Amanda Wilde (Host): The colon is a crucial part of our digestive system. A healthy colon can mean a longer, richer life. How do you know if your colon is healthy? And what can you do to keep it that way? General Surgeon Dr. Sahand Bamarni is here to answer those questions and offer insight into keeping your colon healthy. This is BayCare HealthChat. I'm Amanda Wilde. Welcome to the podcast, Doctor.

Sahand Bamarni, MD: Thank you.

Host: Let's start with what is the function of the colon? I know it's part of the digestive system, but what does the colon itself do, and how does the colon affect your overall health?

Sahand Bamarni, MD: Yeah. So colon is the last part of the digestive system. The length of the colon is about five feet. And, there are two main functions of the colon. First, it absorbs the water, minerals, and vitamins from the food and the second function, it forms and stores the feces before it empties to the rectum.

Host: And how does the colon affect your overall well-being?

Sahand Bamarni, MD: The colon is a very important structure because first it absorbs the water, as I said before, so any person with dehydration will present with constipation and other disease of the colon like diarrhea or inflammation of the colon may affect overall health and nutrition of the patient.

Host: What is a healthy colon?

Sahand Bamarni, MD: We can define a healthy colon by two things. The first being in good condition with the absence of any inflammation or infection. And second, by functioning properly, with regular bowel movement. I would say regular bowel movement means that they are easy to pass and soft stool.

Host: How do you keep your colon healthy then, and keep it in that kind of condition?

Sahand Bamarni, MD: This is a very good question. Actually, you can keep your colon healthy by following six habits. So any of these habits are important to maintain healthy colon. The first one, having a healthy diet by consuming fat rich in fiber, like whole grain, vegetables, and nuts. And other healthy diet like beans, white meat, and try to avoid excess red processed meat. Actually, according to WHO (World Health Organization) eating 50 grams of processed meat daily, it increases the risk of colon cancer by 18%.

Host: Wow.

Sahand Bamarni, MD: Yeah. The example of processed meat we have in the market like ham, sausage, hot dog, pepperoni, beef jerky, but if you decide to have these type of food it's recommended not to exceed more than 18 ounces per week.

And the second habit, I would say, drink plenty of water as dehydration is the major cause of constipation. And it's according to United States National Academies of Science and Medicine, they determine that adequate fluid intake for male is 15 cups and for female is 11 cups per day. And fluid can be like in water or food. Third habit is regular exercise. So exercise is very helpful for all well-being, including the colon, actually it lowers risk of some cancer, including colon cancer. I would say try to aim for 30 minutes of moderate exercise every day if possible. The fourth habit, you need to watch your weight. Gaining extra weight actually will increase your risk of colon cancer.I would say for every person, talk to your health care team if you need help with losing weight.

The fifth habit is avoiding excessive alcohol and use of tobacco. You can ask your health care team, they can give you some tips or refer you to a program to help you stop smoking. And the sixth recommendation is to follow up with regular medical checkup with a health care professional. It can help detect and address any potential problem early on.

Host: Well, speaking of potential problems, Doctor, after a certain age, you should be screening for colon cancer. Is that correct?

Sahand Bamarni, MD: Correct. Now screening for colon cancer is considered the gold standard for health care here in the United States. And it is one of the most important cancer prevention strategies. Usually the screening starts at the age of 45, but it also depends on other risk factors, especially family history.

Host: I was just going to ask that. What are the risk factors for colon cancer? There can be a genetic component?

Sahand Bamarni, MD: We have many risk factors for colon cancer. It could be environmental, it could be genetic. The main risk factor is being overweight, being physically inactive, or if you consume excess alcohol and tobacco, or you consume excess red processed meat, or you have a personal history of inflammatory bowel disease, like Crohn's disease, or a precancerous condition called polyps, or if you have a family history of colon cancer. And actually they found Ashkenazi and Native Americans, they have higher risk for developing colon cancer than other ethnicities.

Host: However, I understand that regular screenings really prevent most colon cancers.

Sahand Bamarni, MD: Correct. So, we have two ways of screening. The first is colonoscopy. It can reduce the risk of colon cancer by detecting pre cancerous changes, which is called polyp, and removing them before developing into cancer. But the other option we have, Cologuard, which is basically a stool DNA test. Although it is non invasive and can be performed at your home, but it may give you a false sense of security.

It has good cancer detection rate about 92%. But, polyp detection rate, which is the pre-cancerous condition, is low. It's about 40 to 50%. So I still recommend colonoscopy over Cologuard.

Host: Understood. Diverticular disease is another really common disorder of the colon. What are the risk factors for that?

Sahand Bamarni, MD: Yeah. So actually diverticuli are small bulging pouches developed in the colon and sometimes it get infected and sometimes it even perforates. So the risk factor for diverticular disease are the same as the risk factor for colon cancer, although it's not a cancer disease. But the main risk factor is those who consume high fat and low fiber diet.

Host: So basically, we talked about the six things you can do to keep your colon healthy, and the risk factors sound like doing the exact opposite of those.

Sahand Bamarni, MD: Correct. The diet is the main reason for colon problem.

Host: And most colon cancers are actually preventable.

Sahand Bamarni, MD: Correct. Even those with a family history, if they go through the screening program, we can detect early precancerous condition.

Host: When, involving my colon, should I seek medical advice? Let's say I am getting screened regularly, but some red flags have come up.

Sahand Bamarni, MD: You should seek medical advice if you have one or more of these four signs. One of them is rectal bleeding. The second, if you have changing bowel habit, it means your regular bowel movement changed either to diarrhea or constipation, or you have ongoing abdominal pain or anemia. One of these signs may indicate serious underlying colon disease.

Host: So it's really important, really, to be proactive in your colon health. You can have a huge effect on your own condition of your colon. It's not something that's out of your control. Do you have any closing thoughts on the subject of keeping your colon healthy?

Sahand Bamarni, MD: I would say the colon is a major organ essential for water absorption and waste removal in the body. And, if you keep your diet healthy, you will avoid a lot of problem in the future.

Host: Thank you so much for these insights and guidance, Dr. Bamarni.

Sahand Bamarni, MD: Thank you for having me.

Host: And that wraps up this episode of BayCare HealthChat. Head on over to our website at BayCare.org for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all other BayCare podcasts. For more health tips and updates, follow us on your social channels.

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