Southern Ohio Governors for
the American College of Gastroenterology, Practice Management Committee for the American Society
for Gastrointestinal Endoscopy, founding officer of the Gastroenterology Assembly for the Medical Group
Managers Association, National and State GI representative to the Medicare Carrier Advisory Committee,
Chairman of Colorectal Cancer Task Force at the Cincinnati Chapter of the American Cancer Society,
Chairman of the Medical Advisory Committee for the Cincinnati Crohn’s and Colitis Foundation chapter,
National CCFA young investigator training course , Medical Director of the Christ Hospital Center for
Swallowing Disorders, and many others.
Dr. Mangels graduated from the Medical College of Ohio in Toledo and completed his Residency in
Internal Medicine at the University of Cincinnati. His Gastroenterology Fellowship was also completed
at the University of Cincinnati. He is the co-chairman of the Gastroenterology Section at Bethesda
North Hospital and has been awarded Cincinnati Magazine’s “Top Doctor” recognition. He has presented
lectures at medical conferences on a variety of topics such as Gastrointestinal Bleeding. Dr. Mangels is a
Fellow of the American College of Gastroenterology and is Board Certified in Gastroenterology.
Dr. Stephen P. Martin
Capsule endoscopy “Pillcam”, Pancreatic and biliary disorders
Hospital GI leadership
Local Not-for-profit organization leadership
Dr. David Mangels, FACG
Dr. Martin graduated from the University of Cincinnati College of Medicine and completed his Residency
in Internal Medicine at the University Hospitals of Cleveland/Case Western Reserve University. His
Gastroenterology Fellowship, which was completed at the University of Pittsburgh, included a focused
year of pancreaticobiliary endoscopy and pancreatic physiology training. He is the Chief of Endoscopy at
Mercy Hospital Fairfield and has been awarded Cincinnati Magazine’s “Top Doctor” and Cincy Magazine’s
“Best Doctor” recognitions. Dr. Martin is Board Certified in Gastroenterology.
Dr. Terrance O’Toole
• Special Interest: Gastroesophageal Reflux Disease (GERD), Barrett’s therapy,
Clinical outcomes
Dr. O’Toole graduated from the Ohio University College of Osteopathic Medicine in Athens, Ohio. He
completed his Internal Medicine residency training at the University of Cincinnati. He continued his
training at the University of Cincinnati, where he completed his Gastroenterology Fellowship. Dr. O’Toole
has lectured on numerous topics such as Barrett’s, Gastroparesis, and Refractory celiac disease. Dr.
O’Toole is Board Certified in Internal Medicine and Gastroenterology.
Dr. Kris Ramprasad
Dr. Ramprasad graduated from Madras Medical School, Madras, India. He completed his Residency
in Internal Medicine at the Veteran’s Administration Hospital and at Wright State University, both
in Dayton, Ohio. His Gastroenterology Fellowship was completed at the University of Cincinnati. Dr.
Ramprasad is the Gastroenterology section head at Mercy Hospital Western Hills. He is a clinical teacher
of Gastroenterology Fellows at the University of Cincinnati and has been awarded Cincinnati Magazine’s
“Top Doctor” recognition. Dr. Ramprasad is Board Certified in Internal Medicine and Gastroenterology.
Dr. Ravi Ravinuthala, Member of the Royal College of Physicians (UK)
• Special Interest: Hepatology, Mind-Body interaction
Clinical Research
Three decades experience
Involvement in the leading edge of GI therapies
Availability of alternative treatments for patients
We have been involved in clinical research for nearly thirty years. Our research division, Consultants
for Clinical Research (www.ccrstudy.com), has conducted over 350 gastroenterology and hepatology
clinical trials. We have participated in numerous pivotal clinical trials that now form the basis of advanced
treatment in many GI disorders such as: Crohn’s disease, ulcerative colitis, irritable bowel syndrome,
GERD, Hepatitis B, Hepatitis C, Peptic Ulcer Disease, eradication of Helicobacter pylori, and others. Our
involvement in clinical research trials provides us with an increased level of experience and knowledge
regarding new treatments and related pharmacology as well as the ability to offer treatment alternatives
to patients that would otherwise not be available to them.
Dr. Ravinuthala graduated from Rangaraya Medical College in India. He completed his Internal Medicine
Residency, Gastroenterology Fellowship and Transplant Hepatology Fellowship at Henry Ford Hospital,
Detroit, Michigan. He is Board Certified in Internal Medicine, Gastroenterology, and Transplant Hepatology
and is UNOS approved for liver transplantation.
Dr. Z. A. Saeed, FACG
• Special Interest: Pancreaticobiliary (ERCP) and therapeutic endoscopy, Endoscopic
ultrasound-guided biopsies (EUS), Hemorrhoidal band ligation,
Pancreatic and biliary disorders
Dr. Saeed graduated from King Edward Medical College, Lahore, Pakistan. He completed his Residency in
Internal Medicine at Texas Tech University, Amarillo. He received Fellowship training in Gastroenterology
and Hepatology at Georgetown University, Washington, D.C., followed by clinical and basic research
training at The National Institutes of Health, Bethesda, Maryland. He also completed a Fellowship in
Advanced Therapeutic Endoscopy and Endoscopic Research at Baylor College of Medicine, Houston,
Texas, and received formal training in endoscopic ultrasound procedures at Institut Paoli-Calmette,
Marseilles, France. Dr. Saeed is a Fellow of the American College of Gastroenterology and has been
awarded Cincinnati Magazine’s “Top Doctor” recognition. Dr. Saeed is Board Certified in Internal Medicine
Education
Patients and the public
Physicians
Medical students and residents
Nurses
With the enormous amount of medical information available, Ohio GI recognizes the importance of
educating physicians, students, medical residents, patients, and the public at large. Many of our
physicians present lectures to medical audiences on state-of-the-art topics during medical conferences
and hospital grand rounds in town and around the country. Ohio GI conducts an annual CME conference
(usually held in February) for approximately one hundred primary care providers to hear talks on the
latest breakthroughs in the field. We frequently provide lectures to community groups in a variety of
settings on requested topics, such as: inflammatory bowel disease, irritable bowel syndrome, reflux,
colon cancer prevention, liver disease, and others. Through our involvement with the American Cancer
Society, programs have been brought to the area reaching tens of thousands of people with information
and education about colon cancer prevention. We are involved in teaching GI fellows, medical residents,
Some of the procedures we perform:
• EGD with related therapies
• Colonoscopy with related therapies
• Endoscopic Ultrasound (EUS) for GI and non-GI (pulmonary) lesions
• Fine needle aspiration during EUS
• ERCP, sphincterotomy, pancreatic and biliary stent placement, manometry
• Choledochoscopy
• Esophageal, small bowel, pancreatobiliary, and colonic dilation
• Esophageal and colonic stenting
• Pancreatic pseudocyst drainage.
• Endoscopic mucosal resection (EMR)
• Celiac plexus block under endoscopic ultrasound guidance
• Argon plasma coagulation of polyps and vascular lesions
• Percutaneous endoscopic gastrostomy and jejunostomy
• Hydrogen breath testing for small bacterial overgrowth and carbohydrate intolerance
• Endoscopic banding for internal hemorrhoids
• Small bowel wireless capsule endoscopy “pill cam”
• Liver biopsy
• Esophageal Manometry
• Esophageal catheter and BRAVO pH testing
• Esophageal impedance
• Halo Ablation of Barrett’s esophagus
Dr. Alan V. Safdi, FACG
Clinical research
Dr. Alan Safdi graduated from the University of Cincinnati College of Medicine (with distinction being
nominated to the honorary medical society of AOA) and completed his Residency in Internal Medicine
at the University of California at San Diego. He did his undergraduate education at Northwestern
University and was inducted into the honorary society, Phi Beta Kappa. His Gastroenterology Fellowship
was completed at the University of Cincinnati. Dr. Safdi lectures nationally on IBD, colonoscopy
preparation, esophageal reflux, and a variety of gastrointestinal disorders. He has authored many
articles, reviews and updates related to Gastroenterology. He is actively involved in clinical research in
internal medicine and digestive disease disorders. Dr. Safdi has been awarded Cincinnati Magazine’s
“Top Doctor” recognition. He has been the director of the Gastroenterology section at Deaconess
Hospital and was past Chairman of the Cincinnati Crohn’s and Colitis Medical Advisory Committee. Dr.
Alan Safdi is a Fellow of the American College of Gastroenterology and is Board Certified in Internal
Dr. Michael A. Safdi, MACG, FACP
• Special Interest: Hemorrhoidal band ligation, Gastroesophageal Reflux (GERD),
Inflammatory Bowel Disease (IBD), Irritable Bowel Syndrome (IBS),
Peptic Ulcer Disease, Clinical research
Dr. Michael Safdi graduated from the University of Cincinnati College of Medicine and completed his
Residency in Internal Medicine at the University of California at San Diego. His Gastroenterology
Fellowship was also completed at the University of California at San Diego. He has served on numerous
local, regional and national boards and committees with the American College of Gastroenterology and
other organizations. He is actively involved in clinical research of new medications for digestive disorders
and with training young CCFA investigators. Dr. Safdi has been awarded Cincinnati Magazine’s “Top
Doctor” recognition. Dr. Safdi is a Master of the American College of Gastroenterology, a Fellow of the
American College of Physicians, and is Board Certified in Internal Medicine and Gastroenterology.
Dr. Jeffrey D. Stotz
• Special Interest: Gastroesophageal reflux (GERD), Inflammatory bowel disease (IBD)
Dr. Stotz graduated from The Ohio State University College of Medicine and completed his Internal
Medicine Residency and his Gastroenterology Fellowship at University Hospitals of Cleveland/Case
Western Reserve University. Dr. Stotz has recently lectured to a medical audience on Celiac Disease. He
is Board Certified in Internal Medicine and Gastroenterology.
Dr. George Waissbluth
• Special Interest: Irritable bowel syndrome (IBS)
Dr. Waissbluth graduated from the Universidad de Chile in Santiago, Chile, and completed his Residency
in Internal Medicine at Jewish Hospital, Cincinnati. His Gastroenterology Fellowship was completed at
the University of Cincinnati. Dr. Waissbluth is Board Certified in Internal Medicine and Board Eligible in
Gastroenterology.
Hospital Coverage:
Bethesda Hospital
Children’s Hospital Medical Center*
Christ Hospital
Jewish Hospital
Mercy Fairfield Hospital
Mercy Western Hills Hospital
Mercy Mt Airy Hospital*
West Chester Medical Center
Adams County Hospital*
VA Hospital*
* Limited to outpatient coverage
Proven high standards and superior results
Experts with high volume of experience
All of our physicians are experts in the performance of endoscopy and colonoscopy. Additional
subspecialization within our group includes physicians who have had specific and extensive experience and
training in more advanced endoscopic procedures such as: endoscopic ultrasound (EUS) with fine needle
aspiration (FNA), Endoscopic Retrograde Cholangiopancreatography (ERCP), and endoscopic mucosal
resection (EMR). We were the first in the area to perform small bowel wireless capsule endoscopy with
the “Pillcam”. Liver biopsies are performed by one of our Hepatologists in our endoscopy centers. Experts
in esophageal disorders perform a variety of specialized esophageal testing. Our pathologist, an expert
in gastrointestinal pathology, evaluates biopsy material from our endoscopy centers.
OUR WORK
PHYSICIAN ASSISTANTS
Outpatient
Convenient locations
Individualized care
Expedited visits
Close communication with referring doctors
With offices located throughout Cincinnati, Fairfield and surrounding suburbs and counties, we are able
to offer convenience to our patients. We provide outpatient consultation and follow-up care and see
patients on a timely basis. For urgent outpatient care, appointments with our physicians and physician
assistants can usually be made within 24 hours. We emphasize close communication with referring
physicians by direct discussion for more urgent or serious conditions and always with prompt written
reports of patient encounters. Other modalities such as voice mail, fax referral forms, and email have
also been developed to enhance communication.
Inpatient
Always available
Rapid consultation and endoscopic response
Ohio GI physicians work at most hospitals within the Greater Cincinnati area where we provide inpatient
services and are available on a 24 hr/7 day per week/365 day per year basis. When we receive a
consultation request we see patients quickly and provide thoughtful and expedited endoscopic services.
We are the primary providers of GI services and our physicians are directors of the GI divisions or
endoscopy committees at many of the hospitals.
Jennifer Acosta, PA-C, MPAS
Irritable Bowel Syndrome (IBS), Hepatitis
Ms. Acosta graduated from South University with a Bachelor Degree in Physician Assistant Studies. She
received her Master’s Degree in PA Studies from the University of Nebraska. Jennifer is Board Certified
by the National Commission on Certification of Physician Assistants.
Laurie Einwald, PA-C, MPAS
• Special Interest: Inpatient and outpatient digestive care,
Inflammatory Bowel Disease (IBD), Irritable Bowel Syndrome (IBS), Hepatitis
Ms. Einwald graduated from the University of Dayton with a Bachelor Degree in pre-medicine. She
received her Master’s Degree in Physician Assistant Studies from Marquette University. Laurie is Board
Certified by the National Commission on Certification of Physician Assistants.
James Fry, PA-C, MS
Irritable Bowel Syndrome (IBS), Hepatitis, Clinical research
Mr. Fry received his Physician Assistant training while serving in the US Air Force and then obtained his
Master’s Degree from Alderson-Broaddus College. Prior to being recruited to Ohio GI, he was a professor
in the PA programs at the University of Kentucky and Marietta College. He has been chairman of the
education council of the American Academy of Physician Assistants and VP of the Ohio Association of
Physician Assistants. Jim is Board Certified by the National Commission on Certification of Physician
Assistants. Jim is a Distinguished Fellow of the American Academy of Physician Assistants.
CONTACT US
Patient Referrals
Ohio GI Administration
Please see our map on the back cover.
Dan Walker - Chief Operating Officer
Phone - 513-569-1310
RoseAnn Maher - Office Manager
Phone - 513-569-1300
Research Division
Billing
Phone - 513-872-4549
www.ccrstudy.com
Phone - 513-872-4555
Table of Contents
Our Work
OHIO GI LEADERSHIP
AND QUALITY REPORT
Outpatient
Inpatient
Hospital Coverage
Clinical Research
Education
Leadership
Our Patients
Patient Encounters
Specific Disease Encounters
Our Endoscopy Centers
Our Commitment to Quality
www.ohiogi.com
Colorectal Cancer Prevention Studies
Patient Satisfaction Surveys
Liver Disease
Endoscopic Ultrasound
Endoscopic Retrograde Cholangiopancreatography
Endoscopic Mucosal Resection
Our Research Division
Our Physicians
2925 Vernon Place • Suite 100 • Cincinnati, Ohio 45219
www.ohiogi.com
Physicians
Physician Assistants
Contact Us

09 cover outlined.indd - Ohio Gastroenterology and Liver Institute

Transcription

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