# Colonoscopies

**URL:** <https://boards.straightdope.com/t/colonoscopies/659102>\
**Category:** Factual Questions\
**Created:** [May 23, 2013, 7:08am UTC](https://boards.straightdope.com/t/colonoscopies/659102 "2013-05-23T07:08:58Z")\
**Posts on this page:** 20\
**Page:** 2

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**Author:** ![Chimera](https://avatars.discourse-cdn.com/v4/letter/c/8e8cbc/32.png) [@Chimera](https://boards.straightdope.com/u/Chimera)\
**Post date:** [May 23, 2013, 8:51pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/21 "2013-05-23T20:51:56Z")

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Had my second one (at 40 and again at 50) on Monday of last week. Found a single polyp, benign. Now they want me to come back every 5 years.

As much as I hate the prep, I’ll still go back for the next one. Rather that than cancer sneaking up on me until it’s too late.

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**Author:** ![anson2995](https://avatars.discourse-cdn.com/v4/letter/a/c77e96/32.png) [@anson2995](https://boards.straightdope.com/u/anson2995)\
**Post date:** [May 23, 2013, 8:52pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/22 "2013-05-23T20:52:18Z")

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> [@kayaker](#):
>
> My doctor mentioned that _statistically_ colonoscopy might be questionable. Many people are saved, but the effect on a large population is an added year of life on average. (IIRC that was the gist of his explanation)

This is a case where average is a useless measure. Twenty people take the test and 19 get a negative result. One finds cancer and lives twenty years longer.

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**Author:** ![Kansas\_Beekeeper](https://avatars.discourse-cdn.com/v4/letter/k/c37758/32.png) [@Kansas\_Beekeeper](https://boards.straightdope.com/u/Kansas_Beekeeper)\
**Post date:** [May 23, 2013, 9:11pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/23 "2013-05-23T21:11:29Z")

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They really aren’t that uncomfortable.

Read Dave Barry’s description of a colonoscopy, he gets it right:

[http://www.miamiherald.com/2009/02/11/427603/dave-barry-a-journey-into-my-colon.html](http://www.miamiherald.com/2009/02/11/427603/dave-barry-a-journey-into-my-colon.html)

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**Author:** ![KarlGauss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/karlgauss/32/3713_2.png) [@KarlGauss](https://boards.straightdope.com/u/KarlGauss)\
**Post date:** [May 23, 2013, 9:12pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/24 "2013-05-23T21:12:15Z")

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[Recent thread on colon cancer and colonoscopies](http://boards.straightdope.com/sdmb/showthread.php?p=16238668).

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**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\
**Post date:** [May 23, 2013, 9:44pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/25 "2013-05-23T21:44:10Z")

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If you really honestly have no one, try giving your local home health agency a call. While most of what we do is ongoing care, I would bet $100 imaginary dollars that my boss would hire me out for a 5 or 6 hour chunk of time once. (I’m a home health RN.) Not sure what he’d charge, but you tell me - how much is your life worth?

In fact, maybe I’ll talk to him about this. Perhaps we could be the first in town to offer “colonoscopy companions.” They wouldn’t even have to be RNs - anyone over the age of 18 who can pass a background check can be your babysitter for the day. Hmmmm…

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**Author:** ![CC](https://avatars.discourse-cdn.com/v4/letter/c/f1d935/32.png) [@CC](https://boards.straightdope.com/u/CC)\
**Post date:** [May 23, 2013, 10:17pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/26 "2013-05-23T22:17:37Z")

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And\* MY\* doctor said that the procedure is the way to prevent dying of colon cancer. That’s a pretty good recommendation. I’m now on a once-every-five-years schedule. Tolerable prep in light of the notion that there’s not much else you can do that will provide you with something like a guarantee you won’t die of some type of cancer.

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**Author:** ![psychobunny](https://avatars.discourse-cdn.com/v4/letter/p/54ee81/32.png) [@psychobunny](https://boards.straightdope.com/u/psychobunny)\
**Post date:** [May 23, 2013, 10:30pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/27 "2013-05-23T22:30:56Z")

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In terms of screening, colonoscopies are really up there with the best. Unlike mammograms, for example, which are designed to detect early cancers, colonoscopies can actually prevent cancer by removing polyps before they become cancer.

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**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\
**Post date:** [May 23, 2013, 11:12pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/28 "2013-05-23T23:12:30Z")

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> [@BrotherCadfael](#):
>
> I had two colonoscopies, now, and my problem with them is that I am on coumadin (blood thinner). Discontinuing coumadin before the procedure, and starting it up again afterward is not a trivial procedure - it involves giving myself injections and other delights. I am eager to for a non-invasive colonoscopy procedure to be approved. Supposedly, one is on the horizon now, and just needs to get fully tested to make sure it is as effective as the conventional procedure.

Ouch. Yeah, you don’t want 'em snipping anything when you’re on blood thinners. What do you do instead? I mean, do the injections not pose the same bleeding risk?

The virtual CT is supposedly showing that it’s doing a fairly decent job; the reason that it’s not standard for most people is that of course you have to do the same prep, and then if they _do_ find something you have to do it all over again so they can _treat_ whatever they saw. However in a situation like yours, I can see where it’s a decent alternative.

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**Author:** ![BrotherCadfael](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@BrotherCadfael](https://boards.straightdope.com/u/BrotherCadfael)\
**Post date:** [May 23, 2013, 11:22pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/29 "2013-05-23T23:22:32Z")

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> [@Mama\_Zappa](#):
>
> Ouch. Yeah, you don’t want 'em snipping anything when you’re on blood thinners. What do you do instead? I mean, do the injections not pose the same bleeding risk?
> 
> The virtual CT is supposedly showing that it’s doing a fairly decent job; the reason that it’s not standard for most people is that of course you have to do the same prep, and then if they _do_ find something you have to do it all over again so they can _treat_ whatever they saw. However in a situation like yours, I can see where it’s a decent alternative.

I would think that they could do the virtual colonoscopy, and, if they don’t find anything, great, if they do, they give you a shot of Vitamin K (immediately cancelling the effect of the coumadin), and fix the problem on the spot. THEN you go through the hassle of bridging yourself back onto the coumadin, but only then.

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**Author:** ![Hottius\_Maximus](https://avatars.discourse-cdn.com/v4/letter/h/3ab097/32.png) [@Hottius\_Maximus](https://boards.straightdope.com/u/Hottius_Maximus)\
**Post date:** [May 23, 2013, 11:24pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/30 "2013-05-23T23:24:16Z")

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I turn 50 this year. I got one. My mother got one a few months later. Not my favorite thing to do but some non-cancerous polyps were removed. Like anything else, it’s a great preventive measure but not the most pleasant experience in the world. I actually learned to like lime-flavored Jello.

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**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\
**Post date:** [May 23, 2013, 11:27pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/31 "2013-05-23T23:27:24Z")

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> [@WhyNot](#):
>
> If you really honestly have no one, try giving your local home health agency a call. While most of what we do is ongoing care, I would bet $100 imaginary dollars that my boss would hire me out for a 5 or 6 hour chunk of time once. (I’m a home health RN.) Not sure what he’d charge, but you tell me - how much is your life worth?

Would that be $100 imaginary dollars _per hour_ that you might be willing to bet? What if they were realio-trulio dollars? Would it likely be charged by the hour? Do you think it could be billed to Medicare?

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**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\
**Post date:** [May 23, 2013, 11:36pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/32 "2013-05-23T23:36:12Z")

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About the problem of having the runs on the day of the procedure, and after the procedure too:

I had a sigmoidoscopy a few years ago. The prep was done by having me guzzle a few gallons of phospho-soda all afternoon the day before. They was actually quite gentle and painless and no cramps or anything. But they quit using that, because there were occasional patients who got kidney damage from it, including some small number who came out of the procedure with ESRD.

And, I found, once I was good and cleaned out inside, that was the end of the prep procedure, once and for all. After a few hours sitting on the crapper, it was done. No more runs, no more dashing to the loo, no problem with feeling like I had to crap in my pants on the way to the hospital or on the way home – none of that. I think I was clean enough inside they could have used my kishkas to make kosher sausage.

Someone tell me: How does that compare with the toxic potions they use today, like Miralax or GoLytely or Dulcolax, or any of the others that they commonly use now?

I think my instructions (if I hadn’t canceled) were to chug-a-lug a gallon of GoLytely over a few hours, then chow down a whole handful of Dulcolax.

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**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\
**Post date:** [May 23, 2013, 11:42pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/33 "2013-05-23T23:42:35Z")

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> [@Senegoid](#):
>
> Would that be $100 imaginary dollars _per hour_ that you might be willing to bet? What if they were realio-trulio dollars? Would it likely be charged by the hour? Do you think it could be billed to Medicare?

Not sure. But I sent an email to my boss. If he likes the notion he’ll work out all that businessey stuff, and you’ll be the first to know. Or, more likely, the twenty third to know. 😉

[QUOTE=me, to boss]  
I’m a member of an online message board where people are talking about the problems they have with getting a colonoscopy. Particularly, the requirement that many clinics have that you be accompanied by an adult, that you can’t drive yourself home, and that someone has to stay with you for a few hours after you go home in case you have a bad reaction to the anesthesia or the procedure. This isn’t high level nursing stuff, just “Is he bleeding from his butt?” or “Can I wake him up?” kind of non-skilled assessment.

A surprising number of people have put off their recommended colonoscopies for years, or avoided them all together, because they simply don’t have a person they feel comfortable asking to accompany them.

So it got me thinking…why not hire out CNA’s to be “Colonoscopy Companions”? For a flat or an hourly rate, they can go with a patient to the clinic/hospital, wait while the procedure is done, go home with them and keep an eye on them. They can call one of our RNs if they’re concerned about anything, or call 911 if an emergency develops.

I know there’s a ton of business/rates/insurance stuff to consider, and it may be the worst idea you’ve heard today. But it was just a thought.  
[/QUOTE]

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**Author:** ![Claverhouse](https://avatars.discourse-cdn.com/v4/letter/c/13edae/32.png) [@Claverhouse](https://boards.straightdope.com/u/Claverhouse)\
**Post date:** [May 23, 2013, 11:46pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/34 "2013-05-23T23:46:14Z")

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> [@Mama\_Zappa](#):
>
> It’s a bit bizarre that they require the person to be there the entire time. I guess it’s CYA in case you say “yeah, my buddy will be here”, they do the procedure, and you say “I LIED, I’M DRIVING HOME”.

Or they need someone to come out to, and gravely intone: “_I’m terribly sorry, I can assure you we did everything possible._”

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**Author:** ![Chimera](https://avatars.discourse-cdn.com/v4/letter/c/8e8cbc/32.png) [@Chimera](https://boards.straightdope.com/u/Chimera)\
**Post date:** [May 23, 2013, 11:59pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/35 "2013-05-23T23:59:46Z")

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> [@Senegoid](#):
>
> I had a sigmoidoscopy a few years ago. The prep was done by having me guzzle a few gallons of phospho-soda all afternoon the day before. They was actually quite gentle and painless and no cramps or anything. But they quit using that, because there were occasional patients who got kidney damage from it, including some small number who came out of the procedure with ESRD.
> 
> \<snip\>
> 
> Someone tell me: How does that compare with the toxic potions they use today, like Miralax or GoLytely or Dulcolax, or any of the others that they commonly use now?

There are a few variations on the pattern, but yeah, Magnesium Citrate has 2900mg (2.9 grams!) of Magnesium per 10oz bottle. The idea being that your intestines try to get rid of it as quickly as possible and take everything else along with it. I can see where that might tend to cause issues in some people. I remember being forced to drink something like 4 or more bottles of it 10 years ago and it making me violently ill.

I had to go on a light/restricted diet 2 days ahead of time (no seeds, corn, nuts), then stop eating at midnight 2 days before. On the day before, I was on a clear liquid diet. They said “light breakfast”, but fuck if I knew what I could actually have that wasn’t simply a clear liquid. So I just drank diet lemon-lime soda all day.  
At noon I took 2 Ducolax tablets.

Then at 4pm came the Miralax-Gatoraid combo. One 288 gram (14 dose) bottle of Miralax dissolved in 64 ounces of Gatoraid (lemon-lime and orange, as you can’t do blue or red dyes). Drink an 8 oz glass every 15 minutes until it’s gone.

Then since my procedure wasn’t until the afternoon, they had me drink a single bottle of Magnesium Citrate at 8am the day of. I’ve read plenty of on-line instructions (easily googlable) that don’t include that step.

Oh, and do not plan on going anywhere except the restroom between starting the Miralax drink and leaving for the procedure. Frankly, you don’t want to be more than about 15-20 feet from the restroom, period, because your body won’t give you a lot of notice that you need to go.

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**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\
**Post date:** [May 24, 2013, 10:38am UTC](https://boards.straightdope.com/t/colonoscopies/659102/36 "2013-05-24T10:38:54Z")

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> [@WhyNot](#):
>
> anyone over the age of 18 who can pass a background check can be your babysitter for the day. Hmmmm…

Background check? If I needed a watcher/driver for the day and had no one to turn to, I’d consider offering a guy looking for work at HomeDepot a day’s easy wages.

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**Author:** ![svd678](https://avatars.discourse-cdn.com/v4/letter/s/53a042/32.png) [@svd678](https://boards.straightdope.com/u/svd678)\
**Post date:** [May 24, 2013, 4:17pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/37 "2013-05-24T16:17:24Z")

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Re GoLytely: I had severe constipation, no BM for over 10 days, never in my life felt so bad. All the usual- laxatives, suppositories, nothing helped until GL. Love the stuff!! Not really, but in comparison–  
Sigmoidoscopy, colonoscopy – no big deal.

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**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\
**Post date:** [May 24, 2013, 4:26pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/38 "2013-05-24T16:26:31Z")

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> [@Senegoid](#):
>
> About the problem of having the runs on the day of the procedure, and after the procedure too:… a few gallons of phospho-soda all afternoon … there were occasional patients who got kidney damage from it, including some small number who came out of the procedure with ESRD…  
> Someone tell me: How does that compare with the toxic potions they use today, like Miralax or GoLytely or Dulcolax, or any of the others that they commonly use now?
> 
> I think my instructions (if I hadn’t canceled) were to chug-a-lug a gallon of GoLytely over a few hours, then chow down a whole handful of Dulcolax.

Osmo-Prep is the pill version of the same stuff that’s in phospho-soda. I’m surprised at the “few gallons” mention because Fleet’s Phospho-soda is a smallish bottle (I think). Though you do have to drink a lot of other liquids at the same time.

Both are black-boxed (the liquid may have been discontinued even?) because of the kidney issues. I asked my doc and he said that he’s never seen an issue except once, where the patient hadn’t taken in enough liquid.

I’m surprised at your more recent instructions involving GoLytely then Dulcolax - this would seem to be big-time overkill. I’ve heard of the opposite - my first prep involved a 2-day fast, then Dulcolax the night before (a Saturday), then the “cleanout” the following evening (Sunday) and morning (Monday). I haven’t been prescribed the 2-day version since then.

Toxic is a relative term of course. GoLytely, Miralax etc. are perfectly “safe”, just the GoLytely is insanely cruel: you have to drink a large volume of truly foul-tasting stuff. Miralax is just polyethylene glycol (PEG), which happens to be a major component in most of the preps out there including GoLytely, MoviPrep etc. - however all of those include electrolytes while ; GoLytely and others also have additional “cleanout” chemicals which is what makes them so utterly nasty.

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**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\
**Post date:** [May 24, 2013, 9:54pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/39 "2013-05-24T21:54:31Z")

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> [@Mama\_Zappa](#):
>
> Osmo-Prep is the pill version of the same stuff that’s in phospho-soda. I’m surprised at the “few gallons” mention because Fleet’s Phospho-soda is a smallish bottle (I think). Though you do have to drink a lot of other liquids at the same time.
> 
> Both are black-boxed (the liquid may have been discontinued even?) because of the kidney issues. I asked my doc and he said that he’s never seen an issue except once, where the patient hadn’t taken in enough liquid.
> 
> \<snip\>
> 
> Toxic is a relative term of course. GoLytely, Miralax etc. are perfectly “safe”, just the GoLytely is insanely cruel: you have to drink a large volume of truly foul-tasting stuff. Miralax is just polyethylene glycol (PEG), which happens to be a major component in most of the preps out there including GoLytely, MoviPrep etc. - however all of those include electrolytes while ; GoLytely and others also have additional “cleanout” chemicals which is what makes them so utterly nasty.

Okay, that was a few years ago. Now that you mention, yes, I vaguely recall that the phospho-soda was in a little bottle. Just take it with gallons of water.

Nowhere in the instructions (nor in reading on-line) did I see it emphasized anywhere how important it was to drink enough water. But I did see that the occasional kidney problems involved deposits crystallizing in the kidneys. (Kidney stones galore!) So I guessed that the people with problems probably didn’t drink enough. This made me feel it was safe: That I could “take charge” and protect myself by drinking a lot. (Do you remember the children’s story of The Man Who Swallowed The Sea?)

Do PEG and/or all those “cleanout” chemicals cause cramping or other pain or serious discomfort? That’s what scares me. The horror stories I’ve read at other on-line boards! How about we all just chug a few cans of Drano?

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**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\
**Post date:** [May 24, 2013, 11:22pm UTC](https://boards.straightdope.com/t/colonoscopies/659102/40 "2013-05-24T23:22:21Z")

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One small note: colonoscopies are not the only choice out there for colon cancer screening. The American Cancer Society [endorses any of several options](http://www.cancer.org/cancer/colonandrectumcancer/detailedguide/colorectal-cancer-detection-recommendations):

> [@](#):
>
> Beginning at age 50, both men and women at average risk for developing colorectal cancer should use one of the screening tests below:
> 
> Tests that find polyps and cancer
> 
> Flexible sigmoidoscopy every 5 years\*  
> Colonoscopy every 10 years  
> Double-contrast barium enema every 5 years\*  
> CT colonography (virtual colonoscopy) every 5 years\*
> 
> Tests that mainly find cancer
> 
> Fecal occult blood test (FOBT) every year\*,\*\*  
> Fecal immunochemical test (FIT) every year\*,\*\*  
> Stool DNA test (sDNA)\*\*\*
> 
> \*Colonoscopy should be done if test results are positive.  
> \*\*For FOBT or FIT used as a screening test, the take-home multiple sample method should be used. An FOBT or FIT done during a digital rectal exam in the doctor’s office is not adequate for screening.  
> \*\*\*This test is no longer available.

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