When can colonoscopy screenings be stopped?

March 9, 2011 By

DEAR DR. GOTT: My mother is 79 and had a brother who died from complications of colon cancer. She is scheduled for another colonoscopy soon, and we wonder whether there is a point at which this uncomfortable procedure will no longer be recommended. What are your thoughts on the benefits versus the risks, or is it an individual decision based on the person’s health history?

DEAR READER: To my knowledge, there is no set age at which colonoscopy is no longer recommended. Your mother’s medical history will tell the story. She should discuss her concerns with her physician. It is also her right to discontinue the testing whenever she chooses regardless of a doctor’s advice.

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What’s the right timing for medical tests?

December 19, 2010 By

DEAR DR. GOTT: I’m a 49-year-old female. I have given birth to three children ages 19 to 24. There is no known history of ovarian or breast cancer in my family. My brother and I both had our thyroid glands removed due to cancerous tumors.

For the last 25 years, I have had annual PAP smears and vaginal/anal exams, with great results. Last month I went to my internist for an annual physical. This was the fourth year I have seen him. He’s done my gynecological exams and PAPs. This year he said that regulations have changed and because I have had three successive normal PAPs, I do not need one for three more years. I questioned whether this was due to new research or new regulations. He said “new regulations.” I told him I wanted one anyway. My insurance will pay, and I’m not concerned about the cost if the procedure isn’t covered. I am concerned about cancer.
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Colonoscopy at 50?

November 13, 2010 By

DEAR DR. GOTT: I just turned 50, and my doctor keeps talking about ordering a colonoscopy for me. I’m not sure I want to undergo one and haven’t even asked what one entails. Can you enlighten me?

DEAR READER: This is a simple same-day procedure, meaning that you will enter the hospital in the morning, have the procedure performed, and be discharged a short time after the sedative wears off.

Colonoscopy is preceded by a preparation that will be explained by someone from your doctor’s office. You will be given a solution to drink that will remove all solids from your digestive tract. Following that, you will be restricted to drinking liquids such as clear soup broth, fruit juice, ginger ale or tea the day before. You can work or function as you would ordinarily but will find yourself spending a fair amount of time in the bathroom.
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Is a colonoscopy called for?

May 12, 2010 By

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.
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Daily Column

October 13, 2008 By

DEAR DR. GOTT:
I have put off writing to you about my problem as it is not one usually mentioned in polite society; however, others may benefit from your reply.

I am a 74-year-old female in good health. Over the last few months my bowel movements have become consistently hard, small lumps. I mentioned this to my doctor during a routine check up and told him that I had been using stool softeners and Metamucil with little effect. I was told to take large doses of Metamucil (which I had been doing since the onset). I also tried your colon cocktail. I have not seen any improvement and know I shouldn’t have to strain as I do. Should I be concerned? This has never happened to me before and came on quite suddenly. I don’t drink a lot of water but no less than I have always done.

DEAR READER:
I urge you to see a gastroenterologist. Sudden changes to bowel movements (such as consistency, frequency, or color) that are not related to changes in diet or lifestyle need to be addressed. The specialist will examine you and likely order blood work, occult blood fecal tests (to determine if there is blood in your stools) and a sigmoidoscopy or colonoscopy to visualize the colon itself. It is important that this is done quickly to determine if the cause is something benign such as polyps or more sinister.

He or she will likely ask you if you have made any dietary modifications, started new medications or are currently taking anything that may now be causing side effects. If the cause is benign such as irritable bowel syndrome, or no cause is determined, your doctor may recommend increasing your fiber intake, occasional laxative use and increasing your fluid intake.

I also urge you not to strain because you may be causing damage to your colon. Straining can lead to hemorrhoids, anal fissures and other uncomfortable conditions.

To give you related information, I am sending you a copy of my Health Report “Constipation and Diarrhea”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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Daily Column

May 6, 2008 By

DEAR DR. GOTT:
As a senior citizen, I am forced by my gastroenterologist to have a colonoscopy every few years. As anyone who has undergone this ordeal knows, the solution that you that must drink to cleanse your system beforehand has what is undoubtedly the worst taste in the world.

Recently, while drinking the first of the 16 required glasses, I suddenly had a thought. I am willing to endure the taste as I consume each glass, but why must I continue to suffer during the 10 to 15 minute rest period between glasses? What I did was to prepare a glass of diluted soda pop and, after consuming each glass of the solution, I took a sip of my “secret” preparation, refreshed my taste buds, and immediately spit the remainder into the sink. The result was that I did not have to suffer the bad taste while waiting to repeat the process. When I told the nurses at the hospital what I had done, their immediate response was, “Why didn’t we think of that?” For that reason, I concluded that my “invention” might well be worth sharing with other long-suffering senior citizens. If they follow these simple instructions, everything will come out all right!

DEAR READER:
This is a great solution to a common and annoying problem. Many patients have complained to me about the taste of the preparation necessary before colon studies and have asked for something that will reduce the flavor. Until now I have not had a solution. Because I believe many will benefit, I am printing your letter.

In addition, there are new laxatives that are much easier to use than the old-fashioned types. Thanks for writing.

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Daily Column

April 8, 2008 By

DEAR DR. GOTT:
I am a 35-year-old female, am relatively healthy but have chronic constipation. I am taking Zelnorm and milk of magnesia but still only have a bowel movement once a month, usually at the time my menses start. It is very painful to pass the stool because it is like a big ball.

Recently, I started feeling tired and run down after normal activity. I consulted my medical doctor who ordered a colonoscopy and blood testing. The results of the colonoscopy were negative. Blood tests indicated my red blood count was four, so I’ve been taking iron pills for three months. It is still four. Where do I go from here?

DEAR READER:
A red blood cell count of four is hardly abnormal. I don’t believe you are suffering the symptoms of anemia.

When did the constipation and fatigue start? Do they coincide? Have you been diagnosed as having Irritable Bowel Syndrome (IBS) with constipation? (I would also like to add that having one bowel movement a month is a near physical impossibility, especially when taking Zelnorm, a drug used for the short-term treatment of IBS with constipation and milk of magnesia.)

Zelnorm shows improvement in most individuals who take it but can cause diarrhea. Milk of magnesia encourages evacuation. It seems to me that when taking both these medications, you would hardly be able to leave the house for fear of constant diarrhea. It also suggests that you may have an intestinal abnormality causing obstruction or a similar disorder.

You need to be seen by a gastroenterologist. I believe your symptoms are related to your chronic constipation. If the gastroenterologist determines there is no physical reason for the constipation and believes the fatigue is from your very slight anemia, you may wish to see a hematologist (blood specialist) for further evaluation.

To give you related information, I am sending you copies of my Health Reports “Irritable Bowel Syndrome” and “Blood — Donations and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

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Polyps not cause for concern

March 3, 2008 By

DEAR DR. GOTT: Please tell me what causes polyps in the colon. I had eleven removed in 2001 and now have to have a colon test every year. Every year I have at least two or three more new polyps removed. Am I at risk of colon cancer? I constantly worry that I am.

DEAR READER: Polyps are small growths that usually arise in the lining of the colon or sinuses. They are generally non-cancerous but rarely some types of polyps may be pre-malignant.

There is no clear cause for polyps except those associated with familial polyposis. This condition is caused by a mutated gene and therefore runs in families. These polyps have a high malignant potential and generally occur around puberty.
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