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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.

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.

Types of Hemorrhoids: An Overview

Hemorrhoids occur when veins in your rectum dilate and become swollen. Blood pools in the swelling veins, making your veins stretch into your rectal and anal tissue membranes. Often times hemorrhoids can feel quite uncomfortable. While you can’t always see or feel a hemorrhoid, when they fill with blood and enlarge, they can look and feel like a small knob or lump.

Hemorrhoids are extremely common, affecting millions of people across the United States. In fact, the vast majority of people who have hemorrhoids do not even know they have them. While a small number of people have symptoms, an even smaller amount seeks out treatment. 

What Causes Hemorrhoids?

While doctors often do not know why certain people end up having hemorrhoids, many people end up with them following an increase in pressure on the veins in the rectum area. Things that may cause this type of pressure include:

  • Constipation followed by straining during bowel movements
  • Sitting on the toilet for extended periods of time
  • Diarrhea and overuse of laxatives
  • Pregnancy (when the baby puts pressure on your veins, or while pushing during childbirth), and 
  • Sitting for extended periods of time during long air flights, road trips, or in office work environments that are highly sedentary. 

Hemorrhoids tend to be more likely if you do not get enough fiber in your diet, and if you are overweight. They are also more common with age.

The majority of adults will experience a hemorrhoid at some point in life. While all hemorrhoids are similar, there are some variations. Follow along to learn more about the different kinds of hemorrhoids.

Common Types of Hemorrhoids

1. Internal Hemorrhoids are a type of hemorrhoid that is located inside your rectum. Oftentimes they are not visible, and frequently they disappear without any treatment. Some of the time, an internal hemorrhoid may swell up and when this happens, it may rise out of your anus. When this occurs it is referred to as a prolapsed hemorrhoid.

Many times you do not even know if you have an internal hemorrhoid because there aren’t nerves that identify pain in this part of your body. It may be something that comes to your attention when your physician makes note of it following a colonoscopy or childbirth. If hemorrhoids expand in size, you may experience more symptoms that are typical of larger hemorrhoids. This can include a protrusion that you can actually feel as a soft lump, along with burning, cutting or itching sensations and sometimes severe pain.

When you go to the bathroom, feces passing through your rectal area may agitate internal hemorrhoids which can cause some bleeding that you may see on toilet paper. Please note: Any kind of rectal bleeding can be a sign of other more serious health problems, so it is always advisable to discuss this symptom with your doctor.

2. Prolapsed Hemorrhoid is a term used to describe internal hemorrhoids that have swollen and may appear outside of your anus. This type of hemorrhoid, which appears like a swollen lump, may be visible with a mirror. Some people do not experience any symptoms with prolapsed hemorrhoids, while others 

Often physicians are able to assign a grade to a prolapsed hemorrhoid, depending on severity. 

  • Grade one hemorrhoids are not prolapsed in any way.
  • Grade two hemorrhoids are prolapsed but also retract on their own. They may protrude from your anus at certain times like if you are straining during a bowel movement.
  • Grade three prolapsed hemorrhoids stick out of your anus and require you to push them back in yourself. It is possible if you are experiencing this, you may want to consider some type of treatment to avoid possible infections and/or to limit discomfort.
  • Grade four hemorrhoids are large enough that you cannot easily manually push them back into your anus without a significant amount of pain and discomfort. In these cases, it is highly advisable that you consult with your physician to explore treatment options.

3. External Hemorrhoids appear on your anus. You can’t always see them, but if you are able, they tend to appear like lumps. External hemorrhoids are typically not a serious issue, unless they cause you discomfort that negatively affects your daily life. The symptoms of external hemorrhoids tend to be similar to other types, including pain while going to the bathroom – especially if straining, doing certain activities, and sitting (especially on hard surfaces) for prolonged periods.

4. Thrombosed Hemorrhoids can cause people a lot of discomfort. This type of hemorrhoid contains a thrombosis or a blood clot within the tissue of the hemorrhoid. They often look and feel like small lumps around your anus. Thrombosed hemorrhoids are complications associated with hemorrhoids where blood clots appear. They can happen with both external and internal hemorrhoids, though more commonly with external. If you are experiencing one, you may have difficulty sitting, walking or going to the bathroom without discomfort. You may also notice redness along with a blue color around the hemorrhoid area.

If you are experiencing discomfort from hemorrhoids, the experienced team of medical professionals at Gastroenterology Health Partners is here for you using the most advanced treatment options available. For more information or to schedule an appointment, contact Gastroenterology Health Partners today at a location near you. 

6 Fermented Foods For Better Gut Health

Did you know that eating fermented foods can enhance the diversity of the gut microbiome, which reduces inflammation and improves immune response?

If you did not know this, it’s okay. New research is only beginning to unlock the exciting connections between diet, gut microbiome, and body response. A research paper published by Stanford Medicine this July was one of the first formal efforts to delve into the powerful effects of fermented foods on gut health, in particular.

So What Exactly Is Fermentation?

Humans have been fermenting foods for thousands of years. Fermentation is a metabolic process that utilizes live microbes such as bacteria or yeast to create a chemical reaction. In the absence of oxygen, these microorganisms will break down carbohydrates such as sugars and starches into different compounds altogether. This is how simple yeast can turn barley malt into carbonated, alcoholic beer, or how grapes become wine. Fermentation is a natural, nutritious preservation process. You can easily ferment foods yourself, find them on many restaurant menus, or purchase them at a local grocery store!

Why Do Fermented Foods Help The Gut?

Millions of microbes live in your gut, intestines and colon. Known as the gut microbiota, this system of bacteria helps digest food as well as plays a role in your overall health, immune response, metabolism and even mental health. While each person’s unique gut composition is influenced by genetic makeup, your lifestyle can also impact the quality of your gut microbiome. Factors such as your daily levels of exercise and diet can greatly impact the diversity and functionality of gut microbiota.

The live microorganisms found in fermented foods are a source of probiotics, which have innumerable health benefits. These natural probiotics aid the immune system, and in doing so, boost the body’s response to pathogens. Plus, the enzymes and lactic acid created in the fermentation process helps better absorb nutrients such as Vitamin B and C. The full extent of the benefits of fermented foods are only beginning to be realized.

6 Fermented Foods For Better Gut Health

1. Plain Yogurt – Plain yogurt is low calorie, low sugar, and teaming with beneficial probiotics. Add fresh fruit, oatmeal, or granola to make the perfect gut-boosting breakfast.

2. Kombucha – Kombucha is a popular fermented tea beverage. It is carbonated, with a bitter, fruity taste. A single bottle can have as little as 50 calories and millions of good bacteria. Keep in mind that there are many different brands on the market including options without added sugar.

3. Tempeh – Tempeh is made from fermented soybeans, pressed together. Similar to tofu, it is a great meat substitute to be cooked, fried, or baked. It is also a source of antioxidants, probiotics, and is high in protein.

4. Kefir – Kefir is a tangy, yogurt-like beverage made of fermented kefir grains. It is proven to reduce inflammation, strengthen bones, and even reduce symptoms of lactose-intolerance in some people.

5. Kimchi – Kimchi is a Korean dish made of fermented cabbage or similar vegetables like radishes. It can be eaten alone or used as a topping on sandwiches, salads, pasta, etc. You can find it in most grocery stores. Studies have found that it may improve insulin resistance and lower cholesterol.

6. Sauerkraut – Another form of fermented cabbage, sauerkraut is plentiful in fiber, Vitamin C, and antioxidants. It’s also low calorie, and can be put on/in just about anything.

Within recent years, the gastrointestinal microbiome has become an increasingly popular area of scientific study due to its close link to human health and wellbeing. Not only does a person’s gut microbiome help with the digestion of food, but it also plays an important role in supporting the body’s immune system. Future research will no doubt provide additional insight about ways we can improve and support our body’s gut health.

For more information about improving your gut health or other digestive conditions, reach out to Gastroenterology Health Partners (GHP) today. Our clinicians have a passion for seeking out and refining new treatments and advanced solutions for those suffering from disorders of the digestive system. Each of our physicians offers expert specialization, evaluating and treating the entire spectrum of digestive conditions. To learn more about the treatment options available to you, schedule an appointment at one of our locations throughout Louisville, Lexington, and Southern Indiana.

Getting Ready For A Colonoscopy Prep When You Tend To Be Constipated

Preparing for your colonoscopy is important because it enables your physician to visibly access all areas of your colon to provide the best screening possible. A successful prep – one where your colon is thoroughly cleansed in advanced – makes it easier for your gastroenterologist to do their job thoroughly and accurately. When patients do not have a successful colonoscopy preparation, and stool is still visible in the colon, it makes it much harder for your doctor to do a thorough evaluation.

If you’re a person that tends to struggle regularly with constipation, the colonoscopy prep may be a bigger concern. You may wonder if the prep will actually work and feel an added worry about how this relates to the actual procedure. Fortunately, there are some additional things you can do a week or so in advance to make the entire process easier and more successful.

People who are often constipated frequently have a longer, tortuous colon which may be more challenging to completely empty out. In these cases, your doctor may provide some additional guidance regarding your prep.  Follow along for some helpful suggestions for preparing for your colonoscopy if you tend to be constipated.

8 Things To Know If You Are Preparing For A Colonoscopy And Are Often Constipated

1. You should tell your doctor in advance that you struggle with constipation. People who tend to be constipated may have to think about their colonoscopy prep further in advance than those who are not. Make sure to let your doctor know in advance if constipation is something that you struggle with frequently. Depending on your symptoms and medical history, your doctor may advise additional things like Dulcolax to help make sure your colonoscopy prep is a success.

2. Ask your doctor about medications, vitamins and supplements you normally take. You may be advised to adjust your normal routine in some way depending on your situation.

3. Cut out high fiber foods several days before your procedure. This includes things like raw fruits and vegetables, canned and fresh corn, whole grains like oatmeal, brown rice, quinoa, popcorn, and wheat bread, all kinds of nuts, and seeds (including sunflower, sesame, and poppy). Focus instead of non-fibrous foods like soups (without vegetables), eggs, yogurt, white bread and puddings.

4. Your doctor may advise you to begin the clear liquid diet for your prep a day early (two days in advance). This involves avoiding solid foods and consuming clear liquids that are NOT red, blue, or purple in color. This includes things like gelatin, clear broth, sports drinks with electrolytes, black coffee, fruit juice like apple or white grape, and popsicles.

5. It can be helpful to drink lots of extra water the week leading up to your procedure to make sure you are very well hydrated. Not only is hydration a key part of addressing constipation, but it also may help to make your overall prep experience easier. Keep in mind that if you tend to drink caffeinated beverages like coffee and tea, these tend to have a dehydrating effect on your body, and you may need to compensate with additional water.

6. Make the time to deal with your worry and stress. Sometimes constipation is exacerbated by stress. It is important that you recognize and deal with this if possible. Find ways to help yourself relax. Consider trying mindfulness, meditation and/or breathing exercises, listen to relaxing music, and engage in other healthy practices that help you feel calmer and more relaxed.

7. Prioritize a healthy routine including getting enough sleep leading up to the procedure. While it is always important to focus on a healthy routine, including getting enough sleep each night, it may become even more important the week leading up to your colonoscopy. This can help you feel your best for the procedure, enabling you to follow the prep with greater ease, also reducing your level of stress and worry.

8. Don’t be embarrassed, constipation is something many people experience. According to the U.S. Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney diseases, constipation is common among people of every age and population in the U.S. Approximately 16% of adults experience symptoms of constipation on a regular basis, with this number increasing with age, to a third of adults 60 years and older.

Data reported by the Centers for Disease Control and Prevention (CDC) suggests that upwards of one in three adults ages 45 to 75 has not had a colonoscopy, the recommended screening for colorectal cancer. While there are many reasons why people may opt to avoid this recommended procedure, concerns about what is required to prepare for the exam certainly play a role for some.

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

Identifying Different Types of Colorectal Polyps

What Are Polyps?

Polyps are small growths of abnormal tissue, found projecting from the inner lining of the colon (large intestine). Polyps can range in size from a few millimeters to several centimeters. Polyps are very common: In fact, an estimated 25 to 40% of Americans over the age of 50 develop colon polyps. While developing polyps is most associated with being 50 and older, other factors are also considered including: having a family history of polyps/colon cancer, being obese, smoking, heavy alcohol consumption, a history of inflammatory bowel diseases, a poor diet, and other environmental factors. 

The vast majority of polyps are harmless, but they can also be precancerous or cancerous in nature. Polyps can take a long time to become cancerous, and are best to be removed upon identification. During a medical exam or colonoscopy, your doctor may identify and remove polyps. Larger or complex polyps are more likely to be cancerous, and can require additional procedures to remove. Colon polyps rarely cause any symptoms, which means scheduling a colorectal screening test is vital for identification.

Identifying Types of Polyps

There are two main categories of polyps: nonneoplastic and neoplastic. Neoplastic polyps are typically precancerous or cancerous, while nonneoplastic polyps are usually benign (non-cancerous). Within these categories, there are many types of polyps. Some of the most common include:

Types of Neoplastic Polyps

  • Adenomatous polyps (Adenoma): The most common type of polyp as well as the most common cause of colon cancer. Structurally, they’re described as tubular, villous, or tubulovillous. Tubular adenoma is less likely to develop into cancer, and makes up 70% of adenomatous polyps. Villous adenoma is flatter and more difficult to remove, and makes up 15% of adenomatous polyps. Tubulovillous is a mix of the two.
  • Serrated polyps: Serrated polyps cause 20-30% of colon cancers. They are divided into two categories: sessile serrated adenoma (SSA) and traditional serrated adenoma (TSA). SSA’s and TSA’s are very rare and almost always precancerous. 

Types of Nonneoplastic Polyps

  • Inflammatory polyps: Typically found in people with Inflammatory Bowel Disease. Usually benign.
  • Hamartomatous polyps: Rare. Usually caused by autosomal disorders. 
  • Hyperplastic polyps: A form of serrated polyp, but are very common and almost always benign. 

Polyp Shapes

Polyps generally grow in three different shapes: pedunculated, sessile, and flat. Pedunculated (polypoid) polyps grow out from the side of the inner lining of the colon like mushrooms, a clump of tissue on a thin stalk. Sessile polyps, on the other hand, do not have a stalk, but rather grow against the side of the colon. The least common shape is a flat polyp. Flat polyps grow completely flat, or depressed into the side of the colon. Sessile and flat polyps are generally more difficult to detect than pedunculated polyps.

Symptoms of Polyps

There are typically no signs of polyps. However, in some rare cases, they can be associated with symptoms such as:

  • Abdominal pain
  • Blood in stool
  • Diarrhea 
  • Constipation
  • Anemia caused by internal bleeding
  • Weakness or tiredness caused by anemia
  • Weight loss
  • Changes in bowel habits
  • Changes in stool color

Diagnosis and Treatment

If you experience any symptoms of colorectal polyps, it’s recommended that you consult a medical professional as soon as possible. Otherwise, most polyps will be diagnosed and treated through a screening test, like a colonoscopy or flexible sigmoidoscopy. In some cases, polyps are too large or complex to be removed immediately and require further surgical procedures.

It’s also important to note that if you have a neoplastic polyp, like an adenoma or a serrated polyp identified and removed during your screening test, you’re still at an increased risk of developing cancer, and will need regular screenings for polyps. The type, amount, and size of the polyps identified will determine how often you need a screening. This can vary from 6 months to 10 years

The experienced team at GHP has years of experience treating patients with various GI conditions including colorectal polyps. 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 to schedule an appointment today.

 

Importance of Colon Screening in Younger Adults – Dr. Sohi Interviewed

Dr. Sunana Sohi of Gastroenterology Health Partners was recently featured in a WHAS-11 article and video about the increasing rates of colon cancer in younger adults.

The story featured Amanda Blackburn, a 37 year-old mother of two who was diagnosed with stage 3 colon cancer in 2017. She received a diagnosis after coming to Dr. Sohi with her symptoms of rectal bleeding and a change in bowel habits.

Blackburn had no family history of colon cancer and knew very little about the disease, like many younger adults. “It wasn’t on my radar. The ‘C’ word wasn’t a thing for me,” she said.

Dr. Sohi was able to help Blackburn receive diagnosis and treatment.

“If you have symptoms, don’t wait. There are a lot of tests that can be done, including stool tests, but the number one, the gold standard is colonoscopy. That’s because it’s not only diagnostic but preventative, where we can find and remove small polyps before they become cancer,” Dr. Sohi said.

Read the rest of the Dr. Sohi’s write-up here.

Colon Cancer is not a disease of the elderly anymore; article

 

 

 

 

 

 

 

 

 

 

 

 

 

The article also discussed the upcoming Kicking Butt 5K Run/Walk, scheduled for Saturday September 25th at the Louisville Waterfront Park. This event, sponsored by the Colon Cancer Prevention Project, was started in 2003 as a way to bring together cancer survivors and advocates, spread awareness, and encourage screenings. It’s not too late to sign up for the 5K, 1 mile, or virtual event, and support this worthy cause.

If you or a loved one are experiencing symptoms of colon cancer or another GI condition, don’t hesitate to contact Dr. Sohi or one of the many experienced physicians at Gastroenterology Health Partners.

As the largest independent gastroenterology practice in the region, GHP is considered the only one of its kind providing results-orientated treatment for a full spectrum of digestive system disorders. Call to set up an appointment at one of our locations in Southern Indiana, Northeast & Central Louisville, and Lexington.