Brandon is a certified physician assistant with 11 years of experience; with specific clinical experience in liver cirrhosis and treating Hepatitis C. He received his Master of Science in Physician Assistant Studies and his Bachelor of Medical Science from Mountain State University in Beckley, West Virginia.
- NCCPA Certified
- North Carolina State Licenses
Interviews and Articles
HEALTH WATCH: Chronic constipation can have serious medical consequences
By Stephanie Bowens StarNews Correspondent
Posted July 29, 2020
Medication, diet and poor hydration can contribute to chronic constipation
It can be a miserable feeling to need to have a bowel movement and not be able to due to constipation. Almost everyone gets constipated at some point, making it difficult or even painful to pass stool. While constipation can last a short period of time and in most cases is not serious, for some it can be a chronic problem that lasts long term and interferes with a person’s daily routines.
Brandon Ballard, PA-C, is a certified physician assistant at Wilmington Health Gastroenterology in Wilmington. Ballard said while some may feel reluctant to talk about constipation, it’s beneficial to talk to one’s doctor about it.
“It’s not always the most comfortable conversation for people to have, but if you keep in mind that we medical people talk about these things on a daily basis it’s a little bit easier to start talking about it,” he said.
1) Constipation is often due to two problems — consistency or motility issues
According to the U.S. National Library of Medicine, constipation means that a person has three or fewer bowel movements in a week. Ballard said constipation is generally the result of two things — a consistency issue or a motility issue.
“There’s either something that’s causing your stool to be so solid or hard that it’s causing your colon to struggle to move it along throughout your colon, or it’s a motility issue where the colon is just a bit sluggish, and it’s really slow at moving stool along,” he said.
2) Medication, diet and hydration can lead to chronic constipation
“There’s a long list of reasons why someone could be constipated, but most commonly we see things like diet, hydration and exercise (as the cause),” Ballard said.
Diet and lack of proper hydration can cause a consistency issue that leads to constipation. Ballard said eating a lot of processed foods and not eating a lot of fresh vegetables and high-fiber foods can contribute to constipation.
“Also, if we are not doing a good job at keeping ourselves hydrated that can also make your stool really hard because you need fluid in your colon to keep your stool soft,” he said.
While various medical conditions can contribute to motility issues and constipation, Ballard said individuals can also slow the motility of their gastrointestinal (GI) tract by being sedentary or inactive.
“Our GI tract is very dependent upon us moving around in general; so, if we don’t get some exercise, even something simple such as walking around your neighborhood, that can actually cause you to have constipation,” Ballard said.
Medication, especially some pain medication, is another common cause of constipation.
3) Exercise and adding fiber to diet are two ways to treat constipation
There are some simple things that can be tried at home to alleviate constipation and its symptoms.
“If you think about constipation being either a consistency or motility issue, if someone thinks that they are a consistency person, then increasing our dietary fiber is a really easy place to start,” Ballard said. “Getting more greens, fresh vegetables and fruits into our diet, making sure we are staying well hydrated is how you can address the constipation yourself. If you think you are a motility person, the best thing you can do is to start exercising.”
He said people also can take an over-the-counter fiber supplement to add fiber to diet.
4) Consult with a physician before turning to laxatives and colon flushes
Though several laxatives to alleviate constipation are available, Ballard recommends talking to a doctor before trying something beyond a fiber supplement.
“A laxative is something that you want to be careful with,” he said. “Some laxatives can be pretty harsh, and some laxatives out there aren’t always safe (to use with) certain medical conditions …
“I would also be really careful about doing these colon flushes. There’s some safe ways to go about it, but there’s also some not so safe ways out there …There’s a lot of potential complications that can happen with those flushes.”
Ballard said some risk of colon flushes include accidentally perforating or poking a hole in one’s colon due to over filling it if it’s already full of stool.
“If someone is at the point where they are desperate enough to do something like colon flushes it’s probably time to talk to a gastroenterologist,” he said, adding physicians can offer safer options.
5) Significant constipation can cause symptoms one may not think are related to GI tract
“Most of the times the first symptom that you’ll notice with constipation is being bloated,” Ballard said. “Whenever we are not clearing out the amount of stool our body produces it has to build up somewhere and that somewhere is in our colon.”
When constipation progresses and increases in severity, one may experience abdominal cramping, loss of appetite and nausea.
Constipation, however, can also cause symptoms that one may not think would be related to the GI tract.
“Sometimes GI issues in general can cause a lot of non-Gi issues,” Ballard said. “For example, it’s really common that if you have very significant constipation you can develop problems with urination.”
Ballard said severe constipation can cause difficulty urinating in some and frequent urination in others, dizziness, back pain, fatigue, heart flutters, heart racing, and even fainting due to straining to pass stool.
HEALTH WATCH: Think you’re too young for a colonoscopy? Think again
By Stephanie Bowens StarNews Correspondent
Posted September 30, 2020
When film star Chadwick Boseman died unexpectedly in August from colon cancer, many were surprised to learn the young actor had the disease. His death helped bring additional attention to colorectal cancer, the second most common cause of cancer death. Colorectal cancer, which develops in the colon and/or the rectum, is highly curable if detected in early stages, making screening for the disease critical.
Brandon Ballard, PA-C, a certified physician assistant at Wilmington Health Gastroenterology in Wilmington, said colorectal cancer is the third most common cancer in the country. He’s encouraging people to get their colonoscopies which can be life-saving. Millions of people in the U.S., however, aren’t getting screened as recommended.
“If everyone were to get their colonoscopies like they are supposed to some experts say that we can cut down risk of colon cancer by 50%,” Ballard said.
Blood in stool, anemia are common signs, but early symptoms are often absent
Colorectal cancer, which often develops from a growth called a polyp inside the colon or rectum, consist of many types. Blood in the stool and sudden change in bowel habits are common symptoms. Iron deficiency anemia is one of the earliest signs, Ballard said.
“The scary thing is that the majority of patients don’t have symptoms early on, which is why there’s such a huge push for colon cancer screening,” he said. “Often by the time a person develops symptoms, it’s pretty advanced. So, iron deficiency or noticing a little bit of blood in your stool are things you don’t want to ignore.”
American Society of Colon and Rectal Surgeons, ASCRS, indicates other symptoms include narrow shaped stools; ongoing pelvic or lower abdominal pain, such as gas, bloating or pain; unexplained weight loss; nausea or vomiting; and feeling tired all of the time.
Diet, race, age and family history can increase one’s risk for colorectal cancer
Diet, race, age, family history, genetics and certain medical conditions can increase one’s risk for colorectal cancer. Ballard said the majority of colorectal cancer occur in patients 45 years or older and that African Americans have the highest incidence of colorectal cancer in the U.S. According to the ASCRS, more than 90% of people are diagnosed with colorectal cancer after age 50.
Ballard said eating a lot of processed foods, tobacco smoking and heavy alcohol use increases the risk for colorectal cancer by causing baseline inflammation in one’s GI tract.
“That constant irritation to the GI tract can predispose you to developing cancer cells,” he said.
Certain medical conditions that tend to cause persistent inflammation in the intestines, such as Crohn’s disease or ulcerative colitis and family history of colorectal cancer, also increase the risk for developing the cancer. In some cases, colorectal cancer is linked to inherited genetic conditions. Increased risk is also linked to obesity and diabetes.
Colon Cancer can be detected and prevented with a colonoscopy
Ballard said colonoscopies not only look for colon cancer, but they can prevent the vast majority of colon cancers by removing polyps.
“We have the capability of preventing a lot of colon cancers with colonoscopies,” he said. “The easiest way that we can try to prevent someone from getting colon cancer is making sure you’re doing your screenings, and if you have polyps stay up to date on your colonoscopies.”
Ballard said polyps are precursors to colon cancer.
“When we do a colonoscopy, our primary goal is to look at the colon lining to see if there are any polyps, and if so, we remove them,” he said. “If we remove the polyps, then we remove the risk of that polyp developing into a colon cancer.”
While colonoscopies are often recommended at 50, young people can develop the disease
American Cancer Society recommends people at average risk of colorectal cancer start regular screening at age 45. According to the U.S. National Library of Medicine, men and women should start screening at age 50. Seeing an increase in younger people with colorectal cancer, some favor starting to screen at age 45, and some providers recommend Blacks begin screening at age 45.
American Cancer society indicates that colorectal cancer is rising in younger age groups with 12% of cases estimated to be diagnosed in people under 50 this year — about 18,000 cases. According to the organization, colorectal cancer incidence rates have been increasing since the mid-1980s in adults 20-39 and since the mid-1990s in adults 40-54, with younger age groups experiencing the steepest increase.
In light of younger people developing the disease, Ballard said depending on research, screening guidelines may change.
While it shouldn’t replace colonoscopies, Cologuard offers another testing option
Ballard said while insurance companies often don’t cover colonoscopies for people under age 50 who aren’t at elevated risk, Cologuard provides another test option. Cologuard is a home-based stool test. It’s used for people 45 and older at average risk for Colorectal cancer.
“If (results) come back as abnormal then you can proceed with having a colonoscopy which at that point will be covered by insurance as we would have proof that there’s something abnormal that requires a closer look,” Ballard said. “If it comes back normal, it helps reassure us that odds are you are probably okay and can wait until age 50 to have that first colonoscopy.”
Diagnosing and treating conditions and diseases of the digestive system including the stomach, colon, small bowel, liver, pancreas, and gallbladder
Our patient satisfaction surveys help us identify areas of improvement to work toward providing you with the best healthcare in the area. Patient satisfaction, along with increasing the quality of care delivered and reducing healthcare costs, are the three organizational objectives we focus on each and every day.
Provider Specific Scores
6. How would you rate how well this provider communicates? (easy to understand, listens carefully to you, shows respect for what you had to say, sensitivity, friendliness)4.92 out of 5
7. Using a number from 1 to 5, where 5 is the best provider possible and 1 is the worst provider possible, what number would you use to rate this provider?4.90 out of 5
How does Brandon Ballard compare?
|1. How would you rate getting an appointment as soon as you needed?||4.58|
|2. When you contact the office, how would you rate getting the help or advice you need?||4.65|
|3. How would you rate the friendliness and helpfulness of the staff?||4.81|
|4. How would you rate the comfort and cleanliness of the waiting area? (How neat, comfortable, pleasant was the waiting room)||4.62|
|5. Wait time includes the time you spend in the waiting area and the exam room before you see your provider. How would you rate the amount of time that you had to wait to see the provider?||4.69|
|6. How would you rate how well this provider communicates? (easy to understand, listens carefully to you, shows respect for what you had to say, sensitivity, friendliness)||4.92|
|7. Using a number from 1 to 5, where 5 is the best provider possible and 1 is the worst provider possible, what number would you use to rate this provider?||4.90|
|8. When this provider orders a blood test, x-ray, or other test for you, how would you rate how well this provider’s office follows up to give you those results?||4.40|
|9. How would you rate how easy it is to get appointments with specialists?||3.89|
|10. Considering all aspects of the office, would you say that you are: completely satisfied, very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied?||4.66|
"He is very knowledgable, listened to what I had to say, explained the treatment plan and the reasoning behind it."
"My appointment went very smoothly. I didn't feel rushed, things were explained to me and my questions were answered."
"I really can’t praise Dr. Ballard enough. I am not exaggerating when I say I do not know if I would be here today had I not been referred to him. His bedside manners are excellent and he is extremely knowledgeable. He genuinely cares about his patients and I feel heard during our visits."