Gastroenterology
Digestive health issues can be disruptive, but you don’t have to navigate them alone. Whether you’re managing Ulcerative Colitis or Crohn’s Disease, seeking preventative care like a Colonoscopy, or need advanced testing for Hepatitis C or Cirrhosis, our clinic is here to provide answers and solutions. Unlike most Gastroenterology clinics, every provider on our team is therapeutically trained, meaning you won’t have to wait; each provider can diagnose and treat complex pancreatic and biliary conditions.
Plus, with one of only three Endoscopic Ultrasound services in Montana, you have access to state-of-the-art care without traveling far from home. Your health matters, and we’re here to make sure you get the expert, accessible care you deserve.
Gastroenterology (GI) Providers
Andrew B Gentry
MD
Gastroenterology
(Internal Medicine)
Andrew Herman
MD
Gastroenterology
(Internal Medicine)
Kathryn L Lynch
MD
Gastroenterology
(Internal Medicine)
Kleanthis G Dendrinos
MD
Gastroenterology
(Internal Medicine)
Peter F Walsh
DO
Gastroenterology
(Internal Medicine)
Amy D Anderson
APRN, ANPBC
Gastroenterology
(Internal Medicine)
Melissa Shepherd
NP
NP - Gastroenterology
Melissa L Pew
PA-C
Gastroenterology
(Internal Medicine)
Christopher Lumsden
PA-C
Gastroenterology
(Internal Medicine)
Prevent Colon Cancer - A Colonoscopy Could Save Your Life
Regular colonoscopy screenings are essential for the early detection and prevention of colorectal cancer. Adults aged 45 to 75 should undergo regular screenings. During a colonoscopy, physicians examine the inner lining of the colon and rectum to identify and remove precancerous polyps, thereby reducing the risk of these polyps developing into cancer. Detecting colorectal cancer at an early stage significantly improves treatment outcomes and survival rates. For individuals at average risk, it’s generally advised to begin screenings at age 45 and continue every 10 years until age 75. However, those with higher risk factors, such as a family history of colorectal cancer, may need to start screenings earlier and undergo them more frequently. Consulting with a healthcare provider can help determine the most appropriate screening schedule based on personal risk factors.
To schedule a Colonoscopy, call or talk to your primary care provider about a referral.
Don’t Ignore Persistent Symptoms - Endoscopy Can Help Detect Issues Early
To schedule a Endopscopy, call or talk to your primary care provider about a referral.
Early Detection. Expert Treatment. Comprehensive Support - Coordinated Cancer Care
When cancer is detected through a gastroenterology procedure, a coordinated transition of care ensures patients receive comprehensive support during this challenging time. The gastroenterology team, after identifying the concern through endoscopy, colonoscopy, biopsy, or imaging, promptly connects the patient with a general surgeon and cancer care team. The Surgeon evaluates the need for biopsy confirmation or surgical intervention, while the cancer team develops a personalized treatment plan, which may include chemotherapy, radiation, or further surgical care. Throughout the process, providers communicate closely to streamline appointments, provide clear guidance, and offer emotional and medical support, ensuring patients and their families feel fully supported every step of the way.
Advanced Esophageal Diagnostic Procedures
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a specialized medical procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions affecting the bile ducts, pancreatic ducts, liver, and gallbladder. During ERCP, a physician inserts a flexible, lighted tube called an endoscope through the patient’s mouth, esophagus, and stomach into the duodenum (the first part of the small intestine). A contrast dye is then injected into the bile and pancreatic ducts, allowing X-ray imaging to identify any blockages, strictures, gallstones, or tumors. This procedure not only aids in diagnosing issues but also enables therapeutic interventions, such as removing obstructions or placing stents to restore normal bile or pancreatic fluid flow.
Esophageal Manometry
Esophageal Manometry is a diagnostic procedure that assesses the function of the esophagus—the muscular tube transporting food from the mouth to the stomach. This test measures the strength and coordination of esophageal muscles during swallowing, including the performance of the upper and lower esophageal sphincters. During the procedure, a thin, flexible catheter equipped with pressure sensors is gently inserted through the nose and advanced into the stomach. As the patient swallows, the catheter records muscle contractions and pressure changes, providing valuable data on esophageal motility. The test typically lasts about 30 to 45 minutes and is performed on an outpatient basis without the need for sedation. Esophageal manometry is particularly useful for diagnosing conditions such as achalasia, diffuse esophageal spasm, and other motility disorders that can cause symptoms like difficulty swallowing, chest pain, or gastroesophageal reflux disease (GERD).
Endoscopic Ultrasound (EUS)
Endoscopic Ultrasound (EUS) is a minimally invasive procedure that combines endoscopy and ultrasound imaging to obtain detailed images of the digestive tract and surrounding tissues. During EUS, a thin, flexible tube called an endoscope is inserted through the mouth or rectum into the gastrointestinal tract. The endoscope has a small ultrasound device at its tip that emits high-frequency sound waves, producing images of the digestive tract and nearby organs such as the pancreas, liver, and lymph nodes. EUS is particularly useful for diagnosing conditions like pancreatic cancer, bile duct obstructions, and tumors in the gastrointestinal tract. It can also guide fine-needle aspiration biopsies to obtain tissue samples for further analysis. The procedure is typically performed on an outpatient basis, often under sedation, and may last between 1 to 2 hours. EUS provides valuable information that may not be obtainable through other imaging techniques, aiding in the accurate diagnosis and management of various gastrointestinal disorders.
Managing Chronic Conditions
Ulcerative Colitis (UC) and Crohn’s Disease are chronic inflammatory bowel diseases (IBD) that require ongoing management to control symptoms and maintain remission. While both conditions involve inflammation of the gastrointestinal tract, they differ in location and extent of involvement.
Ulcerative Colitis (UC) primarily affects the colon and rectum, causing inflammation of the innermost lining of the large intestine. Management strategies include:
Medications:
– Aminosalicylates: Such as sulfasalazine and mesalamine, help reduce inflammation.
– Corticosteroids: Used for moderate to severe flare-ups to suppress immune response.
– Immunomodulators: Like azathioprine, modify the immune system to prevent inflammation.
– Biologics: TNF inhibitors (e.g., infliximab, adalimumab) and other biologics target specific immune pathways.
– Janus Kinase (JAK) Inhibitors: Oral medications like tofacitinib interfere with pathways leading to inflammation.
Lifestyle Modifications:
– Dietary Adjustments: Identifying and avoiding trigger foods can help manage symptoms.
– Stress Management: Techniques such as mindfulness and yoga may reduce flare-ups.
Surgical Intervention:
– In cases unresponsive to medication, procedures like colectomy (removal of the colon) may be considered.
Crohn’s Disease can affect any part of the gastrointestinal tract, from mouth to anus, and often involves deeper layers of the bowel wall. Management includes:
Medications:
– Aminosalicylates: Reduce inflammation in the intestines.
– Corticosteroids: Address acute flare-ups by suppressing inflammation.
– Immunomodulators: Such as methotrexate, help maintain remission.
– Biologics: TNF inhibitors and other biologics target specific immune responses.
– Janus Kinase (JAK) Inhibitors: Oral medications that reduce inflammation.
Lifestyle Modifications:
– Dietary Counseling: Working with a nutritionist to identify foods that may exacerbate symptoms.
– Supplements: Addressing nutrient deficiencies due to malabsorption.
Surgical Intervention:
– Surgery may be necessary to remove damaged sections of the intestine or address complications like strictures or fistulas.
Eosinophilic Esophagitis (EoE)
Chronic immune-mediated disease characterized by an accumulation of eosinophils, a type of white blood cell, in the esophagus. This buildup leads to inflammation, resulting in symptoms such as difficulty swallowing (dysphagia), food impaction, chest pain, and reflux-like symptoms. EoE is often associated with food allergies and other allergic conditions like asthma and eczema. Diagnosis typically involves endoscopy with biopsy to identify eosinophil infiltration. Treatment strategies include dietary modifications to eliminate triggering allergens, medications to reduce inflammation, and, in some cases, esophageal dilation to alleviate strictures and improve swallowing function. Early detection allows for more effective treatment, while delayed intervention can limit available options.
Hepatic Elastography
Liver Elastography: A Quick, Noninvasive Liver Test
Liver elastography is a quick, noninvasive liver test that helps your primary care provider better understand your liver health. This advanced imaging exam measures liver stiffness and fat content and can often reduce the need for a liver biopsy.
Bozeman Health offers liver elastography for patients with known or suspected liver disease, including fatty liver disease and other chronic liver conditions.
Why Liver Elastography Matters
Liver elastography provides your primary care provider with a clearer, more complete picture of your liver health. The results help guide diagnosis, treatment and ongoing monitoring of liver disease.
What to Expect
- Minimal preparation: Little to no preparation is required before your liver elastography exam.
- Short visit: The test takes about 10 minutes.
- Noninvasive: No needles, incisions or recovery time.
Where the Exam is Performed
Scheduling and Referrals
Your primary care provider orders the liver elastography exam. After the order is placed, the Bozeman Health Gastroenterology team will contact you to schedule your appointment.
Hepatitis C: A Curable Condition
Say Goodbye to Hemorrhoid Discomfort
Irritable Bowel Syndrome (IBS): Find the Relief You Deserve
We’re Here to Support You
Understanding your digestive health can feel confusing, but you’re not alone. We partner with you to provide the knowledge, support and care that you deserve to make informed decisions about your health. The American Society for Gastrointestinal Endoscopy offers helpful educational videos, and our team is always available to answer your questions.
If you’re ready to take control of your digestive health, schedule an appointment with Bozeman Health today. We’re here to help you feel better – every step of the way.
