Gastroenterology | Mount Sinai Today

How Much Do You Know About Colorectal Cancer? Take the Quiz

Updated on Mar 4, 2026 | Cancer, Featured, Gastroenterology, Your Health

Colorectal cancer is now the leading cause of cancer deaths in the United States for both men and women under the age of 50. There are many misconceptions about the disease, and knowing the facts can help you fight it. Can you separate myth from fact? Take the quiz below, then click “Done” to see your score and correct answers.

This quiz was developed with Pascale White, MD, MBA, MS, FACG, Director of Health Equity in Action for Liver and Digestive Diseases and Associate Professor of Medicine (Gastroenterology and Liver Disease) at the Icahn School of Medicine at Mount Sinai.

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Colorectal Cancer Is Rising Among Younger People. Here’s What We Know.

Updated on Feb 18, 2026 | Featured, Gastroenterology, Your Health

Colorectal cancer (cancers of the colon and rectum) is now the leading cause of cancer death in the United States for both men and women under the age of 50. In 2018, the American Cancer Society changed their screening recommendation from age 50 to 45 because of the alarming increase in early-onset colorectal cancer (affecting those under 50 years old).

A recent study published in the Journal of the American Medical Association (JAMA) reported that colorectal cancer mortality has risen 1 percent annually since 2005, an increase that has now placed colorectal cancer as the No. 1 cause of cancer mortality in young adults. Experts don’t know why more younger people are getting colorectal cancer, but it’s clear that early-onset colorectal cancer is an important public health issue.

Pascale White, MD, MBA, MS, FACG

In this Q&A, Pascale White, MD, MBA, MS, FACG, Director of Health Equity in Action for Liver and Digestive Diseases (HEALD), and Associate Professor of Medicine (Gastroenterology and Liver Disease), Icahn School of Medicine at Mount Sinai, discusses warning signs younger people should look out for and when to see a doctor.

Why are many people in their 20s and 30s going undiagnosed with colorectal cancer?

Many young people may not have primary care doctors or are ignoring their symptoms. They may go to an urgent care center for strep throat or the flu but may be too embarrassed to discuss symptoms like rectal bleeding and may not be thinking they could have colorectal cancer. Regardless of how old you are, you should never ignore symptoms and should seek medical attention. Having a primary care doctor who could start a timely workup of the symptoms and make a referral to a gastroenterologist is critical to making the diagnosis early. The earlier colorectal cancer is diagnosed, the greater your chances are for survival.

Unfortunately, we are seeing that younger patients are being diagnosed with advanced stage colorectal cancer (stages III and IV). A majority of cases are occurring in the rectum and the distal (left) colon, which can present as rectal bleeding. That is why it is important not to delay seeing the doctor.

What increases my risks as a younger person?

While scientists do not have the exact answers, lifestyle and environmental factors are being investigated. Some studies have linked risk factors for early-onset colorectal cancer to obesity and alcohol intake. Note that these are similar risk factors for older adults too. Other risk factors include having a family history of colorectal cancer or having a hereditary condition like Lynch syndrome; not getting enough physical activity; using tobacco and eating a low-fiber diet high in processed foods.

A Colorectal Cancer Health and Screening Fair will be held at The Mount Sinai Hospital Friday, March 6, from 9 am to 3 pm. Click here to learn more.

Are certain groups more at risk than others?

Early-onset colorectal cancer is increasing in both men and women, but racial disparities exist. Although incidence among non-Hispanic white patients has shown a consistent increase, Black patients still have the highest overall incidence and lowest survival rates.

What type of family history puts me at risk?

The majority of young people who are getting early-onset colorectal cancer don’t have a family history of cancer. That said, any family history of colorectal cancer could be relevant. Knowing first-degree family history (mom/dad/brother/sister) helps your doctor determine if there is a higher risk. However, second-degree family history (aunts/uncles/grandparents/grandchildren/half siblings/nieces and nephews) can help spot potential patterns that might put you at risk. Mount Sinai has genetic counselors that can help identify these patterns.

What symptoms indicate that younger people should see a doctor?

A majority of younger people who are coming to see the doctor with early-onset colorectal cancer are symptomatic, and the most common symptoms are blood in stool and abdominal pain. Other symptoms include iron deficiency anemia, unintentional weight loss, and a change in bowel habits. Young people need to understand seeing blood in the stool (whether it is bright red blood or black stool) should not be ignored. Bleeding could be caused by something benign like hemorrhoids or something malignant like colorectal cancer. If you experience these symptoms, see a doctor as soon as possible. If colorectal cancer is caught early, your chances of survival are higher.

Should I Be Worried About Changes in My Stool?

How can I reduce my risk?

Some things may not be in your complete control. For example, we are investigating whether there are certain environmental exposures that put younger people at risk. That said, there are actions you can take regardless of age that reduce overall risk for colorectal cancer. These include eating a well-balanced diet of high-fiber foods (fruits, vegetables, nuts, legumes, and whole grains); reducing your intake of processed foods, especially processed meat; reducing alcohol intake; getting regular exercise; and monitoring any health conditions you have, such as diabetes and obesity.

What is a colonoscopy?

A colonoscopy is a safe and effective procedure where a doctor uses a camera to examine the lining of the colon and rectum for growths called polyps and/or other abnormalities, including colorectal cancer. During the examination, you are given some sedation to keep you comfortable. If polyps are found, they are removed and sent to a pathologist for evaluation. Some polyps are benign while others could be precancerous. The type of polyps removed will determine when the colonoscopy should be repeated in the future.

Will my insurance cover it?

Insurance companies cover colonoscopies for people who are 45 years and older for screening colonoscopies. A screening colonoscopy is what the procedure is called when it is being done on a patient who has no symptoms. If you are under age 45 but are experiencing symptoms, you would be sent for a diagnostic colonoscopy because the procedure is being done to find the diagnosis that would explain the symptoms. In either case, we encourage patients to communicate with their insurance company prior to procedures to ensure they will cover the cost.

How can I get a colonoscopy if I don’t have insurance?

Call your health provider to see what resources may be available for free or low-cost colonoscopies. They can help navigate patients to centers that accommodate people who do not have insurance.

Learn more about Digestive Diseases and Gastroenterology at Mount Sinai

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Should I Be Worried About Changes in My Stool?

Mar 4, 2024 | Gastroenterology, Your Health

Your stool—a very basic fact of life—is a good reflection of your health. It provides insight into the quality of your diet and, potentially, may indicate certain diseases, such as cancer. While changes in bowel habits are usually not a cause for alarm, they can indicate potential issues. How can you tell if your stool is healthy, and when is it time to see a doctor?

Pascale White, MD, MBA, MS, FACG

In this Q&A, Pascale White, MD, MBA, MS, FACG, Director of the Gastroenterology Clinic, and Associate Professor of Medicine (Gastroenterology), Icahn School of Medicine at Mount Sinai, discusses how to monitor your bowel movements for potential problems, and offers simple tips on how to eat for better gut health.

How often should I be having bowel movements and what should they be like?

Every individual has their own baseline bowel habits, which are largely affected by diet and can vary in frequency for all of us. Here are some general guidelines:

Some bowel frequencies can vary anywhere from three times a day to every other day.
Healthy stool is soft formed, typically sausage-shaped, and should be easy to pass.
The color is typically brown but sometimes varies based on what you eat. In some cases, color may indicate a potential health issue. For example, if your stool is very pale or clay-colored, it may be something you ate or could be a sign of liver disease.

What changes indicate I should see a doctor?

We all experience changes in bowel movements, and occasional changes typically do not indicate a problem. However, if you are experiencing a big change in your typical pattern, you should speak to a doctor, especially if you experience:

Stool that is black and tarry or contains red blood (indicates potential internal bleeding, hemorrhoids, inflammatory bowel disease, or colon cancer)
Hard pellet-like stools that are difficult to pass or will not pass (indicates constipation)
Bowel movements that are completely watery (diarrhea)
Stool that is pencil-thin or ribbon-like (indicates potential colon cancer, polyp, or other lesion causing narrowing of your large intestine)

What can I eat to ensure good colon health?

You should eat a lot of fiber—including fruits, vegetables, nuts, and legumes—which bulks up stool and keeps it moving along, and also produces substances your colon needs. Generally, you should eat 20 to 30 grams of fiber daily. Keep in mind that eating fiber (particularly insoluble fiber) may cause some bloating or loose stools, but it is generally well tolerated. You should also drink plenty of water to prevent constipation.

Colorectal Cancer Is Rising Among Younger People. Here’s What We Know.

What foods should I avoid?

You should avoid red meat in general, which is high in fat and does not contain fiber, and especially processed meats, such as sausage, bacon, and deli meat. The process of curing and smoking meat generates carcinogenic compounds that can promote changes in the colon cells that can lead to cancer.

What are some easy ways to include more fiber in my diet?

Here are some simple steps:

Plan your meals and prepare them in advance. For example, making overnight oats before bed is a great way to ensure you are getting fiber in the morning.
Look for ways to make easy switches to what you normally eat. When eating out, get a salad, ideally one with dark, leafy greens, instead of fries. Instead of drinking fruit juice, eat the whole fruit.
Swap white potatoes for sweet potatoes, which are higher in fiber, and leave the skin. Make sandwiches with whole grain bread instead of white bread.
For a snack, grab a bag of nuts instead of a bag of chips.
You may also find that food-tracking apps are a great way to ensure you are getting enough fiber and other nutrients every day.

What are some other ways to maintain good colon health?

Exercise, moderate your alcohol intake, and do not smoke. If you are over the age of 45, or are considered high risk for colon cancer due to health issues or family history, you qualify for a colonoscopy. The procedure not only screens for colon cancer and other potential issues, but also allows us to remove polyps that can turn into cancer. Stool tests may also help identify potential issues, though they are not as effective as a colonoscopy.

Learn more about Digestive Diseases and Gastroenterology at Mount Sinai

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The Importance of Breakfast for Your Health

Nov 1, 2023 | Diet and Nutrition, Gastroenterology, Your Health

Many of us are tempted to skip breakfast in the rush to start our day. Parents, in particular, may feel challenged getting their kids to have breakfast and make it to school on time.

In this Q&A, Stephanie L. Gold, MD, a gastroenterologist at The Mount Sinai Hospital, provides practical advice on getting a healthy start to your day—eating nutrition-packed foods and making sure to drink water. Dr. Gold, who specializes in inflammatory bowel disease, researches how nutrition affects IBD patients. However, her study of nutrition provides insights for all.

Is breakfast important for our health? Why or why not?

There are a lot of studies that have shown that eating breakfast is very beneficial for your health. It gives you energy to start the day. It helps with concentration. We’ve all seen that it’s very hard to work and focus on what you’re doing if you’re hungry. Also, when we don’t eat breakfast, it can lead to overeating later in the day. You become overly hungry, and you overindulge.

For kids, it’s vitally important that we send them to school with breakfast in their bellies. They can concentrate better and do well in their schoolwork when they aren’t thinking about how hungry they are. I suggest that parents work with their kids to find out what they like to eat. Eating together is also important. If you spend 10 or 15 minutes together to have breakfast, they see that it’s a priority and a special time. It also sets up healthy habits for a lifetime. It’s great if you can prepare something simple the night before, like overnight oats. Or if you’re going to make something more involved, like pancakes, perhaps do the prep work the night before (or on the weekend and freeze the pancakes/waffles) so it’s less stressful for you.

If your kid is a finicky eater or their tastes change, that’s ok. Ask them what they’re interested in or take a walk in the grocery store to explore new options. Try something new—different flavors or tastes—on a weekend when you have more time, and if they like it, you can introduce those during the week. I also know some families are stretched tight, and thankfully, there are also programs in school to make sure kids get breakfast.

What foods are best for breakfast?

It’s very important to have something that is high in fiber and lean protein for breakfast. The reason is to keep you full longer during the day so that you feel satiated, and you get to lunchtime without feeling extra hungry. An example I like is steel cut oatmeal or even regular oatmeal. It’s high in soluble fiber, and you can add a handful of nuts or some nut butter for some healthy fats. I also like to add some fruit for additional fiber and some sweetness. Oatmeal is a great option, as it is easily modified for your personal preferences. You can even change it up by the season. Add some pumpkin spice seasoning or some canned pumpkin in it and it becomes like pumpkin pie oatmeal. The important thing is that people don’t get bored with it.

Some people may not be able to get fresh fruit often, whether due to expense or not being able to get to a grocery store often. We tell our patients that frozen fruit is also a great option. It also simplifies food prep in the morning.

There are a lot of healthy fats to choose from for breakfast. Nuts are a great option. Some people like low-fat cheese sticks that combine protein with some healthy fats. Having an egg in the morning is always nice, as well. It’s all about balance.

Also, having water in the morning is important for hydration. It’s not just about what we eat, but also about what we drink in the morning. Coffee in moderation is fine, but since it can be dehydrating, it’s not a substitute for water.

What foods should most people avoid?

My recommendation is to avoid things that are high in sugar and heavily processed foods, as well. A sugary breakfast cereal, as delicious as it is, may not keep you full very long. Also, you may be surprised that some muffins may have as much sugar as a cupcake, so reading labels is a good idea. Heavily processed foods, such as bacon, sausages, and ham, are fine occasionally but there are healthier options out there. For a weekend breakfast or a special occasion, they are fine but it’s not something that I would recommend eating every day.

How does breakfast affect gut health? And what is gut health?

Gut health is, in part, the prevention of symptoms like diarrhea and constipation, but it’s also maintaining the integrity of the gastrointestinal (GI) tract. The GI tract has a mucosal barrier that contains a lot of immune cells. It’s the first line of defense against bacteria and other things found in food that we want to avoid getting into our system. It allows for the absorption of nutrients but keeps the bad stuff out. Maintaining the microbiome in our gut, or the healthy bacteria that are good for us, is beneficial to our colon. Fresh fruits and vegetables that are high in soluble and insoluble fibers feed the bacteria in our gut that produce short chain fatty acids. These can be anti-inflammatory, and for our IBD patients, it’s particularly important. However, we all benefit from having a healthy, diverse microbiome.

What is your opinion on intermittent fasting and skipping breakfast?

There’s been a lot of interest in intermittent fasting recently. While this can be beneficial for some, you should ask your physician if this is an appropriate strategy for you. There is some interesting data on intermittent fasting, but successful weight management seems to be dependent on the individual. Intermittent fasting doesn’t just mean skipping breakfast, it’s limiting your eating to eight hours. In animal models, eating earlier (prioritizing breakfast) but having a smaller or lighter dinner may lead to better blood sugar control. However, we need more research to understand the mechanisms that come into play when we shift meals during the day both in animal models and in humans.

How to Overcome Food Anxiety When You Have Inflammatory Bowel Disease

Updated on Mar 29, 2023 | Gastroenterology, Your Health

If you are one of the more than three million people in the United States living with inflammatory bowel disease (IBD), you are likely struggling with anxiety around food. Many living with IBD associate specific foods, or even whole food groups, with getting sick, and so they avoid many foods. This common misconception has led many with the disease to become malnourished.

Stephanie Gold, MD

In this Q&A, Stephanie Gold, MD, Instructor of Medicine (Gastroenterology) at the Icahn School of Medicine at Mount Sinai, explains why IBD patients struggle with food anxiety, how they can overcome this problem, and where to get more information.

What is IBD, and how is it different from having a food intolerance or allergy?
IBD is a condition that includes Crohn’s disease and ulcerative colitis. Both are characterized by chronic inflammation of the gastrointestinal tract that often leads to diarrhea, abdominal pain, and rectal bleeding. IBD can also lead to fatigue, weight loss, malnutrition, and vitamin and mineral deficiencies. Specific foods are not known to trigger IBD flares. IBD is different from irritable bowel syndrome (IBS), food allergies, and food intolerances, as it is a chronic inflammatory condition of the entire digestive tract (Crohn’s disease), or specifically, the large intestine (ulcerative colitis), which can inhibit absorption and impair digestion.

How common is malnutrition among people with IBD, and what are the symptoms?
While the exact prevalence of malnutrition in patients with IBD is unknown, we estimate that about 30 percent of patients seen in our outpatient IBD clinic are malnourished, and up to 80 percent of those requiring hospitalization are malnourished. Malnutrition can produce few or mild symptoms, or it can result in more serious symptoms of increased fatigue and weakness, as well as specific symptoms associated with vitamin and mineral deficiencies, such as rash, mouth ulcers, muscle spasm, pins and needles, loss of appetite and irritability, and many other symptoms.

Why do many people with IBD have food anxiety, and how does this affect their everyday lives?
Patients with IBD often associate their gastrointestinal symptoms—abdominal pain, diarrhea, rectal bleeding, nausea or even vomiting—with the foods they eat. More specifically, patients commonly believe that a food they ate immediately prior to the development of an IBD flare or complication is the cause of their worsening disease, and naturally tend to avoid these foods in the future. While certain foods may contribute to gastrointestinal symptoms in some patients, food does not directly worsen IBD or cause disease flares. Unfortunately, IBD-related food anxiety can lead to a very restrictive diet overtime, which can result in long-term malnutrition and vitamin and mineral deficiencies.

I have IBD. What should I eat?
All patients with IBD are unique and therefore should discuss diet and nutrition with their gastroenterologist. However, in general, here at Mount Sinai, we encourage our patients with IBD to eat a wide variety of foods and to have an overall healthy diet that is rich in fruits and vegetables, lean proteins, whole grains, and heart healthy fats. While many used to believe that all patients with IBD need to avoid fruits and vegetables, we now understand that the micronutrients and certain types of fiber found in fresh produce can be very beneficial for the gastrointestinal tract. While raw fruits and vegetables may contribute to symptoms in some IBD patients, texture modification, such as peeling, cooking, and even pureeing specific, easier-to-tolerate fresh fruits and vegetables, can make these vital foods better tolerated in patients with active disease or ongoing symptoms. However, we guide dietary recommendations based on type of IBD as well as disease location, activity, and complications, and therefore, it is really important for patients to seek specific nutrition guidance from their gastroenterologist or dietitian. This is especially true of those with an ileostomy or intestinal narrowing (stricture), as this requires additional dietary modification. There is a lot of ongoing research in this area, and we hope to be able to better define a more specific, ideal diet for IBD patients in the future.

What resources are there to help me improve my diet?
It is essential that people with IBD ensure they are getting adequate nutrition from a wide variety of foods. The best thing they can do is seek out professional guidance from a registered dietitian who specializes in working with IBD patients. Since there is not one specific diet that we can recommend for all patients with IBD, a registered dietitian can help evaluate and broaden the diet based on your specific disease type, location, activity, and current symptoms. To find a dedicated IBD dietitian, you can ask your gastroenterologist for a referral. In addition, many of the gastroenterology societies, including the American Gastroenterological Association, have lists of registered dietitians who specialize in IBD that are available to the public. Patients with IBD should feel empowered to ask their gastroenterologist any nutrition-related questions and inquire about additional support from a registered dietitian when needed.

Contact the Nutrition-IBD clinic at The Susan and Leonard Feinstein Inflammatory Bowel Disease Center at Mount Sinai

Food Intolerance or Food Allergy? How to Spot the Symptoms and Get Help

Updated on Mar 23, 2023 | Allergy, Gastroenterology, Your Health

Bloating, diarrhea, vomiting—these are just some of the unpleasant symptoms that food allergies and intolerances can trigger.

It’s normal to experience stomach issues from time to time. But if you find yourself experiencing them on a regular basis, you may have developed a food intolerance or a food allergy.

You can still enjoy a healthy, balanced diet. But if you think you have a food intolerance or allergy, you should not try to diagnose it yourself and should talk with a medical provider. Food allergies and intolerances can be difficult to identify, and trying to resolve them on your own may lead you to eliminate foods from your diet unnecessarily.

Laura Manning, MPH, RDN, CDN

In this Q&A, Laura Manning, MPH, RDN, CDN, a registered dietitian at the Inflammatory Bowel Disease Center in The Mount Sinai Hospital, explains the differences between food intolerances and allergies, how to identify the symptoms, and how to seek help.

What are food allergies?

When someone has an immune response and produces an allergy antibody against a certain food, they have a food allergy. The most common food allergies are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soybeans, which are behind a majority of food allergies in the United States, according to the Food and Drug Administration. Allergic reactions typically occur within minutes, or up to two hours after ingestion.

What are the symptoms of food allergies?

An allergic reaction occurs every time you eat a food you are allergic to. Common symptoms include coughing, wheezing, itching, lip tingling, rashes, mouth swelling, hives, throwing up, and breathing difficulties. In severe cases, food allergies can cause people to go into shock and can be life threatening. You can experience changes in blood pressure and narrowing of your airways, which can cause difficulty breathing or vomiting.

What are food intolerances?

A food intolerance may happen when you lack enzymes responsible for digesting a certain food or food group. A common example is lactose intolerance, in which a person lacks a key enzyme for digesting lactose, a sugar found in milk. Other common examples of foods that may be poorly tolerated are beans, garlic, mushrooms, onions, and watermelon. These are foods that are high in FODMAPS, or fermentable carbohydrates, including lactose, fructose, fructans, galacto-oligosaccharides, and polyols. These can rapidly ferment during digestion causing gas, bloating, diarrhea, and constipation when consumed in high amounts. Food intolerances typically develop in the gastrointestinal tract or the digestive system, and can sometimes be triggered by stomach infections. Certain gastrointestinal conditions, such as irritable bowel syndrome (IBS), can make someone more susceptible to FODMAP intolerances. Because FODMAPs are in a wide array of foods, it is important to seek help from a medical provider and trained dietitian to identify the foods causing the problem without completely eliminating them from a healthy diet.

What are the symptoms of food intolerances?

When you eat foods your body cannot digest, you will experience discomfort, including gas and bloating, and may also experience diarrhea, constipation, reflux, and gas.

What is the difference between food intolerances and food allergies?

Unlike food allergies, food intolerances do not involve the immune system, do not cause allergic reactions, and are not life threatening. People with food intolerances can usually have small amounts of these foods without a reaction, whereas those with allergies cannot. Those with food intolerances may even be able to acclimate themselves to these foods by eating small amounts over time, whereas those with food allergies cannot have even the smallest amount without a reaction. However, some food allergies may change or go away on their own with time, especially after adolescence. If you have a known food allergy, an allergist can help you safely retrial the foods you are allergic to.

How are food allergies diagnosed and treated?

A skin prick test, typically on the upper back or forearm, or blood test can identify food allergies. Because food allergies cannot be eliminated, you will need to avoid eating foods that trigger your allergies, including foods that have been manufactured in factories where those foods are also processed (a warning should be displayed on food labels). Working closely with a board certified allergist will help determine what your reactions are to certain foods and best treatments. You can schedule an appointment at the Elliot and Roslyn Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai. You can also find qualified food allergists nationwide through The American College of Allergy, Asthma & Immunology.

How are food intolerances diagnosed and treated? Can I use a food sensitivity test?

Unlike food allergies, there are no official tests for food intolerances, which makes them more difficult to diagnose. While food sensitivity tests are available and popular, they are not FDA-approved, are unreliable, and frequently lead people to eliminate foods unnecessarily, which can lead to health issues. If you have an intolerance triggered by a FODMAP, going on a supervised food elimination diet, or low FODMAP diet, can help you identify the foods behind the intolerance. This diet involves eliminating high FODMAP foods and then slowly reintroducing them to identify the triggers. To avoid malnutrition, you should only go on this diet with guidance from a gastroenterologist and a trained registered dietitian. These experts will guide you through the process of identifying foods you are intolerant to and help you modify your diet in the healthiest way possible.

Contact the Elliot and Roslyn Jaffe Food Allergy Institute at Icahn Mount Sinai

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Find a registered nutritionist through Clinical Nutrition Department at The Mount Sinai Hospital