By TERRY O’CONOR toconnor@breezenewspapers.com Email: "Boca doc talk: Colonoscopy can ID No. 1 American killer&quot Photos Fact Box

Dr. Anthony Di Tomaso at a glance

Business: Gulf Comprehensive Gastronenterology

Specialty: diagnostic and therapeutic gastronintestinal endoscopy. Practice limited to digestive and liver diseases.

Address: 655 N. Indiana Ave., Suite D, Englewood FL, 34223

Contact: (941) 473-8881

You should know: Available every other Wednesday at the Boca Grande Health Clinic. call for an appointment.

Colon cancer is the No. 1 killer of Americans because we let it be, according to Dr. Anthony Di Tomaso. The Englewood-based physician told a Boca Grande audience of more than 100 at the Boca Grande Health Clinic Physicians Lecture Series that colon cancer’s impact can be greatly lessened if we just take the relatively simple step of trying to detect it.

The only other option is trusting to luck, a gamble that has turned out badly for many on Boca Grande and elsewhere such as the 97,000 Americans who died of it last year. this week, Di Tomaso tells us how to discover whether we have the disease, how to treat it if present and how to ward it off through detection.

Question: how serious is colon cancer in America?

Answer: I still don’t think people realize how common it is. It’s the No. 1 cancer for men and women in the United States. if you take women separately, it’s breast cancer. if you take men separately, it’s prostate. but if you take men and women together it’s colon cancer by far.

Q: how many new colon cancer cases occur each year?

A: There were about 147,000 new colon cancer cases last year. almost 50,000 died (66 percent survival rate).

Q: Who gets colon cancer?

A: Age is the No. 1 risk factor. as we get older our risk increases. Genetics play a role. There’s nothing we can do about that. In case you have a family member who had colon cancer, you’re obviously at higher risk. Diet plays a huge role. A high-fat, high-red meat diet is a huge risk factor for colon cancer.

Q: when should you start being screened for the disease?

A: we start screening people at the age of 50.

Q: does a high-fiber diet help protect against colon cancer?

A: Conversely, a high-fiber diet does not really protect you from colon cancer. Many studies have been done. What happens is you stop eating red meats and you’re eating healthier foods and staying away from the fatty, rich foods, and your risk from colon cancer will start to go down.

Q: What’s the most common symptom of colon cancer?

A: Actually, no symptom at all. Most patients have no symptoms. but they could present with anemia, a change in bowel habits, abdominal pains, weight loss, obviously blood in the stool. There’s a whole myriad of symptoms that may or may not represent colon cancer. amidst the colon cancer, you may not have any symptoms at all. People think you have to feel something wrong or feel something at all but the truth is it could be very silent, which is why we recommend screening at the age of 50.

Q: how do you diagnose colon cancer?

A: by far the best technique is a colonoscopy. It allows direct visualization of the colon, it allows biopsy or taking of tissue for diagnosis, it’s a simple exam that takes about 15 minutes. You are sedated but it’s called twilight sleep. You basically breathe on your own but you’re sleeping like in your bed at home.

Q: Is there are preparation involve for the patient prior to the colonscopy?

A: There is a bowel prep involved prior to this procedure. You usually take that the day before the procedure. It cleans it out so the operator can get a good look at the colon and remove any polyps or growths and biopsy as needed.

Q: how would you describe a colonoscopy?

A: Basically the patient is lying on a stretcher, well-sedated by an anesthesiologist. The operator inserts the camera while watching a TV screen. The colon is basically shaped like a horseshoe. There are angles we have to go around. The goal is to get all the way to the other side.

Q: how do you know you’ve reached the end of the colon?

A: There are actually two landmarks we look for: One is the opening to the appendix, which we always see even if you’ve had your appendix removed. The opening doesn’t go away. Then finally, the bowel between the large intestine and the small intestine. It’s very prominent. You can’t miss it. You see those two landmarks, you’ve gotten to the other side and given the patient a complete exam.

Q: What is the treatment for colon cancer?

A: Surgery by far is the No. 1 treatment.

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By TERRY O’CONOR Email: "know true source of holiday stomach upset to be safe&quot Photos Fact Box

Dr. Anthony Di Tomaso at a glance

Business: Gulf Comprehensive Gastronenterology

Specialty: diagnostic and therapeutic gastronintestinal endoscopy. Practice limited to digestive and liver diseases.

Address: 655 N. Indiana Ave., Suite D, Englewood FL, 34223

Contact: (941) 473-8881

You should know: available every other Wednesday at the Boca Grande Health Cliic. call for an appointment.

The holiday season with its rich foods and sometimes over-indulgent party atmosphere can leave victims in its wake wrestling with symptoms more serious than just tummy aches and mild hangovers. but how can you tell when a real problem has developed?

Dr. Anthony DiTomas recently warned a Boca Grande audience of more than 100 at the Boca Grande Health Clinic Physicians Lecture Series that it’s important to understand where common concerns such as heartburn or hiccuping is really coming from. it might just signal a serious health problem such as chronic acid reflux and diverticulitis – two common island maladies.

Question: Why has acid reflux become an epidemic in the United States?

Answer: It’s because of our lifestyle. We’re the No. 1 consumers of coffee in the world. We eat late at night. We work hard and we just don’t pay attention to those kinds of things.

Q: how many people suffer from chronic acid reflux disease, which allows stomach acid to back up through the esophagus to cause a burning sensation?

A: At the time that I will put the camera down and look at people’s esophagus, about 10 percent of the patients already have this problem. They’ve been having reflux for many years and didn’t think they needed to go see the doctor for it.

Q: what are some myths about acid reflux disease?

A: First of all, it’s not inherited. It’s an acquired condition. It’s a condition based on lifestyle, eating habits, the way we basically treat ourselves.

Q: If there’s no heartburn, is it safe to say there’s no reflux disease?

A: not true. you could have silent reflux and not even know it until you develop some complications such as laryngitis and difficulty swallowing.

Q: is there no cancer risk with acid reflux?

A: That’s totally false. There is a cancer risk. Chronic reflux should always be investigated.

Q: Are over-the-counter medicines effective in treating the disease or do they just mask the symptoms of acid reflux?

A: Over-the-counter antacids come in different sizes and shapes and they work – everything from Tums to Maalox to Prilosec. those drugs are the strongest acid suppressors that are available. but if you’re self-medicating and treating yourself with Prilosec or Pepcid, it says right on the box you shouldn’t take it for more than two weeks. Prilosec is the best but you shouldn’t be taking it for an extended time without being under care of a doctor.

Q: do you need acid for normal digestion?

A: The truth is you don’t need acid for normal digestion. Digestion actually takes place in the small intestine. Stomach acid id more detrimental than beneficial.

Q: Why is diet so critical in treating acid reflux?

A: because some foods increase acid production and reduce the sphincter muscle tone. The big ones are coffee or tea. They’re a double whammy. they increase acid production and lower sphincter muscle tone, which really puts a person at risk for reflux disease. Citrus- and tomato-based products will increase acid production. Alcohol is in that group, tobacco is in that group. Anti-inflammatory drugs also affect reflux disease.

Q: Why is a bedtime snack a really bad idea?

A: Think about it. You’re putting food in your stomach, which is the most potent stimulator of acid, and then you’re going to lay down so reflux can freely happen and you can get a lot of damage while sleeping.

Q: how can someone recognize they have diverticulosis and how serious is it?

A: It’s very common in the United States. By definition, diverticulosis is a sac-like protrusion along the colonic wall. The good news is 70 percent of the patients will never develop and symptoms or problems.

Q: Why do we get diverticulosis?

A: The theory is stool moves through your colon through a process called segmentation, which just means it’s pushed from one part of the colon until the next part takes over. but certain parts of the colon are at angles and each angle creates a pressure within the colon. This pressure change causes more tension on the wall. over time it causes these projections to form.

Q: what are the risk factors for diverticulosis?

A: a high-red meat diet is the No. 1 risk factor. Western civilizations, we’re more affluent, we have a high-fat, high-red meat diet. you won’t see this disease in Third World countries or less developed countries. Chronic constipation could be a risk factor as well.

Q: what if diverticulosis causes bleeding?

A: The most common complication that you see from diverticulosis is bleeding. The bleeding is painless. it could be large volume, quite scary, but usually you have constipation for weeks leading up to that bleeding. you can have an infection. The dreaded complication is perforation, a hole in the wall of the colon, basically. This is a medical emergency that requires surgical intervention.

Q: how should diverticulosis be treated?

A: If you’re having complications, if you’re bleeding, we would watch the patient and give a blood transfusion if needed Rarely do any of those patients need any other intervention. almost 80 percent stop bleeding on their own and they can go home in a few days. If the condition requires antibiotics, some people get better within 24 hours, some people need several days or weeks in the hospital. Surgery is indicated only for severe complication such as perforation.

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