well hello and welcome to Health and I'm Jennifer Blomquist.

I have the privilege of hosting the program this evening and I'm so glad you joined us.

I know we have our regular crew that that joins us every week and so you know the routine we are live in the studio.

We have a physician here as a guest tonight.

We have a gastroenterologist with us.

So a lot of interesting things to talk about and we welcome your questions so please take advantage of that.

That's why we keep the phone number to reach us at the bottom of the screen throughout the program and also now you can text.

So that's a great way to get any questions you may want to ask the doctor taking care of .

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Just dial 866- and then the rest of the number you talk to a call screener, a very nice person.

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No close it's two six zero (969) it's 27 three zero.

>> And I want to tell you that your phone number stays private so don't worry about that if you feel comfortable giving us maybe your first name and even telling us where you're calling from and then just a brief question and then we'll get your your question answered that way.

So lots of options just want to make you aware that and feel free to call at any time between now and about five till eight .

So take advantage of the time that you have to get some free advice.

Let's go ahead and meet our guest tonight.

As I said, we have a gastroenterologist this is Dr.

Praveen Sateesh.

>> So nice to have you on the show.

Oh, thank you for having me.

Thank you.

And you know we don't often get to do gastroenterology gastroenterologist program so this will be fascinating because I was telling you before the show I feel I can meet so many people who have some kind of a GI issue and you see so many commercials now if you pay attention that are you know, to treat irritable bowel syndrome, Crohn's disease, things that are GI related and so that right there kind of tells you it's a prevalent issue in our society today.

>> Yeah, absolutely.

You tend to see a lot GI related symptoms, G.I.

related pathology in pretty much any community tends to be pretty pretty prevalent and I know we wanted to talk about colonoscopies.

>> Everybody's favorite topic for sure but that's a great way to get some answers and I know you and I were talking before I have two children.

Two of my children have Crohn's disease.

So you learn a lot about what all these tests can tell you.

But that was like the first thing that we had to do was a colonoscopy and I don't know if you want to talk about that.

>> I mean it's I think it's the prep that scares people the most.

>> Yeah.

That's probably the toughest part of the procedures for cleaning yourself out.

We do have different options now that weren't there years ago including a tablet prep as well that might help some people that have struggled with the traditional prep with nausea.

Yeah, Stolarik I was drinking quite a bit of water though along with the tablet prep but it's not that they used to give you a certain kind of fluid to drink and I know I just remember my grandparents saying that was what they said it tasted like charcoal.

I don't know why they described it like that but but now you can just do like you know, the things that would give you enough electrolytes like a sports drink or water.

>> Yeah, you can so that to old prep there the Golightly is still what we use predominantly because it provides the best results and he talks about when you talk about a clean out being able to get a good look.

>> Yeah but yeah the the salty nature of it the taste of it sometimes people can't tolerate it you can't get flavor packets for it.

>> Oh OK.

And I always tell them pick a flavor you don't mind never tasting again.

Yeah that's true bad memory bad memory but but even just the result of the prep it's a night where you're in the bathroom quite a bit as you're getting cleaned out so yeah but the actual procedure itself is pretty easy.

>> You know you're you're asleep so you don't feel it.

It doesn't hurt and there's no pain after afterward typically typically no pain some people may have just a little bit of bloating that can go away pretty quickly.

>> OK, yeah.

How in general how long would you say the colonoscopy itself lasts the procedure oh the procedure itself could be anywhere from 15 to 30 minutes.

>> Oh that's right sure yeah.

It's not a long procedure.

Everything that surrounds it can take longer coming in, getting prepped, getting an IV, needing me meeting the anesthesiologist.

>> Sure.

So and what kind of answers can you get from a colonoscopy because I know when I took my sons they actually printed out pictures so that we could see what the inside their intestines look like for trouble spot areas.

>> Yeah, absolutely.

And you know anything that you would see any inflammation ulcers sources for bleeding in those situations colon polyps.

>> So what yeah.

Can you talk about Paoletta because I don't think you know I don't think most people probably know exactly what you mean.

I mean is it it's almost like a little growth.

Yeah.

>> Inside the colon kind of like you can think of it it like a little skin tag but within the colon inside the colon are obviously different tissue than the skin is OK but some colon polyps can be benign and some colon polyps if left unchecked can grow and eventually become colon cancer.

>> So what so can you eyeball it and just know from looking at it if if it's troublesome or do you typically always, you know, biopsy?

>> Yeah, honor well yes you can kind of make good educated guesses on which are going to be precancerous versus which are going to be benign but we typically send all of the polyps to pathology to confirm .

>> Yeah.

And then if you you know if there was something an issue you know that came back positive for colon cancer, I mean can you remove the polyps?

>> Does that help with the colon cancer?

Is that so that's the the the main benefit of a colonoscopy when you're talking about colon cancer screening is that colonoscopy is the only test where you can remove these polyps and hence prevent colon cancer.

>> So removing Apollo up that is precancerous effectively prevents that polyp from becoming cancer in the future.

>> And if you so is this correct I mean you have if you if you come back away with a clean bill of health if it looked OK, are you typically good is it seven seven or ten years you might not have to worry for the general population and somebody that doesn't have like family history a genetic cancer syndrome or they themselves have had previous colonoscopy where there were polyps removed.

>> Yeah.

Then typically it's every seven to 10 years for the screening.

>> OK, yeah.

All right.

So it's it's a it's a challenge but you know and it's different probably than most other medical procedures you know so yeah.

>> You know it's it is one of the things that I would say people don't look forward to getting done and that is a challenge you I think the importance though is that you know when we're talking about colon cancer, it is the third most common cancer in the US.

Yeah.

And one of the more preventable ones getting your colonoscopy is at the right age and typically for somebody that doesn't have high risk factors like a family history that age is now forty five.

>> Yeah.

You it's really one of the cancers that you can prevent and so there are other methods to screen but really the colonoscopy is the gold standard for not just screening but prevention.

>> Yeah I wanted to talk to you about some of the other other options that people have for screening but I do want to address a text message that we got so it was from Wesley.

He's from Fort Wayne and he wanted to know if Colin's colonoscopy can help to diagnose GI problems so maybe not just the cancer it can die.

>> There are a lot of other diseases and things you can have in your in your intestinal tract.

>> Absolutely.

And you know, depending on what your symptoms are, things like inflammatory bowel disease like we were discussing Crohn's disease, ulcerative colitis those are chronic GI diseases that do require medication and long term management.

>> So yeah, yeah there's no cure for them yet but you just have to manage it.

>> Yeah the treatment is really suppression and just you know management with the medications now are really good when we're talking about inflammatory bowel disease.

>> Yeah.

And managing and keeping the disease in remission but there's no cure.

That's true and we've come a long way because I mean growing up course I'm older than you but I remember you know, we never heard about anything like inflammatory bowel disease or you know, you just you know of people maybe who had upset stomach all the time and they would just take some over-the-counter medication to try to quell things.

But I feel like now most people would be familiar with it and not embarrassed to talk about it.

>> Right.

And there's Foundation's out there like the Komen Foundation, plenty of social media groups that people are part of that have the disease.

And so yeah, there's a lot of you know, just a lot of community regarding yeah.

>> A lot of support right with that.

>> So yeah.

Yeah it is not a pleasant thing to have and there's a social can be a social stigma associated with it.

Sure.

And you know and it's no joke you know you see these commercials where people are always you know they a lot of them will say I always had to make sure I was near a bathroom and and you do because sometimes you just don't know when you're going to have a flare up or an issue so.

>> Right.

And those are difficult disorders to live with and really getting them diagnosed is the first step and then treatment can really change your life .

>> Sure.

Yeah, I can attest to that.

So I want to get another question.

So this was somebody this is data called in and she said what do you think of the use?

OK, this is what we're going to talk about.

We we're going to talk about other things you could use to diagnose cancer screening.

One of them you probably heard of is called collagen and you do it by mail.

So I don't know if you know, she's asking what's your opinion of that?

So you want to talk first about what do you do and maybe you know how effective it is or not.

>> Yeah, so I mean that is probably the alternative to a colonoscopy at this point.

The main one in colon cancer screening it is you know like you had mentioned it's a stool test that you can mail in and your primary care doctor can order it.

Now the the one thing is that with colon guard that is approved for patients that don't have family history or a history of polyps, it's not approved for those patients only colonoscopy.

And secondly, Legard even though it's an alternative screening test, it doesn't detect polyps as well.

>> Oh, so really the colonoscopy is the gold standard for prevention detecting polyps or removing polyps and the you know, preventing colon cancer or collagen has higher likelihood of missing that so you can have false negative results when it comes to polyps.

>> Any positive color guard though does require a colonoscopy.

OK, yeah because then you could have either colon cancer or colon polyps which would need to be removed.

>> Yeah.

So I'm just wondering because you and I were talking and you had mentioned this in the show too that forty five is now the recommended age so insurance is probably going to cover it but say you're younger than forty five and you're just a little concerned.

I mean is is that probably if you didn't want to go through the hassle of a colonoscopy at that younger age is this maybe something that you might want to consider?

>> Yeah I mean at a younger age I think if you're having symptoms because you know what would kind of prompts a younger person to worry they may be having some symptoms and that could be bleeding.

There could be change in bowel habits.

It could be abdominal pain or it could be just some very vague symptoms.

And that's the scary part about colon cancer is that it doesn't necessarily have a hallmark symptom.

It can present very vaguely or with no symptoms at all.

So I would say if you're younger, you know the key being early detection, removal of polyps and I think combined with the fact that a collagen may miss that, I think if you're younger having symptoms I would highly advise it being a colonoscopy at that point because we are seeing an increase in younger people under the age of 50 developing colon cancer.

>> Yeah, I was I was shocked at least autistics you know, one hundred and fifty nine thousand new cases of colon cancer every year and then fifty five thousand deaths every year.

>> And like you said, it's the third leading cause the third the most common third most common cause of cancer in the US behind and prostate.

>> Yeah and it is very I mean it's just sad most I've never I want to I mean you would know better than me but in my own personal life people I've known who've had colon cancer do not survive it.

>> You know, they may be able to have some treatments to tide them over for a while but it's added some of them have been quite young.

>> Yeah, it is it can get pretty aggressive especially if you're not getting screened and or maybe ignoring symptoms but there are as to any cancers or stages to it.

Yeah.

So even you know, catching a colon cancer at an earlier stage you still have the possibility where a surgery removing that part of the colon could be curative.

>> OK, all right.

Well and I was going to remind everybody to call or text us we have a phone numbers at the bottom of the screen.

>> We did just get another text so I'll go ahead and ask you this question.

Dr.

Satish.

So this is from Lucas from Fort Wayne .

He says he can't gain weight because of undiagnosed digestive issues and what should he do to help himself gain weight?

>> Yeah.

So Lucas, have you have you seen a gastroenterologist and they've done tests are actually this is a tax oh I'm sorry Doctor.

Yeah, no.

So yeah he should probably I think I think definitely talking to start with your family.

>> Yeah.

Talk with your family doctor there's a there's a variety of reasons for not being able to gain weight and again one of those vague symptoms you does Lucas need further testing to rule out other conditions if he hasn't had it done so I would first start with your family doctor and they can determine if if you need a referral to a gastroenterologist.

>> Yeah, well, you know, it's another issue I find with my children in school we meet so many kids who have issues it started with that you know, not being able to gain weight or losing weight and a lot of it's the gluten issue.

I mean celiac disease and I'm shocked at how many people have that as well.

I never you never heard about that when I was growing up so so many things that probably were there that just never were diagnosed as people weren't coming in to get seen or getting the endoscopy tests, getting the diagnoses and celiac is one of those that we're seeing more and more.

Yeah.

Is there an increase in celiac or is just a difference between who's actually getting tested now versus in the past?

>> Yeah.

And do you think it's an issue I mean some of these things are autoimmune diseases.

I realize that but do you think part of it is your lifestyle?

>> I mean do you want to address that part of your eating habits?

So there's there's no clear causative thing that's been determined.

>> But I think just correlation being that I think you know and we see this predominantly in Western countries too when you see all this GI pathology and diet and lifestyle I think are very associated with that.

So there's, you know, an increase in obesity and metabolic syndrome in general diabete and there's strong connections between that and our gut health .

So that's probably one of the leading contenders as a cause.

>> Try and keep your weight under control, healthy life healthy eating healthy.

>> Yeah, healthy body.

So it's just we have it we have a busy lifestyle.

I feel like it if you look at the other I remember when I was studying for a language I took French and they were talking about the whole country shuts down every day for two hours and they just have a nice meal and which included wine and just cheese and all that you know and that would never happen in this country.

>> We don't slow down.

Yeah.

And yeah we have lifestyles that require convenience especially with our eating habits.

Yeah.

And you're right you can see this in other cultures and other countries where you know people are picking up fresh produce fresh meat on their way home from work cooking at whereas we tend to pick up things from supermarkets or get fast food.

>> Yeah more yeah well and they are a lot of the supermarkets offers like almost like fast food to go Sure.

>> Stuff in their deli or whatnot and then send it home.

>> So I just want to remind everybody that we don't have a whole lot of time left and if you want to get a question answered please feel free to call us (969) 27 two zero you can text us (969) 27 three zero.

We still have enough time to get some more questions in but I just wanted to remind you of that before the time slips away.

So looks like we are getting another text message right now, Dr.

Sateesh.

So this is from Diane.

She's from Fort Wayne and she says if she is an adult diagnosed with is it carcinoid of some of the small intestine, she wanted to know if she should have her child tested with genetic testing and I don't know if that was a common hereditary issue.

>> You know that it's a little different than what we're talking about with some of the genetic cancer tests or genetic cancer syndromes that relate more to to colon cancer.

Carcinoid tends not to fall under what we call adenocarcinoma, which is what we're primarily thinking about when we talk about the colon and colon cancer.

You can have carcinoid in the colon.

>> You can have carcinoid in the small intestine and typically, you know, there's there's a solitary carcinoid versus carcinoid syndrome and I guess long answer short no, you don't need to have your child genetically tested but if your child is having symptoms probably should get evaluated as well to see OK.

>> All right, great.

So I can we just quickly go over some of the you said not everybody presents symptoms with colon cancer but I know you sent me a list of common symptoms if you do experience them.

So I don't know if you want to remind people things to look for .

>> So yeah, common symptoms tend to be bleeding, red bleeding.

You can also see black tarry stools which could be an indication of bleeding as well in your intestinal track diarrhea, constipation, a change in bowel habits or a change in stool caliber abdominal pain, unexpected weight loss, just vague symptoms that some people may attribute to being more irritable bowel.

Yeah, typically we would have a low threshold to investigate with endoscopy or in a colonoscopy just to rule out things like colon cancer, rule out things like ulcerative colitis, rule out Crohn's because they can present so vaguely so yeah.

>> And it's not like you were saying before it can be an aggressive cancer for sure.

>> Yeah, absolutely.

There was something else I wanted to ask you about so this was new to me something another thing in the family of colon cancer screening has the fit test Yes.

>> Fit now when I had not heard of before and if you can talk about Yeah it's also a stool based test and honestly it has kind of been pushed aside by color guard.

>> Yeah you don't hear about it very much.

Yeah but it used to be an alternative to the colonoscopy which is a stool based test and there may be some places that still use that as a positive fit test would also indicate that you would need to have a colonoscopy but it also suffers from the same drawbacks as the color guard is.

It's not very good at knowing if you have polyps in your colon.

>> OK, so it's kind of the same thing when you mail it in a mail and a stool sample.

Yeah, yeah.

And I think there's maybe certain institutions that may still use it like the VA system .

>> Yeah yeah.

All right again we just have they showed me the Q card we just have a few minutes left but enough time to get a question or two in so please take advantage of that by calling the number of the bottom of your screen or texting us a question that a lot of good text messages and also people calling in questions.

So do you want to talk about just the average the risk you know that you've seen it jump up.

You have you know a lot more that's why they they lowered the age of the colonoscopy used to be fifty to forty five.

>> Any thoughts on what caused that?

So 30 years ago the proportion of patients under the age of 50 that had colon cancer is 11 percent now it's 20 percent more recently.

>> So you're seeing an increase in that younger patient population.

>> Why?

Again, I think it has a lot to do with diet, lifestyle, metabolic syndrome, obesity, diabetes there there's a lot of thought that that might be prevalent more prevalent now than than it was thirty years ago.

>> OK, yeah, it's just interesting usually when they lower it by that you know to that you said it might even go you suspect it could go even lower I think yeah it you know who knows what what the future will hold but it was just lowered to forty five five six years ago.

Yeah you could it be lowered even more in the future.

I think if this trend continues for sure we'll see it lowered.

>> OK all right MASC we just have a couple minutes left but we did get another tech so let's see if we can get real quickly.

Mark is seventy six year old man and had one colonoscopy at age forty five with a growth that was found and removed so that he wanted to know he's seventy six now so what is there an age after which colonoscopies are no longer performed or maybe no longer.

>> Yeah so did a lot of it also depends on the individual patient and their overall health status but typically between seventy five and eighty is when you would stop doing screening colonoscopy.

Now if someone had a colonoscopy at forty five even if there were no polyps, O'Groats found they would still need to have another one it at age fifty five and then sixty five if they don't have any polyps if you do have polyps depending on if those were precancerous polyps or not it could be sooner that you would need to have your next colonoscopy.

>> Sure.

But typically you know I usually use a cutoff age of of 80 because people are living longer nowadays.

Yeah but anywhere between seventy five and 80 and that really depends on the patient's overall health status if they have a lot of other illnesses it may not benefit them to have a colonoscopy, you know, depending on their comorbidities.

>> Then again I've met patients in their 80s that are incredibly healthy and would likely benefit from having a cold case by case.

>> I would say it's a case by case and the patient's personal preferences.

So yeah, I mean I think you know, the cliche that age is just a number really is true.

>> But according to the guidelines and then this also may be dictated by one's insurance typically it's between seventy five and 80 that we stop doing colonoscopy for screening purposes.

>> OK, so if you have an issue if you have if you have symptoms you can you can be based still need one OK yeah.

>> See some good things can come with getting older so I can tell myself that every day but I don't always believe it so unfortunately we are out of time is a wonderful show.

Dr.

Parveen Sateesh, thank you so much.

Really a pleasure to have you tonight.

So and I I think we all learned a lot.

I appreciate all of you who called in or texted in questions.

Thank you so much.

Take care and just want to remind everybody we have some severe weather that could be hitting us overnight.

So please do take care.

Of course we at Fort Wayne we have that weather radar so listen to that.

They will sound the alarm if we have some severe weather headed our way.

>> Take care.

I'm Jennifer Blomquist.

Have a great rest of your week.

Bye bye.