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Are colonoscopies worth it?

asteriskmag.com

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Re: Are colonoscopies worth it?

#91

Post by rocqua »

russellbeattie wrote: post #71

I had an abdominal MRI done a few years ago to look for intestinal issues, and was surprised at the resolution. Ever since I've wondered why we don't just do that regularly to see if there's anything that looks worrisome, before going through such an invasive process as a colonoscopy. Actually, I just looked it up. Apparently it's a thing and called "virtual colonoscopy" [1]. Seems like the future to me. 1. https://w…

MRI machines are much more expensive than colonoscopy machines. Orders of magnitude more expensive.

Re: Are colonoscopies worth it?

#92

Post by s1artibartfast »

People struggle with binaries. It is very likely that regular colonoscopies are net harmful for most people, and very beneficial for some.

The population isnt homogeneous.

Some people have significant risk factors, like family history, others do not.

We don't ask if everyone should start wearing glasses at 40, so why this?

Re: Are colonoscopies worth it?

#93

Post by stuckkeys »

sillysaurusx wrote: post #58

It’s time to share something personal again. When I was 20, I vividly remember being in the bathroom at my workplace when a large amount of blood started coming out. I did what any smart, effective 20yo would do: ignored it because I was embarrassed. Fast forward 10 years, and I’d been ignoring it for a decade. It had continued to happen every few months. Sometimes the blood was so bad I’d have to wait up to 20 minut…

Lucky you. I am color blind. I cannot see certain hues which in poop is very critical. Although once I did drink prune juice and I freaked the hell out after going to the bathroom (I had forgotten I had taken few cans) The color was so strong. But yeah, I think men in general like to postpone having to bring this to anyones attention and it sucks.

Re: Are colonoscopies worth it?

#94

Post by theodric »

sillysaurusx wrote: post #58

It’s time to share something personal again. When I was 20, I vividly remember being in the bathroom at my workplace when a large amount of blood started coming out. I did what any smart, effective 20yo would do: ignored it because I was embarrassed. Fast forward 10 years, and I’d been ignoring it for a decade. It had continued to happen every few months. Sometimes the blood was so bad I’d have to wait up to 20 minut…

I've had two colonoscopies done in the last 10 years. The second was possibly unnecessary, but I pushed for it because I just really enjoy propofol. Maybe if more people knew that the sedative drugs used in the procedure are fun, they'd be more inclined to have it done.

Edit: downvotes? Really!? I'm 100% fucking serious! Work any angle to get people to test!

Re: Are colonoscopies worth it?

#95

Post by conductr »

rocqua wrote: post #82
ChrisCinelli wrote: post #77

Earlier quoted context omitted.

If it is RED blood, it is a vein that breaks when the your stool passes. Most likely hemorrhoids. The problem is when you have BLACK blood in the stool. That may be an internal bleeding.

Red blood consistently still deserves to be checked out.

I had a misdiagnosed anal fissure for a year. Get the ass doctor involved early, my GP was clueless about it and had me trying hemorrhoid/lidocaine creams for a year while in agonizing pain. The first thing the ass doctor asked was; do you know what a fissure is? before the exam even started. I learned to skip past the general doctors to the specialist from this experience. Also, the anus is the fulcrum of your body, treat it well.

Re: Are colonoscopies worth it?

#96

Post by fsckboy »

stouset wrote: post #26
joshuaheard wrote: post #16

My doctor recommended Cologuard, a test of your stool sample for cancerous DNA, instead of a colonoscopy. I can't imagine taking a colonoscopy now.

Cologuard has a significantly high false positive rate, as far as I’m aware.

does a cologuard false positive indicate a colonoscopy? if so, as long as the false negatives aren't substantially worse, it sounds like a win.

Re: Are colonoscopies worth it?

#97

Post by kashunstva »

ChrisCinelli wrote: post #77
sillysaurusx wrote: post #58

It’s time to share something personal again. When I was 20, I vividly remember being in the bathroom at my workplace when a large amount of blood started coming out. I did what any smart, effective 20yo would do: ignored it because I was embarrassed. Fast forward 10 years, and I’d been ignoring it for a decade. It had continued to happen every few months. Sometimes the blood was so bad I’d have to wait up to 20 minut…

If it is RED blood, it is a vein that breaks when the your stool passes. Most likely hemorrhoids. The problem is when you have BLACK blood in the stool. That may be an internal bleeding.

Black stool (melena) indicates an upper GI source: esophagus, stomach, duodenum chiefly.

But _any_ source of colonic bleeding is likely to be red to bright red. The possible pathologies are numerous: hemorrhoidal - as you mention, tumours, inflammatory bowel disease, arteriovenous malformations, diverticular disease, etc.

Re: Are colonoscopies worth it?

#98

Post by jldugger »

woleium wrote: post #35
Barrin92 wrote: post #30

Earlier quoted context omitted.

This is a large, randomized control trial, so obviously you should value this significantly higher than whatever doctors are doing to themselves. (history has more than a few examples of doctors practicing medicine that didn't make a whole lot of sense).

If only Semmelweis wasn’t such a strange chap, we’d have been much more further forward now.

But it cuts both ways: Walter Freeman[1] was only banned from performing lobotomies after 100 patients of his had died of hemorrhage.

[1]: https://www.econtalk.org/megan-mcardle-on-the-oedipus-trap/

Re: Are colonoscopies worth it?

#99

Post by gcheong »

amrocha wrote: post #68
raverbashing wrote: post #46

Earlier quoted context omitted.

And the big disadvantage that to get there your need to book 2 professionals (?) and take pretty much one day off, and there are risks associated with anesthesia and the procedure itself I don't think it scales (Not to mention the interests of doctors of suggesting things that make them more money) Edit: now I see TFA mentions risk of perforation and that the risk is smaller without anesthesia

In Japan, everyone over 40 gets yearly colonoscopies as part of a general health check up. That should be a really good source of data, someone should take a look at that. But what I was getting at is that it can scale.

Source? Yearly colonoscopies sound dubious - my google search results said they use fecal occult blood tests yearly with a follow-up colonoscopy if you test positive which sounds more reasonable to me.

Re: Are colonoscopies worth it?

#100

Post by dgellow »

Given people don’t read the full article, and that feels pretty important in this discussion, I will quote the way it ends:

> One thing is clear: Screening works. If you’re of the appropriate age, please get screened. If your tubes are acting funny, please get screened without delay. The best method and the level of benefit are debatable, but we know it helps. Use a stool test if you want (multitarget DNA test if you can), or a colonoscopy, or a sigmoidoscopy, or a “virtual” CT colonoscopy, or a crazy edible camera. Do one of them. Statistics show colorectal cancer is highly curable when caught early, and now that we have feisty checkpoint inhibitor immunotherapies,it’s probably even better now. Just do it. Your tubes will thank you.

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