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January 25, 2013

Colonoscopy For Cancer Screening: My Encounter

Colonoscopy For Cancer Screening: My EncountercolonoscopyColon Cancer

Someone once told me when your short on topics to write on, write about yourself. So today we’re going to get personal as I share my colonoscopy experience. But, no photos of my colon will be uploaded – sorry for the disappointment as it’s really rather attractive. We will focus on colonoscopy for cancer screening in this article (we do focus on prevention after all).

Colon cancer is the most common cancer next to skin cancer, and the number 2 cancer killer in men and women. Colon cancer usually evolves from colon polyps most of which are benign but can become cancerous.  Polyps can easily be removed during the colonoscopy making colon cancer quite preventable.

Doctors Make the Worst Patients

First, doctors are probably the worst patients as we tend think we’re invincible so we invariably delay going to the doctor when something is wrong.  Or, when it’s finally our turn by virtue of our age we put off having screening examinations done on us, to us, in us like colonoscopy, rectal exam, mammograms, etc.

I’m pretty good about not doing that, and I do strongly follow my own advise I give to patients, but I did delay getting the colonoscopy done since I have no family history of colon cancer and never had any GI complaints.  But, I recently decided it was time to bite the bullet and finally had it done this past summer.  For pure screening purposes in those without a family history of colon cancer age 50 is the recommended age to have that first colonoscopy.

The Colonoscopy Prep

The colonoscopy itself was quite unremarkable.  It’s the PREP that was nasty and challenging. The actual procedure was a walk in the park compared to drinking the prep. I used Suprep® which by all accounts is easier and more tolerable than older bowel preps. It’s a mixture of potassium sulfate, magnesium sulfate, and sodium sulfate.  It has a mixed berry flavor and is sweetened with Splenda® (the active ingredient  in Splenda® was initially developed as a insecticide.  So that’s comforting).

Suprep® is a split-dose prep.  You drink half of the night before the colonoscopy and the other half the morning of the procedure.  I was instructed also to not eat any solids and only consume clear liquids the entire day before and morning of the colonoscopy. Not eating solids was actually easier than I expected.

Each dose of Suprep® is 6 ounces to which water is added making 16 ounces which you then drink. It tastes like water-downed cough syrup – berry flavored.  I thought I might be able to chug it down quickly like a beer, but to no avail. The consistency of the prep is too viscous to make chugging doable, at least for me. And,  I found myself drinking it in quick short sips.  Each dose is then followed by drinking 2 glasses of 16 ounces of water to prevent dehydration and facilitate cleaning of the colon as the prep draws fluid out of the intestinal tract.  My stomach did small somersaults following each dose with minimal nausea and bloating.

The Colonoscopy Procedure

Some patients find the procedure mildly uncomfortable, but I did not.  In fact, I could not tell anything was done other than having minimal and vague discomfort in my left lower quadrant for a day following the procedure, but nothing that slowed me down.

I was told the colonoscopy would be free going in, but it would cost two thousand dollars to remove the scope from my body.  I’m glad someone (insurance company) had the two thousand dollars so the scope could be removed. That’s a joke.

The anesthetic I received was Propofol, a “killer” anesthetic (it’s what Michael Jackson used when he died), which burns a little bit as it enters the bloodstream through an IV. But, I fell asleep quickly and awakened as if almost no time had passed. I had Propofol once before for a spine procedure and experienced much the same that time, too. Propofol is very safe when administered by an anesthesiologist for appropriate indications.

I recommend that a gastroenterologist perform the your colonoscopy as recent studies suggest that colonoscopy is safer and fewer colon cancers are missed when a gastroenterologist performs the procedure as compared to physicians with less training and experience.

There’s no reason to be skittish about having a colonoscopy performed for colon cancer screening.  Given today’s newer anesthetics, newer scopes, and increased experience and skill of doctors, colonoscopy can be performed with little if any discomfort.  

Anyone who can come up with a better bowel prep than what currently exists stands to make a fortune.  So keep that in mind if you’re entrepreneurial.

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Dr. Joe Jacko

Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio at Grandview Primary Care. Read more about Dr. Joe Jacko

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