Colonoscopy: What Your Doctor Wants You to Know?

In case you were thinking about skipping your colonoscopy.
— Dr. Dale

Colonoscopy: What Your Doctor Want You to Know?

http://abc30.com/health/colonoscopy-what-your-doctor-wants-you-to-know/1599096/

SAINT LOUIS, Miss. (KFSN) -- Ninety-percent of all colon cancers are preventable, yet more than twenty-four million Americans who should have the recommended screening test will not do it. There are three things your doctor wants you to know that should change the way you think about colonoscopy.

Sixty-year-old Patricia Kamler always keeps up with routine maintenance. Whether it's her flower garden or her health. Although the idea of colonoscopy made her squirm. 

She said, "It's like you're going to do what to me, how?"

During colonoscopy, doctors pass a thin scope through the colon to check for polyps, tiny growths that can eventually turn into cancers. 

Gastroenterologist Matthew Ciobra says for starters, think of colonoscopy as a one-stop shop. 

Matthew Ciorba, MD, gastroenterologist at Washington University in St. Louis, said, "The advantage is not only can you diagnose cancer at the early stages or the precursors of cancer, but you can also remove them at the time of the procedure." 

Patricia said, "The prep is the bad part. Plain and simple." 

Doctors say the prep necessary to completely clear the colon has vastly improved. 

Doctor Ciorba explained, "Now there are some other options that can use about half that volume, so about a half a gallon of liquid." 

Best of all, many patients are now "under" anesthesia. 

"Most of the time, patients enter into a relative dream-like twilight zone level and when they wake up, they don't even remember the procedure was done," said Doctor Ciorba. 

With a family history of colon cancer on both sides, Patricia got over her initial objections. 

"They did find polyps the first several times that I had colonoscopies," she said. 

All caught early, before they could become life-threatening. 

"It's worse in your brain than in reality," Patricia told Ivanhoe.

Patients are most concerned about the risks of perforating the wall of the colon and reactions to the sedative. Doctor Ciorba says the risks are rare, and colonoscopy is still considered the gold standard for screening in the U.S.

Common food additive promotes colon cancer in mice

Interesting new study regarding the promotion of colon cancer.
— Dr. Dale

Common food additive promotes colon cancer in mice 

https://www.sciencedaily.com/releases/2016/11/161107110639.htm

Emulsifiers, which are added to most processed foods to aid texture and extend shelf life, can alter intestinal bacteria in a manner that promotes intestinal inflammation and colorectal cancer, according to a new study.

The findings, published in the journal Cancer Research, show regular consumption of dietary emulsifiers in mice exacerbated tumor development. The study was led by Drs. Emilie Viennois, Didier Merlin, Andrew T. Gewirtz and Benoit Chassaing, researchers in Georgia State University's Institute for Biomedical Sciences.

Colorectal cancer, the fourth leading cause of cancer-related deaths worldwide, was responsible for about 700,000 deaths in 2012. There is increasing awareness that the intestinal microbiota, the vast, diverse population of microorganisms that inhabits the human intestines, play a role in driving colorectal cancer.

The microbiota is also a key factor in driving Crohn's disease and ulcerative colitis, the two most common forms of inflammatory bowel disease (IBD). IBD is known to promote colon tumorigenesis and gave rise to the term "colitis-associated cancer." Low-grade inflammation, a condition more prevalent than IBD, was shown to be associated with altered gut microbiota composition and metabolic disease and is observed in many cases of colorectal cancer. These recent findings suggest dietary emulsifiers might be partially responsible for this association.

"The incidence of colorectal cancer has been markedly increasing since the mid-20th century," said Viennois, assistant professor in the Institute for Biomedical Sciences. "A key feature of this disease is the presence of an altered intestinal microbiota that creates a favorable niche for tumorigenesis."

"The dramatic increase in these diseases has occurred amidst constant human genetics, suggesting a pivotal role for an environmental factor," said Chassaing, assistant professor in the Institute for Biomedical Sciences.

Previous reports by the Georgia State research team suggested that low-grade inflammation in the intestine is promoted by consumption of dietary emulsifiers, which are detergent-like molecules incorporated into most processed foods that alter the composition of gut microbiota. The addition of emulsifiers to food seems to fit the time frame and had been shown to promote bacterial translocation across epithelial cells. Viennois and Chassaing hypothesized that emulsifiers might affect the gut microbiota in a way that promotes colorectal cancer. They designed experiments in mice to test this possibility.

In this study, the team fed mice with two very commonly used emulsifiers, polysorbate 80 and carboxymethylcellulose, at doses seeking to model the broad consumption of the numerous emulsifiers that are incorporated into the majority of processed foods. Researchers observed that consuming emulsifiers drastically changed the species composition of the gut microbiota in a manner that made it more pro-inflammatory, creating a niche favoring cancer induction and development. Alterations in bacterial species resulted in bacteria expressing more flagellin and lipopolysaccharide, which activate pro-inflammatory gene expression by the immune system.

When using a well established model of colorectal cancer, the researchers observed that dietary emulsifier consumption was sufficient to make the animals more susceptible to developing colonic tumors because this created and maintained a pro-inflammatory environment associated with an altered proliferation/apoptosis (cell death) balance. The researchers observed that enhanced tumor development was associated with an altered intestinal microbiota, characterized by an increased pro-inflammatory potential.

This study demonstrated that emulsifier-induced alterations in the microbiome were necessary and sufficient to drive alterations in intestinal epithelial cells' homeostasis, which is thought to govern tumor development. The effects of consuming emulsifiers were eliminated in mice devoid of microbiota (germ-free mice), and transplanting microbiota from emulsifier-treated mice to germ-free mice was sufficient to transfer alterations in intestinal epithelial cells' homeostasis, suggesting a central role played by the microbiota in tumor development.

Overall, these findings support the concept that agitating host-microbiota interactions to cause low-grade gut inflammation can promote colon carcinogenesis. The team is now investigating which microbiota members are triggering this detrimental effect, as well as the mechanism of altered microbiota-induced cancer promotion.

Sleep Poorly? You May Eat Too Much the Next Day

New sleep study shows lack of sleep may cause you to overeat the next day.
— Dr. Dale

Sleep Poorly? You May Eat Too Much the Next Day 

http://www.nytimes.com/2016/11/02/well/eat/sleep-poorly-you-may-eat-too-much-the-next-day.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=stream&module=stream_unit&version=latest&contentPlacement=8&pgtype=sectionfront&_r=0

Not enough sleep last night? You may overeat today.

That’s the conclusion of investigators after reviewing data on 172 participants in 11 sleep studies. The study designs varied, but tested people after a night of restricted sleep, usually about four hours, and then after a night of normal rest.

The next day, participants were offered a breakfast buffet or scheduled meals later in the day. The scientists tracked calorie intake and energy expenditure.

The analysis, in the European Journal of Clinical Nutrition, found that after a night of limited sleep, people consumed an average of 385 extra calories the next day, roughly the equivalent of a frosted cupcake or a serving of French fries. They also consumed more fat and less protein.

Some have suggested that sleep deprivation affects the hormones that control appetite, but the authors wrote that a lack of sleep may heighten the desire for food as a reward.

They acknowledge that the studies had small samples, were conducted in controlled laboratory conditions and were short.

Still, the senior author, Gerda K. Pot of King’s College London, said the subject was worth investigating further. “Poor sleep,” she said, “could be a risk factor for obesity, and it’s something we can change.”