January's Wellness Topic: Setting Goals
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Dr. Linda Lee
Setting Goals

Colon Health in the New Year
by Linda Lee

This is a good time to think about your health in the coming year and what preventative screenings you may be due for.

If you are not a gastroenterologist, you might be uncomfortable entering into a conversation about your colon. But having a healthy colon is important! Your colon performs the very important function of storing and concentrating waste your body must eventually eliminate. When it doesn't do this right, this may lead to physical discomfort and in some cases, disruption in your life.

The colon is also an organ that may be affected by cancer. In fact, colorectal cancer is the third most common type of cancer (after lung, breast in women, and prostate in men), affecting men and women equally. You have about a 1 in 20 chance of developing colorectal cancer sometime in your life.

Lifestyles factors are key to colon cancer prevention

Lifestyle factors that have been associated with an increased risk for developing colorectal cancer include eating a diet that is heavy in red meat and low in fiber, fruit and vegetables; drinking more than 3 alcoholic beverages each day; and smoking. Being overweight or obese is another independent risk factor for colorectal cancer so this is another good reason to work on getting that body mass index below 25. Moreover, if you have a first-degree relative who has had colorectal cancer under the age of 60, then you are also at increased risk.

In addition to modifying your lifestyle to decrease any of the risk factors above, you should also undergo colorectal cancer screening starting at age 50. If you have a first-degree relative with colorectal cancer under the age of 60, then you should start screening at least 10 years earlier than the age at which your family member was diagnosed. If you have had symptoms, such as rectal bleeding or a sudden change in your bowel habits, talk to your doctor as soon as possible.

Getting a colonoscopy

The best and most comprehensive way to get screened is to undergo a procedure called a colonoscopy. This is an exam of your entire colon using a flexible lighted tube that is gently passed along the 6-foot length of your colon — done while you are asleep! While this might sound terrible, it actually isn't. Because of new medications that are available, most patients report awakening from the procedure from a comfortable sleep. Some people don't even realize the procedure has been completed.

The worst thing about having to undergo a colonoscopy is the preparation you must take the evening before. Some practitioners are still giving their patients a full gallon preparation to drink, but there is one that is only 32 ounces now available. But that also requires you to drink additional clear liquids to help keep you hydrated. The good news is that it doesn't taste bad and does not cause significant cramping. I've tried three different regimens myself, and I can tell you the newest ones are indeed much better.

During the colonoscopy, your colon will be inspected for polyps, which are small growths that have the potential to slowly grow and become cancer. Not every polyp turns into cancer, but since we don't know which ones will do so, we remove any polyp we find. Removing polyps from your colon is a painless experience, and it has been shown that removing them can reduce your future risk for colon cancer.

Other screening types

If you are not in an area where colonoscopy is readily available, there are other methods that can be used to screen you colorectal cancer. These methods include stool testing which is the least sensitive way for detecting colon cancer, as well as virtual colonoscopy, which is a special kind of x-ray test (a 3D version of a CT scan) of your colon to look for polyps. The radiologist inserts a tube into your rectum and puts in air so your colon will be fully distended on the x-ray images. This can be somewhat uncomfortable if you have a very sensitive gut or have irritable bowel syndrome. Not all radiology centers offer them and the CT scan has a more difficult time detecting tinier polyps. Though getting a virtual colonoscopy might sound more attractive, you still have to take the same laxative regimen the night before as for the colonoscopy. But a virtual colonoscopy does not involve being sedated, and this might be your personal preference. Talk to your doctor about it and also your insurance company to find out if it is covered. A virtual colonoscopy is only appropriate for anyone who is at average risk for colorectal cancer and does not have any of the family risk factors outlined above or a personal history of colon polyps or colon cancer.

Screening every 10 years is recommended for most people

If your colonoscopy is normal then you might be a lucky enough to not have to have another one for up to 10 years. Those who have polyps are brought back sooner, because once you have had a polyp, you are at increased risk for developing new ones in the future. So take care of your colon by eating the right diet and getting screened for colorectal cancer. Removing polyps decreases the chance you will get colorectal cancer, and finding it at the early stages gives you the best chance for cure.

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