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A colonoscopy helps prevent or detect cancer by identifying polyps before they turn into cancer. If you're age 45 or older, you can call GastroIntestinal Specialists to schedule your colonoscopy without a referral. Although many people hesitate about the preparation process, many patients have admitted that it was not as bad as they expected.

Brad and Omerror’s stories are important reminders that symptoms aren’t always obvious, but that doesn’t mean screening isn’t necessary. The physicians at GastroIntestinal Specialists can help catch issues early. Waiting for symptoms can mean waiting for cancer, which is why staying up-to-date on screenings is so important.

After a routine checkup, Brad was referred to GastroIntestinal Specialists (GIS). A colonoscopy by Dr. David Dies at GIS revealed a polyp, and a biopsy confirmed cancer. Although Brad needed surgery, the cancer hadn't spread. No further treatment was required for him. Brad's story is an important reminder to not wait and to get screened.

Omerror, a retired school teacher, visited a primary care doctor for the first time in two decades. This visit led to a referral to GastroIntestinal Specialists (GIS) for a colonoscopy, during which a large cancerous polyp was found by Dr. Nicolas LaBarre at GIS. Following the successful removal of the polyp and her recovery, Omerror has become a passionate advocate who encourages others to get screened.

If a problem with the biliary system is suspected by your healthcare provider, an ERCP may be recommended. This endoscopic retrograde cholangiopancreatography is a type of endoscopic imaging test that allows for evaluating the bile ducts and the pancreatic ducts. In general before the procedure, we recommend to not eat anything for eight hours prior to. Blood thinner should be held for an appropriate length of time determined by your endoscopist. Any allergies (especially to contrast) should be reported prior to the procedure date. A small tube with a camera on the end is passed through the mouth, down the throat and into the small intestine while you are under sedation. It is through this small tube that even-smaller instruments are passed to reach the bile duct or pancreatic duct, depending on the issue at hand. Contrast is then injected into the ducts to help visualize your biliary tree or pancreatic duct on X-ray. Primarily, blockages from gall stones, tumors or scar tissue are then able to be found and treated in real time. Following the procedure, you should have your driver bring you home. Anesthesia may take up to 24 hours to wear off. Sore throat, a bloated stomach and nausea may occur immediately after, but is generally mild and wears off quickly.

Anal fissures are small tears in the lining of the anal canal, while hemorrhoids are dilated blood vessels that occur both inside the rectum as well as outside. Internal hemorrhoids typically present with itching, pressure or bleeding, while external hemorrhoids typically present with pain and swelling. Occasionally, internal hemorrhoids can prolapse or push to the outside. This typically occurs with more severe hemorrhoidal disease. Internal and external hemorrhoids can be treated with medication. If this is ineffective, we perform a procedure called hemorrhoidal banding here at GIS to disrupt the blood flow to the hemorrhoid and create a scar tissue in its place. It's extremely effective to manage internal hemorrhoids. If all else fails, hemorrhoids can be managed surgically.

Female patients require a unique approach due to their complicated anatomy and unique experiences (such as pregnancy and child-birth) that affect the pelvic floor. Occasionally, the muscles of the pelvic floor become uncoordinated, leading to symptoms such as constipation, straining or heaviness. Rarely, pelvic organ prolapse can occur if these muscles become too weak. Addressing the issues that arise from pelvic floor dysfunction requires an experienced team, a thorough history and physical exam, and usually multiple diagnostic modalities. All of the information obtained from these studies leads to a custom formulated plan to address your specific issues. This may include medications, pelvic floor physical therapy or a surgical referral if this is felt necessary.

In addition to developing and maintaining a healthy lifestyle with proper diet, exercise and bowel habits, laxatives may still be warranted when suffering from constipation. Over-the-counter options ( such as MiraLAX® or osmotic agents) can be safe and beneficial if used as directed, and work by pulling fluid into the intestine and stool to help the stool be softer and increase the amount of bowel movements. Stool softeners may be helpful in reducing the need to strain when having a bowel movement, such as in cases after surgery or child-birth. Stimulant laxatives make the intestines contract or squeeze and move the stool along. In general when considering a laxative, you should always discuss with your healthcare provider or gastroenterologist who may consider other health concerns that may require caution with certain medications.

While constipation can be a normal experience for most people with certain life events like with travel or changes in your diet, you should speak to your provider about your constipation if any of these following alarm signs are present: if the constipation is lasting more than three weeks, if the symptoms are really bad or disabling, stomach pain whenever you pass stool, changes in the stool caliber like the stool becoming thinner, blood in your stool, black stools, any signs of anemia like low iron in the blood, weakness, fatigue or any weight loss without trying. When you speak with your doctor, be sure to tell them about all medications, including over-the-counter medications you're taking. Your doctor or healthcare provider will decide if tests are needed to find out if the constipation is a symptom of an underlying health problem.

Constipation is when a person has infrequent or hard to pass bowel movements, has hard stools, or feels like their bowel movements are incomplete. Most of the time, constipation can be treated medically. It may be normal to have some constipation at times. In most cases, constipation is a symptom rather than a disease. Common causes of constipation include dietary choices, medications, irritable bowel syndrome, poor bowel habits or pelvic floor dysfunction. At home, diet is key. Eat a well-balanced diet with whole-grains, fresh fruits and vegetables. We recommend drinking plenty of water and ensuring an adequate amount of fiber in the diet. Exercise regularly. Set aside time after breakfast or dinner to use the restroom. Go use the restroom when the urge strikes rather than ignoring it. When these daily habits may be insufficient, adding supplemental fiber, stool softeners or laxatives may be beneficial.

ERCP is one of the most technically demanding and high-risk procedures performed by GI endoscopists. It requires significant focused training and experience to maximize success and to minimize poor outcomes. ERCP has evolved from a purely diagnostic to a predominantly therapeutic procedure. ERCP and its ancillary interventions are effective in the non surgical management of a variety of pancreaticobiliary disorders, most commonly the removal of bile duct stones and relief of malignant obstructive jaundice. The American Society for Gastrointestinal Endoscopy (or ASGE) has published specific criteria for training and granting of clinical privileges for ERCP, which detail the many skills that must be developed to perform this procedure in clinical practice with high quality. EUS has become integral to the diagnosis and staging of GI and mediastinal mass lesions and conditions. EUS-guided FNA and FNB (or fine needle aspiration and fine needle biopsy) enables for sampling to further analyze these conditions.

An endoscopic ultrasound (or EUS) is a procedure to examine the inside of the digestive tract. This is done by using a thin, flexible tube with a camera and light on the end, as well as an ultrasound probe that sends out sound waves to produce images of your organs, tissues and blood vessels. During the EUS, your endoscopist may also perform fine-needle aspiration or biopsy, which is done to remove a small sample of fluid or tissue. This sample goes to a pathology lab to be examined further for signs of disease, including abnormal or cancer cells. Before the EUS, your healthcare provider will discuss with you any changes in medications (such as blood thinners) that may need to be held. You should not eat or drink for eight hours prior to the test. The procedure typically lasts no longer than 30 minutes. You'll be under sedation while the procedure takes place. You shouldn't feel any pain during or after the procedure. Upon awakening, you'll be in the recovery area until you're ready to be discharged home with your driver. Prior to leaving, your endoscopist will be able to discuss the findings of the exam.

Anal fissures are primarily treated with medication. It's traditionally a topical ointment applied three times daily for six-weeks. This allows the anal sphincter to relax and the overlying skin to heal on its own. This is effective for symptom management more than 80% of the time. Anal fissures can recur, and a repeat course of medication is effective therapy. If fissures are refractory to the ointment, our next step is injecting Botox® into the anal sphincter. This allows for prolonged relaxation of the anal sphincter and additional time for the tear to heal. Botox® cures approximately 70% of fissures that do not respond to medication therapy. Finally, if the previous measures fail, there are surgical options that can be explored.

Endoscopic ultrasonography is an endoscopic test similar to upper or lower endoscopy that involves a dedicated ultrasound probe at the end of the scope to allow for visualization of structures outside the GI tract. Typically, EUS is used for cancer diagnosis and staging, assessment of lymph nodes, and evaluation of pancreatic diseases and small lesions under the surface of the lining of the GI tract. While EUS is a minimally invasive procedure with an endoscopist who has undergone appropriate training, it can be extremely useful in diagnosing and assessing certain conditions if or when other imaging methods may not be as useful.

At GastroIntestinal Specialists, some of the common anorectal disorders we treat are hemorrhoids (both internal and external), anal fissures, fecal incontinence, and pelvic floor dysfunctions such as dyssynergia that may contribute to chronic constipation. These disorders are typically initially evaluated with a thorough history and physical exam. We can perform a special office-based procedure known as anorectal manometry to test the pressures of the pelvic floor. We also have access to special imaging of the pelvic floor if needed. We utilize all of these tools to provide comprehensive care and management of all anorectal disorders.

The gold standard test for colorectal cancer screening and actual prevention of colorectal cancer is the colonoscopy procedure. However for average-risk patients without inflammatory bowel disease, a personal history of colon polyps or colon cancer, or family history of colon cancer, there are a few types of at-home screening tests that (while not perfect) may help lead to the diagnosis of colorectal cancer if done properly. Generally, a frank discussion between you (the patient) and your healthcare provider should be held when deciding which screening test would be the best one for you.

Treatment of fecal incontinence is multifaceted. Supportive measures such as time toileting, incontinence pads and avoiding triggers for diarrhea are preventative actions. Active treatment includes antidiarrheal therapy, bulking agents such as methyl cellulose, pelvic floor physical therapy, surgery, and sacral nerve stimulation (also known as inner stem). Inner stem is a two-stage procedure. I perform stage one here at GIS, which is a seven-day trial stimulation. The electrodes stimulate the sacral nerve, allowing the anal sphincter muscles to stay contracted to prevent leakage of stool. If this is successful, I refer you to a surgeon to undergo permanent placement of the implant. While this is the most invasive therapy we offer, it's also by far the most effective treatment for fecal incontinence. It's a very safe procedure that requires light sedation.

An anal fissure is a tear in the lining of the anal canal. It is typically very painful (specifically during a bowel movement) and can cause bright red rectal bleeding. Fissures can occur for a variety of reasons, most commonly straining, hard stools, and constipation or diarrhea.

At GastroIntestinal Specialists, some of the common anorectal disorders we treat are hemorrhoids (both internal and external), anal fissures, fecal incontinence, and pelvic floor dysfunctions such as dyssynergia that may contribute to chronic constipation. These disorders are typically initially evaluated with a thorough history and physical exam. We can perform a special office-based procedure known as anorectal manometry to test the pressures of the pelvic floor. We also have access to special imaging of the pelvic floor if needed. We utilize all of these tools to provide comprehensive care and management of all anorectal disorders.

IBS, or irritable bowel syndrome, is a very complex topic. Irritable bowel syndrome is basically divided into an irritable bowel syndrome with constipation and irritable bowel syndrome with diarrhea. In the field of irritable bowel syndrome with constipation, there have been numerous medicines that have come out in the last few years that have helped us treat and target the colon or the large intestine to help achieve better bowel movements and better control of symptoms. In the field of irritable bowel syndrome with diarrhea, we have seen that intestinal bacteria plays a major role. Our small intestine and large intestine have several bacteria. Most of them are friendly bacteria, and there’s a small portion of bacteria that is harmful. We’ve noticed that when the balance of bacteria changes in the intestines, that can lead to various problems. Irritable bowel syndrome with diarrhea may be linked to some of this bacteria. Now, we have antibiotics that selectively target to kill bad bacteria in the intestines, and that helps symptoms of diarrhea in these patients. Also, there’s been several important changes in probiotics and prebiotics. Probiotics are basically bacteria that are good to the intestine, and these are bacteria that normally reside in the intestines. They help regulate the daily function of the intestines. Prebiotics, or nutrients that the probiotic bacteria use, and by consuming prebiotics and probiotics, the normal bacterial flora and the intestines are maintained, which subsequently leads to good regulation of bowel habits and helps with irritable bowel syndrome.

The risk factors for esophageal cancer are numerous. Excessive body weight, smoking, excessive alcohol consumption and excessive use of caffeinated products all increase the risk of reflux and subsequently increase the risk of esophageal cancer. Many of these are modifiable including the diet we consume; increasing activity, which will help reduce weight; reducing the amount of alcohol; and reducing the amount of caffeinated products. This can all reduce reflux and reduce the risk of esophageal cancer. Another important risk of esophageal cancer is family history of esophageal disease, Barrett’s, or esophageal cancer. If a family member such as a parent has an esophageal cancer, your risk of esophageal cancer also increases. You should consult with your gastroenterologist to get evaluated for precancerous changes that may exist in your esophagus.

Healthy diet is very important. It is important to prevent cancers. It is important for a healthy lifestyle. It is important for overall well-being. Diets rich in vegetables and fruits. The “Mediterranean diet” has been repeatedly proven to be the most beneficial diet to prevent cancers and live a longer and healthy life. We recommend patients consume more healthy vegetables and fruits, and more grains, as well as reduce the amount of red meat consumption, which has shown in many studies to be linked to cancers of the colon and the gastrointestinal tract. Diets that are rich in ultra-processed foods like bacon and packaged meat have also been shown to increase the risk of cancers in the gastrointestinal system and should be avoided.

Endoscopic ultrasound technology is a relatively new technology that has been available over the last decade or so. It offers a window for us to reach certain organs in the body that are very difficult to reach. Examples are the gallbladder, the pancreas and the bile ducts. Many times, small precancerous lesions, tumors, gallstones or pancreas diseases can be seen and visualized very well with endoscopy ultrasound. It offers an unprecedented access to these organs that are not usually available with other techniques such has a CT scan or MRI. There are certain diseases that are only diagnosed with endoscopic ultrasound, and that has been a major breakthrough in gastroenterology. Endoscopy ultrasound also offers an access to reach some tissue in these important organs by using a small needle that can be guided under ultrasound guidance to obtain biopsies from precancerous lesions, cysts and tumors in the body.

Barrett’s esophagus is a condition where the inner lining of the cells in the esophagus changes to a different type due to constant acid reflux and acid exposure. Barrett’s esophagus is detected by a simple endoscopy procedure where a patient is put to sleep. A small, flexible scope is introduced through the mouth and the parts of the esophagus are evaluated, and biopsies are taken to be tested for Barrett’s. If Barrett’s esophagus is identified, most of the time it requires constant surveillance every one to two years, and can be monitored with medication and treatment. In some cases, the Barrett’s can progress to early changes of cancer called dysplasia. If dysplasia is detected, a simple endoscopic procedure can again be used to use radio frequency waves to burn and treat the Barrett’s and eradicate the Barrett’s before it turns into cancer. Simple endoscopic procedure is available to treat advanced cases of Barrett’s or precancerous changes in the esophagus to prevent esophageal cancer, but the key is early detection.

Simple heartburn can be a serious problem. Heartburn is because of acid reflux or GERD. This happens when you have a weakness in the lower sphincter or a valve in the bottom of the esophagus, which causes acid that’s made in the stomach to reflux back and cause damage to the lower part of the esophagus. This can lead to scarring and inflammation in the esophagus and also lead to a change called Barrett’s esophagus, which is a precancerous condition that can happen over time. So yes, acid reflux and heartburn can lead to cancer and is a serious concern.

Symptoms of colon cancer are very important to understand. Symptoms of colon cancer would include weight loss, changes in your bowel habits, blood in your stool, abdominal pain, bloating and discomfort. Any of these signs can be symptoms of colon cancer.

NASH has become an epidemic in our society. It is projected that, by 2020 or 2025, the most common cause of liver transplantation in America will be related to obesity and NASH. We have now, in our research center, more than six trials where we are testing different drugs to see if we can find an effective drug that will decrease the fibrosis and prevent cirrhosis in these patients, and consequently save their lives.

Yes, IBD treatment has evolved significantly in the last 20 years. Fifteen years ago, there were only three or four drugs available to treat Crohn’s and Ulcerative Colitis. Right now, we have more than 20 in the market. On top of that, we have another six or seven drugs in clinical trials and that have made the treatment more available. The serious side effects that were mentioned initially are considered safer at this time, and we believe that the benefits of these trials and treatments greatly exceed the potential risks associated with these medications.

The main treatment for NASH at this point is going to be diet and weight loss. We do have several research studies available where they’re using medications to try and see if that can help with NASH and fatty liver. We also recommend regular exercise and also controlling any other risk factors, such as high cholesterol, diabetes and high blood pressure. We really encourage our patients to participate in these clinical trials because if we were able to develop

In the last few years, we have been dedicated to inflammatory bowel disease. There are two main conditions: Crohn’s disease and ulcerative colitis, and also to the treatment of patients with NASH, patients who have an excessive amount of fat in the liver.

NASH stands for non-alcoholic steatohepatitis, which basically means its advanced fatty liver. Just like you can have fat other places in your body, you can also have fat in the liver. The reason we care about it is because in some patients it has the ability to progress to scarring of the liver or cirrhosis.

In the last few years, we have developed a large research center in an institution, and we provide a significant number of clinical trials for treatments of patients with different conditions, mainly patients with Crohn’s, Ulcerative Colitis and NASH. We do research. We believe the research is very important because if nobody volunteers to do clinical trials, no new drugs will ever be developed. We ask for our patients to participate in an act of generosity from their part but with the idea to help society and humanity in general to try to get better treatments for those conditions.

The way we treat gastroparesis is to first make the diagnosis, and generally we do that with the combination of an upper endoscopy and imaging studies. In this case, we do what’s called a gastric emptying study to see how quickly food leaves the stomach or how long it stays in there. Once the diagnosis is made, then we need to go about treating it. One of the first modalities we use to treat gastroparesis, especially if you’re a diabetic, is to get a patient’s blood sugar under tight control because poorly controlled blood sugar results in increased and worse symptoms of gastroparesis. Additionally, we enact lifestyle changes. We have the patient eat small, frequent, low-volume, low-fat and low-fiber meals because high-fiber and high-fat meals tend to be hard to digest, and that impairs the emptying of the stomach. Additionally, we can put the patients on a handful of different medications that we use to try to improve the rate of gastric emptying and improve their symptoms.

Gastroparesis is a condition that affects the normal spontaneous contractions of the stomach that help propel food through the digestive tract. In a normal person, those contractions quickly move the food through the stomach and into the small intestine. In patients with gastroparesis, those normal contractions are slowed or absent, and that results in food or liquids staying in the stomach for long periods of time. That causes symptoms for patients. There are multiple causes for gastroparesis, some of which include its association with poorly controlled diabetes. Medications can also slow and delay gastric emptying. Even viruses can impact the nerves that supply the stomach and result in delayed gastric emptying.

GERD stands for gastroesophageal reflux disease, and it’s the condition where acid in the stomach refluxes back into the esophagus. The esophagus is the tube that connects our mouths to our stomachs. When we have a reflux of acid contents into the esophagus, it can cause painful symptoms. Over time, that acid content can even damage the lining of the esophagus and cause additional problems for patients.

Heartburn is a symptom and the term used to describe the substernal chest burning or upper-abdominal burning that we typically associate with gastroesophageal reflux disease or that reflux of acidic contents backing up into the esophagus. GERD is the disease state, but heartburn is a symptom. It has nothing to do with the heart itself.

If patients are 50 years of age and they’ve had a lot of reflux symptoms for a long time, we typically would screen them if they’ve had reflux, especially Caucasian males. If they’ve had reflux for more than five years or one or more times a week, then we might screen them even before the age of 50. Obese males as well tend to be more susceptible to Barrett’s esophagus.

In terms of when we ask patients to seek treatment for reflux symptoms, there are some clues we look for, and signs and symptoms that we identify patients for which we might think they need further evaluation. One of those symptoms is chest pain. We also always want to exclude heart disease as being the cause of the patient’s chest pain before we chalk it up to reflux disease. Additionally if patients have trouble swallowing or pain with swallowing, that would prompt us to do a little more research. One of the problems with reflux disease is, if left untreated over time, that reflux can damage the bottom of the esophagus and cause what’s called Barrett’s esophagus. That condition is important for us to know about and screen patients for Barrett’s esophagus because untreated Barrett’s esophagus can result in esophageal cancer. It’s a very high risk associated with Barrett’s esophagus and one of the reasons why we want to identify patients that may be at risk for its development.

As far as symptoms of gastroparesis are concerned, when the stomach doesn’t empty properly and food and liquids stay in the stomach for prolonged periods of time, it typically causes nausea and vomiting in patients. They may even have associated upper abdominal pain, bloating and feeling very full after only a few bites of meals. They can even have a loss of appetite and lose weight because of it.

Once you have cirrhosis, there is a risk of progression to death and/or liver transplantation, but our job is to keep you from that. That’s why we formed a cirrhotic care clinic. It’s the only one of its kind in North Louisiana, and the vast majority of our patients actually never die or get transplanted. We follow them, and we stop problems before they occur. It’s very important to get good follow-up once you’re diagnosed with cirrhosis.

We have wonderful treatments for hepatitis C. We have oral-based therapy, which is tablets. You could take one tablet a day or three tablets a day for anywhere from 8 weeks up into 12 weeks and in some cases 16 weeks. They’re very effective with very few side effects. These tablets are very easily tolerated, and the cure rate is very high: between 95 and 100 percent. We cure almost everyone.

It’s hard to pinpoint a symptom to hepatitis C. It’s typically picked up just because your liver enzymes are elevated, but right now, we think anyone born between 1945 and 1965 needs one-time testing. Those are the “baby boomers.” Even without symptoms and with normal liver enzymes, we want that group tested.

Hepatitis C is a blood-born virus that is contracted either through blood transfusion prior to 1992, intravenous drug use, intranasal drug use or homemade tattooing. This is a virus that’s not easily transmitted sexually. This is something we do have appropriate treatment and a cure for.

We deal with a lot of liver diseases in our practice in our Liver Center. Part of which includes fatty liver disease, hepatitis B, hepatitis C, alcoholic liver disease and cirrhosis with serratia care. Primary biliary cholangitis is one that we typically see as well. Our Liver Center has the only two Board-certified and fellowship-trained liver specialists in North Louisiana. So, we deal even with rare genetic disease, but probably the most common would be fatty liver disease.

The biggest risk factor for liver cancer is obviously cirrhosis of the liver. However, there are other reasons why. Hepatitis B alone, without cirrhosis, can cause liver cancer. There are other risk factors if you know you have liver disease and you’re smoking and drinking. Those are two things you should not do.

GERD, or G-E-R-D, stands for gastroesophageal reflux disease. Gastroesophageal reflux disease is one of the more common problems that we see as gastroenterologists. It’s manifested by a variety of symptoms. The most frequent symptom is heartburn.

Heartburn tends to be the most frequent symptom, along with a feeling of regurgitation of acid. You can also, in the more advanced stages of GERD, develop difficulty swallowing. This typically comes from scarring of the end of the esophagus in the formation of what is called a stricture that can block food from going from the esophagus into the stomach. There are occasionally symptoms that are manifested in the throat. These typically include hoarseness. Patients may present with asthma-like symptoms, wheezing and also a chronic cough.

GERD typically occurs when the lower esophageal sphincter, which is a muscle at the end of the esophagus, relaxes inappropriately. This allows acid from the stomach to come up into the esophagus fairly frequently. This then causes inflammation of the end of the esophagus, and this can progress on to ulceration, which is the more severe type of inflammation, and scarring, which can lead to what is called a stricture.

There are several things a person can do on their own to treat GERD symptoms. One of them, if they are overweight, is they can lose weight. That’s a known contributor to reflux disease. If they smoke, that is also a contributing factor. If they’re eating late at night and going right to bed, giving themselves about three hours before lying down can help. Certain things in their diet, like excessive caffeine and alcohol, can be at least reduced substantially. Those can get a patient started to see if they can manage some of the symptoms themselves. Additional things, there are over-the-counter products such as Pepcid, Zantac, Prevacid, over-the-counter Prilosec and Nexium. Those all can be taken as directed by the package, which is typically once a day. If symptoms come back after the short use of these medications, that’s another reason to see their physician or a gastroenterologist for further evaluation.

It’s not unusual for people to have heartburn. That doesn’t mean that a patient or person has gastroesophageal reflux disease. Gastroesophageal reflux disease is better defined as having heartburn on a weekly basis. Initially, patients may treat themselves. If they’re experiencing other symptoms, such as difficulty swallowing or painful swallowing, they may present with a cough and heartburn. If patients have had these symptoms for a long time, they ought to also be seen to evaluate for any precancerous conditions such as Barrett’s esophagus.

GastroIntestinal Specialists is the largest, most experienced and cost-effective institution to perform colonoscopies in northern Louisiana. We’ve been measuring the quality of colonoscopies for many years here, and we exceed all national standards at GastroIntestinal Specialists. This is really the best place to undergo a colonoscopy in northern Louisiana.

Typically, people have their first colonoscopy at age 45. Recent recommendations changed from the American Cancer Society to lower it from age 50 to 45. There are groups that are at higher risk with significant family history, and those patients are done 10 to 15 years before the onset in the family. Patients who have a significant genetic risk of colorectal cancer may have the procedure done at a significantly earlier age as well.

The preparation for a colonoscopy requires that the colon be cleared. There are multiple different preps available to us. Typically, the day before the procedure, patients will remain on a clear liquid diet. They will undergo some preparation in addition to the clear liquid diet. Stay without food after Midnight the night before, and come in for their exam the following day.

Dr. Arthur Poch: Do colonoscopies require an overnight stay?

Signs of colon cancer can include a change in bowel habits, such as diarrhea or constipation. A narrowing of the stool that lasts more than a few days or unexplained rectal bleeding also warrants further investigation with a colonoscopy.

Not everyone with colon cancer has symptoms, especially if it’s at an early curable stage. Waiting until symptoms start may mean the disease is at a more advanced stage. That’s why a routine screening colonoscopy starting at age 45 for average-risk individuals is so important and potentially life-saving.

A hospitalist is a physician and, in our case, a GI physician who takes care of emergent and non-emergent GI consults in the hospital.

A well-balanced diet is the first go. That would include fruits and vegetables, fiber, protein and water. Try to lower your sugar intake, as well as your carb intake. Exercise, of course. Try to reduce your stress as much possible, which is sometimes very difficult, but exercise does help. Just know your body. Know what makes you feel good and what you can try to do to get you to that goal.

At GastroIntestinal Specialists, we actually have a wider range of physicians with different interests. Gastrointestinal cancers are not simply designated just to colon cancer. It entails the entire gastrointestinal tract beginning at the esophagus and the digestive organs, including the pancreas, bile duct and liver, and then the small intestine and colon. There are cancers in all of those areas, unfortunately. Here at GIS, we have the tools in order to detect many of those cancers, and we also have tools enabling us to be able to treat many of those cancers.

Your first step is to see a gastroenterologist to identify the risk factors that you have for colon cancer. The next step is a colonoscopy. Here at GIS, we are trained gastroenterologists that perform the procedures. There are other things out there that patients hear about for screening, and some of those tests do provide detection but not actually screening. It’s important that patients understand what true screening is.

Physician extenders are a unique group of individuals that were brought on the scene somewhere around the 1960s. Duke University was the first program to bring on physician assistants, and they did it because there was a shortage of nursing care, as well as physicians. They brought them on-board to help us bridge what we provide for patients. They provide us the opportunity to have quicker access into our offices, quicker diagnostic tests being done and answers to many of the questions that are needed. It helps alleviate a lot of the fears and concerns patients have. It helps us to be more “present” when we’re physically unable to be present.

Preventing gastrointestinal cancers begins with preventive care. A colonoscopy is a preventive measure that can actually find polyps and remove them before they become a cancer, thus preventing colon cancer. Similarly, we can have other areas in the body, such as the esophagus, where we may find Barrett’s esophagus, which is a precancerous condition. If we find that condition, we have things we can do that would enable us to treat that and prevent cancer. It’s very important to have screening done early and detection sooner.

Some of the gastrointestinal cancers we treat include esophageal cancer, and that may be treated by us putting in a stent to allow the patients to be able to take in food and medicine. That’s very important during their treatment for that cancer. We also can put stents into the bile duct to relieve obstruction, and we can put stints into the small intestine and the colon for similar reasons to relieve obstruction. That’s how we can treat some of those gastrointestinal cancers.

According to the American College of Gastroenterology, people at average risk should be screened at 50 years old and African-Americans at 45 years old. There have been some recent studies done, and the American Cancer Society came out with a statement. We’re trying to work on this now, where the general population will begin to be screened at age 45. There are ongoing studies, and there’s a lot of momentum behind this push.

The very first step in being screened for colon cancer usually is the primary care physician telling a patient that it’s time for their screening. We like to tell our patients to please find out about your family history because history is critical. If a person in the family was diagnosed with colon cancer, the patient should be screened 10 years prior to their family member’s diagnosis.