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The gastrointestinal (GI) tract is a tube-like passageway that extends from the mouth to the anus and measures approximately thirty feet in length. The GI tract is responsible for digesting and processing the food we consume, absorbing the nutrients and disposing of the left over waste. The GI tract is aided in this endeavor by the liver, pancreas and gallbladder. In aggregate, this system is referred to as the gastrointestinal system.

Diseases of the gastrointestinal system are among the most widespread and varied illnesses requiring medical attention. Among the most common reasons patients see their physicians are gastroesophageal reflux disease (GERD, reflux, “heartburn”), gastritis, and screening for colon cancer. Although there are several options available to evaluate these problems, not infrequently an endoscopic procedure will be required. This entails the passage of a flexible scope into the gastrointestinal tract with a camera at the end to allow your physician to actually see the inside of your GI tract and more accurately evaluate the problem. This also gives your physician the option of performing a biopsy if he/she sees a suspicious lesion. The biopsy is then sent to a pathologist for microscopic evaluation and diagnosis. This provides your physician the information necessary to choose the best treatment options for you.

GASTRITIS
The stomach lining is a remarkably resilient membrane. It allows stomach acids, which are as powerful as car battery acid, to begin the digestive process. If the stomach lining breaks down for any reason, then these acids are exposed to the underlying gastric tissue potentially resulting in ulcer formation. This disease process is referred to as peptic ulcer disease. Approximately 350,000 to 500,000 new cases of peptic ulcer disease are diagnosed each year. One of the most common reasons the stomach lining breaks down is due to inflammation (gastritis) and one of the most common causes of gastritis is infection by a bacteria known as Helicobacter pylori (H. pylori). Many of us will be infected by this bacterium but not all of us will develop ulcers. However, for those that have long-standing inflammation the potential for ulcer development is high. There are several ways that your physician can diagnose gastritis due to H. pylori but the gold standard is via endoscopy and biopsy. Endoscopy also allows the physician to visually evaluate the stomach and get an idea of how much damage has been done. If you do have H. pylori, your physician will prescribe treatment to kill the bacteria and decrease the amount of stomach acid you produce allowing your stomach to heal.

Other causes of gastric ulcers include pain medications called non-steroidal anti-inflammatory drugs (NSAIDs) such aspirin and ibuprofen. Long-term use of these drugs can significantly increase one’s risk of ulcer.

COLON CANCER SCREENING
Colon cancer is the third leading cause of cancer related death in men (behind lung and prostate cancer) and women (behind lung and breast cancer). Approximately 148,000 people will be diagnosed with colon cancer each year and about 56,000 people will die from the disease annually. However, if it is detected early it can be effectively treated and often cured.

Every one of us is at risk for colon cancer. One out of 50 people or approximately 2% of the population will be diagnosed with colon cancer. Although the cause of colon cancer is not known, there are certain factors that can increase your risk for the disease. The factors that affect colon cancer risk include

  1. Age – the risk increases as we get older, particularly beyond the age of 50
  2. Diet – a high fat, high calorie, low fiber diet can increase your risk
  3. Lifestyle – smokers have a 30-40% higher risk than nonsmokers for the development of colon cancer; in addition, alcohol consumption, lack of exercise, and obesity can increase your risk
  4. Family history – having first degree relatives who have had colon cancer is associated with a higher risk, the more relatives with colon cancer, the more significant the risk
  5. Colon polyps – while polyps are common in people over 50, a certain type of polyp, referred to as an adenoma, increases the risk of developing colon cancer
  6. Personal history – a history of a chronic inflammatory disease of the colon such as ulcerative colitis or Crohn’s disease is associated with a higher risk

Unfortunately, colon cancer may strike without symptoms. For this reason it is important to get regular examinations, referred to as colorectal screenings. The purpose of these examinations is to detect cancer at its earliest stages when it is most likely to be cured. In general, annual colorectal screening should begin at age 50 and consist of a physical exam and a test to detect small amounts of blood in the stool. This test is known as a fecal occult blood test. These small amounts of blood, which may not be visible to the naked eye, can be the first sign of an underlying colon cancer. In addition, periodic endoscopy (colonoscopy) should be performed so that your doctor can inspect the inside lining of your colon and potentially biopsy any suspicious lesions. The frequency of colonoscopy depends on your risk factors and should be discussed with your doctor. The American Cancer Society has recommended guidelines for colorectal screening. Occasionally, colon cancer will be associated with symptoms. These symptoms include: blood in the stool, a change in bowel habits (constipation/diarrhea/rectal pain), unexplained weight loss and fatigue. Although, these symptoms may be caused by many other diseases, if you suffer from any of them, you should see your doctor and be evaluated.

What can you do to prevent colon cancer? Even though we do not know exactly what causes colon cancer, there are some steps you can take to try to reduce your risk. First of all, you should have regular screening examinations to help detect colon cancer early, when it is most curable. If you have a family history of colon cancer, inform your doctor. Your diet can be quite important. The National Cancer Institute recommends eating a high fiber, low fat diet to reduce your risk for colon cancer. In addition, studies suggest that a multivitamin containing folic acid or folate and calcium supplementation may help lower your risk. The good news is the death rate from colon cancer has been going down for the past fifteen years. This is likely due to several factors including an actual decrease in the number of new cases, colon cancer being detected earlier due to effective screening and improved treatments. Hopefully, this trend will continue.

Resources (Links will open in a new window):

www.cancer.org
www.webmd.com