The Real GI Doc Show (Fred Gandolfo, MD)

In this episode, Dr. Fred Gandolfo welcomes a special guest, Dr. Noreen Vail, a licensed psychologist with expertise in behavioral change, to discuss the psychological aspects of making lifestyle changes for managing fatty liver disease. Building on last week's episode about natural treatments for fatty liver, Dr. Gandolfo and Dr. Vail dive into why some patients struggle to make essential changes and how clinicians can better support them.

Topics covered in this episode: - Recap of last week's episode on fatty liver disease and natural treatments. - Common excuses patients give for not making lifestyle changes. - The Transtheoretical Model: Understanding the five stages of change. - Effective strategies for clinicians to assess and support patients in making behavioral changes. - Practical advice for patients on how to foster positive changes at home. - The role of family support and how loved ones can help without nagging. - The importance of a multi-specialty approach to treating fatty liver disease.

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Referenced in today's show- Episode 10: The Natural Way to Treat Fatty Liver Disease at Home

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

Join Gastroenterologist Dr. Fred Gandolfo as he delves into a common and often deadly liver disease related to excessive alcohol consumption called alcoholic hepatitis. In this episode, Dr. Gandolfo reviews a tragic patient case to discuss the risk factors, symptoms, and treatment options for alcoholic hepatitis. Learn about the amount of alcohol it takes to develop this severe condition, the impact of nutritional status and other risk factors, and the importance of alcohol abstinence and proper nutrition in managing the disease.

Topics covered in this episode:

• Understanding Alcoholic Hepatitis: What is it and how does it develop?
• Risk Factors: How much alcohol is too much?
• Symptoms: What to watch out for?
• Treatment Options: From alcohol abstinence, to medications, to liver transplant.
• Case Study: A detailed look at a tragic patient case of a young woman with alcohol-related hepatitis. 

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

References cited in this episode:

• Resources to get help with alcohol problems
• Alcohol-related hepatitis: A review article

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

In this unique episode, Dr. Fred Gandolfo steps away from the usual format to share a recent patient interaction that highlights the complexities of finding the "root cause" of health problems during a crisis. Through an engaging analogy, Dr. Gandolfo illustrates the importance of addressing immediate health emergencies before diving into the root causes.

Topics covered in this episode:

• The House Fire Analogy: Understanding the urgency of immediate health issues.
• Case Study: A 62-year-old woman with poorly controlled diabetes, high blood pressure, and GI symptoms.
• Root Cause vs. Immediate Treatment: Why focusing on the root cause during a crisis can be detrimental.
• Human Psychology and the Internet: How the quest for the "root cause" may be manipulated more by "influencers" on the internet and less by reality.
• Practical Advice: Addressing immediate health concerns and planning for long-term solutions rather that focusing mainly on a theoretical root cause. 

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Referenced in today's show- Episode 10: The Natural Way to Treat Fatty Liver Disease at Home

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

Join Dr. Fred Gandolfo in this engaging Q & A session where he tackles some of the most intriguing questions submitted by listeners. From the intricacies of colostomies to the potential benefits of acupuncture, and even the curious reason why poop is brown, Dr. Gandolfo provides insightful answers with his signature blend of expertise and humor. Plus, learn about his personal journey into the field of gastroenterology.

• Colostomies and Colonoscopies: Can you still get a colonoscopy if you have a colostomy?
• Acupuncture: What does the evidence say about its effectiveness for gastrointestinal issues?
• The Color of Poop: Why is poop brown, and what do different colors indicate?
• Career Path: How did Dr. Gandolfo decide to become a gastroenterologist?

Have a question for Dr. Gandolfo? Reach out on social media @realgidoc or visit realgidoc.com to leave a voice message question.

References cited in this episode:

Acupuncture fMRI review article

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

Join Dr. Fred Gandolfo as he delves into one of the most common gastrointestinal complaints: acid reflux, or gastroesophageal reflux disease (GERD).

In this insightful episode, Dr. Gandolfo discusses a real patient case, shedding light on the presentation, workup, and management of GERD. Discover effective strategies for treating acid reflux through diet, lifestyle changes, and medication.

Learn about the importance of recognizing alarm signs, the role of endoscopy in diagnosing conditions like Barrett's esophagus, and the potential complications of untreated GERD. Dr. Gandolfo explains the nuances of proton pump inhibitors (PPIs) and offers practical tips for managing this uncomfortable condition.

Whether you or someone you know suffers from acid reflux, this episode provides valuable information and actionable advice to improve quality of life and prevent serious complications.

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question at realgidoc.com.

References cited in this episode:

American College of Gastroenterology Guidelines: GERD Management 2022

Dr. Gandolfo's Bio The Real GI Doc Show Monthly Newsletter Stay updated with the latest episodes and exclusive content by subscribing to our monthly newsletter!

In this episode, Dr. Gandolfo dives into a recent and rather sensational news story about a colonoscopy that took a troubling turn. The case involves an 84-year-old doctor in Florida who allegedly performed a colonoscopy without wearing his hearing aids, resulting in the patient screaming in pain without the doctor's knowledge.

Dr. Gandolfo provides his expert insights and thoughts on this unusual situation, discussing the importance of proper sedation, communication in the operating room, and the potential consequences of such incidents on the reputation of critical medical procedures like colonoscopies.

Topics covered in this episode:

- Overview of the Florida colonoscopy incident. - The importance of sedation during colonoscopy. - Communication and teamwork in the endoscopy suite. - Implications of sensational news stories on public perception of medical procedures. - Proper protocols and practices for performing colonoscopies. - The role of age and physical condition in a doctor's ability to perform procedures. - Encouragement for proper colorectal cancer screening.

Referenced in this episode: Fox News article "Tampa doctor couldn't hear colonoscopy patient scream because he wasn't wearing hearing aids, board finds"

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

What do psychiatric patients, gastroenterologists, Queen Elizabeth I, and prisoners all have in common? If you guessed bezoars, you're correct!

Join Dr. Fred Gandolfo as he delves into two odd and uncommon conditions that gastroenterologists sometimes encounter: Pica, the eating of non-food substances, and bezoars, masses of non-digestible material stuck in the GI tract.

In this episode, Dr. Gandolfo shares a fascinating case study, discusses the treatment of these rare conditions, and explores the blurred lines between psychiatric and medical issues.

Tune in for an informative and entertaining discussion on these medical curiosities!

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Link to My Strange Addition episode discussed in this episode.

Dr. Gandolfo's Bio The Real GI Doc Show Monthly Newsletter Stay updated with the latest episodes and exclusive content by subscribing to our monthly newsletter!

Dive into this episode of The Real GI Doc Show where Dr. Fred Gandolfo unpacks the case of a 51-year-old complaining of abdominal pain and fatigue. Discover the pivotal role of the differential diagnosis and the power of second opinions in medical practice. Dr. Gandolfo emphasizes the necessity of patient advocacy and the dangers of common diagnostic fallacies.

Listen as he recounts the patient's path to uncovering a hidden condition, highlighting the significance of an open-minded medical approach. This episode is a must-listen for anyone interested in the intricacies of gastrointestinal health and the art of accurate diagnosis.

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc.

References cited in this episode:

American College of Gastroenterology Guidelines Update: Diagnosis and Management of Celiac Disease

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Dr. Gandolfo's Bio

The Real GI Doc Show Monthly Newsletter

In this episode, we cover the relationship between food and gut inflammation. Using a case of diverticular disease, Dr. Gandolfo and guest Stephanie Schiff, RDN discuss the best way to start eating an anti-inflammatory diet.

Registered Dietitian Stephanie Schiff explores how dietary choices can influence the onset and recurrence of diverticulitis, a common yet often misunderstood condition. Through a real patient case, Dr. Gandolfo illustrates the challenges and treatment strategies for managing diverticulitis. Stephanie provides invaluable insights into the Mediterranean diet and its benefits on reducing gastrointestinal inflammation, debunking myths about seeds and nuts, and offering practical advice for incorporating high-fiber foods into your diet.

Topics covered in this episode:

- Introduction to diverticular disease and diverticulitis. - Case study of a 59-year-old woman with recurrent diverticulitis. - Risk factors for developing diverticular disease. - The role of diet in preventing and managing diverticulitis. - Debunking myths about seeds and nuts in diverticular disease. - The benefits of the Mediterranean diet and its anti-inflammatory properties. - Practical tips for increasing dietary fiber intake safely. - The impact of processed foods and lifestyle choices on gut health. - Supplements and other considerations for managing diverticulitis.

Referenced in today's show:

Review article on diverticular disease in Gastroenterology

Seeds and nuts in diverticular disease in JAMA

Dietary fiber and diverticulitis in Nutrients

AGA guidelines on diverticular disease

Follow Stephanie Schiff, RDN on Facebook, Instagram, TikTok, X, and LinkedIn

Read Stephanie's articles about healthy lifestyle and nutrition on medium.com

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Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

In this episode, Dr. Gandolfo covers the essential yet often dreaded topic of colonoscopy preparation, aka cleaning out your colon. With a mix of humor and expert advice, Dr. Gandolfo demystifies the process, emphasizing the importance of a thorough prep to ensure a successful colonoscopy. He shares practical tips and personal anecdotes to help you navigate the prep with ease, making sure you're well-prepared for this crucial cancer screening procedure.

Topics covered in this episode:

- The importance of colonoscopy prep for effective screening.

- Colorectal cancer statistics and the significance of early detection.

- The process of finding and consulting with a gastroenterologist.

- The role of polyps in the development of colorectal cancer and how colonoscopy can prevent cancer.

- Different types of bowel preps: liquid, pill, and over-the-counter options.

- Practical tips for a successful bowel prep, including dietary adjustments, medication management, and logistical considerations.

- Troubleshooting common issues with bowel prep, such as nausea and an incomplete cleanout.

- The benefits of split-dose prep and the importance of following instructions.

- The impact of insurance policies on pre-procedure consultations and prep coverage.

Referenced in today's show:

- Dr. Gandolfo's YouTube channel for detailed prep instructions and troubleshooting tips.

- The Real GI Doc Show Episode 15 on non-invasive colorectal cancer screening options.

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Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

Join Dr. Gandolfo as he delves into the pervasive and often devastating impacts of alcohol consumption on our health. In this eye-opening episode, Dr. Gandolfo discusses the definitions of light, moderate, and heavy alcohol use, and reviews the myriad ways that alcohol can harm your body. Learn about the signs of alcohol use disorder and discover simple questions you can answer to assess whether you or a loved one may have a problem with alcohol.

Dr. Gandolfo shares a poignant case study of a patient with alcohol-induced liver cirrhosis, illustrating the severe consequences of long-term heavy drinking. He also explores the broader societal impact of alcohol, including its role in accidents, violence, and various cancers.

Whether you drink occasionally, socially, or heavily, this episode provides crucial insights into the risks associated with alcohol consumption. Tune in to understand how alcohol can affect your heart, liver, brain, and overall health, and learn why it's important to address alcohol use issues early.

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

References cited in this episode:

• Resources to get help with alcohol problems
• Estimated Deaths Attributed to Excess Alcohol Use Among U.S. Adults

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

Explore the secrets of stomach acid with board-certified gastroenterologist Dr. Fred Gandolfo. Learn about the critical role of acid in digestion and how medications affect stomach acid. Discover when to schedule your next colonoscopy, and get expert advice on increasing dietary fiber without unwanted gas.

Dr. Gandolfo covers the following topics on this episode:

- The Mystery of Stomach Acid: Functions and Medication Effects

- The Colonoscopy Conundrum: Timing Your Next Procedure

- Battling Bloat: Tips for a High-Fiber, Low-Gas Diet

To submit a question for our next Q & A episode, message us on social media @realgidoc or send us an audio question here.

References cited in this episode:

ACG Clinical Guidelines: Colorectal Cancer Screening 2021

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Dr. Gandolfo's Bio

The Real GI Doc Show Monthly Newsletter

Dr. Gandolfo dives deep into the common yet often misunderstood issues of constipation and bloating. Drawing from real-life clinical experiences, Dr. Gandolfo provides valuable insights and practical advice for managing these prevalent gastrointestinal concerns.

Topics covered in this episode:

- A detailed case study of a 34-year-old woman with chronic bloating and constipation.

- The differential diagnosis process for bloating, including ruling out serious conditions.

- The difference between bloating and abdominal distension.

- Understanding the causes of bloating and constipation.

- Practical dietary and lifestyle changes to improve bowel movements.

- The role of fiber, water, and exercise in promoting digestive health.

- Effective use of over-the-counter remedies like psyllium husk and Miralax.

- The importance of bowel hygiene and daily routines to facilitate regular bowel movements.

- When to consider medical evaluation and prescription medications for chronic constipation and bloating.

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

In this episode, Dr. Gandolfo delves into fatty liver disease, affecting over 30% of Americans. Dr. Gandolfo explains what fatty liver disease is, how it develops, and most importantly, how to manage and treat it naturally at home with minimal cost.

He introduces a patient case to illustrate common scenarios and provides actionable advice on diet and lifestyle changes that can make a significant difference.

Topics covered in this episode: - Defining Fatty Liver Disease: What it is and how it happens. - Patient Case: A 48-year-old man with prediabetes, mild hypertension, and elevated liver enzymes. - Terminology Updates: Understanding MASLD, MASH, and MetALD. - Risk Factors: How diet, lifestyle, and genetics contribute to fatty liver disease. - Natural Treatment: Effective weight loss strategies and exercise routines. - Diet Recommendations: Sustainable eating plans and the benefits of the Mediterranean diet. - Exercise Benefits: How regular physical activity can improve liver health and overall well-being.

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

References cited in this episode: - AASLD Practice Guideline on Fatty Liver Disease

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

In this episode, Dr. Gandolfo will address a common clinical question: What should you do if you have a stool test positive for blood but recently had a colonoscopy?

Dr. Gandolfo explores the purposes of stool tests in colorectal cancer prevention, comparing their strengths and weaknesses to colonoscopy. He reviews a patient case and discusses the utility of performing stool guaiac tests after a recent colonoscopy.

Topics covered in this episode:

- Stool Tests: Understanding their role in colorectal cancer prevention.

- Colonoscopy vs. Stool Tests: Strengths and weaknesses.

- Patient Case: A 52-year-old woman with a positive guaiac test two years after colonoscopy.

- Quality of Colonoscopy: Key factors to ensure a protective exam.

- Practical Advice: When to consider a repeat colonoscopy and when it might be unnecessary.

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

References cited in this episode:

• VA study on fecal occult blood testing
• Australian study "To scope or not..."

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

In this episode, Dr. Fred Gandolfo explores the importance of taking action when faced with complicated health issues, drawing parallels between medical treatment and business management. Dr. Gandolfo emphasizes the need to start somewhere, even if everything isn't perfectly understood or optimized, and discusses how to avoid the pitfalls of over-researching and under-acting.

Topics covered in this episode:

- Understanding the urgency of addressing immediate health problems.

- The value and limitations of using the internet for medical research.

- Finding a trusted medical team and making informed decisions.

- The concept of "paralysis by analysis" and how to overcome it.

- Creating actionable plans with realistic timelines for health improvements.

- Breaking down long-term goals into daily, weekly, and monthly tasks.

- The importance of continuous action and adjustment in achieving health goals.

Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Referenced in today's show- Episode 12: When the House is on Fire: Prioritizing Health Emergencies Over Root Causes

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

In this episode, Dr. Gandolfo explores the latest advancements in non-invasive colorectal cancer screening, including the new FDA-approved "Shield" blood test and the updated Cologuard stool test. With only 60% of eligible individuals getting screened in the US, these new tests offer alternatives for those who are unable or unwilling to undergo a colonoscopy. Dr. Gandolfo dives into the pros and cons of these non-invasive tests and discusses their effectiveness compared to the gold standard of colonoscopy.

Topics covered in this episode:

- Introduction to non-invasive colorectal cancer screening options.

- Detailed explanation of the Shield blood test and its recent FDA approval.

- Overview of the updated Cologuard stool test and its improvements.

- Case study of a 73-year-old patient with undiagnosed colon cancer.

- The importance of early detection and screening for colorectal cancer.

- Sensitivity and specificity of non-invasive tests versus colonoscopy.

- Practical advice on choosing the right screening method based on age, health, and risk factors.

- The role of non-invasive tests in increasing screening rates among the unscreened population.

Referenced in today's show:

- Study on the new generation of Cologuard

- New England Journal of Medicine article on the Shield blood test

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Be sure to subscribe to The Real GI Doc Show for more insights, and reach out with your questions on social media @realgidoc or leave an audio question for Dr. Gandolfo here.

Find The Real GI Doc Show on social media, join the newsletter, read Dr. Gandolfo's bio, or ask a question using this link.

Why do we need another gut health podcast?

In this introductory episode you will get to know more about Dr. Gandolfo and his journey to becoming a gastroenterologist. He will cover his training from college to fellowship, and discuss his career path to becoming a private practitioner.

We also discuss the purpose of "The Real GI Doc Show" and why we need more health podcasts from real medical doctors. We clarify who should listen to the show, and what the show is NOT going to be about.

Be sure to subscribe so you don't miss an episode. You can also follow Dr. Gandolfo on social media @realgidoc for more GI insights!

Related links:

Dr. Gandolfo's practice: Precision Digestive Care

The Real GI Doc Show Monthly Newsletter