Colonoscopy prep too much to bear

The Daily Courier - - LIFE & ARTS - KEITH ROACH Med­i­cal Ad­vice

DEAR DR. ROACH: I am a 72year-old male in good health. I’ve had a cou­ple of colono­scopies (the first one found some ade­no­mas), but the re­quired cleans­ing prep with harsh lax­a­tives has be­come in­creas­ingly dif­fi­cult for my body to take. I only got halfway into the last prep be­fore be­com­ing so sick that I had to dis­con­tinue the cleans­ing and can­cel the colonoscopy.

I’ve been read­ing about new non­in­va­sive colon can­cer de­tec­tion meth­ods that do not re­quire the harsh prep.

Two of them are Co­lo­guard, which an­a­lyzes stool sam­ples, and Epi proColon, a blood test. What is your opin­ion of th­ese?

I re­al­ize that they test only for ev­i­dence of can­cer and that a pos­i­tive test would call for a colonoscopy, but could they serve as screen­ing tests? Would a neg­a­tive re­sult mean I could rea­son­ably skip a colonoscopy and its (for me) de­bil­i­tat­ing prep pro­ce­dure?

AN­SWER: I rec­om­mend colonoscopy as the first-line screen­ing test for colon can­cer, as it eval­u­ates the en­tire colon and al­lows for a biopsy to be done at the same time.

How­ever, colonoscopy is ex­pen­sive, has risks of side ef­fects, some­times can miss small polyps, isn’t avail­able ev­ery­where and isn’t defini­tively proven to be bet­ter than other meth­ods (though most ex­perts think it is, and nearly all choose it for them­selves). The prepa­ra­tion is, at best, un­pleas­ant, and some peo­ple find it hard.

For peo­ple who can­not or will not get a colonoscopy, three op­tions in­clude fe­cal blood test­ing, the Co­lo­guard stool DNA test and the Epi proColon blood DNA test.

Th­ese tests have never been com­pared against each other, but most au­thor­i­ties feel the Co­lo­guard test and stool blood test are likely more sen­si­tive tests than the blood-based proColon DNA test.

How­ever, any of th­ese tests is bet­ter than not get­ting screened at all.

Peo­ple with a pos­i­tive test, and peo­ple at high risk for colon can­cer due to his­tory or med­i­cal con­di­tion still should have a colonoscopy.

Fi­nally, you might ask your gas­troen­terol­o­gist about dif­fer­ent prepa­ra­tion op­tions: Some are much bet­ter tol­er­ated than oth­ers.

The book­let on colon can­cer pro­vides use­ful in­for­ma­tion on the causes and cures of this com­mon mal­ady.

Read­ers can ob­tain a copy by writ­ing: Dr. Roach, Book No. 505, 628 Vir­ginia Dr., Or­lando, Fla., U.S.A., 32803.

En­close a cheque or money or­der for C$6 with the re­cip­i­ent’s printed name and ad­dress. Al­low four weeks for de­liv­ery.

DR. ROACH WRITES: A re­cent col­umn about the flu vac­cine gen­er­ated some let­ters. Some read­ers won­dered whether the ques­tioner may have had a bad re­ac­tion to the 1976 swine flu vac­cine. I re­call that in­ci­dent, and in med­i­cal school we learned that it wasn’t clear why that vac­cine caused more side ef­fects than other flu vac­cines.

How­ever, it was a live, at­ten­u­ated (weak­ened) flu strain, not the killed flu vac­cine that has been the stan­dard now for decades.

I cer­tainly have en­coun­tered many peo­ple who had a bad re­ac­tion 40 years ago and who still refuse to get a vac­cine now.

Another reader noted that a fam­ily mem­ber com­plained of get­ting “the flu” af­ter a flu shot, but re­ally meant an episode of vom­it­ing or di­ar­rhea.

In­fluenza does not usu­ally have many gas­troin­testi­nal symp­toms: The term “stom­ach flu” is a mis­nomer. There are plenty of viruses that can cause vom­it­ing and di­ar­rhea, but not in­fluenza, which causes sud­den on­set (my col­league Dr. Fred Pelz­man talks about peo­ple get­ting hit with the “flu truck”) of fever, a high de­gree of fa­tigue and feel­ing un­well, headache and some­times pro­found mus­cle aches. Cough, sore throat and nasal dis­charge show the res­pi­ra­tory na­ture of this ill­ness.

Read­ers may email ques­tions to ToYourGoodHealth@med.cor­

Newspapers in English

Newspapers from Canada

© PressReader. All rights reserved.