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Colorectal Cancer – Prevention is Key

Dr. Monica Borkar March 13, 2013 12:00 PM This chat has ended. Thank you for participating.
Angela (Moderator) - 11:53 AM:
Welcome! Today’s chat: Colorectal Cancer – Prevention is Key will begin shortly. Please start submitting your questions and Monica Borkar, MD will begin answering them as soon as we get started. While you are waiting for the chat to begin, feel free to visit the, Preventing Colorectal Cancer page on our website. Thank you for participating in our online chat today. An online transcript will be available shortly. To learn more about Colon Cancer Prevention, read our recent blog post. We will do our best to answer all of your questions, but because this is such a popular chat, the physician may not be able to answer all of your questions in the time allowed. Your understanding is greatly appreciated.

Jackie Freeman (Glenview, IL) - 12:01 PM:
I have been suffering from chronic pain in my digestive tract for over 5 years. I had a colonoscopy done and the Dr. wanted to remove my gallbladder. I refused surgery because I do not think it is my gallbladder, but my intestines that is the problem. Where do I go to have a full exam done when I do not have health insurance.

Dr. Monica Borkar (NorthShore):
You can always call Northshore University at 888-364-6400 and see one of our physicians for a clinic appointment and for further evaluation.

Debra (Chicago, IL) - 12:02 PM:
Do you have any suggestions for a first time colonoscopy?

Dr. Monica Borkar (NorthShore):
Firstly, it's great that you have decided to have a colonoscopy...it's an important step in your health initiatives. Remember that the preparation is really the worst part. The procedure itself takes only 30-45 minutes and you will experience little to no discomfort. While preparing for the colonoscopy, you can use flavor packets to make the drink more palatable, chill the prep, and use a large straw to drink it. I have had patients also say that mixing the prep with apple juice or sucking on a lemon wedge after taking the prep helps. Stay close to your bathroom while taking the prep. You may want to set up with a few magazines or your computer that evening.

Paula (Evanston, IL) - 12:07 PM:
I had a colonoscopy the other day and the doctor discovered four polyps. Two of the polyps seemed to look very different from the other two, and all of them were sent for further analysis. I am really nervous for the results. Is it normal for benign polyps to look different?

Dr. Monica Borkar (NorthShore):
Absolutely. Polyps can be raised or flat, and range in color from very pale to red. If the polyps were small (less than an inch) in size, there is a very small chance that they are something to worry about. Also remember that the majority of polyps are benign, so hang in there. You should get the results soon. It's also great that you had the colonoscopy done as a proactive step in your health. The polyps wouldn't have been found otherwise.

Erik (Skokie) - 12:10 PM:
On a somewhat frequent basis (3-4x per month) I have very intense abdominal pain that doesn’t pass until after I go to the bathroom. I eat a high fiber diet and am not often constipated. The pain almost feels like a clenching in my intestines and bowel tract. What could this be?

Dr. Monica Borkar (NorthShore):
What you are describing sounds like a spasm of the lower colon. The colon is trying to expel feces, which is why you feel better after having a bowel movement. It's great that you are consuming high-fiber. Along with the diet, there are certain medications that can help with the spasm in the colon such as levsin taken as a tablet under the tongue.

Dave (Lincolnwood) - 12:13 PM:
I’m only 26, and don’t think that I have a family history of colorectal cancer. I’ve had blood in my stools for the past month, coupled with some abdominal pain and dizziness. Some days it’s quite a bit of blood, and others days it’s hard to spot. Is this something I should be concerned about?

Dr. Monica Borkar (NorthShore):
You are right, given your age, it would be extremely unlikely for you to have colorectal cancer. The blood is most likely coming from internal hemorrhoids, which are extremely common. However, I would recommend talking to your doctor about a colonoscopy to make sure a polyp at the end of the colon isn't causing the bleeding.

Gerry (Chicago) - 12:17 PM:
Many years ago I watched my father undergo various treatments (surgery, chemo, etc.) for his colon cancer. This treatment severely impacted his quality of life, and I know he often wished he would have just went untreated. My brother just got diagnosed with colon cancer (he’s 71), and is wondering what a projected life expectancy would be if he denied treatment.

Dr. Monica Borkar (NorthShore):
Firstly, I am sorry that your family had a difficult time with your father. Treatment can be hard but we certainly want to prevent the progression of colon cancer when we can. Regarding your brother and his recent diagnosis, it would be important to ask which stage of the cancer was diagnosed. Oftentimes, local surgery with or without chemotherapy, is extremely successful. If his cancer was caught in an early stage, the five-year survival rate is over 90%.

elaine (evanston) - 12:21 PM:
What are some of the common symptoms of colorectal cancer? My good friend was recently diagnosed with Stage 4 cancer, and never had any signs or symptoms. Is that normal?

Dr. Monica Borkar (NorthShore):
You are correct, many people who are diagnosed with advanced colon cancer may never have had any signs. Things to look for are a change in bowel habits, rectal bleeding (very dark or bright red), diarrhea or constipation, a feeling that the bowels have not completely emptied, stools that are narrower than normal, general abdominal discomfort, fatigue (which can indicate anemia, or a low blood count), or unintentional weight loss.

Jennifer (Schaumburg) - 12:26 PM:
I have IBS and have been noticing changes in my bowel movements as well as a throbbing pain in my abdominal. Neither of these symptoms have been ones that have surfaced with my IBS. Could it be something else or am I just worrying too much about it?

Dr. Monica Borkar (NorthShore):
This could certainly be a new symptom that is related to your IBS, as long as you haven't changed your diet drastically or started any new medications. Factors like your age, family history, and other medical conditions would need to be considered to decide if you need a colonoscopy.

James (Skokie) - 12:30 PM:
If I have a family history of colon cancer. Every year I have to have polyps removed and wonder if the colon is every removed as a precautionary method? To date none of my polyps have been malignant.

Dr. Monica Borkar (NorthShore):
People who have genetic syndromes such as FAP (familial adenomatous polyposis) or Lynch syndrome where they develop hundreds to thousands of polyps at a young age usually have their colons removed in their 20's to prevent the development of colon cancer. For you, however, I would recommend continuing the annual colonoscopies, as your polyps are most likely small and nothing to be concerned about. Having the entire colon removed is a significant surgery and healing after the surgery can be difficult. In the meantime, make sure you are eating a diet high in fruits, vegetables, and whole grains, avoiding red meat and high fat foods, as well as exercising on a regular basis.

Adam (Chicago) - 12:37 PM:
I have Crohn's Disease and I've heard that people with IBD have an increased rate of colon cancer. How common is it with IBD patients and is it the same as much a risk for people with Crohn's as it is for UC?

Dr. Monica Borkar (NorthShore):
Yes, that is correct. The risk of colon cancer in IBD is directly correlated to the amount of bowel involved and the duration of the disease. If only a small part of your colon is involved and the symptoms are under control, you have a tiny chance of developing colon cancer. We know that after 8-10 years of inflammation, your risk increases so we recommend you have a colonoscopy every 1-2 years. People who have ulcerative colitis have an even higher risk of developing colon cancer than those with Crohn's.

Heidi (Oak Park) - 12:40 PM:
What are some of the best foods to eat to help keep your colon healthy? Does diet affect your odds of getting cancer?

Dr. Monica Borkar (NorthShore):
Yes, it certainly does! The best foods to eat are those rich in fiber, including fruits, vegetables, and whole grains. Patients who eat a diet high in red meat and low in fiber tend to develop colon cancer more than those who have a fiber-rich diet. Also, we know that staying active and avoiding alcohol and tobacco will lead to a healthier colon and less risk for developing colon polyps and ultimately, colon cancer.

Jean (Evanston) - 12:43 PM:
My husband complains that he frequently has blood and mucus in his stools. He has a very stressful job and I am wondering if some of this has to do with that. It’s been a few years since he last had a colonoscopy. Should he go again? How often do you need to?

Dr. Monica Borkar (NorthShore):
Blood or mucus can be normal in the stools, especially if the stress is causing a change in his bowel habits (like diarrhea) or abdominal pain. However, I would recommend he have another colonoscopy. If no polyps are found (and he has no family history of colon cancer or polyps), he doesn't need another one for 7-10 years assuming no new symptoms develop. If polyps are found, he would need to return in 3-5 years, depending on the number and size of the polyps.

Amanda (Chicago) - 12:46 PM:
I have always had really bad menstrual cramps, but lately I feel like they last much longer than my period. Aside from these cramps, I also now have a lot of rectal pressure. My stools haven’t been notably different, but I have been going more frequently and losing weight. Should I be concerned?

Dr. Monica Borkar (NorthShore):
If the abdominal symptoms and rectal pressure are occuring only during the time of your menstrual period, then they are related to estrogen and progesterone hormones. However, if you are losing weight unintentionally and noticing a change in bowel habits, it's something to address with your doctor. For example, things like celiac disease/gluten sensitivity can cause similar symptoms so I would get it checked out.

Dan (Wilmette) - 12:49 PM:
Last time I had a colonoscopy I had horrible gas pain afterwards. It’s been a few years and I am scheduled to go again in April. What can I do to ease this pain? What tips to have to have it be more comfortable?

Dr. Monica Borkar (NorthShore):
This is very common after a colonoscopy. When taking the preparation, make sure you avoid sugarfree liquids and stick to regular juice, chicken broth, and water. Before the procedure, make sure to tell the gastroenterologist about your past experience. Since we introduce air into the colon during the procedure, you may still feel the after effects with the abdominal discomfort and bloating. Your physician will be sure to take out as much of this air as possible during the procedure so you should have a much better experience.

Angela (Moderator) - 12:50 PM:
Thank you everyone for your great participation. The chat will be ending in approximately 10 minutes. Please submit your final questions.

Samantha (Evanston) - 12:54 PM:
I underwent chemotherapy for colon cancer two years ago. My husband and I would like to try to start a family and I am wondering if there’ll be any complications. Should we anticipate fertility issues because of the treatment?

Dr. Monica Borkar (NorthShore):
Chemotherapy should not affect your fertility, especially since it has been two years since your last treatment.

Steve (Chicago) - 12:57 PM:
Lately I’ve had to go to the bathroom much more frequently and have noticed a slight change in my stool. Should I be worried? I also don’t feel like I have completed emptied by system after going to the bathroom.

Dr. Monica Borkar (NorthShore):
If these symptoms are new for you (and you haven't changed your diet by increasing fiber or haven't started any new medications), it would be something to discuss with your physician. If you are young, your chances of a problem are very low, particularly if you have no family history of GI problems. In the meantime, I would recommend starting a probiotic, such as florastor, twice daily; these are "healthy bacteria" and are good for the health of your colon.

Angela (Moderator) - 12:59 PM:
Thank you for participating in our online chat today. An online transcript will be available shortly. To learn more about our Gastroenterology services, visit our website.

Angela (Moderator) - 1:05 PM:
Have additional questions? Join us tomorrow night (Thursday, March 14) from 5:30-8p.m. at Evanston Hospital in the Frank Auditorium for our Wenske Women's Health Series. View the event page.
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