# Session 464: All About Colon Health

An episode of [Therapy for Black Girls](https://invisiblenetwork.ai/podcast/1223803641), 20 May 2026, 43 min.

Audio: https://podtrac.com/pts/redirect.mp3/traffic.omny.fm/d/clips/e73c998e-6e60-432f-8610-ae210140c5b1/2a22ac04-0eb4-4aad-8dc2-ae270179efb9/92c8fdd3-15ed-4e0a-b513-b450000eb54c/audio.mp3?utm_source=Podcast&in_playlist=2d42d89c-4962-4760-a616-ae270179efd5

When was the last time you really thought about your colon health? For many of us, conversations about digestion, gut health, and colorectal cancer can feel uncomfortable or easy to put off—but the reality is that colorectal cancer rates are rising among younger adults, and Black communities continue to face significant disparities when it comes to diagnosis, treatment, and outcomes. Today, I’m joined by gastroenterologist and health advocate, Dr. Sophia Balzora, to talk about what we all need to know about colon health. Dr. Balzora helps break down what the colon actually does, the warning signs we shouldn’t ignore, and why early screenings can be lifesaving. We also discuss the unique ways colorectal cancer impacts Black women, how stress and diet can affect gut health, and the importance of advocating for yourself in medical spaces when something doesn’t feel right. About the Podcast The Therapy for Black Girls Podcast is a weekly conversation with Dr. Joy Harden Bradford, a licensed Psychologist in Atlanta, Georgia, about all things mental health, personal development, and all the small decisions we can make to become the best possible versions of ourselves. Resources & Announcements Want to reflect on this conversation in community? Join us inside our Patreon community where we’re unpacking this episode together. You can now catch episodes of the Therapy for Black Girls podcast on YouTube. Be sure to subscribe to get new episodes every week. Did you know you can leave us a voice note with your questions for the podcast? If you have a question you'd like some feedback on, topics you'd like to hear covered, or want to suggest movies or books for us to review, drop us a message at memo.fm/therapyforblackgirls and let us know what’s on your mind. We just might share it on the podcast. Grab your copy of Sisterhood Heals. Where to Find Our Guest Instagram Stay Connected Is there a topic you'd like covered on the podcast? Submit it at therapyforblackgirls.com/mailbox. If you're looking for a therapist in your area, check out the directory at https://www.therapyforblackgirls.com/directory. Grab your copy of our guided affirmation and other TBG Merch at therapyforblackgirls.com/shop. The hashtag for the podcast is #TBGinSession. Make sure to follow us on social media: Instagram: @therapyforblackgirls Facebook: @therapyforblackgirls Our Production Team Executive Producers: Dennison Bradford & Gabrielle Collins Director of Podcast & Digital Content: Ellice Ellis Producers: Tyree Rush & Ndeye Thioubou Production Assistant: Bria Mosley See omnystudio.com/listener for privacy information.

## Transcript

[0:10] Speaker 1: Welcome to the Therapy for Black Girls Podcast, a weekly
[0:14] Speaker 1: conversation about mental health, personal development, and all the small
[0:19] Speaker 1: decisions we can make to become the best possible versions
[0:22] Speaker 1: of ourselves. I'm your host, doctor joy hard and Bradford,
[0:27] Speaker 1: a licensed psychologist in Atlanta, Georgia. For more information or
[0:32] Speaker 1: to find a therapist in your area, visit our website
[0:35] Speaker 1: at Therapy for Blackgirls dot com. While I hope you
[0:39] Speaker 1: love listening to and learning from the podcast, it is
[0:43] Speaker 1: not meant to be a substitute for a relationship with
[0:46] Speaker 1: a licensed mental health professional. Hey, y'all, thanks so much
[0:57] Speaker 1: for joining me for session four sixty four of the
[0:59] Speaker 1: Therapy for Black Girl's podcast. We'll get right into our
[1:02] Speaker 1: conversation after a word from our sponsors. When was the
[1:14] Speaker 1: last time you really thought about your colon health? For
[1:17] Speaker 1: many of us, conversations about digestion, good health, and coorectal
[1:21] Speaker 1: cancer can feel uncomfortable, are easy to put off, but
[1:24] Speaker 1: the reality is that colorectal cancer rates are rising among
[1:27] Speaker 1: younger adults, and Black communities continue to face significant disparities
[1:31] Speaker 1: when it comes to diagnosis, treatment and outcomes. So today
[1:35] Speaker 1: I'm joined by gastro enterologists and health advocate doctor Sophia
[1:39] Speaker 1: Belzora to talk about what we all need to know
[1:41] Speaker 1: about colon health. Doctor Belzora helps break down what the
[1:44] Speaker 1: colon actually does, the warning signs we shouldn't ignore, and
[1:49] Speaker 1: why early screenings can be life saving. We also discuss
[1:52] Speaker 1: the unique ways colon cancer impacts black women, how stress
[1:56] Speaker 1: and diet can affect good health, and the importance of
[1:58] Speaker 1: advocating for yourself and medical spaces when something doesn't feel right.
[2:02] Speaker 1: If something resonates with you on enjoying our conversation, please
[2:05] Speaker 1: share with us on social media using the hashtag TVG
[2:08] Speaker 1: in session or join us over in patreons and talk
[2:11] Speaker 1: more about the episode. You can join us at Community
[2:13] Speaker 1: not Therapy for Blackgirls dot com. Here's our conversation. Well,
[2:22] Speaker 1: thank you so much for joining us today, doctor Velzora.
[2:24] Speaker 2: Of course, it's my pleasure. Thank you for having me.
[2:27] Speaker 1: So for those who may not be familiar, can you
[2:29] Speaker 1: tell us what a gastro entrologist and a hepatologist actually do?
[2:33] Speaker 2: Oh? Definitely, a gas genurologist is a digestive disease doctor.
[2:37] Speaker 2: So basically we deal with all diseases from the mouth
[2:40] Speaker 2: to the anus. So if you're having belly pain, if
[2:43] Speaker 2: you're having reflux symptoms or heartburn, if you're having diarrhea, constipation,
[2:48] Speaker 2: you name it blood in the stool. That's what we're
[2:50] Speaker 2: here for. Even low blood counts can involve digest a
[2:53] Speaker 2: disease docs and then a hepatologist is a section of
[2:57] Speaker 2: like what we think about more generally is gastroentrology, and
[3:00] Speaker 2: they deal specifically with liver issues. So if people have
[3:03] Speaker 2: abnormal liver tests or sseorrhosis, hepatitis B, appatitis C, autoimmune
[3:08] Speaker 2: diseases that affect the liver, those are all encompassing and
[3:11] Speaker 2: that's what patologists do. So there are some gastrologists who
[3:14] Speaker 2: do some liver stuff and some hepatologists or liver doctors
[3:18] Speaker 2: who do some GI stuff. When we think about those
[3:21] Speaker 2: disease entities, like those are like what I just mentioned
[3:25] Speaker 2: were like the more specific nuances.
[3:27] Speaker 1: And I'm always really interested in hearing from physicians how
[3:30] Speaker 1: you actually chise your specialty.
[3:32] Speaker 2: Hmm, that's a great question. I'll say that in the
[3:35] Speaker 2: exam room, that question comes up because you know, I
[3:38] Speaker 2: deal with butts and guts, so admittedly I do deal
[3:41] Speaker 2: with like the nether regions and areas that people can
[3:44] Speaker 2: be a little bit ick about, which is part of
[3:46] Speaker 2: why I'm here to demystify that, right and destigmatize that
[3:50] Speaker 2: there aren't that many women in the field, right. There
[3:53] Speaker 2: are more now than there were when I trained. You know,
[3:56] Speaker 2: it's still under twenty five percent, So that, to be honest,
[4:00] Speaker 2: that drew me to the field. And then by extension,
[4:03] Speaker 2: obviously there's much fewer black women in gas genurology compared
[4:06] Speaker 2: to other specialties. So I think that coupled with fact
[4:10] Speaker 2: I like tease my hands, I love doing procedures. It's
[4:12] Speaker 2: definitely a highlight of my work. And then I think
[4:15] Speaker 2: the culture of the field and the people who were
[4:18] Speaker 2: attracted to it and the disease states, like all of
[4:21] Speaker 2: those things really landed me into a field of GI
[4:25] Speaker 2: So and I know that there is so much that
[4:27] Speaker 2: we can talk about because your feel covers so much.
[4:29] Speaker 2: But specifically today we want to talk about colorectal cancer.
[4:33] Speaker 2: So can you tell us about this cancer and what
[4:35] Speaker 2: it is and how it presents absolutely so. Unfortunately, col
[4:39] Speaker 2: rectal cancer is incredibly common and it is a cancer
[4:44] Speaker 2: that affects the large intestine. So when we talk about
[4:46] Speaker 2: colon that's synonymous with large intestine. So when you think
[4:49] Speaker 2: about the body, the mouth, you have the food pipe,
[4:52] Speaker 2: or the esophagus, you have the stomach, there's a small
[4:55] Speaker 2: intestine and then there's a large intestine. So when we
[4:58] Speaker 2: talk about colorectal cancer, we're talking about cancers of the
[5:01] Speaker 2: large intestine. And then when we talk about the rectum,
[5:03] Speaker 2: that's just the very last part of the large intestine
[5:06] Speaker 2: before the anus.
[5:07] Speaker 1: And you mentioned that it is fairly common, and it
[5:09] Speaker 1: does feel like we are hearing more about it recently,
[5:12] Speaker 1: or at least I am right, Like it could just
[5:14] Speaker 1: be because more people are talking about it social media.
[5:17] Speaker 1: But is it something that has increased in diagnosis in
[5:20] Speaker 1: the past maybe three to five years, And can you
[5:24] Speaker 1: talk about like why it is such a common cancer.
[5:27] Speaker 2: Yeah, absolutely so. I mean when you think about men
[5:29] Speaker 2: and women combined, it is up there in terms of
[5:31] Speaker 2: cancer deaths, unfortunately, and it is also quite common in
[5:34] Speaker 2: terms of diagnoses. When you think about men and women combined,
[5:37] Speaker 2: the second most common cancer killer in America, unfortunately, it's
[5:40] Speaker 2: now creeped up to the first or the most common
[5:43] Speaker 2: cancer killer in those under the age of fifty, So
[5:46] Speaker 2: you know, it's gaining a lot of traction because we're
[5:48] Speaker 2: seeing so many young people being diagnosed with colorectal cancer
[5:52] Speaker 2: and unfortunately dying from it. So it's definitely more than
[5:54] Speaker 2: something that's just like an anecdote or a story like
[5:57] Speaker 2: this is a phenomenon that we're seeing in the literature
[5:59] Speaker 2: time and time again, and it's becoming increasingly obvious that
[6:02] Speaker 2: no one is immune to it, which is definitely one
[6:04] Speaker 2: of the points I want to get across today. Everyone
[6:06] Speaker 2: is at risk for corectal cancer. Unfortunately, there are some
[6:09] Speaker 2: that are at even increase risk, and we'll talk a
[6:12] Speaker 2: little bit about that, and in terms of why that's happening,
[6:15] Speaker 2: there's so many different proposed reasons, a lot of things,
[6:18] Speaker 2: a lot of medical problems. It's usually not just one thing,
[6:22] Speaker 2: it's a combination of different factors, many of which we
[6:25] Speaker 2: can change the tide on. I think the more aware
[6:28] Speaker 2: we become about them, the more we can do something
[6:31] Speaker 2: about them and perhaps decrease the rates over time. But
[6:35] Speaker 2: it's incredibly sad to see because when we look at
[6:37] Speaker 2: the older folks, corectal cancers always thought of like an
[6:40] Speaker 2: old person disease right until recently, and thankfully those rates
[6:44] Speaker 2: are lowering in folks who are over sixty five. But
[6:47] Speaker 2: this trend that we're seeing of people under the age
[6:51] Speaker 2: fifty five being diagnosed is incredible. It's one in five
[6:55] Speaker 2: new diagnoses of correctal cancer that are happening in people
[6:58] Speaker 2: under the age of fifty five, which is shocking.
[7:02] Speaker 1: And can you talk about like some of the of
[7:03] Speaker 1: course there is not one thing, but what are some
[7:05] Speaker 1: of the factors in the field talking about as people
[7:09] Speaker 1: talking about influencing the increase in rates.
[7:13] Speaker 2: So that's a good question. So we're seeing this big
[7:16] Speaker 2: block of folks, like this whole generation of people who
[7:18] Speaker 2: are being diagnosed. We're thinking about people who are like
[7:22] Speaker 2: Gen xers and millennials essentially, right, so like those born
[7:26] Speaker 2: like after nineteen fifty, people who are mostly like in
[7:30] Speaker 2: their forties and fifties who are being diagnosed. We're thinking
[7:33] Speaker 2: about exposures, right, We're thinking about like what are people's
[7:38] Speaker 2: diet and lifestyle habits. What are the things in our
[7:40] Speaker 2: everyday life that are making things much more convenient for
[7:43] Speaker 2: us but maybe harming us. There's talk about like microplastics,
[7:46] Speaker 2: and there's talk about the microbiome, which is basically like
[7:49] Speaker 2: when you think about the composition of bacteria in your gut,
[7:53] Speaker 2: What impact is that having on your health? What type
[7:55] Speaker 2: of exposures did you have in utero? Right, like so
[7:58] Speaker 2: before you were even your even born, Like what kind
[8:01] Speaker 2: of exposures did your mother have the person who bursed you?
[8:04] Speaker 2: So all those things are what's really being looked at,
[8:07] Speaker 2: and we think about things like the obesity epidemic. It's
[8:10] Speaker 2: not to say that everyone who gets corectal cancer at
[8:11] Speaker 2: a young age is obese, but they're definitely because it's
[8:15] Speaker 2: affecting this large group of people born at a certain age,
[8:18] Speaker 2: which we call the quote unquote Cohort effect. Then we
[8:22] Speaker 2: have to think about what exposures did this age group
[8:26] Speaker 2: have environmentally that has led to this increase in correctal cancer?
[8:32] Speaker 1: And of course ask therapy for black girl who definitely
[8:34] Speaker 1: want to hone in on the ways that this is
[8:37] Speaker 1: impacting the black community drastically, right, And so Black Americans
[8:42] Speaker 1: are fifteen percent more likely to be diagnosed with coorectal cancer,
[8:45] Speaker 1: but thirty five percent more likely to die from it.
[8:48] Speaker 1: So can you talk a little bit more about that
[8:50] Speaker 1: gap and like why you know this is impacting the
[8:53] Speaker 1: black community in this way? Yeah?
[8:55] Speaker 2: Absolutely, And I think it's important to focus on the
[8:58] Speaker 2: fact that this is not like just the simple fact
[9:00] Speaker 2: of genetics, right, or family history. Like, there's a lot
[9:03] Speaker 2: of systemic factors that are impacting why we're seeing these differences.
[9:07] Speaker 2: And we talk about systemic factors, that means things that
[9:10] Speaker 2: are in our environment, where we grow up, where we pray,
[9:13] Speaker 2: where we go to school, where we work. All of
[9:15] Speaker 2: these factors are contributing access to care, All these factors
[9:18] Speaker 2: are contributing to the different rates that we're seeing. So, yeah,
[9:22] Speaker 2: we oftentimes quote that unfortunately, black people are about twenty
[9:25] Speaker 2: percent more likely to get correctal cancer about forty percent
[9:28] Speaker 2: more likely to die from it from their white counterparts.
[9:31] Speaker 2: What does that do to number one? We can think
[9:33] Speaker 2: about screening rates, right, So though black people don't have
[9:36] Speaker 2: the lowest rates of screening, they're not as high as
[9:38] Speaker 2: we want them to be. And so when we talk
[9:40] Speaker 2: about screening, we're talking about when people have no symptoms whatsoever,
[9:44] Speaker 2: they go to the doctor, they get screened for colorectal
[9:46] Speaker 2: cancer or cancer of the large intestine, even without symptoms.
[9:50] Speaker 2: Because it's important to realize that for correctal cancer, especially
[9:54] Speaker 2: in its earliest stages, people have no symptoms whatsoever. So
[9:57] Speaker 2: that's why screening is so important. Think about people even
[10:01] Speaker 2: being referred to get a correctal cancer screening. So sometimes
[10:05] Speaker 2: there is that barrier. There is your primary care provider
[10:08] Speaker 2: recommending a COLONOSK could be at the appropriate age, and
[10:11] Speaker 2: that age is forty five by the way, if you
[10:13] Speaker 2: are average risk, and we'll definitely hone in on that
[10:15] Speaker 2: and mention that over and over again, so we remember
[10:18] Speaker 2: that by the end of our time together. But we
[10:20] Speaker 2: have to think about the people that our communities are
[10:23] Speaker 2: seeing to get the care they need. Are they being
[10:25] Speaker 2: referred at the right age right? So that's important too.
[10:29] Speaker 2: Family history. We know that unfortunately, correctal cancer does run
[10:33] Speaker 2: in families, and so it's important not to keep those issues,
[10:38] Speaker 2: those medical problems that people don't want to talk about
[10:40] Speaker 2: inside and not discuss it with their family, because if
[10:43] Speaker 2: you do have correctal cancer in the family, you have
[10:46] Speaker 2: to have to get screened earlier than forty five. So
[10:49] Speaker 2: that's important too. A lot of it is about having conversations,
[10:54] Speaker 2: bringing the awareness to the forefront, knowing what your family
[10:57] Speaker 2: history is, knowing when you should be screened, and knowing
[11:00] Speaker 2: that different options you have for screening all of those
[11:03] Speaker 2: sorts of things are really important, and then things that
[11:06] Speaker 2: you can do for yourself when you think about your
[11:08] Speaker 2: dietary choices, thinking about being more active, thinking about not smoking,
[11:14] Speaker 2: limiting how much alcohol you consume, and getting screened at
[11:17] Speaker 2: the appropriate time can all be really helpful.
[11:20] Speaker 1: So you've mentioned the screening and I definitely want to
[11:22] Speaker 1: spend some time there. So the colonascopy I think is
[11:25] Speaker 1: probably the most common way, or at least that I
[11:28] Speaker 1: know about, in terms of screening. What are the other
[11:31] Speaker 1: screening procedures that can happen besides a colonoscapy.
[11:34] Speaker 2: That's a good question because I think that coolosophy is
[11:36] Speaker 2: the one that's most often talked about, especially in the US.
[11:39] Speaker 2: That's oftentimes what's most recommended as the best test. And
[11:42] Speaker 2: I'll say that for people who are average risk, meaning
[11:44] Speaker 2: they have no increased factors either in their family history
[11:49] Speaker 2: or their personal medical history that would predispose them to
[11:52] Speaker 2: earlier onset correctal cancer meeting, they would get it earlier
[11:54] Speaker 2: than the average individual. So people were considered average risk,
[11:58] Speaker 2: they have a lot of different options available to them. Colonoscopy,
[12:01] Speaker 2: which is a procedure that's done under sedation, which means
[12:04] Speaker 2: that you're nice and comfortable. It's not general anesthesia. There's
[12:07] Speaker 2: not a machine breathing for you. You get medication through
[12:10] Speaker 2: the vein to make you nice, sleepy, comfortable. People say
[12:12] Speaker 2: it's the best sleep they've ever had. And for about
[12:15] Speaker 2: twenty twenty five minutes, I'm in there with a camera
[12:18] Speaker 2: and I'm looking inside your large intestine. You don't feel
[12:21] Speaker 2: a thing. You wake up, it's like I was never there.
[12:24] Speaker 2: But I'm able to find small growths that we call
[12:26] Speaker 2: polyps and remove them before they become colorectal cancer. So
[12:30] Speaker 2: for that reason, the colonoscopy is considered the preferred test
[12:34] Speaker 2: because you're really preventing colorectal cancer, like you're taking out
[12:37] Speaker 2: a growth that could otherwise lead to cancer in the future.
[12:40] Speaker 2: The barriers to that exam or I think what makes
[12:42] Speaker 2: people fearful of it or people may shy away from it,
[12:45] Speaker 2: is because it is under sedation, and some people are
[12:48] Speaker 2: admittedly afraid to get sedated. But we take all of
[12:50] Speaker 2: the measures that we need to keep you safe. Of course,
[12:53] Speaker 2: the preparation, which I think it's the worst wrap. Right,
[12:56] Speaker 2: that's what the colonoscopy is notorious for, and that is
[12:59] Speaker 2: basically something they have to do the evening before the
[13:01] Speaker 2: procedure where you drink a medication that's essentially a laxative,
[13:04] Speaker 2: so it makes you go to the bathroom. There's no
[13:06] Speaker 2: like mincing words there. That's what's going to happen because
[13:09] Speaker 2: we need to see, right, we're looking for things that
[13:11] Speaker 2: are millimeters in size. I'm talking like literally this big.
[13:14] Speaker 2: And in order to do that, the colon needs to
[13:16] Speaker 2: be clean of stool. And the last thing I think
[13:19] Speaker 2: is bringing an escort. So you do have to have
[13:20] Speaker 2: somebody along with you, right, you have to have a
[13:22] Speaker 2: trusted adult, so someone over the age of eighteen to
[13:25] Speaker 2: leave with you because you will have perceived the medication
[13:27] Speaker 2: to make you sleepy. So when we think about different communities,
[13:31] Speaker 2: who may have barriers to those things, right, either the
[13:33] Speaker 2: time that they have to be at work it's hard
[13:36] Speaker 2: to find an escort, right, or they're the caregiver for
[13:38] Speaker 2: someone else they have to take time off of work
[13:40] Speaker 2: right to be sedated. Those things are real, that's reality,
[13:43] Speaker 2: and I know that that can be really difficult for people.
[13:46] Speaker 2: But thankfully, if your average risk, you have other options available.
[13:49] Speaker 2: So there are some what we call non invasive screening,
[13:52] Speaker 2: which means that it doesn't involve a procedure. One is
[13:55] Speaker 2: coming at a box, which I'm sure a lot of
[13:57] Speaker 2: people have heard of before, and that's a stool based test,
[14:01] Speaker 2: which means that they take a little bit of your
[14:03] Speaker 2: stool and what they're looking for is hidden blood, so
[14:07] Speaker 2: blood you don't see with the naked eye and the
[14:08] Speaker 2: toilet bowl or mixed with the stool, and they're looking
[14:11] Speaker 2: for abnormal cells of the lining of the large intestine
[14:14] Speaker 2: that might signal a cancer or a very large growth
[14:18] Speaker 2: that can become cancer if it's not taken out of
[14:20] Speaker 2: your colon. So that's a really attractive option. You you
[14:22] Speaker 2: don't have to miss school, right, you don't have to
[14:24] Speaker 2: miss work. You can do it in the comfort of
[14:25] Speaker 2: your own home, and then you send it in and
[14:27] Speaker 2: you get a result back. If the test is positive,
[14:30] Speaker 2: next step is a colonoscopy, right, So it's not a
[14:32] Speaker 2: one and done. If the test is positive, you need
[14:35] Speaker 2: to get a colonoscopy. That's like the full screening. If
[14:38] Speaker 2: the test is negative, you repeat it in three years.
[14:41] Speaker 2: Another non invasive test just looks for hidden stool. It
[14:44] Speaker 2: doesn't look for abnormal cells. And that's been around for
[14:46] Speaker 2: quite some time and the same theme. If it's positive,
[14:50] Speaker 2: next step is a colonoscopy. It's negative, you repeat it
[14:52] Speaker 2: in the appropriate timeframe, which is usually a year. And
[14:55] Speaker 2: then the last test I'll mention is a what we
[14:58] Speaker 2: call a virtual colonoscopy, which is like a cat scan,
[15:01] Speaker 2: a special type of cat scan. You still have to
[15:03] Speaker 2: drink the preparation, but it's not invasive. They are able
[15:07] Speaker 2: to take pictures of your belly, pictures of your abdomen
[15:09] Speaker 2: and look for any abnormal growth, and if it's a
[15:12] Speaker 2: positive test, then you have to get a colonoscopy. So
[15:15] Speaker 2: the important caveat is that for these non invasive tests,
[15:18] Speaker 2: like all the tests that are not colonoscopy, if they
[15:21] Speaker 2: are positive, the next step is a colonoscopy. So that's
[15:24] Speaker 2: an important understanding and conversation you have to have with
[15:27] Speaker 2: somebody if they choose not to get a colonoscopy, which
[15:29] Speaker 2: is fine if they're average risk, but with the understanding
[15:32] Speaker 2: that there is another step involved.
[15:34] Speaker 1: More from our conversation after the break. So for the
[15:46] Speaker 1: more non invasive procedures that you talked about, when might
[15:50] Speaker 1: those be suggested, Like if it's before the age of
[15:52] Speaker 1: forty five, Like under what circumstances would those be suggested
[15:55] Speaker 1: versus a colonoscopy.
[15:57] Speaker 2: It's still the same age. Actually, if your average risk
[16:00] Speaker 2: screening starts at forty five, regardless of the modality, So
[16:02] Speaker 2: regardless of what you end up choosing, forty five is
[16:05] Speaker 2: the year. If you have blood in your stool, right,
[16:08] Speaker 2: if you have blood in your poop, And when I
[16:10] Speaker 2: say that, that means blood when you wipe, So blood
[16:12] Speaker 2: on the toilet paper, blood mixed with your stool, blood
[16:15] Speaker 2: in the toilet bowl, all of those things, we consider
[16:18] Speaker 2: that blood from the intestine. So I want to make
[16:21] Speaker 2: clear that. And so what I've heard from a lot
[16:23] Speaker 2: of patients is, oh, the blood was bright red or
[16:25] Speaker 2: it was just on the toilet paper. That doesn't mean
[16:28] Speaker 2: that it's normal. Like, we can't be in denial. I
[16:29] Speaker 2: think that's human nature right for us to be in denial.
[16:32] Speaker 2: But blood anywhere from your bottom is never normal. It
[16:35] Speaker 2: doesn't always mean correctal cancer, but it's never normal. So
[16:37] Speaker 2: if you have blood in your stool, if you have
[16:40] Speaker 2: belly pain that you can't explain, right, not just a
[16:43] Speaker 2: one off, but something that's like it keeps happening and
[16:45] Speaker 2: you're just trying to figure out why if you're losing
[16:48] Speaker 2: weight without trying if you were three time a day,
[16:51] Speaker 2: or and now you're like at three times a week,
[16:53] Speaker 2: or where the opposite is occurring, so like there's a
[16:55] Speaker 2: change in how often you're going, or what it looks
[16:57] Speaker 2: like when you poop, like if the consistency has changed changed,
[17:00] Speaker 2: or if you're anemic, which means your blood counts are
[17:02] Speaker 2: low or your iron is low, any of those things.
[17:06] Speaker 2: We take the non invasive tests off the list, right
[17:09] Speaker 2: because at that point you're having symptoms. It's no longer
[17:11] Speaker 2: a screening exam. The appropriate exam is of colonoscopy, that
[17:14] Speaker 2: colonos We can have an age, right, some act people
[17:17] Speaker 2: are like, I'm too young for colonoscopy. There's never an
[17:19] Speaker 2: age where colonoscopy is one hundred percent off the table.
[17:22] Speaker 2: There are some situations where it might be a discussion
[17:25] Speaker 2: and you see if it's right for you, But those
[17:27] Speaker 2: types of symptoms, it's really not appropriate to get a
[17:29] Speaker 2: non invasive test. You need a more thorough look.
[17:32] Speaker 1: Got it? And is there any concern with false negatives
[17:37] Speaker 1: with the non invasive is what you may do like
[17:39] Speaker 1: the more non invasive one and then it's like, oh, actually,
[17:42] Speaker 1: you probably should have actually had the colonoscopy.
[17:45] Speaker 2: That's a really good question. No test is one hundred percent.
[17:51] Speaker 2: No test is one hundred percent. So just like there
[17:52] Speaker 2: are false positives, meaning that the test is positive, you
[17:55] Speaker 2: do the colonoscopy, you don't find anything. False negatives do
[17:59] Speaker 2: exist too, that happens, So it's really important to choose
[18:03] Speaker 2: the right test for you and the one that gets
[18:05] Speaker 2: done properly and completely. I'll say that with colonoscopy, the
[18:09] Speaker 2: likelihood of a false a false negative test meaning like
[18:12] Speaker 2: there's a corectal cancer there that you had a colonoscopy
[18:15] Speaker 2: but they didn't see it. I mean, the likelihood of
[18:17] Speaker 2: that is exceedingly low compared to non invasive tests. So
[18:22] Speaker 2: the non invasive tests are good, and especially in the
[18:24] Speaker 2: right situation as I described, or someone's like, I'm either
[18:27] Speaker 2: getting non invasive screening or no screening, Like, obviously we
[18:30] Speaker 2: welcome the non invasive screening with open arms, and it
[18:33] Speaker 2: does increase access. But if your concern is exactly like
[18:37] Speaker 2: you mentioned, like what if the test comes up negative
[18:40] Speaker 2: but I actually have colorectal cancer. The way to decrease
[18:43] Speaker 2: that fear and have that occurring much less likely it
[18:47] Speaker 2: would be with a colonoscopy.
[18:49] Speaker 1: Got it. So you mentioned that as a part of
[18:51] Speaker 1: the colonoscopy, you're looking to see if there are any polyps,
[18:54] Speaker 1: and if there are, then you're removing them. Is it
[18:57] Speaker 1: the expectation that polyps are normal? Do most of the
[19:00] Speaker 1: let's have polyps? Or is it some people don't actually
[19:02] Speaker 1: have any polyps?
[19:03] Speaker 2: So what I like to tell people is that polyps
[19:05] Speaker 2: by definition aren't normal, but they are very common for
[19:08] Speaker 2: someone who's average risk. Ause I mentioned, so no family
[19:11] Speaker 2: history of corectal cancer, they don't have a chronic disease
[19:14] Speaker 2: like Chrohn's disease or ulcerratific colitis. They don't have certain
[19:18] Speaker 2: genetic mutations that predispose them to colorectal cancer. They don't
[19:21] Speaker 2: have something like cystic fibrosis which can increase their risk
[19:23] Speaker 2: of correctal cancer, and the absence of that, If your
[19:26] Speaker 2: average risk on your first colonoscopy, you have about a
[19:29] Speaker 2: one in three to one in four chance of having
[19:31] Speaker 2: at least one pre cancerous benign polyp. So it's you know,
[19:35] Speaker 2: that's pretty common, but polyps by definition aren't necessarily normal.
[19:39] Speaker 2: It doesn't mean that if you have a polyp, you
[19:40] Speaker 2: should automatically freak out and be anxiety ridden. And I
[19:44] Speaker 2: do really need to drill that into patients. But at
[19:47] Speaker 2: the same time, they are very common, just like correctal
[19:50] Speaker 2: cancer is. And that's why screening is so important, because
[19:52] Speaker 2: that polyps don't cause symptoms, nor does correctal cancer in
[19:56] Speaker 2: its earliest stages.
[19:59] Speaker 1: And what a chances if you can give us a number,
[20:01] Speaker 1: like of polyps returning after they've been removed, if you
[20:04] Speaker 1: find them during a colonoscopy.
[20:06] Speaker 2: Mmm, So I will say, you know, when we remove
[20:10] Speaker 2: a poll up, it's gone right if it's removed correctly,
[20:13] Speaker 2: But if you remove a poll up, it's gone. So.
[20:16] Speaker 2: But I'll say that people who have a propensity to
[20:19] Speaker 2: grow precancerous polyps, we bring them back for their next
[20:22] Speaker 2: colonoscopy sooner than someone who never had polyps, because the
[20:26] Speaker 2: chance of them growing new polyps is higher than someone
[20:29] Speaker 2: who has never grown them. So we're not so concerned
[20:31] Speaker 2: about the same polypty removed we removed coming back more
[20:35] Speaker 2: so we know that, hey, you've grown polyps before, we're
[20:38] Speaker 2: going to keep a closer eye on you. We're going
[20:40] Speaker 2: to bring you back sooner than someone who's never grown polyps,
[20:42] Speaker 2: because your chance of growing them again is higher than
[20:45] Speaker 2: someone who's never grown them.
[20:47] Speaker 1: Got it, So you are supposed to get your first
[20:50] Speaker 1: colonoscopy eight forty five. If there's nothing found, when is
[20:55] Speaker 1: the next time you should have another colonoscopy.
[20:57] Speaker 2: So if you had a good exam, and when I
[20:58] Speaker 2: say good exam, I mean like your colon as clean
[21:01] Speaker 2: as a whistle. There's no stool that's covering polyups. We
[21:04] Speaker 2: got from beginning to end and back again. We call
[21:07] Speaker 2: that a quality exam. And you had no pollups, you
[21:10] Speaker 2: don't have to return for ten years. So colonosky is
[21:14] Speaker 2: an infrequent exam. Yeah, it's generally an infrequent exam. And
[21:17] Speaker 2: that always gives people a huge sigh of relief when
[21:19] Speaker 2: I tell them that, Like their face completely relaxes, and
[21:23] Speaker 2: you know, because the prep is tough. As amazing as
[21:25] Speaker 2: the sedation is, the prep is tough. I'm not gonna
[21:27] Speaker 2: try to tell people that it's not or pretend, but yeah,
[21:30] Speaker 2: it's an infrequent exam. So like if your average risk
[21:33] Speaker 2: and you have no issues in the interim, like no
[21:35] Speaker 2: digestive issues between the time that I see you, and
[21:37] Speaker 2: you have no pollups. The next time we're gonna have
[21:39] Speaker 2: your polonoscopy, it's ten years. It's not like a mammogram
[21:42] Speaker 2: that's every year, or you know, like prostate screening or
[21:44] Speaker 2: something like that. So it's an infrequent exam. And so
[21:47] Speaker 2: I so strongly impart to people. It's a pain, it's
[21:50] Speaker 2: a pain in the butt to do. It's time out
[21:52] Speaker 2: of your day, you had to take this laxative. But
[21:54] Speaker 2: it is a life saving exam that it's really not.
[21:57] Speaker 2: It doesn't happen that often, and it is truly life saving.
[22:01] Speaker 1: But if there are things found, then is it something
[22:03] Speaker 1: that you're repeating like every year or every two years,
[22:06] Speaker 1: Like what's the cadence after that?
[22:08] Speaker 2: So I'll say that it's a rare occurrence. When people
[22:10] Speaker 2: have to repeat colonoscopies every year, those are people who
[22:13] Speaker 2: are quite high risk. So I was alluding to before,
[22:15] Speaker 2: people who have crone disease that affects the large intestine
[22:18] Speaker 2: or the colon or ulstertp colitis, or people who have
[22:21] Speaker 2: these genetic mutations that significantly raise their risk of corectal cancer.
[22:24] Speaker 2: Outside of that, I'd say, if you go in there
[22:28] Speaker 2: and you find a pretty large pollup and When I
[22:31] Speaker 2: say large, I mean about like think about the width
[22:33] Speaker 2: of your pinky nail, something like that, or larger if
[22:36] Speaker 2: you have a pollup that looks a certain way unto
[22:38] Speaker 2: the microscope, or if you have a number of pre
[22:41] Speaker 2: cancerous polyps, like if you have like three, four or
[22:43] Speaker 2: five something like that, then we actually have people return
[22:46] Speaker 2: in three years because if you think about no pollups
[22:49] Speaker 2: whatsoever in your average risk to colorectal cancer, there's a
[22:52] Speaker 2: lot in between. And so if you find like one
[22:54] Speaker 2: small dinky polyp, right like something that's two three millimeters
[22:57] Speaker 2: in size, like the size of a hangnail, those people
[23:00] Speaker 2: don't have to come back for seven to ten years
[23:02] Speaker 2: because their risk of getting correctal cancer is much lower
[23:04] Speaker 2: than someone who has a big poll up, one that
[23:07] Speaker 2: looks like a certain way into the microscope. It's closer
[23:10] Speaker 2: to the colorectal cancer spectrum. And so those are people
[23:13] Speaker 2: we keep a close eye on. So we would say
[23:14] Speaker 2: come back in three years, but I'll say for most people,
[23:17] Speaker 2: they're coming back if they have a quality exam, a
[23:20] Speaker 2: couple of very small poll ups, nothing too concerning, they're
[23:23] Speaker 2: coming back in seven to ten years.
[23:25] Speaker 1: So I want to go back to the prep because
[23:26] Speaker 1: I think so we had a kind of preliminary conversation
[23:29] Speaker 1: about this in our community, and this is the thing
[23:31] Speaker 1: that most people were concerned about, as you mentioned, right,
[23:35] Speaker 1: So has the prep for this change really at all
[23:38] Speaker 1: kind of since the invention. It feels like like this
[23:41] Speaker 1: is the thing that has happened, Like we made no
[23:43] Speaker 1: progress in use.
[23:45] Speaker 2: There's no pio form. You gotta just off the yeah,
[23:49] Speaker 2: and people are like you bring people like their astronauts
[23:52] Speaker 2: going into the moon. All these things are happening and
[23:54] Speaker 2: you guys can't create a better prep.
[23:56] Speaker 1: What?
[23:57] Speaker 2: And I get that. There are a lot of different
[23:59] Speaker 2: formula for preps, right, there's over the counter versions, there's
[24:03] Speaker 2: prescription liquids that tastes disgusting. There are pills, a lot
[24:09] Speaker 2: of pills, but there are pills. So I will say
[24:12] Speaker 2: for most people who have like pretty non complex medical
[24:17] Speaker 2: problems or of a young age, all the preps are
[24:20] Speaker 2: really available to you, and your body will do a
[24:22] Speaker 2: pretty good job of cleaning itself out with the pills.
[24:25] Speaker 2: It's very person dependent. If you have chronic constipation, you
[24:28] Speaker 2: may not clean out as well, and you need a
[24:30] Speaker 2: little bit of help with the liquid prep. If you're
[24:32] Speaker 2: not as mobile, your prep might not be as good.
[24:35] Speaker 2: If you have kidney issues, some preps may not be
[24:38] Speaker 2: as favorable because they can cause abnormal electrolytes sodium and
[24:42] Speaker 2: potassium and those sorts of things that we have to
[24:43] Speaker 2: be mindful of. But there are a lot of different versions.
[24:46] Speaker 2: There's liquid and there's pills. So I will say that
[24:49] Speaker 2: in my practice, I do prefer the liquid because it's
[24:53] Speaker 2: tried and true. And I don't think that's me necessarily
[24:56] Speaker 2: being stuck in my ways. As much as I hate
[24:58] Speaker 2: to see a patient and do a lot of work
[25:02] Speaker 2: at home, come in and their prep is not good.
[25:05] Speaker 2: And when their prep is not good, you know when
[25:08] Speaker 2: I was talking about that quality exam, it's not a
[25:10] Speaker 2: quality exam, and you can miss pollups and you can
[25:14] Speaker 2: miss small cancers. And so in order for me to
[25:18] Speaker 2: feel confident in the exam that I do, I would
[25:20] Speaker 2: have to bring somebody back, which means they have to
[25:22] Speaker 2: take another day off of worker school, which means they
[25:25] Speaker 2: have to have another escort arranged to take time off
[25:28] Speaker 2: of their work or school. It's a whole other thing.
[25:30] Speaker 2: You got to buy another prep, and so I'd like
[25:32] Speaker 2: to get it right. The first time with whatever prep
[25:35] Speaker 2: you choose, It's just really important to follow the directions
[25:37] Speaker 2: to a tee, review the instructions, make sure a healthcare
[25:41] Speaker 2: professional reviews it with you. And I'll also stress to
[25:44] Speaker 2: people the night before the prep, when you're about to start,
[25:47] Speaker 2: is not the time to read the directions because then
[25:49] Speaker 2: people read it and they're like, oh my gosh, I
[25:51] Speaker 2: wasn't supposed to eat this that or the other. We're
[25:53] Speaker 2: also supposed to stop this medication or are supposed to
[25:55] Speaker 2: take this a couple of days beforehand, and we need
[25:58] Speaker 2: those kinds of surprises. We want you to be as
[26:00] Speaker 2: well prepared and relaxed and stress free as possible coming
[26:03] Speaker 2: in there. And I think, like you said, because the
[26:05] Speaker 2: prep causes so much anxiety, knowing about it beforehand is
[26:10] Speaker 2: your best defense. But I know I have a lot
[26:11] Speaker 2: of people come in the next day and they're like, yeah,
[26:13] Speaker 2: it sucked, but it wasn't as bad as I thought
[26:15] Speaker 2: it would be. I hear that a lot like both
[26:17] Speaker 2: from the procedure standpoint itself and then the prep. They're like,
[26:20] Speaker 2: it wasn't as bad as I thought it would be.
[26:21] Speaker 2: And I do think a lot of what we read
[26:23] Speaker 2: online and absorb online is really the worst of it.
[26:26] Speaker 2: But there are ways to make it easier. Put it
[26:28] Speaker 2: in the fridge, chill it. You can put things like
[26:30] Speaker 2: crystal light powder in it to make it more palatable.
[26:33] Speaker 2: I know some people have like prep parties. If you
[26:36] Speaker 2: really have your have close friends, you don't mind during
[26:38] Speaker 2: your bathroom with that you've known for a long time
[26:41] Speaker 2: and they're all of the same age. It makes things easier.
[26:43] Speaker 2: And like everybody goes to the bathroom, like everybody's the bathroom,
[26:46] Speaker 2: everybody farts, like these are normal things. It's just so
[26:49] Speaker 2: important to destigmatize these things that are absolutely normal, Like
[26:53] Speaker 2: the body has to make waste and get rid of it,
[26:56] Speaker 2: like that is a normal process. Whether you're sitting on
[26:58] Speaker 2: the toilet to do that, or you have any to
[27:00] Speaker 2: me or what have you, Like, these are normal processes,
[27:03] Speaker 2: and so that's just really important to understand and remember
[27:07] Speaker 2: we're all human and these are things that we do,
[27:09] Speaker 2: so there's no point in being shy about it. But
[27:12] Speaker 2: I definitely understand how difficult the prep can be for
[27:15] Speaker 2: some people. But I'd like for people to do it
[27:17] Speaker 2: right the first time. They don't have to come in
[27:19] Speaker 2: again when they otherwise wouldn't have to.
[27:22] Speaker 1: I kind of love the idea of a prep pooty.
[27:24] Speaker 1: It makes it like a social like a health intervention. Right,
[27:27] Speaker 1: we are all of the same age. Let's all schedule
[27:29] Speaker 1: this for the same day to do the prep together,
[27:32] Speaker 1: talk about it, share those like. I kind of like
[27:34] Speaker 1: that idea.
[27:35] Speaker 2: Yeah, And I also see a lot of couples come together,
[27:38] Speaker 2: so they'll come in for their appointment to talk about
[27:40] Speaker 2: the procedure, and then they'll bring a third person as
[27:42] Speaker 2: their escort and they'll have it done on the same day.
[27:44] Speaker 2: I've had people take pictures in the postop area holding
[27:48] Speaker 2: hands both in a stretch, and it's a great promotion
[27:51] Speaker 2: of good health habits. We're doing this together, we're in
[27:53] Speaker 2: this together, we're kind of suffering through the prep together.
[27:56] Speaker 2: I think it's like a it's a beautiful thing, quite honestly. So,
[27:59] Speaker 2: so I hope that, like, I hope we spread the
[28:01] Speaker 2: word on that and people.
[28:02] Speaker 1: Take that in. Yeah. Yeah, that's definitely fun. More from
[28:06] Speaker 1: our conversation after the break, continue to talk about the screening,
[28:18] Speaker 1: especially for men, there is sometimes a connection between like
[28:22] Speaker 1: the way this procedure is done to sexuality, right, that
[28:25] Speaker 1: feels like it also adds this level of stigma. Can
[28:28] Speaker 1: you address that and talk about dispel any kind of
[28:30] Speaker 1: myths there?
[28:31] Speaker 2: Yeah, that happens a lot more often than you would think.
[28:35] Speaker 2: And I couldn't stress enough that this is a completely
[28:38] Speaker 2: medical procedure. Like as physicians, we're not remembering what people
[28:41] Speaker 2: look like down there. Quite honestly, we see so many
[28:45] Speaker 2: but today and like I tell people, like, we've seen
[28:48] Speaker 2: it all and there's nothing sexual about it in any
[28:51] Speaker 2: stretch of the imagination. Again, it can be a life
[28:54] Speaker 2: saving procedure for some people. And just knowing that we
[28:57] Speaker 2: have higher rates of colorectal cancer and it is a
[28:59] Speaker 2: highly preventable cancer for most people, I hate to see
[29:04] Speaker 2: that be the barrier. So that's why I do love
[29:07] Speaker 2: when I see black men get in front of the camera,
[29:10] Speaker 2: in front of the screen, not the camera that I use,
[29:12] Speaker 2: but I mean like in front of the camera on
[29:14] Speaker 2: social media, in front of the screen talking about how
[29:16] Speaker 2: they got screened and even talking about their fears with it.
[29:20] Speaker 2: I think can be really impactful. But I can't stress
[29:23] Speaker 2: enough that that is like the furthest thing from our minds.
[29:26] Speaker 2: What is a medical procedure, just like any other, just
[29:29] Speaker 2: like any other. I think that that's really important to impart.
[29:32] Speaker 1: Yeah, So I want to address a few more myths
[29:35] Speaker 1: in the form of a little game. So I'm going
[29:38] Speaker 1: to throw out some things that I've heard people say
[29:40] Speaker 1: about kolonoscopy's in collorectal cancer, and I want you to
[29:43] Speaker 1: tell me whether this is a myth or a fact,
[29:45] Speaker 1: and then tell me why it matters.
[29:47] Speaker 2: Okay, Okay.
[29:49] Speaker 1: So the first one is that corectal cancer is mostly
[29:52] Speaker 1: something men deal with.
[29:55] Speaker 2: I would say that's not true. I think for all
[29:57] Speaker 2: intents and purposes, we should be thinking of this as
[30:00] Speaker 2: a disease that affects all sexes, all genders. No one
[30:04] Speaker 2: is at low risk for colorectal cancer. You're either at
[30:06] Speaker 2: average risk or high risk. But I wouldn't say men
[30:08] Speaker 2: suffer from it at a significantly higher rate.
[30:12] Speaker 1: Got it. The next one is a colonoscopy is painful.
[30:17] Speaker 2: I'll say that is also false. The majority of folks get,
[30:20] Speaker 2: the overwhelming majority of folks to get sedation for their procedure.
[30:24] Speaker 2: The type of physidation may differ across different regions of
[30:27] Speaker 2: the US. But you are asleep, you are comfortable, you
[30:31] Speaker 2: are dreaming, well, you wake up. People say that was
[30:34] Speaker 2: the bestlyp I ever had, as I said before verbatim,
[30:37] Speaker 2: or I didn't even remember it happened, or when are
[30:39] Speaker 2: we starting? Then we've already finished. So it is a
[30:43] Speaker 2: painless procedure. We're taking good care of you the entire time,
[30:47] Speaker 2: and you don't feel a thing. It's like we were
[30:48] Speaker 2: never there.
[30:50] Speaker 1: Is there pain or discomfort after the procedure, Doctor Beldora,
[30:54] Speaker 1: that needs to be addressed.
[30:55] Speaker 2: The expectation is that you shouldn't have any I'll say
[30:58] Speaker 2: that we do put air inside the the large intestines
[31:01] Speaker 2: that we can see the majority of the time you're
[31:02] Speaker 2: walking around there's either pecs in or stool and you're
[31:05] Speaker 2: intestine or it's collapsed like there's no air, but for
[31:07] Speaker 2: us to see things, we put air inside the intestine
[31:10] Speaker 2: with the camera. Afterwards. Some people may complain of a
[31:14] Speaker 2: little bit of bloating or gas. I'll say, if you
[31:17] Speaker 2: walk around as the day passes, you're going to pass
[31:19] Speaker 2: the gas. It's going to expel out of your body
[31:21] Speaker 2: and you should feel fine. I'll also say that for
[31:25] Speaker 2: some people, I do do colonoscopies unsedated, So I don't
[31:29] Speaker 2: know if doctor Joy, if you've heard of that, but
[31:31] Speaker 2: some people do get unsedated colonoscopies, either because they're like
[31:34] Speaker 2: I got to go to work after this, I have
[31:35] Speaker 2: to drive, or have to take care of a minor
[31:37] Speaker 2: or some other thing that prevents them from getting sedated,
[31:40] Speaker 2: or unfortunately they don't have the support system to have
[31:43] Speaker 2: somebody with them, and so they get procedures unsedated. And
[31:46] Speaker 2: I think it is actually a more common phenomenon now
[31:49] Speaker 2: than it had been like when I first started practicing
[31:52] Speaker 2: a decade and a half ago, and it's for the
[31:54] Speaker 2: majority of folks, they tolerate it extremely well, Like you
[31:57] Speaker 2: would be surprised. I will say, it's not painless, but
[32:01] Speaker 2: it's not necessarily like a procedure that is causing excruciating pain.
[32:05] Speaker 2: Like the entire time. It's very subjective, but that is
[32:08] Speaker 2: an option for folks that they can always talk about
[32:10] Speaker 2: with their doctor if it's something that's attractive to them.
[32:12] Speaker 2: And so I don't want to take kolonoscopy off the
[32:14] Speaker 2: table for folks who don't have an escort or have
[32:16] Speaker 2: some other reason why they otherwise think that they're not
[32:19] Speaker 2: able to have a colonoscopy. But that's your original question.
[32:22] Speaker 2: We shouldn't expect any pain afterwards. Even when you remove
[32:25] Speaker 2: a polyp, right, even if you're totally awake, you have
[32:28] Speaker 2: no sedation, you're not going to feel that. So the
[32:30] Speaker 2: only thing you really feel is air, and sometimes you
[32:32] Speaker 2: might feel that afterwards, but that's usually not so common.
[32:36] Speaker 1: And for the unsedated version of the kolonoscopy, is there
[32:39] Speaker 1: like a local anesthesia that you're using or is it
[32:42] Speaker 1: just completely nothing?
[32:44] Speaker 2: You're awake as you and I are right now.
[32:46] Speaker 1: Got it? Okay?
[32:47] Speaker 2: Yeah? I will say for people, especially for speaking to
[32:51] Speaker 2: a black female audience, vibroids, history of any pelvic or
[32:56] Speaker 2: abdominal surgeries, and nometriosis that make the procedure more technically challenging,
[33:03] Speaker 2: which patients may feel right because they're gonna feel you
[33:06] Speaker 2: going through the turns. The procedure is longer than usual,
[33:09] Speaker 2: not as comfortable, and so that's why I do think
[33:11] Speaker 2: it warrants a discussion to see if that's right for you.
[33:14] Speaker 2: But again, like men, women like, and anything in between,
[33:18] Speaker 2: like we do, a colonask to be unsedated. The majority
[33:21] Speaker 2: of the time, they actually tolerated, okay, And they're not
[33:23] Speaker 2: gonna feel me taking tissue samples. They're not gonna feel
[33:25] Speaker 2: me removing poll ups. It's only something to consider in
[33:27] Speaker 2: the right patient.
[33:28] Speaker 1: On the next one, if my stool test came back fine,
[33:31] Speaker 1: I don't need a colonnascaby.
[33:33] Speaker 2: That's true. If your average risk And when I say,
[33:36] Speaker 2: when you say fine, I'm gonna I'm gonna interpret that
[33:38] Speaker 2: as negative, I meaning the test was normal. Then you
[33:41] Speaker 2: don't need a colonoscopy, like you don't need to do
[33:43] Speaker 2: more than one screening test. If the test is negative,
[33:46] Speaker 2: the non invasive test is sufficient.
[33:47] Speaker 1: If colorectal cancer runs in your family, screening won't change
[33:51] Speaker 1: the outcome.
[33:51] Speaker 2: Okay, that's a great question, and the answer is definitely no.
[33:55] Speaker 2: You're not destined to get corectal cancer, and that's why
[33:57] Speaker 2: screening is so critical. I will say for people who
[34:01] Speaker 2: do have a family history, which it's so important to
[34:03] Speaker 2: talk about, they get screened earlier than the average individual.
[34:07] Speaker 2: So if it's someone who is in your immediate family
[34:09] Speaker 2: we're talking parents, siblings, children, that gives you the highest
[34:13] Speaker 2: risk of getting corectal cancer yourself. So we advise people
[34:17] Speaker 2: to get screened ten years before your immediate relative was
[34:22] Speaker 2: diagnosed with colorectal cancer. So if your mother was diagnosed
[34:26] Speaker 2: at age fifty, you should get screened at age forty.
[34:29] Speaker 2: If your mother was diagnosed at age forty five, you
[34:32] Speaker 2: should get screened at age thirty five. So if you
[34:34] Speaker 2: have a first degree relative with coorectal cancer, you either
[34:37] Speaker 2: start at forty or ten years before that person was diagnosed.
[34:42] Speaker 2: Forty is the latest we would start.
[34:44] Speaker 1: Got it? And is this something that is typically This
[34:48] Speaker 1: may not be something you can answer, but is this
[34:50] Speaker 1: something that's typically like approved by insurance, Like, if you
[34:52] Speaker 1: know you have a family history and you need to
[34:54] Speaker 1: get screening earlier than you know, woulds typically advise? Is
[34:58] Speaker 1: that something that's typically covered by insurance?
[35:00] Speaker 2: I hate to say that that's true across the board,
[35:02] Speaker 2: which is absolutely terrible, but yeah, because it is still
[35:05] Speaker 2: a screening exam, but because the age is before forty five,
[35:10] Speaker 2: it can definitely depend upon your insurance.
[35:13] Speaker 1: Got it? And I think you justice, But I want
[35:16] Speaker 1: to make sure that the audience knows is in and
[35:18] Speaker 1: that I'm reminded if there is a family history and
[35:21] Speaker 1: you are wanting to start an early screening, you would
[35:24] Speaker 1: still suggest a colonoscopy and not one of the other
[35:27] Speaker 1: non invasive ones.
[35:28] Speaker 2: Absolutely, yes, thank you.
[35:30] Speaker 1: I appreciate you. I'm sharing that.
[35:32] Speaker 2: Yeah.
[35:33] Speaker 1: In addition to all of the work that you're doing
[35:35] Speaker 1: kind of in your full time job, you've also co
[35:37] Speaker 1: founded the Association of Black gastro Enterologists and Hepatologists in
[35:41] Speaker 1: twenty twenty one. What were you seeing that made you
[35:44] Speaker 1: feel a need to create the organization.
[35:47] Speaker 2: Too much? What's eleven of us co founders And we're hepatologists, physician, scientists,
[35:54] Speaker 2: community physicians, and you know, we knew each other, it's
[35:57] Speaker 2: through different circles, like we were either friends or Theren't
[36:00] Speaker 2: that many black gis and hypatologists, So there's that. But
[36:04] Speaker 2: in twenty twenty peak COVID, we were just writing back
[36:07] Speaker 2: and forth, like trying to be community for each other
[36:09] Speaker 2: and leaning on each other. So it was like all
[36:11] Speaker 2: through like WhatsApp chats. And then George Floyd was murdered
[36:17] Speaker 2: and then we saw what happened with Breonna Taylor, and
[36:19] Speaker 2: then Chadwick Boseman died so early in his life in
[36:22] Speaker 2: correctal cancer, and we were like, let's create a PSA
[36:26] Speaker 2: at least to let people know about col rectal cancer
[36:29] Speaker 2: screening because similar to breast cancer screening or mammograms, as
[36:33] Speaker 2: you recall, the rates had of course dropped down in
[36:35] Speaker 2: terms of screening because people can go to the doctor,
[36:38] Speaker 2: and we knew that there would be a cascading impact
[36:40] Speaker 2: with that, especially for black and brown people, and so
[36:43] Speaker 2: we created this PSA, and then we said, we need
[36:45] Speaker 2: to start something formally, like if we need each other
[36:47] Speaker 2: so much, we can't imagine what's happening to people who
[36:50] Speaker 2: are siloed, people who don't live in big cities. They
[36:53] Speaker 2: need us, they need to see our faces, they they
[36:55] Speaker 2: need community. And so those were the one, two, three
[36:59] Speaker 2: strikes that really got us to form an organization because
[37:03] Speaker 2: we know that there are so few black gis and
[37:05] Speaker 2: hepatologists in this country. There's less than six hundred of us.
[37:08] Speaker 2: So that's abysmal when you think about how many Black
[37:11] Speaker 2: people are in the United States, when you think about
[37:13] Speaker 2: how we suffer from digestive disease cancers disproportionately compared to
[37:18] Speaker 2: other races and ethnicities, and how we're just our outcomes
[37:21] Speaker 2: are so bad, and not even for people who die
[37:24] Speaker 2: from the disease, which is terrible, especially for preventable ones
[37:27] Speaker 2: like colorectal cancer, but even those who survive, right, like
[37:31] Speaker 2: what mental health resources do they have, what's their nutritional status, right,
[37:36] Speaker 2: what's the impact of the finances that are required to
[37:40] Speaker 2: get the care that they need? All of those sorts
[37:42] Speaker 2: of things. And it's not just digestive diseases, right, Like
[37:45] Speaker 2: that's the field that I'm in, But unfortunately, that's a
[37:46] Speaker 2: stat we see across the board for so many chronic conditions.
[37:50] Speaker 2: And it was a call to action, and we're here
[37:53] Speaker 2: five years later, thankfully, and we're bringing along people with us.
[37:57] Speaker 2: And I think it's just so important to have a
[37:58] Speaker 2: future of GI that is more reflective of the country
[38:03] Speaker 2: that we live in, because we need to be seen.
[38:08] Speaker 2: And we just hear so many patient stories of people
[38:10] Speaker 2: how people were dismissed or you know, they even they
[38:13] Speaker 2: did all the steps that they needed to and they
[38:15] Speaker 2: still didn't get where they needed to be. And that's
[38:17] Speaker 2: just horrible. And so we just don't want people to
[38:20] Speaker 2: be dismissed. We don't want people to be to feel unseen.
[38:22] Speaker 2: We want people to know that we are here for them.
[38:25] Speaker 2: Seeing somebody looks like you, shares your experiences in the
[38:28] Speaker 2: doctor's office is gold, right. It's like I guess, so
[38:31] Speaker 2: when I was talking about how people have this like
[38:33] Speaker 2: weight lift that's just lifted and their face relaxes and
[38:36] Speaker 2: they're able to tell their story. That translates into better health,
[38:40] Speaker 2: better health care, better outcomes. And so that's why ABG exists.
[38:45] Speaker 1: So it sounds like a lot of it is like
[38:46] Speaker 1: health promotion, and you mentioned it kind of started with
[38:48] Speaker 1: the PSAs what else does the organization do?
[38:51] Speaker 2: We do a lot and sometimes it's hard to actually
[38:54] Speaker 2: realize it when you're in the thick of it. You know,
[38:56] Speaker 2: we have professional development events where we're create community for
[39:00] Speaker 2: other black gis and hepatologists, connecting them to people outside
[39:05] Speaker 2: of the field of GI because collaboration is key, right,
[39:08] Speaker 2: and we can lift each other up in that way.
[39:10] Speaker 2: We have a and then when we think about the
[39:12] Speaker 2: patient side of things, we have a lot of community
[39:15] Speaker 2: facing resources. We have this phenomenal campaign, the Doctor will
[39:18] Speaker 2: See You Now that was rooted in the statistic that
[39:21] Speaker 2: six out of ten black people change their appearance because
[39:26] Speaker 2: they think it will improve what their doctor experience is
[39:29] Speaker 2: like they think they will be treated differently if they
[39:31] Speaker 2: change your parents, so six out of ten people believe that.
[39:34] Speaker 2: So we have this campaign and coupled with that is
[39:37] Speaker 2: this doctor Discussion Guide, So we give people the tools
[39:40] Speaker 2: to empower them from when they're going to the doctor's office,
[39:43] Speaker 2: questions to ask how to be best prepared, bringing somebody
[39:46] Speaker 2: with them so they have an extra set of eyes
[39:48] Speaker 2: and ears, someone can advocate for them, all those types
[39:50] Speaker 2: of things, and so providing resources, partnering with community based organizations,
[39:55] Speaker 2: having initiatives that help promote scholarship right bring faculty to me,
[40:00] Speaker 2: bring trainees to meetings, to meet leaders in the field,
[40:03] Speaker 2: because those things are really hard, like financially to get
[40:06] Speaker 2: to these meetings, and so anything we can do to
[40:09] Speaker 2: make the future of GI much more colorful than it
[40:11] Speaker 2: is right now. And also by extension, having that impact
[40:16] Speaker 2: in patient care and having patients see us is really
[40:19] Speaker 2: like what all of our programming and initiatives are about.
[40:23] Speaker 1: Perfect and we have covered so much ground today, Doctor Belzora,
[40:26] Speaker 1: If there was one thing that you would want people
[40:28] Speaker 1: to walk away with from this conversation ready to do,
[40:31] Speaker 1: what would it be?
[40:33] Speaker 2: I would say, screening saves lives, Screening starts at age
[40:37] Speaker 2: forty five, don't ignore symptoms, and know your family.
[40:41] Speaker 1: History, and where can we stay connected with you? What
[40:44] Speaker 1: is your website as well as any social media channels
[40:46] Speaker 1: you'd like to share.
[40:48] Speaker 2: So my social media channels are Sophie Balzora, MD, across
[40:53] Speaker 2: the board that's Instagram and LinkedIn and for Black and
[40:57] Speaker 2: Gastro especially what I reference with the doctor will see
[40:59] Speaker 2: you now and all the other things that we have
[41:01] Speaker 2: going on. Www. Dot Black and Gastro dot org is
[41:05] Speaker 2: where you can find us and all of our resources
[41:07] Speaker 2: are there and our upcoming events that I encourage you
[41:09] Speaker 2: to to come to because we have a lot of
[41:11] Speaker 2: community facing events. We have physician and physician trainee events,
[41:15] Speaker 2: and we just have a lot for everyone in our community,
[41:18] Speaker 2: and so we're so excited to share that with.
[41:20] Speaker 1: You, beautiful. We sure to include all of that information
[41:23] Speaker 1: in nashow notes. Thank you so much spending some time
[41:25] Speaker 1: with us today.
[41:26] Speaker 2: Thank you for having me. I appreciate it.
[41:28] Speaker 1: Thank you. I'm so glad doctor Belzora could join us
[41:34] Speaker 1: for today's conversation to learn more about her and her work.
[41:37] Speaker 1: You should have visited the show notes at Therapy for
[41:39] Speaker 1: Blackgirls dot com SASH session four six four and don't
[41:43] Speaker 1: forget to text this episode to two of your girls
[41:45] Speaker 1: right now and tell them to check it out. Did
[41:48] Speaker 1: you know that you could leave us a voicemail with
[41:49] Speaker 1: your questions or suggestions.
[41:51] Speaker 2: For the podcast.
[41:52] Speaker 1: If you have a message for us, drop it at
[41:54] Speaker 1: Memo dot fm, sash Therapy for Black Girls and let
[41:57] Speaker 1: us know what's on your mind. We just might feature
[41:59] Speaker 1: it on the pod. If you're looking for a therapist
[42:02] Speaker 1: in your area, visit our therapist directory at Therapy for
[42:05] Speaker 1: Blackgirls dot com slash directory. Don't forget to follow us
[42:08] Speaker 1: on Instagram at Therapy for Black Girls, or come on
[42:11] Speaker 1: over and join us in Patreon for exclusive updates, behind
[42:15] Speaker 1: the scenes content, and much more. You can join us
[42:17] Speaker 1: at community dot Therapy for Blackgirls dot com. This episode
[42:21] Speaker 1: was produced by Elise Ellis, Indechubu and Tyrie Rush. Editing
[42:25] Speaker 1: was done by Dennison Bradford. Thank y'all so much for
[42:28] Speaker 1: joining me again this week. I look forward to continuing
[42:30] Speaker 1: this conversation with you all real soon.
[42:33] Speaker 2: Take good care.

Shows are listed from Apple Podcasts' charts and directory, and Podcast Index where it is used. Every show and episode belongs to its publisher and plays from the publisher's own feed; this site hosts none of them.