Lotsu Health

Online Medical Advice by Dzi, MD


Blood in the stool


I often times am asked whether or not a small amount of blood in your stool is normal or whether it’s concerning when the blood is bright red and/or it was only a couple of drops noted on the toilet paper (a long time ago) or in the commode or on the stool.
My answer to questions relating to blood in the stool is that it is not normal. A drop of blood in the stool indicates a need to be evaluated by a health care professional immediately. While it is very possible that the blood in your stool is due to hemorrhoids or a small tear, it is also possible that the blood in the stool may be indicative of a bigger problem than needs to be formally diagnosed. Even if an individual is considered to be healthy and fit, there still may be a risk that the blood in found in the stool is due to colorectal cancer. I’ve diagnosed colorectal cancer in marathon runners, vegetarians, people born in Asia and Africa, along with those who may be considered as unhealthy. Based on growing evidence and my personal practice, more younger persons without a family history of colon cancer are being diagnosed with polyps and/or colorectal cancer. While there are those who are at a higher risk of colon cancer, being a person of younger age does not mean you cannot be diagnosed with colorectal cancer. The youngest patient that I diagnosed with colon cancer was age 19. Remember, it is quite possible for you to have both hemorrhoids and something more serious like colon cancer or other diseases within the colon. Because these things are not mutually exclusive, I recommend that every person who has blood in the stool be evaluated by a physician as soon as they can and be referred for colonoscopy.

Some evidence-based guidelines and recent data for you to look up for yourself:

1.  American Cancer Society recommends colorectal cancer screening at age 45 https://www.cancer.org/health-care-professionals/american-cancer-society-prevention-early-detection-guidelines/colorectal-cancer-screening-guidelines.html

2. American College of Gastroenterology recommends that African-Americans be screening for colorectal cancer starting at age 45 https://gi.org/guideline/colorectal-cancer-screening/

3. ASGE position on Latino-Americans less likely to be screened and second-most diagnosed with colorectal cancerhttps://www.asge.org/docs/default-source/importfiles/ed-yourself-hispanic-americans—final—1-20-08.pdf

4. In Asian-Americans, cancer alone is the #1 cause of death. Asian-Americans have lowest colorectal cancer screening rates https://www.ncbi.nlm.nih.gov/pubmed/23991947

Some general articles below for your perusal:

Read Sarah’s story… https://www.nytimes.com/2017/03/16/well/live/what-young-people-need-to-know-about-colon-cancer.html




Follow Your Gut Blog


Dzi, MD


Digestive Health Common Myths by Dzi, MD


“Gunk” builds up in our gut over time and we must ‘detoxify’ or ‘cleanse.’

I hear this all the time and always causes me to laugh when I hear it. I do colonoscopies nearly every day and the gunk that people believe is there is fecal matter, which is easily cleared out with a laxative that we give prior to the procedure. The origin of this myth goes back a couple centuries where people believe that fecal matter within gut causes your body to rot and if you don’t have regular bowel movements, you get sick. Truth be told: yes, it’s healthy to have regular bowel movements but there is a range from one bowel movement every three days to 2 to 3 bowel movements in one day. This is all considered healthy and if your bowel movements don’t fall into this range, you should see your primary care physician who may refer you to a gastroenterologist.

My advice is to avoid these expensive cleanses and focus on increasing fruits and vegetables in your diet as these fibrous foods are natural ways to cleanse your body by promoting healthy gut bacteria and facilitating regular healthy bowel movements. These expensive cleanses are merely just water or whatever liquid agent these facilities choose to instill in your rectum or colon. You can do this yourself simply with water, healthy green vegetables, and fruits. Save your money!

Follow Your Gut! 

‘Eating multiple small meals throughout the day speeds up your metabolism.’


Your metabolism is the rate you burn calories. Remember that, the rate you burn calories. You cannot change the rate you burn calories by eating small meals or frequently. Everyone’s metabolism has what’s called a basal metabolic rate and this refers to how fast you burn calories over the course of 24 hours. Everyone has his or her own metabolic rate that is determined by his or her age, genetics, lean muscle mass, and hormonal levels. If you eat 10 snacks that yield 1500 cal and eat one meal that yields 1500 cal, it’s all the same. Weight loss is a simple equation and that is a deficit determined by CALORIES IN=CALORIES OUT on a weekly basis. There are so many people that try to have a deficit one day only to make up the following day with a surplus. Thus, the net difference is no weight loss! You cannot rob from Peter to pay Paul! Gender differences: metabolism in males and females are quite similar. The reason why some people believe males burn faster or have a higher metabolism than females is because males in general are larger humans with more muscle mass. Here’s an example: a 180-pound female compared to a 150-pound male, on average, 180-pound female will have a higher metabolism. Now, if that 180-pound female drops down to 140 pounds, her metabolism generally will be lower than the 150-pound male. Yes, you guessed it weight loss alone can slow your metabolism and the best way to boost it is making sure when you lose weight that you maintain lean body muscle mass!!

Follow Your Gut!


Dzi, MD