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What Do You Think Of Colonoscopies? And Other Probing, Open-Ended Questions

By Gary Gillis

Yes, the pun was intentional. Just trying to insert a little humor….oh, sorry…just trying to introduce a little humor into the discussion of what many folks view as an unpleasant topic. Personally, I view it as an important topic but I understand the unease around the subject. I've been there and done that…..several times.

I may joke about the procedure, but colon cancer is serious business. The last time I checked colorectal cancer was the third most common cancer in both men and women, and the third leading cause of cancer mortality. There's nothing funny about that. For the last decade or so the incidence of colorectal cancer and mortality rates have decreased which is great news and no doubt due in part to the early detection and treatment. Enough said.

It's recommended that most folks include a colonoscopy as part of a comprehensive health screening once they turn fifty. At the suggestion of my primary care physician, who was aware of my family health history, I was initiated earlier than most. While not all that enthusiastic about the process, I was convinced that it was important to learn the results. Is it fun? No. Is it worth it? Absolutely.

Here's the deal. Because my colon has been found to sprout a few pre-cancerous polyps - clumps of cells that, if left unchecked, could develop into cancer, a colonoscopy has become a yearly ritual. I usually schedule it sometime around my birthday which falls near Halloween…..trick or treat. Maybe a little of both.

The trick is getting through the prep. It is not the most pleasant process and there are several methods that your gastroenterologist might recommend but they are all designed to accomplish the same goal….flushing out your digestive system to make your lower bowel shiny and clean so the doc can take a good look around.

It begins the day before the procedure with a fast. Clear liquids like water, juices, coffee or tea. You can have jello or a hard candy like a life-saver but you're asked to avoid anything with a red or blue dye in it because that can make it harder for the doctor to pick up subtle tissue changes during the exam.

In the evening you take a stool softener and shortly thereafter begin the process of drinking a large volume of fluid which will essentially wash out whatever is in there. A product called Golytely is what my doctor prescribes (it's available in several flavors) and I mix it up in the morning and leave it to chill in the refrigerator. When the time comes I can usually chug down the first glass or two then it starts to get a bit more difficult. Friends have told me that they find it easier to use a straw or mix in a little seltzer water. I find that keeping a peppermint handy helps.

The process takes a few hours but soon enough you'll get the urge to go and you'll visit the bathroom several times. It's important to drink all of your prep and eventually, when what you see in the bowl is nothing but clear liquid, congratulate yourself on a job well done. I like to schedule my procedure for the doctor's first appointment on a Friday morning. I arrive at Beth Israel Deaconess-Needham bright and early, check in and change into my designer johnny. After a brief chat with the nurse and a check of my blood pressure and temperature we get an IV started. It's not too long after that that I'm on my way to the endoscopy suite.

I can't recall what sedatives they administer before the procedure, but that's fine. They work quite well and I can't recall much of what goes on afterwards. There are times when I am aware that something is going on. I feel something like a stitch in my side - the kind you get while running sometimes, but that's a hazy recollection. Usually the next thing I recall is a pleasant voice asking me how I'm doing and whether I would like another warm blanket as I slowly realize I'm back in the room where I started. Hospital coffee and a microwaved muffin never tasted so good.

You know one thing I often say is, "I'm glad there are smart people in this world." Glad someone was smart enough to develop the instruments and the procedure that can detect colorectal cancer. Glad there are smart doctors and nurses who train to perform colonoscopies. Glad that there are smart researchers who are working to improve the odds should cancer be detected.

I'm also glad that you took the time to read this story, and I hope you are smart enough to do something important for yourself.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted September 2010

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General Medicine and Primary Care
Department of Medicine
Beth Israel Deaconess Medical Center
Carl J. Shapiro Clinical Center
330 Brookline Avenue
Boston, MA 02215
617-754-9600

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