Transcription:

Joey Wahler (Host): Colon cancer ranked second behind only lung cancer among deadliest cancers. So how can you maintain good colon health? And why is that especially important for women? We're discussing what doctors wish their patients knew about colon health.

This is One on One with Regional One Health, you're inside look at how we're building healthier tomorrows for our patients and our community. Join us for expert insight that empowers you to achieve a lifetime of better health. I'm Joey Wahler. Thanks for listening. Our guest, Dr. Liz Wood, a colorectal surgeon at Regional One Health. Dr. Wood, thanks for joining us.

Dr Liz Wood: Thanks for having me here, Joey.

Joey Wahler (Host): So, as I alluded to, while colon cancer strikes men and women pretty equally, statistics also show that females are less likely to report symptoms and prevent problems initially. Why is that from your experience and how can that be addressed?

Dr Liz Wood: Yeah. So exactly like you touched upon, it's the second leading cause of death in both men and women. But I think women, for the most part are reticent to talk about their bowel habits. Women's digestive tracks are actually very different from men. there's differences in anatomy and hormone levels. And so, women are more likely to have irritable bowel syndrome, so irregular bowel movements changes in bowel habits, diarrhea and constipation. And I think most women just chalk this up to, "You know, it's just my gut. It's irritable bowel syndrome. Nothing's wrong. I'm just going to push through." But in reality, sometimes this can be a sign of things like cancers or things that we need to deal with.

Joey Wahler (Host): Sure. So how much can colorectal issues affect quality of life and, in women, possibly even impact planning a family, right?

Dr Liz Wood: Yes, absolutely. So colorectal cancer is actually quite preventable once we catch it early. Screening colonoscopies are extremely important. The guidelines have actually changed, so now we recommend starting colonoscopies at age 45, unless there is a strong family history. When we catch these early, they're usually curable. But sometimes when cancers are low, like in the rectum and we need to do pelvic surgery, that can actually affect fertility.

Joey Wahler (Host): Now, when you talk about a colonoscopy, I speak from experience in saying there's perhaps no simpler, more painless procedure and, at the same time, more important and yet, there are still many people out there that don't realize that, right?

Dr Liz Wood: Yes, I think the though of getting a colonoscopy is still pretty scary to most people. It is an invasive procedure where, you know, someone's putting a tube up your bottom and taking a look inside your colon. And so for most, this type of screening can seem scary. You also have to do a bowel prep and, you know, kind of sit on the commode for the whole day beforehand. But there are other options for screening. So speaking with your primary care provider, there's other options such as the Cologuard or fecal blood tests that are less invasive and might be a good place to start.

Joey Wahler (Host): Yeah, Cologuard is a product that seems to be growing in popularity. I see a lot more commercials for it in recent years. And basically, that's where you provide a stool sample at home. You put it in the mail, true. May sound funny to some. And it doesn't really take the place of a colonoscopy, but it's at least a first step toward going in that direction of finding out what's going on, right?

Dr Liz Wood: Yes, that's absolutely correct. So all of these kinds of less invasive procedures are just a screening tool. If any of them come back positive, then we would go forward with a colonoscopy. And if you have a family history, say your mother was diagnosed with colon cancer at a young age, you actually would not qualify for any of these screening options and we would recommend going forward with the colonoscopy.

Joey Wahler (Host): Right. So good point. That's only for people, something like Cologuard, who don't have a family history. I wanted to ask you next about those who do. How common are colorectal issues in general, especially for people that have had that in their family?

Dr Liz Wood: There are some genetic disorders that are what we call autosomal dominant, meaning if they have a child, say their spouse does not have the gene, there's a 50% chance that their child will have the gene and have the disease. And if you have those disorders, you have 100% chance of developing colon cancer. So understanding your family history is extremely important.

Joey Wahler (Host): So, whether we're talking about colitis or irritable bowel syndrome, what are the initial signs for someone to look for that there may be a problem down there, so to speak?

Dr Liz Wood: So just kind of keeping an eye on your bowel habits. So if you notice that there's more cramping, pain, bloating, or irregularity such as a change in your stool caliber, or if you notice blood in your stool, or if you notice a lot of diarrhea or constipation, none of these are normal and you should see your primary care doctor.

Joey Wahler (Host): And in terms of treating things like that, often medication can get it under control, short of surgery, right?

Dr Liz Wood: Correct. There are a lot of medications that can kind of control these irregular bowel habits. But the most important thing is making sure there isn't anything underlying causing this such as like a cancer or inflammatory bowel disease, like Crohn's or ulcerative colitis, because the treatment for those are extremely different.

Joey Wahler (Host): So speaking of which, when we talk about colitis, Crohn's, irritable bowel, in a nutshell, what's the difference between the three?

Dr Liz Wood: Crohn's and ulcerative colitis are what we call inflammatory bowel disease, and it's often confused with irritable bowel syndrome. Irritable bowel syndrome or IBS is essentially a catchall for generalized abdominal discomfort. And usually, it's a diagnosis of exclusion, so once we've ruled out things like Crohn's and ulcerative colitis and cancers and diverticulitis; whereas Crohn's and ulcerative colitis known as the inflammatory bowel diseases, they are autoimmune disorders that we diagnose based on colonoscopy and biopsy.

Joey Wahler (Host): How about lifestyle in terms of diet and other things that can either help prevent something like this from developing, some of these conditions, or can lead to it in the opposite direction?

Dr Liz Wood: There are risk factors that have been proven to be associated with colon cancers. Specifically in terms of diet, having a low intake of fruits and vegetables, having a low fiber and high fat, and having a diet consisting of highly processed foods and processed red meats have all been attributed to the development of colon cancer. So we recommend for all patients just to eat a well balanced diet, eat plenty of raw fruits and vegetables, and just make sure that you're taking either a fiber supplement or something to help you avoid constipation.

Joey Wahler (Host): And then like with many medical conditions, I suppose, stress can add to a condition like we've discussed, right?

Dr Liz Wood: Yes. Being in a high stress environment, but also the opposite can contribute as well, so living a very sedentary lifestyle, not having regular physical activity, basically the two extremes. As long as you're kind of doing everything in moderation, getting some light exercise every day, staying active, staying healthy, avoiding smoking, avoiding too much alcohol consumption. Those are all things that you can do to kind of help maintain your gut health.

Joey Wahler (Host): And you mentioned earlier, doctors are now recommending colonoscopy starting around age 45. And recently insurance companies have started to insure those at that age, as opposed to 50, which was more the insured level minimum for years. So have you noticed that drop from 50 to 45 in terms of coverage helping more people to come forward?

Dr Liz Wood: So I think most people don't know that they can have colonoscopy starting at age 45 now. so I haven't actually seen a huge increase in the number of patients that we're scoping that are under the age of 50, but I think that's coming.

Joey Wahler (Host): And you can sometimes from a colonoscopy, if I'm not mistaken, find things short of cancer that can be addressed by discovering them like a polyp, for instance, which if unaddressed could lead to cancer.

Dr Liz Wood: Absolutely. Polyps are kind of a precursor. There are different kinds of polyps that you can grow, but there are certain kinds that have a higher risk of turning into a cancer. And so if you get your routine screening colonoscopies, your GI doctor or your colorectal surgeon can actually remove these polyps and potentially prevent you from needing a major surgery down the road.

Joey Wahler (Host): And so in summary, doctor, what's the main message you want people to come away with here again, especially women who tend to be a little more reluctant because they may be embarrassed about what's going on?

Dr Liz Wood: I think the most important thing is for people to realize that if there are changes in your stools, changes in your bowel habits, that these aren't normal and you should seek help and do not be afraid of you to talk to your primary care provider or your surgeon about this. We see patients like this all day every day. And we want to help you and we want to prevent you from developing a cancer and potentially needing a major surgery. So doing the things such as screening colonoscopies or the Cologuard or fecal occult blood tests, those are all great ways to prevent you needing a major surgery, major hospitalization in the future.

Joey Wahler (Host): I mean, bottom line is you're a doctor, right? You've been there, done that. You've seen these things before, right?

Dr Liz Wood: Yes.

Joey Wahler (Host): No need to be embarrassed. All right. Well, Dr. Liz Wood, we hope that folks now have a much better understanding, especially women, of what it means to maintain good colorectal health. Thanks again so much.

Dr Liz Wood: Thank you for having me.

Joey Wahler (Host): And to make an appointment at Regional One Health, please call 901-545-6969. Again, 901-545-6969. And thanks for making One on One with Regional One part of your journey to better health. Join us next time for the Regional One Health podcast as we cover another important topic to keep you on the path to a healthier tomorrow. If you found this podcast helpful, please do share it on your social media. Hoping your health is good health, I'm Joey Wahler.