Living Well … Colonoscopy: The gold standard
By Brian Schultz, DO
Ministry Medical Group
Colorectal cancer is the second leading cause of cancer deaths among American men and women, and it’s probably the easiest to prevent through screening. Most cancers develop as polyps/growths which are a small clump of cells in the lining of the colon. Although the majority of these polyps are benign/non-cancerous, a good number of those identified are pre-cancerous and sometimes potentially malignant/cancerous.
Colonoscopy, one of several screening tests recommended by the American Cancer Society, uses a thin, lighted, flexible scope to examine the entire length of the colon. At the end of the scope there is a camera to view the colon, and various tools to flush and take samples. A colonoscopy allows your surgeon to biopsy a suspicious polyp when one is identified, and it is sent to pathology for further testing.
Concerning symptoms that you should be aware of include any change in your bowel habits, rectal bleeding, blood in your stool, abdominal pain, fatigue or weight loss could be some of the early stages of the disease. Paying close attention to your health and body is important and symptoms should not be ignored.
People of older age, African-American race, have a personal or family history of polyps or cancer, diet/lifestyle, diabetes, smoking, and alcohol are some risk factors. Many of these risks are preventable.
It is usually recommended that colon cancer screenings start at age 50. Unless you have concerning symptoms and/or risk factors that suggest earlier screening. The frequency of colonoscopy exams also depend on your history, symptoms and risk factors.
As a patient, you can play a role in improving the quality of colonoscopy results. The most difficult part is the bowel preparation, and doing it well is critical for satisfactory screening test. It is very important to follow the instructions your surgeon provides you. It is in your best interest to have a clean colon for an excellent view with the colonoscope. In addition to drinking the entire contents of the bowel prep a clear liquid diet is required the day before the procedure.
Performed as an outpatient procedure, a colonoscopy is considered a highly effective way of detecting cancer and preventing cancer deaths. The procedure itself usually takes approximately 30 minutes and a mild sedation is used. Also a responsible driver to bring you home after surgery is required due to the anesthesia. Your surgeon will discuss the pathology results with you once they become available which usually takes several days to come back and be reviewed. At that time a recommendation on follow-up will be determined as well.
Other screening options include sigmoidoscopy, which examines only part of the colon, and barium enema, which is less effective. When polyps are detected through these or other methods, a colonoscopy must be performed to remove them. Other options are stool tests including FIT (fecal immunochemical test) which only detects blood in your stool which can be an early sign of cancer. A positive FIT result will be followed by a colonoscopy for a more complete screening where biopsies can be obtained and tested.
Regardless, colorectal cancer can be prevented and caught early can be treated. Preventative screenings are essential and available to you. With any surgery there are risks and benefits and your surgeon would be able to talk with you in more detail about those. Speak with your primary care clinician regarding the options and to get your colonoscopy scheduled.
For more information on colonoscopy or FIT testing, please visit ministryhealth.org or contact Ministry Medical Group at 715-361-2000.
Brian Schultz DO is a General Surgeon with Ministry Medical Group.