When Sarah would take her job clients to dinner, she would don long-sleeved shirts — even on summer nights.
She would order the blandest and mildest meal on the menu, and barely touch it.
When Sarah was 17, she was diagnosed with Crohn’s disease, an immune disorder where the body is not tolerant to healthy bacteria and sends white blood cells into the intestines, leading to inflammation.
She lost about 25 pounds. At five feet three inches tall, she weighed nearly 90 pounds. For her to be able to eat, doctors inserted IV tubes in her arm. She hooked the tubes every day to a machine that provided her with the needed nutrients.
“It’s difficult,” said Sarah of Pinecrest, now 34. “I was always trying to hide the tubing in my arm because people didn’t know what I was going through. For the sake of my job, I would try to make it look like I was eating. Like I was OK.”
Sarah is not alone in her struggle with an inflammatory bowel disease. About one million people in the U.S. have an inflammatory bowel disease, according to the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Inflammatory bowel disease is an umbrella classification of several diseases caused by an immune disorder that leads to inflammation in the intestines. According to the Centers for Disease Control and Prevention, Crohn’s disease and ulcerative colitis are the most common types of inflammatory bowel disease, and are conditions that can lead to colon cancer.
To prevent colon cancer, people get colonoscopies. A video chip inside a small tube inserted into the colon transmits an image on a screen. Doctors look for polyps, or three-dimensional bulges in the colon, that may lead to colon cancer.
But with ulcerative colitis and Crohn’s disease, patients often develop flat abnormalities in the inner-intestinal lining, or mucosa. That makes them difficult to detect through a regular colonoscopy, as the colon is about 70 centimeters long and the growths could be smaller than a centimeter, said Dr. Daniel Sussman, gastroenterologist at the Division of Gastroenterology at the University of Miami Miller School of Medicine.
“That is kind of like looking for a needle in a haystack,” Sussman said. “You are looking for one very small abnormality in a large surface area.”
In the past couple of years, however, new colonoscopy techniques have been introduced to detect potentially cancerous flat areas in the colon. While doctors at UM’s Division of Gastroenterology use chromoendoscopy to ink the colon, doctors at Memorial Healthcare System in Hollywood use high-definition optical images, allowing them to see abnormalities not easily detected before.
“It’s just like watching your TV in standard resolution versus high resolution,” said Dr. David Weiss, gastroenterologist at Memorial Healthcare. “It gives you better resolution for seeing smaller and flatter polyps. I think we are seeing more polyps that in the past would have been more difficult to see.”
In chromoendoscopy, a procedure during a colonoscopy, ink is flushed in the colon through the endoscope, temporarily dying the pits of the mucosa with contrasting colors to help doctors identify potentially cancerous areas, Sussman said.
Now, they would know from where in the colon to take the biopsy.
“Using this dye allows you to take this biopsy almost as if you are seeing that needle in the haystack, instead of just randomly looking for it,” Sussman said.
When Sarah had a colonoscopy last October, doctors used the chromoendoscopy technique and did not detect any cancerous areas. For the past six years, her Crohn’s disease has gone into remission thanks to a bi-monthly shot.
But, she said, now that she is a mother of 1-year-old twins, the threat of colon cancer is something she takes even more seriously.
“No one wants to develop cancer. It’s not something that I ponder over every day. But it’s always in the back of your mind,” she said. “Chromoendoscopy definitely puts that fear at ease, knowing that this new technique is being used that is more specific and more efficient.”