Colon prep requires several days of low-fiber diet, causing constipation and possible painful diverticulitis flare-up. Last colonoscopy was 7 years ago, no polyps. Anxiety motivated me to ask for another one after 3 family members diagnosed with colon cancer. However, all were determined to be sporadic cancers, ie, not genetic. And colonoscopies are recommended every 10 years. I’m now re-thinking if I should proceed; I’ve read about the elevated risks of colonoscopy for those over 70 (the recommended cut-off for these screenings is age 75). I'm obese, have high blood pressure (well controlled) and pre-diabetes (controlled with diet). Sometimes my pulse dips to 40-42 momentarily, but heart monitoring two years ago indicated nothing serious. My resting pulse is 60-65, though I’m not an active person. I read where the fluid loss during the prep, even while trying to stay hydrated, can cause an electrolyte imbalance. In seniors, that could lead to a cardiovascular event. Then there’s the risk of a perforated colon with the procedure or even with a diverticulitis flare. I decided to cancel my appointment for the scheduled procedure and instead, made an appointment to discuss these issues with my primary care doctor. Perhaps a less invasive screening would be preferable? Would love to know folks’ thoughts and experiences. Thanks!
My SIL is a GI doc and routinely does colonoscopies, obviously. He has said that he has a chat with his 'over 70' patients to see if they need one. The worries of problems really escalate with age, and he may actually deny someone one or opt for another procedure.
10 years between screenings is what is usually reccomended, unless you have problems.
Right now I’m suffering on 2nd day with severe constipation because I started the pre-prep low-fiber/residue diet last weekend. Feels like my innards are about to burst. Miralax hasn’t kicked in yet - body’s poo-plumbing has stopped. Nothing’s moving - this was predictable, as this happens when I skip fiber. Drinking plenty of water, which runs out of me because I take a diuretic for bp. Mentioned constipation issues at pre-colonoscopy meeting with gastroenterologist’s office. Hoping I don’t end up in ER.
Thanks again!
There is that box test. Maybe try that and if comes up positive then have the colonoscopy.
Sorry I have no personal details because mine is set for July. There is prep but it is less invasive. Check with your Doc to see if it might work in your situation. Good luck.
That said, the johnshopkins site suggests that this CT scan might actually "see" areas of the large intestine a regular colonoscopy can't access. Pros and cons:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/colon-cancer/virtual-colonoscopy-for-cancer-screening
Whether or not you choose to proceed with the test, should be based on what you would do it the results were positive for cancer. If you would choose to have treatment, then have the test. If you would not have treatment, then why have the test?
My step Dad was in his mid 70's when he was diagnosed with colon cancer. He did have surgery and was given the all clear. When he was 84, the cancer metastasized and he died less than 2 months later.
At the last one in 2019 age 72, I had a fair bit of back pain because I couldn’t take my normal drugs beforehand. The specialist said that as I had had no more bowel symptoms, I could decide not to have another. I was getting to the age when they stop them, plus with no recent polyps and the slow-growing nature of cancer following well-developed polyps, the chances are that I will outlive any problems.
Your post doesn’t say why you have had ‘routine’ colonoscopies. If you have had no polyps, and the family members’ cancers were ‘sporadic’, the only real issue is that it’s 7 years since you were checked. Where I am in OZ, people don’t have ‘routine’ colonoscopies, and the ‘poo’ test is free.
The ‘poo’ test is very simple. It shows cancers because they cause minute traces of blood in the poo. In your shoes, I would certainly have that first. If it comes back clear, I probably wouldn’t put myself through another colonoscopy. Best wishes in making a decision you are comfortable with, Margaret
Your state of health sounds from your description to be normal for you, so leave well alone, no point having something done that may cause problems where none exist.
Why do you want any screening done, if your Dr thinks there may be a cancer present from other symptoms then they will suggest an appropriate test/screen, I don't see the point of you screening for something you are no more likely to have than the rest of us.
say the elderly do not need anymore
colonoscopies for the rest of their lives. Unless they are having rectal
bleeding or pain that isnt gas, My mother’ GI doctor told her even with small polyps she doesnt need anymore followup Colonoscpies😌
due to her age.
She will have gas due to the nature
of how many diverticuli she has
You are not suppose to eat any popcorn or nuts anything that could get stuck in the divericili.
They look like swiss cheese that is the way diverticuli form. Even with
diverticuli you can still follow
the no colonoscopies after a certain
age.
Read here:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216380
However, diverticulitis can cause complications; if you are having symptoms, it would probably be a good idea to get one.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265196/
There is no such thing as "pre-diabetes". You are diabetic.
https://www.cdc.gov/diabetes/library/features/truth-about-prediabetes.html#:~:text=Prediabetes%20Is%20a%20Big%20Deal,%2C%20heart%20disease%2C%20and%20stroke.
Be more concerned with weight control and lifestyle changes.
Cologuard has many false positives AND false negatives.
Like my GI doctor said, It's the false negatives you have to worry about.
Is a negative truly negative or a false negative?
I would never use Cologuard again.
As far as a CT virtual colonoscopy, the prep is the same as a colonoscopy,
You have to be cleaned out. If polyps are found, they can't be removed.
You still need a colonoscopy. I was a CT tech for 40 years.
My advice to anyone would be to just get the colonoscopy.
I wouldn't get one!
But, because you sound very (maybe overly?) concerned, you should ask your doctor these questions, the GI doc, or even your primary care doc. I don't mean to make light of your situation, but you really sound stressed and I think it would be the best for reassurance from one of your docs who knows you best.
The less invasive tests often lead to false positives resulting in you having to go through what you want to avoid. OR it can lead to a false negative and that leaves you with the same result as if you do not have the colonoscopy.
Personally....
Given the reasons you state.
The health concerns you have.
I would opt not to have the colonoscopy.
Given that you showed no signs previously, no precancerous polyps or none at all.
The fact that colon cancer is slower growing, sometimes taking 10 years to grow putting you in your 80's if it does develop. From then there is the choice to A) do noting or B) seek treatment. It would depend on the stage that it is in when discovered. If early again option is to do nothing or treat. If it is late stage, same option treat or not. (personally I would opt for no treatment if I am late 80's and late stage)
Ok...all that rambling on leads me to
Cancel the test, talk to your doctor.
If there are non invasive tests that are pretty accurate go for that.
Find the book "Rethinking Aging: Growing Old and Living Well in an Overtreated Society" by Nortin Hadler.
Here is a review:
"For those fortunate enough to reside in the developed world, death before reaching a ripe old age is a tragedy, not a fact of life. Although aging and dying are not diseases, older Americans are subject to the most egregious marketing in the name of successful aging and long life, as if both are commodities. In Rethinking Aging, Nortin M. Hadler examines health-care choices offered to aging Americans and argues that too often the choices serve to profit the provider rather than benefit the recipient, leading to the medicalization of everyday ailments and blatant overtreatment. Rethinking Aging forewarns and arms readers with evidence-based insights that facilitate health-promoting decision making.
Over the past decades, Hadler has established himself as a leading voice among those who approach the menu of health-care choices with informed skepticism. Only the rigorous demonstration of efficacy is adequate reassurance of a treatment's value, he argues; if it cannot be shown that a particular treatment will benefit the patient, one should proceed with caution. In Rethinking Aging, Hadler offers a doctor's perspective on the medical literature as well as his long clinical experience to help readers assess their health-care options and make informed medical choices in the last decades of life. The challenges of aging and dying, he eloquently assures us, can be faced with sophistication, confidence, and grace."
In the end (pun intended), you have to decide what is best for you. Nobody can make that decision for you.
Talk with your PCP AND your cardiologist about the risk. No genetic predisposition for cancer or polyps? Why bother if your last screening was good and clear? If they find something, what are the options for treatment and are you willing to follow through with those options, and what are the risks of those possible options for you?
I'd ask those questions.
My Mom is 91 and has GI issues, but an endoscopy is a high risk that her PCP, pulmonologist and cardiologist say NO WAY. She couldn't risk any surgery to correct whatever they might find anyway. Only doc gunho about the endoscopy was the GI doc, of course. All her other docs were like WHY and what's the point.
Personally, I had a routine colonoscopy and concurrent endoscopy about 5 years ago, all clear and even though I have GI issues and IBS, I will never have another colonoscopy unless you put a gun to my head. The after effects of it made me poopy incontinent for over a year because, with IBS my colon closes up, but the doctor rammed the thing up my yahoo to get it in there and damaged my sphincter nerves where I had no control. I was only 50 y.o. Took 2 years to regain total control of my poops. No colon cancer or polyps run in my family either. So, it's a hell no for me.
Talk with your drs about the necessity and the risks.
I would research dr’s who have a successful record of performing this procedure. Perforations do happen & can be very dangerous.