Study Confirms Lifesaving Value of Colonoscopy

“As a reminder, if you’re age 45 or older, it’s important to get screened for colorectal cancer. Call us to schedule 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."

Vitamin D May Help Ease Irritable Bowel Syndrome

Source: https://www.healthline.com/health-news/vitamin-d-may-ease-ibs

Vitamin D May Help Ease Irritable Bowel Syndrome

Researchers say they’ve noticed a vitamin D deficiency in many people with IBS. Increasing the level of the vitamin could reduce symptoms.

It’s the most common disease diagnosed by gastroenterologists and it affects approximately 10 to 15 percent of the adult population in the United States.

But there is no known cause and no cure for those suffering from irritable bowel syndrome (IBS).

Treatment for the condition is focused on alleviating symptoms such as abdominal pain, constipation, bloating, and diarrhea.

Now, researchers from the University of Sheffield in England have found a new way to possibly manage IBS — vitamin D supplements.

The inspiration for the study came simply from speaking with a patient with IBS.

“The vitamin D/IBS link wasn’t spotted by medics or scientists. It came from patients,” Bernard Corfe, PhD, lead author of the study and principal investigator in molecular gastroenterology at the University of Sheffield, told Healthline.

“Vitamin D is an important factor in multiple diseases and areas of health, including musculoskeletal, immune, mental health, and other gut health conditions, including colorectal cancer and IBD (irritable bowel disease),” he added. “The latter two suggested to us that there might be a plausible role for vitamin D in other colon conditions.”

What the study uncovered

Corfe and his team reviewed and integrated all research available on vitamin D and IBS, and also assessed the potential benefits of vitamin D supplements for those with IBS symptoms.

They found a high prevalence of vitamin D deficiency in IBS patients around the world.

“This study looked at all research reported throughout the world and found the deficiency was consistent irrespective of latitude or geography,” Corfe said.

It is unclear why those with IBS seem to have vitamin D deficiency. One theory is that diet plays a role. Another is that the impact of IBS on a person’s daily habits may prevent them from getting enough vitamin D.

“It’s unclear which is the chicken and which is the egg,” Dr. Jeffrey Baumgardner, an assistant professor of medicine in gastroenterology at the University of California, San Francisco (UCSF), told Healthline.

“Certain behaviors in IBS… that you’re not feeling well so you don’t go outside as much, would lead to people having vitamin D deficiency based on the consequences of the disease,” he said.

A disease that affects many

Although only 5 to 7 percent of the estimated 10 to 15 percent of adults living with IBS have been formally diagnosed, it is estimated in the United States there are between 2.4 and 3.5 million physician visits for IBS annually.

About 40 percent of patients who report having IBS are male, while about 60 percent are female.

For those living with the condition, the impact goes far beyond physical discomfort.

“It can lead to people being fearful of leaving the home, unable to go to work, and a significant use of the medical system. The difficult part of IBS is there is no good test to officially diagnose IBS… so often people are stuck being told it’s all in their head and there’s nothing wrong,” Baumgardner said.

Checking patients for vitamin D deficiency is becoming a common practice for gastroenterologists. It only requires a simple blood test.

Dr. Arnold Wald, a professor of gastroenterology at the University of Wisconsin, is one of many who regularly request tests of patients’ vitamin D levels.

“I do check vitamin D deficiency in many of my GI patients and I’m often rewarded by finding it,” he told Healthline. “It’s very inexpensive to order and very inexpensive to treat.”

Vitamin D solution

Wald argues that the link between IBS and vitamin D calls for further exploration and may become a regular test requested by physicians.

“It’s so easy to detect, it’s so easy to treat that you might be remiss in not thinking about vitamin D deficiency in almost any patient you see, particularly those with GI symptoms,” he said.

“It makes a lot of sense from a public health standpoint, as long as we don’t overdo the treatment and call people vitamin D deficient who may simply have marginally low levels. If we do that, we’re just making expensive urine,” Wald added.

Corfe and his colleagues concluded that the large majority of patients with IBS were likely to benefit from vitamin D supplements.

“Even if the vitamin D doesn’t benefit the IBS, there are multiple health reasons to maintain good levels of vitamin D,” he said.

Vitamin D also promotes bone health, immune function, general well-being, mental health, and gut health.

Baumgardner says patients with IBS should be cautiously optimistic about vitamin D supplements.

“If I were someone with IBS, I would want this to be the easy, simple silver bullet because vitamin D is cheap and has a low side-effect protocol. So, it could be useful,” he said.

However, he says, it is important people understand that as everyone’s symptoms of IBS vary, so too will their response to possible treatments.

“There is nothing that is 100 percent effective because everyone’s symptoms are somewhat different, so not everyone is going to respond to the same thing,” he noted.

“It will help people, but it won’t help everybody. If you are someone with IBS, I think you should talk to your doctor about vitamin D, but don’t be discouraged if it won’t work,” Baumgardner said.