Gastrointestinal Health

1. Colonoscopy: Do You Need One?

Colon cancer, or more specifically, colorectal cancer, is one of the most common forms of cancer and a leading cause of cancer-related death among men and women. Prevalent in about 4% of the population, colorectal cancer occurs in about 1.8-1.9 million individuals annually and is seen in about 150,000 people in the United States yearly.

Because of its prevalence rates, it’s recommended that people above the age of 45 should receive a colonoscopy every 1-5 years.

What follows will be a discussion about the diagnostic colonoscopy, why the test is necessary, and how often to have this procedure.

While the recommendations vary slightly depending on certain circumstances and health factors, such as health status, age, sex, race, and family history, it has been shown that this procedure has been effective in the prevention and management of colorectal cancer.

What is a Colonoscopy?

A colonoscopy is the use of a visual device to examine the inner aspect of the large intestine, which includes the rectum and colon. This process will help to identify any abnormalities of these regions.

A colonoscopy is performed using a long tube-like instrument called a colonoscope, which is inserted into the anal region. With the aid of the attached imaging camera, a colonoscopy is able to capture internal images of the entire large intestine.

During a routine colonoscopy, the practitioner may need to perform a biopsy of a mass or the removal of an intestinal polyp. The biopsy is performed by passing a wired biopsy forceps through the scope into the area where the mass is located and then withdrawing the tissue back through the scope for removal and transfer to a pathologist for tissue examination.

When to Get a Colonoscopy

The primary reason for an individual to seek a colonoscopy is to screen for the potential of colorectal cancer and to monitor for any additional developments of new masses or new polyps.

The other typical reasons for obtaining a colonoscopy are signs of blood in the stool, determination of microscopic blood in the stool, pain in the rectal region, and age greater than 45 years.

How Often Should You Get a Colonoscopy

If you’ve been diagnosed with colorectal cancer or have had a history of polyps identified during routine colonoscopy, you will need to have a colonoscopy more often than another individual who has had no history of colon disease. The interval can vary depending on the specific individual case, and your gastroenterologist will tell you this information based on your individual condition.

If you’re above the age of 45, you should schedule routine colonoscopy in collaboration with your primary care provider. This way the primary care provider and the gastrointestinal specialist can both monitor the intestinal health of the individual.

Finally, a colonoscopy should also be performed if you meet any or all of the following criteria:

• Above the Age of 45
• Have Family History of Colorectal Cancer
• Have Previous History of Benign or Pre-Cancerous Polyps
• Suffer from Inflammatory Bowel Disease
• At Risk of Related Cancers



Final Thoughts

A colonoscopy is a highly effective preventative and management protocol for screening against colorectal disease. In fact, 90% of such abnormalities and malignancies can be detected by colonoscopy.

If you’re part of the high-risk population, or if you have concerns regarding the potential need for a colonoscopy, it’s important to consult your primary care provider as soon as possible. Early detection is key, and prevention is best.



2. Jaundice And Liver Health Conditions

Jaundice is a condition that can be found in both infants and adults. Neonatal jaundice happens to be the most prevalent condition requiring medical attention in the infant population. The prevalence of jaundice in both children and adults is low, but it is helpful to know more about the condition as a parent or a family member.

In the following, we’ll discuss the condition of jaundice in infants and in adults, and we’ll discuss the medical reasons for why it occurs.

Definition of Jaundice

Jaundice is a yellowing discoloration seen on the skin and the whites of the eyes that occurs due to excess bilirubin levels in the body. It can also cause stools to be pale and urine to be dark yellow.

Bilirubin is a yellow pigment that occurs secondary to the breakdown of hemoglobin which is a building block of red blood cells. Normal breakdown of blood cells or damage to blood cells will release bilirubin, and it is normal to have some amount of bilirubin in the bloodstream. The liver breaks down bilirubin to allow it to be released from the body in the stool or urine.

Jaundice can either be a short-term or a long-term condition. Certain symptoms that occur along with jaundice include constipation, bloating, gas, upset stomach, and diarrhea.

Jaundice in adults will sometimes require treatment of an underlying medical condition, and, in some cases, it will improve without any treatment. Jaundice can occur in otherwise healthy children as well as adults with liver or pancreatic-related conditions.

Common Causes of Jaundice

Babies born prematurely, can often have high levels of bilirubin due to the fact that the liver is underdeveloped. Jaundice in an infant is often a mild condition and can usually be treated with noninvasive methods such as “bili lights” or “bili blankets”. This phototherapy causes the excess bilirubin to change to a form that can be eliminated effectively in the stool and urine.

Excess bilirubin can occur in several medical conditions which can be seen in adolescents and adults. Some of the most common causes of jaundice are hemorrhages, hematomas, hepatitis infection, blood infections, enzyme deficiencies, alcohol abuse, and some medication side effects.

Other conditions that can lead to jaundice are cancer of the liver, gallbladder, and pancreas. The classic presentation of pancreatic cancer is painless jaundice. In all of these cases, the underlying cancer will cause an obstruction of the normal flow of bile and levels of bilirubin will be increased in the bloodstream.

A yellow discoloration of the skin should prompt anyone to consult with their primary care provider for rapid evaluation.

Final Thoughts

Jaundice is a sign of an underlying medical condition in many cases, and it should be evaluated in a timely manner. There are many things that can cause an elevated level of bilirubin, and many times the liver can be the primary cause of the condition.

When left untreated or ignored, jaundice and elevated bilirubin can worsen, especially if liver disease or cancer is the primary cause. Rapid treatment of the underlying condition offers the best chance of a positive outcome.




A Different Cause of Cholecystitis: Biliary Dyskinesia


Cholecystitis is an inflammatory condition of the gallbladder caused by irritation to the walls of the gallbladder, typically from gallstones blocking digestive bile from exiting the gallbladder and entering the small intestine.

The primary responsibility of the gallbladder is to store and transport digestive bile to the small intestine in order to allow the body to digest fats. When this process is disrupted, inflammation can develop and cause all kinds of problems and can lead to the development of cholecystitis.

The signs and symptoms of cholecystitis are typically pain and nausea that is brought on by the ingestion of fatty foods.

Causes Of Cholecystitis and Pain

The most common cause of cholecystitis is blockage of the exit of bile from the gallbladder secondary to gallstones. The inflammatory process that develops can also lead to significant infection if not treated.

Another reason for obstruction of the flow of bile is gallbladder dysfunction or biliary dyskinesia. This is when the gallbladder is nonfunctioning and does not contract to squeeze the stored bile out of the gallbladder. In many cases, gallstones are not present and the pain from the condition is a colicky type of pain.

Gallbladder dysfunction only occurs in about 2% of the adult population and is a much rarer cause of cholecystitis. Gallbladder dysfunction is a condition that should be considered in cases in which no gallstones are identified by ultrasound.

How Biliary Dyskinesia Is Diagnosed

In order to diagnose a case of biliary dyskinesia, it needs to be determined if the gallbladder is emptying. If you identify that the gallbladder doesn’t empty, the diagnosis is clear.

Many individuals present to a doctor with signs of biliary colic. They have pain in the right upper quadrant of the abdomen which is often brought on after eating a fatty meal. Individuals can also develop fever and infection with this condition and may need treatment with intravenous antibiotics, analgesia, and hydrating liquids.

Upon initial assessment, several imaging tests can be ordered. These tests and examinations include ultrasound, CT scan, and HIDA scan, otherwise known as a Hepatobiliary Iminodiacetic Acid scan.

The HIDA scan, in particular, is a scan that creates imagery of the liver, gallbladder, and bile duct. This information provides the clinician with the ability to analyze, track, and determine whether or not the flow of bile from the liver and gallbladder is normal or if there is a blockage of flow. If there is an abnormality of flow from the gallbladder, the diagnosis of biliary dyskinesia is established.

Final Thoughts

The diagnosis of a gallbladder condition can be somewhat complex, especially if the gallbladder is not functioning correctly. With biliary dysfunction, the recommended treatment is usually removal of the gallbladder or mechanical drainage of the gallbladder to try to relieve the inflammatory process.

If left untreated, cholecystitis can become a major health concern by leading to infection and risk of rupture of the gallbladder. It’s best to seek treatment at an early stage of the illness to achieve the best outcome.




The Pathophysiology of Appendicitis


Appendicitis, an acute inflammatory condition of the appendix, is categorized as an infection and a medical emergency. Appendicitis is the most prevalent abdominal emergency requiring surgery, with a lifetime prevalence rate of 7%.
If left untreated, the appendix can rupture and lead to a life-threatening condition.

The appendix is a small embryonic remnant connected to the large intestine. The function of the appendix has been thought to have some function in immunity, yet as individuals age, the appendix becomes less and less useful. Eventually, it becomes a redundant organ vulnerable to infection.

Another theory of the role of the appendix is that it acts as a storage for good bacteria, activating its responsibilities only during digestive distress, yet this theory has not been proven.

What Causes Appendicitis?

There are several causes of appendicitis, and the most notable are viral, bacterial, or parasitic infections. Other causes include blockages of the large intestine and appendix, and sometimes intestinal tumors are responsible for appendicitis.

In appendicitis, there is swelling and inflammation of the appendix, abdominal pain and development of infection within the appendix. This process can lead to increased pressure and the risk of rupture of the appendix.

Appendicitis doesn’t always have classic signs and symptoms and can be difficult to diagnose in certain cases. When the case presents in a classical manner, the nature of the progression of pain is very logical.

The Pathophysiology of Appendicitis

During the initial phases of appendicitis, tenderness and discomfort will begin to be recognizable in the umbilicus region of the abdomen. This occurs because the pain fibers for colicky pain, the pain produced by obstruction of the appendix, are referred to the umbilicus region at the middle of the abdomen.

Within 24 hours, more and more inflammation occurs at the appendix, which then begins to affect the abdominal wall on the right side of the abdomen. Somatic pain fibers are located right at the area of the inflammation on the right side of the abdomen.

At this stage, symptoms are likely intense enough for the patient to seek immediate emergency attention. If pain progresses past the 24-hour mark, arterial blood flow will be compromised to the appendix, and additional symptoms of nausea and vomiting will likely occur.

Because appendicitis is such a spontaneous condition that worsens at rapid speed, early diagnosis and treatment is key to avoiding complications such as a ruptured appendix.

Final Thoughts

While appendicitis is an emergent condition that can result in severe complications, it can be managed well if detected early. Once the appendix has been removed surgically, patients usually recover rapidly.

Interestingly, the logical pathophysiology of appendicitis can make it easier to understand and diagnose, however, this classic presentation of appendicitis isn’t always the case. Prudent and thorough evaluation will provide the accurate diagnosis and appropriate treatment of the condition.




Best Dietary Guide To Prevent Diverticulitis

Diverticulitis, which was seen with less frequency in the past, is now quite prevalent, diagnosed in about 65% of the population by age 85. One of the common contributors to the increase in prevalence has been the standard American diet, otherwise known as the Western diet.

Diverticulitis can become quite a debilitating and uncomfortable condition and can worsen to the point of severe infection. Yet, 75% of diverticulitis cases do not result in complications, according to the National Institute of Health (NIH).

In what follows, we’ll be discussing diverticulitis and the type of diet recommended to help prevent the condition.

What is Diverticulitis?

Diverticulitis is a condition that affects the digestive tract and specifically involves the lining of the large intestine. It occurs when tiny pouches, otherwise known as diverticula, develop in the large intestine and become inflamed or infected. The area of the large intestine often affected is the sigmoid colon, which is the part of the colon just before the rectum. This process of inflammation of the diverticuli occurs over time and may take several days to develop into an advanced condition.

Types of Dietary Protocols Used to Prevent Diverticulitis

Certain foods can create conditions that can increase the risk of diverticulitis, such as red meats, refined grains, and fatty foods. Yet, the best way to approach the management of diverticular disease is to make some fundamental changes in the way that you eat overall.

In the case of acute diverticulitis, the diet will need to be as mild as possible in order to prevent further inflammation of the diverticuli. A clear liquid and low fiber diet will be the least irritative to the intestine while the inflammation improves and the areas heal over the course of about 2-3 days.

Once the digestive system has had the chance to recover, a diet that can help prevent diverticulitis should be instituted. This will comprise fruits and vegetables and other whole foods designed to increase the fiber content of the diet. High fiber will help to prevent constipation, which causes increased pressure in the large intestine, and this is one of the most significant causes of diverticulitis. Some other examples of great foods to eat that can be preventative of diverticulitis are beans, legumes, and nuts.

Final Thoughts

In order to improve your health and prevent conditions such as diverticulitis, it’s important to consume a well-rounded diet consisting of whole foods and lots of high-fiber fruits and vegetables.

To further complement this type of dietary adherence, be sure to drink sufficient amounts of water daily, exercise regularly, and prioritize variety in the foods that you eat. Consulting with a dietician can be a great way to plan for an overall improved diet that is helpful for gut health.