Show 1316: Protecting Your Digestive Tract

This week on our nationally syndicated public radio show, we invite gastroenterologist Nicholas Shaheen into our studio to answer your questions about protecting your digestive tract. He is a nationally recognized expert in esophageal disease and has helped write numerous treatment guidelines for gastrointestinal disease.

Detection of tumors of the digestive tract:

Two of the most common cancers affecting Americans are colorectal cancer and esophageal cancer. Colorectal cancer, for example, is the third most common cancer diagnosis in the United States. Approximately 4% of us will develop it at some point in our lives. However, the death rate from this type of cancer has been declining, in part because screening through colonoscopy has been so effective. During this procedure, polyps that can be bothersome are found and removed.

Colon cancer:

The only difficulty with colonoscopies is that they are unpopular. Preparation for the procedure requires cleaning the colon so that the doctor performing the procedure can clearly see the walls. There are now new approaches that make preparing for a colonoscopy easier. In addition, there are other technologies such as FIT (fecal immunochemical test) that some people could use for cancer screening. How do they compare?

Esophageal cancer:

At the other end of the digestive tract, esophageal cancer is much less common, but doctors have more trouble detecting it. Because it is relatively rare, most people do not need to be screened for esophageal cancer. On the other hand, people with Barrett’s esophagus have a higher risk of this tumor. New technologies have made it easier for gastroenterologists to detect esophageal cancer. They can also treat Barrett’s esophagus so it doesn’t progress to cause problems.

New ways to treat Barrett’s esophagus:

Dr. Shaheen has pioneered several ways to treat Barrett’s esophagus so it is much less likely to develop into esophageal cancer. He will describe research on radiofrequency ablation as well as the much newer cryoballoon ablation. The latter technique uses targeted cold to reverse the precancerous nature of the cells lining the esophagus (American Journal of Gastroenterology, November 2020). When is this approach most helpful in protecting your digestive tract?

Are there ways to detect Barrett’s esophagus without endoscopy? The answer is yes. Gastroenterologists have identified DNA methylation markers. These can be recovered from a small balloon swallowed by a potential patient (Scientific Translational Medicine, 17 January 2018). In most cases, patients prefer this approach to endoscopy (Digestive Diseases and SciencesJanuary 2022).

How can you overcome heartburn?

One way to protect your digestive tract is to reduce your experience of heartburn. This discomfort is usually caused by stomach acid splashing into the esophagus where it can damage delicate tissues. Although occasional heartburn is probably not dangerous, it is unpleasant. And frequent heartburn, also called reflux, can trigger Barrett’s esophagus. Are there ways to reduce the likelihood of heartburn? If you have been relying on a proton pump inhibitor (PPI) like omeprazole or esomeprazole for months, are there ways to stop the medication with minimal suffering?

What are your concerns about protecting your digestive tract?

Having Dr. Shaheen in the studio during the show offers a unique opportunity for you to ask the questions that have been bothering you. Add your comment below or email us your question: [email protected] You can also contact us through Facebook or Twitter. We will try to answer as many questions as we can. Between 7 and 8 a.m. EDT on September 24, 2022, you can call 888-472-3366 with your questions.

This week’s guest:

Nicholas J. Shaheen, MD, MPH, is Bozymski-Heizer Distinguished Professor of Medicine at the University of North Carolina School of Medicine and Chief of the Division of Gastroenterology and Hepatology at UNC. He also holds a position in the Department of Epidemiology at UNC’s Gillings School of Global Public Health. Dr. Shaheen is a renowned expert in esophageal diseases and endoscopy. He is the author of multiple treatment guidelines for gastrointestinal diseases.

Listen to the podcast:

The podcast of this show will be available on Monday, September 26, 2022, following its broadcast on September 24. You can stream the program from this site and download it for free. The mp3 link is always at the bottom of this page on Monday morning.

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