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Speaker 1: Welcome to Bill and Juliana the podcast.

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Speaker 2: Today we are talking shit. We're going to tackle many questions.

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Speaker 2: So many people have, like why is my poop green? Now,

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Speaker 2: believe it or not, thousands of people search that very question,

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Speaker 2: why is my poop green? Every day there's like twenty

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Speaker 2: to sixty thousand monthly searches why is my poop green? Obviously,

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Speaker 2: it is normal for people to panic when they see

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Speaker 2: green poop in their toilet. It's visually alarming, it's unexpected,

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Speaker 2: it feels urgent, but it's very awkward to talk about,

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Speaker 2: as we know, unless you're us and we have you,

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Speaker 2: We've got you. That's what this show is about. We

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Speaker 2: are asking the awkward questions and we're asking them to

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Speaker 2: very reputable doctors. So doctor Ruckham, one of the most

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Speaker 2: searched questions on the internet is why is my poop green?

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Speaker 1: It's unbelievable.

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Speaker 2: It's like twenty to forty thousand searches a month at least,

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Speaker 2: people wondering what is the answer to that question.

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Speaker 3: One answer is you look at leaves that you see

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Speaker 3: on the tree. What makes them green chlorophyll. So if

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Speaker 3: there is some chlorophyll in the food, like spinach, like kale,

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Speaker 3: like broccoli that could put that could put a green

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Speaker 3: tinge to it. It usually doesn't. It usually doesn't. The

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Speaker 3: most common reason is bile. Bile is made in the

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Speaker 3: liver stored in the gallbladder and is released when you

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Speaker 3: eat food. Bile helps us digest and absorb fat. If

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Speaker 3: things are going through you rapidly, the bile, which is

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Speaker 3: what normally changes from green to turn stool brown. That's

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Speaker 3: what makes brown stool. If it's going through you rapidly,

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Speaker 3: it'll come out green. So most people that see green

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Speaker 3: in their stool, it's usually liquidy and it's benign doesn't

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Speaker 3: mean anything.

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Speaker 4: I mean, it can be part of an infection.

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Speaker 3: If you have like salmonel or chagel and stuff is

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Speaker 3: running through you, it could come out greenish, But then

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Speaker 3: you know you're sick. You don't feel good, you're going

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Speaker 3: multiple times, you may have a fever. But the general

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Speaker 3: person that sees it, it's benign. It's nothing. It should

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Speaker 3: just go away in a day or two. I mean,

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Speaker 3: obviously if something didn't go away for days, then you

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Speaker 3: would check it out.

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Speaker 4: Green stool is nothing to worry.

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Speaker 5: The cereal loops or fruit loops, one of the two yeah,

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Speaker 5: well anything they would have a yeah, but that would

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Speaker 5: But it's bottom.

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Speaker 4: Line is green isn't anything to be worried about.

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Speaker 2: Got it?

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Speaker 3: You want to know what we should be concerned about. Okay,

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Speaker 3: So if somebody had clay colored stools, not just a

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Speaker 3: day an if anything could happen for a day or two.

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Speaker 3: But suddenly you have clay color stools where there's no brown,

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Speaker 3: usually that means there's there could be some blockage of

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Speaker 3: the bile coming through, because bile turns it brown. And

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Speaker 3: you know, as we get older, it may mean nothing.

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Speaker 3: But if it's a new normal, the urine could start

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Speaker 3: getting darker, the eyes could get yellow. That could be

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Speaker 3: a sign of liver disease, to be a sign of cancer,

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Speaker 3: be a sign of a gallstone blocking, but that requires

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Speaker 3: medical attention. Clay colored stools that are lasting for.

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Speaker 1: A while, okay, so not green green spine.

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Speaker 2: So if it's solid and green, it might be you

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Speaker 2: just had too many fruity pebbles.

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Speaker 4: Correct, and it should go away in a day or two.

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Speaker 5: And how often should we check our stool, like after

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Speaker 5: every movement, you know, as you recommend taking a look

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Speaker 5: making sure it's okay.

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Speaker 1: Always well, can you not look at your stool? Well,

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Speaker 1: look at it all the time.

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Speaker 4: I don't know all the time.

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Speaker 3: Yeah, I mean everyone's got their own personality. You could

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Speaker 3: be compulsive. Yes, you don't need to look at it,

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Speaker 3: but people would tend to know if something doesn't feel

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Speaker 3: right or if they saw blood in the toilet bowl. Now,

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Speaker 3: I mean you want to talk about other colors. Yeah,

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Speaker 3: all right, what about black stool?

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Speaker 4: That's a scary one.

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Speaker 3: Okay, well, but you got to know. So if you

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Speaker 3: have like black and a formed regular bowel movement, that

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Speaker 3: usually means nothing. Can mean you have an iron pill.

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Speaker 3: You mean you took pepto bismo that can turn stool black,

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Speaker 3: But formed and black usually means nothing. Where the concern

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Speaker 3: is if it's black like tar, like when you see

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Speaker 3: them pouring tar on the street, where it's loose and mushy,

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Speaker 3: that can be a sign of GI bleeding.

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Speaker 4: Everybody will see some blood on the toilet paper once

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Speaker 4: in a while.

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Speaker 3: Yes, get irritated you had a hard stool. You don't

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Speaker 3: want to overreact. But you know, now, with this stuff

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Speaker 3: that we mentioned about colon cancer between twenty and forty

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Speaker 3: nine going up, we got to be careful as doctors

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Speaker 3: when someone comes in and says, I see red blood that.

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Speaker 4: We just don't blow it off.

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Speaker 3: That it's a hem Right, did it happened once twice

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Speaker 3: and then you haven't had it again and you're twenty

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Speaker 3: five or thirty. Fine, if you're fifty and you saw it, hey,

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Speaker 3: have you had your colonoscopy, because it's probably hemorrhoid. But

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Speaker 3: if you haven't had it, come on, let's just do

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Speaker 3: it's get it done. And if you had it a

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Speaker 3: year or two ago or three ago, I'm not worried

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Speaker 3: because you've been checked.

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Speaker 4: Everyone's worried. It's cancer. It's rarely cancer.

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Speaker 3: It's usually something else, colitis and illustmation, something more.

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Speaker 4: But it's time to check it out.

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Speaker 1: So clay, green, black, we've covered a lot.

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Speaker 4: Red is the least worrisome.

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Speaker 2: Green mean, you got to layer off the and some

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Speaker 2: lucky charge. And you know what else has given me

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Speaker 2: green poop now that I think about it is gummy bears,

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Speaker 2: just like any s and all the fake die stuff.

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Speaker 5: I did it at fifty. You did it a little

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Speaker 5: bit before you were fifty. And you know, colonoscopies obviously

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Speaker 5: are so important and Juliana being a breast cancer survivor,

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Speaker 5: we know the importance of early detection and that's everything.

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Speaker 5: And now we're starting to read that colon askabis are

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Speaker 5: being done at earlier and earlier ages. What's the story

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Speaker 5: set us straight?

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Speaker 3: Well, between twenty and forty nine years old, colon cancer

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Speaker 3: now is the number one cancer. It always was breast

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Speaker 3: cancer for years, and now it's affecting younger people. With

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Speaker 3: that in mind, the prior recommendation to start at age

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Speaker 3: fifty was lower to forty five, and even then we're

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Speaker 3: going to miss some. But you know, it's still not

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Speaker 3: a common thing, and we don't want people to unnecessarily

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Speaker 3: get worried, but it's something to be aware of.

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Speaker 2: I'm sure people ask you, what do you think the

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Speaker 2: reason is that the age is getting younger and now

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Speaker 2: it's the number one leading cancer in that age group.

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Speaker 3: None of us really know, but if you're going to

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Speaker 3: make a suspicion, I got to believe it's something in

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Speaker 3: our diet, the food, the plastics, the preservatives, the antibiotics

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Speaker 3: that animals get hormones. It's got to be something in there.

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Speaker 5: So one thing a lot of people are talking about

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Speaker 5: is some of these alternative options to colonoscopies, whether it's

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Speaker 5: the Coli Guard or the at home test. Now there's

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Speaker 5: even a blood test. There's some pill you can take, right,

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Speaker 5: I think that that's happening. So tell us about the

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Speaker 5: alternative options and how effective are they.

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Speaker 3: Yeah, so you know, in general, there's an old saying

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Speaker 3: the best test is the one you do.

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Speaker 4: It's better than doing nothing.

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Speaker 3: But if we look at it objectively, colonoscopy is the

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Speaker 3: most accurate. It can find polyps and you can remove

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Speaker 3: them at the same time, and if it's normal, you

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Speaker 3: don't need it for ten years. But if someone says

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Speaker 3: I don't want to do it, or they want to

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Speaker 3: be checked, but they're seventy eight years old and they're

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Speaker 3: a little more fragile, but they don't want to do

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Speaker 3: nothing than something like Coli Guard, which is a stool

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Speaker 3: based test. The company mails it to your home, You

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Speaker 3: put the stool in, and you mail it back. They

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Speaker 3: look for about ten different altered DNAs in the stool

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Speaker 3: and some blood and it's very effective for picking up

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Speaker 3: coal and cancer. It'll pick up about ninety two percent

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Speaker 3: of coal and cancer. But that's already getting late. We

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Speaker 3: want to pick it up in the pre cancer. When

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Speaker 3: it's a power it's picking up cancer hopefully at the

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Speaker 3: earlier stage. But again it's more accurate for the more

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Speaker 3: advanced colon cancer.

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Speaker 4: Maybe a little less, a little late to the party,

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Speaker 4: but it's better.

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Speaker 1: Than doing nothing nothing right, that's a good point.

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Speaker 3: We also just did the there's fitka with the fecal

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Speaker 3: immunochemical tests.

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Speaker 4: I don't know.

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Speaker 3: That's just a regular stool based test. That's a little

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Speaker 3: cheaper than coali guard. The actors can even do it

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Speaker 3: in their office. But if that's negative, that should be

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Speaker 3: almost every year.

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Speaker 4: Got it? Okay?

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Speaker 5: We did the perneval full body scans. Is that something

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Speaker 5: that could pick up anything with the colon or I

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Speaker 5: don't know. I guess it's scanned or colon too. Right,

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Speaker 5: We had to tow.

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Speaker 4: Those tests.

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Speaker 3: I mean, you might just like any cat scan, pick

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Speaker 3: up a growth in the stomach or colon.

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Speaker 4: It would have to be have some bulk to it,

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Speaker 4: you know, an early flatter one it might not pick up.

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Speaker 3: But if there was bulkiness to the tumor in the

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Speaker 3: colon or stomach or esophagus, it might see it.

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Speaker 2: Doctor Bork, And let me ask you this on the

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Speaker 2: note you were saying before about the different tests you

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Speaker 2: can do. So, for instance, like breast cancer, right, they

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Speaker 2: don't recommend mammograms until a certain age for women. So

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Speaker 2: as a breast cancer survivor, I always tell younger women

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Speaker 2: at least at the very least, do self exams, right,

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Speaker 2: and then the yearly exam with your obgyn. For you

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Speaker 2: younger people listening who are maybe too young for the colonoscopy,

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Speaker 2: but are still want to stay on top of their health.

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Speaker 2: They want to be proactive. They've heard of people getting

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Speaker 2: colon cancer in their twenties and thirties. So someone of

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Speaker 2: their twenties and thirties listening right now, would you recommend

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Speaker 2: maybe one of those blood tests.

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Speaker 3: So to do it before the approved age of either

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Speaker 3: forty five or younger. If there's a family history of

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Speaker 3: polyps or cancer.

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Speaker 4: May not be covered by insurance, right, because it's meant

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Speaker 4: for as a.

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Speaker 2: The colonoscopy want to be covered, or the colon guard

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Speaker 2: or the oh okay or the shield.

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Speaker 3: So you may say, hey, look, I'm willing to pay

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Speaker 3: out of pockety okay, but it may not be covered.

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Speaker 3: The stuff that you could do if you see your

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Speaker 3: primary care doctor. They could do a stool test in

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Speaker 3: their office, and that's at least a way to say,

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Speaker 3: is there some blood in there?

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Speaker 1: Okay, got it? So that could be something that could

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Speaker 1: be also preventative.

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Speaker 3: Yeah, and maybe things will change, you know, you know

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Speaker 3: if some of these costs come down. But everything you're

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Speaker 3: doing doing, the earlier you do it where there's more

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Speaker 3: likely to be normal than a positive may have a

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Speaker 3: greater chance of being a false positive.

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Speaker 2: And also back to the colonoscopy prep. There's the liquid, right,

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Speaker 2: the liquid prep. And then now people talk about too

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Speaker 2: they take.

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Speaker 4: Pills, pills.

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Speaker 2: Are the pills as effective as getting the full cleanse

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Speaker 2: as a liquid or I imagine liquid would probably be

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Speaker 2: more effective.

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Speaker 4: The pills are very effective.

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Speaker 3: The older ones that were around maybe ten years ago

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Speaker 3: had phosphors in it, so you got to be very

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Speaker 3: careful that people drink a lot because they could cause

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Speaker 3: kidney stones, okay if you had an underlying problem. The

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Speaker 3: ones today are safe. They're very safe, they're very effective,

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Speaker 3: and we use them all the time. The only negative

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Speaker 3: sometimes is the COPEI can be a little higher for

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Speaker 3: people when they go to buy. But you also got

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Speaker 3: to know two it's to me, it's as effective as

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Speaker 3: the liquid. But when you do it, you're taking twelve

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Speaker 3: pills times two. So when you do it, but if

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Speaker 3: you're doing it with water, there's no funny salty tape.

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Speaker 3: Take the pill with water, pill with water, the pill

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Speaker 3: with water four times, then fifteen minutes later you do

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Speaker 3: another four. Fifteen minutes later you do another four and

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Speaker 3: then you just drink water, buckle up, and then you

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Speaker 3: wait and then when you would do the second one,

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Speaker 3: which usually we tell people five to six hours before

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Speaker 3: the procedures schedule. That's why we delay the second dose.

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Speaker 3: We want any mildew and debris that builds up overnight

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Speaker 3: to be flushed out right before then you do that again. Wow,

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Speaker 3: that's essentially the same timing as the liquid.

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Speaker 5: I want to get my hands in case I need

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Speaker 5: to lose a few pounds, I'm gonna just run through

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Speaker 5: the twelve pills.

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Speaker 4: Some trim up from myself.

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Speaker 1: Will do that.

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Speaker 4: I'm kidding.

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Speaker 5: Knowledge is power, I think you know. That's the one

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Speaker 5: thing we always talk about on this podcast. See your doctor,

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Speaker 5: get checked regularly, ask questions, your own best advocate when

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Speaker 5: it comes to your medical health. And I think this

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Speaker 5: has been really helpful, so thank you. I know that

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Speaker 5: you're a busy man. You're doing literally thousands of colonoscopies

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Speaker 5: every year, which is incredible.

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Speaker 3: So you know, the most important thing is not to

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Speaker 3: be overly don't get overly worried, but don't ignore something.

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Speaker 3: Use your common sense, use your heart. You know when

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Speaker 3: you're not feeling right.

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Speaker 2: And the early detection is the most important thing, right

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Speaker 2: because when you can catch something.

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Speaker 1: Early, correct in anything, that's the name of the game.

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Speaker 1: Early detection. Well, thank you.

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Speaker 4: I have learned so much to thank you so much,

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Speaker 4: doctor Ruckham.

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Speaker 2: I can't believe how much I've learned. This is amazing.

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Speaker 2: Thank you so much. I hope everyone is learning a

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Speaker 2: time today.

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Speaker 5: We'll have you back again soon.

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Speaker 1: Yes, thank you, Thank you, doctor Ruckholm. Thank you.