Digestion, health and nutrition: Dr. Anil Minocha, a gastroenterologist and nutritionist

Diabetes may lead to colon cancer

Diabetes mellitis predisposes patients to numerous systemic ailments with increased morbidity and mortality. Does it increase colorectal cancer too?

This question was recently answered by Dr. Limburg and colleagues from the Mayo Clinic College of Medicine in Rochester, Minnesota in their report published in the American Journal of Gastroenterology (August 2006).

These investigators identified a cohort of diabetic (type 2) Rochester residents (997 men and 978 women) between 1970 and 1994. Over this period, they found that colorectal cancer occurred in 51 cases in the diabetic group as opposed to 36.8 expected cases. This risk was greater in men and among smokers. It remains to be determined how and/or if the metabolic factors involved in glucose metabolism are involved in the carcinogenesis.

Take home lesson: Quit smoking. Maintain diabetes under control with the help of your physician.

Botox or nitrogylcerine for anal fissure?

Chronic anal fissures are common. As anyone who has had these would testify, these are very painful and can be difficult to heal. One patient once described it as pieces of glass in the raw area. Although surgery is effective, it is accompanied by the risk of fecal incontinence.

Nitroglycerine ointment helps in healing. More recently botox (botulinum toxin A) fad has invaded the realm of treatment of chronic anal fissures also. So which one is better, the very cheap nitroglycerine ointment or the very expensive and very hyped botox.

Dr. Fruehauf and colleagues from University Hospital Zurich in Zurich, Switzerland compared application nitroglycerine ointment (0.2%) locally in the area of fissure twice daily for 2 weeks versus a single injection of Botox directly into anal sphincter. The results of their findings were published in American Journal of Gastroenterology (September 2006).

Fifty patients with chronic anal fissure were studied. At the end of the initial treatment for 2 weeks 52% of those using nitroglycerine (NTG) had healed as compared to only 24% who received Botox. When treatments were switched at end of two weeks for those who had not healed, additional patients accomplished healing with NTG but none with botox.

The authors concluded that nitroglycerin ointment is superior to the more expensive and invasive botox injection for chronic anal fissures although it is accompanied by mild side effects such as headaches.

Have you or someone you know has had anal fissure? How was your experience and what was done to heal it?

Colon polyps and cancer? Curry to the rescue!

A recent study done in small human sample indicates that naturally occurring substances such as quercetin and curcumin may reduce risk of colon cancer. While curcumin is the active ingredient of the Indian curry spice turmeric, foods rich in quercetin include apples, green and black tea, onions, raspberries red grapes, citrus fruits, broccoli and leafy green vegetables and cherries.

Bearing in mind the epidemiological data suggesting that daily consumption of curcumin-containing turmeric and quercetin-rich foods lower the incidence of gastrointestinal cancers, Dr. Cruz-Correa and colleagues from the Cleveland Clinic, Florida, performed a study in 5 human subjects with familial adenomatous polyposis or FAP. They published their findings in the journal Clinical Gastroenterology and Hepatology (2006).

Each patient received 480mg of curcumin and 20 mg of quercetin three times a day for a period of six months. While the dose of quercetin was similar to usual daily consumption in diet, the dose of curcumin was considerably higher.

These investigators found that while the average number of polyps dropped 60 per cent, and the average size of polyp decreased by half. Periods of poor compliance were associated with an increase in number of polyps.

It should be noted that the positive results of this could be due solely to curcumin, since the normal diet provides similar amount of quercetin.

Do you or someone you know has colon polyps or cancer. Remember that colon cancer is largely preventable and colon cancer screening saves lives. Many physicians consider colonoscopy to be the best method for colorectal cancer screening.