Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
The life-time
risk for an adult American
to develop colorectal cancer is approximately 6%. Fecal occult
blood tests
and flexible sigmoidoscopic examinations are the recommended screening tests
for these
individuals at average risk for developing colorectal
cancer.
These tests are designed to detect and remove precancerous polyps and
identify early
cancers in order to decrease mortality from colorectal cancer.
Fecal occult blood testing and sigmoidoscopy are
affordable, easy to perform, and comfortable for
healthy
individuals.
Fecal occult
blood tests are chemical tests
that are
performed on samples of stool to detect the presence
of "occult"
blood (amounts of blood that are so small that
they cannot be seen with the naked eye). These tests usually
are begun at age 40 and then are repeated annually along with a digital rectal examination that is performed by a doctor. The use of fecal occult
blood tests is
based on the observation that slow bleeding from colon polyps
or cancers
can cause small amounts of blood to mix with the colonic contents. (This sometimes can lead to an
iron
deficiency anemia .) Since the small amounts of blood are not visible
to the naked eye, sensitive chemical tests are needed to
detect the traces of
blood in the stool.
Fecal occult blood testing consists of checking for occult blood in 3
stool specimens collected
on special cards at home. To
properly prepare
for collecting the specimens, individuals are asked to abstain
(for
3-5 days before stool collections begin) from certain foods,
medications and
vitamins that can interfere with the accuracy of the
test.
These include certain meats, vitamins (especially vitamin C),
iron,
aspirin, and other antiinflammatory medicines (NSAIDs)
such
as ibuprofen that
are used in treating arthritis and other painful
inflammatory
conditions.
An individual whose stool
specimen
tests positive for occult blood then undergoes a colonoscopic
examination of
the entire colon to look for polyps, cancers, or other conditions
that cause
bleeding (such as abnormal blood vessels and colitis). The majority
(greater
than 90%) of the polyps detected at colonoscopy can be removed
painlessly
and safely during the colonoscopic examination. Polyps so removed
are examined
later under the microscope by a pathologist to determine if they are precancerous. Individuals with
precancerous polyps
have a higher than average risk for developing colon cancer, and are
advised
to return for periodic surveillance colonoscopies (see below). Colon cancers that
are detected at colonoscopy usually are removed surgically though under
certain
circumstances they may be removed at colonoscopy. Precancerous polyps that
are too large
or technically not possible to remove during colonoscopy also are
removed surgically. Several studies have shown that fecal
occult blood
testing can reduce death rates (mortality) from colorectal
cancer by
30-40%.
If no colonic abnormalities are found in an individual whose stool contains
occult blood, consideration then is given to examining the stomach and the small
intestine as sources of bleeding.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Colon cancer is a malignancy that arises from the inner lining of the colon. Most, if not all, of these cancers develop from colonic polyps. Removal of these precancerous polyps can prevent colon cancer.
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Inflammation of the inner lining of the colon is referred to as colitis. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool. There are several causes of colitis including infection, ischemia of the colon, inflammatory bowel disease (Crohn's disease, Ulcerative colitis, or microscopic colitis). Treatment depends on the cause of the colitis.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
A colon polyp is a benign tumor of the large intestine. Benign polyps do not invade nearby tissue or spread to other parts of the body. Benign polyps can easily be removed during colonoscopy and are not life threatening. If benign polyps are not removed from the large intestine, they can become malignant over time.
Anal cancer, cancer located at the end of the large intestine, has symptoms that include anal or rectal bleeding, anal pain or pressure, anal discharge or itching, a change in bowel movements, and/or a lump in the anal region. Treatment for anal cancer may involve radiation, chemotherapy, or surgery and depends upon the stage of the cancer, its location, whether cancer is eradicated after the first treatment, and whether the patient has HIV.
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Gardners' syndrome, or familial adenomatous polyposis (FAP), is an inherited condition in which cancer of the colon and rectum develop. Colon polyps and growths may develop as early as the teens. If these polyps are not removed, they will become cancerous. There are different inheritance patterns for familial adenomatous polyposis.
Disease prevention in men includes routine screening tests that are part of basic prevention medicine. Take an active role in your own health care and discuss screening tests with your doctor early in life. Age of screening and timing of screening depends upon the condition being assessed.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
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