QUALITY AND EFFECTIVENESS OF COLONOSCOPY
Recent press coverage of the Canadian case-control study published in the Annals of Internal Medicine regarding colonoscopy has again focused attention on colon cancer screening. At IGA we welcome this study as providing further information about the second most common cause of cancer death in the United States. Some things we would like you to know:
COLONOSCOPY IS THE BEST AND ONLY TEST WHICH PREVENTS COLON CANCER!
MAXIMIZING QUALITY IS VERY IMPORTANT
to get the best quality study you should:
- seek out a well trained endoscopist who consistently meets quality criteria
- get the cleanest colon possible before your exam
Further information:
- This study highlights a weakness of colonoscopy, that of detection of polyps and cancers in the right colon.
it's important to note that the study enrolled patients starting more than a decade ago, and a third of the physicians performing colonoscopies were not Gastroenterologists. During the past decade, there have been significant advances in how colonoscopies are performed and in the colonoscopes themselves with wider fields of view and better optics.
- Quality of colon preparation is the most important factor for preventing "missed lesions".
- Know the quality of your preparation at the end of your exam, and how far around the colon the endoscopist was able to reach. Ask what you can do to make your prep better!
- Our colonoscopists meet or beat national averages on cecal intubation, withdrawal time and adenomatous polyp detection which are currently the most recognized benchmarks for exam quality. In other words, we are the specialists who are trained to perform the best possible colonoscopies.
- Current guidelines for surveillance intervals have not changed, however, guidelines may evolve as we learn more.
- All IGA MD's are board certified gastroenterologists, with extensive training specifically in colonoscopy. The recent article in the Statesman states you should seek a "colonoscopist". We feel this should be a Gastroenterologist in most cases!
- We are benchmarking and monitoring our performance and always trying to improve. As new techniques and technologies are proven to be effective, we will adopt them to decrease your risk.
- If you have new red flag symptoms: persistent change in bowel habits, rectal bleeding, unexplained weight loss or abdominal pain - you should discuss this with your physician.
- If you wish to discuss the appropriateness of your surveillance interval, please contact our office for an appointment!
Tips on getting the best prep possible:
- eat an extremely low fiber diet for the week prior to your colonoscopy (very low in fruits and vegetables). To learn more about fiber in your diet, read our handout.
- take only clear liquids for at least 24 hours before your exam
- consider "split dosing" the prep - you should discuss this with your colonoscopist
- if you have had a poor, fair or inadequate colon preparation previously, further steps may need to be taken to cleanse the colon in the future (larger volume, more days of clear liquids). Patients who are debiliatated, elderly, have severe constipation or are on chronic narcotic medications may not be able to get a good or excellent colon prep with the usual preparation.
Where to go for further information:
425 Bannock Boise ID 83702 208.343.6458
2235 E Gala Meridian ID 83642 208.887.3724
John Witte, MD Richard Uhlmann, MD Mark Lloyd, MD Paul Baehr, MD
Ellen Hunter, MD Judith Woods, MD Bonnie Kim Waite, MD
Dave Wood, MD Phil Jensen, MD Chad Morse, MD
