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Pandemic Alcohol Intake and GI Health

The past year-and-a-half has been incredibly difficult for everyone. From hundreds of millions of deaths to the challenge of lockdowns, social isolation and economic hardship, no one has remained unscathed.

Many people have turned to harmful coping mechanisms to deal with the medical, psychological, and sociological problems brought on by pandemic-related stress. While research is still limited, studies suggest that alcohol consumption has increased greatly. The first week of the pandemic, alcohol sales increased by 54% and online alcohol sales increased by 262%. A cross-sectional survey of American adults published in December 2020 found that 60% of people reported increased drinking. 34% of people engaged in binge-drinking and 7% reported extreme binge-drinking.

The impact of increased alcohol consumption on gastrointestinal health is even more staggering. Studies presented at the 2021 Digestive Disease Week suggest a major surge in inpatient consults for alcohol-related gastrointestinal and liver diseases since the beginning of the pandemic. Waihong Chung, a research fellow for the Division of Gastroenterology at the Warren Alpert Medical School of Brown University, conducted extensive research on the subject.

Chung found that during the initial lockdown phase of the pandemic, the number of in-person gastrointestinal appointments decreased by 27% (due to restrictions/closings). However, of those appointments, the proportion of consults for alcohol-related GI and liver diseases, such as hepatitis, pancreatitis, gastritis and cirrhosis increased by 59.6%! And, as lockdowns lifted, that percentage increased to 78.7%. Furthermore, patients with alcoholic hepatitis increased by 127.2% (since 2019) and the number of inpatient endoscopic procedures almost tripled.

Chung also contested that the occurrence of alcohol-related diseases could be much higher than reported, since many illnesses take time to manifest or show mild symptoms. Even if you seem to experience no ill-effects from binge-drinking, you should be aware that excessive alcohol is wreaking havoc on your gastrointestinal system. In the short-term, excessive alcohol causes intestinal inflammation and organ damage, alters intestinal microbiota, harms intestinal immunity and homeostasis, and damages the liver. In the long-term, you can suffer from alcohol-related gastrointestinal and liver diseases.

Unfortunately, the long-term effects of Covid-19 on alcohol misuse and overconsumption still have yet to be realized. For example, following the 2003 SARS epidemic, individuals in China who had been directly affected/involved were far more likely to abuse alcohol three years after the epidemic ended. The lasting psychological effects of the pandemic will likely increase alcohol misuse for years to come.

Besides causing fatal gastrointestinal conditions, alcohol can worsen existing mental health disorders such as anxiety and depression. If you or a loved one has been struggling to maintain a healthy relationship with alcohol during the pandemic, it’s recommended that you talk to your primary care doctor or seek medical help. There are behavioral, medical, and mutual-support-based treatment options available for you.

If you are struggling with gastrointestinal issues, induced by alcohol or by something else, seek experienced medical attention. The professional team of medical providers at Gastro Health Partners serves patients across the state of Kentucky and Southern Indiana. Contact a location near you today for more information, or to schedule an appointment.

Colon Cancer Stories

Colon cancer touches many lives each year. It can be powerful to learn how other people have experienced screenings, a diagnosis, and fighting the disease. To wrap up our blog posts on colon cancer for this awareness month, we’re going to showcase a few stories from several sources today.

Colon Cancer Foundation: Jamie’s Story

The Colon Cancer Foundation (CCF) has compiled a number of patient stories about colon cancer. One story features Jamie Crespo, who had both parents diagnosed with colon cancer in the same year (2017). Jamie details how the diagnoses came as a surprise due to a lack of immediate family history of the disease, and how it changed everyone’s lives. She also talks about her parents’ recovery, what she’s learned, and how she has made lifestyle changes following the experience. Read Jamie’s story and others on the CCF’s website.

Colon Cancer Coalition: Melissa’s Story

The Colon Cancer Coalition (CCC) also has a huge number of patient stories you can peruse. One is from Melissa Marshall, who was got colorectal cancer at the age of 51. She had been ignoring symptoms for a while before her diagnosis, including rectal bleeding, weight loss, and fatigue. Melissa eventually met with a colorectal surgeon who performed a colonoscopy and found a tumor in her sphincter. She was diagnosed with Stage III colorectal cancer, and went on to receive chemotherapy and an ostomy bag. Today, Melissa is cancer-free and is a strong advocate. She has also formed a non-profit dedicated to educate people about colorectal cancer. You can read Melissa’s story along with many others here.

Colon Cancer Prevention Project: Lindsay’s Story

The Colon Cancer Prevention Project has featured a striking story from Lindsay Norris, an Oncology nurse who survived Stage III colorectal cancer. She talks about how she never truly understood how her patients felt until she experienced colorectal cancer. In a lengthly blog post, Lindsay goes through all of the elements of her diagnosis and experience receiving treatment, comparing how she viewed these things as a nurse versus how she experienced them personally. It’s a highly insightful read- you can read the post here or visit her website.

Celebrity Colon Cancer Stories: Chadwick Boseman and Will Smith

Colon cancer has affected several well-known celebrities. Just in the past year, Chadwick Boseman passed away with colorectal cancer. The actor, known for films like Black Panther and Thurgood, was only 43. He had been fighting colon cancer for four years. We wrote a blog back in November of 2020 about Chadwick’s life and battle with colon cancer. You can read that post here.

Another story we recently featured is about actor Will Smith. Back in 2019, Will documented the process of his colonoscopy screening. In a vlog posted to his YouTube channel, he shows conversations with his doctor, the prep process, the day of the screening, and the follow-up. It’s a great video that showcases what the experience of getting a colonoscopy is like, and it also drives home the importance of screenings. Read our blog post on the video here.

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

ValueOfColonoscopy.org: ASGE’s Useful Awareness and Screening Tool

There are a lot of great resources if you are interested in learning more about colon cancer and screenings. One of our favorites comes from the American Society of Gastrointestinal Endoscoy (ASGE). The ASGE has a plethora of resources including videos, a screening tool, and statistics at ValueOfColonoscopy.org. Today on the blog, we’ll take you through some of the useful resources on the website.

Screening Tool: Determining Which Test You Should Get

One question many people have about screenings is which test to get. There are numerous options available. It can be confusing when figuring out which is the best fit. Fortunately, the ASGE created a tool that helps you identify the screening method that’s right for you. In a simple yet informative document, they take you through your options based on your risk level (no personal or family history of colon polyps or cancer, family history, or personal history). This tool shows you how these factors impact when you should be screened, how often, and with which screening method. For example, if you have a family history of colon cancer or polyps, it shows that you should have a screening as early as age 40. It also shows that a colonoscopy is best screening given your family history. It recommends talking with your doctor to establish a plan.

Colonoscopies during the Pandemic

During the pandemic, many people have had valid concerns about the safety of activities like doctor’s visits. This has actually impacted how many colonoscopies doctors have performed, and as a result an increase in the number of missed colorectal cancer diagnoses (read our blog post here to learn more). In a video, the ASGE shows how many steps medical professionals are taking to ensure your safety during screenings. They talk about pre-arrival screenings, in-office distancing and barriers, masking, PPE, testing, staff vaccinations, and more. We highly recommend watching this video to get a clear picture of how safe your screening will be. Plus, read our blog post here about what we have been doing at GHP to keep you safe.

Tips as you Prepare for a Colonoscopy

Another important thing this website covers is common patient FAQs leading up to a colonoscopy. The ASGE has a number of helpful guides and tips for you as you prepare for a screening. For example, they have a webpage dedicated to understanding bowel prep, an aspect of screening that many patients dread. They discuss the importance of bowel prep, what type of prep you may need to pursue, and other helpful tips. They even discuss common side effects, specific steps in prepping, and what to do if you forget to take prep medication. This is a great resource to help you make sure your screening is as effective as possible. The ASGE also has content and FAQs that help you understand colon polyps and colonoscopies.

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

Colon Cancer Awareness: Our Favorite Online Resources

March is colon cancer awareness month. This disease is preventable with timely and regular screenings. Awareness-raising resources and campaigns are a key part in increasing screening rates, so today on the blog we’ll share some of our favorite online resources on the topic.

CDC Resource Library

The Centers for Disease Control and Prevention has an excellent website full of resources. Among these resources is all of their colon cancer content. They have everything from personal stories to an awareness quiz and posts to share on social media. Here’s a list of some of our favorite resources they offer:

  • Data visualizations tool
    • You can examine colon cancer statistics with tools including an interactive map, tables, and charts.
  • Basic information
    • The CDC provides a central hub for all of the basics about colorectal cancer, including symptoms of the disease, screening information, and questions you can ask your doctor.
  • Screening stories
    • Read stories from people who have gotten screenings and learn about their experiences.

ASGE Colon Cancer Awareness Resources

The American Society for Gastrointestinal Endoscopy has a number of great resources you can use as a patient and as an advocate. Here are a few highlights from their website:

  • Tool to start dialogue about screening for patients and doctors
    • This document breaks down the different types of screening available, divided by different risk categories.
  • Videos
    • ASGE has a number of videos that cover topics like colonoscopies, myths about colon cancer, and community outreach.
  • Banner and poster
    • The organization provides a banner you can use on your website or email signature, plus a poster you can print and hang up.

ASCRS’ Resources

The American Society of Colon & Rectal Surgeons has several resources on their website that you might find helpful. Here are a few favorites:

  • Media pitch letter
    • ASCRS has a letter that you can modify and send to local news organizations, asking for air time to talk about colon cancer.
  • Online store
    • The organization has an online store where you can purchase brochures in bulk for use in treatment settings.

Colon Cancer Coalition’s Targeted Campaign

The Colon Cancer Coalition has a targeted awareness campaign called #BlueForCRC that you can participate in. Their website has resources for this campaign including:

  • Sample social media posts
  • A training webinar for advocates
  • Informational resources that can be distributed
  • Tips and tricks for successful advocacy using their campaign

ACG’s Website

The American College of Gastroenterology’s website features resources that you can use for awareness-raising. Some of our favorites are:

  • A library of graphics that you can print for patients, hang as posters, and share on social media.
  • A podcast series that addresses colon cancer topics in a Q&A format. Episodes cover topics including risk factors, screenings, bowel prep, and early detection.

Our team at GHP has years of experience screening for colorectal cancer. We can help establish the best plan of care for you. Read more about how we perform screenings here. Contact any of our office locations to learn about the options we offer and book an appointment today.

How has the Pandemic Affected Colonoscopies?

The coronavirus pandemic has impacted our lives in countless ways. From finances to health and other aspects of life, it has changed how we live each day. In particular, many common medical check-ups, screenings, and elective procedures have been put on hold or delayed. One of these, the colonoscopy, has seen significantly decreased rates during the pandemic. This is a serious issue, as we know colonoscopies are a key screening strategy to prevent colorectal cancer. On today’s blog, we’ll take a look at how the pandemic has affected colonoscopies.

Colonoscopies During the Pandemic

Early on in the pandemic in 2020, medical practices put many elective and non-essential medical visits and procedures on hold. As a result, screenings for cancer like colonoscopies dropped significantly. One study examining screening rates in the San Francisco area found that colonoscopies decreased about 90% from February to May 2020. This coincided with an 85% decrease in fecal immunochemical testing (FIT), another screening method in the same time frame. There was also a 70% decrease in all in-person appointments, and a 60% increase in telehealth visits. Another report estimated that if that trend continued through early June 2020, there could be around 19,000 missed colorectal cancer diagnoses and over 4,000 additional colorectal cancer deaths across the United States.

These are significant impacts, and compound existing inequities in health outcomes. Many groups that have an increased risk of colorectal cancer have also experienced a higher risk of death from the coronavirus. These groups include Black, Native American, and Hispanic people.

Clearly, the pandemic has caused cascading public health problems. Fortunately, as we have learned more about the coronavirus, medical practices have been able to respond to transmission threats to practice safely. Masking, social distancing, sanitizing, and now vaccinations for medical staff have helped to create safe spaces for patients to receive medical care.

Importance of Screening for Colorectal Cancer

Screening for colorectal cancer is extremely important. When properly done, it has a high success rate at cancer prevention. With a colonoscopy, doctors can identify and remove precancerous polyps that could otherwise develop into cancer over time. The colonoscopy is the gold standard for screenings. When patients get colonoscopies on a proper schedule, the incidence of colorectal cancer falls by around 90%.

Gastro Health Partners, in line with various other organizations, is now endorsing regular screenings starting at age 45. Previously, 50 was the standard for beginning screenings. By changing this to 45, we can prevent more potential cases of cancer and save lives. If you are close to 45 or older, talk with your doctor about getting screened. They will take your situation into account and may recommend earlier or more frequent screenings depending on factors like family history and personal history of polyps.

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

Colorectal Polyps: What You Need to Know

Colorectal polyps are excess tissue that can form in the lining of the colon or rectum. While most are harmless, some can develop into cancer. Here’s what you need to know about polyps.

Causes, Risk Factors, and Symptoms of Colorectal Polyps

Polyps occur when certain mutations in genes cause uncontrolled cell growth. This continued growth can turn into groups of tissue- polyps- in your large intestine. Some of the risk factors for polyps include family history, being 50 or older, obesity, low exercise levels, and tobacco or alcohol use.

In many cases, polyps may not cause any symptoms at all. You may find you have a polyp only after an examination like a colonoscopy. However, in some cases polyps do cause symptoms. These include rectal bleeding, pain, changes in bowel habits, and a change in stool color (red streaks or black stool).

Neoplastic Polyps

One of the two main kinds of polyps is neoplastic. Neoplastic polyps have the potential to become cancerous. Within this classification, there are a few additional types of polyps. Adenomas are the most common type of polyp, making up around 70% of polyps. When found, it’s tested for cancer. It can take many years for these kinds of polyps to become cancerous, so with proper screenings they can be taken care of before they become a major problem. Serrated polyps are the second main type of neoplastic polyps. These can become cancerous depending on their location and size. Larger polyps have a higher risk of becoming cancerous.

Non-neoplastic Polyps

In comparison, non-neoplastic polyps usually do not turn cancerous. One common kind, hyperplastic polyps, are small and very rarely become cancerous. Another type, inflammatory polyps, are common in people with inflammatory bowel disease. These do not grow like other polyps- they develop in response to chronic inflammation. They tend to be benign. One final type is hamartomatous polyps. These may occur as part of a genetic syndrome, and tend to be benign as well.

Reducing Risk and Preventing Colorectal Cancer

In general, there are several lifestyle and screening measures you should take to reduce the risk of polyps and colorectal cancer. Eating fruits and vegetables and reducing fat intake are key dietary steps that can help you remain healthy. In addition, you should limit alcohol and tobacco consumption. Plus, staying active is a must.

You should also consider your risk for colorectal cancer or polyps based on family history. In some cases, you may want to pursue genetic counseling if your family has a history of colon polyps. Additionally, if you have a hereditary disorder that causes polyps, you may need earlier and more regular screenings.

Screenings themselves are a key aspect of preventing colorectal cancer. The colonoscopy remains the gold standard for screenings. It allows doctors to both detect and remove polyps to prevent colorectal cancer. In fact, annual colonoscopies reduce cancer incidence by around 89%. Screenings are now recommended earlier- at GHP we endorse annual colonoscopies for all patients ages 45-75. Visit our website to learn more.

Our experienced team at GHP has years of experience screening for and treating 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.

 

Colorectal Cancer and Age, Race, and Ethnicity

Colorectal cancer is not experienced equally by everyone. In the past several years, younger people have experienced increased colorectal cancer rates and deaths. Additionally, Black people and American Indians experience more cases of this cancer and related deaths. Here’s what you need to know about how this disease affects different people.

Colorectal Cancer in Younger Adults

Rates of colorectal cancer have been on the rise for younger and younger adults over the last several years. According to the American Cancer Society, while rates for adults 50 and older have fallen due to increased screenings, the opposite trend has occurred for younger adults. Recently, people 65 and older have experienced a decrease of around 3% per year from 2011 to 2016. In contrast, people ages 50 to 64 have seen rates rise by 1% per year in the same time frame. People under 50 have actually seen rates rise by 2.2% per year in the same window. Clearly, younger adults are seeing steeper increases in cases. Death rates have followed similar patterns. Death rates for colorectal cancer also vary by age group. Between 2008 and 2017, death rates fell by 3% per year in people 65 and older and dropped by 0.6% in people 50 to 64. However, they rose by 1.3% in people younger than 50.

Fortunately, colorectal cancer can be very treatable if it’s caught early. Younger adults should be aware of warning signs. These include changes in bowel movements (particularly over two weeks or more), rectal bleeding, unusual stools, and tiredness or low energy. If they have any of these symptoms, they should see their doctor.

Disparities Based on Race and Ethnicity

Along with age, looking at colorectal cancer rates and death rates based on race and ethnicity shows significant variation. The American Cancer Society’s data from 2012-2016 showed that rates were dramatically different based on race. Rates for Asian people and Pacific Islanders were the lowest at 30 per 100,000. Non-Hispanic white people had a rate of 39 per 100,000, and Black people had a rate of 46 per 100,000. Alaska Natives and American Indians had the highest rate, at 89 per 100,000. Death rates vary significantly as well- colorectal cancer rates are around 20% higher for Black people than non-Hispanic white people, but death rates are nearly 40% higher in Black people. Additionally, for Alaska Natives and American Indians, death rates are about double the rate for Black people.

Early Screenings Save Lives

While many of these statistics are troubling, we do know that screening early is an effective way to catch more cases of colorectal cancer. More and more organizations, including Gastro Health Partners, are pushing for earlier screenings and research on the disparities around this disease. Early screenings save lives.

Our experienced team at GHP has years of experience screening for and treating 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.

Lynch Syndrome: An Overview

Lynch syndrome is an inherited genetic condition that increases risk for colorectal and other cancers. It is the single most common cause of hereditary colorectal cancer. Here’s what you need to know about the condition.

What causes Lynch Syndrome?

Lynch syndrome, sometimes called hereditary nonpolyposis colorectal cancer, is inherited by children from their parents. It is inherited in an autosomal dominant pattern, meaning that only a single copy of the altered gene needs to be present. So, if someone inherits a mutation in a gene related to the syndrome, they will still have a normal copy. However, cancer occurs when a second mutation affects the normal copy of the gene.

The specific genes involved in the syndrome are all involved in repairing errors that occur during DNA replication. If any of the genes (MLH1, MSH2, MSH6, and PMS2) have a mutation, errors occurring in replication accumulate, which can end up leading to uncontrolled cell growth and cancer.

Complications from Lynch Syndrome

If you have Lynch syndrome, you have a higher risk of developing colorectal cancer, and developing it at a younger age. People with the syndrome also have a higher risk of developing kidney, stomach, brain, liver, uterine, and some skin cancers. There are several other inherited conditions that can increase your risk of colon cancer, but this syndrome is the single most common. A rough estimate is that around 3% of all colorectal and endometrial cancers are caused by the syndrome. Around 1 in 279 people in the United States have Lynch syndrome.

In addition, having Lynch syndrome has impacts on the rest of your family. First, a positive diagnosis means that your blood relatives may have a chance of having the syndrome. In addition, any children you may have are at a higher risk of having it. If one parent has a genetic mutation related to the syndrome, a child has a 50% chance of inheriting it. This is because the syndrome is autosomal dominant, as discussed previously. You may want to meet with a genetic counselor to talk through these implications if you have a Lynch syndrome diagnosis.

The Importance of Family History

Since you inherit Lynch syndrome, knowing your family history related to colorectal cancers is crucial. If your family has a history of colorectal or endometrial cancer, you should talk with your doctor to evaluate your risk. In particular, you are more likely to have the syndrome if your family has a history of colorectal cancer at a young age, endometrial cancer, or other related cancers.

Your doctor may recommend a genetic evaluation of your family history and risk. Genetic counselors can help you understand Lynch syndrome and whether genetic testing is a good option for you. Usually, family members with the syndrome share the same specific genetic mutation. If any of your family members have a known a syndrome mutation, you may be tested for the same mutation if you are pursuing genetic testing.

The good news is that we can prevent a lot of the cancers caused by Lynch syndrome with early screenings. Screening early and often can help catch cancer early and lead to better outcomes.

Our experienced team at GHP has years of experience screening for and treating cancers caused by Lynch syndrome. 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.

Colorectal Cancer Screening at 45

Colorectal cancer screening is a crucial step to identify cancer early and save lives. Previous medical guidance has dictated that screenings should start at age 50 in most cases. However, the American Cancer Society now endorses screenings starting at age 45. Gastro Health Partners endorses this approach as well. Here’s an overview of why screening is so important, and what your options are.

Colorectal Cancer

Colorectal cancer, sometimes called colon cancer, is cancer that occurs in the rectum or colon. Abnormal growths called polyps can grow in the colon or rectum and become cancerous. When this happens, cancers grow into the wall of the colon or rectum over time. They then have the potential to spread into lymph vessels or blood vessels and travel to other parts of the body.

Screening is important because it can prevent the development of colorectal cancer and more widespread cancer in the body. If caught early, colorectal cancer is often very treatable. For example, during a screening, precancerous polyps in the colon or rectum can be removed before they become cancerous. Screening is a life-saving preventative measure: in this case, there is a 90% survival rate when cancer is found and treated early on. It is also helpful because many people will not exhibit symptoms until their colorectal cancer has progressed significantly. Getting screened can help doctors catch and treat cancer before it develops or spreads significantly.

Who Should be Screened and When?

Screening is the key prevention strategy for all adults. Everyone should get a screening regularly at a certain point. As mentioned before, the previous guidance was most people should be screened starting at age 50. Now, guidance has shifted to starting at age 45.

Additionally, other factors can influence when and how often you should be screened. If your family has a history of colon cancer, if you have had polyps, or if you have an inflammatory bowel disease or some genetic disorders, you may need to be screened earlier and/or more often.

Types of Screening and How Often to Get Screened

There are a few main screening options. You should talk with your doctor to determine the best path for you. As alluded to, the colonoscopy is the gold standard for screenings. During a colonoscopy, your doctor is able to look at your entire colon and can remove polyps. You may only need a colonoscopy once every 10 years if you have a negative screening. Another screening option is a Flexible Sigmoidoscopy, which is performed every 5 years with negative screenings. The downside of this method is that it doesn’t give a full view of the colon like a colonoscopy does. Only the lower parts of the colon are viewable with this test.

There are also a few stool-based screenings available. With stool tests, you collect a stool sample at home and send it in to your doctor for analysis. This method does not identify abnormalities as effectively as a colonoscopy. Doctors may also pursue follow-up testing if they confirm a positive result. There are a few other screening options that may be available as well, like a Capsule Endoscopy or a CT Colonography. Your doctor will recommend the best option based on your specific case.

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

Featured press release: DHPA Supports USPSTF Recommendations to Begin CRC Screening at 45, Calls for More Research on Disparities in Communities of Color

The Digestive Health Physicians Association recently announced its support for the U.S. Preventive Services Task Force (USPSTF)’s draft recommendation to begin colorectal cancer screenings at age 45. Gastro Health Partners endorses these changes as well. Read more about the DHPA’s support for the changing guidance in this press release:

“Washington, DC – The Digestive Health Physicians Association (DHPA) voiced its support for a draft recommendation by the U.S. Preventive Services Task Force (USPSTF) that Americans begin screening for colorectal cancer at the age of 45, an update of 2016 guidelines that had recommended that adults without risk factors for CRC should begin screening at age 50 and continue periodically until 75.”

Click here to read the full press release