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Back of the Pack: A kinder, gentler colonoscopy?

Health

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A kinder, gentler colonoscopy?

Comments (32)
By Peter Hadzipetros

A co-worker's been asking a lot of personal questions lately. See, he's reached a certain age, too. An age when the medical industry seems to take a sudden interest in you — especially what's inside you.

The industry develops this overwhelming need to probe your inner depths, put you through all kinds of tests, just to make sure you'll be around long enough to eventually cost the system a fortune.

Now, most of these tests are a snap for the average person. Not so for those of us who get light-headed even looking at a picture of anything that — in the hands of a doctor — could be used to mess with the way nature meant your body to be.

High on that list is the colonoscopy. Everyone's heard of it. Everyone dreads it. And with good reason. The thought of somebody in a white coat threading more hose than you'll find on a fire truck through your back door isn't exactly appealing. The invasive nature of the procedure has my colleague concerned.

I can understand that he's not looking forward to entering that waiting room — the one where you can tell who's in for which test. If — under their hospital gown — they're wearing something below the waist, you know the optical scope is going down the throat. If you can see their knees and they're nervously tapping their foot, the scope's taking an alternate route through the body.

Well, there's another option. A recent study suggests the virtual colonoscopy — or the three-dimensional computed tomography (CT) colonography — is as accurate as the old-fashioned procedure.

And that's important. According to Health Canada colon cancer is the third most common cancer. It kills more than 6,500 Canadians a year.

It's highly treatable if caught early. But, by the time you're exhibiting symptoms, the disease is already well established.

Not everyone's on the virtual colonoscopy bandwagon. Some gastro-intestinal doctors say the procedure may be a little too sensitive and may detect abnormalities where none exist.

The other advantage to the old invasive way of doing it is that if the scope detects something that shouldn't be there, it will remove it. No need for another procedure. If the virtual colonoscopy finds something, you have to go back and take it the old-fashioned way again.

Still, my co-worker shouldn't worry about the procedure. They recommend sedation. I concur — even though I've been known to be a little wobbly after undergoing a blood test or taking a needle in the arm.

All I remember is feeling a little sting in my hand and a voice telling me to roll on my side, "before you get too comfortable." When my eyes opened, I was in recovery.

The colonoscopy is a piece of cake. Getting ready for it — well, that's another matter.

Spending the evening before your test cleaning out your system by drinking — and then rapidly disposing of — four litres of a fluid that is cruelly mislabelled "new improved flavour" is truly an endurance event. Keep a good book — maybe a few — handy.

Virtual Klean-Prep: now that would be a breakthrough.

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Comments (32)

Fine

I just had my first colonoscopy today, by Dr. Heed. I felt no pain whatsoever. I had asked for numbing cream, but wasn't even awake for that.

Posted January 3, 2007 01:52 AM

J. Fraser

Ontario

As a supplement to my previous posting 21 December regarding my colonoscopy, I can tell you this now post-procedure. My doctor prescribed Pico-Salax as the laxative, it was easy to take, 2 small doses, not unpleasant to drink. The following bowel movements were not so bad, rather infrequent and not irritating. I did keep up with fluid loss. As it seemed so easy I was worried my bowel was not completely flushed out. When I entered the procedure room the anesthetist was pleasant and gave me enough relaxant to not recall the procedure. My surgeon was very happy with the results of the Pico-Salax. My bowel was very clean. What a relief, my bowels are free from problems at this time! I guess mom is looking down at me now with a big smile. I would like to give thanks to the folks who make Pico-Salax, my surgeon Dr. Olsson, Dr. Beaver, and the nursing staff at Norfolk General Hospital. They made my experience a very tolerable and unbelievably easy one. They are a great team of professionals.

Jim Fraser

Posted December 23, 2006 04:24 AM

J. Fraser

Ontario

My mother complained of abdominal cramps and pains. When she finally had testing in May 2003 (colonoscopy) it was determined she had cancer. In fact, she had colon cancer Dukes "C", the worst stage of cancer. It had metastsitized beyond her lymph nodes. She had chemo and in March 2005 she was placed in a wonderful hospice. Mom passed away in June 2005. The doctors and nurses were wonderful and did their best. I am now 50 and having my first colonoscopy tommorrow. I want to dect a problem before it's too late. I wish mom had testing before it was too late. Take heed folks, an ounce of prevention is worth....

Posted December 21, 2006 04:08 AM

Harold

Boston

My exp. I orig had a colo 6 mo ago aft turn 50 aft nagging of wife,dad had c cancr.Bosss wife had year of hell with c cancer w/surg, rad,chemo. & aquaint in 40s, now dying from c-cancer. I was scared S-less after web research. Lost 10lbs from worry, couldt eat 2 wks bef proced. Was nervous wreck! # of my friends, wife said was no big deal & just slept through it. I calld the md and told them I wont do gallon of crap my wife did, wanted sometg else. They RXd Miralax. It was great! No taste at all! It wked vy mildly. No cramp, vy few b-room trips. But, didnt clean me enough.Aft scope insert, MD had to stop.Was crushed! Have to try again! 1 good thing, as soon as meds inject, lost all stress & became vy relaxed.Noted scope slid in vy easy.This was easy! List to wife nag for anoth 6 mo, got courage to sched new test. This time, bec of my 1st exp,MD put me on 3 day prep. No food for 3 DAYS. Had to take 1/2 dose of M-lax 2nd day and full dose the 3rd. Able to drink Ensure tho, 4 2 days. Drank lots of juice. Wasn't bad. Didnt miss food that much.& as b4,the M-lax was easy even 4 2 days.Was less stressed this time, prob bec of my prev exper. So yday I went for the proced. Had my ipod with me during the proced,and as bef,as soon as the meds hit, I relaxed and started a playlist on ipod of slow jazz, closd my eyes& relaxed. Tube slipped in real easy again.Then, a moment of discomfort it was pushed to the end of my colon. Wasnt bad at all and prob wasnt more than 3 seconds. After that, absol. no discomfort at all. After few min saw it wasnt so bad,relaxed in a nice high and list. to music. After a couple songs, was relaxed enough to open my eyes and look at monitor, where I watched the last few min of the proced. Awake, aware entire proced, w total memory, unlike many friends. Maybe diff MDs use diff meds and strengths. Unbelievably easy. If youre thinking about having it done, dont think. Just do it!

Posted December 15, 2006 04:48 PM

Randy Huff

work

I just had my 3rd one in a year done on 11\30\06 and the Dr. had a bad day and started the test before the Meds took affect.All I remember was PAIN and screaming,and then I was in recovery rm.He finally came around and said he found ANOTHER POLYP and removed it.Did'nt know the statis of it and to have it done again in 2YEARS!!!!This was done at a major high dollar hospital and I won't go back there again.At least my family Dr. will talk and listen to me.

Posted December 15, 2006 06:54 AM

withheld

ontario

I suffered a ruptured bowel a few years ago and since then have been overly concious of any bowel changes either in habits or type. The surgeon who operated that first time should receive a medal and the four bowel re-sections that followed, in hindsight, don't seem as bad as the colonoscopy prep. Every 3-5 years I need the colonoscopy but there doesn't seem to be any concensis as to the number of days without food and how many doses of citro-mag are required to completely knock you silly. This time even my dog is mad with me - he didn't get to share my morning toast with me and I was damed if I was making the dog toast when I can't eat any of it for another 2 1/2 days. Given that I don't have a medical degree, although there are days when I know what is going on inside me better than the guy/gal with the degree, I follow what I am told to do. The doctors all seem to have their own likes and dislikes for the prep but surely they can at least get the number of days right when it comes to not eating. At one time the prep included a day of a light diet and then fluids on day 2 and the colonoscopy was done fairly early the next day ( before noon). Now that they have all these baby boomers reaching the dreaded 50 mark it necessitates colonoscopies to be done well on into the afternoon which only prolongs the suffering. The citro-mag will do it's job most asuredly so if I sneak a cracker or a drop of milk in a cup of tea 2 days before the dreaded colonoscopy will it really matter? I figure it will all come out in the end.

Posted December 5, 2006 01:14 PM

Brian

Ontario

......'preciate the comments, exactly the type of stuff I pay attention to. Closing in on 50 yrs old, I have NEVER been "Dr friendly", not even a physical. Was taken, kickin' and screamin', to a liver biopsy a few yrs back(hep C)and had to be given a sedative.....THERE'S NO WAY I would stand (or lie down) for something like this. Invasive procedures like this, can be done at my autopsy...............

Posted November 4, 2006 09:13 AM

Lynne FitzGerald

I am one of the lucky ones!
I was diagnosed with colon cancer stage IV on Jan 26 2005. It had spread to my liver - no symptoms until about 3 weeks before my diagnosis. I am not obese, I walked to work, I ate organic vegetables when I could afford them and I had no family history of colon cancer - but there I was... dumbfounded! Why didn't they have a PAP smear or something, a mamogram anything to test me to see if i had this beast lurking in my body!
Well, It's November, 2006. I have had a colon re-section, 9 horrific months of ferocious chemotherapy and a blessed liver re-section. I'e lost my gall bladder also but i don't care! I am alive! And I am cancer free at the moment. Never again will I fear my colonoscopy because never again will I have to drink 4 litres of anti-freeze before my colonoscopy. I feel blessed because I also have discovered pico-Silax!! I will welcome it as I will welcome every CT scan. Anything that will keep me from having that beast - that colon cancer back in my body! If I could just get my short term memory back again so I could go back to work - life would be perfect.
But hey, I'm alive. I'll just live on my line of credit.

Posted November 4, 2006 12:05 AM

Elsie

Moncton

I had surgery on July 24th 2006 for a tumor in my lower rectal of my colon. The cancer had spread thru the pelvic wall into the ovaries, so that meant a complete hysterectomy at the same time as the bowel resectioning. I had a barium enemy done 2yrs previous because of blood in my stool but because the tumor was so low, in the rectal canal the tube they use of the barium covered that part of the bowel and it was left undetected for the next two years until the pain got so pain I could hardly function and lost 60 lbs. Now Thank God I'm feeling much better but still having some problems with bowel function and also dealing with nerve damage on my left leg and hip area that happened during surgery. If anyone has any post surgery tips for me about bowel control, I would love to hear it.

Posted November 3, 2006 11:51 PM

Liz Montour

Well I don't concur with your opinion that a colonoscopy is a piece of cake. I just had mine a few days ago. My first day started with preparation and starting of drinking prescribed fluid at 5:30 pm, cramping and lots of time spent in the bathroom. Next morning I was thirsty, but told not to drink anything. I underwent procedure at approximately 9:30 am and was given anesthesia. The doctor did his thing and I was so uncomfortable that he told me if I did not quiet down he would stop the procedure. I muffled my groans as well as I could and the nurse gave me a second dose of anesthetic. I threw up in the recovery room and on the ride home. I slept all afternoon and it took me another day of light activity before I started to feel totally normal. If you have not gone through it, you have no idea of what it is like. I am glad to have done it, as the results were negative and I feel great about that, but never again!

Posted November 3, 2006 11:42 AM

gil

toronto

I have Crohn's disease and have had at least 12 colonoscopies ( I've lost count ) and I can say that it is not very pleasant, and doesn't get any easier the more you had it done. The prep for the procedure is really annoying too. (Fasting and drinking that stuff to clean out your system, Yuck ).

However my GI doctor said that on scoping can predict you bowel health up to 10 years into the future. So even though it is invasive, ( the sedation really helps ) it is a good thing to do if you have symptoms or a family history of Bowel problems.

I wouldn't mind trying the virtual scoping, where you swallow a small camera in a capsule and then they take photos of your insides every 10 secs for about 8 hours.

Posted November 3, 2006 10:48 AM

Ray

BC

I recently had my third colonoscopy. I have a family history - my father had successful surgery for colon cancer at 74 and his grandfather died of it. (His father didn't live long enough to find out....)
My two prior colonoscopy screenings were negative. In September I developed agonising abdominal pain that took me into the ER for three days of morphine with X-rays, ultrasound and CAT-scan that found nothing. Two days later the surgeon had me in for a colonoscopy - about all there was left to check - and it was thankfully also negative! The conclusion - probably a musculoskeletal problem with referred pain from a pinched nerve. I had recently worked for two days on the roof removing moss. Proved two things by it: first, I am still capable of doing the job - and second, at 75 it wasn't a good idea! I lived on pain killers for a month, then the pain stopped and all is well again! As for the colonoscopy, it's a piece of cake - and amusing to watch the TV display of my interior. But the prep is another story!

Posted November 2, 2006 03:35 PM

Caroline

Hamilton

I recently celebrated my 9th cancer-free anniversary, following major bowel surgery for colon cancer. I was lucky that my tumor produced symptoms (colon cancer often doesn't)though I wouldn't wish the two months of excruciating pain before diagnosis on anyone. The surgery was extensive but I'm better than ever, since; I didn't need chemo or radiation, and EVERY test since then has been good news. I actually saw the tumor at the same time the doc did during my first colonoscopy -- no doubt about it, and at last I had an explanation for the pain.
I've had several colonoscopies since (none of which I stayed awake for) and now go every 3-5 years. Yes the Klean-Prep is horrible -- so thanks, Doug James, for the Pico-Slax suggestion. I'll try it out on my doc next time I see him..
Do the test! Life is better!

Posted November 2, 2006 12:57 PM

jOE L

toronto

Due to unspecified internal bleeding i have had at least six colonscopy and five endoscopy procedures in the last four years. the prep.is horrible but the procedure vas easy.I was enbarrassed and a little dizzy.Once they did both procedures on the same session and my main concern was i hope they have two scopes or top end first please.Also four polyps where removed.My problem is still uresolved but at least i do not have colon cancer

Posted November 2, 2006 12:08 AM

Robert Millar

Brossard,Quebec

I lost my father to colon cancer in 1951 when I was 17.My brother died from it at age 45 in 1988.My doctor immediately recommended that I have a colonoscopy.As others have stated the pre-treatment(cleansing) was and still is the treatment from "hell".The scope used at that time was the size of a garden hose.Medication was a necessity.Since 1988,I have had on every two years(#10 this year).Some years they have found polyps,other years they have found nothing.This year they found two polyps that were cancer free buy(always a but)one of the polyps had cells in it that a prone to turning cancerous.So now I go no a yearly cycle.I don't think the virtual CT scan would have found this without having to have the procedure anyway.Yes,the prep has not improved over the years but the tube size has diminished to the point where I have not required sedation for the last 5 procedures.
Having been through several prostate biopsy's and a radical prostatomy a colonoscopy is a piece of cake.

Posted November 1, 2006 03:29 PM

Wayne

Foxtrap

My mother had colorectal cancer two years ago & thank God she survived. As far as I can remember, she always complained of a problem with her bowels & was treated for irritable bowel syndrome. Looking back in hindsight, I believe she wss mis-diagnosed, but that is another story.

Due to her cancer, I was required to have a colonoscopy. To me, the word itself evens sounds dangerous. Even more so when it was explained to me that there was a 1 in 1000 chance that my bowel could be punctured during the invasion and I would therefore require immediate surgery.

I went through the 'prep' from hell & if the taste is now described as new & improved, then thank God for that. I would not have survived taking the old & inferior. The new & improved is a vile and despicable concoction that would be cruel to even test on cattle.

However, I did endure the prep & on the day of my procedure, felt relieved & was actually looking forward to it. Having gone through the prep I felt invincible & that I could now take whatever may come along. The procedure itself was more embarrassing than painful. I received only a minor sedative, was alert throughout, watched the intrusion on a monitor in front of me, & talked openly with the doctor. In the end (pardon the pun), everything was ok & I am now required to take another test in 5 years time.

I found the pre-treatment to be worse than the actual test. When I consider what my mom went through, I am more than willing to take the 4 litre cocktail from hell at all costs. Consider the alternative & do yourself & your family a favor - get a colonoscopy.

Posted November 1, 2006 07:19 AM

withheld

I was referred to a specialist in 2002,after having some minor rectal problems caused by a reaction to an antibiotic for a sinus problem. The specialist recommended a colonoscopy and found I had polyps. Two were removed at that time, but one was very large and could not be removed by that method. I underwent surgery to remove a foot of my colon about four months later.
Luckily for me all polyps were benign. However, had I not had the colonoscopy they would have stayed undetected and most probably become cancerous at a later date. In 2005, I underwent another colonoscopy to make sure there was no new polyps. All three procedures were a piece of cake. I watched the first one on T.V. The surgery was expertly performed and I recovered very quickly after having major surgery. During the 2nd colonoscopy last year I think I fell asleep. I don't remember it at all. Please don't hesitate to have a colonoscopy if needed. They are a life saver. I am now 66 years old.

Posted November 1, 2006 12:05 AM

Jay

London

I got problems so I get one done every year. Something to note for those going in for one, I wouldnt necessarily recommend sedation.
If you spend an entire day cleansing yourself, you generally are feeling a little weak. Throw in the sedation and it turns into a two day hangover. Also, when you take the sedation, they suggest not to eat for several hours. Having no food for a day, generally I am feeling pretty hungry when I get finished.
It can be a little uncomfortable and painful. But definitely bearable. Certainly the worse part is the cleansing. And if you stay awake you can watch the video. :)

Posted October 31, 2006 09:57 PM

rob

ontaro

been there done that. thanks for an entertaining description of our reality.

Posted October 31, 2006 04:35 PM

jim thompson

kingston

speaking of colonoscopy's in 1991 after the 3rd one it was determand that a colon operation was required to remove a cancer they found.After the proceedure I was required to have one every 6 months for the next 2 years,then every two years for the rest of my life ....so next year will be my 19th look see and compaired to the operation a colonoscopy is a wiz...believe me..

Posted October 31, 2006 02:26 PM

Pat D

I have a fanily history too, and had my first routine screening, luckily clear. (And the prep from hell, about which I whined to my family all through!)The sedative I was given was Versed, which I'd never heard of - turns out it's a 'conscious sedative' so I came to with nothing but a feeling of having just forgotten a dream. It seems you're actually able to respond during the procedure which can be informative for the doctor, I'm sure, but you don't remember it afterwards. Isn't modern medicine impressive! It makes me very grateful for our wonderful medical system, whatever problems it may have.

Posted October 31, 2006 02:22 PM

Withheld

Ontario

There is no doubt that a colonoscopy can be a lifesaver. Yes... preparation is a little uncomfortable, but its nothing compared to the alternative.

My husband, who is of a certain age, experienced some intestinal upset this past spring... and has a wonderful Doctor who referred him to a specialist. Within weeks, he had undergone a couple of examinations, and it was determined that a colonoscopy would be required. The procedure took half an hour, and was painless (he slept through it). Two weeks later, the specialist told him that they had located a polyp, it had been removed and tested, and it was the variety that, with 100% probability, turns into cancer.

The amazing thing is the symptons my husband experienced had nothing to do with the polyp. He was lucky - lucky that he listened to his body, lucky to have a diligent doctor, and lucky that it was all caught before things turned ugly. I get sick just thinking what might have been, had he not undergone testing.

Colon cancer is silent. By the time you experience symptoms, you life could be in serious danger. Suck it up and take the test.

Posted October 31, 2006 01:26 PM

Cindy Orr

My Aunt passed away two and a half years ago after a horrific battle with colon cancer at the age of 54. Since my maternal side was now obviously genetically predisposed - my Mother, Aunt and Uncle were also sent for colonoscopies (where polyps were found and removed in all of them). Last fall, at the age of 24, I was sent for my first barium enema. I completed the 2 days of 'prep' and drove myself in for the procedure. I'd be lying if I said it was pleasant, but there are certainly worse things to suffer in this world. For all of you who may doubt yourselves ... I would not wish a colorectal cancer upon my worst enemy! Please endure the preparation and screening. Your health is invaluable.

Posted October 31, 2006 12:54 PM

Harry Panjer

Elora

I am on a five-year cycle due to family history. The last time, a large polyp was found. I go in later this week for the followup procedure to remove it. The procedure is completely pain-free, recovery is easy. The only grumble is about the prep the day before. It's inconvenient to be in (or close to) the bathroom for most of a day. If you are given a choice, I recommend the pico-salax-based prep.
All in all, this minor inconvenience is worth it. Knowing is better than not. I lost a brother to colo-rectal cancer. He didn't know until it was too late.

Posted October 31, 2006 12:45 PM

John

Toronto

I have had 2 of these invasive procedures and the first was when I was 31 yrs old. They found a polyp and the second time they found nothing but because of my age I have to return every 4 years like the Olympics. And the preparation for it was by far the worst part- they should sell that stuff for $100 a bottle because it does exactly what it states it will do, how many products out there can say that.

Posted October 31, 2006 11:40 AM

Sandra

I just had the dreaded scope completed and I quite frankly was pleasantly surprised. I was given a sedative and do not remember a thing. Luckily my results were negative. The worst part of the test besides the worry is the preparation, the purgatives!! I would much rather know, I wish the test had been available to family and friends who have died from colon cancer in the 60's.

Posted October 31, 2006 10:31 AM

Kate Brown

Ontario

Just waiting for the doctor to call with a date for my first colonoscopy at age 59, and more than a little nervous. But I'm just as afraid of sedation as the procedure itself. But the alternative is more frightening, so I'll bite the bullet and do the test.

Posted October 31, 2006 10:28 AM

Colin

Kitchener

I agree completely with both Andries and Doug. The prep may not be completely pleasant, but I found it much easier to cope with than watching my father die of colon cancer. Do yourself and your family a favour: find out about your own risk factors, minimize them, and if it is warranted, do the test.

Posted October 31, 2006 09:41 AM

John West

Michigan

Thanks for the pep talk. In the USA under private health care this procedure costs anywhere from $3,000 to $7,000! Since I'm on a high deductible insurance plan I will be paying most of this cost myself to go along with everything else you talked about.

Posted October 31, 2006 09:40 AM

john

winnipeg

I was just wondering at the age of 35 when I should consider going for this test. I recently had a friend die from cancer that began as colon cancer and it was an absolutely terrible experience. Concerned.

Posted October 31, 2006 09:34 AM

Andries Heidinga

Toronto

I'm just recovering from a year of treatment for Colo/Rectal cancer. It was the most difficult year of my life! I had 5 weeks of radiation, 3 months of chemo and two surgeries. It looks like I'm a survivor! Anyone who whines about taking a simple procedure like a colonoscopy should go see a shrink! It may save you from going through what I did. TAKE THE TEST!!!!

Posted October 31, 2006 08:36 AM

Doug James

Oakville

Entertaining, but articles like this are what continue to give colonoscopy a bad name. Preparations are not nearly as bad as you suggest and there is a product available that tastes almost like Orange Tang called Pico-Salex. My first colonoscopy was a breeze and I can now rest easy for another 10 years without worrying that one day I may join the ranks of those 6,500 who die of colon cancer each year.

Posted October 31, 2006 07:43 AM

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