Q. My doctor says it’s time for a
colonoscopy. Please tell me I shouldn’t worry about this exam.
A. You definitely shouldn’t worry. I’ve had the three
major tests for colon cancer: sigmoidoscopy (very uncomfortable), the barium
enema (a nightmare) and the colonoscopy.
I was given anesthesia for
the colonoscopy and all I recall is getting on the examining table, feeling
like I had a cocktail, and waking up in recovery as rested as if I had a
late-afternoon nap on the beach.
The colon, or large bowel,
is about a five-foot tube that connects the small intestine to the rectum. It
removes water and nutrients from digested food.
The colonoscopy is the
gold-standard procedure for colon-cancer detection. The colonoscope is a
slender, flexible, lighted tube with a video camera at its tip. The examining
physician inserts the tube into the rectum. The scope inflates the colon to
provide a better view. The camera sends pictures of the inside of the colon to
a TV monitor. The exam takes 15 to 30 minutes.
During the procedure, a
doctor can remove most abnormal growths such as polyps with tiny tools passed
through the scope. Most polyps are benign, but some can turn into cancer. By
getting the polyps early, a colonoscopy can avoid a major operation.
Patients are given pain medication
and a moderate sedative. Discuss sedation with your doctor in advance. People I
know who’ve had the procedure have experienced different degrees of alertness,
recall and discomfort.
After the exam, you might
feel some cramping or gas, but it should stop within an hour.
By the next day, you should
feel normal. You’ll probably need someone to take you home after the procedure
because it takes a while for the sedative to wear off.
If no abnormalities are
found, you’ll probably be told to come back for another exam in three to five
years. If there are abnormalities, you may have to return more often.
Now for
the bad news. The preparation for
a colonoscopy is awful.
Preparations vary. You take
either pills or liquids to purge the colon completely. You may need an enema.
You will spend a lot of time on the throne.
My doctor prescribed the
liquids; they taste awful and you have to drink a lot of them. Next time, I
plan to ask if I can take the pills.
During the 24 hours before
the exam, you have to drink only clear, nonalcoholic liquids. You can eat only
soft foods such as Jell-O. And nothing can be red because it could be confused
with blood.
Your diet may permit liquids
up to two to four hours before the exam. My doctor required total abstinence on
exam day.
There are other colon exams
available. These include CT colonography (“virtual colonoscopy”), sigmoidoscopy
and barium enema.
CT colonography uses
computer tomography (“CAT”) scanning, a minimally invasive procedure. CT
colonography combines special x-ray equipment with sophisticated computers to
produce multiple images or pictures of the inside of the body. These
cross-sectional images of the area being studied can then be examined on a
computer monitor or printed. This method is an alternative for patients who are
at risk of complications from colonoscopy such as patients who are frail. If a
virtual colonoscopy finds significant polyps, they have to be removed by
conventional colonoscopy.
Like a colonoscope, a
two-foot sigmoidoscope is a slender, flexible, lighted tube with a tiny video
camera linked to a monitor. In a sigmoidoscopy, the doctor inspects only the
lower parts of the colon.
A barium enema, or lower
gastrointestinal (GI) examination, is an X-ray procedure. To make the intestine
visible on an X-ray image, the colon is filled with a contrast material
containing barium, a silver-white metal.
If you have a question,
please write to fred@healthygeezer.com
All Rights Reserved © 2009
by Fred Cicetti