What is a colonoscopy?

1. What is a colonoscopy? • Study of lining of colon and rectum by a gastoenterologist

2. Colonoscopy Long, thin, flexible instrument connected to camera and video display monitor is inserted into rectum and up to T.I.

4. Colonoscopy recommended if: • bowel habits change • blood in stool • persistent abdominal pain • patient is aged 50 years or older

5. Major step towards preventing colon cancer! • Colorectal cancel 2nd leading cause death in US • 1 in 20 adults will develop colon cancer • Colonoscopy more accurate than all other methods to detect polyps and early cancer • Simpler than exploratory surgery

6. Colonoscopy vs. Sigmoidoscopy • Colonoscopy inserted into rectum-moved through entire colon • Sigmoidoscopy- inserted into rectum-final 2 ft colon

7. Sigmoidoscopy Colonoscopy vs. Sigmoidoscopy • No drugs! • Major pain and cramping Colonoscopy • Good drugs! • No cramping

8. Polyps • Benign growths on inner wall of colon • Size: pinhead to several inches • Painless • Slow growing- years before become aggressive cancer

9. Polypcont’d • If encountered- • thin wire snare is used to lasso it • electrical heat (electrocautery) applied to remove painlessly

11. Colonoscopy(cont’d) • Takes less than an hour • Mild sedation - relieve anxiety and discomfort (someone must drive you home) • Often not remembered by pt. • May experience bloating- will quickly improve. • Can resume eating a regular diet later that day

12. Prep • Similar to BE and ACBE • Low residue foods 2 day before • Eat jello, drink clear liquids day before AM appt. • Afternoon before: • laxative • gallon of liquid (Golytely) • Starve • AM appt.!

13. Advantages over Barium Studies • No x-ray! • Can perform polyp removal, tissue sampling during study • More accurate than BE, pneumocolon

14. Virtual Colonoscopy (VC) (CT Colonography)

15. What is a VC? • Procedure to look for signs of precancercous growths (polyps), other diseases of large bowel • 1st introduced 1994 as alternative to regular colonoscopy • Produces 2 and 3 dimensional images and video • Uses CT scanner, sometimes MRI

16. Advantages of Virtual Colonoscopy over previously accepted forms of determining colorectal cancer • Less rigorous bowel prep • short procedure – 15- 20 minutes • no sedation or anesthesia • no invasiveness-no scope- more compliance! (thin tube to pump air to inflate colon) • no risk of perforation of colon • more complete exam of colon (often can’t reach end- blockage, redundant bowel with conventional colonoscopy • Faster- more pts can be done ($$$)

17. Besides colon you see: • liver • gallbladder • pancreas, spleen • kidneys, adrenals, lymph nodes organs (Dr. Graham) • uterus • ovaries • prostate • assessment of aorta to exclude aortic aneurysm

18. Disadvantages - Virtual Colonoscopy over Colonoscopy • Cannot remove polyps! • Uses radiation • Pt. confined in tight area

19. Cost • Though just as effective in diagnosing lesions larger than 6mm • Insurance companies won’t pay unless • Severe coagulopathy • Can’t tolerate sedation • Must pay for it yourself! Special offer!$425 Body Scan ($800 for two people) $825 Body Scan/ Virtual Colonoscopy combination($1550 for two people) Prices include physician consultation!

20. How often do you need to have test? • No cancer or positive finding - 10 years • Cancer or positive finding - 5 years

21. The End