Fun with Colonoscopy

You want to put a long hose, up where?

#WellnessWednesdays

Although I am not looking forward to it, I have scheduled my next colonoscopy.

Even as a doctor I stress the importance of a regular colonoscopy test to look for cancer. I advise may patients, but have been delaying my own exam.

In the past, the age of 50 was the recommended time for beginning the screening colonoscopy exam. However recently the Mayo Clinic and the U.S. Preventive Services Task Force recommends that the beginning screening age be lowered to 45. The Task Force further recommends that adults age 76 to 85 talk to their doctor to see if continued screening is necessary.

So let me reiterate the recommendation. If you are 45 and are at average risk, you should have a colonoscopy screening.  You should repeat this process every 10-years if the screening test showed no lesions or polyps. Risk factors include age, or family history, or blood in your stool, unexplained abdominal pain or weight loss.  Don’t wait if you have these. Consult with your physician.

This screening process is important because of the way colon cancer, also known as colorectal cancer grows. Tumors or polyps that appear on the inner wall of the large intestine or rectum may not create symptoms. You probably would not know about them, but for the screening.  In the U.S., colorectal cancer is the third-leading cause of cancer in men, and fourth in women.  Diagnosing and treating this cancer early can save your life.

Further, the research also shows that colorectal cancer disproportionately affects the black community, where the rates are highest of any racial or ethnic group in the US. African Americans are about 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups.  Something to think about, isn’t it?

Long and Short of Colonoscopy

My apprehension to undergo the procedure was just the mental picture of knowing that a “long hose” with a light and camera attached at one end will be pushed up “you know where” and also the preparation time needed to clean out the intestines.

A colonoscopy lets a doctor closely see the inside of the entire colon which is about 5 feet (150 cm) long, and divided into five major segments. The rectum is the last segment.  The doctor is looking for polyps that over time can become cancer.  If a polyp is seen it is removed by the “long hose” and sent to test for cancer. While the procedure is being done small amounts of air is pumped into the colon to keep it open and facilitate the doctor clearly seeing the inner wall of your intestine.  Don’t be surprised or embarrassed because this ‘air’ will have to be ‘released’ through the natural opening of your body, again if you know where I mean, over the next 12 to 24 hours.

Your doctor may recommend a sigmoidoscopy. There is a difference between a colonoscopy and a sigmoidoscopy.  If your doctor recommends a sigmoidoscopy, only the first 2 feet (30 cm) of the colon will be examined.  Remember a colonoscopy looks at the entire 5 feet (150 cm) of the colon.  Another very important difference between the two procedures is that you will be given medication to make you sleep through a colonoscopy so you don’t feel any pain or discomfort but medicine usually is not given for a sigmoidoscopy.

While serious side effects of having a colonoscopy are rare, you will probably lose a bit of weight preparing for the procedure. Your bowels need to be completely clear for the test. That could mean you take an enema, laxatives or avoid solid food for two to three days before the exam. And, you will need to be close to a bathroom.  The exam itself takes about 30 minutes. Finally, plan on having someone go with you for this test so they can take you home afterwards.

Reduce Your Risk of Colorectal Cancer

Now supposed I told you that there is a way to decrease your risks of developing colorectal cancer? Would you be interested?  Well there is a way. Your diet.

Multiple research studies have shown that what you eat plays a large role in your risks for developing colorectal cancer. Studies show that a diet of mostly fruits, vegetables and a moderate amount of fish appears to offer the most protection against developing colorectal cancer.  A study published in the JAMA Internal Medicine, found that a Pesco-vegetarian diet–predominantly fruits, vegetables and including a moderate amount of fish–is associated with a 45% reduced risk for colorectal cancers compared to people whose diet included meat.

Researchers at Loma Linda University also studied and analyzed the diets of over 78,000 people and then compared the diets to cancer incidence rate to establish the number of people who might develop colorectal cancer. The research found that vegans who do not eat any foods derived from animals or fish and do not eat dairy products such as cheese, butter, milk and eggs, were at a significant lower risk for colorectal cancer compared to non-vegetarians.  But the research interestingly found that the Pesco-vegetarian diet, a vegetarian diet that abstains from meat except for fish, appears to offer the most protection against colorectal cancer. Did you get that? Eating meat in your diet may be a contributing factor to you developing colorectal cancer, especially in the African American population, but substituting fish for meat is protective.

So, in conclusion, it is my recommendation that you have your regular  colonoscopy beginning at age 45 and seriously consider adapting to a vegetarian diet and specifically a pesco-vegetarian diet. And at your next visit with your health care provider, why not take the initiative yourself and bring up the subject of the “long hose?”

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