Good To Know

Hello, Friends!

This week, I thought I would cover a topic which is changing before our eyes, and that is colorectal cancer (CRC). For decades, we have been telling people to do the same things: colonoscopy for screening after the age of 50. Well, first of all the age has gone down to 45 for the first screening colonoscopy. Why, you might wonder? That is because the age for colorectal cancer is lower. What used to be a cancer of the elderly is now becoming prevalent in 30 and 40 year olds. That is a big change!

The next question is, what has changed to lower the age for the colon cancer rates in the last couple of decades? In short, we are sitting too much and exercising too little. If we don’t drink enough water or exercise, we can have difficulty with routine bowel movements. If we are constipated, we reach for the dulcolax or Miralax, instead of thinking about what we should change to keep things moving. When stool sits in the colon, the body continues to take moisture from the stool. And then we start to have hard stools which are difficult to pass, back pressure can lead to hemorrhoids and tiny diverticuli (blind pouches which are like blebs on an innertube). Those diverticuli can have small seeds or stool stuck inside, and they can become infected. This is more inflammation in the gut. And hemorrhoids can bleed at any time, often just inside the rectum.

Another risk for colon cancer is not drinking enough water with our daily exercising! Less water leads to constipation, hemorrhoids and diverticuli as well. So once again, the recurring theme for us as human beings is drink a gallon of water and move/exercise every single day. This helps us avoid the most common causes of rectal bleeding: hemorrhoids and rectal fissures.

But what happens when we get our bowels moving at least 2 or 3 times a week but still have rectal bleeding? Persistent blood from the rectum must be investigated. We have new types of testing for blood in the stool which don’t always require three days of stool samples, dietary restrictions or hassles. We have tests that measure the hemoglobin directly in a single stool sample, and do it with accuracy. This is called the FIT test, and requires just one icky stool sample. If blood in the stool is identified, the next step is a colonoscopy to investigate. Colon polyps cause colon cancer, and this is one test that can diagnose, biopsy and treat polyps by removing them. The prep is the worst part, but the information and assistance obtained from a colonoscopy is the lifesaver with colon cancer. Colorectal cancer is one that is very avoidable with screening. If you or a loved one has had persistent rectal bleeding over days or weeks, especially in spite of normalizing bowel movements, you must contact your primary care provider to investigate. Because colon cancer has taken hold in younger adults in their 30’s and 40’s, we must be careful to screen with a colonoscopy any time we can’t explain rectal bleeding or it occurs over days or weeks at a time. This test can save your life or that of a loved one.

Keep lots of fiber in your diet, drink plenty of water, exercise daily, even if it is walking around the block to prevent colon cancer. And see your provider if you have any questions about your own risk of colon cancer and especially with blood in the stool. Have a great week!