|
Colonoscopies Save Lives
Prepping for procedure may be worst part
Click here to view this story as it appeared in the Morganton News Herald (Includes additional graphics and information) in pdf format.
Read other Blue Ridge HealthCare Health-Page stories at this link
BY ED HOLLER, MD
BLUE RIDGE HEALTHCARE
MORGANTON - The American Cancer Society recently reported that the incidence of newly diagnosed colon cancer has dropped. Even better news, the incidence of death from colon cancer was also down.
ACS officials attributed the decline to the increase in screening colonoscopies. Endoscopic exams of the colon and upper GI tract (esophagus, stomach and first part of the small intestine) have become the most frequently performed procedures done at Grace Hospital.
Colonoscopies are proven to find and treat polyps, felt to be the source of the majority of colon cancers. This year, it is estimated that more than 120,000 people will be diagnosed with colon cancer. The vast majority of these cancers can be prevented with early detection, which involves screening.
Why is this so important?
Recently I operated on a patient found to have a malignant tumor during a routine exam done by Mushtaq Bukhari, MD, a gastroenterologist. I found no evidence of distant spread during the surgery. This patient had her exam at the insistence of her husband despite having little or no symptoms.
If the tumor had not been found for another six to eight months, it surely would have spread to other sites. This exam not only saved her a long course of chemotherapy but most likely saved her life.
Who needs to be screened?
The current recommendations from the ACS are that all persons over age 50 undergo a screening colonoscopy. Those folks with symptoms (rectal bleeding, changes in bowel function such as diarrhea or constipation, or abdominal pain) should also have their colons examined.
Family history of colon cancer or colon polyps is also an indication for an exam. Family history is very important even though more than 80 percent of newly diagnosed cancers arise without any prior family disease. Patients found to have polyps in earlier studies should be checked with follow-up exams done on a regular basis.
I ask that you not postpone this exam if one of these indications applies to you because a colonoscopy could save your life.
What is involved in having an endoscopic exam?
A colonoscopy is an outpatient procedure done with a light sedation administered through an IV catheter and takes about 20 minutes to complete. Patients also must do a bowel prep at home the night before which functions as a laxative to cleanse the colon to permit a good visual exam. Most patients feel the bowel prep is the worst part of the entire process.
Generally patients recall very little of time during the actual exam due to the medications used.
Patients are asked to have a friend or family member present drive them home afterwards. Patients can resume normal activities the following day.
What are the risks?
With any procedure there are risks involved. The risks with an endoscopy include bleeding if biopsies are taken, therefore blood thinners and aspirin are stopped several days prior.
There is also the risk of tearing a hole the bowel.
Fortunately the risk of this occurring is very small, and if it should happen would require surgery to repair the site. Patients may also experience some abdominal fullness or bloating after the procedure due to air used to dilate the colon during the exam.
Who does the exams?
Talk with your caregiver about having your exam here in Burke County by one of our gastroenterologists or general surgeons. Efforts are currently under way to fast track patients by eliminating some pre-op evaluations.
This will mean less time away from work and fewer office visits. Also efforts are being made to lower the out-of-pocket expense to the patient which we hope will make the exam more affordable.
March is Colon Cancer Awareness month and is a good time for patients to discuss with their family doctor when an endoscopy is indicated.
Many local physicians perform endoscopies and generally appointments are made by referral through your family doctor. Should a malignancy be found - surgery, chemotherapy, and radiation therapy are all available at Grace and Valdese Hospitals.
Dr. Edwin Holler has been on the active staff at Grace Hospital since 1993.
Colonoscopy Facts
Who is a candidate for the test?
- A colonoscopy may be recommended for a person with:
- abdominal pain
- a change in bowel habits
- colorectal polyps, which are small growths on the intestinal wall that may lead to cancer
- a history of colorectal cancer
- mucus, pus, or blood in the stool
- prolonged or unexplained diarrhea
- ulcerative colitis
A colonoscopy may also be recommended for someone at high risk for colorectal cancer. This may include a person with a strong family history of colorectal cancer or polyps.
What do the test results mean?
Abnormalities in the lining of the colon may include:
- colorectal cancer
- colorectal polyps
- diverticulosis, which are pockets in the intestinal walls
- gastrointestinal bleeding
- inflammatory bowel disease
- abnormal blood vessels
A colorectal polyp, an abnormal growth of tissue on the inside lining of the colon or rectum, are very common. They affect about 25 percent of adults who are 50 years of age and older. They are most often benign, or noncancerous. However, polyps can sometimes develop into colorectal cancer.
When polyps are seen with a barium enema X-ray test, the person may need a sigmoidoscopy or colonoscopy. During these procedures, the healthcare provider can sometimes remove or destroy polyps through the tube. Otherwise, the provider may cut off a small piece of the polyp for a biopsy to be looked at under a microscope.
The second largest employer in Burke County, Blue Ridge HealthCare serves a four-county area and includes Grace and Valdese hospitals, Blue Ridge Home HealthCare, Grace Heights and College Pines Health & Rehabilitation Centers, Grace Ridge Retirement Community, Phifer Wellness Center and a number of physician practices.
|