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help with anal cancer | GI North | North Atlanta areaAs with other malignant diseases, early detection is an essential tool in treating cancers of the digestive tract. Fortunately, those portions of the digestive tract near the beginning and end can be more readily examined, making early detection for conditions such as anal cancer a real possibility. Understanding the risks for developing anal cancer can help make it clear why a visit to a gastroenterologist is a worthwhile and healthy habit.

Locating anal cancer

The anus is the final portion of the digestive tract where two ring-like sphincter muscles control the passage of solid waste from the body. Stool that has been stored in the rectum passes through the approximately 1½” anal canal before being released. As such, disorders of the anus or anal canal can cause symptoms during defecation. The anus is made of both skin and intestine, making conditions that affect both of these tissue-types relevant for the anus.

Risks for anal cancer

Risk factors increase the chance of getting cancer. Not everyone who develops cancer had specific risk factors nor does everyone with risk factors develop cancer. While this may inspire some to take chances with risk factors for cancer, a gamble on health is not a bet worth taking.

An important risk factor in the development of anal cancer is infection with the human papilloma virus (HPV). This is the same virus that causes cervical cancer in women, placing women with cancer of the cervix at an increased risk for also developing cancer of the anus. HPV can also cause cancer of the vagina, vulva, penis and throat.

Any type of skin-to-skin contact with an infected area of the body can cause HPV to spread to other parts of one’s body or to another person. Due to the body sites HPV infects, sexual and intimate contact is an important source of HPV infection. Due to the associated increased risk for HPV infection, multiple sexual partners and receptive anal intercourse are important risk factors in the development of anal cancer. The risk is also increased by cigarette smoking, being age 50 or older, anal fistulas or frequent anal redness, swelling and soreness from any cause.

Symptoms of anal cancer

Some strains of HPV cause the formation of papillomas, i.e. warts, but the strains most often associated with causing cancer are also likely to have asymptomatic infection. The potential to remain asymptomatic until an advanced stage in cancer development makes regular screening tests even more important in detecting anal cancer early.

Some important symptoms of anal cancer include anal bleeding, itching and abnormal discharge. A lump or feeling of fullness in the anal area or swelling of the lymph nodes in the groin can also indicate anal cancer. Changes in bowel movements including narrowing of the stool can be another important symptom.

Assessing your risk

While knowing and reducing your risk factors is an important step in cancer prevention, only a clinical examination and other diagnostic tests for anal cancer can confirm the presence or absence of cancerous cells.

While intended to be informational, this article does not take the place of professional medical advice. If you have questions about your risk for anal cancer or other GI concerns, please contact Dr. Simon Cofrancesco and Dr. Sergio Quijano at GI North or another healthcare professional near you for more information.

GI North is the gastroenterology clinic led by Dr. Simon Cofrancesco and Dr. Sergio Quijano located in Cumming, GA. GI North is also proud to serve the surrounding areas of Alpharetta, Roswell, Canton, and Suwanee. For appointments in Spanish, please ask for Dr. Sergio Quijano.

© 2017 GI North Gastroenterology Services. All rights reserved.

image with icons showing causes of fatty liver disease | GI NorthA diagnosis of liver damage can come as something of a surprise, particular to those without a history of excess alcohol intake. While alcohol may be a well-known cause of liver disease, it is not the only one. Learning more about the sources of and treatments for fatty liver disease and steatohepatitis can help make facing and treating these conditions easier.

The many functions of the liver

The body’s largest internal organ, the liver sits in the upper right portion of the abdomen where it is mostly covered by the lower ribs. The functions of the liver are manifold and include vital processes related to the breakdown of toxins in the body. The liver also produces proteins needed for functions such as clotting and transport of nutrients in the blood. The production of bile to help digest fats and eliminate waste products is another important function of the liver.

Recognizing liver damage

Liver damage can include many signs and symptoms such as pain or tenderness in the right upper portion of the abdomen. Accumulation of waste products normally removed by the liver can lead to jaundice, a painless yellowing of the skin. Widespread itching can be one of the more distressing symptoms of liver damage, as it tends to be persistent and resistant to normal anti-itch therapies.

Not everyone with liver disease has apparent symptoms nor are these the earliest indicators of deteriorating liver function. Rather, blood tests to measure the level of liver-specific enzymes serve as an early and reliable measure of liver disease. Biopsy and ultrasound can also be important in determining the cause of liver function derangement.

NASH diagnosis and treatment

Nonalcoholic steatohepatitis (NASH) is a type of Nonalcoholic fatty liver disease (NAFLD), a condition in which fat accumulates in the liver. In NASH, the fat in the liver has led to inflammation and liver cell damage. Left untreated, NASH can cause scar tissue formation, a condition referred to as fibrosis and that can lead to cirrhosis.

It has been estimated that about 5 percent of Americas have NASH. Prior NAFLD, a condition affecting between 10 and 45 percent of Americans, is an important risk for developing NASH. Other risk factors for NASH include central obesity, type 2 diabetes, dyslipidemia, and metabolic syndrome.

Left untreated, NASH can result in severe and even irreversible liver damage. One of the most effective treatments for NASH is weight loss. Avoidance of liver-toxic substances such as alcohol and certain medications is also important during recovery from NASH. All the while, working closely with a healthcare professional to monitor liver function and disease regression is an indispensable part of disease management in NASH.

The road to recovery from NASH

Although intended to be informational, this article does not take the place of professional medical advice. Please call an M.D. in your area with any questions, or contact our staff at GI North to make an appointment with Dr. Cofrancesco or Dr. Quijano, who speaks fluent Spanish. Located in Cumming, GA; the GI North team serves the entire Atlanta metro area including Alpharetta, Roswell, Canton, and Suwanee. Set your mind at ease and find out today how GI North can get you and your liver on the road to better health.

© 2017 GI North Gastroenterology Services. All rights reserved.

photo of young woman lying on couch holding her stomach in pain | GI NorthAt present, about 1 – 1.3 million people suffer from Inflammatory Bowel Disease (IBD), affirms the Centers for Disease Control and Prevention. Although the cause is unknown, there is an understanding how IBD affects some subpopulations more than others. For instance, Crohn’s disease is more common in woman than men and Ulcerative Colitis is a little more common in men that women. Studies also show that IBD occurs more in Caucasian and Ashkenazic Jewish origin than other ethnicities. However, the Centers for Disease Control and Prevention states that there is no precise understanding of how many people suffer from ulcerative colitis and Crohn’s disease. This is because there is a lack of standard criteria for diagnosing IBD. Quite often, IBD is identified as another condition.

Environmental conditions also play a factor in IBD statistics. For example, IBD is more prevalent in developed countries. As well, IBD is more prevalent in urban communities compared with rural areas. Many experts claim that is may be due to a “westernization” lifestyle. As well, Crohn’s disease is found more often in smokers and ulcerative colitis is more common with ex-smokers and nonsmokers.

There have also been studies on the relationship between socioeconomic factors and IBD. Some research showed that Crohn’s disease (CD) and ulcerative colitis (UC) is more common in white collar occupations. Other studies revealed that ulcerative colitis and Crohn’s disease was less prevalent in groups with higher income and education. As well, other research found a slight connection between IBD and specific occupations.

Other factors that may be contributing to the increase of inflammatory bowl disease are perinatal and childhood infections, diet, atypical mycobacterial infections and oral contraceptives. However, these factors have not been proven to play a part in developing IBD.

Symptoms and Treatment

Inflammatory bowl disease symptoms depend on the area of the intestinal tract being affected. However, the symptoms are not always specific and can fluctuate from mild to severe. According to WebMD the symptoms of the IBD can include:

  • Fever
  • Sweats
  • Weight loss
  • Possible fatigue
  • Diminished appetite
  • Diarrhea with possible blood
  • Abdominal pain and cramping
  • Severe need to have a bowel movement
  • Iron deficiency (anemia) from blood loss
  • Arthralgias (non-inflammatory joint pain)
  • Bloody stools – common in UC, less common in CD
  • Perianal disease (abscesses, fistulas) – Fifty percent of CD patients

If you suspect that you have either Crohn’s disease (CD) or ulcerative colitis (UC), it is best that you seek the advice of a professional. At GI North, gastroenterologists Dr. Cofrancesco and Dr. Quijano are renowned for their expertise and outstanding patient care.

Combined, the two physicians bring numerous years of experience, specializing in the diagnoses and treatment of digestive issues such as IBD. As well, Dr. Quijano speaks fluent Spanish. Also, the highly trained, friendly professional staff is committed to providing the highest quality in service and personal care.

The staff’s expertise and passion for every patient’s well-being easily creates a trusting and warm environment for everyone. Moreover, the staff is more than happy to answers any questions or concerns you may have.

For easy accessibility, GI North serves Cumming, GA as well as the surrounding areas of Alpharetta, Canton, Dawsonville, Duluth, Milton, Johns Creek, Suwanee and Roswell.

Note: This article is not meant to replace professional medical advice. If you have any questions or concerns about Inflammatory Bowel Disease (IBD), make an appointment at GI North with Dr. Cofrancesco, Dr. Quijano, or a physician in your area.

© 2016 GI North Gastroenterology Services. All rights reserved.

photo showing a composition of medical items including blue pills, injections, and a syringe | GI NorthHemorrhoids or piles are swollen veins in the lower part of the anus and rectum. A more severe case is when the blood vessel walls are stretched so thin that the veins become irritated and bulge especially when relieving the bowels.

Rendering to Medical News Today, a hemorrhoid can be very painful and dreadful but are preventable and effortlessly treated. Left untreated, a hemorrhoid will actually worsen over time. In fact, most physicians recommend seeking immediate care.

Medical News Today also reports there are up to 75 percent of adults in the US and Europe will have a hemorrhoid at some time in their lives. And about 50 percent of the same people are over 50 years old. Most will also need treatment. However, only about 4 percent seek medical treatment.

For the most part, a hemorrhoid is most common in adults between the ages of 45 to 65. However, young adults and children can also get a hemorrhoid. As well, they are more common in men than in woman. Moreover, pregnant woman are very likely to get hemorrhoids.


There are a wide variety of factors that can cause a hemorrhoid such as prolonged sitting or standing, hard stools (generally a lack of fiber), great strain during a bowel movement and heredity.

During pregnancy, there is a lot of excess weight and pressure on the rectum. This puts strain on the veins resulting in irritation and swelling. Also, during childbirth the veins go through a lot of strain and pressure that often causes a hemorrhoid.

Numerous Types

Basically, there are two types of hemorrhoids. If the hemorrhoid first arises from the lower part of the anal canal close to the anus, it is regarded as an external hemorrhoid. If it is inside the rectum, it is known as an internal hemorrhoid.

An external hemorrhoid is the most recognized. They also cause a lot of pain due to clotting under the skin and irritation. Internal hemorrhoids are difficult to diagnose because they are not within sight and are generally painless. However, according to the Mayo Clinic, an internal hemorrhoid may not be painful but they do tend to bleed

Hemorrhoid Symptoms

The most common hemorrhoid symptoms are pain near the rectal area, bleeding during bowel movements and itching. Sometimes that can also be blood in the stool or toilet paper. In the medical world, physicians often use a grading scale that describes the level of hemorrhoids:

1st degree – A hemorrhoid that is bleeding but is not prolapsed.
2nd degree – Hemorrhoids that are prolapsed and retracted (may or may not be bleeding).
3rd degree – The hemorrhoid has prolapsed and needs to be pushed back in.
4th degree – The hemorrhoids have prolapsed and cannot be pushed back in.


One of the best ways to prevent hemorrhoids is a healthy diet and lifestyle such as:
• Daily exercise to improve blood circulation
• Eat a diet high in fiber and plenty of water to encourage soft stools.
• Avoid extended amount of hours of sitting or standing. If work requires you to sit all day, use a doughnut pillow and move around every 20 minutes.


Sometimes severe cases require surgery, but it is not a common necessity. If you suspect that your hemorrhoids are severe, do not hesitate to contact your doctor or a physician at GI North that specializes in gastroenterology and other issues such as hemorrhoids. Dr. Cofrancesco and Dr. Quijano at GI North serve the Cumming, GA area as well as Alpharetta, Canton, Roswell and Suwanee. Dr. Quijano also speaks fluent Spanish.

© 2016 GI North Gastroenterology Services. All rights reserved.

photo of Thanksgiving Turkey dinner | GI NorthThe holidays are upon us and that means getting together with family for large meals around the dining room table. Unfortunately, many of us end up with stomach upsets or indigestion after eating much more than we’re used to having at one sitting.


Your digestive system is composed of the gastrointestinal (GI) tract, liver, pancreas and gallbladder. When you eat food, it travels through the hollow “tubes” that make up the GI tract, making its way through other organs that take in nutrients, with the waste passing through the anus.

Digesting food is vital for getting nutrients into your system. The digestive process involves chewing food, swallowing it into the esophagus, stomach, small intestine, pancreas and liver. Your body uses muscles and natural digestive juices to move the food and nutrients along.

How Holiday Meals Can Cause Stomach Upsets

When you eat large portions of food in one sitting, it puts pressure on your esophageal sphincter. When that pressure builds, it can cause food and acid to move back up, causing heartburn. In fact, your entire digestive system can be slowed down, causing stomachache and constipation.

Those rich foods on the table are mostly full of sugar and fat. Fat can slow digestion and cause reflux. The same is true of chocolates, coffee, and acidic foods.

The stress of the holidays can also be the cause of stomach upsets. Think of all that shopping for gifts, cooking, cleaning, traveling, and arguing with family members. Stress can result in upset stomachs and heartburn, plus, when you are stressed, you may want to deal with the tension by drinking and eating too much.

Preventing Stomach Upsets

Before going to or hosting a large holiday dinner, try to plan your behavior ahead of time and become aware of how much you’re eating. Here are a few tips to avoid stomach upsets:

  • Only have a second helping of that one dish you really enjoy.
  • When you know the holiday dinner will be especially rich and fatty, compensate by eating a healthy lunch of high-fiber foods.
  • Be conscious of everything you eat throughout the holiday season. Think before you eat, because tasty treats will be everywhere!
  • Eat lavish meals slowly. Savor your food and you won’t overeat as much.
  • Alcohol can irritate your GI tract, so don’t overdo it.
  • Take a short walk after a large meal instead of collapsing on a couch for a nap.

When To Seek Help for Digestive Issues

If you experience ongoing, longer-lasting symptoms that go beyond the holidays and occasional stomach upsets, diarrhea or a little heartburn, then it may be time to see a GI specialist.

The staff and physicians at GI North specialize in digestive system medicine. Dr. Simon Cofrancesco, a gastroenterologist, founded GI North in 2011. Dr. Sergio Quijano, who speaks fluent Spanish, joined the GI North practice after moving to Georgia from New York. GI North serves the Cumming, GA area, including Alpharetta, Roswell, Canton, Suwanee and beyond.

The above article is not meant to take the place of professional medical advice. Please call the staff at GI North if you have any questions or wish to make an appointment.

© 2016 GI North Gastroenterology Services. All rights reserved.

medical illustration showing colon polyps | GI NorthColonoscopy has become an integral part of routine preventive care. While health promotion materials regarding regular colonoscopy screening has become wide-spread, what often remains unclear for patients is just why this exam is so important. By further discussing the need for colonoscopies, it may become apparent how the Adenoma Detection Rate (ADR) further indicates the need for routine colonoscopies.

What you need to know about adenomas

Adenomas, abnormal growths that can be found in many parts of the body, are benign by definition. This means that they are localized accumulations of abnormal cells. Adenomas are also referred to as polyps, or adenomatous polyps. After the age of 50, nearly 2 in 5 people can expect to have these abnormal growths in the colon but only about 2% of these adenomas ever pose the risk of transformation to colon cancer.

Detection of adenomas is important because they have the potential to become malignant (i.e. cancerous). In fact, around 1 in 20 apparently adenomatous polyps in the colon actually harbor cancerous cells. The size of an ademoma can be an important indicator as to the risk of cancerous transformation: polyps over 2 cm in size (or about ¾”) have up to a 40% chance of being malignant, while the risk can be as low as 1% with small polyps.

Why you need to have adenomas removed

During routine colonoscopies, adenomas are regularly removed, a process called polypectomy. This is done in order to examine the tissue microscopically and determine if it contains any cancerous cells. Having removed a growth that was later found to be cancerous, the process of polypectomy is not only diagnostic, it can also be curative. In such cases, a physician may recommend more frequent colonoscopies to ensure that the curative process was complete.

What the adenoma detection rate can indicate

The adenoma detection rate (ADR) is the percentage of patients over 50 years old who are undergoing a colonoscopy screening test for the first time and who have one or more adenomas found and removed during the procedure.

Higher ADRs have been linked to lower rates of cancer in patients who have undergone colonoscopy. The ADR can be influenced both by the prevalence of adenomas in the population at-large as well as by the technique of the gastroenterologist performing the colonoscopy. Look for a colonoscopist who can report a high ADR, as this is suggestive of a high quality of care.

How to decrease your risk of colon cancer

While this article is intended to be informative, it is no substitute for professional medical advice. Visit a health care provider to learn more about your risk of colon cancer and how colonoscopy should be incorporated into your health maintenance plan.

Turn to GI North for all your colonoscopy and gastrointestinal health needs. Drs. Cofrancesco and Quijano and their GI North team serve the Cumming, GA area as well as the surrounding areas of Alpharetta, Roswell, Canton, and Suwanee. GI North welcomes patients who prefer health care services in Spanish, as Dr. Quijano is fluent. Whether for an ounce of prevention or a pound of cure, find out today how GI North can address your GI health concerns.

© 2016 GI North Gastroenterology Services. All rights reserved.

photo of oatmeal and raspberries in a white bowl | high fiber dietBetween the inconvenience of digestive discomfort and the risk for serious diseases of the digestive tract, there are more than enough reasons to seek-out the best foods for digestive health.

Eat your roughage: why Grandma was right

Adequate intake of dietary fiber has long been recognized as fundamental to good digestive health. As it turns out, eating your vegetables really can help to fend off serious diseases such as colon cancer. Despite long-standing advice to have a diet rich in fiber, Americans currently only get about half of the recommended 25-30 grams of dietary fiber daily.

Enhance your fiber intake with a variety of fiber-rich foods such as split peas (16 grams), artichoke (10 grams), raspberries (8 grams) and instant oatmeal (4 grams). Save the prepared fiber nutritional supplements for moments when a bit of extra fiber is required, such as during an occasional bought of constipation. Consider consulting a medical professional for cases of frequent constipation.

The gut microbiome: your bacterial buddies

Although the idea may take some getting used to, bacteria are one of the most important contributors to digestive health. The specific composition of commensal flora contained in the digestive tract determine how well we can fend off pathogenic organisms. These bacteria can also help break down the foods we eat and provide important proteins that affect how well we absorb the nutrients in our food. This may be why studies on obesity have found compelling connections between the types of microbes in the gut and the risk for obesity.

Maintaining a healthy microbiome

In order to keep the gut microbiome in tip-top shape, be sure to get regular servings of probiotic and prebiotic foods. Due to their generous content of gut-friendly bacteria, probiotic foods help ensure that the ratio of friend-to-foe in the digestive tract stays tipped in your favor. Probiotic foods include natural yogurts and other types of fermented foods including kefir, miso, kombucha and sauerkraut.

Help keep the friendly bacteria thriving by also getting generous doses of prebiotic foods, those on which the friendly gut flora flourish. Inulin, a special type of starch, is a prebiotic that can be found as a supplement in many foods such as yogurts and yogurt drinks and can also be found occurring naturally in chicory. Other foods containing naturally-occurring prebiotics include bananas, oatmeal, asparagus, garlic, onions and leeks.

Finding your digestive health coach

While this article is intended to be informative, it is not a substitute for professional medical advice.

Consider a visit to GI North to address all your digestive health needs. From optimizing dietary plans for digestive health to treating advanced disease, GI North provides a full-range of services for the GI tract. Along with their GI North team, Drs. Cofrancesco and Quijano serve the Cumming, GA area as well as the surrounding areas of Alpharetta, Roswell, Canton, and Suwanee. Appointments are also available in Spanish: Dr. Quijano speaks fluently.

© 2016 GI North Gastroenterology Services. All rights reserved.

help with digestive issues | GI North | north Atlanta area

Stress and Digestion: The Brain-Gut Link

Anyone who has ever felt butterflies in their stomach or felt their stomach was tied in knots, knows that stress affects digestion. Many people can’t eat when stressed while others tend to overeat, and some are running to the bathroom while others find using the bathroom increasingly difficult. Even low levels of stress can cause issues for the digestive system as the brain cannot easily run digestion while under duress.

During fight or flight, the enteric nervous system, which controls digestion, can shut down the digestive process. Yet even mild stress can cause issues such as indigestion, heartburn, nausea, diarrhea, and constipation. Even your immunity can decrease as the good bacteria in your digestive system tends to get flushed and your nutrient absorption decreases since things often move too quickly. Your metabolism will slow as well since blood is redirected to your brain causing a decrease in blood flow and oxygenation in your digestive system.

Our bodies are built to deal with certain levels of stress, and in fact this brain-gut link has aided in the survival of the human race, but the levels of stress that some people experience can have long-term effects. Experts agree that stress is a major factor in functional GI disorders such as IBS, where there is no clear physiological cause. And while stress does not cause IBDs such as Crohn’s and ulcerative colitis, it can certainly worsen and trigger symptoms.

Avoiding stress altogether would allow your digestive system the opportunity to function properly without interruption, but a more realistic goal is to try and manage your stress levels.

  • Prioritize
  • Limit your responsibilities
  • Take time for yourself
  • Start a journal
  • Try relaxation therapy (yoga, meditation, hypnosis), talk therapy (with friends, family, or a therapist), or cognitive behavior therapy
  • Avoid overeating and eating junk food
  • Avoid smoking and drinking alcohol

Stress can engulf us easily, and even the digestive side effects can be overwhelming creating even more stress and starting a vicious cycle. For those with GI concerns, controlling stress can mean controlling symptoms, so it is important to contact a gastroenterologist for advice.

Whether you are suffering from a gastrointestinal disease or chronic stress-related digestive issues, Dr. Cofrancesco and Dr. Quijano at GI North can help you diagnose, treat, and manage any of your digestive concerns. Located in Cumming, GA and serving the surrounding areas of Alpharetta, Roswell, Canton, and Suwanee, the professionals at GI North provide personal, specialized care with Dr. Quijano speaking fluent Spanish. Don’t put off talking to a professional, contact us and get some relief today!

© 2016 GI North Gastroenterology Services. All rights reserved.

photo of young woman in pain lying on bedThe definition of constipation is having difficulty in bowel movements or having a bowel movement less often than normal. The medical definition of constipation is having less than three bowel movements a week. Severe constipation is having less than one stool per week. In truth, going three days or more without a bowel movement is way too long. Actually after three days, stools are harder to pass.

You will feel a whole lot better when your system works properly. However, constipation is generally not a serious condition. Symptoms of constipation include:

  • Abdominal pain
  • Small or hard stools
  • Fewer bowel movements
  • Irregular bowel movements
  • Bowel movements are strained
  • Discomfort in the lower abdomen
  • Occasional distension or abdominal bloating
  • Feeling of unfinished emptying after bowel movements
  • Fissures or anal bleeding from the strain of passing hard stools
  • Possible worsening of hemorrhoids, diverticular disease and prolapse of the rectum

Causes of Constipation

According to WebMD, the causes of constipation are vast. Some of the reasons include:

  • Stress
  • Pregnancy
  • Eating disorders
  • Lack of exercise
  • Cancer in the colon
  • Irritable bowel syndrome
  • Eating too many dairy products
  • Changes in normal activities or diet
  • Not enough fiber or water in the diet
  • Hypothyroidism (under active thyroid)
  • Multiple sclerosis or Parkinson’s disease
  • Weakened bowel muscles from overuse of laxatives
  • Antacid medicines that contain aluminum or calcium
  • Issues with muscles and the nerves in the digestive system
  • Some medications like strong antidepressants, iron pills or pain meds


If you have problems with constipation for more than two weeks, it is recommended to see a specialist as soon as possible. Generally, a specialist will do a few tests in order to find the cause of your constipation. Some of the tests include:

  • Blood test to inspect hormone levels
  • Tests that look for colon blockages like a colonoscopy
  • Barium analyses to search for any colon blockages. It entails drinking a special concoction and then being X-rayed

At GI North, their expert practice offers focused care and advanced experience in the treatment and prevention of constipation. In fact, between the two professional physicians, they have numerous year of experience.

When to Call a Physician

According to most specialists, it is important to call a physician straightaway if you have sudden constipation that accompanies cramping or abdominal pain plus you are unable to pass a stool or any gas. Equally, call a physician if:

  • Stools are pencil thin
  • There is blood in your stool
  • Loss of weight without dieting
  • Constipation lasts more than two weeks
  • Constipation is not something you typically have

GI North

If at any time you have concerns or questions about your constipation, contact the professional staff or a physician at GI North. And for your upmost convenience, Dr. Cofrancesco and Dr. Quijano at GI North serve the Cumming, GA area as well as the surrounding areas including Alpharetta, Milton, Canton, Dawsonville, Roswell and Suwanee. Moreover, if you would like a Spanish speaking physician, you can request an appointment with Dr. Quijano.

© 2016 GI North Gastroenterology Services. All rights reserved.

image of a diagram of medicare | GI NorthFew would argue that budget cuts are necessary, but where exactly to make those cuts is vastly complex. For several years now, the Centers for Medicare and Medicaid Services (CMS) has been making cuts in an effort to avoid over payment as required by the Affordable Care Act. And while reducing overpayment sounds beneficial, the consequences often outweigh the savings.

In 2015, CMS proposed drastic cuts to reimbursement rates for colonoscopy and other lower GI endoscopy procedures. As you can imagine, there was much resistance to these cuts, but in the end, many of the proposed cuts were made cutting reimbursement for some codes as high as -16%.

These reductions focused on services provided in physician offices and freestanding facilities, which leaves hospitals to perform the procedures at the previous reimbursement rate. And, in some cases, rates were increased for hospital procedures.

At this point you might be wondering why you should care, and the truth is because these cuts could impact the quality of care available to you, as well as your choice of providers. Now in 2016, the physicians that perform colonoscopy are receiving up to 19% less for the procedure. This reduction in reimbursement will pose a challenge for physicians to continue to perform this life saving procedure.

Colon cancer is the third most common cancer in the U.S., and a colonoscopy is the most effective way of detecting and treating pre-cancer growths. Gastroenterologists are specialized in performing colonoscopy having a more focused training in comparison to a proctologist, yet gastroenterologists are the group of physicians directly affected by the cuts. Research continuously shows that gastroenterologists are less likely to miss potential concerns and less likely to undergo complications such as perforations.

Additionally, the National Colorectal Cancer Roundtable (NCCR) set a goal to increase screening rates for colorectal cancer to 80% by 2018, which could prevent 277,000 new cases of cancer and 203,000 deaths. While the NCCR has been making strides, reaching that goal with these new cuts poses a serious challenge since availability of screening facilities may decrease.

Every American after the age of 50 should undergo a screening for colon cancer every 10 years and many before that if high risk, so the question is who do want in charge of saving your life?

For those in the Atlanta area, GI North Gastroenterology Services offers excellent, specialized care with personalized attention. GI North is still accepting Medicare and performing quality colonoscopies. So if you are over 50 or carry one of the risk factors for developing colon cancer, contact our office. GI North is conveniently located in Cumming and serves the areas of Alpharetta, Roswell, Canton, and Suwanee. Dr. Cofrancesco and Dr. Quijano, who speaks fluent Spanish, are available to assist you with any gastroenterological need.

© 2016 GI North Gastroenterology Services. All rights reserved.


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