Colonoscopy Prep, Experiences and Tips

What would the deal be with a "precancerous polyp"?

My theory is that the doctor will ALWAYS describe any polyp that they remove as "precancerous". That's likely done to ensure that the insurance pays for the entire procedure, including any polyp removal. Chances are that if they didn't describe them in that way, the insurance might not pay for their removal. Again, that's just my theory.

I asked my GP at what age I should get a colonoscopy? She said never, unless there's serious symptoms that require a closer look. She said the routine colonoscopy is gone, due to the risks involved, and the cost.

She said the routine colonoscopy is gone, due to the risks involved, and the cost.

That's interesting since I heard just the opposite, that at a certain age (maybe 50 or so) you should get one periodically. And then if any "precancerous" polyps are discovered, the frequency accelerates.

Did she say that was just for women, or everyone?

I asked my GP at what age I should get a colonoscopy? She said never, unless there's serious symptoms that require a closer look. She said the routine colonoscopy is gone, due to the risks involved, and the cost.

I'd get a second opinion as your GP is swimming upstream of the common, accepted wisdom. Routine colonoscopy starts at 50 unless you have a first degree relative with a positive history, then 40 or earlier with symptoms. If no polyps are found, repeat exams occur on a 10 year schedule.

Cost? In the USA, it's required to be covered by law (ACA). With modern techniques and equipment, the serious risk (perforations) is minimal. Much more prevalent is transient bleeding if polipectomies are performed. Most of the time, it resolves without further treatment. With age, the risk increases but so does the benefit. If I'm 80 and they find a cancer that's going to kill me in 20 years, do I care anymore?

My theory is that the doctor will ALWAYS describe any polyp that they remove as "precancerous". That's likely done to ensure that the insurance pays for the entire procedure, including any polyp removal. Chances are that if they didn't describe them in that way, the insurance might not pay for their removal. Again, that's just my theory.

I know this was something more, because my parents were worried and they usually aren't (and my dad has had multiple polyps cut out pretty much every time he goes in that I know of, so polyps aren't unusual). I'm sticking with the "everything is fine it was a normal polyp" interpretation because it works for me 😉 don't have to worry about a dying dad).

We can always hope that Buttwoman's doctor is on the cutting edge!

Interesting responses. I'm 58, and have had 2 or 3 GP's in the last ten years, a gyno, and an endocrinologist, and none has ever suggested a colonoscopy. I'll investigate further next time I see one.

I asked my GP at what age I should get a colonoscopy? She said never, unless there's serious symptoms that require a closer look. She said the routine colonoscopy is gone, due to the risks involved, and the cost.

Interesting responses. I'm 58, and have had 2 or 3 GP's in the last ten years, a gyno, and an endocrinologist, and none has ever suggested a colonoscopy. I'll investigate further next time I see one.

Did any of your doctors mention that, by the time you're symptomatic, it's generally no longer a preventative thing, but you're likely facing treatment for colon cancer?

And that is the only reason I'm getting one. I don't want to die of something stupid easy to fix if caught early.

@Buttwoman I've had 2, and I highly suggest you get one. They found 3 polyps the 1st time and said the one usually turns to cancer. The 2nd one they didn't find any. I know 2 people that died from colon cancer and it's not pretty, you just watch them waste away. 😢

I know 2 people that died from colon cancer and it's not pretty, you just watch them waste away. 😢

Seen a couple in my family die from colon cancer, it's not nice. Had some friends with close family members die of colon cancer.

One of my family members probably would still be here today if it had been found a year or two earlier.

That's why I'll probably suck it up and do almost whatever my PCP recommends, even if it's a happy birthday when I'm 45. The one non-negotiable: they ain't touching me with their drugs.

I guess it's possible that Canada relies on the FOBT instead because of economics.

Did any of your doctors mention that, by the time you're symptomatic, it's generally no longer a preventative thing, but you're likely facing treatment for colon cancer?

Two of those I know initially had treatable cancer, were treated, and it came back in 10-15 years. Even though it's improved, chemo is still nasty...

Well, I survived and would do it again. I created a bunch of blog posts detailing the experience if anyone is interested.

Thanks for the blog posts. Nice read, and excepting the first one where you detailed your reactions to sedation before were among the few I could read without getting worked up. Since there seems to be a number of people here either where sedation is not an option because of reactions or unsedated is a preference perhaps there would be some way to put together a list of doctors who will do it unsedated, since it seems as though it can be difficult to locate one.

I know that isn't strictly within the main thrust of zity, but it could be helpful.

Re: this discussion.

I was at a huge state of the art hospital, with one of Canada's best oncology departments. I was talking to a specialist in an unrelated field, but they are all M.D.'s. I asked him why no Dr. had ever suggested a colonoscopy to me.

He said in Canada, after the poop on a stick test, and blood tests, the next test is a cat scan. He said colonoscopy was then used if the cat scan had found anything. I asked about the prevalence of colonoscopy in the United States, and he said he was sure it was an insurance thing.

Someone noted elsewhere that insurance likes it because they can do all needed polyp removals and biopsies at the same time rather than having a FOBT or CT/MRI colonography and then have to go in and cut stuff out. It also is supposedly more likely to find polyps and other hidden nasties before they try to take over.

Re: this discussion.

I was at a huge state of the art hospital, with one of Canada's best oncology departments. I was talking to a specialist in an unrelated field, but they are all M.D.'s. I asked him why no Dr. had ever suggested a colonoscopy to me.

He said in Canada, after the poop on a stick test, and blood tests, the next test is a cat scan. He said colonoscopy was then used if the cat scan had found anything. I asked about the prevalence of colonoscopy in the United States, and he said he was sure it was an insurance thing.

That was his excuse for Canada's socialized medicine program.

That was his excuse for Canada's socialized medicine program.

That's what I suspected as well.

I read once that there were more MRI machines in Pittsburgh than all of Canada. Rich and connected Canadians come to America for the best health care quickly. The premier of Newfoundland went to the US for a heart valve replacement because the Canadians offered open chest repair and the Americans did it via minimally invasive.

Frankly, I don't want the same people that ruin everything else and can't balance a budget to ruin health care.

@buttwoman: According to this Canadian M.D., how would insurance companies benefit by recommending routine colonoscopies?

@JimmyJohnson: The doctors don't charge extra for clipping off a polyp. That's included in the cost of the colonoscopy, which is paid for whether something is found or not.

@buttwoman: According to this Canadian M.D., how would insurance companies benefit by recommending routine colonoscopies?

I didn't say anything remotely like that. Could be just a difference in protocols., as in, perhaps American insurance companies prefer their customers have colonoscopies.

Colonoscopy is much cheaper than treating someone for colon cancer for months or years. Preventative, expensive procedures are what ins. companies are looking for.

Canada has a completely different economic setup for their system then our mess where you can hardly find out what something is going to cost until (sometimes) well after it's been done. It's probably cheaper for them to rely on simpler general screenings and save the more expensive ones for if something comes up, whereas here that would be who knows how many individually billable office calls and tests.

Then again it could also be that they have budget limitations and so even if colonoscopy is better they might not be able to do it across the board. I guess that would be a question for a Canadian.

If you've had a bowel resection, sigmoid removal, upper rectal removal, 3 months of chemo., 25 days of radiation and then told you had a 50-50 chance of survival, you'll have no problem getting scoped every 3 years for life. My Gastro. finds new polyps about every other scoping. He tells me it takes about 7 years for them to become malignant, but by then they are too large to snip out with a scope.

After that experience, I'd have one every year if he suggested it. I take the Dulcolax tabs, drink the gallon of PEG solution AND take 2 qts. of tap water the morning before I go in. I don't look forward to it, but I want to stay alive!

I also have a cystoscopy every 6 months, after removal of a malignant polyp from my bladder. I HATE that procedure much more than the colonoscopy. The prep. for the colonoscopy is by far the worst part of the ordeal.

My sons are aware that they could have inherited the genetics from me for colon cancer and I strongly urge them to get screening colonoscopies every 10 years.

I had one a few years ago when I was 45. Sadly, there was nothing sexually arousing about it. The prep was horrible. Drank nothing but this salty/sweet liquid for 24 hours that gave me terrible yellow diarrhea. For the procedure, I was naked under a double exam gown. When I was rolled into the room, the nurse had me turn onto my left side and she unsnapped a few snaps to expose my buttocks. Shortly thereafter, the anesthesiologist started a propofol drip that knocked me out immediately. I woke up in the recovery room with no memory of the procedure.

I've had it. I have to do a three day fast, but most people only have to do a one day fast.

Most people object to the prep. There are several ways to do it. I couldn't tolerate the Go-Lytly. I used the five bottles (if you do a one day fast it's only 2-3 bottles) of citrate of magnesia and then an enema the morning of.

Once there, it's a breeze. You get an IV and conscious sedation. If you wake up during the procedure, you can watch it on the TV screen, as I did, then go back to sleep. You wake up in recovery and all is well. You'll need to have someone who can walk you into your house show up at the clinic to take you home; you can't take a cab.

Well worth the effort.

Moliere here is a link about polyps, hope it helps to provide more information about colonic polyps.

https://patient.info/health/bowel-colonic-polyps-leaflet

https://patient.info/doctor/bowel-colonic-polyps-pro

This is basically what we provide for our patients following a colonoscopy and polypectomy.

RN

Did what I should have done in the first place and asked my dad. Seems it was the type of polyp more likely to develop into cancer and was looking a little funny, but the biopsy came back as not cancer yet. I can sit back and relax knowing that I'm not going to have to watch another relative die of cancer quite yet.

Since 2011 I have had 4 of them the first one because I had blood in my stool and my gp recommended it. I didn't meet the doctor until that day. After the procedure he told me he had taken out three polyps one being the size of a 50cent piece and if I had waited a few more months he would have had to cut me open to remove it. when I got home I had a small plate of Chinese food and about 10 minutes later had to run to the bathroom and after going looked like I butchered a cow. I went three more times in the next twenty minutes and then called the doctor he told me if it happened again to go to the emergency room. I was taken back from his lazy attitude like it happened all the time. I ended up at the er an hr later and spent three days in the hospital on the second day I got my second colonoscopy so they could inject a steroid and cauterize the site from the polyp that was bleeding I had to get one the following year as well. After that I switched doctors and had my last one two years ago what a difference with the prep and attitude of the doctor I will have anther one in 2018. every time except for the second one they have found pre cancerous polyps. My advice to anyone is to get one when your doctor recommends it and have the conversation with the doctor beforehand and discuss your feelings/concerns about the prep and the anesthesia if you have a good doctor they will want you to be comfortable!!! I had the first three with anesthesia and the prep was a gallon of this awful stuff to drink in two hrs plus ducolax pills 4 after the drink and two fleet enemas in the morning. awful I could barely choke down that awful stuff and threw up twice during the two hrs. My last one I did a split dose of this stuff called suprep first dose the night before and second dose 4hr before appointment and two fleet enemas 1hr before leaving. When it comes to the anestisia part I have always got it with no problems but understand some people don't like it? I woke up during my 3rd colonoscopy and it felt like I was getting run through with a sword the doctor kinda yelled at me and said you have to stay still and I said are you fucking kidding me!!! Last time with that asshole!!!

I was adopted but my biological father had colon cancer. Because of this my doctor recommends a colonoscopy every 5 years. Thankfully they have all been normal. The worst part is not eating the day before and the prep.

I was still a bit concerned because some people said it was just fine with no drugs, other people said they woke up and it was very painful. I just realized another reason I probably don't have to worry: The people who said it was very painful were sedated and the drugs wore off. The doctors were in "this side of beef won't remember anything" mode and the patient wasn't expecting to feel anything. I'm guessing if you go in without sedation the doctors will be more gentle and you'll be expecting some discomfort/minor pain, so there really shouldn't be a problem.

I think I'm OK with it now, this time reading this didn't push up my heart rate, provided that at the time it will be done without sedation. If I can't do no-sedation then it's no-go.

I was still a bit concerned because some people said it was just fine with no drugs, other people said they woke up and it was very painful. I just realized another reason I probably don't have to worry: The people who said it was very painful were sedated and the drugs wore off. The doctors were in "this side of beef won't remember anything" mode and the patient wasn't expecting to feel anything. I'm guessing if you go in without sedation the doctors will be more gentle and you'll be expecting some discomfort/minor pain, so there really shouldn't be a problem.

My guess it is the sudden burst of pain, or the acute awareness of it, upon being roused from a groggy state would be quite a shock. Much like plunging your hand into 110°F water would feel painful, a slow increase from body temp to the same temp would just be uncomfortable.