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Are colonoscopies worth it?

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Re: Are colonoscopies worth it?

#281

Post by Aeolun »

kalium-xyz wrote: post #215
Aeolun wrote: post #155

Earlier quoted context omitted.

“Recurrent bleeding from colon is bad, go see a doctor.” Is a fairly simple rule.

IMHO depends on the amount. If you are severely dehydrated and you notice your stool physically hurt coming out. A small amount of blood might honestly not be unexpected. Edit: To be clear “severely dehydrated” is kinda an important factor here. Point being that if the cause is obvious I dont see why you’d get a colonoscopy. Please correct me if im wrong instead of just downvoting for anyone who knows more about this…

If you are consistently severely dehydrated that’s also a good reason to see the doctor ;)

But yeah, if it happens once it’s not necessarily a problem. It’s when you keep having bloody stool that it’s a good idea to get checked.

Re: Are colonoscopies worth it?

#282

Post by DanBC »

Supermancho wrote: post #237
hermitcrab wrote: post #120

>3. It’s irresponsible to call colonoscopies “invasive” (as CNN did) since that might make people think they are unpleasant and not do them. LOL. It hard to imagine anything much more invasive than having a metal tube (with light and camera) shoved up your arse. It is definitely unpleasant. I speak from personal experience. That said, it is less unpleasant than bowel cancer. So don't be put off if you really need to…

Let's discuss what "invasive" means. Putting something in the body and getting it back out without tearing, is not invasive. Eating and vomiting would be categorized as invasive, in context. A colonoscopy/endoscopy is internal and dangerous, which is not the same thing as being invasive, so the term "minimally invasive" is sometimes used as a happy middleground, which has then been sensationalized.

> Let's discuss what "invasive" means.

> Putting something in the body and getting it back out without tearing, is not invasive.

Just for clarity colonoscopy is an invasive procedure.

Re: Are colonoscopies worth it?

#283

Post by DanBC »

dgellow wrote: post #100

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…

> 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.

Screening is for people without symptoms.

If you have symptoms it's not screening, it's diagnostic testing. Diagnosis is important - if you bleed from anywhere you need it to be explained - but there are big differences in how you look at a test that's done for screening vs diagnosis.

Re: Are colonoscopies worth it?

#284

Post by DanBC »

collinstevens wrote: post #161

If you're worried about getting a colonoscopy, don't be. I got one last year and it was the best sleep I ever got. It was two days of the prep stuff you drink to shit your brains out which is a little rough, but I have a bidet, no big deal. Then you go to the hospital, you dress down into a gown, nurses come in, they put some things on your chest, you get a little cold, they put a nice warm blanket on you, they start…

> they wheel you into the procedure room, and then you pass out.

This is the bit that a lot of people have a problem with, and there's usually some choices in the amount and type of sedation you get.

In the US they use much heavier sedation than other countries - use of propofol is not uncommon in the US - and it's one of the things that makes colonoscopy more risky than it needs to be.

Re: Are colonoscopies worth it?

#285

Post by Supermancho »

DanBC wrote: post #282
Supermancho wrote: post #237

Earlier quoted context omitted.

Let's discuss what "invasive" means. Putting something in the body and getting it back out without tearing, is not invasive. Eating and vomiting would be categorized as invasive, in context. A colonoscopy/endoscopy is internal and dangerous, which is not the same thing as being invasive, so the term "minimally invasive" is sometimes used as a happy middleground, which has then been sensationalized.

> Let's discuss what "invasive" means. > Putting something in the body and getting it back out without tearing, is not invasive. Just for clarity colonoscopy is an invasive procedure.

> Let's discuss what "invasive" means.

> Just for clarity colonoscopy is an invasive procedure.

The definition is the point at hand. Stating that it is intrinsically a truism, is not compelling.

Re: Are colonoscopies worth it?

#286

Post by Supermancho »

hermitcrab wrote: post #257
Supermancho wrote: post #237

Earlier quoted context omitted.

Let's discuss what "invasive" means. Putting something in the body and getting it back out without tearing, is not invasive. Eating and vomiting would be categorized as invasive, in context. A colonoscopy/endoscopy is internal and dangerous, which is not the same thing as being invasive, so the term "minimally invasive" is sometimes used as a happy middleground, which has then been sensationalized.

The first relevant definition I found online was: "(of medical procedures) involving the introduction of instruments or other objects into the body or body cavities." YMMV

Maybe it's something more like the insertion of a foreign instrument through the epidermis or into a body cavity that...

I dunno. Ears (eardrums), colons, etc are tricky to cover all at once. I don't envy the authors of medical literature.

Re: Are colonoscopies worth it?

#287

Post by timr »

riku_iki wrote: post #263
timr wrote: post #148

Earlier quoted context omitted.

The high end of that range is much higher than the baseline rates of colon cancer (also mentioned in the article), which are 90/100,000 in the USA. That's one thing that I wish the author had spent more time on.

90/100k cancer rate is likely annual rate, while complication rate is likely per procedure, so you would need to multiply cancer rate by 3 (avg years between procedures) to have reasonable comparison.

You can't just multiply by 3 (it's smaller than that), but yes, you need to adjust both.

https://planetcalc.com/7044/

(Just to be clear: this is the wrong model. An annual rate of cancer (X%) at a population aggregate does not mean that you have X% independent probability of getting cancer per year. But even assuming that was true, you couldn't just multiply by 3.)

Re: Are colonoscopies worth it?

#288

Post by kwhitefoot »

DanBC wrote: post #284
collinstevens wrote: post #161

If you're worried about getting a colonoscopy, don't be. I got one last year and it was the best sleep I ever got. It was two days of the prep stuff you drink to shit your brains out which is a little rough, but I have a bidet, no big deal. Then you go to the hospital, you dress down into a gown, nurses come in, they put some things on your chest, you get a little cold, they put a nice warm blanket on you, they start…

> they wheel you into the procedure room, and then you pass out. This is the bit that a lot of people have a problem with, and there's usually some choices in the amount and type of sedation you get. In the US they use much heavier sedation than other countries - use of propofol is not uncommon in the US - and it's one of the things that makes colonoscopy more risky than it needs to be.

I didn't have any sedation or other medication when I had a colonoscopy (in Norway). It was uncomfortable but not painful.

Re: Are colonoscopies worth it?

#289

Post by ubermonkey »

I was very, very worried about mine earlier this year.

It was 100% a nonevent. My doc's prep regime was fairly mild (basically, a jug of gatorade with a whole jar of miralax in it at 6pm, and then another at 1am, for an 0800 call). I had no cramping or bloating to speak of. I didn't sleep in the bed with my wife after the 1am dose, mostly b/c I didn't want to disturb her by getting up over and over, but also slightly b/c I was a LITTLE afraid of not making it to the loo in time. This fear proved completely unfounded.

The "worst" part for me really ended up being that I (wisely) did NOT go cycling on the Sunday before, since I know that ramps up my metabolism and leaves me very hungry the day after. I missed my ride, but it made the clear-diet Monday much more tolerable.

Re: Are colonoscopies worth it?

#290

Post by holuxian »

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…

Agreed.

I only had one sign something was amiss - a small amount of bright red blood in my stools, once. No pain, no discomfort. But it alarmed me enough to schedule a colonoscopy, a procedure I hadn't had before. The doc told me not to worry, as it was probably just a hemorrhoid.

Before the procedure, the doctor was cordial and animated. As I was waking up afterward, his composure was totally changed - a sign something was wrong. He told me he found a mass, and scheduled a CT scan for the next day. That scan showed I had stage IV colon cancer, with metastases in my lymph nodes and liver.

Other than that single blood sign, I had no indicator whatsoever of the dire situation. Thankfully, I was admitted to MD Anderson, where I firmly believe I had the best team possible treating me. I have a good amount of collateral damage as a result of the treatment, but remain cancer free. I am grateful to still be here, as several of my friends with similar diagnoses aren't.

I am definitely pro-colonoscopy. The short-term discomfort of the prep is nothing in comparison with 12 rounds of chemo.

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