If you think politics and religion are tough topics at the family holiday dinner table, try discussing family health histories or more specifically the health of your colon.
Dr. Omar Khokhar is an OSF HealthCare gastroenterologist in Bloomington. Khokhar said holiday gatherings are a time one can get to the bottom of family health histories, pun intended.
“We are very open about our bowel habits and our gastrointestinal health as a whole, much to the chagrin of some of my family, but that's what we do,” said Khokhar.
For those not so inclined to talk about something that personal, Khokhar advises a slow start by talking about your own physical or exercise program.
“I think the key here is emphasizing the wellness component of it,” said Khokhar. “The conversation may lead to health history. Depending on the age of the person, the 30s or 40s, having a conversation with siblings, and parents could be, what else, could we do preventatively? Have we ever looked at our family history of cancer?"
He said colon cancer is the second most common cancer in the country. And family members can find out which of them has been screened for it.
“If they've had a colonoscopy, there'll be a report of it somewhere. If they had a polyp removed, there'll be a report of that analysis under the microscope. If they had a stool sample done, there'll be a report of that. And now with most people having access to electronic health records, either on your computer, on your phone, on your tablet, those are pretty accessible now. And so most gastroenterologists, if we find something worrisome, we'll actually tell the person that, hey, make sure your siblings know make sure your son or daughter know,” said Khokhar.
But having a detailed health history question checklist next to the pie on the holiday table can be off putting. Khokhar advises keeping it simple with two numbers.
“Number one, the age for everybody to be screened for colon cancer recently dropped from age 50 to 45. If you're 45 and up, colon cancer screening is now part of your annual physical as a checkbox. Number two, when we talk about family history of colon cancer and colon polyps, the age 60 is important. If somebody in your family had a polyp or cancer before age 60, that increases your risk profile for development of something similar. If your grandma had colon cancer or a polyp and she's 88, that does not increase your risk profile,” said Khokhar.
He said family links to inflammatory bowel disease or peptic ulcer disease might also turn up in conversation.
“You know, everybody's got a family member. Oh, her stomach's always given her problems. Or your dad's always had a problem going to the bathroom, or she she's skipping out on eating because it hurts every time. You know, those are those are some things where you can be a little inquisitive,” said Khokhar.
Khokhar said he has seen some people bring in complete family trees. But that might be overdoing it. First degree relationships are mother, father, and immediate siblings. And all other relatives are second degree, he said.
“One single degree family relative with a polyp or cancer under 60 is an increased risk factor for a person or two second degree relatives. That counts as an increased risk factor."
Khokhar said colonoscopies catch 96% of polyps and cancers, and 90% of polyps can be removed at the time of the colonoscopy.
Family history is the most important data point in a risk profile, but Khokhar said people should also pay attention to warning signs like changes in bowel habits, abdominal pain, and loss of weight without trying.
