I'm Dr. Matt Deppe, I'm a general surgeon with Mayo Clinic Health System and one
of the areas that are of particular interest and passion is in colorectal cancer
prevention. I think there are few things that patients don't know about
colonoscopy and about colon cancer screening, that might alleviate a bit of
concern or help them make better decisions about choosing to do a
colonoscopy or choosing the screening technique that's right for them. I think
one of the things patients don't realize is how far the equipment has come
technologically, in our system we use the 190 series Olympus equipment, which
is the newest on the market and has a lot of features that help us keep
patients more comfortable as we do the examination.
Our typical patient, who should be screened for colon cancer, is any patient
over age 50. There are patients, however, who have a family history of colon
cancer, in which, depending upon when they're their relative had colon cancer,
we'll recommend it at an earlier age, but of course any patient who has symptoms,
blood within their stool, as an example, are patients who we more urgently push
to consider colonoscopy for safety reasons.
Colonoscopy begins with a patient taking a preparation which is medication that's
taken by mouth, to clear out the colon, clearly the least pleasant portion of
the procedure. Most patients come in and they think that there's more discomfort
ahead, and certainly sometimes exams can be more difficult than we
anticipate, but usually they're not. Usually patients are are surprised to
find they have no discomfort, and my favorite phrase, you're done already? Which I
really enjoy and I think all of our endoscopists do.
So we have several options for anesthesia. Our most common choice is
what's called conscious sedation that involves, for most practitioners, a
medication called Versed and also a pain medication called Fentanyl and they're
both designed to be effective very quickly and very reliably effective and
very short duration, in that they wear off very quickly and we can predict how
long they'll be within that patient system. That being said, about 10% of our
patients will choose to have no medication for their colostomy and of
course if we think that that's not a great idea, we will advise them otherwise,
but for most patients who choose that they have a pleasant experience and are
comfortable throughout the examination and are able to essentially leave
immediately after the examinations finished. We also have a third option
which is anesthesia provided by our anesthesia practitioners and that means
a deeper form of anesthesia there are some benefits to it and some negatives
to it as well and and some patients will choose that
option because of previous experience with Colonoscopy or other anesthetic
experiences. I think another thing patients don't realize is that recovery
is very quick. Perhaps years ago, it was several hours of trying to pass gas
trying to feel less bloated waiting for medication to wear off.
Now we use carbon dioxide, in order to see within the colon. What that means is
that it absorbs in just a matter of minutes. So patients, even a half-hour
after the examination, no longer feel bloated and feel normal.
So our patients are staying much less, for a much shorter duration, in our
recovery area after the procedure and are able to go home feeling normal.
The common concerns that we have from patients are will I have more
discomfort than I anticipate? Will it be difficult for me to get
through the examination? Will I be bloated for hours after the examination, as an
example, and I think the thing that patients find most comforting, is not
only the experience of their friends and family, who undergo the examination, now,
and temporarily, but as we start the examination some patients may choose to
be awake to see what it feels like to start with and often those of the
patients who are flabbergasted when we've completed the examination and the
first thing they do is tell their friends.
I think the important thing when it comes to colorectal cancer prevention is
do something. Colonoscopy is, for many people, the best test in the best option
and as the end evaluation, the end tool, that we have to evaluate the positive
result results from some of our other screening examinations but the key is do
something this is a condition that in many cases is preventable. Why not?