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What is Colorectal Cancer?

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Colorectal cancer refers to a cancer that starts in the colon or rectum. While cancers that start in either place may be called colon cancer or rectal cancer, respectively, they are often known collectively as colorectal cancer because of similarities between the cancers. 

Here’s what you need to know about colorectal cancer. 

Causes and Risk Factors

Scientists are not exactly sure what causes colorectal cancer. We do know that colorectal cancer begins when healthy cells’ DNA mutates. These cells can then overgrow and divide, creating tumors. Cancerous cells can also destroy healthy tissue and travel to other parts of the body and form deposits. However, there are several well-documented risk factors. These include being over 45, having diabetes, smoking, drinking alcohol, having a high-fat diet, having an inflammatory bowel disease, and having a family history of colon cancer or polyps. 

Types

Most colorectal cancers (around 96%) are Adenocarcinomas. This kind of cancer starts in mucus-producing cells which lubricate the colon and rectum. 

There are a few other kinds of colorectal cancers that are much more rare. Lymphomas, cancers of immune system cells, can start in the colon or rectum (although they typically start in lymph nodes). Carcinoid tumors start from hormone-producing cells in the intestine. Gastrointestinal stromal tumors start from cells in the colon wall, and while most are non-cancerous, some can be. 

Symptoms

It’s common for colorectal cancers to have few symptoms until they have advanced. There are some potential warning signs, but they may be indicators of other issues. These symptoms include lower abdominal pain, blood in stool, bloating, cramps, vomiting, unexplained weight loss, and changes in bowel functions. As always, it’s best to consult a medical professional to determine what your symptoms are caused by. 

Diagnosis

The best way to cure colon cancer is to identify it at an early stage. However, since symptoms may not present early on, doctors recommend screenings for healthy people, usually beginning around age 50. People with more risk factors, as discussed above, may be advised to be screened at a younger age. 

A colonoscopy is one of the most common methods of screening. This involves using a scope to examine the inside of the colon. Your doctor can pass tools through the scope to take tissue samples if they see something suspicious. Biopsies of these tissue samples can help determine if cancer is present. Doctors also may remove polyps found during a colonoscopy to prevent them from becoming malignant. 

Treatment and Prevention

There are three main treatments for colorectal cancer- surgery, chemotherapy, and radiation therapy. These three treatment options are often used together in various combinations, depending on a patient’s situation. The best treatment options for each person depends on factors including overall health, the cancer’s stage, and whether the cancer is recurring. 

Localised, small, early-stage cancer in a polyp can be removed during a colonoscopy. A more invasive surgical procedure called a partial colectomy can remove the cancerous area of the colon and some surrounding healthy areas. This can prevent the cancer from growing back. Lymph nodes near the surgical site are removed and tested. Surgery can also be pursued to relieve symptoms and provide comfort for people in very poor conditions. 

Chemotherapy is another treatment option, often used after surgery to destroy remaining cancer cells. If the cancer has spread beyond the colon lining, this may be recommended. 

Radiation therapy utilizes beams of intense energy to destroy cancer cells. Radiation may be utilized before surgery to reduce tumor sizes, or after surgery to kill off remaining cancer cells. 

Preventing colorectal cancer is extremely important, and it starts with screening (as discussed above). Additionally, you can reduce your risk of developing colorectal cancer by avoiding smoking, reducing or avoiding alcohol consumption, staying active, maintaining a healthy weight, and eating a healthy diet. 

Our experienced team at GHP has years of experience helping people manage and treat colorectal cancer. 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.

 

 

Dr. Michael Krease on a Broad Scope of Practice

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Dr. Michael Krease was recently featured in an MD-Update Magazine article where he discussed broadening perceptions of what gastroenterology is:

 

 “Scope Junkie.” “Scope Monkey.” He’s heard them all, and he gets the joke, but Michael Krease, DO, wants to make sure that everyone understands that there is much more to what he does than performing scopes.

 “That really is the common misconception,” he says of gastroenterology, which he practices at Gastroenterology Health Partners’ Louisville location. “We are much more than that.”

 It wasn’t the opportunity to perform endoscopies and colonoscopies, after all, that drew Krease to the medical field in particular. Growing up in the suburbs of Detroit, Michigan, Krease had an early interest in being a veterinarian, but by high school he knew he wanted to be a doctor. He narrowed his field of interest to internal medicine before attending medical school at the West Virginia School of Osteopathic Medicine. He met his wife, Megan, there. She is a pediatrician at All Children Pediatrics in Louisville. They did their residencies together at Oklahoma State University Medical Center. Krease then completed his Fellowship in gastroenterology, hepatology, and nutrition at the University of Louisville School of Medicine.

 

Read the full article here:

 

Michael Krease

5 Things to Know About Ulcerative Colitis

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Ulcerative Colitis (UC) is a chronic inflammatory bowel disease that causes inflammation in the digestive tract. When someone has UC, ulcers form where inflammation has injured cells lining the colon and these ulcers eventually may bleed and create pus. This can lead to the colon needing to be emptied frequently. 

While there is no cure, healthcare professionals can help patients with Ulcerative Colitis pursue proven treatment options for managing their symptoms, and researchers continue to study the disease. Here are 5 things to know about Ulcerative Colitis. 

Causes and Risk Factors

Medical understanding of the cause of Ulcerative Colitis is limited. There are two primary causes of UC that researchers are working to understand. 

First, it could be related to your immune system. A virus or bacterium might trigger UC because of inflammation from an immune response. Some developing research may support this theory. In a recent study, Stanford researchers found that a group of patients with Ulcerative Colitis had a depleted amount of a specific family of bacteria that produces anti-inflammatory substances. 

A second possible cause of Ulcerative Colitis is related to hereditary factors. There is evidence that UC is more common in people with family histories of the disease, so family history is considered a risk factor. However, most people with the disease do not have a family history, so it is not considered a proven cause of UC. 

Types

There are several types of Ulcerative Colitis, each of which is classified by location in the digestive tract. Ulcerative Proctitis is a classification for UC where inflammation is confined to the rectum. Proctosigmoiditis is a type where inflammation occurs in the rectum and lower end of the colon. Left-sided Colitis is when inflammation extends further into the descending colon. Pancolitis is a classification for inflammation that goes beyond just the descending colon and often affects the entire colon. Lastly, Fulminant Colitis is an acute life-threatening form of UC that affects the entire colon.

Symptoms 

Symptoms of Ulcerative Colitis can vary by type and degree of the disease. Loose and urgent bowel movements, bloody stool, abdominal pain and cramps, and persistent diarrhea are common symptoms. Outside of the intestine, symptoms may include fever, nausea, loss of appetite, and weight loss. Often times, symptoms will not be constant. Flare-ups are a common occurrence for people with UC, as are remission periods without symptoms.

Diagnosis

Patients are advised to see a medical professional if they are experiencing persistent changes in their bowel habits or other Ulcerative Colitis symptoms. When a patient is tested for UC, there are several possible approaches. Blood tests, barium enemas, CT scans, colonoscopies, and flexible sigmoidoscopies can all be used to diagnose UC. 

Treatment

Treatment for UC is focused on managing symptoms, as there is no known cure. A combination of medications and lifestyle changes is often helpful, including anti-inflammatory drugs, antibiotics, corticosteriods, avoiding gassy foods, managing stress, and staying hydrated. If these measures do not relieve symptoms, surgery may be recommended by a doctor. Surgery typically means removing the entire colon and rectum. 

Ulcerative Colitis can often be effectively managed with professional guidance and care. GHP is dedicated to helping patients with UC manage their symptoms and live healthy, happy, and full lives. Contact any of our office locations learn about the options we offer and schedule an appointment today.

October’s MD Update: Dr. Jones Speaks “Going on Offense Against Cancer”

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Our very own Dr. Whitney Jones graced the cover of MD-Update’s October issue.  Read about how he embraces preventative measures to beat colon cancer before it starts in the following article.

“We spend a lot of money on healthcare and health insurance. The problem is, we’re not spending enough on prevention.”— Whitney Jones, MD

 In the movie “Karate Kid,” there’s a scene where Mr. Miyagi asks the title character if he’s training to fight. In his light bulb moment, the student responds that he trains, “So I won’t have to fight.”

Make no mistake, Whitney Jones, MD, knows how to treat cancer. He’s trained for it and has years of experience in it. But it’s a fight he would prefer doesn’t take place.

“We’re going on offense against cancer,” says Jones, a gastroenterologist at Gastroenterology Health Partners (GHP) in Louisville. “We are working on becoming the number one state and the first in the nation to develop programs where we can use genetic testing. We spend a lot of money on healthcare and health insurance. The problem is, we’re not spending enough on prevention. The cost of cancer treatments totally overwhelms the cost of prevention.”

That has been the central message and purpose of the Kentucky Colon Cancer Prevention Project, which Jones helped found in 2004. The project’s work includes education, advocacy, survivor support, and health system change.

“It put the work of the state in front of the legislature,” Jones says, noting that a diverse group of leaders from across the state formed the project’s advisory committee. “It added a mix of healthcare, politics, and business that was catalytic.”

The project has received state funding as well as additional funding from the Kentucky Cancer Foundation, which Jones also helped found in 2012. “We have helped pay for a lot of uninsured people to get colorectal cancer screening,” Jones says.

The impact of the Colon Cancer Prevention Project is reflected in the state’s improvement versus the rest of the country. Jones notes that Kentucky ranked 49th out of 50 in the nation in colon cancer prevention statistics when the project was launched. The state also had the highest rates of incidence and mortality in the nation. Earlier this year, Kentucky ranked 17th best in the nation in the same colon cancer related categories and earned an American Cancer Society Achievement Award for the most improved state in the nation for colorectal screening over the past 15 years.

“When we started our work at the Colon Cancer Prevention Project, there was a huge gap between what could be done and what we were doing,” Jones says. “It’s been a broad coalition, including many of our state leaders and city officials. I think it’s proven that Kentucky can address its own problems, we can develop solutions, we can implement them locally, and we can save lives and save money.”

Read the full article here:

Common Causes of Constipation

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Constipation is often defined by tough, hard to pass bowel movements that occur infrequently. Other signs and symptoms include bloating, having the sensation of an incomplete evacuation, abdominal pain and blood present in the stool.

While constipation is known for being both physically uncomfortable and embarrassing, the condition is more common than one might think. Constipation affects approximately 30 percent of the general population, and is most prevalent in women, children and the elderly. Persistent constipation should not be ignored as it could be the sign of a more serious condition, such as colon cancer or Irritable Bowel Syndrome (IBS).

What are some of the Common Causes of Constipation ?

Dehydration

“If you don’t have enough water in your body already, the large intestine soaks up water from your food waste,” making for harder to pass stools. Caffeine can cause dehydration, and even dairy has been known to constipate some people. Proper hydration however, can help move food through the intestines and create softer stools.

Lack of Fiber

Fiber encourages regular bowel movements by allowing more water to remain in your stool and hastening it’s passage through the gut. Foods like fruits, vegetables, whole grains, beans and nuts are the best natural source of fiber. However, fiber supplements can be helpful as well.

Stress

Just like most of your bodily functions, the nervous system is in constant communication with your digestive system. During periods of intense stress, the digestive system can slow down resulting in constipation. Waiting too long to go to the bathroom for example, can cause a build up.

Not Enough Physical Activity 

Regular activity helps to stimulate the muscles in intestines and can also help alleviate stress.

Medication

Though laxatives can help ease constipation, they can also become habit forming meaning that one’s bowel movements end up depending on them. Overusing laxatives can over time can weaken the bowel muscles. Additionally, many anti-depressants and pain medications are common causes of constipation. It is recommended that any and all medications should be discussed with your doctor.

While many lifestyle changes can help to relieve constipation, if you experience chronic constipation, schedule an appointment with one of our fellowship-trained gastroenterologist today.

 

2019 Kicking Butt 5K Event Saves Lives

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Kicking Butt 5k at the waterfront Dr. Whitney Jones at the 2019 Kicking Butt 5K

Thank you to everyone who came out and participated in this year’s Kicking Butt 5K! Survivors, fighters, advocates, healthcare providers and community partners all came together on what turned out to be a beautiful Saturday to help raise awareness of colon cancer. Gastroenterology Health Partners was proud to be one of the many sponsors who made this event possible. The Waterfront Park and Big Four Bridge were gracious hosts!

2019 Kicking Butt 5K booths Gastro Health Partners at the 2019 Kicking Butt 5k

The Kicking Butt 5k is an annual race put on courtesy of the Colon Cancer Prevention Project. Our very own physician Dr. Whitney Jones founded the Colon Cancer Prevention Project in 2004.  All of the funds raised as a result of the event go towards supporting their mission of eliminating preventable colon cancer death and suffering. The Project’s resources span from education and advocacy, to health systems improvement and survivor support. While colon cancer is the second leading cause of cancer deaths, many don’t understand how preventable it is. A donation of $50 can help reach over 100 people who may need to be screened for colon cancer.

5K at the big four bridge 5k at the Louisville Waterfront Park

While the 5k is over, donations can still be made online. For more information on when you or a loved one should start the screening process, schedule an appointment with us online. We have a clinical team of 21 fellowship-trained Gastroenterologists and 13 advanced practice clinicians. All of which conveniently serve the Louisville, Lexington, Kentucky and Southern Indiana communities.

 

2019 Kicking Butt 5K

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Join us Saturday, August 24th at at the beautiful Big Four Bridge on Waterfront Park in Louisville, Kentucky for the 2019 Kicking Butt 5k!

This annual family friendly event is put on by the Colon Cancer Prevention Project whose mission it is to eliminate preventable colon cancer death and suffering. Participants are encouraged to spend the morning walking, strolling, running, and rolling to a world without colon cancer! Whether you’re a survivor, fighter, advocate, healthcare provider or community partner, all are welcome!

You can donate to the cause or register for the event online. The race starts at 8:30am with day of registration beginning at 7:30am.

Kicking Butt 5k

About the Colon Cancer Prevention Project

Our very own Dr. Whitney Jones founded the Colon Cancer Prevention Project in 2004. Since then, colon cancer is down more than 25% in the state of Kentucky. The project works to bring awareness to what is a highly preventable disease as well as offer support to those fighting it.

While colon cancer is the 2nd leading cause of all cancer deaths in the United States, when it is detected early, colon cancer is up to 90% curable. According to the Colon Cancer Prevention Project, “It is estimated that 6 out of 10 (60%) deaths from colon cancer could be prevented if everyone were screened at 50.” However, even young people are at risk for developing the disease. 1 in every 10 patients diagnosed are under the age of 50.

How to Take Action

Prevent colon cancer by talking to your doctor about the right time to get screened. It is recommended that men and women of average risk should start screenings by age 50. However, those with a family history or symptoms may need to be screened sooner. Don’t be afraid to ask your family if they’ve been screened as doing so could save their life.

The Gastroenterology Health Partners proudly sponsors the 2019 Kicking Butt 5k. Get screened and schedule an appointment by contacting us today!

National Clinical Alert Part 3: Preventing Young Adult Colorectal Cancer

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Health care providers can aid in young adult colorectal cancer prevention by taking steps to educate the public on the rising rate of colorectal cancer found in people under the age of 55. For example, patients diagnosed with colorectal cancer prior to the age of 55 are 58% more likely than older patients to be diagnosed with a more advanced stage of the disease. This is in large part due to a general lack of awareness of young onset colorectal cancer.

The following are important actions steps health care providers can take in preventing young adult colorectal cancer:

1. Be Informative About Basic Digestive Health

Educating patients on the basics of digestive health should be part of regular office visits, especially yearly exams. Patients should understand what and where the colon is and know to take symptoms seriously should they experience them. For example, rectal bleeding and blood in the stool is never normal. Such symptoms require further assessment by a doctor to determine the root cause.

2. Relaying the Risk Factors

Patients should also be made aware of the risk factors associated with having a family history of colorectal cancer and or advanced colorectal polyps. Assessing one’s family history is critical in determining one’s risk for developing colorectal cancer themselves. Those at an increased risk may be eligible for more frequent colorectal screenings at an earlier age than others.

3. The Importance of Early Assessments

Patients at any age that are presenting symptoms or signs of colorectal cancer should be referred for diagnostic evaluation immediately and be given an early assessment with their physical exam. If found and treated early, colorectal cancer has a 90% survival rate.

To schedule an appointment or refer a patient, contact the Gastro Health Partners location nearest you today.

 

Dr. Emori Carrara On Solving Gastroenterology Enigmas

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Dr. Emori Carrara was recently featured in an MD-Update Magazine article where she is credited with treating her patients with both compassion and insight.

Dr. Carrara has been practicing gastroenterology and hepatology at Gastroenterology of Southern Indiana since 2010. As the Kentuckiana area is “one of the nation’s hot spots for obesity related epidemics such as colon cancer and non alcoholic liver disease,” Carrara treats a wide variety of patients and offers endoscopic diagnostic and therapeutic procedures.

Common patient complaints include:

  • Acid Reflux
  • Irritable Bowel Syndrome
  • Constipation and Diarrhea
  • Celiac Disease
  • Crohn’s/Ulcerative Colitis
  • Hepatitis C
  • Alcoholic Liver Disease
  • Fatty Liver Disease
  • Pancreatic Disease

Dr. Emori Carrara Specializes in Treating Susceptible Female Patients

As most women prefer a female doctor when it comes to these rather sensitive topics, Carrara’s patient base is mostly female. According to MD-Update, “Functional gastrointestinal diseases or conditions in which doctors can’t pinpoint a root cause, even after a thorough evaluation, are more common among women.” For example, a woman’s hormone levels have been known to complicate GI symptoms, and can even cause bowel movement issues. Carrara specifically treats the needs of pregnant women and has seen problems like gallstones and liver issues arise during pregnancy.

GI & The Psyche

When it comes to GI disorders, Carrara believes in taking note of one’s behavioral patterns and considering lifestyle changes before treatment. “Anxiety can contribute to nearly every gastrointestinal symptom and heighten each one,” says Carrara. IBS for example often stems from anxiety or depression. This is why Carrara recommends “stress reduction through exercise or engaging in hobbies as well as a healthy, balanced diet” in addition to medication.

Colon Cancer

In addition to participating in clinical trials and supporting the latest in preventive care, Carrara sees preventing colon cancer as one of the most important things she does as a gastroenterologist. “Colon cancer can be prevented with a colonsocopy as we are able to remove polyps before they can develop into colon cancer,” says Carrara.

To talk to your doctor about screening, contact us today.

Read the full article here:

Young Adult Colorectal Cancer National Clinical Alert: Part 1

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The rate of young adult colorectal cancer has been on the rise in the United States since the mid-1980s. Adults born in the 1990s (now in their 20s) and beyond have double the lifetime risk of colon cancer, and quadruple the risk of rectal cancer, compared to adults born in the 1950s. Currently, approximately 20% of all colorectal cancer cases diagnosed in the United States are patients under the age of 55.

Unfortunately, patients diagnosed with colorectal cancer prior to the age of 55 are 58% more likely than older patients to be diagnosed with a more advanced stage of the disease (stage III or IV). This is due to a delay in diagnostic evaluation of symptoms and less access to medical care. Delays in diagnosis, late stage presentation, and limited access to care all contribute to an increase of mortality for young adult colorectal cancer patients. Both the increasing incidence and mortality of young adult colorectal cancer are in sharp contrast to the overall declines in incidence & mortality observed in people over the age of 55.

Patients with these symptoms and signs need to be referred for diagnostic evaluation. To schedule an appointment, contact the Gastro Health Partners location nearest you today.