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February 2014

22 million Americans are not up-to-date on their colorectal cancer screenings.

From blood pressure to cholesterol, there are many screenings Americans accept as part of their health routine without a second thought. At the age of 50, a colorectal cancer screening joins the list of recommended screenings, and yet 22 million Americans ignore or put off this particular test.

Candidly speaking, it's not the most pleasant screening to consider. However, the potential for long term health rewards far out way any temporary discomforts.

Colorectal Screening Options

There are several types of colorectal cancer screenings, and the most commonly used are: 
•    fecal occult blood testing: tests stool sample for blood
•    sigmoidoscopy: checks for polyps or cancer inside the rectum and lower third of the colon
•    colonoscopy: examines the rectum and the entire colon for polyps or cancer 

Though less common, a virtual colonoscopy is a newer procedure that uses CTSCAN and digital  technology to create 3D images of the rectum and entire colon. This may be a good option for patients who had a failed colonoscopy.

Colonoscopy: The Screening That's More Than a Screening

Colonoscopy is the gold standard of colorectal cancer screenings for several reasons — the first being that it is the most proven and thorough examination. However, this procedure is much more than a screening tool. Not only does it check for cancer — it can prevent or even remove cancer on the spot.

During a colonoscopy, your physician may find a polyp (abnormal growth) and remove it during the process. The polyp can be tested to see if it's cancerous. 

"While most polyps are noncancerous, removing them can actually prevent future cancer from forming," said Monroe Clinic Gastroenterologist Wissam Mattar, MD. "Deaths from colon cancer have decreased over the past 20 years as screening rates increase."

But when it comes to getting screened, there is still room for improvement.  Of cancers that affect both men and women, colorectal cancer is the second leading cause of cancer-related deaths in the United States.   An estimated 30,000 lives would saved each year with increased awareness and screening. 

And unlike blood pressure or cholesterol screenings, the good news is if the results are normal, a person of average risk won't need another colonoscopy for 10 years.

Anxiety can cause symptoms similar to a heart attack.

Chest pain. Shortness of breath. Dizziness.

These are just some of the common red flags of a heart attack. However, they are also typical of what's known as a "panic attack." Other symptoms, such as vertigo, numbness of hands and feet, fainting and trembling, also join this list.


When one considers the similarity of symptoms, it's no surprise that reports show 17% to 32% of patients who visit an emergency room with chest pain have a panic disorder. 

During a panic attack, people often feel strong heart palpitations and a sense of pending doom or loss of control. It can be a very scary experience with very real physical symptoms. While it can be triggered by a stressful event, a panic attack can also occur spontaneously.

The crucial difference is that a panic attack will eventually subside on its own and pose no immediate danger. On the other hand, a heart attack is extremely dangerous and requires immediate medical attention.

While a panic attack may be mistaken for a heart attack and cause a person to visit the emergency room unnecessarily, the more serious problem is when a heart attack is mistaken for a panic attack and ignored.  This is especially a concern for women, who more often delay seeking treatment  when experiencing a heart attack. 

If you experience symptoms that could be a heart attack, do not wait to contact help. If you decide to wait, the concequences may be fatal. As soon as you experience symtoms of a heart attack call 9-1-1. Allow your healthcare professional to rule out a heart attack.

According the American Heart Association, heart attack warning signs may include:

  • Discomfort in the following areas:  chest, one or both arms, back, neck, jaw or stomach
  • Shortness of breath, with or without chest discomfort
  • Cold sweat, nausea or lightheadedness

If tests show your heart is healthy, then it is possible the symptoms are the result of an anxiety disorder. If so, a behavioral health specialist can offer further evaluation and treatment, as well as assist you in developing strategies to cope with your anxiety and your body's reaction to it.

Diverticulitis becoming more common in younger adults.

Diverticular disease is a condition occurring when pouches form from weak muscle spots in the colon wall. In the majority of cases it is symptomless. In a minority of people, it can lead to pain and infection which is called diverticulitis or bleeding in the stool.


Unknown cause

Researchers aren't certain what causes diverticular disease, recent studies repealed the notion that fiber intake has anything to do with the induction of diverticular disease.

We know that the condition is common in Western and industrialized nations (United States, England, and Australia) but less frequent in Asia and Africa. Probably genetics have the most important role in the development of diverticulosis and to a much lesser extent the environment such as smoking, obesity or medications.


Affecting Young and Old

In recent years, diverticular disease is increasingly common in the "under 50" group of patients when it previously primarily affected the senior population. 


Getting Help

There is no specific treatment to adopt to treat diverticulosis. No food restrictions or dietary changes are required. Most people live with it without any problems or complications. Only a minority of patients develop diverticulitis or bleeding. If the latter problems arise, then interventions such as a CT scan, a colonoscopy, antibiotics or even surgery may be required to treat appropriately.


Diverticulitis Complications & Treatments

When occasional bouts of diverticulitis occur, antibiotics and a liquid diet often address the infection. 

Attacks of diverticulitis can come on suddenly and cause serious complications, such as:

  • abscess: swollen, pus-filled area outside the colon wall
  • a perforation: a tear or hole in the colon wall
  • peritonitis: inflammation of tissues in the abdomen
  • a fistula: an abnormal passage formed between two organs
  • intestinal obstruction.

These complications of diverticulitis require medical attention. If diverticulitis becomes frequent and unmanageable, further action is needed.

"When attacks of diverticulitis do not respond to medication, it may be time to consider surgery," said Dr. Wissam Mattar, Monroe Clinic gastroenterologist. "Anybody who has lived with acute diverticulitis knows how painfully taxing it can be on their quality of life.  We are fortunate to have effective surgical treatments, including minimally invasive options, that offer permanent relief."

If you have concerns or difficulty managing diverticular disease, talk to your primary care provider.  You can also make an appointment with Monroe Clinic Digestive Health by calling 608-324-2210.