By Judy O’Gorman Alvarez
Many people are plagued with digestive issues from time to time. If you’ve got an upset stomach and you’re getting by with ginger ale, antacids or a hot water bottle, how do you know when it’s time to call the doctor?
“Obviously, people can have all kinds of intestinal complaints,” said Dimitry Oleynikov, M.D., a board-certified minimally invasive general and robotic surgeon, at Monmouth Medical Center (MMC).
Complaints can range from stomach pains to gas, constipation or vomiting. “Some intestinal complaints are worrisome, such as finding blood after having a bowel movement. Or an intestinal blockage where you feel like you can’t eat because the food is blocked or even causes you to vomit.”
While not every twinge signifies a larger problem, other “symptoms can sometimes be a marker for alarm for something that needs to be taken care of,” he said.
“The No. 1 thing that a lot of people experience is heartburn or regurgitation, or they feel like the food is kind of coming up on them,” he said.
Diagnostic testing will help determine if medication, dietary and lifestyle changes, or surgery could be called for. Oleynikov oversees MMC’s Digestive Health Center and sees patients after they’ve consulted their physician for symptoms such as excessive heartburn or pain that could be unsettling.
After tests they may learn they have inflammation or a precancerous polyp, an ulcer, or a hiatal hernia, among other conditions.
BUT IS IT IBS?
If it feels like you’re hearing a lot more about irritable bowel syndrome (IBS) recently, you may be right.
“IBS becomes sort of a catchphrase that people use anytime they have any kind of stomach upset of any kind,” Oleynikov said. “They go to a party, they eat too many chips and they have an upset stomach and they say, ‘irritable bowel.’ Well, probably it’s not irritable bowel, it’s probably too many chips.”
Dairy, too, is a frequent source of irritation for some digestive tracts. “People forget that as we get older, our ability to tolerate dairy gets less,” Oleynikov said. “As children, we actually make more enzymes to take care of dairy than when we do as we get older. So dairy intolerance oftentimes is seen as irritable bowel. It’s really not. It’s just dairy intolerance. And they need to know that.”
As Oleynikov explained, IBS can have a major impact on a person’s life and it is not a syndrome to be taken lightly.
“Patients who have pretty significant irritable bowel syndrome suffer from either severe diarrhea or severe constipation. These are things that are worrisome and they require seeing a physician for. You can’t just treat these (conditions) just by going to the drugstore and buying some TUMS.”
The doctor also mentioned that many people are adopting a gluten-free diet, convinced that it’s needed to help with digestive issues. “The reality is that true gluten allergies, which manifest themselves in in a disease called celiac disease is exceedingly rare. So most people who are ‘gluten intolerant,’ probably are not.” He suggests they not incur the time and expense of gluten-free diets, because they don’t need it.
Oleynikov suggests a healthy approach is to acknowledge your everyday digestive symptoms. Occasional bouts of diarrhea, constipation or bloating are not concerning, but red flags such as blood in bowel movements, recurring pain or everyday reflux, should be looked into.
“I think it all depends on the severity,” he said. “I would say if you’re taking a lunch and then you can’t take a nap because you’re having heartburn, that’s a problem.”
PULL UP A STOOL AND LET’S TALK ABOUT COLONOSCOPIES
March is Colon Cancer Awareness Month and, according to the American Cancer Society (ACS), excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States with 106,180 new cases of colon cancer and 44,850 new cases of rectal cancer expected in 2022.
The good news is the rate of those being diagnosed has dropped mainly because of increased screening and lifestyle changes. But that’s been mainly with older adults. Since the 1990s, the rate of colorectal cancer has more than doubled among adults younger than 50, according to the National Cancer Institute. Not only that, but more younger people are now dying from the disease.
“Although a colonoscopy is considered the ‘gold standard’ for colon cancer screening, it’s one of those things that people really dread,” according to Rosario Ligresti, M.D., chief of the Division of Gastroenterology at Hackensack University Medical Center.
But scientists have been working on new options.
The future holds new screening choices that may make colon cancer screening easier and faster for patients: including FIT, fecal immunochemical testing, a stool-based test that can be done at home; virtual or CT colonoscopy, a CT scan of your colon and rectum, a 10-minute procedure with no sedation or colon cleansing needed, just a solution to drink; Cologuard, where a stool sample is mailed to the laboratory for testing; tablet-form prep instead of the unpalatable liquid colonoscopy preparations; and even a capsule containing miniature cameras to travel through the digestive tract.
Oleynikov said many of these new screenings aren’t perfect yet and people should stop trying to avoid a colonoscopy.
“Honestly that’s the best way right now and that’s why the recommendations made in cancer societies is to get a colonoscopy,” he said. “We’re probably a little ways away from some magical pill that does it. But slowly but surely we’re making progress.”
The ACS recommends people at average risk of colorectal cancer start regular screening at age 45. For screening, people are considered to be at average risk if they do not have a personal history of colorectal cancer or certain types of polyps; a family history of colorectal cancer; a personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease) among other reasons.
Up to 85 percent of colorectal cancers could be prevented or successfully treated if everyone who is eligible for a colonoscopy got screened.
This article originally appeared in the March 3 – 9, 2022, print edition of The Two River Times.
