Colonoscopy is the most effective screening for colon cancer because it allows a gastroenterologist to examine your entire colon for precancerous polyps called adenomas. All adenomas are benign in their initial stages, but some benign adenomas can become malignant if a GI doctor does not remove them during a colonoscopy.
 

Adenoma Detection Rate: The Primary Quality Colonoscopy Indicator

The best indicator for a quality colonoscopy is adenoma detection rate (ADR), which measures your gastroenterologist’s effectiveness in detecting adenomas in screening colonoscopies. Two other indicators for a quality colonoscopy are withdrawal time and cecal intubation rate.

Withdrawal Time

The goal of a colonoscopy is to view the entire colon from the rectum to cecum. If you have done a thorough bowel preparation, your gastroenterologist should be able to advance the colonoscope all the way to the cecum, near your appendix. Withdrawal time refers to the number of minutes your GI doctor spends inspecting your colon wall for adenomatous polyps. This quality indicator is always expressed in minutes.

You should expect your gastroenterologist to have an average withdrawal time of at least six minutes. Longer withdrawal times often reflect that your physician is especially meticulous and methodical in performing a colonoscopy, which usually produces a higher adenoma detection rate.

Cecal Intubation Rate

The percentage of success in which a gastroenterologist advances the colonoscope to the cecum in his or her patients is called cecal intubation rate. This indicator is always expressed as a percentage. The national standard for cecal intubation is 90 percent, but you should expect your gastroenterologist to have a higher cecal intubation rate. A high cecal intubation rate means your specialist takes time to fully insert the colonoscope to detect any precancerous polyps or lesions.

The quality of your bowel preparation affects your gastroenterologist’s cecal intubation rate. An incomplete bowel flush can impact a doctor’s ability to view the cecum and provide a complete visual inspection. Patients who do not follow instructions in the bowel preparation literature put themselves at increased risk for expensive re-testing or missed polyps.

A colonoscopy is an important component of preventative healthcare. Use quality indicators like ADR, withdrawal time and cecal intubation rate as criteria for selecting a gastroenterologist. It’s likely that you won’t have another colonoscopy for ten years, so make an informed decision when choosing your partner in colon cancer prevention. 

 

Colon cancer affects one in 20 Americans, making it the third-leading cause of cancer death in the United States. Most cases of colon cancer are preventable through routine colonoscopy, but one out of every three Americans is not up to date on their colon screenings.

Although colon cancer rates are decreasing among men and women who are 50 and older, colon cancer incidence is steadily increasing among younger Americans. For this reason, the American Cancer Society recommends that men and women who are at average risk for colon cancer begin preventative screenings at age 45.

A colonoscopy is a life-saving procedure, so it is important to make an educated decision when selecting your gastroenterologist. Here are some guidelines to help you choose the best GI doctor in your area:

1. Call several gastroenterologists and take notes. Choosing a gastroenterologist requires as much time and attention as you would dedicate to making any major purchase. Research your options, read online physician reviews, call several endoscopy centers and take detailed notes.
2. Select a gastroenterologist who is board certified by the American College of Gastroenterology.
3. Inquire about each GI doctor’s area of specialty. All gastroenterologists are required to complete a fellowship in gastroenterology that trains them to examine, assess, diagnose and treat digestive disease. Most fellowships last anywhere from two to four years, and during that time, gastroenterologists select a few areas of specialty. These can include pediatric gastroenterology, hepatology, celiac disease, gastroparesis or inflammatory bowel disease. When you’re seeking to schedule a colonoscopy, you will want to look for gastroenterologists who specialize in endoscopy.
4. Ask the endoscopy center for the center’s ADR or an individual physician’s ADR. Adenoma detection rate (ADR) is the most important quality measure in colonoscopy. ADR is calculated by the percentage of patients in whom a physician detects one or more adenomas (precancerous polyps) during a screening colonoscopy. When choosing a gastroenterologist, keep in mind that the national average ADR is 30 percent in male patients and 20 percent in female patients.

If during your screening colonoscopy, your gastroenterologist suspects you may have a colon tumor, he or she will remove a segment for biopsy. If the growth is cancerous, you may need a surgeon who specializes in colorectal surgery to remove the tumor. 

You can follow many of the same guidelines above when qualifying a surgeon, but you may want to ask about the surgeon’s area of expertise, and how many years of experience he or she has had in colorectal surgery.

If you are at least 45 and have not yet had a baseline colonoscopy, it’s time to select a gastroenterologist for your procedure. As a patient, you have a right to ask qualifying questions and inquire about physicians’ areas of specialty and expertise.

For years, physicians and researchers sought to treat depression by treating the brain, but recent research is shifting our attention to the gut as the center of mental health.

The Gut, Our “Second Brain”

The nervous system transmits and interprets information from all parts of the body through an intricate network of neurons. Although we mostly associate neurons with the central nervous system and the brain, the gut serves as a secondary hub of neurological activity. Trillions of bacteria and over 100 million neurons line the digestive tract, and they communicate with the central nervous system, endocrine system and immune system. This complex network is called the enteric nervous system or the “second brain.”

“Gut Feeling” Isn’t Just a Saying

We’ve all had a “gut feeling” or “butterflies in our stomach,” but those expressions aren’t just idioms.  According to a study by E.M.M Quigley, the second brain strongly influences emotions, moods and behavior. The enteric nervous system and gut microbiome control 80 percent of the communication between the body and the brain.

Gut Inflammation Increases Depression, Anxiety Risk

Healthy emotions begin with a healthy gut. One study proposes that gut inflammation initiates chronic conditions like depression and anxiety. A healthy gut is comprised of a wide diversity of bacteria and high concentrations of beneficial strains of bacteria. Poor diet, illness or antibiotic use can disrupt the delicate balance of gut flora, and this imbalance can result in inflammation and increased risk for depression and anxiety disorders (Huffington Post).

Gut Health Diet: How to Maintain Healthy Gut

Eating many colorful varieties of fresh fruits, vegetables, whole grains, lean proteins, nuts and seeds is essential for a nutritious diet and healthy digestion. You can boost concentrations of beneficial bacteria in your gut by adding probiotics to your diet like yogurt, kefir, kimchi, sauerkraut, tempeh, miso and kombucha.

A GI Doctor Can Help

Depression and anxiety is a serious condition that requires a physician’s care. Make an appointment with your doctor to discuss how improving your digestive health can boost your mental wellness. 

Colorectal Cancer: Facts on 3^rd Leading Cause of Death in US

When you hear someone mention colorectal cancer, you probably don’t give it much thought. After all, colon cancer is rare and it only affects older people, right?

Actually, nothing could be further from the truth. Colorectal cancer is the third-leading cause of cancer death among men and women in the United States, and it’s expected to cause 50,630 deaths in 2018.

Here are Colon Cancer Facts for Americans:

1. The risk of developing colorectal cancer is one in 22 for males and one in 24 for females.
2. In 2018, an estimated 97,220 Americans will develop colon cancer and an estimated 43,030 will develop rectal cancer.
3. Obesity is a major risk factor of colorectal cancer, and according to the Centers for Disease Control, over 36.5 percent of U.S. adults are obese.
4. Although overall colon cancer incidence is dropping in the U.S., young-onset colon cancer in the has increased over the past decade.
5. One-third Americans between the ages of 50 and 75 are not being properly screened for colon cancer and are putting themselves at unnecessary risk. This includes men and women who are not up-to-date on colon screenings or have never been screened for colon cancer. 
6. Having health insurance impacts colon cancer screening rates. Adults who carry health insurance are more likely to be current with their colon screenings (71.1 percent) than adults who don’t have health insurance (36.3 percent).
7. Adults between the ages of 65 to 75 are more likely to be current with colon screenings (78.4 percent) than adults aged 50 to 65 (61.8 percent) (Source: Center for Disease Control).

Why Colon Cancer is Common in US

Colon cancer rates in the United States continue to be high because of unhealthy lifestyle choices. Our high-fat/low-fiber diet coupled with a sedentary lifestyle puts Americans at risk for obesity, diabetes, heart disease, and colorectal cancer. Smoking and alcohol use also significantly increase cancer risk, as well as eating red and processed meats. 

How to Lower Colon Cancer Rates in US

We can reduce the number of new cases of colon cancer through education and screening. Americans need to know that colorectal cancer is a real threat and take active steps to prevent it.  Because young-onset colon cancer is increasing, the American Cancer Society now recommends baseline colon screenings at age 45 instead of 50  for men and women at average risk for colon cancer. If you are African American or have a family or personal history of colon polyps or colon cancer, you should get screened earlier.

Prevent Colon Cancer with Colonoscopy

Colonoscopy is the gold standard for colon screening because it is the only test that can prevent colon cancer. During a colonoscopy, your gastroenterologist can remove precancerous polyps so they can’t develop into cancer.

A preventable cancer shouldn’t be the third-leading cause of cancer death in the United States. Tell your family, friends and loved ones about the importance of getting a colonoscopy. It’s truly a life-saving exam.

Do you ever feel like your brain is overloaded with stuff you need to remember? An efficient memory is an important component of well-being and happiness, so it’s definitely worth our effort to find ways to boost our recall memory.

The Second Brain: Gut and Memory

Studies show that the gut makes most of the important chemicals that affect memory. Often called “the second brain,” the gut houses the largest colony of microorganisms that regulate digestion, immunity, vitamin production and, yes, memory. Maybe that’s why we always talk about having a “gut feeling” about someone or about how “something in our gut” steered our decision.

Probiotics Benefit Brain Function

Probiotics are the beneficial yeast and bacteria in the gut that keep you healthy, and research shows that probiotics are responsible for making most of the body’s serotonin that sends messages and chemicals to the brain. So, it’s safe to say that you can’t have a keen memory without a thriving gut. 

In a recent study, participants took probiotics for four weeks and a placebo for four weeks. They scored higher on memory tests and reported less anxiety and stress while taking probiotics than when taking placebo.

Probiotic Balance

If you’ve got a “gut feeling” that your memory is declining, you can add probiotics to your diet to boost your gut health. The delicate flora of your gut can easily be disrupted by stress, illness, poor diet or contaminants in food. Another disrupter of a healthy gut is antibiotics. Taking antibiotics can eliminate a large percentage of the good bacteria in your system, so it’s important to restore the balance with a diet that’s high in probiotics.

Foods like yogurt, kefir, sauerkraut, kombucha, tempeh, miso, pickles, sourdough bread, kimchi and even dark chocolate are full of probiotics. You might notice that many of these foods are pungent or sour, and that’s  because they’re fermented. The fermentation process exponentially increases the number of probiotics in foods, so look for products that boast “trillions of live cultures.” Incorporating these foods into your diet will enhance your memory, boost immunity and improve digestion (Hyperbiotics).

Talk to your doctor about how your body – and mind – can benefit from probiotics. Before changing your diet, get approval from your physician so you can make the best decisions for your health.

June is National Cancer Survivor Month, a time to celebrate the 15.5 million Americans who are currently in treatment for cancer, as well as those who have finished treatment and are cancer-free.

Gastrointestinal Cancer

With the advancement of modern medicine and surgical techniques, there are more cancer survivors today than ever before. But there is still an urgent need to increase awareness of gastro-intestinal (GI) cancers.

GI cancers include cancers of the esophagus, gallbladder, liver, pancreas, stomach, small intestine, colon, rectum and anus. Overall, cancers and deaths from cancer involving the GI system outnumber those of any other system in the body.

Colon Cancer: A Preventable Disease

Colon cancer is the most common of the GI cancers. Colon cancer is the third-leading cause of cancer death among men and women in the U.S., affecting one in every 20 individuals. It is estimated that there will be 97,220 new cases of colon cancer during 2018 (American Cancer Society).

Although colon cancer is preventable through routine colonoscopies, one of every three eligible Americans is not being screened. This increases the risk of advanced stage colon cancer which is challenging to treat and is associated with poor outcomes.  

Schedule a Colonoscopy to Prevent Colon Cancer

During National Cancer Survivor Month, schedule a colonoscopy if you are due for a screening. Adults who are at average risk for colon cancer should get a baseline colonoscopy at age 50, but certain risk factors could indicate a need for early screening. These include being African American or having a personal or family history of polyps or colon cancer.

Talk with your doctor about your personal risk for colon cancer and the right time for you to have a colonoscopy. Then, encourage friends and loved ones to be screened. Colonoscopies are not only used to diagnose cancer – they are used to prevent and treat cancer as well. Help spread the word that screenings save lives.

Osteoporosis medication helps prevent bone loss, but it could also harm the esophagus. A recent study suggests that oral bisphosphonates could irritate esophageal tissue and increase risk of esophageal cancer.

Bisphosphonates May Increase Cancer Risk in Women

Bisphosphonates are a class of drugs called anti-resorptives that are prescribed to prevent the loss of bone mass. Oral bisphosphonates include risedronate sodium (Actonel), ibandronate sodium (Boniva), and alendronate sodium (Fosamax). There are also bisphosphonates that can be delivered intravenously (through an IV), such as zoledronic acid (Reclast).

The bisphosphonate study, co-authored by Matthew Drake, M.D., Ph.D., examined data from women in the United States and Great Britain and noted a marginal increase in esophageal cancer. According to the results, the increase in risk is low, but it does merit attention.

Esophageal cancer accounts for only one percent of cancers in the United States, and it affects more men than women. The lifetime risk of esophageal cancer in the United States is 1 in 455 in women and 1 in 132 in men (Cancer).

3 Facts About Osteoporosis Medication

Oral bisphosphates have only been available for a decade, so it is still early for researchers and physicians to formulate conclusions. If your doctor is encouraging you to take bisphosphates for osteoporosis, keep these facts in mind as you make your decision:

1. You can request intravenous treatment to prevent bone loss. Elevated cancer risk was only associated with oral bisphosphonates. Consider asking for IV bisphosphonates in the form of zoledronic acid (Reclast).
2. Other risk factors for esophageal cancer can increase complications for those taking bisphosphonates. If you have difficulty swallowing or have structural abnormalities in your esophagus, you should be cautious about taking medication that could cause further irritation. Anyone with Barrett’s esophagus should avoid oral bisphosphonate medication.
3. Occasional heartburn or reflux does not put you at increased risk. Suffering from indigestion every now and then is normal and does not increase your risk for esophageal cancer by taking oral bisphosphonate medication (Everyday Health).

If you are concerned about how medication may affect your GI health, make an appointment with a gastroenterologist. Talk with your doctor to determine whether osteoporosis prevention medication is right for you.

Heartburn medications like proton pump inhibitors (PPIs) should not be taken for longer than two weeks at a time, but post-menopausal women should be especially cautious with reflux medicine. Studies show that extended use of PPIs could put women at risk for hip fractures. Since May is Women’s Health Month, let’s take a moment to focus on how these medicines can affect gastrointestinal health and bone health in women.

Pros and Cons of Proton Pump Inhibitors

PPIs like Nexium, Prevacid, Prilosec and Protonix are among the most powerful heartburn medications available without a prescription. They reduce the amount of acid produced by the stomach and are highly effective in treating gastroesophageal reflux disease (GERD), peptic ulcers, erosive esophagitis, and a precancerous condition known as Barrett's esophagus.

At first glance, PPIs seem to be the perfect solution for heartburn. They are effective, cheap and easy to obtain. But reducing stomach acid can cause serious health risks – like malabsorption of calcium, which can be particularly dangerous for post-menopausal women. Other side effects of PPI use include C. difficile infections, which can cause chronic diarrhea and pneumonia; low magnesium levels, which can cause muscle spasms; heart palpitations and convulsions.

Hamed Khalili, M.D., of Massachusetts General Hospital in Boston, found that long-term use of PPIs may increase fracture risk by 35 percent in older women and by up to 50 percent in smokers. Risk increased with longer PPI usage, but risk disappeared after women stopped taking PPIs for two years (Women’s Health Research Institute).

PPIs are not considered harmful to everyone, however, but it is important to take them as directed. You may find that a less potent acid reducer like an H-2 blocker (Pepcid, Zantac or Tagamet) works just as well, but first, consider changing your eating and lifestyle habits.

Home Remedies for Heartburn

Treating your heartburn may be as simple as making lifestyle modifications like:

• Eating smaller meals
• Eating at least two hours before bedtime
• Quitting smoking
• Avoiding alcohol
• Decreasing caffeine
• Wearing loose-fitting clothing
• Avoiding heartburn trigger foods
• Losing weight, if necessary  

 A GI Specialist Can Help

Make an appointment with a gastroenterologist to discuss how you can manage your heartburn without sacrificing your bone health. Ask about your risk for fractures and get a bone density scan if your doctor suggests it. Don’t forget to get enough calcium, vitamin D and exercise, and you’ll be on your way to bone strength and digestive health.

Preventing heartburn can seem like a Catch-22. Excess weight can aggravate heartburn symptoms, so you exercise to lose weight. But exercising can also make heartburn worse. Sometimes, it feels like you just can’t win!

You might feel like giving up, but don’t. Studies show that losing just five to ten percent of your excess weight can significantly reduce acid reflux (GERD) and heartburn. Gaining weight, on the other hand, can increase heartburn symptoms by as much as 300 percent. So it’s worth it to find an exercise plan that works for you and won’t exacerbate your heartburn.

Ladies, it’s time to focus on your physical, mental and emotional fitness. As we age, exercise becomes more important than ever. You may have noticed that you have lost muscle tone or that you are carrying more weight around your middle. This added weight can put pressure on the valve between your esophagus and stomach and cause reflux.

It is essential to incorporate physical activity into your schedule, but be patient as you determine which activities don’t cause reflux. Here are five tips for heartburn-safe exercise:

1. Treat acid reflux before it starts. If you tend to experience heartburn every time you exercise, take an antacid before working out.
2. Pre-hydrate. If you get dehydrated during exercise and drink large gulps of water, it could trigger acid reflux. Drink moderate amounts of water throughout the day and only take tiny sips during your workout.
3. Choose low-impact activities. Start with simple, fluid activities like walking, cycling or using the elliptical machine. Avoid activities that jostle the stomach like running, tennis or interval training.
4. Avoid inverted positions. Yoga can seem like a gentle activity, but stretches like downward-facing dog or swan dive can cause reflux. Opt for upright yoga poses.
5. Avoid eating one to two hours before your workout. If your stomach is empty, you will be less likely to experience reflux.

If you are just beginning to add exercise into your daily routine, talk to your doctor. It is always a good idea to ensure your workout plan is appropriate for your fitness level.