After years of living with Crohn's disease and trying treatments that didn't work, Amy Marshak felt she was running out of options. The chronic illness affected her career, her energy and the everyday family moments she cherished most. At Mayo Clinic, she found a new treatment approach and renewed hope for the future.

Watch: A mom's journey beyond Crohn's disease and back to the moments that matter

Journalists: Broadcast-quality video (2:35) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"I first started noticing symptoms of my Crohn's disease in the fall of 2018," Amy recalls.

She is a lawyer, a wife and a mom of two.

"It was about six months after my younger daughter was born," Amy says. "She's really never known me as a parent without Crohn's."

Crohn's disease is a chronic inflammatory condition that can cause abdominal pain, weight loss and digestive issues.

"It's really difficult day-to-day living with Crohn's because of the amount of pain I experienced," Amy says. "It really felt like I could do one or the other, be a lawyer or be a mom, to have the energy to do either of those things."

Amy had a portion of her colon and small bowel removed, then went through a series of medications.

"Some of them worked for a short period of time, and then I developed antibodies to them and would never work again," Amy says. "I was sort of at the end of all the options that exist because my Crohn's disease is spread throughout my small intestine."

Months turned into years.

"I worked so hard to find a solution to make Crohn's disease livable but felt no closer to a solution than I was before," Amy says. "I did some research, spoke with my doctor, and they suggested coming to Mayo Clinic." 

In July 2024, Amy traveled to Jacksonville, Florida, to meet Dr. Jana G. Al Hashash, a Mayo Clinic gastroenterologist.

"She really did want something cutting-edge and something different," recalls Dr. Al Hashash, who has collaborated closely with colleagues, including Dr. Ernesto Ayala, a hematologist and oncologist, to treat refractory Crohn's disease.

"What we're performing here is a newer protocol," says Dr. Al Hashash. "This stem cell transplant program is for patients like Amy who have failed multiple medical therapies and whom we want to try to reset the (immune) system."

The process uses chemotherapy followed by the body's own stem cells to reset the immune system and reduce the effects of Crohn’s disease.

"If Crohn's disease comes back, we'd like to see that it's coming back weaker than it was before, with less inflammation and less impact on the body," says Dr. Al Hashash.

"This was really both the best and the only option there was, and that there was another option that had such promise was really exciting," Amy says.

In addition to getting back to her family and career, Amy had another milestone in mind: to be able to sit through a whole family dinner without pain.

"I love family dinners," Amy says. "I think they're a wonderful way to connect with my kids. It just feels frustrating not to be part of that family moment."

Amy's treatment began in early 2025 and kept her in the hospital for nearly two months. She recorded herself reading bedtime stories to her children nightly, who were nearly 1,000 miles away.

About 100 days after treatment, tests confirmed that the stem cell transplant was successful.

"Amy is a beacon of hope for people with Crohn's disease who failed multiple therapies," says Dr. Al Hashash. "She's done fantastic."

Amy's care team continues to monitor her progress. Since returning home, Amy has been able to get back to the things she loves, starting with that family moment around the dinner table.

"I'm excited to be able to play with them more, to be with them more, to have more energy for their projects and ideas," Amy says. "And also, to be able to balance work-life in a way that I haven't been able to balance in the past few years because of my Crohn's."

The post A mom’s journey beyond Crohn’s disease and back to the moments that matter (VIDEO) appeared first on Mayo Clinic News Network.

Mayo Clinic oncologist explains risk factors, treatment considerations for patients under 50

PHOENIX — You may have heard that colorectal cancer is increasingly affecting young adults. However, it is not the only gastrointestinal (GI) cancer that doctors are diagnosing in patients below the age of 50, explains Christina Wu, M.D., an oncologist at Mayo Clinic Comprehensive Cancer Center in Arizona.

"People under 50 are not too young to develop gastrointestinal cancers," Dr. Wu says. "If young adults notice new or persistent symptoms, it's important to get them worked up."

At Mayo Clinic, early-onset gastrointestinal cancers are defined as GI cancers diagnosed in people under 50 years old. Research shows that the most common type of early-onset GI cancer worldwide is colorectal cancer, followed by stomach cancer, esophageal cancer and pancreatic cancer. Less common types of early-onset GI cancers include bile duct, gallbladder, appendix, neuroendocrine and small bowel cancers.

"More research needs to be done to understand what causes the rise in incidence of early-onset GI cancers," Dr. Wu says. "We know that certain factors can increase the risk of developing GI cancers, and early detection gives patients a better chance of successful treatment."

Risk factors

Several factors can increase the risk of developing early-onset GI cancers, including genetic conditions, chronic diseases and lifestyle:

• Lynch syndrome and familial adenomatous polyposis are hereditary conditions that are associated with an increased risk of early-onset colorectal cancers.

• Inflammatory bowel disease and primary sclerosing cholangitis can increase the risk of developing GI cancers such as colorectal cancer and cholangiocarcinoma, respectively.

• A sedentary lifestyle, obesity, diets high in processed foods, alcohol consumption, smoking and environmental exposures may be associated with an increased risk of GI cancers.

Early detection and symptoms

Recommendations for when people at average risk for colorectal cancer should be screened vary by country but generally start in their 40s or early 50s. In the U.S., colorectal cancer screening is recommended to start at age 45 for people at average risk; people with risk factors such as a family history of colorectal cancer may need to start screening earlier.

Having a primary care clinician, getting regular health checkups and discussing any health concerns with a healthcare professional can help determine what screening or tests may be needed, depending on individual risk factors.

In some cases, symptoms of early-onset GI cancers may present and be associated with specific cancer types:

• Unintentional weight loss with jaundice and pain may indicate pancreatic cancer.
• Weight loss, pain, and difficulty eating or swallowing may be linked to stomach cancer.
• A persistent change in bowel habits, abdominal pain and iron-deficiency anemia may be associated with colorectal cancer.

"Any new symptoms that are persistent or worrisome should prompt a visit to a healthcare professional to get checked out," Dr. Wu says. "If symptoms are ignored or not investigated, young adults may experience a delay between when they first experience symptoms and a cancer diagnosis. Recognizing symptoms early is important," Dr. Wu explains.

Tailoring care for younger adults  

Young adults diagnosed with GI cancers often need multidisciplinary care due to differences in cancer biology, as well as unique social and life-stage needs.

"Before starting treatment, we perform genetic testing and tumor profiling to identify mutations that may guide targeted therapies," says Dr. Wu. "These advances allow us to provide more personalized and effective treatment for our patients."

In addition, young adults may require support, such as fertility preservation and resources to navigate the emotional and practical challenges of a cancer diagnosis. Mayo Clinic's Early-Onset and Hereditary GI Cancers Program provides specialized, multidisciplinary care for this patient population.

Innovations in treatment

With advances in genetic testing and tumor profiling, cancer care teams can provide more personalized and targeted treatments, including immunotherapy in some cases, and identify patients who may be eligible for clinical trials. Analysis of the tumor helps guide treatment decisions and identify appropriate therapies.

For certain GI cancers, treatment may involve a combination of chemotherapy, radiation (including proton beam therapy) and surgery. Advances in treatment, including minimally invasive approaches and immunotherapy, are improving care for some GI cancers.

Mayo Clinic researchers have been exploring the use of artificial intelligence as an additional aid in the detection of gastrointestinal cancers such as colorectal cancer and pancreatic cancer.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Caroline Auger, Mayo Clinic Communications, newsbureau@mayo.edu

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Research identifies subtype of `hungry gut' obesity phenotype

ROCHESTER, Minn. — Why do some people lose substantial weight with GLP-1-based medications while others see more modest results? A Mayo Clinic study offers a potential answer by identifying a distinct biological subtype of obesity that responds especially well to tirzepatide, a medication that mimics two naturally occurring hormones involved in appetite and blood sugar regulation, moving the field closer to precision medicine for obesity.

The research, published in Gastroenterology, identified a subgroup of patients with obesity who produce lower levels of natural appetite-regulating hormones, experience faster stomach emptying and report greater hunger after meals. This is a subtype of the "hungry gut" obesity phenotype, characterized by an abnormal duration of fullness. People with hungry-gut obesity may eat normal portion sizes but snack more frequently.

These patients lost nearly twice as much weight after six months of tirzepatide treatment as patients with other obesity subtypes.

"Obesity is a complex disease driven by different biological mechanisms," says senior author Andres Acosta, M.D., Ph.D., a gastroenterologist and the Delaney Family Director of the Nutrition Obesity Research Program at Mayo Clinic in Minnesota. "Our findings suggest we can begin identifying which patients are most likely to respond to specific therapies rather than treating obesity as a single disease."

Researchers studied 483 adults with obesity and found three different biological types of the disease. About 1 in 4 participants produced lower levels of GLP-1 and other hormones that help people feel full after eating. Patients in this group lost an average of 21.5% of their body weight after six months of treatment with tirzepatide, compared with 11.7% for patients in the other groups.

The findings support growing efforts to personalize obesity treatment using an individual's underlying biology rather than relying on a one-size-fits-all approach. Because obesity increases the risk of diabetes, heart disease, certain cancers and many other serious chronic conditions, identifying the right therapy sooner could improve long-term health outcomes.

The researchers also found that the reduced hormone levels were associated with decreased hormone production in the intestine rather than differences in the gut microbiome, providing new insight into the biology underlying this subtype of obesity.

The authors caution that prospective studies are needed before this approach can be incorporated into routine clinical practice, but these findings represent an important step toward more precise, individualized treatment for obesity.

For financial disclosures and other details, please see the paper.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

The post Study identifies patients with obesity most likely to benefit from GLP-1-based treatment appeared first on Mayo Clinic News Network.

A routine screening turned into a life-changing diagnosis for Angela Tripido. After learning she had stage 4 colorectal cancer that had spread to her liver, she faced months of treatment, multiple surgeries and uncertainty about what came next.

When the cancer returned, a liver transplant offered a new path forward.

Watch: A routine screening reveals stage 4 cancer, leads to life-changing transplant

Journalists: Broadcast-quality video (2:35) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

Screening

"I have lived a super healthy life. You know, always been an athlete, always working out," says Angela.

"I ended up having my, what I would just call, 50th (birthday) screening colonoscopy. The nurse said, 'The doctor will be over in a minute. We're just getting your husband.' I knew immediately that wasn't good," she says. "(The doctor) showed us some pictures and said, 'You have stage 4 colorectal cancer."

Additional imaging showed the cancer had spread to her liver.

Near her home in South Florida, Angela began treatment with chemotherapy and a series of surgeries to remove tumors.

But the cancer returned.

"(Another institution) identified some recurrent lesions in the liver," says Dr. Kris Croome, a Mayo Clinic transplant surgeon. She was not felt to be resectable because she didn't have adequate liver left."

That's when Angela turned to Mayo Clinic for another option.

"She was an excellent candidate for our liver transplant," says Dr. Croome. "She was otherwise a very young, healthy person, and so we felt that if we were able to do a liver transplant, we would be able to clear her of her disease."

"As scary as everything was that was on the plate of what was coming, I want to live, and I want no tumors in me," says Angela.

The wait

Once Angela's disease was confined to her liver and she completed a comprehensive evaluation, she qualified for transplant and was placed on the waiting list.

"My phone rang," Angela remembers. "The voice on the other end said, 'I'm calling to see if you are interested in liver that we believe will be a perfect match for you.'"

After an anxious night with little sleep, transplant day arrived on July 7, 2025. She remembers the final moments with the surgical team before the procedure began.

"I always say to the team, right before they put me under, 'Thank you all for taking really good care of me.' And there was this nice gentleman next to me, one of the nurses, and he was like, 'We've got you, don't worry,'" says Angela.

Good news

The surgery was a success.

"What the transplant has given me is there's a lot more hope for longevity — not having chemo in me, quality of life," says Angela.

Nearly a year after her transplant, Angela is getting back to the life she loves. She and her husband have celebrated their 30th wedding anniversary. They're traveling again and raising awareness in the community.

"We were involved in a charity run locally to promote screening for colon cancer with one of the local health groups, and had the opportunity to run into her," says Dr. Croome. "Just to see her out and about enjoying her life disease-free, I think, really is why we do all this."

Angela also carries deep gratitude for the organ donor who made it possible.

"You can give someone a chance at a longer life and a healthier life, and that's a miracle," she says. "I will be writing that letter and thanking that family, and I hope they know what it's given me."

Related stories:

• How innovation is shaping the future of transplant care (VIDEO)
• Mayo Clinic Q&A: What is life like after an organ transplant or donation?
• Mayo Clinic Minute: How liver transplant is transforming care for patients with advanced colorectal cancer

The post A routine screening reveals stage 4 cancer, leads to life-changing liver transplant (VIDEO) appeared first on Mayo Clinic News Network.

The findings offer new insight into how the immune system and gut microbiome interact in this chronic condition and point to potential new therapeutic strategies.

IBD, which includes Crohn's disease and ulcerative colitis, affects millions of people worldwide. The condition is driven in part by the immune system reacting to normally harmless bacteria in the gut, reflecting a breakdown in what is known as immune tolerance. Symptoms of ulcerative colitis and Crohn's disease usually include belly pain, diarrhea, rectal bleeding, extreme tiredness and weight loss.

While many current therapies focus on reducing inflammation, less is understood about how to restore balanced interactions between the immune system and the gut microbiome.

"This study suggests vitamin D may help rebalance how the immune system sees gut bacteria," says lead author John Mark Gubatan, M.D., a gastroenterologist at Mayo Clinic in Florida. "That's an important step toward understanding how we might restore immune tolerance in IBD."

In the study, researchers evaluated 48 people with IBD who had low vitamin D levels. Participants received weekly vitamin D supplements for 12 weeks. Blood and stool samples collected before and after treatment were analyzed using advanced sequencing to map interactions between immune responses and the gut microbiome.

Vitamin D supplementation was associated with increased levels of immunoglobulin A (IgA), which is typically linked to protective immune responses, and decreased levels of immunoglobulin G (IgG), more often associated with inflammation. The researchers also observed changes in immune signaling pathways and increased activity of regulatory immune cells that help control inflammation.

Together, these findings suggest vitamin D may help promote a more balanced, protective immune response to the gut microbiome.

Vitamin D supplementation was also associated with improvements in disease activity scores and a stool-based marker of inflammation. However, the researchers emphasize the study was small and not designed to establish cause and effect.

"We saw encouraging signals, but this was not a randomized trial," Dr. Gubatan says. "These findings need to be confirmed in larger, controlled studies."

The researchers caution that patients should not change their vitamin D use without medical guidance.

“Vitamin D is widely available, but dosing needs to be individualized, especially in patients with chronic inflammation,” Dr. Gubatan adds. “Patients should work with their healthcare team.”

This work was supported by a grant from Doris Duke Physician Scientist Fellowship Award (Grant #2021091), Chan Zuckerberg Biohub Physician Scientist Scholar Award, and National Institutes of Health (NIH) NIDDK LRP Award (2L30 DK126220). For a complete list of authors, disclosures and funding, see the study.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

The post Vitamin D linked to immune response to gut microbiome in inflammatory bowel disease appeared first on Mayo Clinic News Network.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:09) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

Polyps in the colon can vary in size and shape. Some are more mushroom-shaped, but that's not always the case. 

"Some polyps spread out more like a bed of moss; they're flat," says Dr. Wallace.

Advances in imaging and tools help care teams detect and treat difficult polyps. 

"Technology has been clearly shown to improve our ability to find more polyps and reduce the miss rate for some of these flat, subtle polyps," says Dr. Wallace. 

Early detection leads to better outcomes. 

"Stage 1 cancer, so-called T1 cancer, we can actually remove that through an endoscope or through a colonoscope, specifically, in a curative way," says Dr. Wallace. "This is something that has had profound implications for patient care." 

Dr. Wallace adds that the most important step is to get screened. 

"Whatever test you choose, get screened," Dr. Wallace says. "This is a preventable cancer. It's one of the very few cancers that we can almost completely prevent. So getting screened starting at the age of 45 — one caveat is — if you have a family history of colon cancer, you need to start even earlier."

Related posts:

• Mayo Clinic Q&A: Treating colorectal cancer with surgery
• (VIDEO) Transforming colon cancer care through precision medicine
• (VIDEO) Treatment options for advanced colorectal cancer

The post Mayo Clinic Minute: AI advances help care teams find hard-to-see colon polyps appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: Fiber has been getting a lot of attention in the news lately. What exactly is dietary fiber, and why is it important to my overall health?

ANSWER: Dietary fiber refers to the parts of plant-based foods that your body can’t digest or break down. Unlike proteins, fats or simple carbohydrates, fiber passes through the digestive system largely intact. Because your body can't digest it, fiber becomes an important fuel source for the trillions of microbes that live in your gut.

As food moves through the digestive tract, nutrients your body can absorb are taken up earlier in the process. What remains — much of which is fiber — travels to the colon, where gut bacteria use it for energy. 

Dietary fiber is often associated with digestion, but its role in the body goes far beyond keeping you regular. Fiber plays an important part in gut, heart, immune and metabolic health. Research shows that adequate fiber intake helps:

• Lower cholesterol levels and reduce blood pressure.
• Improve blood sugar control, aiding in the prevention and management of type 2 diabetes.
• Decrease the risk of colorectal cancer, stroke and chronic inflammation.
• Manage a healthy weight.
• Regulate immune responses.
• Maintain a healthy and diverse gut microbiome, which supports many aspects of overall health.

Fiber is often described as soluble or insoluble, based on whether it dissolves in water or not. However, this distinction is less important for overall health than how fiber functions in the body. A more meaningful way to think about fiber is whether it’s fermentable or nonfermentable. Here’s what this means:

• Fermentable fiber can be broken down by gut microbes and used as fuel. This process produces beneficial compounds, such as short-chain fatty acids.
• Nonfermentable fiber isn’t readily used by microbes and mainly adds bulk to your stool, which helps support regular bowel movements.

While you may hear about the benefits of taking supplements to add fiber to your diet, but fiber is best obtained from food rather than supplements. That’s because many whole foods contain a mix of different fibers, which is especially beneficial for gut health. Fiber-rich foods include:

• Fruits, such as berries, pears and apples.
• Vegetables, like broccoli, Brussels sprouts and leafy greens.
• Legumes, including lentils, chickpeas and beans.
• Nuts and seeds, such as almonds, chia seeds and flax seeds.
• Whole grains, including whole-wheat bread, oats and wheat bran.

It's important to eat a variety of these foods. The more different types of fiber-rich foods you eat, the more different types of fiber you'll get, which is optimal for your health. Making small, sustainable changes, such as choosing whole-grain bread instead of white bread or swapping chips for nuts or fruit, can add up over time.

Most adults who are in good health should aim for 30 to 40 grams of fiber per day. However, your fiber needs can vary by age and general health. For example, older adults may need to balance fiber intake with adequate calories and protein. 

As you increase your fiber intake, you may experience some abdominal discomfort, bloating and gas. To prevent or lessen these symptoms, gradually add more fiber to your diet rather than increasing your intake all at once. A helpful approach is to:

• Increase fiber intake by about 3 grams per week. This can be as easy as adding just 1/2 cup peas, squash or cauliflower; 1 cup carrots; 1 medium sweet potato; 1 cup brown rice; 3 tablespoons of shredded coconut; or 2 tablespoons of sesame seeds.
• Maintain that level for seven to 10 days before increasing again.
• Drink plenty of water, aiming for 80 ounces a day.

Slowly increasing your fiber intake allows your digestive system and gut microbes time to adapt, and any symptoms will improve after a short while.

Fiber is an essential part of a healthy diet. By eating a variety of plant-based foods, increasing fiber intake gradually and staying well hydrated, you can support gut health and overall well-being while making fiber goals more achievable and sustainable.

Purna Kashyap, M.B.B.S., Gastroenterology, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q&A: Why is fiber good for your overall health? appeared first on Mayo Clinic News Network.

Precision medicine is rapidly transforming modern healthcare. It's a personalized approach that tailors prevention and treatment to each individual — moving beyond the traditional one-size-fits-all model.

Colorectal cancer is one area where precision medicine is reshaping the standard of care for patients like Eric Minnesota. 

At 56, Eric was training for an Ironman triathlon when he got a devastating diagnosis — stage 3 colorectal cancer. 

Eric is sharing his inspiring story to raise awareness for National Colorectal Cancer Awareness Month.

Watch: Transforming colon cancer care through precision medicine

Journalists: Broadcast-quality video (3:10) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic" – Read the script.

Man on a mission

Eric has been an athlete his whole life. He's a soft-spoken man with a gentle demeanor and a never-give-up attitude that defines everything he does. "I've competitively raced mountain bikes for the last 20 years," says Eric. "I'm an outdoors person...hiking, fishing, camping, anything outdoors is what I really enjoy."

Eric's dream has long been to compete in an Ironman triathlon, one of the toughest endurance events in the world. Competitors must complete a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile run. That's 140.6 miles in one day.

"From a health point of view, I thought I was nearly at the top of my game based on my age," says the Arizona man. "I've been healthy my whole life — no surgeries, no broken bones...I've never taken a sick day from work in my 25-year career."

Toughest challenge yet

Eric was in the midst of training for Ironman Arizona. All was going as planned. Then one day, Eric began having stomach pain. He went to his doctor who delivered a diagnosis Eric never expected.

"He discovered a significant mass. He relayed to me that I should see a colorectal surgeon as soon as possible to have it evaluated and find out what the next steps should be," recalls Eric. Soon after, Eric got his official diagnosis — stage 3 colorectal cancer.

"The plan was to remove my colon and replace it with an ostomy," says Eric. An ostomy is a surgically created opening in the abdomen that allows waste to exit the body into a bag. It may be needed after colon surgery so the body can eliminate waste.

In preparation for surgery, Eric and his wife, Paula, turned to Mayo Clinic in Arizona. "The doctor at Mayo said a team of specialists would convene as a group to review my case. Mayo was quicker than I ever imagined. The following week they called me to discuss my treatment plan," says Eric.

Hope through innovation

Mayo Clinic's treatment plan included more than surgery as an option. The team explained that by using precision medicine, they were able to determine Eric was a candidate for a nonsurgical approach to treatment called immunotherapy.

"By performing genomic sequencing on the patient's blood and the tumor, we were able to identify a precision treatment approach, including immune therapies, that can sometimes allow a patient to avoid the need for complex and life-altering surgeries," says Dr. Jewel Samadder, a gastroenterologist and cancer geneticist with Mayo Clinic's Early Onset and Hereditary Gastrointestinal Cancers Program.

Immunotherapy works by using the body's own immune system to fight the cancer. The nonsurgical treatment is delivered in a series of treatments by IV infusion. "The treatment is surprisingly easy. To be truthful I feel guilty based on the type of treatment that I had for my cancer versus what other individuals go through. It's just a simple infusion that takes less than an hour start to finish," explains Eric.

Crossing the finish line

Eric crossed the finish line of his immunotherapy treatment in six months. The results were a success. A colonoscopy following treatment showed the cancer was gone. "I won the lottery," says Eric. "The stars aligned with my markers and the care team had the expertise. It was incredible. It was all a perfect fit."

"This is a perfect example of why patients come to Mayo Clinic and see multiple physicians in our multidisciplinary cancer clinics and our early-onset program so that we can understand the cause of their cancer, determine the best treatment approaches, including clinical trials, and sometimes avoid complicated life-altering surgeries when possible, as in this patient's case," says Dr. Samadder.

"As soon as we heard about immunotherapy, we had to try it. This aligned with his goals. I'm just over the moon," says Paula.

Eric was able to keep working and training throughout his treatment. He says his only side effect was mild fatigue. "We spent a lot of time together as a family. Just being able to maintain that quality of life through the treatment was irreplaceable. You just can't put a price on that," says Eric.

"We are so grateful to everyone at Mayo Clinic, especially our oncologist Dr. Christina Wu," says Paula. "I would be lost without her. Thanks to Dr. Wu, I have my husband here with me today."

Celebrating life and love

Eric is back to working on his dream of one day becoming an Ironman triathlete. "Giving up is never an option," says Eric. "You have to turn on the switch, and keep going."

As Eric and Paula celebrate life, they are also celebrating their love. "We just had our 32nd wedding anniversary. These moments, these struggles together, it all has just made us stronger." says Eric. "I'm grateful for Mayo, for everything. I came out a better person."

Related stories:

• Eric and Paula Minnesota with a special message to Mayo Clinic
• Mayo Clinic Minute: Inside a colonoscopy
• Mayo Clinic Minute: Warning signs of colorectal cancer in younger adults

The post Transforming colon cancer care through precision medicine (VIDEO) appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I’m confused about prebiotics and probiotics. Could you help me understand what they are and how they could benefit my health?

ANSWER: You're not alone in wondering about the health benefits of prebiotics and probiotics. Even the names can be confusing.

The human gastrointestinal tract houses roughly 100 trillion microorganisms (good bacteria). These microorganisms make up what's called the gut microbiome.

These good bacteria fight off bad bacteria to help keep our intestinal tract healthy. 

Probiotics: Promoting digestion, benefiting health

Let's start with probiotics. Probiotics are living organisms, also known as microbes. They're primarily bacteria and yeast whose main role is to aid digestion and improve overall health. Probiotics help strengthen the gut barrier, aid in the absorption of nutrients, and replace less beneficial or harmful microbes. 

Research shows that probiotics can treat and even prevent conditions such as gastrointestinal (GI) tract infections, irritable bowel syndrome (IBS), lactose intolerance, allergies, cystic fibrosis, urogenital infections, diarrhea, high cholesterol, eczema and certain cancers. 

Probiotics also may support dental health by treating and preventing tooth decay, periodontal disease and bad breath. 

In addition to aiding digestion, another essential role of probiotics is promoting a healthy immune system and preventing chronic diseases. 

Some examples of probiotics include fermented foods, such as certain yogurts, many cheeses, pickled vegetables, apple cider vinegar, fermented teas and sauerkraut. Probiotic supplements also are available in pill or powder form. 

Prebiotics: Feeding probiotics

Prebiotics are the food for probiotics. They help feed the probiotics through fermentation and metabolization, which are beneficial to the gut. These microorganisms contribute to a variety of processes, including cell energy, immune function, hormone regulation, anti-inflammatory responses and bowel management. 

Research indicates that high prebiotic consumption may enhance our immune system, help regulate blood sugar levels, reduce the risk of colorectal cancer and increase calcium absorption. When good bacteria (probiotics) are fed an abundance of healthful food (prebiotics), our bodies will be healthier.

Prebiotics are found in foods that contain:

• Dietary fibers, which the body doesn't fully digest.
• Resistant starches, which are a form of carbohydrate that isn't digested in the small intestine. Instead, it ferments in the large intestine. 

The most common prebiotics are inulin, oligosaccharides and pectin, which are found in fibrous foods. Foods containing prebiotics include most fruits and vegetables — especially green bananas, asparagus and onions — as well as garlic, nuts, seeds, oats, barley, potatoes, and legumes such as soybeans, dried beans, peas and lentils.

Adding probiotics and prebiotics to your diet

Food composition changes with cooking, so to get the most benefit from prebiotics and probiotics, it's important to pay attention to cooking methods. For example, boiling potatoes is better than baking them. When potatoes are boiled and then chilled, they develop a white starchy film, which is the most beneficial part. Serving beans and legumes hot increases their starch content, which is good for your gut.

Eating most fruits and vegetables while they are fresh and raw will provide healthful prebiotics. 

Researchers suggest gradually introducing these foods into your diet. Adding a lot of new foods containing prebiotics and probiotics may produce gas, cause bloating and lead to gut discomfort.

Anne Harguth, Nutrition, Mayo Clinic Health System, Waseca, Minnesota

The post Mayo Clinic Q&A: What are prebiotics and probiotics? appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — As rates of obesity, high blood pressure, type 2 diabetes and sleep apnea increase, cases of advanced chronic liver disease and resulting liver scarring or cirrhosis also are rising. Patients often are diagnosed based on symptoms, such as gastrointestinal bleeding, fluid retention or jaundice, which happen when liver disease has progressed to a late stage. This problem led Mayo Clinic researchers to develop an artificial intelligence (AI) model that resulted in twice the number of advanced chronic liver disease diagnoses in patients without symptoms, helping physicians treat them before the disease had progressed.

"Chronic liver disease is a progressive condition, so the sooner we can diagnose it, the sooner we can stop it from advancing to irreversible stages. Early intervention may decrease the likelihood that a patient will need a liver transplant in the future," says Doug Simonetto, M.D., a Mayo Clinic transplant hepatologist and lead author of the study published in Nature Medicine.

The heart and liver are closely linked. Liver scarring may lead to increased local pressure that can affect the heart. As a result, a heartbeat test called an electrocardiogram (ECG) can capture electrical signal changes in the heart connected to advanced liver disease. Dr. Simonetto and colleagues developed an AI model to analyze data from 11,513 Mayo Clinic patients undergoing routine ECGs. The model looked for patterns connected to advanced liver disease in the ECG data, and it found twice the number of patients who were diagnosed by standard methods. The diagnosis was confirmed by validated imaging or blood tests.

"As a family physician, I've often seen how advanced liver disease — which frequently has no symptoms until it becomes irreversible — can go undetected," says David Rushlow, M.D., Mayo Clinic Health System family physician and study co-author. "Many patients identified through the AI-ECG model had no idea they were living with advanced liver disease. By identifying these cases earlier, we were able to connect them to the right treatment — at a time when intervention can truly make a difference. For these patients, the technology helped us not only to uncover a diagnosis, it created an opportunity for better health outcomes and, in some cases, may have saved lives."

In this randomized clinical trial, 248 clinicians at Mayo Clinic in Rochester and throughout the Mayo Clinic Health System participated.

"The idea that a simple, noninvasive and inexpensive test could help identify patients at risk of developing advanced liver disease was very compelling. This study provided an opportunity to evaluate AI in our real-world clinical environment, where the true test of innovation is whether it improves care for patients in the community," says Dr. Rushlow. "We're only beginning to understand the full potential of AI-enabled tools like this and the promise they hold for preventive, personalized care."

In the next steps, the researchers will follow up with the patients, who were newly diagnosed with advanced liver disease, over the next two years.

The research is part of a larger effort at Mayo Clinic called the Precure initiative focused on developing tools that empower clinicians to predict and intercept biological processes before they evolve into disease or progress into complex, hard-to-treat conditions.

Review the study for a complete list of authors, disclosures and funding.  

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About Mayo Clinic 
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Media contact:

• Kelley Luckstein, Mayo Clinic Communications, newsbureau@mayo.edu

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