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The Colonoscopy: A Life-Saving Screening

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Tanicia Haynes, Nurse Practitioner with Occupational Health, asks Dr. Roberta Muldoon, Assistant Professor of Surgery, Colon and Rectal Surgery from the Division of General Surgery, about the importance of colonoscopies and tips on how to prepare for a colonoscopy.

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Tanicia Haynes: Welcome to this edition of the Vanderbilt University Health and Wellness Wellcast. I am Tanicia Haynes with Occupational Health. As a part of colon cancer awareness month, we are discussing colonoscopies with Dr. Roberta Muldoon, Assistant Professor of Surgery, Colon and Rectal Surgery, and the Division of General Surgery at Vanderbilt University Medical Center. To begin, can you tell us what a colonoscopy is and why we do it?

Dr. Roberta Muldoon: Colorectal cancer is one of the leading causes of cancer deaths. The problem is oftentimes it is asymptomatic. So, we need a way to be able to find and detect these cancers, preferably as early as possible. So, the best way to do that is with a colonoscopy. So, colonoscopy is a test that we can do that we can actually look at the inside of your colon, and the real reason that we are doing it is we are looking for polyps and we are looking for cancer. So, polyps can turn into cancer and that is what we are really trying to see if we can identify. If we see polyps, we can usually get those out. So, it prevents them from turning into a cancer, and if we see cancer, we oftentimes can then treat it, and the earlier we find the cancer, the better off we are.

Tanicia Haynes: Many of our listeners have heard that there is a preparation to be done before colonoscopy. Can explain what that is and why it is important?

Dr. Roberta Muldoon: Most people actually have heard about the dreaded colon prep and that is the part of the whole test that most people do not want anything to do with and that kind of scares them off, which is why a lot of people do not have to test it all, but it is very important. So, what that prep does is that actually clears out the stool out of the colon so that the person who is doing your endoscopy can actually see the inside lining of your colon. Now, there are a number of different preps on the market, and your doctor will actually pick the one that they feel is best suited for you. There are two types in general. So, one of them you would take the prep basically over about a 4-hour time period, and the other option is called a split prep, and what that is is you take half of the prep the afternoon or evening before the procedure scheduled, and then the second half of the prep is usually taken approximately 4 hours before your procedure. So, there are some pros and cons to both of those, but definitely one of the advantages of the split prep is that people that have a hard time just drinking a large volume of fluid which you would have to with kind of to do this bowel prep. In the split prep, you do half of it the night before and then half before the procedure. So, a lot of people are able really to complete the whole prep and thus have a better clean out and then have a better colonoscopy.

Tanicia Haynes: Do you have any tips about completing the prep?

Dr. Roberta Muldoon: Yes, the first recommendation I would have, first tip, is read through the directions for the prep. One of the things that oftentimes get missed is that for approximately 3 days before your procedure you really should avoid eating things like seeds, grains, wild rice, things like that. It takes a little bit longer for those to clear through your system. So, if you eat that right up until the day before your procedure, that might not be cleared out. So, read the directions and make sure you follow them very specifically, but on to really ways of how do you get that darned prep down because it is hard, I will attest to that. First thing, try it cold, so chill the prep beforehand that usually helps. Second thing is if you drink it with a straw, preferably a large straw, that really helps to just get prep down a little bit quicker. So, do not sip on it, do not prolong your agony. Just get it down. Large straw is the way to go. If you can complete your whole prep, you are much more likely to be completely cleaned out, which leads to a better colonoscopy because your doctor can see everything. One other thing is that some people depending on the prep say that there is a little bit of an aftertaste, a bad aftertaste with the prep. So, one of my patients actually gave me this suggestion, I thought it was great, and that after you drink a cup of the prep, if there is an aftertaste, you can rinse your mouth with a little bit of mouthwash. Obviously, you spit the mouthwash out, but that really can help take that aftertaste away. My patient told me about this tip that he tried. He said he got the rest of his prep down, no problem, did great with it, and swears by it. So, I passed that tip on to you. The biggest thing is again follow those directions, do the whole prep, and your colonoscopy will actually be better.

Tanicia Haynes: What are some common concerns about colonoscopies that patients have mentioned and how do you respond to those concerns?

Dr. Roberta Muldoon: I think the biggest thing that I hear about from patients and their concern and why they potentially do not have a colonoscopy, the biggest thing has to do with the prep. The preps have gotten better over time. They do what they are meant to do, which is clean out your colon, which does mean you are going to spend a lot of time in your bathroom, and you will unfortunately have to become one with your bathroom for a little bit, but you just have to keep in mind that the benefit of doing the colonoscopy is so great. I mean it could prevent you from having colon cancer. It could save your life. So, a little inconvenience from doing a bowel prep, you just do it. The benefit is so great, you just get that done. One of other things is that some people are just embarrassed. I mean they do not want to have to go and have somebody looking at their bottom or sticking something in their bottoms, so they are very embarrassed by it. I will tell you though all the doctors and nurses that do these procedures everyday are very professional. They know what the benefits are. They will take very good care of you. They cover you up as much as they can during the procedure, and you will survive. It is far better to again not die of colon cancer. You will never die of embarrassment, but you can die from colon cancer. So, again you just got to kind of get over that part, and a lot of people are concerned about the risk associated with the procedure, and there is some small risk associated with it, but it is very small and it is a safe procedure to have done. So, this is a cancer that it is preventable, it is treatable, and so it is curable. We really want people to get their colonoscopies done so that we can avoid people dying from this disease.

Tanicia Haynes: Thank you Dr. Muldoon for allowing us to interview you for a podcast for colon cancer awareness month. We really appreciate the time that you have taken with us.

Dr. Roberta Muldoon: You are very welcome.

Tanicia Haynes: Thanks for listening. Please feel free to leave us any comments on this Wellcast on the form at the bottom of this page. If you have a story suggestion, please email it to us at health.wellness@vanderbilt.edu or you can use the “Contact Us” page on our website at healthandwellness.vanderbilt.edu.

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Posted on Friday, March 24, 2017 in Occupational Health Clinic, Wellcasts and tagged , ,

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