What happens when a talented physician journeys from Pakistan's largest city to the heart of the American healthcare system? Dr. Sajid Zafar's remarkable path from Karachi to becoming a respected gastroenterologist in St. Louis reveals fascinating insights about medicine, migration, and the ever-evolving landscape of digestive health.

Dr. Zafar takes us behind the scenes of modern gastroenterology – a specialty that straddles the worlds of internal medicine and surgery. Performing between 1,500-2,000 procedures annually (likely more than any other medical specialty), gastroenterologists use scopes just millimeters wide to diagnose and treat conditions throughout the digestive system. From controlling bleeding and removing tumors to placing feeding tubes that once required major surgery, these minimally invasive techniques have revolutionized patient care. But the specialty also confronts difficult ethical dilemmas, particularly when families request interventions for elderly patients with advanced dementia.

The conversation takes an urgent turn when discussing the alarming rise in colorectal cancer among people under 50. This trend prompted the recent change in screening guidelines, lowering the recommended age for first colonoscopy from 50 to 45. Dr. Zafar emphasizes that family history dramatically impacts risk – if your parent or sibling had colon cancer before 60, you need screening at 40, or ten years before their diagnosis age. Unlike many aggressive cancers, colorectal cancer caught early has excellent survival rates, making proper screening potentially life-saving.

Perhaps most valuable is Dr. Zafar's wisdom about diet and digestive health. Following a primarily plant-based eating pattern himself (only 20% meat), he explains why whole fruits beat juices, how high-glycemic foods trigger problematic insulin responses, and why our sedentary modern lifestyles require more careful food choices than our physically active ancestors needed. Want to learn how simple dietary changes could transform your health? This episode delivers practical knowledge directly from a gastroenterology expert who lives what he teaches.