Study Confirms Lifesaving Value of Colonoscopy

“As a reminder, if you’re age 50 or older, it’s important to get screened for colorectal cancer. Call us to scheudle your next Colonoscopy. ”

— Dr. P

https://www.webmd.com/colorectal-cancer/news/20180314/study-confirms-lifesaving-value-of-colonoscopy

By Alan Mozes

HealthDay Reporter

WEDNESDAY, March 14, 2018 (HealthDay News) -- A large study has confirmed what many public health experts have long believed: Colonoscopy saves lives.

The study looked at roughly 25,000 patients in the Veterans Affairs (VA) health system, where colonoscopy is widely used. The VA views it as the main screening test for patients aged 50 and older who have average odds for developing colon or rectal cancer.

Of that group, close to 20,000 patients were cancer-free between 2002 and 2008. About 5,000 were diagnosed with colorectal cancer during that time and died of the disease by 2010.

Those who died were significantly less likely to have had a colonoscopy, the study found.

A comparison of screening histories over about two decades found that "colonoscopy was associated with a 61 percent reduction in colorectal cancer mortality," said study author Dr. Charles Kahi.

Kahi is gastroenterology section chief with the Roudebush VA Medical Center in Indianapolis.

The U.S. Centers for Disease Control and Prevention recommends everyone between the ages of 50 and 75 get screened for colon cancer. Those at high risk -- including those with a family history of the disease -- should be tested even earlier, the CDC advises.

Screening can take several forms, including stool tests; a lower colon exam called flexible sigmoidoscopy; and even a "virtual" colonoscopy that relies on X-rays to scan the entire colon.

But many public health advocates favor a full colon exam, or colonoscopy. For the test, a patient is typically sedated and a doctor inserts a flexible, lighted tube to examine the entire colon. If found, growths called polyps can be removed during the procedure.

Between 11.5 million and 14 million Americans have a colonoscopy each year, according to the study team.

The new study focused on patients aged 50 and older who were treated at VA facilities between 1997 and 2010.

The investigators found that a colonoscopy reduced the risk of death from right-sided colorectal cancer by 46 percent and left-sided cancer by 72 percent, equaling a combined drop of 61 percent.

Stress, Anxiety and Irritable Bowel Syndrome

From WebMD: 

It's not totally clear how stress, anxiety, and irritable bowel syndrome are related -- or which one comes first -- but studies show they can happen together.

When a doctor talks to people with this digestive disorder, "what you find is that about 60% of IBS patients will meet the criteria for one or more psychiatric disorders," says Edward Blanchard, PhD, professor of psychology at the State University of New York at Albany.

The most common mental ailment people with irritable bowel syndrome have is generalized anxiety disorder, Blanchard says. He thinks more than 60% of IBS patients with a psychiatric illness have that type of anxiety. Another 20% have depression, and the rest have other disorders.

Regardless of whether they have irritable bowel syndrome, people with anxiety tend to worry greatly about issues such as health, money, or careers. Other symptoms include upset stomach, trembling, muscle aches, insomnia, dizziness, and irritability.

There are several theories about the connection between IBS, stress, and anxiety:

• Although psychological problems like anxiety don’t cause the digestive disorder, people with IBS may be more sensitive to emotional troubles.
• Stress and anxiety may make the mind more aware of spasms in the colon.
• IBS may be triggered by the immune system, which is affected by stress.

Ways to Cope With Stress and Anxiety

There's proof that keeping your stress under control can help you prevent or ease IBS symptoms. You could learn about  relaxation techniques such as deep breathing or visualization, where you imagine a peaceful scene. Or you can zap tension by simply doing something fun --  talk to a friend, read, listen to music, or go shopping.

It's also a great idea to exercise, get enough sleep, and eat a good diet for IBS.

Try different stress-busting techniques to see which may help ease your IBS symptoms.

If you’re still tense and anxious, talk with your doctor. Make sure you're getting the right medical treatment for your constipation or diarrhea. Then discuss whether talk therapy might help.

People with irritable bowel syndrome "should really start with their primary care physician, and work with that person," Blanchard says. "They should only go the next step [psychological care] if what they're doing with their doctor is not working."

Help for hemorrhoids

“This is great. I’m here if you need me. Read more here.”

— Dr. P

https://www.health.harvard.edu/diseases-and-conditions/help-for-hemorrhoids

Help for hemorrhoids

One of the most embarrassing conditions also can be one of the easiest to treat and manage.

Hemorrhoids are without doubt among the most unpleasant of health topics. But if you have suffered from them, you may find comfort in knowing that you are not alone.

More than 75% of people ages 45 and older have had hemorrhoids, with symptoms like rectal pain, itching, and bleeding after a bowel movement.

Put an end to your hemorrhoid flare-ups, with these tips from the experts at Harvard Medical School

"Hemorrhoids can be painful and embarrassing, but they often shrink on their own with simple self-help and over-the-counter remedies," says Dr. Howard LeWine, assistant professor of medicine at Harvard Medical School.

A look inside

Hemorrhoids are swollen veins near the anus. There are two types: internal and external. You can have either type by itself, or both at the same time.

Internal hemorrhoids form inside the anal canal and are often painless. However, they may cause intermittent bleeding, usually with bowel movements, and sometimes discharge mucus. Internal hemorrhoids may also protrude outside the anus, where they appear as small, grape-like masses.

External hemorrhoids form just outside the anal opening, where they primarily cause swelling, bothersome protrusions, and discomfort.

Cause and self-care

Sometimes hemorrhoids develop for no apparent reason, but often they are associated with chronic constipation or diarrhea, straining during bowel movements, and prolonged sitting on the toilet. This can interfere with blood flow to and from the rectum (the last six inches of the large intestine) and the anus, causing blood to pool in the veins around the anus, enlarging them.

The good news is that neither kind of hemorrhoid is dangerous, and severe complications are rare. Still, it's important to see your doctor if you experience rectal bleeding, feel a lump in the anus, or have ongoing rectal pain, as these might be signs of an unrelated and more serious condition, such as colorectal or rectal cancer.

Symptoms for either kind of hemorrhoid often can be relieved with self-care treatments. For example:

Sitz baths. A regular sitz bath can relieve itching and irritation. Fill a tub with three to four inches of warm (not hot) water and sit in it with your knees bent for about 10 to 15 minutes. Gently pat yourself dry with a towel.

Fiber supplements. These reduce hemorrhoid bleeding, inflammation, and enlargement by drawing water into your stool to make it easier to pass. A psyllium husk fiber supplement, such as Metamucil or a generic equivalent, is a good choice, although psyllium may cause gas or bloating. In that case, try a supplement containing wheat dextrin (Benefiber) or methylcellulose (Citrucel).

Topical therapies. Over-the-counter products are available for hemorrhoids, such as pads infused with witch hazel (Tucks), as well as soothing creams that contain lidocaine, hydrocortisone, or other ingredients like phenylephrine (Preparation H). These substances help shrink the inflamed tissue and provide relief from itching. External hemorrhoids rarely need more than self-care.

"The exception is a thrombosed hemorrhoid, the sudden formation of a hard, inflamed clot inside the hemorrhoid," says Dr. LeWine. "If this occurs, contact your doctor, since you may need a surgical procedure."

Nonsurgical options

When internal hemorrhoids continue to cause symptoms despite home treatment, your doctor may recommend an office-based nonsurgical procedure. Here are the most common options.

Rubber band ligation. This is the most widely used procedure for treating internal hemorrhoids. The doctor inserts a small elastic band into the anal canal and places it around the base of a hemorrhoid. The band cuts off the hemorrhoid's circulation, which causes the hemorrhoid to wither and die. The rubber band eventually falls off unnoticed. The procedure requires no anesthesia, although a numbing agent is sometimes used if you feel discomfort.

Sclerotherapy. The doctor inserts a proctoscope (a special metal or plastic scope used to view the hemorrhoids) into the anus. He or she then injects a chemical solution directly into the hemorrhoid or the area around it. This solution causes a local reaction that interferes with blood flow inside the hemorrhoid, causing it to shrink. Afterward, some people experience mild bleeding, pain, and pressure.

Coagulation therapy. This uses heat, laser, or electric current to cut off the hemorrhoid's blood supply. Once the hemorrhoid shrinks and dies, scar tissue forms on the anal canal wall to hold nearby veins in place so they don't bulge into the anal canal. One hemorrhoid is treated at a time, with a 10- to 14-day period between treatments.