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Hemorrhoids are a condition where the pillow-like cluster of veins under the mucus membranes lining your anus and the lowest part of your rectum swell up and protrude, causing irritation, pain, and that dreaded itch.

Hemorrhoids are uncomfortable and can be a little scary but they are very common and can be easy to treat. About 1 in 20 Americans have some sort of hemorrhoid issue, and that number jumps up to almost 50 percent after the age of 50. Most Hemorrhoid problems can be resolved with at-home or over-the-counter treatments such as a higher fiber diet, regular hot soaks, or witches’ hazel wipes and preparation H.

However, if you are experiencing one of these 5 issues with your Hemorrhoids, it might be time to speak with your physician and receive treatment:

– If you see any signs of rectal bleeding in your stool or as you wipe

– If OTC products leave you with side effects like dry skin or a rash around your anus

– If your stool has a reddish or bronzish tint to it, another sign of bleeding

– If your symptoms persist after trying at home or OTC treatments after one week

– If your Hemmoroid pain and discomfort is affecting your lifestyle and ability to go through your day

Going to see a doctor about your Hemorrhoids can be stressful and embarrassing, but you are not alone. More than 1.1 million people visited their doctor in regards to Hemmmorids in 2010 alone, and the vast majority are able to leave relieved and treated.

If you are suffering from any of the symptoms listed above, or you have any questions or concerns about your Hemorrhoids, it might be time to contact your physician today

When it’s time for surgery, patients should definitely ask their surgeon about robotic surgery.  Over the past 20 years, surgery has evolved from open surgery to minimally invasive laparoscopic procedures to robotic surgery.  The Surgery Group of Los Angeles is proud to offer patients with a variety of surgical problems an advanced, minimally invasive robotic surgical approach.

What is robotic surgery?

Robotic surgery combines the best features of traditional open and minimally invasive laparoscopic surgery. It uses small incisions of laparoscopic surgery with the wristed movement, 3-D visualization, and precision control of surgical instruments of open surgery. A small camera is inserted through a tiny incision and the surgeon sits at a console performing the procedure by guiding the camera and surgical instruments.  The robot is designed to provide skilled surgeons even greater visualization, precision and expertise in performing more complex, minimally invasive surgeries, including dissection and reconstruction.

The benefits of robotic surgery

Over the years, particularly with the newer generation Da Vinci robots, robotic surgery has successfully proven to be beneficial to both patients and surgeon.

Patient benefits:

  *   Reduced pain and discomfort
  *   Minimal scarring/incisions
  *   Reduced risk of infection and blood loss
  *   Reduced time in hospital
  *   Faster recovery

Surgeon benefits:
  *   Enhanced visualization (higher magnification, higher resolution)
  *   Superior dexterity with greater range of motion
  *   Enhanced precision, flexibility, and control of surgical instruments
  *   Better access to hard-to-reach areas

What surgeries can be done with the Robotic system?

Robotic surgery can be used for all types of surgeries including gallbladder, abdominal hernia, thyroid/parathyroid, and colorectal.  Of course, the use of robotic surgery correlates with the surgeon skill set and level of expertise.

At the Surgery Group of Los Angeles, our world-renowned surgeons have adapted robotic surgery from early on and have taken on the toughest cases.  They are highly skilled and experienced in robotic surgery.  If you are thinking about having surgery, come for a consultation at the Surgery Group of LA.

If there is anything positive to take away from the Covid crisis, it is the number of people who understand now how important having a plan can be in ensuring a healthy future. In that spirit, The Surgery Group of Los Angeles is working alongside organizations like the American Cancer Society in advocating for people over 45 to consider getting their first Colorectal Cancer screening. 

Colorectal cancer screenings are tests designed to detect cancer before symptoms arise. When done regularly, these tests can find colorectal cancer when it’s smaller and perhaps even easier to treat. While there are many screening options that we would like to go over with you today, the key is that you are tested. The types of tests that the American Cancer Society recommends are split into two major categories: Visual and Stool based screening. 

Stool Based tests can be separated into two categories: Blood-based and DNA based. While they are less invasive and simpler to perform, they need to be performed far more often than their Visual counterparts. 

• Blood-based tests come in two forms: Fecal Immunochemical (FIT), or Guaiac-based fecal occult (gFOBT). Both can be performed at home and work by finding trace amounts of hidden blood inside of your stool. Both need to be performed once a year and may require you to avoid red meat and some medicines (ibuprofen, aspirin, and large amounts of Vitamin C) several days before testing. 
• Stool DNA testing looks instead for certain DNA or gene changes that can form inside of your stool from polyps or cancerous cells. Some tests also check for blood as well. These tests are also can be performed at home, but only need to be done every 3 years 

If any of these tests show positive for blood or DNA changes, a colonoscopy must be performed. It does not however mean that cancer has formed in the colon, as it may also be Ulcers or Hemorrhoids. 

Visual Tests are recommended for patients that have an average to high risk of having colon cancer. They don’t have to be performed as often as their stool counterparts but often require more lead uptime.  

• A Colonoscopy is the most common form of visual test and if nothing is found abnormal on an average risk patient, will not need to be performed for another 5-10 years. A flexible tube is inserted into the anus, where a small camera allows your doctor to observe the totality of your colon and rectum.  This test is done under twilight anesthesia.  There is of course the “bowel prep” and you will need a ride home, but the test is very safe. 
• A CT Colonography is very similar to a colonoscopy but due to it being virtual, does not require sedation. It still requires drinking a bowel prep the day before. If any abnormalities are observed, a follow colonoscopy will need to be performed. While less painful, a CT Colonography must be performed every 5 years. 

Regular screening is key in preventing colorectal cancer. If polyps are found during the testing process, they can usually be removed before turning into cancer. If you’re 45 and older talk to your doctor about which test is right for you. Be sure to mention your family medical history, as that will provide key insight into testing your unique situation.  

Often seen as a necessary but guilty pleasure, a new study of 1,171 colorectal cancer patients found that patients who reported drinking 2-3 cups of coffee a day lived longer and had a decreased risk of cancer progression.

What is even more surprising is that this effect scaled. Patients who drank 4 cups of coffee, saw even more profound health effects. And for patients who prefer decaf, the results were similar for patients who drank caffeinated and decaf coffees.

This hasn’t been the first time that coffee has found itself on the bright side of oncology news. In 2016, scientists for the International Agency for Research on Cancer (IARC) found that coffee could no longer be labeled as possibly carcinogenic.  In 2015, the National Library of Medicine released a study suggesting coffee reduced the risk of liver cancer and long term liver disease.

This is of course only one study, and some medical professionals suggest that the relation might be incidental, that simply patients who suffer worse from colon cancer symptoms would be less likely to drink coffee. Others point out that while antioxidants have been pointed out to be beneficial for cancer patients, the direct relation between coffee and cancer prevention or support has yet to be proven.

Colon cancer has been on the news with the sad passing of Chadwick Boseman at only the age of 43, a pioneer for african american actors and the star of Black Panther. His passing has increased the awareness of a disease that is increasingly affecting young people.

Colon cancer is one of the leading causes of death for young Americans, with 10% of new colon cancer patients projected to be under 50 by the year 2030. Symptoms of colon cancer include a change in bowel movements, rectal bleeding, blood in the stool, and abdominal pain. If you are experiencing any of these symptoms please consult a medical professional right away.

No one wants to talk about what goes on inside the bathroom, but the truth is hemorrhoids are one of the most common bowel ailments that affect people in this country. According to the National Institute of Diabetes and Digestive Kidney diseases (NIDDK), more than 1 in 20 people in the US have hemorrhoids. That number jumps to 1 in 2 once you’re past 50.

Hemorrhoids can form internally inside the anal canal and rectum, or externally on the anal verge. Either way these swollen veins can cause massive discomfort and bleeding. Here are some easy ways to treat hemorrhoidal pain that goes beyond just water and fiber.

1. Consider a squat stool – Popularized by the viral item Squatty potty, these items have actually been proven to work! By squatting you allow your anus to relax allowing for easier stool evacuation. A study done by TIME magazine showed that out of 1000 people who used a squat stool, 91% strained less.
2. Yoga – While exercise in general has been shown to be effective in easing hemorrhoid pain, experts at a Hemorrhoid clinic found yoga, and other abdominal exercise to be the most effective. Consider this Malasana pose as a start.

3. Sitz Bath – Sitz bath are a great therapy achieved by sitting in warm, shallow water, often done with salt. This works by reducing spasm and itching caused by hemorrhoids.
4. Go as soon as you feel it – Often times the pain and irritation from hemorrhoids can be so frustrating, people delay their bowel movements all together. This can cause the stool to dry up, leading to more pain, bleeding and irritation
5. Over the counter creams – While you should always consult your doctor before a treatment, doctors at the mayo clinic found creams with Witch Hazel are safe and cheap way to numb and soothe your anus.

A person’s life should not be spent going from one bad bowel movement to another. If none of these solutions provide relief in a week or so, speak to our colorectal physician specialists.

SURGERY GROUP LOS ANGELES:

THE CENTER OF CHOICE FOR PROFESSIONAL TREATMENT OF HEMORRHOIDS

Surgery Group Los Angeles is an experienced medical group constituting of highly skilled board-certified colorectal surgeons. Our team concentrates in hemorrhoid management. Conservative management and avoidance of surgery is the desired treatment.

Please, refer to our website and mission statement for further information. You may schedule an appointment with us for the evaluation and recommendations for you or your loved one’s condition so you can make an informed decision.

References:

https://time.com/5498225/squatty-potty-study/#:~:text=After%20sorting%20through%20descriptions%20of,go%20after%20using%20the%20bathroom.

https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/definition-facts

https://www.mayoclinic.org/diseases-conditions/hemorrhoids/diagnosis-treatment/drc-20360280

Can I Lower My Risk of Developing Breast Cancer?
The risk of developing breast cancer in women is factual. As women grow older, this scare tends to strengthen. The statistics about women developing cancer as they age are shocking. They say that one in every eight women is vulnerable to developing cancer as she reaches forty years of age. No one remedy or tonic will remove the chances of you developing cancer. However, there are many things that you can do to lower your risk of breast cancer. It is possible to act wiser and change your lifestyle to reduce your risk of developing this deadly disease. The steps that you need to take in this regard are as follows:

1. Exercise:

Exercising comes with a plethora of advantages, and the most valid one is that it lowers your risk of breast cancer. Studies have shown that working out cuts down the chances of a person having this disease. Alongside this, it aids the breast cancer survivors to have a longer life and develops their stamina to heal. What you want to do is to choose your favorite form of exercise and stick to it. It could be jogging, running, walking, swimming, or dancing. You can select one of your choices quickly.
Exercising for at least thirty minutes a day will reduce your chances of developing breast cancer a lot.

2. Quit smoking:

In case you are a smoker, you need to quit this habit soonest possible. The nicotine in the cigarette tends to damage a lot of crucial body organs and parts. The most damaging effect of smoking is on the lungs, hearts, and veins. The habit of smoking is directly connected to the chances of premenopausal women developing breast cancer.
You can surely lower your risk of breast cancer by abandoning smoking once and for all.

3. Do not opt for HRT:

Hormone replacement therapy is one of the biggest reasons behind women developing breast cancer. If you are someone who is about to decide to opt for HRT, you need to reconsider it. It is always recommended to discuss it with your doctor and share your concerns before jumping into it.

4. Change your eating habits:

If you are a junk food lover and have never touched vegetables, you may need to do this for your health. Adding vegetables and fruits as a necessary part of your life will keep the scare of cancer away from you. As these vegetables are natural antioxidants, they fight with all the toxic chemicals getting their way into your body.
It is always recommended to avoid taking supplements for the needed nourishments. A platter of veggies and fruits a day would be enough for the required nourishments for you.

5. Regular scans:

As soon as you find something weird happening to your breast, you need to get a scan immediately. At times it is a harmless bump, which can be removed easily. If not removed on time, it can turn into a tumor. Thus immediate response to anything strange occurring to the body is necessary. 

Being a woman is the biggest risk factor for developing breast cancer. As women age, the absolute risk of developing breast cancer increases.  We have all heard the 1 in 8 statistic.  We know that 1 out of every eight women has a risk of developing breast cancer.  But as a surgical oncologist, I need women to understand the difference between the Absolute Risk of developing breast cancer vs the Relative Risk for developing breast cancer.  I want my patients to feel in control during their entire journey.
Absolute Risk of Developing Breast CancerWhen I tell my patients about the risk of developing breast cancer, I mean “the absolute risk” that they are likely to get breast cancer or develop recurrence.  The term “risk” is used to refer to a number or percentage that describes how likely a certain event is to occur.  

• If your current age is 20, the probability of developing invasive breast cancer in the next 10 years is   .06%, or 1 in 1,732. This means that 1 in 1,732 women in this age group can expect to develop breast cancer. Put another way, your odds of developing breast cancer if you are in this age range are 1 in 1,732.
• If your current age is 30, the probability of developing invasive breast cancer in the next 10 years is .44%, or 1 in 228.
• If your current age is 40, the probability of developing invasive breast cancer in the next 10 years is 1.45%, or 1 in 69.
• If your current age is 50, the probability of developing invasive breast cancer in the next 10 years is 2.31%, or 1 in 43.
• If your current age is 60, the probability of developing invasive breast cancer in the next 10 years is 3.49%, or 1 in 29.
• If your current age is 70, the probability of developing invasive breast cancer in the next 10 years is 3.84%, or 1 in 26.

       (BreastCancer.org)
Basically the younger you are the lower your absolute risk while the older you are, your absolute risk for developing breast cancer increases. These numbers and percentages are averages for the whole population. Your individual breast cancer risk may be higher or lower, depending on a number of factors, including family history, reproductive history (such as menstrual and childbearing history), race/ethnicity, and other factors.  When I see patients, I pay careful attention to risk factors such as family history.  Women who have inherited mutations in the genes known as BRCA1 or BRCA2 carry a higher absolute risk for developing breast cancer.  For women with a BRCA1 mutation, the risk of developing breast cancer by age 80 is 72%. For women with a BRCA2 mutation, the risk is a bit lower, at 69%.
Relative Risk of Developing CancerThe relative risk for developing breast cancer is basically reported by research studies, which often compare groups of women with different characteristics or behaviors to determine whether one group has a higher or lower risk of breast cancer than the other (either as a first-time diagnosis or recurrence).  Basically I want to empower my patients, to make If I make certain lifestyle choices that will impact their relative risk of developing breast cancer or having a recurrence.  The Relative Risk calculation is always a bit tricky and can easily be distorted. It is very important to have a clear understanding of the actual medical research rather than  jumbled interpretations of medical research.

There’s the famous study that links breast cancer to drinking two or more alcoholic drinks per day.  Summarily, women who have two or more alcoholic drinks each day have a have a 50% higher risk for developing breast cancer than non drinkers.  That is an astounding statistic and frankly dishonest. It is also unnecessary to burden a woman going through breast cancer with guilt. The truth is that women who drink two or more alcoholic beverages a day are NOT 50% more likely to develop breast cancer.  Women who already have a 12% absolute risk of developing beast cancer, increase their absolute risk by 1.5 (50% is .5 and the number one is used as a baseline-BECAUSE MATH) times if they consume 2 or more alcoholic beverages. (.12 x 1.5 is about .18 or 18%).  So out of the 12% of women who develop breast cancer, women who have two or more alcoholic drinks a day have an18% absolute risk of developing breast cancer.  When it comes to statistics, ignore the hype beasts and focus on the math.  
So now that I have explained the difference between absolute risk vs. relative risk, its important that women know there are many different factors can increase and/or decrease the absolute risk of developing breast cancer.  My next blog will discuss those factors.