Talk:Colonoscopy

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This article contains material from the public domain NIH Publication No. 02-4331, dated February 2002, URL http://digestive.niddk.nih.gov/ddiseases/pubs/colonoscopy/

Welcome to the Colonoscopy discussion page if you would like to contribute, or are curious about information not presented here, then please check the "to be added" section Before adding, or if you remove something, please check the removed section. If you remove something then please give justification. Before making changings, please sign into your account. --eximo (talk) 02:57, 17 March 2009 (UTC)

To be added or updated

Video Talk:Colonoscopy

History

Just randomly browsing, but it occurs to me that this page would greatly benefit by having something on the history of the procedure. Eg, this is a recently developed procedure (relatively), when did it first come into use? I don't have a clue on this myself however. 128.250.5.246 (talk) 14:05, 11 March 2009 (UTC)

I agree, so added some text and citations about the inventors of the procedure and the instrument used, Wolff and Shinya. There is potential for a lot more, but it's a start. -- Preceding unsigned comment added by 98.248.37.30 (talk) 04:54, 16 December 2015 (UTC)

Maps Talk:Colonoscopy

Procedure

When they add air to "puff" you up, what psi do they inflate to, or max diameter. This is encylopedia worthy.--eximo (talk) 02:57, 17 March 2009 (UTC)

I don't think it's a specific pressure. It's just that the colonoscope emits air, which rapidly leaks out. As to the pressure of the air ejected by the colonoscope, unsure. 128.250.5.245 (talk) 15:31, 25 April 2009 (UTC)

Removed

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I removed the pictures because they were grossing out my buddies

The pictures were :obscene:and:did:not:add:anything:to:the:article --Preceding unsigned comment added by 24.19.183.198 (talk) 23:26, 5 January 2008 (UTC)

How do you know they did not? Where can I find these pictures? ee1518 (talk) 07:53, 9 November 2017 (UTC)

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Removed for now

A 4 liter polyethylene glycol solution (Colyte, Golytely) remains the gold standard colonic prep with the best clearance of particulate stool. Due to the large volume and unpalatble taste, alternative regimens may be considered in the appropriate patient population.

I'm not a doctor (just somebody who's had to do this on several occasions and thus has read a good deal of info on the procedure) what I've read some studies suggest that some of the other methods work just as well or better than polyethylene glycol, and are more tolerable by patients. If you've got something to back the removed statement up, please add a reference to it, and put the statement back in. --Robert Merkel 01:46, 23 August 2006 (UTC)

Actually, there exists a colyte solution that is fruit flavoured; it is actually adequately tasty and palatable, having the flavour of an over-sweet Kool-aid combined with a slick texture. With a little vodka, it'd be a pretty neat drink! Seriously, though: Most patietns find that drinking 4 litres by way of 250 ml glasses every ten minutes is quite difficult. Usually, the patient finds the fourth to seventh drinks to be the hardest to get down and keep down, but by then the mental powers are fully focused on finding the water closet, finding it in a hurry! Victims (I mean patients) should remember the following points: 1) it's hard to drink four litres (goodness, that's the size of an anti-freeze cannister!) in any day, letalone in 3-4 hours, but you will be able to do it; 2) don't make any plans to do anything outside the home for the rest of the day; 3) you will sit and read your favourite book about 10 - 20 times interspersed with drinking more of that antifreeze; 4) don't bother being obsessed about cleaning the tailpipe - it will hurt like heck the more you wipe; 5) it seems to never end - the drinking stops but all that fluid is in the fast lane to your city's sewage treatment facility - the product works as advertised, fully expelling everything that's in your bowels; 6) the thought of never drinking more water in your life is powerful, but make sure to have a drink of water around midnight - it's the last fluid allowed before the procedure; 7) this lavage prepartion is far worse than getting goosed by the doctor with scope.DocEss 18:45, 3 November 2006 (UTC)

Person experiences

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My colonoscopy & endoscopy experience (with tips)

I recently underwent a colonoscopy and endoscopy (sedated) for the first time at the age of 34 (female). My GE has been trying to diagnose why I have chronic diarrhea and lower abdominal cramping (1.5 years). And yes, I tried all sorts of elimination diets prior!

The doctor's office (pre-visit) and later the hospital (for the actual procedure) were amazing. I was slightly worried about being sedated as I've never been through that before but it all went very smoothly. Everyone explained everything in detail and gave me information sheets. There was nothing left to "guess" and I felt very comfortable during the whole procedure and also about asking questions. I gathered information from the internet, including Wikipedia, to better inform myself about what would happen and why. I will briefly tell you what happened (along with helpful pointers):

-> The day before the procedure I started the Halflytley Bowel Prep Kit I had obtained from the pharmacy the week before. For the clear liquid diet I stuck with Sprite all the way. Right about 2 hours after taking the 2 tablets at noon, the first BM came along. From there, and all throughout drinking the solution every 10 minutes as others have mentioned, I had dozens of pure watery BMs. I vomited once, which can be expected, and also felt quite gassy throughout. This is where I want people to take note: your bum is not used to this many BMs, nor wiping all the time. Even the wet bathroom tissues were painful. I would suggest asking for advice and using a diaper/nappy cream if possible...you really do need a barrier as I was literally in tears due to pain on the outside. It took til 2 days after for me to recover just from this. I was never further than 10 steps from a toilet because the BMs come on suddenly and exit quickly. Plan on being stuck in and getting through this in once piece. This was by far the worst part of the colonoscopy. By the next morning I had only 1-2 small watery BMs just before the procedure.

-> For women: I suggest take a urine sample container home with you before you start the above preparation. The morning of the procedure I had to give a urine sample and was just about fresh out of anything remotely resembling urine as I had emptied myself all too well with the above. I wasn't allowed anything to drink at all after midnight and nothing on the morning of the procedure and apparently you give the urine sample as they take a pregnancy test minutes before.

-> Upon arrival at the hospital clinic, I checked in and had a short wait before a nurse did the prep work. She got me into a gown (complete with sockies and a warm blanket) and inserted an I.V. with electrolytes. I had never had an I.V. and I was surprised at how painless it was. Another short wait and I walked into the colonoscopy room.

-> For the procedure my GE doctor came from his office to the hospital, and in the room with him was a colonoscopy tech and a nurse. I was introduced to everyone, they explained what they were doing, I signed some paperwork and moments later I was sedated. I felt nothing and never stirred during. Upon waking (I believe it was about 40 minutes later), my doctor greeted me and told me that everything looked fine, but he did take 4-5 biopsies to send off for further analysis. I was wheeled into the recovery room where I was given fruit juice. The nurse was very good to me and explained to my husband and I about the follow up---what to eat and when and when to go back in for the results. She was there to make sure I could sit up properly and had me sit for a while before standing. Though I was a little bit groggy within the hour I felt just fine and had my first meal in 2 days.

-> When I left the hospital I had a follow up sheet to take home with all the instructions and appointment information and also 10 color images on a sheet of paper from the colonoscopy and 6 from the EGD (esphagogastroduodenoscopy) or endoscopy exam. They are absolutely fascinating and this whole experience has helped educate me in how my entire digestive system works.

-> I just found out today that my biopsies came back normal so I'm going back in 2 weeks for the Pillcam (especially for small intestine viewing). I will write about this after the procedure and results are back.

Whatever your reason for needing/wanting/being referred for a colonoscopy and endoscopy (and I'm well aware there are risks in this type and many other types of procedures), please be aware that the procedure can go very smoothly and you can gain vital information in diagnosing.

Lisametcalf 05:02, 7 July 2007 (UTC)

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Gettin scoped

The anxiety and insecurity created by patients prior to procedures like this are nearly always powerful and seemingly uncontrollable --- and nearly always unwarranted. Note that, compared to the lavage preparation, the procedure itself is hardly bothersome at all; indeed, some patients find that watching there own insides is fascinating [there is a tv monitor for you to watch]. They also find the doctor's adeptness with the scope and all the little tools on the end of it to be fascinating and admirable - what skill! The sedative seems to provide the required amount of placation so that time passes really quickly and the experience is hardly traumatizing; before you know it, it's all over and you realize fretted for nuttin. Relax, joke around with the doctors and nurses, watch your own insides get probed and poked, sleep for an hour when it's done and go eat when you get home.DocEss 19:03, 3 November 2006 (UTC)

src: bowelprepguide.com

Withdrawal times

I don't think that Wiki should be making recommendations about how to conduct a procedure, especially not when there is no evidence to back up the assertion. The only evidence for withdrawal times states a cut off of 6 minutes, not the 20 to 25 minutes stated in the article.

Barclay RL, Vicari JJ, Doughty AS; et al. (2006). "Colonoscopic withdrawal times and adenoma detection during screening colonoscopy". 355 (24): 2533-41. CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)

Gak 19:51, 16 December 2006 (UTC)

src: bowelprepguide.com

Eat Whole Grains

I recently turned 50 and got a colonoscopy, inspired by Katie Couric who had one. They found a polyp and got rid of it. (My doctor told me one in four people my age have a polyp, with the number increasing as a person gets older). Instead of having the next examination in 10 years, (which would be the case if there was no polyp), my next examination is in five years. He advised me to eat whole grain breads, which I do. I also eat rice bran, freshly ground flax seed power, and drink green tea, which some people have suggested is also helpful to prevent certain types of cancers.204.80.61.10 18:23, 4 January 2007 (UTC)Bennett Turk

src: 929thelake.com

Phospho Soda

As no articles link to phospho soda, I was thinking it would be appropriate to put some reference in this article. Is anyone knowledgeable as to whether phospho soda is the same as trisodium phosphate or where it could be best referenced? -- MacAddct1984 ? 21:16, 7 February 2007 (UTC)

The chemical is Sodium Phosphate. trisodium phosphate is not the same. Kd4ttc (talk) 04:44, 18 February 2008 (UTC)

"Sodium phosphate" is an ambiguous name that could refer to several compounds including trisodium phosphate. --Preceding unsigned comment added by 96.32.174.64 (talk) 18:47, 17 July 2010 (UTC)

src: www.healthconnection.in

Colonoscopy Really Can Be Easy

Having tried each method of preparation I can say without reservation that the Fleet Phosphoprep is by far the easiest.

All but my first colonoscopy were done without sedative, although men apparently tolerate it better then women (they are built differently, after all). While I experienced some minor cramping, it was no worse than the prep the night before. Best of all, there is no recovery period aftewards. You're awake and alert...and eager for something to eat!

My poor Mom endured the gallon of water approach (and threw up long before she drank it all), and my wife enjoyed (sic) the 32 horse pills and 8 glasses of water. Never again in either case, you can be sure.

Without doubt, the biggest obstacle to a low stress colonoscopy is the idea that it will be embarassing and someone is going to stick a really long thing up your butt. Get over that and the whole thing really isn't bad, and can be very interesting to watch. Think of it as a new way to inner enlightment and self knowledge?  ;-) --The preceding unsigned comment was added by 76.176.169.212 (talk) 16:58, 13 February 2007 (UTC).

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Time factor

It actually takes a long time getting a colonoscopy done, most of which not spent with an endoscope inside - rather having prep, waiting, recovery time etc etc. doi:10.1111/j.1572-0241.2007.01387.x looks at how this will influence screening programmes. JFW | T@lk 21:39, 2 July 2007 (UTC)

src: www.nextavenue.org

Video record

Is it standard practice to record the video? If so, is it standard practice to keep the video records? For how long? Do any places make this record available to the patient? Do any places send home the patient that day with a DVD/CD video record, if they want it, as standard practice?-69.87.204.35 11:41, 14 July 2007 (UTC)

Taking a video is not standard practice. Photographs are routinely made. Kd4ttc (talk) 04:43, 18 February 2008 (UTC)

That is true, i'm a bioengineer and had a colonoscopy recently, and I was hopping mad after words to find out that I had awoknen the 1980's befoer the age of cheap video!!! I can no BELIEVE THEY DON"T VIDEO!!! the equipment is capable of it, and G-D knows that people staring at colons miss things, why no video?! IT's not expensive or anything, it's just a program. Mark MY WORDS, VIDEO COLON WILL START BEFORE 2020. --eximo (talk) 02:50, 17 March 2009 (UTC)

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Reading Level of Text is way too advanced

Articles like this that are of interest to the general population need to be written at a bit lower of a reading level. Use of simpler language and some bullet points here and there would make this article accessible to everyone.

I don't know--or even understand--all the details enough to make edits. I hope someone else does. Denn333 23:01, 20 July 2007 (UTC)

I don't think Wikipedia articles written in normal English should be dumbed down. In left hand side, there is "simple english" selectable as a language. If not, create article in simple English.

There is already too much unscientific text in this article. For example how much is half a cup of blood and does it mean US or UK cups? ee1518 (talk) 08:06, 9 November 2017 (UTC)

Language of Text is Linguistically too Unsophisticated

For example I am looking at the sentence "A sigmoidoscopy allows an examination of the distal portion (about 600 mm) of the colon, which may be sufficient because benefits to cancer survival of colonoscopy have been limited to the detection of lesions in the distal portion of the colon."

I would like to know for what purpose examination of the distal portion of the colon may be sufficient, that is, examination of the distal portion of the colon may be sufficient to accomplish what? Without first being told this, the clause "because benefits to cancer survival of colonoscopy have been limited to the detection of lesions in the distal portion of the colon" does not seem to make any sense. --Nomenclator (talk) 05:25, 25 December 2015 (UTC)

Pictures of Polypectomy

The pictures were grosss so I removed them. ^yeah --Preceding unsigned comment added by 24.19.183.198 (talk) 00:36, 19 December 2007 (UTC)

You keep removing them, but them being "gross" is not sufficient. Articles are not be edited based on a perception that things are offensive. Stop removing the images, especially since you only removed them, without editing the article to reflect your removal. I am going to replace the images. If you want to actually discuss this, with sufficient reason for removing them, then please do so here, but since you are the one making the change based on insufficient criteria, I will continue restoring the article to its original state, until you provide just cause. Thank you. Nik-renshaw (talk) 22:03, 22 December 2007 (UTC)

See also Wikipedia:What Wikipedia is not#Wikipedia is not censored. Thank you. Nik-renshaw (talk) 22:08, 22 December 2007 (UTC)

Thanks for keeping in the images. I took the images while doing a colonoscopy. The EMR in this example went very well, and I'm rather pleased with the result. For those who think this is gross, you should see how ugly a cancer looks. Better have the polyp out than end up with what looks like a rotten mushroom in the colon, or worse - a spread cancer. Kd4ttc (talk) 04:48, 18 February 2008 (UTC)

Yes, thanks for images...very helpful with such an important topic ```` --Preceding unsigned comment added by CurrentHistoryMatters (talk o contribs) 19:37, 30 June 2008 (UTC)

External Links: Reviews

According to Wikipedia external links policy sites with other meaningful, relevant content that is not suitable for inclusion in an article, such as reviews and interviews can be linked as an external link for a Wikipedia Entry. Do you also feel this external link about Colonoscopy (reviewed by Shehnaz Shaikh, MD.) is a legitimate external link of the colonoscopy medical intervention? --Preceding unsigned comment added by Apotek31 (talk o contribs) 20:24, 20 October 2008 (UTC)

Some food for thought

We all know that a Colonoscopy, bears some risks. We all know, that out there there are doctors, teams that are very gifted at performing this procedure, while some are less gifted. Clearly, the idea to sedate the patient to perform this procedure reminds me of the mechanic that does his best to remove a bolt by sheer force, accepting the risk of tearing away the head of the bolt, simply because it is quicker and easier to do so. The advantages of only using a strong pain reliever (Norway), having a patient that is awake and that can give feedback, that knows what is going on, are obvious. There is far less risk of perforating the colon, the is very little risk of creating a situation because of the use of sedatives. The idea behind the nerve system, that creates the pain signal, is to provide us with a warning, that something is wrong in a given area. In any case, if need be, one can always sedate the patient within very little time to perform certain tasks that would urgently require this. Also in a world where more an more people are single, unable to take off much time from work, have to drive to be able to move around, it makes no sense at all to sedate in a way that makes those patients unable to conduct machinery for 24 hours. The next detail, that requires some attention, is simply moisture in the colon... if there is too little moisture the endoscope will be more painful and harder to move around the bends to where it is required, but if you have a sedated patient you don't notice it and you save yourself the time needed to add a little water to where you need it, you simply try to push your way around the bends, moving the end of the endoscope to create a passage. Frankyl, during a colonoscopy most patients will have too little moisture in some places but with a sedated patient, the force it up there ideology seems to be the most widespread, ignoring the fact that this increases the risks for the patient. Next some things are indeed beyond logic, like the fact that very few colonoscopies are recorded. You can take 10 biopsies and pictures in someone that has a cancer in the colon, that prove otherwise... no problem at all, with a sedated patient it is a very simple thing to do. If you have a recodring of the whole procedure, you can give a copy to the patient, this can also help him get a second opinion, it can also protect those that perform the procedure as well as the patient should something go wrong. A recording can help to pinpoint a possible puncture, enable the doctor to review the images after the procedure to make sure nothing was overlooked. Also more and more colonoscopies are done using HDTV equipment, I will not get into the details on why HDTV is better then the old stuff... I assume that most of you have seen HDTV pictures on a good Plasma/LCD screen. Frankyl, when you are looking for suspect areas that have no tri dimensional anomaly, HDTV is way supperior. Last the withdrawal... There now is plenty of evidence, that the withdrawal is the critical phase to find suspect areas and adenomes that require a biopsy to make certain that these are not a long term problem. Clearly, if the team has a HDTV system, is recording, it can spend much less time on the withdrawal as long as all areas have been filmed and recorded for possible later review. In the abscence of a HDTV recording, it becomes critical to do a slow withdrawal so that nothing is missed. I don't think that anyone, can come up with with a counterpoint that will prove me wrong here. --Preceding unsigned comment added by 212.77.42.158 (talk) 15:44, 17 June 2009 (UTC)

Redundant, tortuous colon

I've had e colonoscopies and 2 virtual colonoscopies in the past 2 years. The scopes were unsuccessful and now they are asking me to have my 3rd virtual. They can't get to the ascending (cecum) and saw something that could be residue left over from the cleansing or maybe something else. I'm 61 years old and my father died of colon cancer over 10 years ago. My ambivalence comes from the fact that if they see something on the virtual, they will want to try another colonoscopy. But, after 3 tries, what would be the point? I'm am so undecided about what to do. I had the scope done at a very reputable hospital.

Linda --Preceding unsigned comment added by 71.224.134.165 (talk) 00:45, 8 October 2009 (UTC)

milk containing fibres?

I've some doubts reading (...)milk containing fibre should not be consumed(...). Does really milk contains fibres? I don't think so, and also Milk doesn't say anything about fibres. Cate | _Talk 15:46, 16 February 2010 (UTC)

I don't think it's just pain that stops people having them

The article guesses that the reason people avoid having them is a fear of pain - "Tens of millions of adults need to have colonoscopies each year, and yet many don't, because they are afraid of the pain." I don't think it's really a fear of pain though, I think it's more likely a fear of having an accident that stops a lot of people. The preparation involved and the risk of being caught short would put a lot of people off, especially when you're not near a toilet, eg when you're driving in to the hospital.

Personally I think it is the prep that is what turns people off about the procedure. I have had a colonoscopy before and I am due to have one again. The prep is the problem here. The whole experience is quite frankly, disgusting and very time consuming. I think there should be more thought and discussion about alternatives to colonoscopies.

Unprofessional

Large parts of this article are rather unprofessional or not encyclopedic in tone. For example, the part discussing the discomfort of the procedure feels more like a guide as opposed to an encyclopedic discussion.

--Heero Kirashami (talk) 17:54, 8 July 2010 (UTC)

Word Usage: "Colonoscopy"

In the intro, "colonoscopy" is used without an article. From what I can tell, it is a noun, and it would read better if it had an article. However, this medical procedure may be a grammatic exception. Is this the case? --Glubbdrubb (talk) 09:51, 28 October 2010 (UTC)

 Done -- AstroU (talk) 13:27, 12 May 2015 (UTC)

Deleted duplicated text

I note that the text "A study published (2010) in the Journal of the American Medical Association concluded, "If de novo decisions were being made today about whether to initiate colonoscopy as a screening tool in place of sigmoidoscopy for average-risk individuals, in light of the available evidence doing so would probably be inappropriate."[36]" appears twice, once in the lede, and once at the end. This should be condensed to a single appearance, so I deleted the first instance.

Inconsistent data on risks

In the section "Risks", the data listed is: "...the most severe complications from colonoscopy are perforation (that occurred in 0.38% of cases), heavy bleeding (occurring in 1.4% of colonoscopies) and death (occurring in 0.016% of colonoscopy patients)."

In the section "Controversy", however: "Perforation of the colon occurs at a rate of about 1 in 1000 procedures with a 40% mortality." (40% mortality would be 0.04%)

The source for the first set of number is listed as "According to a study published in the Annals of Internal Medicine"-- but the actual citation is to an about.com article, so I added a "citation needed" tag. The about.com article gave ranges, not single numbers, so I put the actual number ranges from the article in.

There's no source for the second set of numbers, so I added "citation needed." The immediately following citation in the "Controversy" section linked to the paper "Number Needed to Screen," http://jms.rsmjournals.com/cgi/reprint/8/3/125.pdf , but this refers to screening by fecal occult blood test (see table 1, line 3), and has no mention of colonoscopy. I don't think this is relevant, so I deleted it.

I did find some reasonably good data on perforation rates, so I added these. Geoffrey.landis (talk) 20:17, 2 June 2011 (UTC)

"a temporary drop in blood pressure, and oxygen saturation usually the result of overmedication"? It seems that oxygen saturation is not an adverse condition, so probably "drop in oxygen saturation" is meant, but that is not what the text means. It should probably say "in oxygen saturation", and perhaps the comma before "and" should be removed. Mateat (talk) 04:11, 2 February 2015 (UTC)

That complication rate

Can't be valid, as I just had one and signed a disclamer? saying 1.4% risk of serious complications.Earthsales5 (talk) 00:52, 4 June 2011 (UTC)

Review articles

Wikipedia is based on review articles not commentary. Have removed said commentary from the lead. Doc James (talk · contribs · email) 04:02, 4 June 2011 (UTC)

Review of screening

PMID 20889076 - discusses cost-effectiveness. JFW | T@lk 19:28, 2 December 2012 (UTC)

New NEWS today, for future editing

The cost could come down by replacing the anesthesiologist.

  Headline-1: New machine could one day replace anesthesiologists  

• http://www.washingtonpost.com/business/economy/new-machine-could-one-day-replace-anesthesiologists/2015/05/11/92e8a42c-f424-11e4-b2f3-af5479e6bbdd_story.html

QUOTE: "Colonoscopies are among the most common medical procedures, with about 14 million done annually. The screenings are often uncomfortable and sometimes painful. Many patients would prefer to be knocked out, and in recent years anesthesia has grown more common for these procedures. In 2009, an estimated $1.1 billion was spent on traditional anesthesia services for colonoscopies, according to one research study. Sedation can cost even more than the colonoscopy, with anesthesiology fees adding up to $2,000. By contrast, Sedasys costs $150 to $200 each time." -- AstroU (talk) 13:33, 12 May 2015 (UTC) -- PS: FYI for future editing.

External links modified

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Key performance indicators

doi:10.1136/gutjnl-2016-312043 JFW | T@lk 10:04, 15 November 2016 (UTC)

Source of the article : Wikipedia