What is a colonoscopy?
• Study of lining of
colon and rectum by
a gastoenterologist
Colonoscopy
Long, thin, flexible
instrument
connected to
camera and video
display monitor is
inserted into
rectum and up to
T.I.
Colonoscopy recommended if:
• bowel habits change
• blood in stool
• persistent abdominal
pain
• patient is aged 50
years or older
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
Colonoscopy vs. Sigmoidoscopy
• Colonoscopy
inserted into
rectum-moved
through entire
colon
• Sigmoidoscopyinserted into
rectum-final 2 ft
colon
Colonoscopy vs. Sigmoidoscopy
Sigmoidoscopy
• No drugs!
• Major pain and
cramping
Colonoscopy
• Good drugs!
• No cramping
Polyps
• Benign growths on
•
•
•
inner wall of colon
Size: pinhead to
several inches
Painless
Slow growing- years
before become
aggressive cancer
Polyp
cont’d
• If encountered– thin wire snare is used
to lasso it
– electrical heat
(electrocautery)
applied to remove
painlessly
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 bloatingwill quickly improve.
Can resume eating a
regular diet later that day
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.!
Advantages over Barium Studies
• No x-ray!
• Can perform polyp
removal, tissue
sampling during study
• More accurate than
BE, pneumocolon
Virtual Colonoscopy (VC)
(CT Colonography)
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
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 endblockage, redundant bowel with conventional
colonoscopy
• Faster- more pts can be done ($$$)
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
Disadvantages - Virtual
Colonoscopy over Colonoscopy
• Cannot remove
polyps!
• Uses radiation
• Pt. confined in
tight area
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!
How often do you need to have test?
• No cancer or
positive finding 10 years
• Cancer or positive
finding - 5 years
The End