The Colonoscopy: A Historical Timeline

As we approach the end of this year’s Colorectal Cancer Awareness Month, let’s take a closer look at something near and dear to our hearts: the colonoscopy. 

As the only screening test that detects and prevents cancer, the best test for finding precancerous polyps, and the only test recommended for people with risk factors such as personal history of polyps or cancer, the colonoscopy is truly a life-saving resource. Over 15 million colonoscopies are performed across the United States each year, reducing the widespread risk of colorectal cancer death by over 60%.

However, despite the colonoscopy’s widespread use and unequivocal standard of effectiveness, it is actually a fairly new methodology, one that took decades to be widely-known and well-established. While variations of the colonoscopy were first conceptualized throughout the 1960s, it wasn’t until the last few decades that the standards of quality which govern the colonoscopy as we know it came to be.

Follow along for a deep-dive into our favorite colorectal cancer screening test. 

1960s-70s: The Early Years

Up until the mid-1960s, the closest thing to a colonoscopy was an endoscopic procedure using a rigid sigmoidoscope. This device had very limited movement, reach, and was unable to actually remove polyps. 

In 1969, colleagues Dr. William Wolff and Dr. Hiromi Shinya of Beth Israel Medical Center in New York City invented the fiberoptic colonoscope, the first device to allow doctors to actually examine the entire length of the colon, thanks to its flexible, dynamic design.

Dr. Shinya also invented the polypectomy snare in 1969, a device which was able to physically remove colorectal polyps using a wire and electro-cauterizing mechanism. 

By 1973, the pair had performed over 5,000 colonoscopies, demonstrating the validity and safety of the procedure. 

1980s-90s: Increasing Awareness

In 1983, the Welch Allyn Corporation invented the first video endoscope, allowing doctors to see the procedure on-screen. Before, they were only able to observe the colon through a small eyepiece. 

Although the colonoscopy continued to develop, there was still a lack of general public accessibility and awareness towards the procedure. Many people opted for tests such as fecal occult blood testing and sigmoidoscopy. It wasn’t until 1985, when President Ronald Reagan underwent a life-saving colonoscopy, that the procedure began to garner national attention. 

In the mid-90s, the first screening recommendations were established in the United States. Adults over the age of 50 were suggested to receive regular colonoscopies. However, in a 1999 survey conducted by the CDC, only 40.3% of American adults over the age of 50 reported ever having a colonoscopy or sigmoidoscopy.  

2000-Now: New Developments

In 2000, the American Society for Gastrointestinal Endoscopy (ASGE) published the first colonoscopy guidelines. This seminal work allowed the quality of a colonoscopy to be measured with a numeric value, the Adenoma Detection Rate (ADR) as well as evaluate measures such as the quality of bowel preparation, patient assessments, rate of complications, cecal intubation rate, and withdrawal time. Doctors were finally able to be pragmatically evaluated for their ability to perform a colonoscopy. 

The early 21st century saw a significant increase in colonoscopies. Self-reported colonoscopies across the United States increased from 20% in 2000 to 47% in 2008. This can be contributed to many factors: a variety of educational campaigns and visibility measures pushed by doctors, government, and public organizations; Medicare coverage of colonoscopy, beginning in 2001; even celebrity stunts such as the Today Show’s Katie Couric’s publicized colonoscopy.

From 2000 to 2015, colon cancer rates rose considerably across increasingly younger populations. For adults aged 40-44, colorectal cancer incidence increased by 28%, for those aged 45-49, colorectal cancer increased by 15%, and while colonoscopy rates increased 17% in those aged 50–54. 

Rising colorectal cancer rates have led to efforts such as the U.S. Preventive Services Task Force’s 2020 recommendation that all adults aged 45-75 should be regularly screened. This was an update from the 2016 guidelines that suggested adults without risk factors should begin screening at the age of 50.

What is the future of the colonoscopy?

The colonoscope of the present remains largely unchanged from that first created by Dr. Wolff and Shinya in 1969. While it has developed in mechanical quality, such as flexibility and control, and now features a light source, suction device, lens cleaning, and a camera, it doesn’t really vary in its fundamental use: to observe and remove colorectal polyps, acting as both a diagnostic and therapeutic instrument. Why is this the case? Likely because it is highly effective at what it does! 

With this in mind, the most important development concerning colonoscopies, arguably, is in the public sphere. While the mechanisms of the procedure itself will undoubtedly continue to evolve and innovate, it’s important to consider the future of public access and opinion towards the colonoscopy.

There is still a surprising amount of misconception surrounding the colonoscopy. A 2020 survey of several European countries found that only 45% of people understood that it can prevent colon cancer. In the United States (pre-pandemic), around 68.8% of adults were up-to-date with their colonoscopy. Many people remain uninformed, fearful, and resistant to receiving the  life-saving screening test. Other people are limited by financial means or geographic accessibility to the procedure. 

By working to increase public awareness around the value of the colonoscopy, we can continue to prevent and reduce colorectal cancer deaths around the world. By educating your friends and loved ones about the importance of colonoscopy, partaking in events such as #DressInBlueDay and National Colorectal Cancer Awareness Month, getting involved with organizations like the Colon Cancer Coalition, and getting screened, yourself, you can help promote widespread change. 

See new infographics created by the Digestive Health Physicians Association below. To read stories about people’s experiences with colonoscopies and colorectal cancer, click here. To see our favorite online resources for promoting awareness, click here. To learn more about what exactly colorectal cancer is, click here.

The colonoscopy a historical timelineColorectal screening tests

An Overview of Colorectal Cancer Screening Tests

March is National Colorectal Cancer Awareness Month, an important time to spread awareness and learn more about the risks associated with colorectal cancer.

Colorectal cancer is one of the most common forms of cancer and the second-leading cause of cancer deaths in the world. In the United States this year, an estimated 151,030 adults will be diagnosed with colorectal cancer and ​​an estimated 52,580 will die from the disease. 

Despite its significant rate of incidence, colorectal cancer is highly preventable through the use of screening tests. Gastroenterology Health Partners, in conjunction with the American Cancer Society and Digestive Health Partners Association, recommends that those with an average risk start screenings at age 45. 

Of the colorectal cancer screening tests that we offer, colonoscopy remains the gold-standard of effectiveness and is strongly suggested for anyone eligible. Observational studies have suggested that colonoscopy can reduce colorectal cancer occurrence by 40% and mortality rates by 60%. 

If you’re considering scheduling a screening test, talk to an experienced gastroenterologist. They can help you make the right decision for your needs. 

Keep reading to learn about six commonly-offered colorectal cancer screening tests.

6 Common Colorectal Cancer Screening Tests

1. Colonoscopy

As mentioned above, the colonoscopy is the best diagnostic tool available. This out-patient procedure involves the use of a thin, flexible tube with a camera to exam the lining of the colon (large intestine) for abnormalities such as polyps. Some polyps can be removed with a scope during the procedure. Your doctor may also take tissue samples for analysis as well.

While the colonoscopy does require prep and recovery time, it is a fast, virtually risk-free procedure. Afterwards, your doctor will discuss your results with you and recommend whether you should be screened in 1, 5, or 10 years. To learn more about the colonoscopy, how it works, how to prepare, and more, read here

2. Fecal immunochemical test (FIT)

Often considered the second choice after a colonoscopy, the fecal immunochemical test (FIT) offers a non-invasive method for identifying colorectal cancer. The test, often performed at home, tests for hidden (occult) blood in the stool. This unnoticeable blood is often an early-sign of colorectal cancer. 

If you test positive for hidden blood during a FIT test, your doctor will want to perform another test, most likely a colonoscopy. FIT, unlike colonoscopy, is unable to actually identify or remove polyps and abnormal tissue. Therefore, the FIT is not really a viable “preventative” test and has a much lower accuracy rate. 

3. CT Colonography

The CT Colonography is also known as a “virtual colonoscopy.” This test uses a CT scan (a form of x-ray technology) to exam the colon for polyps. A small scope is inserted slightly into the colon to inflate it with air. Then, pictures are taken of the entire colon. The CT Colonography is highly effective, and, unlike a colonoscopy, it doesn’t require sedation. However, unlike a colonoscopy, this exam doesn’t actually remove precancerous polyps, it only can identify them.

4. Cologuard

Cologuard is another non-invasive, at-home colon screening test. Much like the FIT test, it looks at stool DNA samples. While Cologuard is generally more effective than FIT, it still doesn’t compare to the effectiveness of the colonoscopy–while colonoscopy is known to identify over 70% of precancerous polyps, Cologuard only identifies around 42%.

5. Flexible Sigmoidoscopy

A flexible sigmoidoscopy is a comparable procedure to the colonoscopy. It is an exam of the lower part of the colon using a small, flexible, lighted tube. The tube, called a flexible sigmoidoscope, has a camera which allows the doctor to view the inside of the rectum and the sigmoid colon—about the last two feet of the large intestine. Unlike a colonoscopy, this procedure does not allow the doctor to see the entire colon; any cancers or polyps far in the colon cannot be detected. 

6. Capsule Endoscopy

A capsule endoscopy is a procedure that examines the lining of the middle part of the small intestine, the duodenum, jejunum and ileum. This procedure is necessary because a standard endoscope or colonoscope cannot reach this part of the bowel. Capsule endoscopy is often used to search for causes of bleeding as well as detect polyps, tumors, ulcers, and IBD.

During this procedure, the patient will swallow a tiny pill containing a video camera, light source, and battery. The camera will take 2-3 pictures per second for up to 12 hours, traveling through the GI tract. The photos are saved automatically to a recording device and strung into a video. 

While capsule endoscopy is effective for detecting and documenting significant lesions attributed to conditions such as IBD, tumors, and ulcers, it is significantly less effective as a colon screening test compared to colonoscopy. 

 When it comes to colon cancer screenings, the experienced medical team at Gastroenterology Health Partners is here to serve you. To learn more about our services or to schedule an appointment at one of our offices in Southern Indiana or Kentucky, contact a Gastroenterology Health Partners location near you.

Managing GERD Through Diet: Foods To Seek Out and To Avoid

We’ve all felt it after eating–that burning, uncomfortable feeling in the chest. Maybe you know it as heartburn, indigestion, or acid reflux. While just about everyone experiences this sensation once in a while, there’s actually a significant number of people who suffer from it often. In fact, about 20% of the United States population experiences symptoms of chronic acid reflux, also known as gastroesophageal reflux disease (GERD). Besides being unpleasant and frustrating, GERD can lead to serious complications such as esophagitis or Barret’s esophagus

At this time, there is not a singular commonly-recognized cause of GERD. While some research associates it with obesity, smoking, certain medications, being pregnant, or genetic predisposition, it can really happen to anyone. Symptoms, besides heartburn, include nausea, pain or difficulty swallowing, regurgitation (when gastric contents re-enter the mouth or throat), burping, and a chronic cough. Symptoms of more serious complications from GERD can include loss of appetite, vomiting, blood in vomit or stool, increased pain or difficulty when swallowing, asthma, poor sleep, and weight loss. 

Common Treatments for Gastroesophageal Reflux Disease (GERD)

If you’re diagnosed with GERD, you do have options for treatment. There are a variety of recommended over-the-counter and prescription medications that can neutralize or reduce stomach acid production. For those who wish to avoid long-term medication use, there are surgical options available as well.

Making certain lifestyle and dietary changes are considered essential to reduce symptoms of GERD. Slowing down the speed of eating, avoiding lying down right after eating, keeping your head elevated in bed, and avoiding tight clothes that put pressure on your chest or stomach are all said to improve symptoms for some. 

Foods To Limit Or Avoid If You Are Experiencing GERD

There are certain foods that are recommended for you to avoid if you have GERD. These foods can trigger or worsen symptoms of the disease. These include:

  • Tomatoes
  • Caffeine
  • Acidic fruits, like oranges, lemons, and limes
  • Spicy foods
  • Mint
  • Chocolate
  • Onion
  • Alcohol
  • Carbonated drinks
  • Garlic
  • High-sugar or high-fat foods
  • Fried or processed foods
  • Lactose, if you are lactose-intolerant

Foods To Incorporate Into Your Diet If You Are Experiencing GERD

On the other hand, there are certain foods that are often “safer” to consume for those experiencing GERD. These can include:

  • Non-citrus fruits, like apples, bananas, or melons
  • Oatmeal, brown rice, and whole grains
  • Root vegetables like potatoes or turnips
  • Water-dense vegetables like cucumber or celery
  • Low-acidic vegetables
  • Water and tea
  • Lean meats or fish

Of course, each person’s experience with acid reflux and GERD is unique. Foods affect each of us differently, so it’s important to monitor how you feel after consuming certain meals. Keeping a journal or notes tab on your phone of what “triggers” your symptoms can be a useful tool for you and your doctor. If you experience symptoms of GERD, the most important thing is to seek medical care–don’t self-diagnose or try to manage symptoms on your own. 

If you are suffering from chronic gastroesophageal reflux disease, the experienced team at Gastroenterology Health Partners is here for you. Our clinicians have a passion for seeking out and refining new treatments and advanced solutions for those suffering from disorders of the digestive system. For more information or to schedule a gastroenterological medical evaluation, contact a Gastro Health Partners location near you.

 

Can Weight Loss Reduce the Risk of Colon Cancer?

Obesity is an epidemic in the United States. In 2018, 42.4% of American adults were found to be obese, an increase of over 12% since 2000. In 2020, 36.6% of adults in Kentucky and 36.8% of adults in Indiana were found to be obese.

Obesity is associated with an increased mortality rate as well as a variety of negative health conditions, such as type 2 diabetes, heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, and certain types of cancer. Obesity can impact your quality of life, harming mental health as well as physical. What’s more, obesity costs the American public over $150 billion in medical bills each year. 

How is Obesity Calculated? An Overview of BMI

Obesity is determined by BMI, or “body mass index,” a measurement of weight status based on height and weight. For adults, a BMI of less than 18.5 is underweight, a BMI of 18.5 – 24.9 is healthy weight, a BMI of 25.0 – 29.9 is overweight, and 30.0 and above is obese. You can measure your BMI using this online calculator created by the CDC. 

Being obese, or having a BMI of 30.0 and above, has been considered a risk factor of developing colorectal cancer for years. However, few studies to date have examined the effects of weight change, such as significant weight loss or gain, on the risk of developing cancer. 

The Latest Research on the Health Benefits of Weight Loss

A new study conducted by researchers at the University of Maryland found that weight loss may greatly reduce the risk of developing precancerous polyps (adenomas). They examined the effects of weight loss and weight gain throughout several periods of adulthood for 154,942 American adults. For those who were initially overweight and lost weight over time, the risk of developing certain types of adenomas was reduced by 46%. For those who gained weight in adulthood, the risk of developing adenomas was increased by 30%. Interestingly, these findings were generally more statistically significant in men than women. 

Why is obesity associated with higher risk of developing adenomas? One factor, as discussed by Dr. Kathryn Hughes Barry, a co-author of the study, is insulin resistance. Insulin resistance is associated with obesity. “[Insulin resistance] can increase cell growth and reduce the chance of cell death, changes that are linked with increased chances of developing cancer. Insulin resistance may also lead to type 2 diabetes, which is considered an independent risk factor for colorectal cancer.” 

In addition to reducing the risk of developing precancerous polyps, losing weight in adulthood can improve your energy levels, physical mobility, general mood, and self-confidence, according to CDC data. Even modest weight loss can result in positive health benefits, such as improved blood pressure and cholesterol levels. If you are interested in learning our tips for healthy weight loss, watch this informative video featuring Dr. Sunana Sohi of Gastroenterology Health Partners or check out the CDC’s step-by-step guide to healthy weight loss here.

In addition to maintaining a healthy weight, getting a regular colon cancer screening is another important practice in the prevention of colon cancer. When it comes to colon cancer screenings, the experienced medical team at Gastroenterology Health Partners is here to serve you. To learn more about our services or to schedule an appointment at one of our offices in Southern Indiana or Kentucky, contact a Gastroenterology Health Partners location near you.

 

2022 Bottoms Up Bash

Gastro Health Partners is proud to sponsor the 11th Annual Bottoms Up Bash! This exceptional event, put on by the Colon Cancer Prevention Project, is a celebration of progress in the fight against colon cancer and an opportunity to raise crucial funds for ending preventable colon cancer death and suffering in Southern Indiana and Kentucky.

What is the Colon Cancer Prevention Project?

Here’s some more information about the CCPP’s mission and work:

“The Colon Cancer Prevention Project founded in 2003 by Dr. Whitney Jones, a Louisville gastroenterologist with a passion for preventing colon cancer. Dr. Jones began the organization after diagnosing several patients with colon cancer within one week. Sick and tired of diagnosing patients with cancer that could have been prevented, he set out to make a change.

The Project began as a small grassroots organization with a large mission of eliminating preventable colon cancer death and suffering. It quickly grew to include work across Kentucky, Indiana, and the country. Before the Project, only 1 in 3 Kentuckians were getting life-saving colon cancer screenings. Now, about 2 in 3 Kentuckians are getting screened, and the incidence rate is down more than 25 percent. Kentucky is now nationally renowned for its work, which includes a state-wide screening program for low-income, uninsured people.

We are committed to educating our communities younger about the power they have to prevent colon cancer. The United States Preventative Services Task Force now recommends average-risk people begin screening at age 45 and those with a family history should screen at 40 or younger. With the help of partners across the state and WKYT, the Project is launching first-of-its-kind digital outreach campaigns to educate & empower our communities to get screened by reaching them on their phones and devices.

We continue to work to make screening more accessible to those who are uninsured and underinsured in our community by promoting free screening resources available through Kentucky Cancer LinkKentucky Cancer Program, and the Kentucky Colon Cancer Screening and Prevention Program.

The Bash is Back!

The 2022 Bottoms Up Bash will feature dinner, drinks, dancing, live music by the Crashers, and a silent auction. The event is on March 4, or Dress in Blue Day, and guests are encouraged to dress in their brightest blue to help kick off Colon Cancer Awareness Month. (Note: Event is ages 21+).

“All funds raised will go towards ending colon cancer death and suffering in Kentucky and Southern Indiana. We can’t wait to see you there!” 

Learn more about this great event and buy tickets here: https://coloncancerpreventionproject.org/events/bottoms-up-bash-2021/

2022 Bottoms Up Bash is Sponsored by GHP

 

 

 

 

 

 

 

Gastroenterology Health Partners (GHP) is the largest independent Gastroenterology practice in the region providing care to children, teenagers, and adults across Louisville and Lexington, Kentucky, Southern Indiana, and surrounding communities. GHP has officially endorsed the Digestive Health Partners Association’s message that men and women between the ages of 45 and 75 should be screened for colorectal cancer. This endorsement is backed by the American Cancer Society which also recommends that individuals at average-risk of contracting colorectal cancer begin screenings at the age of 45. 

Our experienced team at GHP has years of experience performing colonoscopies and other colorectal cancer screenings. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

What is Adenoma Detection Rate (ADR)?

For decades, the screening colonoscopy has been recognized as the most effective modality to prevent and detect colorectal cancer. By identifying and  removing precancerous polyps (adenomas), colonoscopies save thousands of  lives each year. Regularly-scheduled screening colonoscopies are crucial for  adults aged 45 and older.  

However, it’s important to note that the effectiveness and quality of each colonoscopy varies from doctor to doctor. Different levels of education,  experience, and methodologies have been found to influence the “success” of a medical practitioner at performing screening colonoscopies. These case-by-case disparities ultimately led to a need for a standard of quality, a numerical  framework. In 2002, a Multi-Society Task Force was assembled to create just that: the adenoma detection rate, or ADR. ADR gives a percentage value to  each doctor’s levels of safety, quality, and thoroughness when performing a  colonoscopy.  

How does ADR work? ADR measures the average rate of precancerous polyps that a doctor identifies and removes in each colonoscopy. In the U.S., it has been  established that at least 30% of men and 20% of women aged 50+ should have  one or more adenoma found in a colonoscopy. It has been found that doctors  that meet or exceed these national quality benchmarks are generally more likely to prevent colorectal cancer, including advanced-stage or fatal cancer. In fact, even a marginally higher ADR can indicate a significant improvement in outcome. Likewise, doctors with lower-than-average ADRs have been connected with the  failure to identify cases of colorectal cancer.  

While the ADR is considered the “gold-standard” of evaluating endoscopic quality, it is not the only measure of a doctor’s ability to identify polyps. Other well-regarded quality metrics include practices such as: the quality of bowel  preparation; patient assessments; compliance rates with general screening  guidelines; rate of complications; cecal intubation rate; withdrawal time (the  amount of time a doctor should spend withdrawing the colonoscope at the end of  the procedure, which should be at least 6 minutes); and documentation of  informed consent. 

By meeting and exceeding these standards of safety and thoroughness, your doctor directly improves your chance of identifying or preventing colorectal  cancer. Therefore, it’s not rude or uncommon to ask about your doctor’s ADR,  withdrawal time, or other procedures that ensure a quality colonoscopy. These  are serious, relevant questions that can aid in your decision to choose a gastroenterologist.  

Our board-certified team of gastroenterologists has addressed many common concerns related to colonoscopies on our website. Click on any of the questions below to see complete answers: 

  1. When should I get a colonoscopy? Isn’t 45 too young?
  2. What should I expect from my colonoscopy? How should I prepare for it? What happens during and after?
  3. Where can I read about someone else’s experience with colon cancer? 
  4. I tend to be constipated. How should I prepare for my colonoscopy?
  5. Why should I get a colonoscopy instead of other screening tests? What makes it more effective? (Video)
  6. What’s the difference between a screening colonoscopy, Cologuard, and other screening tests? (Video)

The experienced team of medical professionals at Gastroenterology Health Partners is committed to making every patient’s experience with a colonoscopy as easy and effective as possible. For more information or to schedule an appointment, contact Gastroenterology Health Partners today at a location near you.

The Gluten Free Diet: Bad or Good?

Diet is known to affect the gut microbiome, the ecosystem of helpful bacteria that lives in our stomach and intestinal tract. Certain foods can promote diversity and multitude of “good” bacteria, improving energy metabolism, boosting immune response, reducing inflammation, and affecting many other areas of physical and mental health. 

Gluten, a wheat protein naturally occurring in rye, farro, barley, oats and other grains, is found in hundreds of popular foods, from pasta, to beer, to salad dressing, to candies. For those with a gluten intolerance, gluten can harm the gut microbiome, increasing inflammation and damaging the intestinal tract. Others report having a “gluten-sensitivity,” which is accompanied by stomach pain, diarrhea, bloating, and cramping. 

The gluten-free diet has gained enormous traction in recent years, not just as a treatment for chronic gluten-intolerances such as celiac disease or wheat allergies, but as a way to lose weight and be healthier. In a survey conducted by the Consumer Reports National Research Center, 63% of Americans thought that following a gluten-free diet would improve physical or mental health and 25% thought that gluten-free foods were higher in vitamins and minerals. For many, a “gluten-free” label has become synonymous with healthfulness. 

Unfortunately, food retailers have weaponized this phenomenon by using the nutritional authority of the “gluten-free” label to sell products that aren’t necessarily healthier, at higher prices. This infographic by Consumer Reports compares products with and without gluten. Gluten-free products often have more calories, sugar, sodium, and fat, as well as less beneficial nutrients like fiber and protein. Wheat flour, which contains gluten, is often replaced with rice flour and other less-nutritional alternatives. 

While the widespread accessibility of gluten-free products has been life-changing for those with gluten-sensitivities, the influx of processed, less-nutritional gluten-free foods has arguably been harmful for many. Like other food trends, the gluten-free diet should be approached with mindfulness and skepticism. 

Is The Gluten-Free Diet Right For You?

For those suffering from celiac disease, a gluten sensitivity, gluten ataxia, a wheat allergy, IBD, or another condition tied to gluten-intolerance, a gluten-free diet is crucial for managing symptoms. If you suspect that you may be suffering from a gluten-related medical condition, consult a doctor for testing. Diagnosing yourself, or choosing to eat totally gluten-free for weight loss without consulting a nutritionist is not recommended. Receiving adequate nutrients on a gluten-free diet can be difficult for many. 

For those of us who don’t suffer from a gluten-related medical condition, gluten is recommended in moderation. Ultimately, avoiding processed foods is far more effective than cutting out gluten altogether. As discussed, many gluten-free products are highly-processed and can be harder to digest, less nutritional, and harmful for the gut microbiome. Consuming more naturally-occurring gluten-free foods, such as fruits, vegetables, legumes, certain whole grains, fish, dairy, and meat, is the best way to cut out gluten, get plenty of vitamins and minerals, and avoid sneaky branding. 

As with any medical condition, it is always best to seek assistance from a qualified medical professional if you are experiencing symptoms that are causing you difficulty. If you need a gastroenterologist in Southern Indiana, or in the Louisville or Lexington Kentucky-area, contact Gastroenterology Health Partners today for more information or to schedule an appointment.  

 

Popular Food Emulsifier Found To Harm Gut Microbiome

While you probably haven’t heard of carboxymethylcellulose (CMC), you’ve definitely eaten it. As the most widely-used cellulose-based emulsifier in the world, CMC is found in almost every type of processed food. And, unfortunately, new research has connected CMC to a range of negative gastrointestinal symptoms. 

What is CMC?

CMC is a stabilizing and thickening agent used in food and nonfood products, including ice cream, milk, fruit juice, toothpaste, detergents, water-based paints, chewing gum, dye, protein drinks, laxatives, and many more processed items. Its use is extensive and fair-reaching, from adding bulk to ketchup to acting as a viscosity modifier in the oil industry.

CMC’s makeup is what has made it so versatile and popular. Considered nontoxic and hypoallergenic, the highly viscous (thickening) substance is derived from cellulose, an organic compound. It easily absorbs/retains water and is clear, tasteless, and colorless. It is known as an emulsifier, a ubiquitous agent used to improve the experience and longevity of food. While it has no nutritional value and cannot be digested by humans, it has long been considered safe to consume. 

In fact, CMC has been used in the food industry since the 1960s. It is generally used in the production of baked goods, since its calorie-free and gluten-free. It is also used as a “texture enhancer,” creating a thicker, creamier “taste experience” in many sauces, jams, and even sausages. On labels, CMC may also go by the name of sodium carboxymethyl cellulose or sodium CMC. 

The Truth About CMC 

Clinical research published in Gastroenterology Journal this past November 2021 found important new insights into the impact of CMC on gut health. In this randomized controlled-feeding study, a group of healthy volunteers were either subjected to a CMC-free diet or a diet with CMCs. Research found that those who consumed CMCs experienced stomach pain, loss of gut bacteria diversity, loss of short-chain fatty acids and amino acids, and symptoms associated with IBD and gut inflammation. 

This isn’t the first study to find fault in CMC, or emulsifying agents in general. In 2015, a study published in Nature found a direct connection between dietary emulsifiers and low-grade inflammation, changes in gut microbiota, obesity/metabolic syndrome, and colitis in mice. 

The findings of both studies can suggest that the widespread use of emulsifying agents like CMC may directly correlate to the rise in IBD (irritable bowel disease), colon cancer, and chronic inflammatory conditions in human populations. By altering the composition of the gut microbiome and number of metabolites present, these agents cause chronic, lasting detriment to gut function and health. 

Beyond suggesting a need to study the effects of CMC and other emulsifiers more extensively, this study “provides a general blueprint to carefully test individual food additives in humans in a well-controlled manner,” according to co-senior author Dr. James Lewis of the University of Pennsylvania. Indeed, this study has highlighted the necessity for large-scale research into the assembly of processed foods, especially components long-believed to be safe and nontoxic, like CMC. 

If you are suffering from symptoms of a GI condition, the experienced team of medical professionals at Gastroenterology Health Partners is here for you using the most advanced treatment options available. We strive to provide the highest quality, most cost-effective GI care in the region. For more information or to schedule an appointment, contact Gastroenterology Health Partners today at a location near you.