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	Do I need a colonoscopy?
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					Family/personal history of colorectal cancer
					Family/personal history of colorectal polyps
					Age 50 or older without symptoms
					Rectal bleeding (bleeding is never "normal")
					Abdominal pain

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Call us:  317.841.8090 or 800.872.5123 in Indiana

Our Hours:  Monday - Friday: 8:30am - 4:30pm

	We know that with less cutting comes a higher quality of life, reduction of patient costs, and a quicker return to full activity. We wrote the book on minimally invasive colon surgical techniques and our center is Indiana's champion of laparoscopic colon cancer treatment. We offer cutting edge scarless surgeries (single incision laparoscopic surgery or SILS), and robotic surgery (Da Vinci) with the benefit of 3D imaging technologies and greater preservation of sexual function which can be damaged in conventional pelvic procedures. We embrace new surgical techniques that are proven to result in higher quality of life and less postoperative discomfort. Some exciting up and coming techniques we offer in anorectal surgery include: artificial sphincter implantation an alternative to colostomy for some patients success rate 70-85% first performed in Indiana by our surgeons procedure for prolapse and hemorrhoids (PPH) less pain less blood loss less time loss from work stapled transanal rectal resection (STARR) relieves constipation improves rectal emptying satisfaction rate of 85% first performed in Indiana by our surgeons transanal endoscopic microsurgery procedure (TEM) avoids need for colostomy shorter recovery time shorter hospitalizations In colonoscopy, experience makes results and our center has over 50,000 complication-free colonoscopies since 1979. During video inspection of the colon our surgeons can sweep the bowel of polyps (polypectomy), spray vital dyes to reveal cancers (chromoendoscopy), bolster intestinal walls against swelling, constrictions, and blockage (stent placement), clot bleeding vessels, mark tumors for removal and remove contained cancer. Noninvasive in-house tests and treatments often won't take longer than a lunch break. A patient with hemorrhoids and 20 minutes can shrink their hemorrhoids with the simple application of a band (band ligation) or treatment with a laser (infrared photocoagulation). A 10 minute Botox injection to relax the sphincter stimulates healing of anal fissures. And diagnostic exams can measure anal sensation and muscle pressure (manometry) and image the rectal muscles to pinpoint rectal masses or fistulas (endoanal ultrasound) within half an hour.
	Schedule an Appointment

 

Call to schedule your screening colonoscopy today at 317-841-8090

People Helping People

"We believe that those individuals who seek our care should receive the most courteous, compassionate, and current care available. This care should be given with dignity and respect. All of us at Colon & Rectal Care Center seek to give the best, to be the best. One day, each of us may well be seeking care and we will expect no less."

Colon & Rectal Care Physicians

Colon Cancer and Diet

Taking a pill to prevent colorectal cancer, the second most common malignancy, is an attractive proposition. While unrealistic, there are measure you can take to prevent colon cancer and colon polyps. Remember, apart from dietary restrictions such as avoidance of animal fats and alcohol and adequate exercise in addition to periodic colonoscopy to exam the colon and remove colorectal polyps and tumors, there are no proven measures that reduce the risk of colorectal neoplasia. However, various dietary supplements have been purported to be protective.

Diet high in fresh fruits and vegetables, low in calories, alcohol and animal fat is cancer protective although the presumed protective effects of fiber per se is doubted by recent trials. Calcium, folate, and selenium may help in colon cancer prevention. Intracellular folate deficiency alters gene-specific DNA methylation and affect DNA stability by production of DNA strand breaks or misincorporation of uracil. Folate supplementation slows cryptal colocyte proliferation in patients at high risk for colon cancer. Low dietary folate and methionine and high alcohol consumption increase risk of colon cancer, possibly by modulating methylation. The inverse association of folic acid consumption with colon cancer risk was greater in women with a family history. More practically, folate seems to abolish the undesirable influence of family history of colon cancer, which increases the risk of colorectal carcinogenesis.

A deficiency of micronutrients such as folic acid, Vitamin B12, Vitamin B6, niacin, Vitamin C, and Vitamin E damages DNA by causing single- and double-strand breaks, oxidative lesions. This damage is similar to radiation induced DNA damage. This may explain high colon cancer risk associated with low folate intake. Vitamin B12 and B6 deficiencies, common in elderly population also lead to high uracil and chromosome breaks. Micronutrient deficiency may explain why the quarter of the population that eats the fewest fruits and vegetables has about double the cancer rate for most types of cancer when compared to the quarter with the highest fruit consumption. Correcting the micronutrient deficiency by dietary supplementation can have noticeable cancer-preventive benefits. Epidemiologically, dietary calcium and vitamin D intake is inversely related to incidence of colon cancer. Dietary calcium supplements lower epithelial cell proliferation indexes from a higher- to a lower-risk pattern, indicating oncoprotective benefit.

Yogurt and Lactobacilli suppress carcinogen-induced preneoplastic and neoplastic lesions in animal models. Yogurt and the lactic acid producing bacteria (probiotics) may decrease the ability of the other colonic microflora to produce carcinogens.

Prebiotics

such as non-digestible oligosaccharides alter colonic microflora by selectively augmenting the growth of Lactobacilli in the colon. Evidence for cancer-preventing properties of pro- and prebiotics is also based on fecal enzyme activities in humans, in vivo and in vitro inhibition of genotoxicity of carcinogens. The combinations of pro and prebiotics (synbiotics) are more effective than either of the categories.

Cox-2 inhibitors may also be candidates in chemoprevention of colon cancer. Carcinoigenesis is a complex process associated with overexpression of prostaglandins. Incidence of colon cancer inversely correlates with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), which inhibit prostaglandin synthesis. The NSAIDs inhibit cyclooxygenases (COX), which are active in prostaglandin production. Cyclooxygenase-2 (COX-2) is usually not expressed in normal tissue but over expressed in premalignant lesions and neoplasms. Early clinical data suggest that COX-2 inhibitors may protect against colon cancer. Prostaglandin E2 acts by binding to the membrane receptor EP1. EP1 receptor is believed to be important in colon carcinogenesis and selective EP1 receptor antagonists may prove to be oncoprotective.

There is no one prescription that you can suggest to your patients when they ask you about colon cancer prevention. Secondary prevention by identification and removal of premaligant colorectal adenomas by periodic colonoscopy is currently the best measure of prevention of colorectal neoplasia.

1. Mason JB, Nutritional chemoprevention of colon cancer. : Semin Gastrointest Dis 2002 Jul; 13(3): 143-53)
2. Khosraviani K. et al Effect of folate supplementation on mucosal cell proliferation in high-risk patients for colon cancer. Gut 2002 Aug; 51(2): 195-9).
3. Fuchs CS. Et al The influence of folate and multivitamin use on the familial risk of colon cancer in women. Cancer Epidemiol Biomarkers Prev 2002 Mar; 11(3): 227-34).
4. (Dang CT et al Potential role of selective COX-2 inhibitors in cancer management. Oncology (Huntingt) 2002 May; 16(5 Suppl 4): 30-6
5. Kawamori T, Wakabayashi K, COX-2 and prostanoid receptors: good targets for chemoprevention. J Environ Pathol Toxicol Oncol 2002; 21(2): 149-53).
6. Holt PR, Wolper C, Moss SF, Yang K, Lipkin M, Comparison of calcium supplementation or low-fat dairy foods on epithelial cell proliferation and differentiation. Nutr Cancer 2001; 41(1-2): 150-5);
7. Wu K et al, Calcium intake and risk of colon cancer in women and men. J Natl Cancer Inst 2002 Mar 20; 94(6): 437-46).
8. Ames BN. DNA damage from micronutrient deficiencies is likely to be a major cause of cancer. Mutat Res 2001 Apr 18; 475(1-2): 7-20).
9. Burns AJ, Rowland IR. Anti-carcinogenicity of probiotics and prebiotics. Curr Issues Intest Microbiol 2000 Mar; 1(1): 13-24)

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