Monday, January 24, 2011

Body & Soul Cleansing

It never ceases to surprise me what some of my patients are willing to put themselves through all in the name of health:

“That stuff I had to prepare me for the colonoscopy – can you give that to me again, Doc?  I need an entire body & soul cleansing, and I want to start with my bowels.”
The colonoscopy is a screen for colon cancer, one of the top cancers found in men and women.  Some people actually rather enjoy the preparation process, which is the most challenging part of the colonoscopy (not the actual procedure itself), like my patient above.  And yet some people rather dread the procedure itself (and not the preparation process), which is really the easy part!

But to be honest, the entire process is really not that bad.  My patients who refuse the procedure either tell me they are too "embarrassed" to have the doctor place a foreign object through their rectum, or are just plain terrified of any discomfort or pain they may possibly face.  But you must remember that the doctor who performs these procedures does them for a living -- one rectum is really not any different than any other rectum to the gasteroenterologist (as special as you may think yours may be).  Please do not be embarrassed.  And as far as pain, it is quite rare.

5 Colonoscopy Expectations:

To combat some of your potential fears, here is what you can really expect from a colonoscopy:

1.  A colonoscopy is a screen for colon cancer, that is recommended either:
     a.  starting at age 50
     b.  or 10 years prior to a first degree relative's (parent, sibling, or child) diagnosis of colon cancer

2.  The day prior to the colonoscopy, you can only drink clear fluids -- broth, black coffee or tea, Jello, etc.  NO solids.  Perhaps the toughest part of the entire process to endure.  But you can do it!

3.  You will be given a special 4 L container of a solution that you will need to chug, and chug quickly (about 8 oz every 10-15 minutes) the night before the procedure.  It will taste better if this solution is chilled.  This will give you the runs -- meaning, you will be literally running to use the bathroom constantly for about two hours after you start drinking the solution.  The goal is to run until it literally runs clear!

4.  If the preparation is not sufficient, then the doctor will be unable to catch a clear view of the colon walls, and this will decrease the validity of the test.  That means that polyps and abnormal spots on the wall of the colon will be potentially missed.  And you may need to go through the entire process once again!

5.  On the day of the procedure, you will be given a medication that will make you very sleepy.  Most people do not remember the procedure and are asleep for the entire thing.  As you can see, there is no need to be afraid!

Have YOU had your colon cancer screen?!


WarmSocks said...

Had my first (and only) colonoscopy at age 43. My grandmother died of colon cancer. She'd had symptoms that were never reported to the doctor because she was too embarassed.

You'd think that would spur her kids to get their screening tests. Those who did, had polyps removed (multiple times); the one who didn't is now waging his own cancer battle.

People need to realize that the test isn't that bad, and is over quickly. Much better than the alternative.

Jill of All Trades, MD said...

WarmSocks, so sorry to hear about your Grandma and uncle. You are right in that it really isn't as terrifying of a procedure as it sounds. It's important for patients to hear and learn from your personal experience with it, so thank you for sharing it.

Jackie Fox said...

What a great post. If this gets only one person to get screened, it's worth it. It's so important. I started getting screened at 47 when my mom was diagnosed with colon cancer. (She died of it in 2003, when she was 68). I'm on a 5-year schedule so I'll have my third one before my husband has his second one! Bummer.

The procedure itself is a piece of cake. Drinking all that yucky stuff beforehand is the not-wonderful part. People seriously volunteer to drink that stuff without the procedure? Wow. Who knew.

Doug Capra said...

Doctor; Interesting post, and I also liked your recent post on KevinMD about compassion.
I co-moderate a blog with Dr. Joel Sherman called Patient Privacy and Modesty Concerns
In your discussion of the colonoscopy I might suggest you consider more some patient concern with modesty. The issue of gender may matter to some. Who will be the room? Will there be observers or students? How will I be draped? Will there be times when I'll be exposed for all the world to see?
These may sound like paranoid questions to thsoe who do these procedures all the time, but for those who are new to them, they are very valid concerns. These may be some of the issues you can bring up with those who are reluctant to have a colonoscopy done.
Anyway, just wanted to express my thoughts. I appreciate your point of view, esp. with the compassion article.
Check out your privacy/modesty blog.
Doug Capra

Erica said...

Thanks for the funny and yet serious articles on medicine - as a patient it is always nice to see physicians with humor. :)

MPS Hurler Scheie syndrome

Jill of All Trades, MD said...

Thanks for the kind words, Erica :) And thanks for reading :)