Alexandra Guillaume, MD

Black Americans are 20 percent more likely to be diagnosed with colon cancer and 40 percent more likely to die from it than white Americans (American Cancer Society, 2024). The American College of Gastroenterology recommends Black patients begin screening colonoscopy at age 45, earlier than the general guideline was for decades, because of that excess risk. Gastroenterologists also manage Crohn's, ulcerative colitis, hepatitis C, fatty liver disease (NAFLD/MASLD), and unexplained GI symptoms.

A 2020 study in Gastroenterology found Black patients with IBD are more likely to present with complications such as strictures and fistulas, reflecting delayed diagnosis.

Conditions we cover

• Colon cancer screening and polyp surveillance
• GERD and Barrett's esophagus
• Crohn's, ulcerative colitis, microscopic colitis
• Hepatitis B/C, fatty liver, cirrhosis
• Irritable bowel syndrome (IBS) and SIBO

When to book

• Blood in stool or rectal bleeding at any age
• Unexplained weight loss or persistent diarrhea over 4 weeks
• Difficulty swallowing or food getting stuck
• Family history of colon cancer or polyps

Advocacy prompts

• Should I start screening at 45 given my family history?
• What's my risk of MASLD given my labs?
• Is a stool-based test enough, or do I need a colonoscopy?