askthedoctor Colonoscopies M

More than 50,000 people die from colorectal cancer each year in the U.S. These deaths would be largely preventable if everyone followed the recommended screening schedule. Colonoscopies actually can prevent colon cancer by locating and facilitating removal of precancerous polyps. It usually takes at least 10 years from the time a polyp starts until cancer develops. A colonoscopy is a much simpler proce-

Age Guidelines For most people, initial screening is recommend- ed at age 50, continuing until age 75. Talk with your primary care provid- er to determine the most appropriate screening schedule and procedures for you.

dure than most fear. The fi rst step is to work with your primary care provider to identify a gastroenterologist (the physician special- ist who will perform the colonoscopy). Then contact your insurance company so you understand any physician network issues and what your insurance will pay. Schedule an appointment for the proce- dure, and choose a day when you have noth- ing else scheduled. You also should plan to spend the day before the procedure at home to facilitate the bowel-cleaning preparation. The gastroenterologist will prescribe a

bowel preparation — either a liquid laxative to drink or pills to swallow — to take the day before the procedure. The bowel prep might be easier if you reduce food intake for a day or two beforehand. If you have other medical problems or a sensitivity to aspar- tame, let your doctor know because that can aff ect the bowel prep prescribed. The gastroenterology clinic will pro- vide a set of instructions that will include how to take the bowel prep and what to do the day of the procedure. Be sure to read all of the instructions a few days before

52 MILITARY OFFICER JULY 2015

Colonoscopies are recommended for early diagnosis and treatment of colorectal cancer. Rear Adm. Joyce Johnson, D.O., provides an overview of this often dreaded procedure.

the procedure and then again the day be- fore. Food and most fl uids are restricted the day of the procedure. If you take regu- lar medications, talk with your health care provider about when to take them. Plan for a friend or family member to drive you home from the procedure; driving or tak- ing a taxi alone is not permitted. When you get to the clinic the day of the

procedure, you will be asked to change into a hospital gown. You will be given a sedative via IV, so you are relaxed and comfortable during the procedure. The procedure itself usually takes about 30 minutes and includes inserting a colonoscope (a small tube with an attached light and camera) through the anus and into the rectum and colon. The area will be carefully examined, and if small polyps are found, they might be removed during the procedure. If larger growths are found, a biopsy might be taken for further examination. The scope is removed when the procedure is over, and you will awake a short time later. There usually are no eating restrictions for the rest of the day. In addition to a colonoscopy, other

screening procedures are available, in- cluding testing fecal matter for blood, fecal DNA testing, fl exible sigmoidosco- py, and “virtual” colonoscopy (computed tomographic colonography).

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— Rear Adm. Joyce Johnson, USPHS (Ret), D.O., M.A., is a health care consultant in Chevy Chase, Md. Find more health and wellness resources at www.moaa.org/wellness. For sub- mission information, see page 6.

PHOTO: STEVE BARRETT