Don’t put off potentially lifesaving colonoscopy

DEAR DR. ROACH

>> I am responding to a recent letter from a reader anxious about undergoing a colonoscopy. One of her concerns was a possible perforation requiring additional surgery and a temporary colostomy. You reassured her that the probability of such an occurrence was very low.

I have seen this fear often. No doubt, it comes from most people having no experience with the procedure and/or from negative portrayals in the media. Yes, it is major surgery. But it is also a lifesaver that, after an initial period of learning and adjustment, does not interfere with quality of life, work or pursuing most activities. There are cases where individuals have refused this kind of surgery and eventually died. The image of “the bag” can be that frightening.

I have an ileostomy [a connection between the small bowel (ilium) and the outside, through the skin, as opposed to a colostomy, which is a connection between the colon and the outside] as a result of years of ulcerative colitis creating precancerous, fast-growing lesions in my colon. I delayed surgery for a year, because of fear. Thankfully with education, I made a good adjustment in a matter of weeks. Today I co-lead a support group. We see a lot of new joiners, but tend to lose members after a few weeks. Why? Because by that time most say they are fine and don’t need the group.

Modern medicine and space-age materials have produced appliance products that are nothing like those from earlier times. Today’s are thin, deodorized and gentle to the skin. They adhere well and allow bathing, swimming, sexual activity and exercise. Most people continue with an unchanged life after recovery. Many would be surprised to learn that there are wellknown celebrities, politicians, and sports figures who have had this surgery. In fact, with over 750,000 surgeries a year in the U.S. (including both bowel and bladder diversion), it’s probable that everyone has come into contact with, or knows, someone who has!

I urge physicians to confront fear surrounding ostomy surgery with reassurance and education. I’m not suggesting that anyone be pushed into a major surgery if they are uncomfortable. But every important decision should be made after receiving as much education and information as possible.

DEAR READER >> I thank E.W. for her thoughtful letter and think it’s important enough to publish.