Dr. Dean Xerras, MD

Blood in the stool is scary, but it is usually caused by hemorrhoids, which are dilated veins in the rectum or anus. Other causes of blood could be an infection or cancer. It is important to call your doctor if you see any signs of blood in your stool.
 
Transcript: "Hey, there. I just wanted to talk a little bit about blood in the stool. Certainly, when you see it, it's scary. And, you know, the first thing you need to kind of consider is when you see something that's red in the stool, is it blood? Sometimes you can see red stool and it's from diet. Sometimes you can eat beets and they can actually cause your stool to look like there's blood in it. So you want to make sure that it is blood. There are tests you can buy to kind of confirm that in the pharmacy. Certainly, when you see red stool or something that you think is blood, give a call to your doctor. They need to evaluate you. But the most common cause of blood in the stool, actual blood in the stool would be a hemorrhoidal bleed. So when you have hemorrhoids, it's a dilated vein in the in the anus or the rectum, they get dilated from increased pressure, increased intraluminal pressure in the colon. Sometimes that's related to dietary changes from you know decreased fiber content. So when you're constipated, you kind of push that vein to kind of get swollen. It's called a hemorrhoid and it's the most common cause of blood in the stool. Other causes would be infection. You can get an infectious diarrheal illness that can cause blood in the stool. That's one other relatively common cause. And then another cause, but not as common, would be cancer. So anytime there's blood in the stool, you need to go give your doctor a call. They need to do some tests to evaluate you. But by far the most common cause of blood in the stool would be a hemorrhoid. Thanks for the question."

Metformin has been used to treat diabetes for decades and has been found to reduce the incidence of cancer, cardiovascular disease, cognitive decline, and dementia. While there is still more research that needs to be done, it is thought that metformin could potentially lead to longevity benefits for those without diabetes.
 
Transcript: "So how does metformin contribute to longevity? This is a fascinating question, and there's been a lot of buzz around metformin over the past few years. You might have seen headlines about metformin being the next wonder drug. Metformin has been around for a couple of 100 years. In the 1950s, it was used for treatment of diabetes in Europe. And in 1995 the FDA approved this use in the United States. So this is a drug that I use all the time in patients with type 2 diabetes. It works really well at lowering blood sugar for those who cannot do it with diet and exercise alone. It essentially helps the body utilize its own insulin. It makes it more sensitive to the glucose that the body is seeing, and then it helps to metabolize that glucose. Thereby, decreasing the insulin that's used in the body, so sort of sparing the insulin and protecting the pancreas for years to come. With its extended use over many decades in the United States and in Europe, it has been studied. In-patients with type 2 diabetes who are taking metformin. We've noticed that they have lower rates of cancer, that they have lower rates of cardiovascular disease, or lower rates of stroke and heart attack. They also have lower rates of cognitive decline, and lower incidence of dementia. So these are things that obviously lead to longevity. And if those rates are reduced, people with metformin who have type 2 diabetes will hopefully live longer. The question now comes as to whether patients who do not have diabetes can be given this medication to offer those same benefits. The jury's still out. This is where there's evidence that hasn't really proven that patients without diabetes taking metformin have the same benefit. But believe me, this is an area that's being studied, and we're hoping that we'll see some results about whether metformin does impact longevity for patients who do not have type 2 diabetes. So Kevin, thanks for the question. Great one. Thanks."

It is a scary time right now, with many viruses spreading throughout the world. The best way to protect yourself is to learn as much as you can about these viruses, speak with your physician and other trusted health care professionals, and make sure you are vaccinated if possible.
 
Transcript: "Hey, Noel. It's Dr. Dean Xerras. Thanks for the question. It's a scary time right now. We've come through a two-and-a half-year pandemic with COVID-19. We are starting to see the spread of monkeypox in the United States. And we are just recently learning of a case of polio virus in New York. So there are a lot of viruses. There's a lot of viruses in the past. There's a lot of viruses in the future that are going to be spreading. And it's a scary time. So I would just say make sure you learn about these viruses, make sure you speak with your physician, your primary care doctor, any trusted health care professionals. You know, getting information and learning about these viruses is the most important thing in terms of preventing them from spreading or from you yourself catching them. Some of these are really hard to catch and it depends on several factors and which virus it is and whether you're vaccinated or unvaccinated, which, you know, such as monkeypox, it depends on physical contact, whereas coronavirus is is is airborne. So there's a lot of things about these viruses. It's scary. Learn about them. Don't be afraid to to ask your physician, ask, again, your your trusted health care colleagues. And knowledge is power, so learn about it. Try not to worry about it. Thanks for the question."

Colonoscopy is the best way to screen for colon cancer, but other less invasive methods such as taking a Cologuard test or stool cards to check for blood can also be used. Discuss with your primary care doctor what is right for you.
 
Transcript: "Hi there. I'm Dr. Dean Xerras. Thank you, Dina for that question. There are other ways to screen for colon cancer other than a colonoscopy. And you just have to understand that there are more effective and less effective ways to do that. Colonoscopy is by far the best way to screen for colon cancer because it is a camera that certainly can see if there is a polyp that can be removed or colon cancer in early stages that can be treated quickly and effectively. If you don't want a colonoscopy, there is something called Cologuard. It's a brand name test by Exact Sciences. And it is a stool test where you collect your stool sample and it looks for cancer DNA. So the DNA is the genetic makeup of cancer. And what the Cologuard does is it looks at your stool and sees if there is any evidence of cancer or polyps. So polyp DNA, cancer DNA is detected in Cologuard. So that is a very effective, less invasive way to look for colon cancer. Other things that we do as primary care docs is give people stool cards to check for blood. There is there's blood that comes out of cancer and polyps, and that is one thing that we can look for as well. Less effective, less invasive than a colonoscopy. But again, you need to just decide what's right for you. Please have this discussion with your primary care doctor. And thanks again for the question."

Dehydration can be caused by diuretics, the elderly population and other factors. Signs of dehydration include decreased skin turgor, dry mucous membranes, dizziness, and lightheadedness. If you experience any of these symptoms, please seek medical attention.
 
Transcript: "Hey there. I'm Dr. Dean Xerras. Thanks for the question about dehydration. In the summer months, we certainly are more concerned about dehydration. We have people that are taking diuretics. We have elderly population that are more prone to dehydration. So we want people to be aware of what those signs are of dehydration. Some of the early signs of dehydration would be things such as decreased skin triggers, so things like tenting. When you raise your skin like that, if it takes a long time to go back to the normal state, that would be a sign of early dehydration. Mucous membranes such as the inner lip area or the tongue those are moist in the normal state. When those look dry, those are early signs of dehydration. Other things like later stages or later signs of dehydration, things such as dizziness or lightheadedness. Because the circulating volume-- your blood if it doesn't have enough water leads to lower circulatory volumes. And that would lead to dizziness, lightheadedness. So those are some of the signs of dehydration. Again, ask your doctor about any questions you might have. Take yourself in and be checked out if you're having dizziness or lightheadedness. If you're having any concerning symptoms of the mucous membranes or the skin as I mentioned, please seek medical attention. Thank you so much for the question. Have a great day."

Yes, you can control your cholesterol with diet and exercise, but it is important to speak to your doctor to make sure that you are reaching the targets necessary to prevent heart disease.
 
Transcript: "So I like to think of answering this question in two parts, sort of a yes but. Yes, you can control your cholesterol with diet and exercise. You've certainly aware that eating foods less in fat and low in cholesterol can lower your bad cholesterol, the LDL and your triglycerides. And things such as exercise can raise your good cholesterol, the HDL. So yes, you can control your cholesterol with diet and exercise alone. Absolutely. But it might not be enough. And so this is where you would need to speak with your primary care doctor, your cardiologist because you can control your cholesterol with diet and exercise, but it might not be enough. Again, there are targets. There are calculators that physicians use to figure out where you fall under risk of heart disease, risk of heart attack, risk of cardiac events. And so we lower your risk by reducing your cholesterol. And so there you might have a target that is not achievable by diet and exercise alone. So yes, you can control your cholesterol with diet and exercise. But you might not reach the target that you need in order to prevent heart disease, either prevent a first event or prevent a second event. So, please speak to your physician about this. This is where they will be able to help you find out what your targets are and how you can best achieve them."