Dr. John Charles Keech, MD, FACS is a thoracic surgeon in Iowa City, IA specializing in thoracic surgery. He graduated from Loyola University Chicago, Stritch School of Medicine in 2004 and has 20 years of experience. Dr. John Charles Keech, MD, FACS is affiliated with University of Iowa and University of Iowa Health Care.
200 Hawkins Drive
Iowa City, IA 52242
Bronchoscopy
Bronchoscopy is a procedure in which a thin tube with a camera, called a bronchoscope, is inserted in the mouth or nose and slowly advanced to the lungs. This allows doctors to see the respiratory tract, which includes the throat, larynx (voice box), trachea (windpipe), bronchi (airways), and lungs. Doctors may recommend those who have or show signs of lung problems - for example, lung cancer or difficulty breathing - to undergo a bronchoscopy.
In performing a diagnostic bronchoscopy, doctors may only wish to visualize the respiratory tract, or doctors may also collect samples of tissue or fluid. The samples can help diagnose patients' conditions or, if patients have cancer, they can be used for staging purposes. One method for sample collection is bronchoalveolar lavage. In a bronchoalveolar lavage, doctors inject saline (salt water) through the bronchoscope and then suction it out of the airways. The washout collected is tested for lung disorders. Doctors can also insert a biopsy tool to collect tissue or mucus samples. The following are biopsies that can be performed by bronchoscopy:
For visualization, bronchoscopy can be done alone, or it can be combined with ultrasound. Endobronchial ultrasound (EBUS) allows real-time imaging of the airway and is used for diagnosing and staging lung cancer, as well as for determining where the cancer has spread. EBUS can be performed with TBNA, a procedure known as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).
Doctors can also use bronchoscopy as a treatment for lung problems. For example, if a foreign body is trapped in the airway, doctors can insert forceps through the bronchoscope to remove it. If the airway has become narrowed - which may occur if patients have an infection, cancer, or some other inflammatory issue - bronchoscopy can be used to place a device called a stent in the area of constriction. The stent will keep the airway open, allowing the patient to breathe properly.
During a bronchoscopy, patients will be given medication (sedative) to help them relax. If it is only a diagnostic bronchoscopy, patients will be kept awake, but if the bronchoscopy is for therapeutic purposes, patients will be put to sleep by general anesthesia. After the procedure, patients will need to stay in the hospital for a few hours. They will not be able to eat or drink for about 2 hours. Some patients may experience discomfort, such as a sore throat or pain while swallowing. Throat lozenges and gargling may help alleviate these symptoms, which should go away after a few days. Patients will need to have someone drive them home once their doctor determines that they are ready.
Gastrointestinal Problems (Digestive Disorders)
The gastrointestinal system, or GI tract, is the name given to a collection of organs that work together to digest food. These organs fit together in a long tube, running from the mouth to the anus, and include the esophagus, stomach, and intestines, among others. With so many parts working together, complicated by today's busy lifestyles and diets, digestive problems are common. As many as 1 in 3 Americans have a digestive or GI disorder. There are a huge variety of digestive problems, but the most common are IBS, constipation, GERD, hemorrhoids, and ulcers.
IBS, or irritable bowel syndrome, happens when the muscles surrounding the colon contract too easily or frequently. The result is abdominal pain, cramps, diarrhea or constipation, gas and bloating. IBS attacks can often be brought on by specific triggers, so a key part of treatment is learning which foods trigger IBS attacks and avoiding them. Treatment also includes exercise, avoiding stress, and medications if needed.
Constipation, or large, hard, or infrequent stools, happens to everyone at some point. It can be caused by a disruption in routine or food, or by eating a diet without many fresh fruits and vegetables. Although it is uncomfortable, constipation is common and usually not serious, but it can sometimes become chronic. Adding fiber to the diet, exercising, and taking medications may help.
GERD, or gastroesophageal reflux disease, is a severe form of chronic heartburn where stomach acid spills back up into the esophagus. Left untreated, the acid may even eat away at the esophagus and cause serious damage. Treatment includes changing the diet to avoid trigger foods, losing weight if needed, medications, or even surgery.
Hemorrhoids are blood vessels around the rectum that become irritated, swollen or torn while straining during a bowel movement. They are most often caused by constipation, but can also be caused by pregnancy, diarrhea, or simply a genetic predisposition towards hemorrhoids. Treatment involves first treating any constipation issues, then keeping the area clean and soothed until it has healed. If these measures are ineffective, surgery is sometimes used.
Peptic ulcers are sores or spots of inflammation in the lining of the stomach or close to the stomach in the small intestine. Usually this area is coated with a protective lining that shields the tissue from the strong stomach acid, but a break in the lining can let acid in, causing the sores. It used to be thought that stress caused ulcers, but now it is known that is not the case. Most often, they are caused by an infection by H. pylori bacteria, but ulcers can also be caused by alcohol abuse or overuse of aspirin, ibuprofen, naproxen, or other NSAIDS. The symptoms of an ulcer are pain, hunger, nausea, and fatigue.
Gastrointestinal problems, perhaps more than any other area, are markedly affected by lifestyle. Many disorders can be prevented or treated at least in part by eating a healthy diet high in fiber, exercising regularly, drinking enough water, and limiting alcohol intake. Still, the frequency of digestive disorders means that even the healthiest person can be affected by them. Anyone who notices blood in their stool, experiences abdominal pain, unexplained weight loss, or any significant change in bowel movements should see a doctor.
Lung Transplant
Patients who have very severe lung disease may need a lung transplant. The diseased lung is entirely removed and replaced with a healthy lung, usually donated by a person who died. Either one or both lungs can be transplanted.
Contrary to popular belief, lung transplant is rarely used to treat lung cancer. It is a more common treatment for patients with other advanced lung diseases, such as cystic fibrosis, sarcoidosis, pulmonary fibrosis, and chronic obstructive pulmonary disease (COPD). Lung transplant is a serious operation and is generally used as a last resort for patients who have only a short time to live without surgery.
During a transplant, an incision is made on the side of the chest (for a single lung) or in the middle (for both lungs). Patients may be hooked up to a heart-lung bypass machine, which will do the work of moving blood and oxygen through the body during the procedure. After the diseased lung is cut away from the main airway and blood vessels, the donor lung is stitched into place. Surgery may take as long as twelve hours, and a hospital stay of two to three weeks after surgery is not uncommon. For the first hours or day after surgery, patients use a ventilator, or a machine to help them breathe. Tubes will be inserted into the chest to help drain excess air and fluid. During recovery, physical therapy and breathing exercises are used to help the new lung work as well as possible.
Lung capacity is carefully monitored for several months after surgery. Patients who have had a transplant will also have to take anti-rejection drugs for the rest of their lives. These drugs stop the body's immune system from attacking the new lung. The main risks after a transplant are infection and rejection (when the immune system attacks the 'foreign' lung). A healthy lifestyle, including maintaining a diet high in vegetables and lean protein, not smoking, and getting enough exercise, is important to keeping the lungs functioning as well as possible. With proper care, many patients can live ten or even twenty years after a lung transplant.
Volume of procedures performed by Dr. John Charles Keech, MD, FACS for Medicare patients.
The highest averages for the top procedures that Dr. John Charles Keech, MD, FACS treated as a thoracic surgeon in Iowa City, IA were minimally invasive procedures, thoracic (chest) surgery procedures, hospital care and inpatient care.
| 16 | |
| 95 | |
| 15 | |
| 19 | |
| 19 | |
| 13 | |
| 16 | |
| 26 | |
| 26 |
Information about Medicare patients treated by Dr. John Charles Keech, MD, FACS.
| 55 | |
| 48 |
| 14 | |
| 25 | |
| 2 | |
| 9 | |
| 51 |
The highest averages of the most common conditions of Medicare patients that Dr. John Charles Keech, MD, FACS treated were hypertension, high cholesterol, chronic kidney disease and ischemic heart disease.
| 59 | |
| 47 | |
| 33 | |
| 22 | |
| 36 | |
| 10 | |
| 3 | |
| 15 | |
| 30 | |
| 25 | |
| 13 | |
| 30 |
Dr. John Charles Keech, MD, FACS graduated from Loyola University Chicago, Stritch School of Medicine in 2004. He is certified by the American Board of Surgery (General Surgery) American Board of Thoracic Surgery (Thoracic Surgery) and has a state license in Iowa.
Medical School: Loyola University Chicago, Stritch School of Medicine (2004)
Board Certification: American Board of Surgery (General Surgery) American Board of Thoracic Surgery (Thoracic Surgery)
Licensed In: Iowa
Dr. John Charles Keech, MD, FACS is associated with these hospitals and organizations:
Dr. John Charles Keech, MD, FACS has an exceptional overall rating with an average of 4.8 out of 5 stars based on 615 ratings. We collect ratings and reviews of Dr. John Charles Keech, MD, FACS from all over the web to help you find the right in Iowa City, IA.
These charts describe general payments received by Dr. John Charles Keech, MD, FACS. Doctors may receive payments for a number of reasons, including meal compensation, travel compensation, and consulting.
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$15,028
DAVINCI XI $11,500 |
Da Vinci Surgical System $3,528 |
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$106
RIBFIX BLU ADVANTAGE $55 |
AdvantageRib $52 |
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$26
ILLUMISITE $26 |
| $11,500 | |
| $3,096 | |
| $564 |
Dr. John Charles Keech, MD, FACS has received 4 research payments totaling $21,274.
Dr. John Keech is a thoracic surgery specialist in Iowa City, IA. Dr. Keech studied medicine at Loyola University Chicago, Stritch School of Medicine. He is affiliated with the University of Iowa Health Care.
