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Healthy Eating and Colonscopy
Colorectal cancer is the 2nd leading cause of cancer deaths in men and women combined. Dr. Himanshu Desai discusses colonoscopies, risk factors for colorectal cancer, and possible lifestyle changes that can help us maintain a healthy colon.
Featuring:
Himanshu Desai, MD
Himanshu Desai, MD is a gastroenterologist with St. Francis Medical Associates. Transcription:
Prakash Chandran: Colorectal cancer is the second leading cause of cancer deaths in men and women combined. There are several risk factors for colorectal cancer. Many of them are lifestyle-related. Being physically inactive, smoking and heavy alcohol use are some of those risks. But if lifestyle is a factor, what can we do to maintain a healthy colon and try to prevent colorectal cancer from developing?
Here to talk to us more about eating healthy and colonoscopies is Dr. Himanshu Desai. He's a gastroenterologist with St. Francis Medical Associates. This is Word On Wellness, the podcast from St. Francis Medical Center. My name is Prakash Chandran. So Dr. Desai, really great to have you here today. Thank you so much for being here.
I'd love for you to start by briefly describing a colonoscopy and what you are capable of doing during this procedure?
Himanshu Desai, MD: Thanks for having me. It is a pleasure being with you. Colonoscopy includes visualization of the lower bowel through the rectum and into the colon. And sometimes we can even see the last part of the terminal ilium, where the small bowel and colon connect. When we look in there, it's a real time visualization of the lining of the colon. And when we look at that, if we see any growths in there, the most common maneuver that we do is tissue sampling, which includes cutting out that growth.
Prakash Chandran: Now, the whole purpose of the colonoscopy is to check for growths as you're saying. I've heard them referred to as polyps as well. And are those like cancerous formations that are indications of something more serious?
Himanshu Desai, MD: They're typically precancerous. They grow slowly, but given enough time some of these become cancerous. So removing them prevents colon cancer.
Prakash Chandran: Understood. So, you know, you said given enough time, they could develop into something more serious like cancer. So what age is it usually necessary to have a colonoscopy?
Himanshu Desai, MD: Currently, if you are a normal risk, which means that you don't have a family history of any polyps or cancers, or I don't have any symptoms, you should start at the age of 45.
Prakash Chandran: Yeah. And, you know, I just turned 40 and it's something that I've been thinking about getting done sooner, especially because of the news recently, Chadwick Boseman, who is the lead for black Panther, I heard that he got it at 42 or 43 years older where he got cancer and unfortunately passed away. So, you know, should people that are concerned get their colonoscopy sooner just to be proactive and make sure nothing's wrong?
Himanshu Desai, MD: If they're concerned and particularly if they have symptoms or have family history, they can get it done earlier. But recently, we used to do it at the age of 50. And because of that concern, the standard recommendation has dropped to 45, but it hasn't dropped to 40 yet.
Prakash Chandran: Okay. So you mentioned symptoms. What are some of the symptoms that might warrant a colonoscopy or concern?
Himanshu Desai, MD: Rectal bleeding that's unusual it's worrisome, weight loss, abdominal pain. Those would be the main symptoms that you would make you worry about getting it checked. Change in your bowel habit would be another common symptom.
Prakash Chandran: Okay, that's helpful. So if during the colonoscopy, you find polyps, talk to us about the process of treating or removing them. Is that something that you do during the colonoscopy or is that something that happens afterwards?
Himanshu Desai, MD: Yes. Now, if we see that, there are different ways of cutting that tissue out. So that's a little bit technical, but either way we aim to remove the whole tissue and then examine it under the microscope to see what type of cells they are. And that gives us an indication whether this was a precancerous polyp or growth likely to cause any cancer. Based on that, then we usually give recommendations on a follow-up colonoscopies which commonly are at five years, but can be sooner if there's more worrisome features.
Prakash Chandran: Okay. So taking a step back, could you talk to us a little bit about the process of the colonoscopy? Like from a patient perspective, what does prep look like? How long does the procedure take and what does recovery look like?
Himanshu Desai, MD: So the preparation for colonoscopy typically involves ingestion of a low-residue diet. So you're trying to avoid leafy stuff. All clear liquids for about a day or so. And then you get some laxatives or a lavage prep that cleans out the stool in your colonoscopy. And it's really important to do that well, because if you get cleaned out well, we get a better look and so, you know, you get more bang for your buck if you cleaned out well, and we get a better look. We find more polyps that way.
Prakash Chandran: Okay. And then after the colonoscopy, is there a regimen or some sort of recovery procedure that people have to go through?
Himanshu Desai, MD: Usually, you recover within half an hour or so, then you get discharged home. We do sedate you so that you don't feel any of the testing and, because of the sedatives, you do need a person to look after you at home. And generally, you're at home for about 24 hours. You're not allowed to drive because the sedatives, but you can eat anything you want really. There's no restrictions afterwards.
Prakash Chandran: Okay. One of the things that I mentioned up at the top of the episode was the risk factors that are modifiable, like lifestyle-related. So we talked about being physically active, smoking, alcohol use. Can you talk a little bit about colon health and how people can give themselves their best chance of not developing colorectal cancer?
Himanshu Desai, MD: Yes. So those are important factors there. You know, moderation in all of those and definitely stopping smoking. Regular exercise is good. Diet-wise, consumption of fruits, vegetables, that's a helpful. Red meat kind of works against you for colon cancer development. So you can help with that. Fiber is also important for colonic health, so fruits, vegetables. Nuts, legumes is good for that as well.
Prakash Chandran: So Dr. Desai, one question I always like to ask, you know, as a gastroenterologist, you've probably seen hundreds of different patients. My question to you before we close is what is one thing that you know to be true that you wish more patients knew either before they came to see you or just in considering their colorectal health?
Himanshu Desai, MD: I think for the whole population, fiber, I would say. Increasing fiber in your diet from an early age is going to help your health overall, especially colon cancer health. And then obviously, getting yourself proactively checked after the age of 45.
Prakash Chandran: Yeah, that makes sense. And when we say fiber, are we talking about just eating lots of oatmeal? Are we talking about supplementing? What do you mean when you say that?
Himanshu Desai, MD: No, oatmeal is a great great form of fiber. Supplements are useful when you can't really eat dietary fiber. So if you can eat a lot of fruits, vegetables, fiber, oatmeal, that's better than supplementing with fiber. And you want to get about a 22 to 24 grams of fiber in as you can on a daily basis.
Prakash Chandran: Now, is that age dependent? Like I'm 40. Is that 20, 22 grams or does that increase with age or decrease with age?
Himanshu Desai, MD: It doesn't really change with age, but you do become a little bit more gassy with fiber as you get older. It's harder to tolerate.
Prakash Chandran: Yeah. Understood. We really appreciate your time. Thank you so much for being here. That's Dr. Himanshu Desai, a gastroenterologist with St. Francis Medical Associates. For more information about St. Francis Medical Associates or to make an appointment with one of our medical providers, you can call (855) 599-SFMC or 7362. So that's (855) 599-7362. You can also visit our website at stfrancismedical.org.
If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks for listening to Word On Wellness, the podcast from St. Francis Medical Center. My name is Prakash Chandran. Thanks and be well.
Prakash Chandran: Colorectal cancer is the second leading cause of cancer deaths in men and women combined. There are several risk factors for colorectal cancer. Many of them are lifestyle-related. Being physically inactive, smoking and heavy alcohol use are some of those risks. But if lifestyle is a factor, what can we do to maintain a healthy colon and try to prevent colorectal cancer from developing?
Here to talk to us more about eating healthy and colonoscopies is Dr. Himanshu Desai. He's a gastroenterologist with St. Francis Medical Associates. This is Word On Wellness, the podcast from St. Francis Medical Center. My name is Prakash Chandran. So Dr. Desai, really great to have you here today. Thank you so much for being here.
I'd love for you to start by briefly describing a colonoscopy and what you are capable of doing during this procedure?
Himanshu Desai, MD: Thanks for having me. It is a pleasure being with you. Colonoscopy includes visualization of the lower bowel through the rectum and into the colon. And sometimes we can even see the last part of the terminal ilium, where the small bowel and colon connect. When we look in there, it's a real time visualization of the lining of the colon. And when we look at that, if we see any growths in there, the most common maneuver that we do is tissue sampling, which includes cutting out that growth.
Prakash Chandran: Now, the whole purpose of the colonoscopy is to check for growths as you're saying. I've heard them referred to as polyps as well. And are those like cancerous formations that are indications of something more serious?
Himanshu Desai, MD: They're typically precancerous. They grow slowly, but given enough time some of these become cancerous. So removing them prevents colon cancer.
Prakash Chandran: Understood. So, you know, you said given enough time, they could develop into something more serious like cancer. So what age is it usually necessary to have a colonoscopy?
Himanshu Desai, MD: Currently, if you are a normal risk, which means that you don't have a family history of any polyps or cancers, or I don't have any symptoms, you should start at the age of 45.
Prakash Chandran: Yeah. And, you know, I just turned 40 and it's something that I've been thinking about getting done sooner, especially because of the news recently, Chadwick Boseman, who is the lead for black Panther, I heard that he got it at 42 or 43 years older where he got cancer and unfortunately passed away. So, you know, should people that are concerned get their colonoscopy sooner just to be proactive and make sure nothing's wrong?
Himanshu Desai, MD: If they're concerned and particularly if they have symptoms or have family history, they can get it done earlier. But recently, we used to do it at the age of 50. And because of that concern, the standard recommendation has dropped to 45, but it hasn't dropped to 40 yet.
Prakash Chandran: Okay. So you mentioned symptoms. What are some of the symptoms that might warrant a colonoscopy or concern?
Himanshu Desai, MD: Rectal bleeding that's unusual it's worrisome, weight loss, abdominal pain. Those would be the main symptoms that you would make you worry about getting it checked. Change in your bowel habit would be another common symptom.
Prakash Chandran: Okay, that's helpful. So if during the colonoscopy, you find polyps, talk to us about the process of treating or removing them. Is that something that you do during the colonoscopy or is that something that happens afterwards?
Himanshu Desai, MD: Yes. Now, if we see that, there are different ways of cutting that tissue out. So that's a little bit technical, but either way we aim to remove the whole tissue and then examine it under the microscope to see what type of cells they are. And that gives us an indication whether this was a precancerous polyp or growth likely to cause any cancer. Based on that, then we usually give recommendations on a follow-up colonoscopies which commonly are at five years, but can be sooner if there's more worrisome features.
Prakash Chandran: Okay. So taking a step back, could you talk to us a little bit about the process of the colonoscopy? Like from a patient perspective, what does prep look like? How long does the procedure take and what does recovery look like?
Himanshu Desai, MD: So the preparation for colonoscopy typically involves ingestion of a low-residue diet. So you're trying to avoid leafy stuff. All clear liquids for about a day or so. And then you get some laxatives or a lavage prep that cleans out the stool in your colonoscopy. And it's really important to do that well, because if you get cleaned out well, we get a better look and so, you know, you get more bang for your buck if you cleaned out well, and we get a better look. We find more polyps that way.
Prakash Chandran: Okay. And then after the colonoscopy, is there a regimen or some sort of recovery procedure that people have to go through?
Himanshu Desai, MD: Usually, you recover within half an hour or so, then you get discharged home. We do sedate you so that you don't feel any of the testing and, because of the sedatives, you do need a person to look after you at home. And generally, you're at home for about 24 hours. You're not allowed to drive because the sedatives, but you can eat anything you want really. There's no restrictions afterwards.
Prakash Chandran: Okay. One of the things that I mentioned up at the top of the episode was the risk factors that are modifiable, like lifestyle-related. So we talked about being physically active, smoking, alcohol use. Can you talk a little bit about colon health and how people can give themselves their best chance of not developing colorectal cancer?
Himanshu Desai, MD: Yes. So those are important factors there. You know, moderation in all of those and definitely stopping smoking. Regular exercise is good. Diet-wise, consumption of fruits, vegetables, that's a helpful. Red meat kind of works against you for colon cancer development. So you can help with that. Fiber is also important for colonic health, so fruits, vegetables. Nuts, legumes is good for that as well.
Prakash Chandran: So Dr. Desai, one question I always like to ask, you know, as a gastroenterologist, you've probably seen hundreds of different patients. My question to you before we close is what is one thing that you know to be true that you wish more patients knew either before they came to see you or just in considering their colorectal health?
Himanshu Desai, MD: I think for the whole population, fiber, I would say. Increasing fiber in your diet from an early age is going to help your health overall, especially colon cancer health. And then obviously, getting yourself proactively checked after the age of 45.
Prakash Chandran: Yeah, that makes sense. And when we say fiber, are we talking about just eating lots of oatmeal? Are we talking about supplementing? What do you mean when you say that?
Himanshu Desai, MD: No, oatmeal is a great great form of fiber. Supplements are useful when you can't really eat dietary fiber. So if you can eat a lot of fruits, vegetables, fiber, oatmeal, that's better than supplementing with fiber. And you want to get about a 22 to 24 grams of fiber in as you can on a daily basis.
Prakash Chandran: Now, is that age dependent? Like I'm 40. Is that 20, 22 grams or does that increase with age or decrease with age?
Himanshu Desai, MD: It doesn't really change with age, but you do become a little bit more gassy with fiber as you get older. It's harder to tolerate.
Prakash Chandran: Yeah. Understood. We really appreciate your time. Thank you so much for being here. That's Dr. Himanshu Desai, a gastroenterologist with St. Francis Medical Associates. For more information about St. Francis Medical Associates or to make an appointment with one of our medical providers, you can call (855) 599-SFMC or 7362. So that's (855) 599-7362. You can also visit our website at stfrancismedical.org.
If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks for listening to Word On Wellness, the podcast from St. Francis Medical Center. My name is Prakash Chandran. Thanks and be well.