Transcription:
Colonoscopy: What to Expect and Why They’re Important

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Sean O' Connor: Welcome to Well Within Reach the podcast from Riverside Healthcare. I'm Sean O'Connor and I'm a Marketing Communications Rep with Riverside and I'm joined today with Dr. Williams, Dr. Gretchen Williams, a General Surgeon.

Dr. Gretchen Williams: Hi.

Host: Hi. I have to clarify that because we have a number of Dr. Williams on staff and so.

Dr. Gretchen Williams: I'm the only one that counts.

Host: Okay. We hope that the other Dr. Williams does not come in at any point and then we'll have to have a battle back and forth. Well, very good. So you're a general surgeon with Riverside and today we're talking about colonoscopies. Now what is a colonoscopy?

Dr. Gretchen Williams: Put simply, it is a lighted telescope exam of your colon, which is your large intestine. We use it as a screening tool for colon cancer. Colon cancers the number three most common cause for colon cancer deaths, for cancer deaths I should say. And so it's a perfect tool to help screen or detect Colon cancers.

Host: Interesting. And is does it detect anything else or what are we looking for when we go in for that colon or colonoscopy?

Dr. Gretchen Williams: So it looks for small little polyps. It can help us diagnose people with other issues, you know, related to maybe constipation or problems with their bowel habits. All the way up to colon cancer.

Host: Interesting, interesting. Now when we say polyps, are they always cancerous or are they just normal growths? What is a polyp?

Dr. Gretchen Williams: A polyp is a growth in the colon. It can be a benign, meaning not cancerous or it could have some features that make us concerned that it could turn into cancer. So when we do these colonoscopies, we like to find them when they're small, benign and we can take them out real easy.

Host: Interesting. And who should receive a colonoscopy?

Dr. Gretchen Williams: The current recommendations are for anyone who is 50 or above. The American Cancer Society recently put out a soft guideline for people who are 45 or older. But we also take into consideration a family history of colon cancer because some people may need to get screened earlier.

Host: Okay. And beyond that, is it any certain demographic or segment of the population beyond people with a family history?

Dr. Gretchen Williams: So there are some, again, very soft guidelines for African Americans to get screened at 45 instead of 50. Patients who have a diagnosis for inflammatory bowel disease or something like that should get screened earlier as well. If you have specific questions about that, you can always talk to your doctor.

Host: And I know not everyone's lining up for colonoscopies.

Dr. Gretchen Williams: I don't know why not. There great.

Host: Well, what are some misnomers about colonoscopies? I, I had a whole bunch of great puns lined up, but beyond just the general juvenile illness that goes into it, I think a lot of people have some apprehensive.

Dr. Gretchen Williams: People do get nervous because again, it's a procedure. It's the unknown. You know, it's painless. I think the biggest concern is that people do have to do a bowel prep so they have to get themselves cleaned out the day before. That's pretty much the biggest issue. There's lots of, you know, different ways that we can help people, you know, get themselves cleaned out because that's the most important thing when we do these colonoscopies.

Host: Yeah. The prep isn't as bad as people think either. It's more of just kind of a basic diet for a day or two.

Dr. Gretchen Williams: Yeah, exactly. So, you know, people should expect to be on a clear liquid diet for about, you know, 24 hours before the procedure. There we give them instructions on what to do in terms of getting themselves cleaned out. Sometimes it's you know, a couple liters of fluids. Sometimes it's a couple pills. Really kind of depends on who you know, who's given you the prep. The key to remember is it's a marathon. It's not a sprint and you just take your time and you know, do the best you can.

Host: Interesting. And we mentioned they aren't painful at all.

Dr. Gretchen Williams: Correct. So you should expect, you know, it's a procedure, so you'll go in, you'll get an IV. Generally if you're going to get sedation, which you can elect to, you can elect not to. You are generally though like Twilight sleep, so you don't really know what's going on. We do the procedure which takes anywhere between, you know, 20 to 30 minutes. And then you wake up, you'll ask us when we get to start and we can tell you we're all done.

Host: Perfect. Interesting. And what is recovery time look like on that?

Dr. Gretchen Williams: So generally people, if they do get sedation, they're in our recovery room for anywhere between 30 minutes to an hour. You're pretty much doing everything that you want to do once you leave. Certainly not driving because of the medication you got for the sedating part of it. But you're back to work the next day. No problems whatsoever.

Host: Good. So you don't really have a good excuse for missing more than one day of work.

Dr. Gretchen Williams: We can arrange something but no.

Host: We can't, we can kind of tell our bosses we need the whole week off.

Dr. Gretchen Williams: The whole week off. Absolutely. Yeah, we talk about that beforehand.

Host: So there is a difference between a regular colonoscopy and what is a spinotonomy or?

Dr. Gretchen Williams: Like a sigmoidoscopy?

Host: There's my word.

Dr. Gretchen Williams: Sure. So a sigmoidoscopy, it's similar to a colonoscopy. You typically don't need to do a full bowel prep, you need to do a couple enemas beforehand. You do not need to get sedation. Some people actually do it in their office. It allows us to look at anywhere between the first 20 to 30 inches of the colon, which we have a lot of Colin. So that's not the whole thing. But it can give us a general idea of that area. Again, it doesn't look at the entire colon. So, you know, recommendations are still to get the full colonoscopy.

Host: Yep. Okay. what are some signs that maybe I should have a colonoscopy sooner than the recommended age?

Dr. Gretchen Williams: Any change in bowel habits from your normal, you know, a lot of people have, you know, loose stool sometimes, constipation sometimes, but really it's just a general change that you notice. Any blood in your stool. If it's bright red blood, if it's dark, definitely talk to your doctor about that. And then, you know, any weight loss, bloating, you know, abdominal pain, those are all very late signs if anything is going on. So that's why we recommend screening when you're 50.

Host: Now if something is found, let's say the polyp does come back cancerous, what is the kind of treatment regimen look like on that?

Dr. Gretchen Williams: It depends on how big the polyp was. Were we able to get it all during the colonoscopy and it's not uncommon for us to be able to do that again, that's why we recommend screening sooner rather than later. Because if we do find something, we want to find it when it's small. If it is something that is bigger and it's cancer, then generally speaking, we would discuss, you know, having that part of the colon removed. There's a lot of that goes into staging, which, you know, people may have heard of. And that involves some lab work and some imaging of your belly and your chest. And then of course another prep to get you ready for the procedure itself.

Host: Okay. And then after the colonoscopy, how soon do we get the results of the colonoscopy, if there are polyps or if they were cancerous or not?

Dr. Gretchen Williams: So if there's, so I tell everyone, you know, after the procedure what we found there's always a loved one with them so that they can remember after their sedating medication. And then the average is anywhere between three to five days. If we do find a polyp we send everything that we take out to our labs so that they can get it tested. Because again, you know, we look at growth we can't tell just with our eyes what it is. So, you know, we get experts to tell us and then I instruct my patients to call the office and we go over everything. If it's something bad, then I'll usually have them come into the office though.

Host: Sure. So I think there's a lot of fear that goes with a colonoscopy, but there's a lot more that could be worse than getting the colonoscopy. So it's almost better to really just get it done, get it out of the way. Is this something that we should have done yearly once we turn 50? Biyearly? Every five years? Every 10?

Dr. Gretchen Williams: Good question. I would like it every year. No, I'm teasing. The recommendation, so if you're at a general risk, you know, you don't have any family members with colon cancer, you've never had colon cancer and you have a colonoscopy that's completely, perfectly normal. Your warranty is 10 years. Of course, if there's signs that we talked, you know, any changes to bowel habits, blood in your stool, that may warrant an earlier colonoscopy. That's about, you know, that's the average though 10 years. Depending on if you had a polyp, there's a lot of different kinds of polyps, depending on what kind of polyp that will then determine when we have to do it again. The average is anywhere between three to five years for that repeat colonoscopy.

Host: Very good. Okay. Do people need a referral? Is this something that once we turn 50 or 45, we should go to her primary care provider?

Dr. Gretchen Williams: Usually the referrals generated by your primary care doctor. A lot of times insurance companies require a referral. It really depends on the insurance. But certainly, you know, ask your primary care doctor if you're at all, you know, wondering about the colonoscopy.

Host: Okay. Does Medicaid or Medicare cover colonoscopies?

Dr. Gretchen Williams: Absolutely. 100%.

Host: That's good to know. I'm not at the age yet, but that's.

Dr. Gretchen Williams: We could do it sooner. I'm down.

Host: I shouldn't say I'm all about it, but at the same time, I, you know, that's one of those, you want to make sure you're keeping yourself healthy before things get too bad.

Dr. Gretchen Williams: Absolutely. And again, I think the, a lot of the hesitation with a colonoscopy is because, you know, people don't like to spend a lot of time in the restroom. They don't want to, you know, have a lot of bowel movements. But what, you know, whenever we do things in medicine, we always weigh risks and benefits, and the benefits to having a colonoscopy when you should have a colonoscopy are so much better than waiting and finding something out, you know, 10 years down the road. So, yeah.

Host: Very good. Interesting. Anything else I should know about colonoscopies?

Dr. Gretchen Williams: No, I think we covered most of it.

Host: I'm a little disappointed cause I had a number of good puns ready to go, but you know, I felt professionalism kind of took over in the end. And so I appreciate you coming on. I appreciate you helping us out to get a better understanding of them because like I keep saying, I think a lot of people are apprehensive about getting them done, but it's better than the potential.

Dr. Gretchen Williams: Oh, absolutely. It's better than the alternative. And again, if there's any questions about colonoscopies, they can always call any of our offices at Riverside. They can talk to their primary care doctor about it. They can call my office. I am more than happy to talk about any and all of this. And I feel very strongly that, again, people should get this done sooner rather than later.

Host: Yes. Well, if we don't see you soon, we'll see a definitely on the table.

Dr. Gretchen Williams: Down in endo. Absolutely. Yeah.

Host: That's my sign off for every guest. I will see you on the table.

Dr. Gretchen Williams: Perfect.

Host: Well, thank you very much.

Dr. Gretchen Williams: Thank you. You're welcome.