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-feet-long 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 help you 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 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
computed tomography (“CAT”) scanning, a minimally invasive procedure. CT
colonography 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
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by Fred Cicetti