Part of staying healthy includes having a well-functioning digestive system. The colon is often one of the most neglected organs in the body despite its important function of making and storing stools to help remove waste. Most people only start to pay attention to their colon health when they experience discomfort from irritable bowel symptoms, constipation and more serious issues such as colon cancer. Find out more about how you can take better care of your colon health with insights from Dr Kevin Kaity Sng, Surgeon at K K Sng Colorectal & General Surgery at Gleneagles Medical Centre and Mount Elizabeth Novena Specialist Centre.
Is it true that processed foods increase the risks of getting colon cancer?
Yes, it is true that processed foods, especially processed meats, increase the risk of colorectal cancer. The reason for this is likely to be due to harmful chemicals used in preservatives that are found within processed meats such as sausages, pepperoni, bacon and ham. Certain methods of cooking your meat, such as grilling, frying or barbeque also increase the amount of these harmful chemicals that may cause damage to the cells lining your bowel and increase the chances of harmful DNA mutations which may trigger the formation of cancer cells. However, this does not mean that one will develop cancer after eating the occasional sausage or bacon. The main message is that these harmful food products should not be consumed on a regular basis over a long period of time.
Does being a vegetarian help to reduce the risks?
Being a vegetarian certainly means cutting out harmful foods known to increase the risk of colorectal cancer such as processed meats and red meat which in turn reduces the risk of cancer. Furthermore, a diet rich in fruits and vegetables is likely to promote a healthy functioning colon with regular bowel habits. Healthy vegetarian diets that contain essential vitamins and minerals, as well as antioxidants also reduce the risk of cancer.
Are there any foods that are beneficial to maintaining a healthy digestive system?
There are many foods and health supplements touted to promote a healthy digestive system but the most sensible approach is to adopt a healthy low-fat diet with generous helpings of fruits and vegetables with each meal. One does not have to be a total vegetarian or vegan. In fact, being a total vegetarian or vegan runs a higher risk of lacking the optimal balance of nutrients in one’s diet, and these individuals would have to take extra care in choosing their foods to ensure they consume all the necessary nutrients. Health supplements that one might wish to consider would include probiotics or yoghurt which contain “good” bacteria that helps keep the digestive system healthy.
Why do some people feel bloated or experience constipation after eating high-fibre foods?
High-fibre foods contain indigestible carbohydrates that are harder for the body to break down. Also, as fibre is not fully digested, it contributes to the bulk of faeces production and if the fibre intake is excessive, this would lead to a large amount of faeces within one’s bowels. So, even after defaecation, one may still have the sensation of remnant stools within the colon causing abdominal bloatedness, flatulence and the perception of being constipated. Hence, although healthy, it is not advisable to over-consume large quantities of high-fibre foods which, apart from causing bloatedness, can also paradoxically cause some people to feel “constipated”.
Lifestyle and hereditary causes
Is it true that despite a healthy diet and lifestyle, one can still succumb to colon cancer due to hereditary factors? What is the likelihood?
This is true. There are many reasons that lead to colorectal cancer. Apart from environmental factors that may be mitigated by a healthy diet and lifestyle, there are also innate factors such as hereditary factors that may increase one’s chances of getting this cancer. The well-known hereditary colorectal cancer syndromes are Familial Adenomatous Polyposis (<0.5% of colorectal cancers) and Hereditary Non-Polyposis Colorectal Cancer (5% of colorectal cancers).
Most of the colorectal cancer patients with a positive family history do not fall into either of the above two categories, so there are likely to be many other genetic factors contributing to one’s risk for developing colorectal cancer. Therefore, although it is extremely important to watch one’s diet and lifestyle to reduce the cancer risk, it is equally important to appreciate that this is not always sufficient, and colorectal screening and medical advice must be sought once worrying bowel symptoms such as perirectal bleeding, change of bowel habit or abdominal bloatedness are experienced.
On prevention and care
When is a good time (age) to have colon screening? And at what frequency?
Anybody aged 50 years and above, should consider a colorectal screening (either colonoscopy or stool test) even if they do not have family members with cancer or even if they feel completely well. By the time colorectal cancer symptoms develop, it is unfortunately more likely to be a more advanced-stage cancer with less chance of cure.
Individuals below the age of 50 years should also consider colonoscopy if there is a personal or family history of polyps or cancer. Individuals with bowel symptoms should also consider a colonoscopy even if they are younger than 50 years as stool occult blood testing is not adequate.
Individuals without a personal history of colon polyps or family history, the colonoscopy interval can be between five to ten years if there are no symptoms developing in the interim. Annual stool testing should be done.
For patients with a family history of colorectal cancer or a personal history of colorectal cancer or polyps, the colonoscopy interval may be between one to five years depending on the exact medical condition.
For patients with bowel symptoms, they should seek medical advice to evaluate their condition, regardless of how recent their last colonoscopy was.
What are the signs and symptoms of colon cancer?
The key point to stress here is that early colorectal cancer often does not have any signs, and the patient often has absolutely no idea that something is wrong. Even a detailed abdominal scan may not be able to pick up colorectal cancer in its very early stages. Such early cancers are usually picked up only during colonoscopy, hence the importance of screening for this very common cancer. the chance of successful cure from treatment is very much higher for an early colorectal cancer. As the colorectal cancer grows in size, symptoms such as constipation, change of bowel habit (e.g. loose stool, prolonged diarrhoea, change in stool size, increased stool frequency), bleeding, mucus discharge, abdominal bloatedness, loss of appetite or weight loss may develop.
Is colonic irrigation effective in helping to maintain good colon health?
Although there are many claims from m manufacturers and colonic irrigation therapists claiming its benefits, there is absolutely no scientific evidence to support this. On the contrary, there are very definite and real risks involved.
What are the risks (colon irrigation) and what should one look out for?
The colon rightfully contains faeces. It is never nature’s intention for the colon to be totally devoid of faeces. Colonic irrigation is unnatural and poses potential health issues. Healthy large intestine contains an optimal balance of different bacteria, including “good” bacteria that prevent colonisation of the colon by “bad” bacteria. This balance is important, not just for the colon’s health, but also for the health of the other systems in our human body. Colonic irrigation can disrupt this delicate balance of gut flora. The lining of our colon also serves as a membrane through which one can lose fluids and electrolytes when colonic irrigation is done. This can result in dehydration and electrolyte imbalances. This, in turn, can cause the person to feel fatigued, unwell, and potentially develop kidney and heart failure (both of which are life-threatening).
If the equipment or fluid used to perform the colonic irrigation is not sanitised and sterilised properly (this industry is difficult to regulate effectively), it can be a source of many infections for the recipient. The equipment used to irrigate the colon can also cause injury and perforation to the intestine. This may even necessitate emergency major surgery to repair the injury.
Tips to ensure optimal balance of nutrients in one's diet:
- Do not limit the selection of vegetable to a small variety of what one perceives to be healthy, include a variety.
- Have regular servings of carbohydrate – potatoes, rice and bread (preferably brown rice and wholemeal bread).
- Include servings of white meat such as fish and chicken, and occasionally red meat.
What is Colon Cleanse?
Colonic irrigation which involves flushing the colon with about 60 litres of water is an ancient Egyptian practice that dates back to 14 century B.C. where it was believed to “drive out excrements” responsible for stomachs and intestinal complaint. Advocates claim that it aids detoxification, banishes bloating and even slims the body.
Tips on taking care of colon health
Here are three easy tips you can follow
- Maintain an active lifestyle and a healthy, high-fibre, low-fat diet, and avoid processed foods, red meat, fried and barbequed foods as far as possible.
- See your doctor early for bowel symptoms and go for colorectal screening.
- Avoid spending prolonged periods sitting and straining in the toilet. It is advisable not to get carried away with your reading material or smart device while doing the deed in the toilet to reduce the risk of problems such as haemorrhoids.
This article was first published in the Feb 2016 edition of You Health Magazine. For more information on colon health, you can make an appointment with Dr Kevin Kaity Sng, head over to GetDoc.
by Hridya Anand
A biochemist by education who could never put what she studied to good use, finally found GetDoc as a medium to do what she loved - bring information to people using a forum that is dedicated to all things medical. View all articles by Hridya Anand.