La Plata Medical Society
  I passed my test again! My colonoscopy, that is.

I had my first one at age 60 and it was normal, so I waited 10 years before having another. After the colonoscopy, Dr. Christensen informed me there were no cancers or polyps but only some diverticula. Next test will be at age 80.

Colorectal cancer remains the second-largest cancer killer in our country. First place goes to lung cancer because of the number of people still smoking.

The rate of colon cancer has begun to fall and this is attributed to the colonoscopy and sigmoidoscopy screening and the removal of the polyps found. It is exciting that doctors can prevent a major cancer.

There are three types of polyps, but hyperplastic polyps have been found not to be pre-malignant. However, polyps that are diagnosed as tubular adenomas or villous adenomas are believed to progress into cancers if not removed. Cancer is rarely found in polyps smaller than 1 centimeter in size, and this allows polyps to be removed and to prevent a cancer.

The progression of the colon lining to form a polyp and the polyp to then form a cancer may take as long as 10 years. This is the reason that if you have a normal colonoscopy, you don't need another for 10 years.

My colonoscopy was not painful at all. The hardest part was preparing the colon the night before and the morning of the test. A colon that has not been completely cleaned cannot be examined.

The "prep" consists of drinking three glasses of clear Gatorade or ginger ale the night before in a one-hour period. A tablespoon of phosphosoda (Fleets Oral) is put in each glass. About two hours later your bowels will start growling and you shouldn't be far from the toilet.

That evening is so much fun that the doctor has you repeat it the next morning, about four hours before the exam. It is rare that the bowel is not completely clean if you follow the directions.

What do I remember of the exam? Nothing! I remember Christensen's nurse saying, "I'm giving you some Fentanyl into your IV." The next thing I remember is waking up in the recovery room. Actually, I also received a Versed IV, which has a wonderful amnesic effect.

The national recommendations for an age for your first colonoscopy has been evolving over recent years. Because of the benefit of removing the polyps, the first exam should be at 50.

If there is someone in the family who has had colon cancer, the first colonoscopy should be at 40. If a patient has ulcerative colitis, the first colonoscopy should be at 20 years after the start of their disease.

Don't miss the opportunity to prevent developing this major cancer.

Thank you, Dr. Christensen. See you in 10 years.

Dr. John N. Withers is a practicing general surgeon in Durango

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