Colonoscopy: Real Questions, Real Answers from Altru’s Gastroenterology Providers

Colonscopy QuestionsFriend: What’d you get for your 50th birthday?

You: I got a colonoscopy!

Probably not the answer your friend was looking for.

While a colonoscopy isn’t as exciting as a new gadget or as fancy as a new piece of jewelry, it’s one of the best presents you can give yourself (and those who love you).

Altru’s Gastroenterology Providers tackle some of the frequently asked questions about colonoscopy.

Do I really need to have a colonoscopy? What are the chances you’ll find something?

» Yes. While screenings for other cancers detect the presence of cancer, colonoscopy screenings can prevent colon cancer. During a colonoscopy, the physician is looking for polyps, small growths that over time can become cancer.

» If a polyp is found, the physician will remove it. In those over 50, polyps are found in approximately 25 percent of males and 15 percent of females, but are usually not cancerous. One in 20 adults will develop colon cancer in their lifetime. If caught early, colon cancer has a 90 percent cure rate.

» Colonoscopy is recommended beginning at age 50 and continuing until 75 years of age. People with an increased risk of developing colorectal cancer should begin screening at a younger age, and may need to be tested more frequently.

Real answers by Anthony Chu, MD.

Will my insurance cover the procedure?

» Most insurance plans and Medicare cover colorectal cancer screening for people who are age 50 or older. Colorectal cancer screening tests may be covered by your health insurance policy without a deductible or co-pay. Consult your insurance provider for your specific coverage.

» Altru’s No-Cost Colonoscopy program offers financial assistance for eligible patients who are uninsured or underinsured. Funding is available from Altru Health Foundation, thanks to Altru’s Gala and grants from the North Dakota Department of Health. For more information, call 701.780.6533.

Real answers by James R. Wood, MD, FACP.

What does the colon prep liquid taste like? Why is it necessary to drink it prior to my colonoscopy?

» Patients have a choice when it comes to colon prep. GoLYTELY® is typically recommended as it has the best coverage from insurance. GoLYTELY® is mildly salty, but patients can mix lemonade or limeade flavor packets in to the liquid to make the flavor more enjoyable. The other two options – Prepopik and Miralax – aren’t covered as well by insurance, resulting in additional out-of-pocket cost to the patient. Prepopik tastes similar to sour orange cream candy. With Miralax, the taste is determined by the Gatorade flavor with which you mix the powder.

» It’s important to drink all of the colon prep to properly clean your colon. This helps to provide your physician with a clear view of your colon.

Real answers by Kamrin Macki, NP.

Who will perform my colonoscopy?

» Our doctors are experienced, board-certified and University-trained gastroenterologists. We follow the national guidelines for performance of the procedures, which assures the highest quality exams. We utilize a state-of-the-art facility with experienced nursing staff. Colonoscopies are performed differently for different issues in different patients, and thus need to be individualized.

» Endoscopic procedures performed by physicians with different training may not be able to provide the same ability to provide the quality of care. For example, identifying and removing large or “flat” polyps requires special training and experience which is available at Altru. Flat polyps were first identified at Stanford University in 2007. These flat polyps are more difficult to identify and appear to pose a higher risk for developing into colon cancers.

Real answers by Howard Hack, MD.

Why is good colonoscopy preparation so important?

» Bowel preparation for colonoscopy refers to the laxatives taken before the procedure to clean the colon of fecal debris. A colonoscope is a long, flexible tube with a television camera on the tip. The camera cannot see through fecal debris. So any fecal debris left in the colon could obscure identification of a polyp or even a small cancer.

» Several studies have shown that fewer small and large polyps are detected in patients with less-than-optimal bowel preparation. And, poor preparation has several potential consequences during the procedure itself. First, your colonoscopy may last longer because the doctor will need to take time to clear out debris. Second, your doctor may lack confidence that the colon lining was seen adequately and may ask you to return for a subsequent screening earlier than would be otherwise recommended (say one year, rather than five or 10 years). This will subject you to increased costs and risk. Finally, if the preparation is very poor, the doctor may have to stop the procedure entirely, and you will need to reschedule.

Real answers by Israr Sheikh, MD

Altru's Gastroenterology Team

To schedule a screening colonoscopy, call 701.780.6533. Learn more at altru.org/colon.

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