In the United States, cancer is second only to heart disease in terms of annual deaths. Almost 600,000 people die from some form of cancer every year, and colorectal cancer is the second leading cause of cancer death for both men and women. More than 140,000 new cases are diagnosed every year of this largely preventable disease. March is National Colorectal Cancer Awareness Month. The main goal of the campaign is to raise awareness of the disease, but also to encourage people to get early screening for colorectal cancer. While it can be a deadly disease, catching it early can make an enormous difference in terms of both life expectancy and quality of life.
What Role Does the Colon Play in Digestion?
Although frequently asymptomatic, colorectal cancer can be related to a variety of gastrointestinal symptoms. It’s helpful to understand how the colon fits into the digestive process. When food enters the mouth and is chewed into a pulp, that mass (called a food bolus) makes its way down the esophagus and into the stomach. Digestive juices and muscle contractions, called peristalsis, act on the food bolus to reduce it to a semi-liquid material called chyme. The chyme then enters the small intestine where additional enzyme-rich juices further break it down into components that can be absorbed into the bloodstream and carried around the body to be used by cells.
After the small intestine, the chyme (composed mostly of waste materials and bits of undigested food at this point) enters the large intestine via the ileocecal valve. The cecum is the first portion of the colon followed by the ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and anal canal.
The small intestine is primarily responsible for true “digestion” in the sense of utilizing the nutrients in food, and it is the colon that processes the remaining waste products by absorbing water and salts and forming stool. Though the colon doesn’t produce digestive enzymes, the gut flora present there can use the waste products in the stool to synthesize valuable vitamins. By the time the stool reaches the sigmoid colon, it is mostly solid and can be expelled through the anal canal.
What is Colorectal Cancer?
Colorectal cancer is an abnormal growth of mutated cells that can develop in either the colon or the rectum. Though the terms colon cancer and rectal cancer are used to describe cancers in those specific areas, colorectal cancer is a commonly used term to group the two conditions together since they both share similar attributes. Like any type of cancer, the abnormal growth of cells starts small and localized but can spread to other parts of the body and lead to major problems for multiple body systems.
Colorectal cancer typically begins in the inner lining of the colon or rectum with small, fleshy growths called polyps. Though typically benign at first, polyps can become cancerous over time if they aren’t removed. Some polyps, such as inflammatory or hyperplastic polyps, are considered to have low malignancy potential and are therefore unlikely to lead to cancer. Adenomatous polyps, on the other hand, are considered precancerous and thus have a much higher likelihood of leading to cancer. Polyps can usually be detected and, more often than not, removed during a colonoscopy.
Symptoms of colon cancer, if present, can vary and can be very similar to other digestive diseases, such as inflammatory bowel disease, irritable bowel syndrome, or hemorrhoids. Below are some of the more common symptoms reported:
- Fatigue or weakness
- Changes in bowel habits that persist for more than several days
- Unexplained weight loss
- Blood in the stool
- Bleeding from the rectum
- Abdominal pain
- Abdominal cramping
Symptoms cannot be relied on for screening or diagnosis, however, both because of their similarity to other diseases and because the symptoms are a late finding in colorectal cancer, meaning there has already been significant progression.
Causes of Colorectal Cancer
Although cancer is a complex process with a variety of causative factors, on a fundamental level, it occurs due to mutations in the DNA of the affected cells. The specific gene types that appear to be involved are called oncogenes and tumor suppressor genes; oncogenes are responsible for helping cells divide and grow, and tumor suppressor genes are responsible for preventing the kind of cellular overgrowth that happens in cancer.
One of the main tumor suppressor genes involved at the beginning of cancer is the adenomatous polyposis coli (APC) gene. When this gene becomes mutated, it can no longer function as a “brake” on cellular growth and therefore overgrowth happens. It is not completely understood why these kinds of mutations happen in the first place. Diseases like familial adenomatous polyposis (FAP), a condition characterized by the development of a large number of adenomatous polyps, suggest that it can sometimes be inherited from a parent. But research suggests that these mutations may also be acquired during the course of life from exposure to a variety of risk factors.
What are the Risk Factors for Colorectal Cancer?
Scientists have found links between certain behaviors and risk factors that make someone more likely to develop colorectal cancer, although it is still unknown how these factors precisely “cause” cancer. The American Cancer Society has identified a number of these risk factors, and they are generally divided into inherent factors (those that can’t be controlled) and lifestyle factors (those that can be controlled):
- Age 50 years or older
- Some diseases, such as inflammatory bowel disease or type 2 diabetes
- Personal or family history of colorectal cancer
- Racial and ethnic background, such as African Americans and Jews of Eastern European descent
- Inherited syndromes, such as FAP or Lynch syndrome
- Heavy drinking
- Smoking tobacco
- Eating a lot of red or processed meats
- Lacking sufficient regular exercise
Treatment Options for Colorectal Cancer
Doctors use a “staging” system to describe and organize the progression of cancer and the appropriate treatments for the different levels of progression. This system runs from very early (stage 0) to very advanced (stage IV):
- Status: The cancer is confined to polyps or small tumors in the mucosal lining of the colon
- Treatment: Endoscopy or surgery to remove the polyps or tumors is standard, but a partial colectomy may also be warranted
- Status: The cancer has grown past the mucosal lining and into the wall of the colon itself, but it hasn’t spread to the lymph nodes or other parts of the body
- Treatment: Surgery is the main treatment option to remove any cancer-containing parts of the colon
- Status: The cancer has grown through the wall of the colon, but still hasn’t reached the lymph nodes
- Treatment: Both surgery and chemotherapy are typically used at this stage, depending on the nature of the spread
- Status: The cancer has spread to the lymph nodes, but not to distant body parts
- Treatment: Surgery and chemotherapy are standard, but radiation therapy may also be employed
- Status: The cancer has spread beyond the colon to other parts of the body
- Treatment: Surgery may be utilized as needed (usually palliative, to improve quality of life), but chemotherapy is the primary treatment option
Colorectal Cancer Screening
It is before cancer develops or when the cancer is still in the early (or local) stage that doctors have the best chance of treating for long-term success. For this reason, those who are 45 years or older should start talking with a qualified gastroenterologist about getting screened. If you want more information about a colorectal cancer screening, Contact Us.
Everyone gets sick or feels run down once in a while. Maybe you’re feeling fatigued with no real explanation for a week, or you’ve had a couple of bouts of indigestion, diarrhea, or constipation. Those things alone may be signs that you’re a little stressed, or maybe you have a viral infection that needs to run its course. Or, these may be signs of digestive problems that could be indicative of a deeper digestive issue. Read on to learn a little bit more about different types of digestive symptoms, what you should look out for, and when it warrants a call to a GI specialist for evaluation.
Signs and Symptoms of Digestive Issues
Most insurance companies have a certain protocol that they follow, and most often, the first appointment patients will make is with their primary care physician, unless they are already under the care of a gastroenterologist and are experiencing new or changing symptoms. If you experience one instance of gas, constipation, or diarrhea, most likely, you aren’t going to give your PCP a call. But if these conditions persist you should give your primary healthcare provider a call. Be on the lookout for new digestive symptoms such as:
- Persistent gas
- Trouble swallowing
- Persistent fatigue or lethargy
If you’re experiencing one or more of these symptoms persist, it may be indicative of some type of digestive problem. Some GI and digestive problems are more “quality of life” issues, where symptoms affect comfort more than anything else, while others can be more serious.
If you notice blood in your stool or wonder about hemorrhoids, you discuss it with your primary physician. Rectal bleeding can be a byproduct of hemorrhoids, or it can be a symptom of other GI disturbances, but it certainly warrants a thorough workup. Similarly, hemorrhoids should also be evaluated and treated. They are not a life-threatening or severe condition, but they can certainly affect the quality of life and can be painful. Some hemorrhoids are internal and are located on the inside of the rectum. These can be removed via colonoscopy or through other methods. Others may need surgical intervention.
Signs and Symptoms You Notice Over Time
Of course, everyone notices a bout of diarrhea or heartburn that lasts a few days, but there are other, more benign signs and symptoms of GI problems that you may not notice over a week’s - or even a month’s - time.
One sign to look for is that your jeans are suddenly too tight. It’s not like you’ve suddenly put on weight, or you’ve gone off your diet. However, jeans that maybe fit three weeks ago are now a little bit snug, and it’s noticeable. This can be because you’re bloated. Bloating can be the result of many different things - from overeating at a few sittings to lactose intolerance, but it can also be from gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), constipation, gallstones, or other GI problems. If you find that your jeans are too tight, and you’re also experiencing heartburn and other GI disturbances, let your doctor know.
On the flip side, if your pants are suddenly too loose and you’re not trying to diet or lose weight, there may also be a problem. Unexplained weight loss could be a sign of an underlying GI problem. If you notice that you’re shedding pounds unexpectedly, it’s time to see your physician.
If your stools are black, tarry stools. It can be a sign of one or more GI problems, so see your doc f you notice these.
Everyone passes gas, but if you notice that your gas is particularly smelly and persistent, this may be a sign of an intestinal issue. Also, unusual amounts of gas paired with other symptoms, such as abdominal pain, changes in bowel habits, or unexplained weight loss are all reasons to see a GI specialist or your PCP.
If you experience trouble swallowing beyond something of a cold or viral infection (such as swollen lymph nodes), let your doctor know. If it feels like there is a “lump” in your throat and it’s painful to swallow food and liquid, this may be a sign of trouble with your esophagus. If trouble swallowing is also paired with coughing and hiccupping, see your PCP or GI specialist as soon as possible.
Common GI Problems
A GI specialist treats a wide array of disorders and problems. Patients may worry that by going to see a specialist that there may be something seriously wrong with them, but that is often not the case. Very often, a GI specialist will want to treat the motility of the GI tract (its ability to keep moving), and the treatment will be changing diet or exercise habits. This may include excluding dairy, adding more fiber to the diet, exercising more, or avoiding certain medications.
GI doctors also treat common, everyday conditions such as diarrhea, constipation, and heartburn.
Irritable bowel syndrome (IBS) is a common problem treated by GI specialists. The primary treatment for IBS includes avoiding certain foods or practices that trigger the irritation of the colon (such as caffeine). IBS, while not a life-threatening disorder, can be a significant condition quality of life issue.
GI specialists also treat inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn’s disease. Inflammatory bowel disease involves inflammation and damage to the tissue and lining of the colon. Left untreated IBD can result in significant and lasting damage.
Gastroenterologists also treat diseases of the liver, pancreas, and esophagus, treat anal disorders such as anal fissures and hemorrhoids, treat cancer such as colon cancer, and manage any disease or disorder that is part of the digestive system.
If you need more information about digestive disorders or need to be seen by a GI specialist, request an appointment with GI Associates today. We have five separate office locations in north and central Wisconsin.
Could eliminating gluten help you live a pain-free, more comfortable life?
Gluten Sensitivity is the term used to describe individuals who cannot tolerate gluten and experience many of the same symptoms of Celiac patients but without the presence of antibodies and damage to the intestines.
There are many signs of gluten sensitivity that could be misunderstood or attributed to something else. Many of these do not appear related to digestion at all, and most occur within hours or days of consuming wheat or wheat products.
Common ailments from headaches, to rashes, to brain fog can all be signs of a gluten sensitivity. It can be hard to recognize patterns, especially since no two people experience symptoms quite the same way. If you have one or more of the common symptoms, you may want to consider gluten sensitivity as a potential cause.
Additionally, a gluten sensitivity can manifest itself in a combination of common or more rare symptoms, so if you are noticing these you should consider discussing the issue with your health care provider.
Common symptoms include:
- Bloating, gas or abdominal pain
- Joint pain
- Numbness in extremities
- Brain fog
- Diarrhea or constipation
Your provider will help you establish a clear connection between your symptoms and your consumption of gluten to make a diagnosis. He or she may ask you to keep a journal of what you eat and when you experience symptoms to help determine if gluten is the cause of your pain and discomfort.
If you think you may have a sensitivity to gluten, let the professionals at GI Associates help you get back to living a more pain-free and comfortable life. Call 877-442-7762 to make an appointment, or submit an appointment request with our online form.
Tips to keep holiday parties pain-free
RSVP yes to holiday parties, but don’t dance with digestive pain afterwards. You’ve made it through Halloween. Thanksgiving is in the rearview mirror. But there’s one month of treats left – and it’s a biggie. December is full of many wonderful (and decadent) traditions. This year, give your stomach the greatest gift: A season free of pain. Keep these things in mind when celebrating and attending gatherings with family and friends, so the only thing your stomach is full of is comfort and joy.
Find (or bring) foods with fiber: So many of the goodies popular this time of year simply lack fiber. Be mindful when filling your plate and choose fruits and vegetables to help compensate for what other treats are lacking. Not only are you making healthier, lower calorie selections, but not getting the proper amounts of fiber can cause pain and constipation. A deficit of fiber is even more painful for those with digestive disorders, such as diverticulitis. If you suffer from diverticulitis, think grains, fruits, and vegetables to make sure your mood remains merry.
Watch portion sizes: We’re not trying to be Scrooge-like, but managing portion sizes – while not always easy – is a great way to avoid pain, reflux, bloating, and other digestive issues. Sometimes it’s a good idea to eat a healthy meal before attending a holiday get-together so you’ll already be full and will be less tempted to go overboard on goodies.
Avoid rich foods: Holiday foods are often heavy on sugar and high on fat. Especially when combined, an excess of foods rich in fat and sugar creates greater stress on your gastrointestinal system triggering stomach aches, reflux, and more. Alcohol, while not a food, also contains sugar and is another trigger that causes reflux. While it may be hard to avoid these holiday favorites completely, enjoy rich foods cautiously, and in moderation.
Greasy foods are on the naughty list: Foods that are full of grease can really wreak havoc on your system and may cause diarrhea and gas. Choose better, healthier options such as leaner meats that are grilled or baked, and raw or steamed vegetables instead of the deep-fried alternatives.
Talk more, eat less: It really is the most wonderful time of the year to reconnect with friends and family. So enjoy the fun and the food, but focus more on people and less on your plate. Striking up more conversations with those around you will automatically prompt you to eat slower and give your stomach time to do its thing. Even better, you’ll have time to really catch up with those you love.
If you’re experiencing digestive discomfort, give yourself the greatest gift and let the expert team at GI Associates get you on the path to a better quality of life. For more information about a consultation, call 877-442-7762 or fill out our online appointment form today.
You hear a lot about Gastroesophageal Reflux Disease (GERD) these days – and for good reason.
GERD affects up to 1 in 5 or more adults in the U.S.; not to mention a growing number of children.
While there’s increased recognition of the acronym “GERD,” there’s still a lot of confusion about the cause and effects of the disease. With that in mind, we thought it would be helpful to explain what GERD is, and the symptoms to watch for.
First: What exactly is GERD?
GERD occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach– your esophagus. The medical term for this “backwash” is “acid reflux,” which can irritate the lining of your esophagus. Reflux becomes a disease when it causes frequent or severe symptoms or damage. Left untreated, it can lead to pain, chronic irritation of the lining leading to cellular changes, chronic cough, and other issues.
While GERD can affect nearly anyone at any age, certain conditions can increase your risk for GERD, including:
- Bulging of the top of the stomach up into the diaphragm (i.e., hiatal hernia)
- Delayed stomach emptying
What symptoms should you watch out for?
Chronic heartburn is most commonly associated with GERD. But many people don’t realize there are several other symptoms that shouldn’t be ignored. For example, some people may experience one or a combination of the following:
- Inflammation of the gums
- Hoarseness in the morning
- Bad breath
- Erosion of teeth enamel
If you have nighttime acid reflux associated with GERD, you might experience:
- Chronic coughing
- New or worsening asthma
- Disrupted sleep
Nighttime reflux is often associated with more aggressive symptoms of GERD. You can learn more about sleep and GERD here.
If you experience any of the GERD symptoms above, it’s important to talk with a gastroenterologist sooner rather than later. Often, GERD can be managed by lifestyle changes and medication. Call us at 877-442-7736 or request an appointment online.
What you need to know about swallowing disorders
Swallowing disorders are surprisingly common, though they rarely get the attention they deserve. Here we will explore the causes, diagnosis, and treatment of some of the most common swallowing disorders.
Johns Hopkins Medicine describes two kinds of swallowing disorders: Dysphagia, “the sensation of food or fluid being regurgitated or stuck in the chest; also any throat dyscoordination leading to coughing or choking during swallowing” and odynophagia, which they describe as “pain in throat or chest during swallowing.”
Symptoms of swallowing disorders
Since some swallowing disorders may be serious, it is important to get a proper diagnosis if you are experiencing the following symptoms. Gastroenterologists can quickly and accurately diagnose any swallowing disorder you may have. Symptoms of swallowing disorders include:
- Pain while swallowing
- Inability to swallow
- Feeling like food is getting stuck in your throat or chest or behind your breastbone
- Being hoarse
- Frequent heartburn
- Food or stomach acid back up into your throat
- Unexpectedly losing weight
- Coughing or gagging when swallowing
How we diagnose swallowing disorders
GI Associates providers may order any of the following diagnostic tests to determine the best course of treatment:
- Barium esophagram
- Esophageal manometry
- Wireless pH testing
- 24-hour pH impedance
Treatment for your swallowing disorder will be determined by what type you have. Your team at GI Associates will work together to develop the best solution for you.
Think you may have a swallowing disorder? Contact GI Associates for a consultation by calling 877-442-7762 or fill out our online appointment form today.
Enjoy the “wow” without the “ow”
A GERD diagnosis doesn’t mean your foodie life is over. There are plenty of foods to enjoy while minimizing your risk for aggravating your GERD. A few tips to keep in mind, regardless of what you eat, is how you eat. For example, avoiding large, late meals will do you a world of good. Try to allow at least 3 hours between your last meal or snack and bedtime. Taking a short walk after eating will help stimulate digestion and keep the system moving.
Don’t forget that not all foods trigger all people. It’s smart to keep a food journal. You may feel better if you avoid a lot of caffeine, carbonated beverages, chocolate, alcohol, citrus and tomato products, and fatty foods. That’s not to say that you can never have these things, just be smart and consume in moderation.
If this sounds like a lot of hassle, take heart: GERD diets can be user-friendly and delicious. We’ve collected some of our top recommendations for you to help make the best—and tastiest—GERD diet choices.
1. Fruits and Vegetables, Even Potatoes
Avoid citrus and citrus juices, but open your table to a smorgasbord of others. Go for fresh, in-season stock and make sure they are prepared perfectly. For example, it’s hard to get excited about a can of asparagus, but roasted with a bit of olive oil and sea salt? Take a new approach with the classics and your taste buds may thank you.
Eggs have plenty of protein and are super versatile. Have them scrambled, in a frittata, or make yourself an omelet. Skip the onions but add other GERD diet-friendly add-ins such as low-fat cheese, mild turkey sausage, spinach, zucchini, or whatever the fridge has in store for you. Using a non-stick pan will help you reduce the oil you’ll need to prepare this breakfast of champions.
3. Fish and Lean Meat
If you are a meat eater, carry on! Just be sure to go for lean cuts. Skip frying and poach, grill, broil, or bake your fish or lean meat and your heart will thank you too.
A good GERD diet can include complex carbohydrates. Oatmeal, whole grain bread, rice, and couscous are good sources of healthy complex carbs. Bonus: whole grains and brown rice add fiber to your diet and help keep your digestive system on track.
If you are not sure how to put this all together, we recommend visiting our GERD education page where you will find resources including a video, other lifestyle modifications for alleviating symptoms, and a GERD assessment.
At GI Associates, we can help you manage your GERD so you can live a more comfortable life. Give us a call at 877-442-7762 to make an appointment today.
GI Associates Welcomes Dr. Melinda Wayde
We are thrilled to welcome Dr. Melinda Wayde to our team of digestive health specialists.
Dr. Wayde completed her fellowship training in gastroenterology and internal medicine at Wright State University in Dayton, Ohio. While there, Dr. Wayde distinguished herself as a leader and scholar, earning the prestigious Outstanding Resident Award.
President of GI Associates, Dr. Christopher A. Young, says he’s looking forward to working with Dr. Wayde: “Dr. Wayde brings with her an expertise in gastroenterology informed by a global perspective, having received additional medical training in Mexico. Dr. Wayde also completed a medical mission trip to Adidome, Ghana. We know she will offer great services for our patients and be an asset to our community.”
Dr. Wayde is truly passionate about gastroenterology. “I love the fast-paced and varied aspects of this profession,” she says. “I love the combination of clinical work, performing procedures, and working with a diverse population.”
Describing her philosophy of care, Dr. Wayde says that it’s collaborative. “It’s very important to me that my patients are active participants in their treatment. I want to help improve not only their health, but their quality of life.”
In her spare time, Dr. Wayde enjoys spending time with her husband and children. They love going outdoors, hiking, biking, and going to festivals.
Dr. Wayde is currently accepting patients. She joins the Board-Certified Adult Gastroenterologists at GI Associates: Dr. Christopher A. Young, Dr. Raymond L. Hartke, Dr. James R. Schlais, Dr. Benjamin M. Schneeberger, Dr. Veronika Gagovic, Dr. Eric A. Johnson, Dr. Susan M. Lepinski, Dr. Justin G. Hartke, and Dr. Adam C. Godsey.
For more information, or to make an appointment at our Wausau office with Dr. Wayde, please call GI Associates at 715-847-2558.
Tips for healthy summer habits
Just because you’re on vacation doesn’t mean your digestive system should be, too! Everything’s a little more relaxed in the summer, which is great for your mental health, but not always your physical health, specifically: your digestion. Even amidst the county fairs, company picnics, road trips, and amusement park visits, it’s important to maintain your healthy habits. Try these tips to stay on track:
Pack Snacks. Save money, calories, time, and potential tummy trouble by bringing your own snacks. This article has plenty of great tips for amusement park trips, the top of which is snack packing.
Eat Beforehand. Grab a banana on the way to the cookout or have a handful of nuts as you head out the door. This will reduce your risk of overeating at summer events—which, let’s be honest, probably don’t always have the healthiest options.
Hydrate. Water is essential to healthy digestion and your body can become dehydrated quickly in the summer. Keep a reusable water bottle with you whenever possible and be sure to drink throughout the day.
Exercise. Summer is a great time to get out and rollerblade, walk, swim, or jog, which is great because exercise is key to your digestive health. Just be sure to stay hydrated!
Get the Meat Out of the Heat. The next time you’re grilling out, keep an eye on those hot dogs and burgers. Prolonged exposure to summer heat accelerates food poisoning risks. Once you have eaten, quickly refrigerate the leftovers.
Stop Grazing. There are spreads galore at summer celebrations, but don’t use it as an excuse to keep your paper plate piled high with cheese, salami, chips, and dip. Eat a moderate amount and then dispose of your plate and pop in a piece of gum. You’ll be less likely to overdo it when it’s more difficult to refill your plate.
You don’t need to deny yourself every funnel cake and brat that comes your way this summer, just be smart about the choices you make so that you can make the most of your summer. Have a great summer and if digestive concerns are slowing you down, call GI Associates at (715) 847-2558 today!
If you have heard the word “colonoscopy,” you may also have heard the word “polyp.” But what do these little tissue growths mean for your health? What happens when polyps are found during your colonoscopy?
The majority of polyps are small (less than half an inch) raised areas or growths that reside benignly until removed during your colonoscopy. When detected, polyps are removed at the time of your colonoscopy and sent to pathology for evaluation.
There are different types of polyps, the majority of which are benign. The polyps of concern are adenomatous polyps, which do have a tendency to turn into cancer growths if left unattended
Adenomatous polyp subtypes include:
- Pedunculated: These look like mushroom stalks and are usually benign
- Sessile: These are flat, so they are harder to detect, but they are also usually benign
- Tubular: Tubular polyps are also rarely cancerous
- Serrated: These saw-toothed polyps are usually benign as well
- Villous: There’s over a 50% chance that these will be cancerous
- Tubulovillous: Because of their larger surface area, these polyps present an increased risk for cancer
This list is just an overview. The American Cancer Society has much more in-depth resources for understanding your polyps if you’d like to learn more. Regardless, it’s important to remember that when your doctor gives you the report on polyps after your colonoscopy, there may be no cause for concern. However, to prevent negative outcomes—and to intervene before adenomatous polyps turn cancerous—it’s important to face your polyps head on. Colonoscopies are the best way to remove your polyps and the most effective way to prevent colon cancer.
To schedule a colonoscopy to get the lowdown on what might be happening with polyps in your colon, contact GI Associates today by calling 877-442-7762 or fill out our online appointment request form.
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