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People don't want to spend time
inside a hospital, of course you will say, but

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maybe you don't study medicine like me and
you don't have a retired doctor like

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He knows everyone and has decided to
help me choose the

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a morphine pill. And how not
lets go through all the sets of more

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medical television show in history
of surgery and research

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although the hospital practice of mine
uncle is decidedly experimental.

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Robert is charming, choose again
more.

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It's really too late to sign up for
jurisprudence?

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This is a profound episode. It will be
all about gases, or rather about

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I am a gastroenterologist and I deal with
any type of system disorder

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digestive. They say we are like them
plumbers. I say plumbers

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they earn much more than us.

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With us the updating is continuous and the
Ours is a highly technological field.

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I look at the intestine and I see a
masterpiece. It feels like I'm watching a movie

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future.

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Gastroenterology Ninth floor if the
memory does not deceive me Ninth floor for

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The visit to gastroenterology was in
in the air for days Here, in the air is the

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exact term Everyone on the ninth floor?

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One moment please He had come
prepared,

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I don't We all eat About 70 million
Americans per year suffer from

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digestive disorders.

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We have different symptoms, though
most are benign, but some

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they can be serious.

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Many benign symptoms come
grouped under the name IBS or

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of the irritable bowel. The patients
complain of chronic abdominal pain,

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spasms, bloating and bowel movements
anomalous.

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Therefore those who suffer from intestines
irritable is as irritable as his

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But lactose food allergies do
manifest with similar symptoms, the

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which can complicate the diagnosis.

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There are patients who have moved on
for years in the belief that they had the

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irritable bowel syndrome. The
do a simple intolerance test

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lactose and discover that it is intolerance
lactose causes the majority

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of the symptoms.

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Sometimes it's hard to talk to yours
doctor of certain symptoms, but often

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minor annoyances are the antechamber
of serious problems.

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It's not stomach acid why you have
ate gorgonzola or spicy food.

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Let's talk about disorders that threaten the
life.

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The disorders with which we have the most
familiarity are usually called

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Crohn's and ulcerative colitis.

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These are the two most ailments
important.

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In IBD.

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IBD or bowel syndrome
inflamed. Nobody knows for sure what

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unleash, but it falls under diseases
autoimmune.

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It means your body is
attacking himself. Crohn's disease

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ulcerative colitis cause inflammation
resulting in injuries, losses of

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blood and scars and digestion
it gets super painful.

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I collapsed at camp. They have me
taken to the hospital where they took me

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diagnosed with Crohn's disease.
Getting sick with ulcerative colitis shortly before

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University was very hard.

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For an accurate diagnosis of these
disorders it is necessary to penetrate into

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cave. When it comes to the apparatus
digestive, let's say it a little

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particular is the way in which it is accessed
to the system itself.

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Well yes, in this episode there is one
penetration. A meter and a half more or

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less. Doctors use this probe
which is brought down from the throat or

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raised from the bottom. The video camera
at the end it films you from the inside. AND

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the endoscopy technique.

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Endoscopy is a tool
observation through naturals

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body.

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00:03:53,180 --> 00:03:59,860
There are also other ways to resume
our intimacies.

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00:04:01,600 --> 00:04:03,660
I am a radiologist.

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00:04:05,120 --> 00:04:10,820
Radiologists and gastroenterologists work
together, they view together, they examine the

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patients' problems together.

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The radiologist is a little less invasive.

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He only takes a few shots from the outside.

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As far as one of the tests that gives you yes
called enema albario.

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This is a table with elevation
vertical. You position your head towards

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down and rotate the
patient as if he were a chicken on one

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spit. With X-rays or endoscopy i
Doctors look for traces of ailments

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'intestine. And believe me, you have no idea
of what comes out. There have been

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hospitalized patients who had swallowed
long needles.

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Coins, wallets.

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I found bones, chicken bones
whole and intact. One of the most

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It was a white label with the
written in the United States the pear number

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The patient had eaten a pear with
so much flavor that you can even swallow it all

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the label without chewing it.

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My uncle prescribed a series of tests for me
gastrointestinal. To be able to do one

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accurate diagnosis I needed first
undergo a deep cleaning.

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The meaning of deep cleansing was to me
clear when they made me drink a gallon

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of laxative, almost 4 litres.

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My uncle didn't need it.

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Ah, uncle!

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But if your inner trumpets do
trigger more than 20 times a day,

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time for you to take a look.

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00:05:30,950 --> 00:05:33,330
The ancient Romans didn't do it
these problems.

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They believed that holding the gas
intestinal was not only wrong, but

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poisonous. Emperor Claudius promulgated
an edict that legalized the issue

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of gas at banquets.

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free chest for the well-being of
people. Who would have been the one to make the

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illegal? Soon you will discover that in
There is a kind of offer for these exams

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special type two for the price of one. Not
I know if it might interest you.

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After the meeting with the patients I was not
more sure that you have the right stomach

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00:06:05,270 --> 00:06:09,150
to gastroenterology and when my uncle
volunteered me for a

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I did the endoscopy on myself
from fear.

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There is no more medical waste from
dispose of. This is thanks to

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I think the preparation is the aspect
more unpleasant than the thing. I found the

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worse preparation than the real exam e
own.

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You drink a super elephant laxative
that makes you do the rounds in the bathroom for

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a few hours.

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And then there's the matter of the flavor that it isn't
the maximum. They told me liquid

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antifreeze.

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thanks to my uncle I was about to meet the
one and a half meter long snake with the

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laxative as an anti-coat sure that its
nephew want to do it? I have to

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do it! no son you don't have to do it
nothing I don't think I have a choice now

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absolutely stop now
impossible and my nephew would do it

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anything in the name of science

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Many of the preconceptions about
gastroenterology arise from the fact that

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things considered dirty and unpleasant,
but the intestine is a splendid part

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of anatomy. If you saw him when he is
spotlessly clean you would say

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it looks like your lips.

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Pink, soft and healthy, and so full of
curves.

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It's as if a single spiral connected
mouth to anus.

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The digestive system is not an organ
only one that extends from the mouth up

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lower parts. It is a variety of organs
different people collaborating with each other.

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And it's long. If you unroll it from your mouth
up to the anus and spread it on the

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floor you will find yourself in front of over 7
meters of intestinal tract.

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On average 5 times your height.

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If you shrink and come
swallowed, you would go down the throat

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'esophagus. It is a long tube made of fibers
muscles that push food into

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stomach. Here the food is processed
by enzymes.

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In this acid and revolting bath the
solid food turns into a gruel.

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Then sail to quieter shores in the
small intestine.

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where trillions of intestinal villi,
thin finger-like folds of tissue,

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they extract the nutritional principles and them
they pass to the blood.

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And last, but not least, the colon.

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If the intestine were a metropolis, the
colon would be the periphery, where the

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traffic is slower than in the centre.

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Food takes over 24 hours to make
pass through the colon, which sucks in ed

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every trace of water. What remains
it is pushed out and rinsed away.

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Once the major cleaning operation was completed,
you are ready for the endoscope.

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Fear? Yes.

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But there's no better way to look
the intestine without intervention

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surgical. The probe has a camera
that sees things in real time. I

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they come face to face with the
problem.

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The first time I saw a probe I
I immediately thought of a snake.

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And I expected it to move like a
snake, whether it flew away or tried

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to attack me.

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I was intimidated, for real, not
I'm joking.

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The first probe was invented by a doctor
named Philip Bozzini. In 1806 the

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called Lichtleiter, in German
conductor of light. It was one

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candle connected to a mini telescope.
But before you can even use it, the

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The work was banned by the University of
Vienna because it is considered too much

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indiscreet. So the probe didn't
really its appearance until the years

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50, with the invention of tubes
flexible.

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And twenty years later, the revolution.

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with the appearance of optical fibers.

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There is a small video chip at the end
which sends all images to a

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monitors. I check it with these
knobs.

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I can go left or right or
go up and down. If the tube

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makes a curve or a crease, I'm in
able to follow him.

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The endoscope, whether it is
gatroscope, For an observation from

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00:10:15,320 --> 00:10:20,580
mouth or colon scope starting from
low, is our most important

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diagnostic. If you proceed from the throat, yes
use the gastroscope.

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The tools are similar, except that the
gastroscope is thinner and flexible,

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to be able to inspect the esophagus and the
stomach.

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Don't worry, the doctor will give you a
sedative to relactate you, he will spray you

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00:10:38,340 --> 00:10:42,100
throat with a lubricant and it will go down
the probe. Usually it takes half an hour

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'now. The esophageal sheath may come
damaged by acid leaks

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stomach. It's called reflux
gastroesophageal and can cause ulcers in the

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upper digestive system. An ulcer it is
essentially a hole in the trim

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mucous membranes. The example we give to
our patients is if a punctured potato

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peel, the pulp at that point
it blackens.

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Many people believe that ulcers
arise from stress, but in reality they are

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caused by a bacterium. The doctor can
prescribe an antibiotic.

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The final section of the intestine includes
the rectum and the colon, commonly called

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large intestine.

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To inspect this part the doctors will help you
they do a colonoscopy.

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Oh yes, the probe should be inserted where you think
you.

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This is the most direct access to the colon
and gives the best screening for the

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00:11:27,890 --> 00:11:30,770
colon cancer and other problems
minor gastrointestinal.

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I was there face to face with the probe. For
luckily my uncle was there to keep me up

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moral.

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Everything the probe detects in its
colon appears on the screen.

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Yes, of course, I know, I know. I'm familiar
with the machinery.

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What do you see, uncle?

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00:11:56,480 --> 00:12:00,680
We're in bad shape and I'm afraid we might
resolve very little.

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00:12:01,660 --> 00:12:05,480
What? I hope the paramedics come here
to lend a hand.

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00:12:06,650 --> 00:12:08,510
Really dramatic. The paramedics?

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00:12:09,230 --> 00:12:12,530
Don't worry Robert, I wasn't referring to
your intestines.

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It's the worst rear-end collision I've ever had
seen.

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Now you may be wondering how to clean them
these things?

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00:12:23,130 --> 00:12:27,730
The probe must be inserted into the equivalent
of a dishwasher. It is submitted

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a wash cycle at high temperatures
which lasts at least a couple of hours.

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Does this kill anything? Yes,
anything.

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If you are male and over 50 years old, i
doctors recommend a nice probe

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00:12:39,690 --> 00:12:40,690
every 5 years.

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00:12:40,770 --> 00:12:44,350
Maybe you don't like this very much,
but they increase the chances of

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diagnose colon cancer for
time.

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00:12:46,890 --> 00:12:51,790
If you spot it at an early stage it is
still benign and presents in the form

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of octopus.

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00:12:54,530 --> 00:12:57,230
Colon diagnostics is a lot
important.

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00:12:57,590 --> 00:13:02,250
Today we know that colon cancer does
develops from polyps in a benign form.

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00:13:03,240 --> 00:13:06,360
The polyp is excess tissue that
it grows inside the body.

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00:13:06,720 --> 00:13:11,220
It basically looks like a wart,
only that it's on the intestine. You don't see it

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00:13:11,220 --> 00:13:12,420
you can't even hear it.

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00:13:13,740 --> 00:13:19,080
This is a polyp, that is, cancer
potential.

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00:13:19,680 --> 00:13:23,920
The more polyps you have, the higher your risk of
get cancer, because every polyp

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00:13:23,920 --> 00:13:28,040
has a 1% chance of transforming
in cancer. Which means you don't

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00:13:28,040 --> 00:13:29,680
you have to free and quickly.

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00:13:30,510 --> 00:13:34,470
True, it does not mean necessarily
that it becomes cancerous, but why

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00:13:34,470 --> 00:13:35,470
take a risk?

201
00:13:35,790 --> 00:13:40,870
The nice detail is that with the
colonoscopy removing polyps is easy.

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00:13:40,870 --> 00:13:43,750
Probe doesn't just play defender, he plays
even in attack.

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00:13:43,970 --> 00:13:47,890
When the doctor finds a polyp, the
probe removes it. There's a special

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00:13:47,890 --> 00:13:51,230
duct in the rubber tube where the doctors
they can insert all kinds of

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00:13:51,230 --> 00:13:55,650
device. Ulcers are cauterized, yes
they grab what little things they can

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00:13:55,650 --> 00:13:56,830
become dangerous.

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00:13:57,260 --> 00:14:01,480
What did I tell you? Two for the price of
one. The purpose of colonoscopy is

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00:14:01,480 --> 00:14:05,880
locate polyps and remove them
during the colonoscopy itself. In this way

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00:14:05,880 --> 00:14:07,160
reduces the risk of cancer.

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00:14:09,040 --> 00:14:11,700
Next topic, the use of
heavy metals.

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00:14:12,240 --> 00:14:15,140
Imagine how I felt there when
I realized that no one would have me

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00:14:15,140 --> 00:14:16,140
given an earring.

213
00:14:16,760 --> 00:14:18,580
This is part of the test!

214
00:14:27,570 --> 00:14:31,830
I had had a colonoscopy, that is, I
they had stuck a rubber tube with

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00:14:31,830 --> 00:14:36,170
camera up the butt. But the
worse never died. They had me

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00:14:36,170 --> 00:14:39,430
in the x-ray room because radiologists and
gastroenterologists work in teams.

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00:14:41,530 --> 00:14:44,210
What the fuck was I going to do to get an enema
to barium?

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00:14:44,590 --> 00:14:46,810
Yep, the word sounds like an alien weapon.

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00:14:47,150 --> 00:14:51,330
A normal bowel x-ray
it wouldn't detect anything because the viscera

220
00:14:51,330 --> 00:14:52,550
they are not dense enough.

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00:14:52,950 --> 00:14:55,190
Then the doctors fill you with barium.

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00:14:55,630 --> 00:14:59,710
A liquid metal that makes everything
photographable as the skeleton, using

223
00:14:59,710 --> 00:15:01,610
same technique they use for the
enema.

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00:15:02,690 --> 00:15:07,190
When the tube is inserted into the rectum
of the patient, a small amount of

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barium flows by gravity inside
of the rectum and on the left side of the

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colon, and then it is pumped,
literally pumped out of the air. The

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very thick mixture, which displays for
contrast the sheaths.

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In this way we can obtain
those images on which we will then go to

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work. It is an excellent exam for
diagnose problems such as colitis

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ulcer or inflammatory processes. They appear
on X-rays as long lines or fractures

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the intestinal wall caused by leaks
chronic blood disorders and inflammation.

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Proof that the immune system is
going crazy and attacking himself.

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The doctor thus has confirmation that the
patient suffers from IBD.

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Almost 4 liters of lazzative, one meter and
half of probe into body and it wasn't yet

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enough. You get thrown into a
'other car.

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With this control panel I can
turn the table over and allow the

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barium to flow better in the intestine.
The liquid contrasts on the walls

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intestinal and the images appear.

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00:16:10,600 --> 00:16:14,620
When the enema is empty it folds in on itself
itself, we blow air into it and

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we get even sharper images.

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What exactly are you looking for?

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We look for anomalies, every possible one
anomaly of the intestinal walls.

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Sorry, I think I can taste the
barium in the mouth, help me please,

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help!

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With this exam you can find out
anything. Not anything,

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one of the disadvantages of enema albarium
is that it doesn't highlight the colon well

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sigmoid. The sigmoid colon,
naturally, sure.

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It's okay Robert, relax. It's there
'family pride, you know that

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he too will become a doctor.

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Help me! Yes son, it's okay, it's okay.

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They are invasive tests, it's true, but the new ones
technologies can make them gradually

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less and less embarrassing.

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00:17:12,109 --> 00:17:16,950
Virtual colonoscopy is another
radiological examination. Instead of pumping yourself up

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a liquid metallic solution, ci
they pump air, as if you were a balloon.

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You will feel bloated and gassy, but the
I assure you that you will not feel any pain.

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All right? Sure, relax. You just have to
forget you have one in your body

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hot air balloon, what do we need.

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It is a probe with an enhanced CT scanner
with 3D software. Shoot an elevated

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number of photos, each one a detail
different. The photos are then assembled

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the complete picture of yours appears
viscera. I work this way. I have

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400 images and now I'm leafing through them
quickly one after the other and in

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I can see a living body.

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Another time a deep breath,
let the air out and now hold

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breath.

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Computers retouch images
digitalis of your colon.

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Retouching means eliminating what
we all eliminate.

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This software is capable of
locate and remove everything

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requested color. It means nothing more
preparation, no more laxative.

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Visiting the gastroenterologist is no more
a tour de force at the bathrooms.

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Most patients prefer it
virtual colonoscopy.

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To the real one. The inconvenience of
virtual is that if a polyp is found, the

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patient will have to undergo actual chronoscopy
to remove it.

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Soon, a leap into the future.

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Less rubber gloves and more gadgets
spacecraft, including a controlled vehicle

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distance with which to venture... where
we know well.

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This part of the test!

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I was manipulated, stimulated and
turned upside down in every way.

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They poured liquid metal into my
butts. The gastroenterologists did

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their worst and I am safe and sound.
But despite machinery, scanners and

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computer there is still a stretch of not
easy access for doctors. It's there

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'small intestine, that special area
between the stomach and colon.

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The future of diagnostics in terms
of endoscopy will have to be an additional one

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in-depth analysis of this part because it is
an area not perfectly explored

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from the endoscope.

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One solution is this simple one
pill, actually a camera.

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It's the camera capsule, an instrument
wonderful that the patient simply

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swallow.

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The camera starts taking photos
as soon as it is swallowed. The electrodes

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placed around the abdominal area
transfer to a recorder placed at

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00:19:37,760 --> 00:19:38,760
side of the patient.

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Takes two photos per second.

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And send photos wirelessly
to a recorder, from which they then come

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download to a regular laptop or the
your computer.

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The camera capsule navigates like a
micromissile along all 8 meters of the

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intestinal tract.

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It takes about 12 hours to travel
complete and then comes out exactly as

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everything else.

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Ah, you only use it once.

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It's not science fiction.

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Wait until you see the nanorobots to which
experts are working on

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medical. Miniature robot
self-ejecting devices designed to get around

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interior.

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They crawl, swim, some even
they guide along the intestinal membranes.

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00:20:21,060 --> 00:20:25,200
Like taking a rover ride on Mars. A
journey that no man has ever taken

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00:20:25,200 --> 00:20:26,019
before now.

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What if we convinced Dr. Cohen to
try this?

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00:20:29,600 --> 00:20:33,360
We can't say anything about this yet
chisel to cut away polyps.

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00:20:34,350 --> 00:20:38,790
Currently cancer prevention
the colon is left with this sort of metal

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detector.

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Doctors are becoming more and more expert
in arranging, unlocking and cleaning the

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'intestinal. But let's be honest, don't
Does it seem a bit like a last resort?

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00:20:48,310 --> 00:20:51,930
Uncle and I asked Doctor
Cohen some preventive measures.

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00:20:52,510 --> 00:20:56,470
Something Americans need to do
prevention is to consume more fibre.

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00:20:58,160 --> 00:21:02,780
Fibers are not just cereals
tasteless. You find them in apples, in

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00:21:02,920 --> 00:21:05,380
in lettuce, in all products of
'vegetable garden.

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00:21:06,500 --> 00:21:10,520
Have a regurgitation of affection towards
that kilo and a half of good bacteria in the

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00:21:10,520 --> 00:21:14,880
your intestines. They help you
assimilate the food and they can come

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00:21:14,880 --> 00:21:17,020
from food supplements called
probiotics.

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00:21:20,560 --> 00:21:24,820
Every test I did was more invasive
of the previous one. What would have been the

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00:21:24,820 --> 00:21:25,820
next?

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00:21:26,040 --> 00:21:27,040
Wake up, Robert!

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00:21:27,820 --> 00:21:28,820
All finished.

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00:21:31,300 --> 00:21:32,300
Really?

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00:21:33,240 --> 00:21:35,080
Wasn't it so hard after all?

325
00:21:35,380 --> 00:21:37,740
But yes, many are scared without it
reason.

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00:21:37,940 --> 00:21:40,420
You just have to grit your teeth and hold on
hard.

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00:21:40,720 --> 00:21:42,600
Thanks for being with me, uncle.

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00:21:43,140 --> 00:21:45,120
I always have your back.

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00:21:45,940 --> 00:21:50,000
And if you just had a colonoscopy,
this gives you some security.

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Many people get scared there
perspective of a pipe entering the

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00:21:55,080 --> 00:21:59,880
moves inside, but practically all one
once the procedure is completed they tell me

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00:21:59,880 --> 00:22:04,340
it wasn't that terrible after all, it's like
a dog that barks but doesn't bite. It's not

333
00:22:04,340 --> 00:22:08,540
not at all like many had told me and
when you do it you realize it. I say

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00:22:08,540 --> 00:22:09,540
it's better to get tested.

335
00:22:12,360 --> 00:22:16,700
When you undergo this test, how
to any other tract examination

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00:22:16,700 --> 00:22:21,740
gastrointestinal, then you realize
which is just mythology. 99% mythology.

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00:22:21,740 --> 00:22:34,300
I would like to

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00:22:34,300 --> 00:22:35,540
stretch me a little, uncle.

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00:22:35,920 --> 00:22:37,520
I go up on foot. Okay.

340
00:22:48,740 --> 00:22:53,640
everything is also in gastroenterology
well that ends well