DEAR DR. GOTT: My wife is 82 and in good health. She exercises and eats well. She takes metoprolol and warfarin and has been urged to have a colonoscopy. She had breast cancer two years ago. Do you think a colonoscopy is appropriate?
DEAR READER: Let’s first discuss your wife’s medical history. She has a history of breast cancer. She is also on metoprolol, a beta blocker commonly used to treat hypertension (high blood pressure), chest pain such as angina and other conditions as recommended by your physician. Because you don’t mention hypertension, hers was likely prescribed because of a cardiac history.
Warfarin is an anticoagulant that reduces the formation of blood clots in veins, arteries and the lungs. It is prescribed to prevent heart attack and stroke. Again, you don’t mention stroke or blood clots, so I interpret the warfarin prescription is cardiac-related, as well.
Has your wife had a change in bowel habits, abdominal pain, blood in her stool and a history of polyps, colon cancer or other intestinal suspicion that needs to be addressed or readdressed? Is this her first colonoscopy or has she had one or more in the past — perhaps with questionable results? If you can answer yes to any of these questions, this may be the reason why her physician is recommending a colonoscopy. With what appears to be a cardiac issue, possible hypertension and her age, I am not sure that her physician or gastroenterologist would have recommended the procedure arbitrarily.
Colonoscopy is a simple procedure recommended for everyone over the age of 50, with follow-up on a periodic basis, usually every five to 10 years. The procedure can detect cancerous polyps and a host of other problems, often nipping them in the bud. However, before committing to anything, I feel your wife needs to visit her physician to determine the exact reason for the recommendation. This holds true of virtually every procedure for everyone. The only way a person can make a decision is through education. So, become educated. Ask your wife if you can accompany her during the visit. Most often, two heads are better than one in sorting things out and for hearing everything that is said. If she disapproves, then she should go on her own with a list of questions that should be answered to her complete satisfaction.
To provide related information, I am sending you a copy of my Health Report “An Informed Approach to Surgery.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
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