Pink Prescriptions - March 2024

Let’s Talk About Colon Health: Because Colorectal Issues are Too Hard to Stomach

PinkRx1122March 2024 Issue — Pink Prescriptions

Let’s Talk About Colon Health
Because Colorectal Issues are Too Hard to Stomach

A healthy colon is a much taken for granted organ when working properly. However, when things go awry, it can turn into a terrible situation. The colon is essential for waste removal in the body. If it’s not working properly, the body can’t absorb essential nutrients, or rid itself of waste. Colon health is incredibly important, although it’s not something most people want to talk about—even to their doctor.

March is Colorectal Cancer Awareness Month—the perfect time to educate yourself about this disease. Colorectal cancer is highly preventable when detected early, but deadly when ignored. It’s the second leading cause of cancer deaths in the United States. And, there is a rise in early-onset colorectal cancer diagnosis—that’s the under-50 crowd.The lesson here is don’t leave your colon health to luck. If you have symptoms, changes in your bowel movements, a family history, or it’s just time to get things checked, trust your gut and get checked. Don’t put it off…colorectal issues are just too hard to stomach.

Here’s what some of the Lowcountry’s medical experts had to say:

PinkRx 0324 Perley
By Kayo Perley, MD | Medical Associates of the Lowcountry

Who’s at risk for colon cancer?

Certain genetic conditions like familial adenomatous polyposis, Lynch syndrome, and BRCA mutations can increase the chances of developing colon cancer. Additionally, personal health factors such as a history of colonic polyps, ulcerative colitis, Crohn’s disease, radiation therapy to the abdomen, acromegaly, renal transplantation, or cystic fibrosis can also elevate the risk.

Another significant risk factor is having close relatives (first or second degree) diagnosed with colorectal cancer or polyps, especially if they were diagnosed before the age of 50. People of African American, Native American, or Alaskan Native descent are also at higher risk.

Individuals with any of these risk factors may need to start colon cancer screening earlier and have more frequent screenings. Other factors like obesity, type II diabetes, pre-diabetes, a diet high in red and processed meats, as well as a history of smoking and alcohol use, can also increase the risk of colon cancer, although they may not necessarily change the recommended age or frequency of screening.

When should I be screened for colon cancer and how often?

For individuals at increased risk of colon cancer, it is crucial to consult with a gastroenterologist to customize screening ages and frequencies based on their specific risk factors. For those at regular risk, screening typically begins at age 45 and continues until age 75. Colonoscopies, which are considered the gold standard of screening, are recommended every 10 years for those with normal results.

There are, however, alternative screening methods available. Fecal immunochemical testing (FIT) is a non-invasive test that detects blood in stool samples and is performed annually. The stool DNA test, also known as Cologuard, checks for blood and specific biomarkers for colon cancer, and can be repeated every three years, if results are normal. Sigmoidoscopy, which uses a camera to examine the lower part of the colon, is another option and is performed every five years, if results are normal. It is important to note that if any of these screening methods yield positive results, a follow up colonoscopy is necessary for further evaluation.

Dr. Kayo Perley is a Primary Care Physician with Medical Associates of the Lowcountry and is taking new patients—call (843) 706-2523 to schedule an appointment.

PinkRx 0324 GiganteBy James F. Gigante, MD

Are at-home colon cancer screenings effective??

A colonoscopy is the best way to not only detect, but also to prevent, colon cancer. During a colonoscopy, the physician can remove polyps that could turn into cancer if they are left to continue growing and changing. Colorectal Cancer is the third most common form of cancer in the US, and if detected early, has a high survivability rate. Early detection is important, as it is in more treatable in early stages.

At-home colon cancer screenings are a tool I would only recommend for people who refuse to do a colonoscopy, or have another medical condition that puts them at high risk if they have a minimally invasive endoscopic procedure. Why? Because they are really only effective in detecting cancer, which means that you have already progressed to that stage, whereas a colonoscopy is more preventative in nature.

The Cologuard test has a 13% false-positive rate, which means one in ten will result in further tests. Furthermore, some studies show that 58% of the time, precancerous polyps are not detected with Cologuard, whereas a colonoscopy is still the gold standard for evaluation and treatment. Cologuard can only detect 42% of large polyps, while a colonoscopy can detect 95% of large polyps. 

All that said, if a patient absolutely refuses to have a colonoscopy, a Cologuard would probably be the best option.

James F. Gigante, MD is a Board-Certified doctor of Internal Medicine and a fellow with the American College of Physicians. He has been practicing medicine for 25 years, the last 17 here in the Lowcountry. 843-681-2222; 35 Bill Fries Drive, Bldg. H, HHI.

PinkRx 0324 Thorpe
By Kimberly Thorpe, PA-C

Beaufort Memorial Hospital

What are the symptoms of a serious colon problem?
The most common symptoms of colon and rectal cancer are often no symptoms at all—at least not in the early stages. That’s why regular colonoscopy screenings are extremely important. A colonoscopy is the best way to detect masses, polyps and colon cancer early. It can even prevent colon cancer by enabling doctors to remove polyps before they become cancerous.

That said, any altered bowel function can be a potential warning sign of colon cancer. Difficulty emptying your bowels or experiencing a change in the frequency or consistency of bowel movements can indicate an issue. Also, because colon polyps often bleed when stool is passed, stool that is red, maroon, dark brown or black, may suggests blood is present and should warrant a visit to your doctor.

Other symptoms include:
• Bright red blood coming from the rectum
• Diarrhea, constipation, or other changes in bowel habits that last several days
• Feeling fatigued or anemic
• Losing weight without trying
• Stomach cramping and discomfort

It’s important to remember, though, that symptoms of colon cancer often appear only when the disease has progressed to advanced stages, when it’s harder to treat. That’s why screening is so important. While colon cancer remains one of the deadliest forms of cancer, it’s also one of the most treatable when detected early with a colonoscopy.

What does it mean when the doctor finds a polyp during my colonoscopy? Does that mean I’ll definitely get colon cancer?

A colon polyp is a small clump of cells that forms on the lining of the colon. Colon polyps are common, and most are harmless. But some types can grow into cancer if they aren't removed.

So no, finding a polyp does not mean you will definitely get colon cancer, but some types can grow into cancer if they aren't removed. That’s why it’s important to have regular screening tests because colon polyps found in the early stages can usually be removed safely and completely. The best prevention for colon cancer is regular screening for and removal of polyps.

Current guidelines recommend adults starting at age 45 have their first colonoscopy to screen for colon cancer. During the test, growths may be removed for evaluation. If everything looks normal, a repeat test would be recommended in increments of 1, 3, 5 or 10 years depending on the size and type of polyps found.

Kimberly Thorpe, PA-C, is a board-certified physician assistant and part of the gastroenterology team at Beaufort Memorial Lowcountry Medical Group Specialty Care in Beaufort.

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