Thursday, September 18, 2014
Would a Colonoscopy be Indicated?
I`m 56 and in decent health except for recent bouts of constipation/diarrhea and some rectal bleeding (only a moderate amount, but distressing to me). I only recently started seeing a famly practice doctor to get routine screening exams and she suggested geting a colonoscopy; my mom had a history of adenomas and my dad had a colon resection in his 40`s. Both my parents are deceased and were living overseas so I don`t have details of their medical histories, but I`m pretty sure that my dad did have colon cancer. My doctor said that she could do a flex in the office, but that we should just go ahead and consider me high risk and do the colonoscopy. That`s my first question: is that reasonable? I live alone in a remote area and will have to drive myself home from the colonoscopy, so I can`t get sedation (which is o.k. with me)..so my choice is a colonoscopy without sedation or no colonoscopy. My second question: is an unsedated colonoscopy of lower quality than an exam with drugs? I understand that it`s uncomfortable; that`s o.k. I spoke with the GI department of the hospital where the exam will be done and the answers range from "colonoscopy can`t be done unsedated and if it is the quality will be poor" to: "if you can tolerate bad gas pains, you should be fine, and unsedated exams take longer". The GI department initially told me that an unsedated exam was impossible, but theycalled me back the next day and said that unsedated exams are possible, but that they discourage them because it slows their schedule down too much. I would appreciate your opinion. Thanks.
A colonosocopy should be done in view of your age and risk factors. Unsedated exams are difficult for both patient and physician. I would consider getting sedation, and staying in a nearby hotel overnight; ask if that can be arranged through the department.
Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati