Clara Kniss didn't know what to do anymore.

For four years, she had struggled with digestive distress, but even when she approached a family doctor, she felt she wasn't truly heard or helped.

Kniss, a 69-year-old Landisville grandmother, struggled to talk about her tummy turmoil, something that many people, especially women, often want to keep under wraps.

As a female, she said, it can be hard to discuss sensitive issues with a male practitioner, but the reality is that in the gastroenterology specialty, you'll find few women.

Kniss was encouraged when she heard about the Center for Women's Digestive Health, a division of Lancaster Gastroenterology Inc. The center, which opened in July, is directed by Dr. Sadiya Cheshty, the first female gastroenterologist at LGI.

"From the beginning, (Cheshty) listened to what I said," said Kniss, who has been a patient at the center for two months. "Being a woman, she understands some of the problems women have, which are different than men."

It certainly isn't that males and females don't share common gastrointestinal ground.

But abdominal authorities like Cheshty acknowledge that, on a gut level, when probing the underbelly of gastric disorders, there is indeed a gender gap — or distinctions between the sexes.

Even starting with ingestion — women taste bitter and sweet flavors more intensely — the fairer sex is more sensitive to stimulation throughout the gastrointestinal tract. Throw in hormonal fluctuations, stress and pregnancy, and detection and diagnosis become a bit more enigmatic, Cheshty said.

Women are some two times more likely than men to develop digestive problems, and two to six times as likely to manifest irritable bowel syndrome, according to the American College of Gastroenterology.

The center opened as both a weekly LGI clinic and outreach program to provide a special sensitivity to women's needs — which often include the desire to see a female practitioner for treatment.

"Our center has been fully booked since the day it opened, and that suggests we are meeting a genuine need in our region," said Mark O'Neill, LGI executive director.

"Women come here and expect to have the issues unique to (them) dealt with in a very knowledgeable way," said Dr. Fred Saunders, managing partner for LGI, and the man behind the plan for the center. "That requires a special empathy and awareness which is helpful for their healing process.

"Feeling heard is a major emphasis."

DR. CHESHTY'S CAUSE

Cheshty is a rarity.

In a field strongly dominated by men, she offers a unique female perspective.

Odds of women entering the gastroenterology specialty traditionally have been slim. A recent survey found that only 16 percent of GI fellowship positions are filled by women.

But the number is slowly increasing, reflecting the fact that more women are entering medicine in general, Saunders said.

He said LGI is actively recruiting more women for the eight-doctor practice.

Cheshty, 31, was born in Afghanistan.

But in 1984, when she was about 6, and in the wake of the Russian invasion in 1979, her family moved to New York City.

Her father was a civil engineer, and her mother at that time a literature teacher. Cheshty has three older siblings, two of whom have gone into medicine.

She embraced the idea of becoming a doctor as early as high school. After earning her undergraduate degree at the New York Institute of Technology, Cheshty attended medical school at the State University of New York (SUNY) Downstate School of Medicine, and completed her medical residency at North Shore University Hospital - New York University (NYU) School of Medicine.

Board certified in internal medicine, she finished her three-year fellowship training in gastroenterology, hepatology and nutrition at Loyola University Medical Center — Stritch School of Medicine in Chicago.

Cheshty is also certified in endoscopic ultrasound, an advanced procedure facilitating the detection and biopsy of lesions, and not readily available locally.

She moved to Lancaster with husband, Ahmad, a computer programmer, in July.

Why gastroenterology?

"I absolutely love doing procedures," she said. "I realized I wanted to do something where I'm working with my hands, and I'm pretty visual.

"The other aspect is that people are very in tune with their GI systems."

AVOIDING GASTRIC IMPASSE

Women should trust their gut and not discount symptoms, Cheshty said, or blame them solely on hormones or anxiety.

"That's essentially dangerous because some major issues can be dismissed because of that. It may have been women have had experiences where they're kind of brushed off, or told they worry too much."

But they shouldn't suffer in silence, she said, and candid conversation should be encouraged, not discouraged.

"Women have become so good about getting mammograms, but their rate of getting colonoscopies is shockingly low," she said.

The option of being able to see a woman to address care may help women become more proactive.

O'Neill cites a case where a woman with chronic constipation hadn't felt comfortable reporting her symptoms to a man, and sought help at the women's center.

Another woman had suffered for years believing she had irritable bowel syndrome, but learned she actually had ulcerative proctocolitis.

"Dr. Cheshty's diagnosis and treatment brought her healing and peace," O'Neill said. "These are the kind of patients we hoped to touch with this service."

"The center is within these walls, but my view is that the women's center is not a geographical place, it's not a room," Saunders said. "It's an area of particular interest and excellence devoted to an attitude and willingness to to take symptoms seriously."

INFORMATION

WHAT: Lancaster Gastroenterology Inc. Center for Women's Digestive Health 
CONTACT: 544-3500 
ONLINE: www.lancastergi.com

sjurgelski@lnpnews.com