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Welfare for the Elderly Seminar Stomach and Intestinal Diseases: How to recognise them Dr Kalpesh Besherdas Consultant Gastroenterologist, Barnet & Chase Farm Hospital Sunday 12 February, 3.30 – 5.00pm BAPS Shri Swaminarayan Mandir, Neasden What to worry about most? What to worry about most? • • • • Bowel cancer Oesophageal and stomach cancer Pancreatic cancer Liver cancer 2003 Estimated US Cancer Cases* Prostate 222,849 Men Men 675,300 675,300 Women 658,800 210,816 Breast Lung/bronchus 94,542 79,056 Lung/bronchus Colon/rectum 74,283 72,468 Colon & rectum Urinary bladder 40,518 39,528 Uterine corpus Melanoma of skin 27,012 26,352 Ovary Non-Hodgkin lymphoma 27,012 26,352 Non-Hodgkin lymphoma Kidney 20,259 19,764 Melanoma of skin Oral cavity 20,259 19,764 Thyroid Leukemia 20,259 13,176 Pancreas Pancreas 13,506 13,176 Urinary bladder All other sites 114,801 62,238 All other sites ONS=Other nervous system. *Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder. Source: American Cancer Society, 2003. How Does Colorectal Cancer Develop? Colon Polyp Colon Cancer Symptoms of Colorectal Cancer Time Course Symptoms Findings Early None None Occult blood in stool Mid Rectal bleeding Change in bowel habits Rectal mass Blood in stool Late Fatigue Anemia Abdominal pain Weight loss Abdominal mass Bowel obstruction Bowel cancer: how to recognise it •Rectal bleeding with change of bowel habit of ≥ 3 weeks duration •Rectal bleeding without change in bowel habit with no obvious cause ≥ 3 weeks duration •Change of bowel habit persisting for 3 weeks or more without bleeding •Abdominal mass thought to be large bowel cancer •Anaemia : fatigue Is Colorectal Cancer Preventable? YES! • Screening The Programme Eligibility Men and Women aged 60-69, and registered with a GP will automatically be invited to participate and offered a FOB test kit every two years Those aged 70 and over are not invited automatically but are able to request a test kit from the Hub THE KIT Colonoscopy CT Colography Colon Polyp CT Colography Colon Polyp CT Colography Colon Cancer Rectal Bleeding •If you’ve had blood in your poo or looser poo for 3 weeks, your doctor wants to know. •Chances are it’s nothing to worry about, but these symptoms could be signs of bowel cancer, so tell your doctor. Finding bowel cancer early makes it more treatable and could save your life. Upper GI cancer Oesophageal/Stomach cancer •Indigestion or heartburn that doesn’t go away •Not feeling hungry (loss of appetite) •Bloating after a small amount of food •Nausea and vomiting •Difficulty in Swallowing •Feeling very tired and lethargic (symptom of anaemia) •Unexplained weight loss •Blood in your vomit or faeces or black tar like faeces. Oesophageal/Stomach cancer causes • Obesity or a poor diet, particularly one which contains a lot of salty, pickled or processed foods • Infection with an organism called Helicobacter pylori • Barrett's oesophagus (where abnormal cells develop in the lining of the lower oesophagus) • Pernicious anaemia (an autoimmune condition where the lining of the stomach becomes thin, less acid is produced and anaemia develops due to lack of vitamin B12), atrophic gastritis or a hereditary condition of growths in the stomach • Smoking • Previous surgery for peptic ulcer Diagnosing stomach cancer • Endoscopy • Barium X-ray • CT scan Abdominal pain Diarrhoea Common causes of constipation • • • • • • not enough fibre in the diet not drinking enough water lack of exercise Medications irritable bowel syndrome changes in life or routine such as pregnancy, older age, and travel • abuse of laxatives • problems with the colon and rectum Bloating Cause of bloating and flatulence Bloating treatment: diet The End