Mammograms Detect Early Breast Cancer

The pink ribbons of Breast Cancer Awareness remind us that screenings save lives. Breast cancer is the most common cancer among women in the United States, but regular mammograms can help detect breast cancer early when it is most treatable. According to the American Cancer Society, all women should begin having annual mammograms by age 45, but they have the choice to begin yearly screening at age 40. At age 55, they can choose to schedule mammograms every other year.

Colonoscopies Detect Colon Cancer Early

A colonoscopy is equally important as a life-saving screening. Colon cancer is the third-leading cause of cancer death in the United States among men and women, but it is mostly preventable through regular screening.

Although there are many other screening methods for colon cancer, a colonoscopy is the most comprehensive because it examines the entire colon for precancerous polyps called adenomas. If adenomas are detected during a colonoscopy, they can be removed so they cannot develop into cancer.

The American Cancer Society recently updated their guidelines on when average-risk adults should begin colon screening. Previously, the ACS suggested that screening should begin at age 50, but they revised the recommended age to 45 due to increased incidence of young-onset colon cancer.

Make an Appointment for a Mammogram and Colonoscopy

Prevention is always less expensive than treatment, so schedule your screening mammogram and screening colonoscopy in October. Medicare and private insurance plans cover most preventative screenings and well visits but call your insurance provider for specific details about your plan. If you have a family history of breast cancer or colon cancer, you may need to schedule a screening before you turn 45, so ask your doctor to review your medical history. 

Elective GI procedures could be much more affordable if you schedule them at the end of the year after you have met your deductible. Your annual healthcare deductible is the amount you must pay out-of-pocket each year for covered medical procedures before your insurance will begin paying. Most deductibles reset on January 1 each year, so this is the time to evaluate whether you should schedule that GI procedure or wait until next year.

You may think you do not have time to call your insurance company about your deductible, but a few minutes of research could save you thousands of dollars, particularly if you have a high-deductible health plan (HDHP) or a Flexible Spending Account (FSA).

Here are four scenarios you may be facing as you approach the end of the year:

You have already met your deductible, or you are close to meeting it.

You should consider scheduling that upper endoscopy or other diagnostic test as soon as possible. If you have already met your deductible, you will pay less now than if you wait until next year. If you are approaching your deductible, call your insurance company to ask for an estimate of costs so you can prioritize things like outpatient surgery, diagnostic testing, lab work and prescription refills.

 You will not meet your deductible.

If you are not close to meeting your deductible, you may choose to delay procedures and appointments so your expenses can count toward next year’s deductible.

However, there is no reason to delay preventative screenings like colonoscopies. Under the Affordable Care Act, screening colonoscopies (and related anesthesia and sedation) are covered at 100 percent for private insurance and Medicare.

You have a surplus in your Flexible Spending Account (FSA).

If you have an FSA through your employment, check your balance regularly and use all funds before the end of the year. FSA money does not roll into next year, and you will lose all unused funds. You may opt to schedule a GERD treatment like an esophageal dilation. Click here to get a comprehensive list of qualified medical expenses for which you can use your FSA dollars.

You have additional funds in your Health Savings Account (HSA).

HSA funds can be rolled over into next year, so you do not need to rush to use that money right away. You may want to accumulate money in your HSA for a more expensive elective digestive procedure in the future.

Call Your GI Doctor

Understanding your health plan is the first step in making it work for you. Call your insurance provider, and then contact your GI doctor to schedule your elective digestive procedure. Quality healthcare can be more affordable when you pay attention to your deductible. 

Latest Research Calls for New Colonoscopy Age Guidelines

Previously, the ACS and other medical organizations recommended colon screenings for average-risk men and women beginning at 50 years of age. The ACS updated their recommendation in May 2018 after examining the most current colon cancer statistics.

Since the 1990s, colon cancer incidence among Americans aged 20 to 54 has gradually risen by between 0.5 and 2 percent per year and rectal cancer incidence has increased by between 2 and 3 percent per year. The ACS asserts if this trend continues, people born in 1990 will double their risk for colon cancer and quadruple their risk of rectal cancer compared to those born in 1950.

Men and women 55 and younger are 58 percent more likely to be diagnosed with advanced-stage colon cancer because they are unaware of the warning signs of colon cancer and may appear to otherwise be in good health.

Why Colon Cancer Screening Matters

Colon cancer is the third-leading cause of cancer death in the United States and is expected to claim the lives of 50,630 Americans this year. Most cases of colon cancer are actually preventable through screening, but one-third of eligible adults are not getting screened.

American Cancer Society’s New Guidance

The new guidance from the American Cancer Society includes the following Colonoscopy Age Recommendations:

• All adults who are at average risk for colon cancer should begin routine screening at age 45.
• Those with a family or personal history of colon polyps or colon cancer should begin screening earlier.
• Average-risk men and women in good health with a life expectancy of more than ten years should continue colon cancer screenings through 75 years of age.
• Men and women between the ages of 76 and 85 should consult their medical provider about whether to be screened, based on their overall wellness, life expectancy, personal preferences and prior screening habits.
• Men and women 85 and older should not be screened for colon cancer.

Insurance Coverage

Although the ACS recommends that first-time colon screenings begin at age 45, not all insurance plans offer preventative coverage for patients between the ages of 45 and 59.

Talk to your doctor about your family and personal medical history so you can be screened at the appropriate time. Then, call your insurance provider about coverage specific to your age, medical history and doctor’s recommendations.

Call a Gastroenterologist

As young-onset colon cancer continues to increase, it is important to remember that you are never too young. More adults in their 20s and 30s are being diagnosed than ever before. The ACS encourages you to familiarize yourself with the warning signs of colon cancer so you can act promptly. If symptoms persist for more than a few days, schedule an appointment with a fellowship-trained gastroenterologist.  

Colon cancer used to be thought of as a Western disease that affected only the affluent, and colon cancer was no exception. According to the World Cancer Research Fund, two-thirds of colon cancer cases occur in countries associated with high income.

Colon Cancer Risk Factors

Life Expectancy

One reason why colon cancer rates are higher among wealthier nations is that life expectancy is higher in developed countries. Colon cancer is usually associated with advanced age, and most new cases of colon cancer occur in men and women over the age of 50.

The Western Diet

The Western diet also contributes to colon cancer risk. A 2018 study found that a pro-inflammatory diet centered on red meat, refined grains, saturated fats, sugary drinks and processed foods significantly increases colon cancer risk. Replacing fiber-rich fruits and vegetables with foods that are high in fat causes inflammation in the colon, a precursor to cancer.

Obesity Rates

As developed nations grow increasingly sedentary, obesity rates are steadily climbing. One out of every three American adults is obese, making our society more prone to diabetes, heart disease and cancer.  Excess weight, especially in the mid-section, increases risk for colon cancer.

Colon Cancer Worldwide

New studies show cancer mortality is a global problem, especially lung, breast and colon cancers. Advancements in colon cancer education, screening and therapies in Western nations have helped to reduce colon cancer incidence, but developing countries are experiencing a surge in new cases.

Lindsey Torre, an epidemiologist at the American Cancer Society, believes lifestyle factors are largely responsible for increases in cancer incidence among low and middle-income nations. For example, smoking is now more common among poorer countries. We are now seeing developing countries adopting unhealthy habits from wealthier nations like eating a Western diet, being sedentary and having a higher body mass index.

Cancer can no longer be considered a Western disease. Colon cancer affects every population group and age level, so it is essential to know the warning signs of colon cancer. If you experience symptoms like abdominal pain, cramping, bathroom habit changes, rectal bleeding or excess fatigue, call a gastroenterologist.

The American Cancer Society suggests that all adults who are at average risk for colon cancer begin screening at age 45. Talk to your GI doctor about your individual risk so you can get screened at the appropriate time.  

A healthy colon is essential for overall wellness, and you can nurture your gut by making a few nutritional changes.

The large intestine, or colon, is responsible for digesting food, processing waste and supporting immunity. A well-balanced diet and proper hydration will help maintain colon function and prevent digestive disease. Colon cancer is the third-leading cause of cancer death in the United States, but most cases of colon cancer are preventable through positive lifestyle changes and routine colonoscopies.

You can be an advocate for your own colon health by consuming more fiber, probiotics and water.

Benefits of a High-Fiber Include Colon Cancer Prevention

Fiber is non-digestible plant material found in skins and peels of fruits, vegetables and whole grains. Eating five to nine servings of fresh fruits and vegetables and three to four servings of whole grains provides adequate fiber to meet the daily recommended allowance. Men should consume at least 38 grams of fiber per day and women should consume 25 grams per day.

Good sources of fiber include black beans, split peas, brown rice, oatmeal, wheat germ, oat bran, baked potato, flaxseed meal, chia seeds, avocados, pears and apples.

Probiotics Benefits

Probiotics are living strains of bacteria and yeast that regulate digestion, immune function and hormone production. A healthy colon contains 100 billion to 100 trillion beneficial bacteria per milliliter, but advanced age, illness, poor diet and antibiotic use can destroy healthy gut flora.

Eating foods that contain probiotics can fortify the gut microbiome with new colonies of beneficial bacteria. Good sources of probiotics include kombucha, kimchi, sauerkraut, kefir, miso, tempeh, pickles, and some yogurts. Many yogurts sold at commercial grocery stores have been pasteurized, which kills the probiotic cultures. When evaluating food labels, look for yogurts and fermented products that contain L. acidophilus and Bifidobacteria.

Water

Proper hydration is essential for colon health. Water is necessary for absorbing vitamins and minerals and removing toxins from the liver and kidneys. Water also binds with fiber to create bulk in the stool and helps move solid waste through the digestive tract.

A good general rule is to drink half of your body weight in fluid ounces. Stay away from caffeinated beverages like soda, coffee and black tea that are diuretics and cause dehydration and constipation.

Schedule a Colonoscopy

Finally, colon-healthy living includes routine colonoscopies at regular intervals, as recommended by your gastroenterologist. The American Cancer Society recommends that people who are at average risk for colon cancer begin screenings at age 45. Although there are other methods of colon cancer screening, a colonoscopy is the gold standard because it allows a gastroenterologist to examine the entire colon for precancerous polyps. Any suspicious polyps that are found during the procedure can be removed, so they do not develop into colon cancer.

Call your gastroenterologist to discuss your digestive health and schedule a colonoscopy. A healthy colon makes a healthier YOU.

You should never delay urgent medical procedures, but you could save money by scheduling elective and screening procedures after you have met your deductible.

Preventative Appointments and Colon Cancer Screenings

Have you ever considered waiting until the last quarter of the calendar year to schedule a colon cancer screening or GI procedure?  Annual well visits and screenings are usually covered at 100 percent under most insurance plans, but labs and diagnostic testing fees are often the patient’s responsibility. Waiting until you have met your deductible means that additional tests and labs may be covered, or at least, may be more affordable.

A colonoscopy is one procedure that can be less expensive if you have met your deductible. Under most private insurance plans and Medicare, colonoscopy screenings are covered at 100 percent for adults between ages 50 and 75. Because young-onset colon cancer incidence is steadily increasing, the American Cancer Society recommends screening colonoscopies starting at age 45. If you are under 50 and choose to have a screening colonoscopy, your cost-sharing responsibility could be much lower if you have met your deductible.

Diagnostic Colonoscopies

If you have a history of polyps or colon cancer, or you receive a positive result from another colon cancer screening test, your colonoscopy likely will be considered diagnostic. It can make financial sense to schedule a diagnostic colonoscopy after meeting your deductible.

The amount that you will pay for the colonoscopy will depend on whether you have met your deductible or not. If you schedule the procedure at the end of the year when you have already met your deductible, you may not be responsible for any out-of-pocket costs. However, if you wait until January, when your deductible resets to zero, you could be subject to a physician fee, facility fee and laboratory diagnostic fee.

Elective GI Procedures

You could also save money by scheduling other GI procedures at the end of the calendar year. Diagnostic testing and treatments for certain digestive conditions are not considered urgent and can be scheduled at a time that is most convenient for the patient. If your GI doctor has suggested a test, lab or procedure to improve your digestive health, it is most cost-efficient to schedule the appointment when you are close to meeting your deductible. Do not delay too long, though. With the approaching holidays, appointment availability will rapidly diminish, so look over your calendar and call soon.  

Elective GI Procedures to Schedule Before September Include:

• Upper endoscopy
• Esophageal manometry
• Esophageal pH test
• Barium esophagram
• Nissen fundoplication

Before you schedule your GI procedure, call your insurance provider. Request a cost estimate for the procedure and ask how close you are to meeting your deductible. Having all the facts can help you plan effectively and can stretch your healthcare spending dollars. 

Sleep apnea and gastroesophageal reflux disease (GERD) are two conditions that appear unrelated. However, research shows a correlation between the two.

What Are Sleep Apnea and GERD?

Sleep apnea is a disorder that causes people to stop breathing during sleep. Obstructive sleep apnea (OSA), the most common type of apnea, occurs when the airway is blocked by soft tissue at the back of the throat. Many people who experience sleep apnea are unaware that their sleep cycle is interrupted throughout the night because they do not awaken completely. They usually complain of daytime sleepiness, headaches, forgetfulness and dry mouth.

About 60 percent of people with sleep apnea have chronic acid reflux, also known as gastroesophageal reflux disease (GERD). Acid reflux occurs when the lower esophageal sphincter remains open and gastric acid backflows into the esophagus. Common symptoms of GERD include heartburn, chest pain, a sour taste in the mouth and bad breath. However, it is possible to have GERD and not experience symptoms at all.

GERD Treatment Helps Remedy Sleep Apnea

Although researchers do not fully understand the relationship between sleep apnea and GERD, studies show that sleep disturbances may induce GERD and that untreated acid reflux impairs sleep. One study followed 48 adults who experienced GERD over three times per week. The men and women who had the most severe GERD symptoms also reported the worst sleep problems.  

The good news is that treating either sleep apnea or acid reflux appears to improve both conditions. Because sleep apnea and GERD are challenging to diagnose, they can go undetected for years. It is essential to be aware of the symptoms of each condition so you can receive prompt diagnosis and treatment.

Schedule an Appointment with a GI Specialist

If you have acid reflux on a regular basis and do not sleep well, make an appointment with a gastroenterologist to be evaluated for GERD. An upper endoscopy can detect inflammation or tissue damage to your esophagus, and you can begin treatment immediately. Talk to your gastroenterologist about your sleep problems as well. You may need to be referred to a sleep specialist or pulmonologist. 

Gastrointestinal distress can be painful, embarrassing and disruptive. Fortunately, most GI conditions can be alleviated with the help of a gastroenterologist. Two GI disorders that can have similar symptoms are gastroparesis and gastroesophageal reflux disease (GERD). Here are some similarities and differences between the two disorders.

Gastroparesis

One common type of GI distress is gastroparesis, a form of digestive tract paralysis. Although few people have heard of gastroparesis, it affects one out of 25 Americans. This chronic condition is characterized by slow, irregular stomach contractions that interrupt or prevent normal digestion.

When digested food material does not pass into the small intestines within a normal timeframe due to gastroparesis, pain and abdominal bloating can result. Other symptoms of gastroparesis include heartburn, cramping, nausea and a persistent feeling of fullness. Because the condition is relatively unknown, gastroparesis can be mistaken for other types of GI disorders like GERD.

Similarities Between Gastroparesis and GERD

Many symptoms of gastroparesis mirror symptoms of GERD. Both disorders may be accompanied by abdominal pain, indigestion and a sensation of fullness, so they are easily confused for one another. It is equally important to receive prompt treatment for each of these disorders, as undiagnosed GERD can lead to Barrett’s esophagus and untreated gastroparesis can result in malnutrition and weight loss.

Differences Between Gastroparesis and GERD

GERD is chronic acid reflux caused by a weakness in the lower esophageal sphincter (LES), the valve the separates the esophagus and the stomach. Gastroparesis, in contrast, often develops after an injury to the vagus nerve, which is responsible for stimulating contractions in the stomach and intestines.

Unlike gastroparesis that develops due to stimulus interruption, GERD flare-ups often are determined by diet. Eating spicy, greasy, creamy or acidic foods or drinking caffeinated beverages, soda or alcohol can aggravate reflux. Lifestyle choices like overeating, wearing tight clothing or lying down after meals can also exacerbate the condition.

Patients with GERD usually experience upper GI pain because stomach acid leaks into the esophagus and causes inflammation. On the other hand, those with gastroparesis tend to have lower GI distress due to food moving slowly through the digestive tract.

Call a Gastroenterologist

Gastroparesis and GERD can cause long-term health problems if you are not under a doctor’s care. If you are experiencing gastric pain or GI distress, make an appointment with a board-certified gastroenterologist for a full exam and consultation.

And remember, August is Digestive Tract Paralysis Awareness Month, so take a moment to inform your friends and family about the condition and encourage them to prioritize their digestive wellness!

What is Gastroparesis?

Gastroparesis is a condition characterized by delayed stomach emptying. In a normally functioning stomach, gastric contractions move food material through the gastrointestinal tract. Patients with gastroparesis experience slow or erratic stomach contractions, which halts the digestive process. Common symptoms of gastroparesis include abdominal pain, bloating, reduced appetite and weight loss.

What Causes Gastroparesis?

One of the most common causes of gastroparesis is a damaged vagus nerve, the main nerve that communicates with the digestive tract. Injury to the vagus nerve interrupts impulses that control involuntary muscles in the stomach, gallbladder and intestines which stimulate secretions and contractions.

Gastroparesis can also be caused by uncontrolled diabetes, medications and other nerve disorders.

Common Misconceptions about Gastroparesis

Many people think that gastroparesis is an eating disorder because it is associated with malnutrition and weight loss, but this is untrue. Gastroparesis is a gastrointestinal disorder that causes a sensation of fullness because the stomach cannot empty properly.

Fatigue and nausea are common with gastroparesis because the body is not being properly nourished. Therefore, people who have gastroparesis are sometimes mischaracterized as being lazy or lacking in motivation. It is important to remember that although those who suffer from gastroparesis may want to perform the daily tasks that most people can accomplish, they may not be able to, since they lack nutritional availability.

 How You Can Help

You can get involved in Gastroparesis Awareness Month by paying attention to your own digestive health. If you are experiencing symptoms of gastroparesis, make an appointment with a gastroenterologist. Undiagnosed gastroparesis can lead to serious health risks.

You can also talk to your friends and family about the condition to spread awareness about the disorder. Many people are unfamiliar with gastroparesis, so start a conversation and share your knowledge with someone else.

Finally, go to the International Foundation for Functional Digestive Disorder’s web page. You will find many resources on gastroparesis including management and prevention tips, personal testimonials and ways you can get involved in your local community.

A blue tablet could help increase your gastroenterologist’s ability to detect polyps during a colonoscopy.

Blue Dye Increases Adenoma Detection Rate (ADR)

A recent study found that oral tablets with methylene blue dye could boost adenoma detection rate (ADR) as much as nine percent. ADR is the percentage of patients undergoing screening colonoscopies in whom a physician detects one or more adenomas, or precancerous polyps.

Alessandro Repici, M.D., of Humanities University Medical School in Milan, Italy, led the study. He and his research team analyzed over 1,200 colonoscopy patients at 20 facilities. Patients received either a placebo, a half-dose of delayed-release methylene blue dye tablet or a full dose. The patients who received the full dose of delayed-release methylene blue had nine percent more adenomas detected because the dye identified small, flat polyps that typically would have been missed.

Blue dye is commonly used during colonoscopy, but it is sprayed into the colon during the exam to highlight specific areas. The oral tablet used in the study is innovative because it is quick, easy to administer and has no known side effects.

ADR and Colon Cancer Prevention

Increasing physician ADR directly affects colon cancer prevention. For every percentage point increase in a physician’s ADR, a patient’s colon cancer risk is reduced by three percent.

Improving colon visualization during colonoscopy is the first and most essential step in boosting ADR since adenomas must be detected before they can be removed. Use of the delayed-release blue tablet still requires further testing but could become an integral part of the colonoscopy procedure.

Colon cancer is currently the third-leading cause of cancer death among men and women in the United States, but the disease is mostly preventable with routine colonoscopy. The American Cancer Society recommends that people who are at average risk for colon cancer begin screening at age 45. If colon cancer or colon polyps run in your family, however, you should be screened at a younger age.

Call Your Gastroenterologist

Talk to a gastroenterologist about when you should begin colon cancer screening. Only a colonoscopy allows your GI doctor to detect and remove precancerous polyps during the same procedure. It is so effective that you won’t have to repeat the procedure for a whole decade if you are at normal risk for colon cancer and have a clean bill of health.