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Published on March 22, 2019

Gastrointestinal Health: Colonoscopies, Common Gastrointestinal Issues in Women, and Kids and Stomachache

Gastrointestinal HealthIn this Fox 8 House Call series, Cone Health Experts explore gastrointestinal health, including:

Gastrointestinal Health: Colonoscopies – When are They Needed and What to Expect

Your physician may recommend a colonoscopy, the first line test for colon cancer screening, to evaluate digestive health symptoms or to look for early signs of colon cancer. Some form of screening is something everyone needs. You should begin getting a colonoscopy at age 50. If you have a strong family history of colon cancer, which usually entails a first degree relative who has been diagnosed with the disease, screening begins at age 40 or earlier. African-Americans should begin at age 45. If you’re experiencing one or more of the following symptoms, your doctor may also recommend the procedure:

  • Persistent rectal bleeding
  • Significant persistent changes in bowel habits
  • Iron deficiency/anemia

Preparation for your colonoscopy begins the day before you have it. You’ll need to have a diet with only clear liquids (like chicken broth and jello) 24 hours before the procedure to make sure your colon is as clean as possible. Coffee and tea are also OK. It’s recommended you not eat seeds or nuts a few days before as well. The night before your procedure, you’ll also be asked to drink a bowel preparation, which will allow your doctor to see clearly inside your colon during the colonoscopy.

Most colonoscopies are done in an office setting at an ambulatory endoscopy center. You should arrive an hour before your procedure is scheduled. During the procedure, you’ll be brought into an exam room and given an IV with anesthesia in your arm. It usually takes anywhere from 15 to 30 minutes and most patients wake up pain-free. Your doctor will place a small camera in your rectum that goes to the end of the colon where it connects to the small intestine to look for abnormalities and polyps. They’ll remove polyps and take biopsies, if needed – both are painless processes. Your doctor will monitor you as you wake up and most patients are able to go home about 30 minutes later. You’ll need someone to drive you home, but you can eat as you normally would that day.

Steven Armbruster, MD, is a gastroenterologist at LeBauer Gastroenterology and a member of Cone Health Medical Group. He graduated from medical school at Loyola University of Chicago Stritch School of Medicine, completed his residency at National Naval Medical Center and fellowship at Walter Reed National Military Medical Center. Dr. Armbruster is a member of American Gastroenterology Association, the American College of Gastroenterology, the North Carolina Medical Society, the Greater Greensboro Society of Medicine and is board certified in gastroenterology.

Gastrointestinal Health: Common Gastrointestinal Issues Women Should Be Aware Of

The GI tract in women can be different compared to men. For example, women are called “supertasters,” and their stomach and large intestine seem to empty more slowly.

The most common GI issues in women are:

  • Gastroesophageal reflux disease (GERD).
  • Dyspepsia (indigestion).
  • Irritable bowel syndrome (IBS) – a functional condition of the GI tract that affects the large intestine.
  • Chronic constipation.
  • Symptomatic hemorrhoids.
  • Inflammatory bowel disease (IBD) – includes Crohn’s disease and ulcerative colitis.
  • Colon cancer – the third most common cancer.

Symptoms vary depending on each condition, and include:

  • GERD – heartburn and regurgitation.
  • Dyspepsia – upper abdominal pain, bloating, nausea and fullness of the stomach.
  • IBS – abdominal pain or cramps, either diarrhea or constipation, or a combination of both.
  • Chronic constipation – infrequent stools, hard or lumpy stools, straining. Leads to symptomatic hemorrhoids that itch, bleed and swell, and cause pain, burning and prolapse. Twice as common in women, and may increase with age. It is also common during pregnancy because of hormonal changes leading to slower emptying from the large intestine.
  • IBD – bloody diarrhea, abdominal pain, fatigue, anemia and weight loss. Also twice as common in women.
  • Colon cancer – unexplained iron deficiency, obvious blood in stool, dark stool, change in bowel habits, and unexplained abdominal pain and/or unusual weight loss.

Treatment varies based on the type of condition. For example, functional GI disorders are treated by managing symptoms with over-the-counter or prescription medications, dietary modification, stress relaxation and exercise. Symptomatic hemorrhoids can be managed successfully with nonsurgical techniques, such as hemorrhoid ligation, performed in your doctor’s office. This procedure is quick, painless and does not involve anesthesia. Early diagnosis and prompt treatment are the key in managing IBD.

Rohini Reddy Vanga, MD, with Alamance Gastroenterology – Burlington, a member of Cone Health Medical Group, is board certified in internal medicine, gastroenterology (GI) and hepatology. She completed medical school at Ghandi Medical College, India, and her residency in internal medicine at Washington Hospital Center/Georgetown University. She completed her fellowship at Baylor College of Medicine in gastroenterology and hepatology, her fellowship in celiac disease at Beth Israel Deaconess Medical Center/Harvard Medical School and an advanced fellowship in inflammatory bowel disease at the University of North Carolina at Chapel Hill.

Kids and Stomachaches – How to Tell If It’s a Stomachache or Something More?

Stomachaches are very common in children. Symptoms usually last 2 to 3 days, and include vomiting and/or diarrhea. The typical stomach bug can usually be taken care of at home. Make sure you give your child plenty of fluids. Pedialyte is best, but apple juice, Gatorade and ginger ale will work in a pinch.

Do not give your child medicine that stops diarrhea, like Imodium, which is intended for adults only. Diarrhea is the body’s way of getting rid of the virus in your child’s system. A common myth surrounding children with stomachaches is that you can’t give them certain foods (like dairy and fatty foods for example). Whatever they are in the mood for is OK, but realize that they probably won’t have much of an appetite.

You should take your child to the doctor if they have any of the following symptoms:

  • Their stomachache is so severe that they can’t get out of bed or move around at all.
  • There is blood in the stool (indicates a different type of bug that needs treatment).
  • They have green or red vomit. This could be a sign of a blockage, so take them to the emergency room immediately.
  • They have pain that is localized in their right side. This could be a symptom of appendicitis.
  • They are extremely sleepy.

If you do have to get help from a doctor, they will do a careful exam to diagnose the problem. They may also do an X-ray or ultrasound to get a better look. Our community is fortunate, as Cone Health has an exceptional network of pediatricians, providers and community partners dedicated to helping you in your family’s health care journey.

Suresh Nagappan, MD, MSPH, has been with Cone Health since 2004. He is currently the medical director for the Children’s Unit at Moses Cone Hospital, is a member of Cone Health Medical Group and serves as the director of the UNC medical school campus in Greensboro. Before joining Cone Health, he spent 4 months as a volunteer physician in Malawi, Africa, at a rural hospital. He earned his doctorate of medicine at Michigan State University College of Human Medicine.

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