Gut Health

Gut Instincts

An interview with Carey Strom, M.D. FASGE

March is colon cancer awareness month, and it seems apropos to post my interview with Dr. Carey Strom this month. 

Whether you are approaching or have settled into the mid life years, there are a considerable number of gastrointestinal issues that arise that need to be addressed. Below is my interview with Dr. Carey Strom, who has been a practicing gastroenterologist for 32 years. Dr. Strom received his medical degree from Chicago Medical School. He completed his residency at The University of Illinois, and received his fellowship from the UCLA-Cedars combined program.

LW: What is the overall chief GI complaint from women in their 40’s and 50’s?

CS: Bloating with intermittent distention, sometimes with constipation, as well as reflux.

LW: What is the cause of these symptoms?

CS: If nothing is structurally wrong, it could be hormone related. Also, emotions play a big part in the manifestations of these symptoms. Depression, anxiety and stress can cause gastrointestinal problems.

LW: If it is hormone related, do you treat it with hormone replacement?

CS: Hormone replacement is usually used for symptoms that are more gynecological, such as hot flashes, vaginitis, things of that nature.

LW: In the absence of those symptoms, how would you treat the issues of reflux, bloating and constipation?

CS: First of all, you have to ensure that there is nothing pathological going on. If they are in their 50’s you want to make sure that their colon is clear. If the constipation is accompanied by bleeding, for instance, then the colon needs to be examined.  Colonoscopies are strongly recommended at the age of 50 and then every 5-7 years thereafter. It is dangerous to assume that these symptoms are merely related to menopause. If you assume that, you could be making a fatal mistake.

LW: What if a woman in her 40’s presents with these symptoms, in the absence of family history of colon cancer or other gastro diseases. How would you proceed?

CS:  If a woman is 45, there is no family history of anything, and there is a change of bowel habits, I would look at her diet, check for blood in the stool, do a blood analysis for anemia, etc. If all of that comes back negative, then it is probably a sluggish, spastic colon. I cannot say with absolute certainty that I wouldn’t scope her. It depends on the specific situation. If there is nothing structurally wrong, and it is just an irritable bowel, then hormone replacement may help. 

LW: What is irritable bowel?

CS: Irritable Bowel is a motility disorder of the gut that has many different causes. It can occur at any age. It could be related to stress or anxiety. It can also be Celiac disease, bacterial overgrowth, use of artificial sweeteners or some type of infection. These are all part of the differential. You need to rule all of these out. Once these are ruled out, the diagnosis of Irritable Bowel is made.

LW: What do artificial sweeteners cause?

CS: Bloating, distention, gas, diarrhea.  Once you cut out the artificial sweeteners, these symptoms should disappear. I often recommend a probiotic, like Culturelle.

LW: What are things that you would discover in a colonoscopy that are abnormal?

CS: Polyps

LW: Describe to my readers what polyps are?

CS: Polyps are growths. They resemble mushrooms.

LW: What is so dangerous about them?

CS: Polyps can become cancerous. Benign polyps are precursors of cancer.

LW: If someone has a benign polyp, will they get cancer in the future?

CS: That is NOT true. It means that the patient has to be followed a little more carefully. Depending on the size, the number and cell type, a colonoscopy should be performed anywhere from 1 to 5 years. It would be unusual to have a colonoscopyevery year, but it can happen. It is more common to have it every 3-5 years, under the aforementioned circumstances.

LW: What are some of the symptoms of reflux?

CS: Heartburn

LW: What does heartburn feel like?

CS: Like acid coming up and causes a burning sensation in your heart or in your throat. It can mimic a heart attack. So in a 50 year old person, you can’t just assume that it is reflux, you have to make sure the heart is ok.

LW: Could you have both reflux and heart problems?

CS: Yes, you must make sure that the heart is ok, because the heart will kill you, the reflux won’t.

LW: How do you treat the reflux?

CS: Antacids and diet can cure it. There is an extensive list of foods that one needs to decrease or cut out of their diet altogether. Things like red wine…there is something about the red grape that relaxes the sphincter and causes reflux. Spicy food is another trigger, red sauce, licorice, chocolate, nuts carbonated beverages, just to name a few.

LW: Wow…that is a lot of different food to have to give up.

CS: Everyone is different, and you don’t have to give it up. I don’t think that diet is all that important.

LW: So what is important?

CS:  Obesity is a predisposing factor. Having weight in that middle area is really bad.

LW: Why is belly fat so dangerous?

CS: Belly fat is dangerous because it causes a release of inflammatory hormones called cytokines, which causes inflammation in the body. That’s why you floss your teeth. Flossing your teeth gets rid of the bacteria, which can lead to inflammation. Your immune system will naturally fight off the bacteria. That creates conflict in your body, which is inflammation. Inflammation in the body is not good.

A huge thank you to Dr. Strom for sharing all of his knowledge and expertise with all of us. This has been very helpful. For more information, you can visit Dr. Strom’s website. 

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