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Colon prep requires several days of low-fiber diet, causing constipation and possible painful diverticulitis flare-up. Last colonoscopy was 7 years ago, no polyps. Anxiety motivated me to ask for another one after 3 family members diagnosed with colon cancer. However, all were determined to be sporadic cancers, ie, not genetic. And colonoscopies are recommended every 10 years. I’m now re-thinking if I should proceed; I’ve read about the elevated risks of colonoscopy for those over 70 (the recommended cut-off for these screenings is age 75). I'm obese, have high blood pressure (well controlled) and pre-diabetes (controlled with diet). Sometimes my pulse dips to 40-42 momentarily, but heart monitoring two years ago indicated nothing serious. My resting pulse is 60-65, though I’m not an active person. I read where the fluid loss during the prep, even while trying to stay hydrated, can cause an electrolyte imbalance. In seniors, that could lead to a cardiovascular event. Then there’s the risk of a perforated colon with the procedure or even with a diverticulitis flare. I decided to cancel my appointment for the scheduled procedure and instead, made an appointment to discuss these issues with my primary care doctor. Perhaps a less invasive screening would be preferable? Would love to know folks’ thoughts and experiences. Thanks!

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You really need to have a pre-procedure mtg with your GI doc. We can't dedtermine whether or not this is safe for you--they can.

My SIL is a GI doc and routinely does colonoscopies, obviously. He has said that he has a chat with his 'over 70' patients to see if they need one. The worries of problems really escalate with age, and he may actually deny someone one or opt for another procedure.

10 years between screenings is what is usually reccomended, unless you have problems.
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jakefix Jun 2021
Thanks! My pre-colonoscopy meeting was with the young, very nice physician’s assistant. Last Friday I received the Sutab prep prescription and started reading over the weekend. I became concerned about potentially serious side effects and then online-researched issues for over-70 year old seniors re colon prep and colonoscopies. Because I’d initiated the request for one out of fear (misplaced, I now believe) - and because 7 years have passed since my last colonoscopy, it occurred to me that the gastroenterologist office waa just rubber-stamping my thoughts. It was like asking for an optional medication and having it delivered without the warning insert. I felt guilty calling and canceling the procedure, but knew I had serious questions needing to be addressed before proceeding. My new primary care Dr talked with me today in a tele-Health call. He agreed with my decision, preferring to do a DNA Cologuard test first. If it comes back positive, then a colonoscopy is in order.

Right now I’m suffering on 2nd day with severe constipation because I started the pre-prep low-fiber/residue diet last weekend. Feels like my innards are about to burst. Miralax hasn’t kicked in yet - body’s poo-plumbing has stopped. Nothing’s moving - this was predictable, as this happens when I skip fiber. Drinking plenty of water, which runs out of me because I take a diuretic for bp. Mentioned constipation issues at pre-colonoscopy meeting with gastroenterologist’s office. Hoping I don’t end up in ER.

Thanks again!
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All my DH had to do is eat light 2 days before the procedure and the day before take a liquid that cleaned him out. Eating nothing more than jello and drinking Gator aid.

There is that box test. Maybe try that and if comes up positive then have the colonoscopy.
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As strange as this might sound, there is a “virtual colonoscopy “.
Sorry I have no personal details because mine is set for July. There is prep but it is less invasive. Check with your Doc to see if it might work in your situation. Good luck.
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disgustedtoo Jun 2021
It's been around for a while. When I asked about it, doc said they might miss seeing some smaller polyps and if they do note polyps, then you have to have the colonoscopy to have them removed. The prep work is going to be pretty much the same. The reason for the prep work is to have your intestines as "clean" as possible - that would still be required for the "virtual" test.

That said, the johnshopkins site suggests that this CT scan might actually "see" areas of the large intestine a regular colonoscopy can't access. Pros and cons:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/colon-cancer/virtual-colonoscopy-for-cancer-screening
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As an RN I have seen people die of colonoscopy (because of perforation of bowel). The risk of this will be explained in any prep for the procedure. I have decided against this procedure for myself. I understand my risk of undiagnosed cancer. This is an individual decision. There are, yes, some few stool tests that can be done, but do know that they have often false positives and in those cases they will again recommend the colonoscopy. Most tumors are found in the lower bowel. You can ask for a colonoscopy that explores only this area without passage of the scopes up the more torturous turns in the bowel. This is called a sigmoidoscopy. You can discuss this with your doctor, but the prep would still have to be done. I have never heard of permanent damage from the prep, tho that doesn't mean there have not been same. You should also discuss heart issues and get a pass from your cardiologist, as arrhythmias can happen with any stimulation inside the bowel; As a nurse I never personally saw this side effect from a colonoscopy but DID see a death during administration of a high enema resulting in arrhythmia. That is, I suspect rare as hen's teeth, but should be discussed with MD.
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JoAnn29 Jun 2021
Me too and I can't explain why but I just don't feel comfortable getting it. My GF, who is a CNA, was against getting one because of the things she has seen working in a hospital. She chose the test, showed positive. The prep made her so sick she became dehydrated and was in ER until 3 hrs before her procedure. Still had the procedure and it showed she was cancer free. It was a false positive.
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I am an RN and in the "colonoscopy crowd." So here's the deal. Colon cancer is a slow growing cancer and usually doesn't show any signs or symptoms until it is advanced. If you wait until you have symptoms you will face having portions of intestine cut out in surgery resulting in a "poop bag" on your stomach or facing possible loss of life if the cancer has spread. Having a colonoscopy and removing polyps (cancer) every 10 years is the usual for most folks. If the doctor finds polyps, he/she will recommend getting follow-up colonoscopies closer together. The prep has changed and is easier on the digestive tract and less likely to cause fluid/electrolyte imbalances. If you have a colonoscopy without any problems, you might wish to ask your doctor about ColoGuard that tests your poop for cancer without an invasive exam.
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disgustedtoo Jun 2021
Question: If there is such concern, then why are the "regular" tests suggested every 10 years? I should think cancers, slow growing or not, would have a better chance at being more advanced if given 10 years.
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Are you using the up to date prep information? I had a Barium Enema about 20 years ago, a friend had a colonoscopy last year. The prep has changed considerably. Basically just 2 days of a liquid diet and the bottle of goop you have to glug. She has diverticulitis too.

Whether or not you choose to proceed with the test, should be based on what you would do it the results were positive for cancer. If you would choose to have treatment, then have the test. If you would not have treatment, then why have the test?

My step Dad was in his mid 70's when he was diagnosed with colon cancer. He did have surgery and was given the all clear. When he was 84, the cancer metastasized and he died less than 2 months later.
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I’ve had a long personal history of this, pushed by the fact that my grandfather died of it and my sister’s colonoscopy found a polyp. Yes, the prep is now easier, but it is still pretty grim. I had a large polyp removed nearly 20 years ago, and have had repeat colonoscopies at 3 then 5 year intervals. No more polyps, just minor diverticulitis.

At the last one in 2019 age 72, I had a fair bit of back pain because I couldn’t take my normal drugs beforehand. The specialist said that as I had had no more bowel symptoms, I could decide not to have another. I was getting to the age when they stop them, plus with no recent polyps and the slow-growing nature of cancer following well-developed polyps, the chances are that I will outlive any problems.

Your post doesn’t say why you have had ‘routine’ colonoscopies. If you have had no polyps, and the family members’ cancers were ‘sporadic’, the only real issue is that it’s 7 years since you were checked. Where I am in OZ, people don’t have ‘routine’ colonoscopies, and the ‘poo’ test is free.

The ‘poo’ test is very simple. It shows cancers because they cause minute traces of blood in the poo. In your shoes, I would certainly have that first. If it comes back clear, I probably wouldn’t put myself through another colonoscopy. Best wishes in making a decision you are comfortable with, Margaret
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As other family members who have had colon problems have been concluded as non genetic, why would you even contemplate having an invasive and currently unnecessary procedure carried out?
Your state of health sounds from your description to be normal for you, so leave well alone, no point having something done that may cause problems where none exist.
Why do you want any screening done, if your Dr thinks there may be a cancer present from other symptoms then they will suggest an appropriate test/screen, I don't see the point of you screening for something you are no more likely to have than the rest of us.
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On my last colonoscopy, the laxitive that was recommended was very harsh. it took a couple of weeks after the colonoscopy to get my digestive tract back to normal. For the next one, I'm planning to ask if there is a more natural way to do it, even if it takes more days. I think you're wise to talk to your doctor about the pros and cons first.
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My mom had her last colonoscopy at around age 69 and it was very, very harsh on her. Colon cancer runs thru my family on my dad's side (dad diagnosed at around age 43, died at 48 and cousin at 36 and he is fine), and I have one of the two cancer genes. I have to have scopes every 3 years....including this year. I have had polyps at all but my last one. This past winter I decided that I was going to stop having them at 69 at the latest. I am 60 now. They are just so brutal on my body. I will accept a less invasive type of screening but not one that requires a prep like the colonoscopy. We can send a man to the moon.... 🙄
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My wife had her last colonoscopy 2 years ago because she was anemic and they couldn’t find where she was losing blood. They still don’t know. However she ended up in the hospital for 10 days because of dehydration due to continuing vomiting. Followed by 3 weeks in nursing rehab. Her kidneys were also involved. She was in and out of the hospital because of dehydration brought about by vomiting. Now they want to do another colonoscopy do to blood in her stool and a thickening of an area in her colon(CT Scan). This time we tried the pills, but she immediately started vomiting after getting the first dose down. I forgot to mention if she doesn’t eat something every 2 hours she get extremely nauseous. Apparently she is prep intolerant and I don’t know where to go from here.
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When an elderly person reaches the age of 75 and older then gi doctors
say the elderly do not need anymore
colonoscopies for the rest of their lives. Unless they are having rectal
bleeding or pain that isnt gas, My mother’ GI doctor told her even with small polyps she doesnt need anymore followup Colonoscpies😌
due to her age.
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sunshinelife Jun 2021
you're old hurry up and die...omg!
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It depends on how severe her diverticulitis is. As long as there is no history of a diverticular bleed.
She will have gas due to the nature
of how many diverticuli she has
You are not suppose to eat any popcorn or nuts anything that could get stuck in the divericili.
They look like swiss cheese that is the way diverticuli form. Even with
diverticuli you can still follow
the no colonoscopies after a certain
age.
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I HATE!!!!!!!!!!!!!!!!!!!!colonoscopies, but my Dad died of colon cancer (I still think his chronic, severe constipation led to the cancer, complicated by Parkinson's disease which may have "frozen" that part of his bowel muscles. I had one doctor laugh at me for saying this, but I truly do believe it. I am 70 and get them every 5 years; have had a precancerous, tiny polyp and have diverticulosis (not inflammation, just pouches or pockets in the intestines). I am supposed to get another one in about 2-3 years, only due to family history. Now that I'm 70, my health if excellent but not perfect - I am 10 pounds overweight and take meds for high blood pressure, high cholesterol and thyroid, but all are under control. My current doctor retires soon, and she said many over 70 continue with the colonoscopies - in her case, they caught cancerous polyps and saved her life. I am meeting with my new doctor (PA-C) soon, and will discuss with her. I don't want to die of colon cancer or have a poo bag at any age. By the way, check with your doctor first, but when I started having mild constipation in my mid-fifties, I went to a probiotic, and that solved the problems. I had to try a few to get one that worked for me, but basically, the one I use now replaces the biome we normally have in our system when we are young and perfectly healthy. Hope some of this helps with questions - I do know that after 70, it has to be an individual decision.
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My wife had her last colonoscopy 2 years ago because she was anemic and they couldn’t find where she was losing blood. They still don’t know. However she ended up in the hospital for 10 days because of dehydration due to continuing vomiting. Followed by 3 weeks in nursing rehab. Her kidneys were also involved. She was in and out of the hospital because of dehydration brought about by vomiting. Now they want to do another colonoscopy do to blood in her stool and a thickening of an area in her colon(CT Scan). This time we tried the pills, but she immediately started vomiting after getting the first dose down. I forgot to mention if she doesn’t eat something every 2 hours she get extremely nauseous. Apparently she is prep intolerant and I don’t know where to go from here.
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sunshinelife Jun 2021
please reconsider your wife taking the prep. Kidney damage & even kidney failure. due to the crystals in the drink are common. As are many other serious health problems, ongoing. Additionally, the vomiting is a clear sign of an allergy to the prep. A substance that causes an allergic reaction, when taken again causes a stronger reaction. Please dont take any more of the prep drink whatever anyone tells you. Let experience be your teacher in this regard. The body does have a breaking point. Google : "common side effects & complications of pre colonoscopy drink" The goal of the drink is to clear enough waste from the colon for the camera on the instrument to get clear pics of the bowel walls. A colonic irrigation the day before will achieve the same objective, without any of the risks of the drink Google: Colonic irrigation clinics in my area" The color of the blood being passed is important in diagnosis. The brighter red the color, the closer the bleed is to the rectum ie. hemorrhoids. Hemorrhoids are also found Inside the rectum...not only on the outside of the anus. A 2oz enema of white oak bark tea will cause no harm at all. However, if the bleeding is indeed hemorrhoids, this will reduce the bleeding If done each day for 10 days it will shrink the enlarged irritated hemorrhoids & stop the bleeding. Do use a thick oil like cold pressed castor oil, or vaseline prior to a BM each time. & for enemas,(not mineral oil enemas from the store...they are irritants. I hope this is of help to you. Medicine was my life for many years. I am pleased if I can assist to alleviate or minimize suffering along the way these days. "Experience is the only true knowledge" Albert Einstein
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"Diverticulitis is not associated  diverticulosis is not associated with an increased risk of advanced colorectal neoplasia. "

Read here:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216380

However, diverticulitis can cause complications; if you are having symptoms, it would probably be a good idea to get one.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265196/

There is no such thing as "pre-diabetes". You are diabetic.
https://www.cdc.gov/diabetes/library/features/truth-about-prediabetes.html#:~:text=Prediabetes%20Is%20a%20Big%20Deal,%2C%20heart%20disease%2C%20and%20stroke.

Be more concerned with weight control and lifestyle changes.
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sunshinelife Jun 2021
diabetes is broken down into catagories. pre diabetic (stage 1) is a stage where the blood sugar can be regulated with diet & exercise You are correct lifestyle changes are the key. ..easier said than done. Most people need education (support groups/class on nutrition & exercise from their hospital system) re the studies you quoted: "always consider your sources" ie the financial incentives directing a study towards a specific finding. 90% of medical studies are funded by the pharmaceutical industry. The highest risk factor for colon cancer is eating red meats. There has been a great deal of research & clinical studies in this area. Many by the Seventh Day Adventist Medical system. Best regards
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After 2 negative colonoscopies over the years, I decided to do the Cologuard this time.It came back positive so I needed a colonoscopy anyway.
Cologuard has many false positives AND false negatives.
Like my GI doctor said, It's the false negatives you have to worry about.
Is a negative truly negative or a false negative?
I would never use Cologuard again.

As far as a CT virtual colonoscopy, the prep is the same as a colonoscopy,
You have to be cleaned out. If polyps are found, they can't be removed.
You still need a colonoscopy. I was a CT tech for 40 years.

My advice to anyone would be to just get the colonoscopy.
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I believe you've answered your own question.
I wouldn't get one!
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First of all, the last time I had a colonoscopy, it was just clear liquids the day before along with a HUGE bottle of go-lytely and some dulcolax tabs, maybe some miralax. The next day, the colonoscopy.

But, because you sound very (maybe overly?) concerned, you should ask your doctor these questions, the GI doc, or even your primary care doc. I don't mean to make light of your situation, but you really sound stressed and I think it would be the best for reassurance from one of your docs who knows you best.
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I am going to take the last part of your post first.
The less invasive tests often lead to false positives resulting in you having to go through what you want to avoid. OR it can lead to a false negative and that leaves you with the same result as if you do not have the colonoscopy.

Personally....
Given the reasons you state.
The health concerns you have.
I would opt not to have the colonoscopy.
Given that you showed no signs previously, no precancerous polyps or none at all.
The fact that colon cancer is slower growing, sometimes taking 10 years to grow putting you in your 80's if it does develop. From then there is the choice to A) do noting or B) seek treatment. It would depend on the stage that it is in when discovered. If early again option is to do nothing or treat. If it is late stage, same option treat or not. (personally I would opt for no treatment if I am late 80's and late stage)
Ok...all that rambling on leads me to
Cancel the test, talk to your doctor.
If there are non invasive tests that are pretty accurate go for that.
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I am older - will be 88 - with many physical problems. There is NO way in hell I would go through that at this age - just wouldn't and I doubt I would in this case either. But this is something that you, along with the medical pro's must decide based on reasons why you might want it done. This is a tough one.
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I would think twice before having it done and make sure it is absolutely necessary and all other tests prove it necessary. A friend at church had it done and they accidentally poked a hole in her colon, she developed peritonitis and died. I think I would rather deal with diarrhea and mild pain before taking a chance with a colonoscopy. It is always good to get a second opinion if you don't feel comfortable with a doctors recommendation.
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Because of a family history of colon cancer, I had a colonoscopy last October at age 83. I have a history of diveticulitis and have had polyps on previous screenings. My gastroenterologist felt that because I am very healthy for my age I should proceed. I had the same prep which I had previously. At 3:00 am the morning before the procedure (appointment was for 7:00 am), I started vomiting. My son took me to the GI center and they gave me some IV medication for the severe nausea which helped. I did have the procedure and everything went well. After arriving home, I started vomiting again. I couldn't keep anything down, even ice chips. At this point, the gastroenterolgist said I should go to the emergency room. Even with IV medication, the nausea persisted. The ER doctor sent me for a CAT scan in case I had a bowel obstruction. Everything was normal on the scan. I had to be admitted to replace my electrolytes. I was in the hospital overnight and was able to leave the next day. The doctors felt I had a reaction to the bowel prep. I feel I was too old to undergo this procedure. My son has used Cologuard (sp) which is very easy and evaluates the DNA in your stool. That might be an option you might try.
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Some doctors recommend 5 year intervals if there is any kind of a risk factor for colon cancer. For those who are in good health, there is nothing unusual about having a colonoscopy over 70. (If I recall correctly, my parents were in their early 80s when they had their final one.) Although I don't particularly love colonoscopy preps, I'll have them as long as I can because I don't want to die of a disease that could have been prevented or arrested at an early stage.
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People here can only give opinions, since we are not doctors, we aren't your doctor, and we certainly aren't you. I would say NO, you do not need one, especially if you had them in the past and did not have any cancer. I bet everybody has polyps, but doctors act like every polyp is going to turn into cancer. I don't think there is any proof of that.

Find the book "Rethinking Aging: Growing Old and Living Well in an Overtreated Society" by Nortin Hadler.

Here is a review:

"For those fortunate enough to reside in the developed world, death before reaching a ripe old age is a tragedy, not a fact of life. Although aging and dying are not diseases, older Americans are subject to the most egregious marketing in the name of successful aging and long life, as if both are commodities. In Rethinking Aging, Nortin M. Hadler examines health-care choices offered to aging Americans and argues that too often the choices serve to profit the provider rather than benefit the recipient, leading to the medicalization of everyday ailments and blatant overtreatment. Rethinking Aging forewarns and arms readers with evidence-based insights that facilitate health-promoting decision making.

Over the past decades, Hadler has established himself as a leading voice among those who approach the menu of health-care choices with informed skepticism. Only the rigorous demonstration of efficacy is adequate reassurance of a treatment's value, he argues; if it cannot be shown that a particular treatment will benefit the patient, one should proceed with caution. In Rethinking Aging, Hadler offers a doctor's perspective on the medical literature as well as his long clinical experience to help readers assess their health-care options and make informed medical choices in the last decades of life. The challenges of aging and dying, he eloquently assures us, can be faced with sophistication, confidence, and grace."

In the end (pun intended), you have to decide what is best for you. Nobody can make that decision for you.
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sunshinelife Jun 2021
Wise lady. Less than 1% of polyps under 1cm are found malignant. Almost 40% of polyps over 2cm malignant cells are identified. There are risk factors for colon cancer. eating red meats is the highest risk factor... Medicine is a business of suffering for the greatest part. Death is essential . Suffering is optional.
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No.
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My 2 cents:
Talk with your PCP AND your cardiologist about the risk. No genetic predisposition for cancer or polyps? Why bother if your last screening was good and clear? If they find something, what are the options for treatment and are you willing to follow through with those options, and what are the risks of those possible options for you?
I'd ask those questions.

My Mom is 91 and has GI issues, but an endoscopy is a high risk that her PCP, pulmonologist and cardiologist say NO WAY. She couldn't risk any surgery to correct whatever they might find anyway. Only doc gunho about the endoscopy was the GI doc, of course. All her other docs were like WHY and what's the point.

Personally, I had a routine colonoscopy and concurrent endoscopy about 5 years ago, all clear and even though I have GI issues and IBS, I will never have another colonoscopy unless you put a gun to my head. The after effects of it made me poopy incontinent for over a year because, with IBS my colon closes up, but the doctor rammed the thing up my yahoo to get it in there and damaged my sphincter nerves where I had no control. I was only 50 y.o. Took 2 years to regain total control of my poops. No colon cancer or polyps run in my family either. So, it's a hell no for me.

Talk with your drs about the necessity and the risks.
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sunshinelife Jun 2021
sorry for your suffering. One gets a more impartial viewpoint to google : risk factors of.... or complications of....With all due respect (you sound like a kind & sincere lady) medics do and will sell whatever they have to sell..procedures, particular meds etc. Even if/when it runs contrary to the best interests of the person/patient . This is my experience "Question everything" Euripides
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These days it is easier to have a colonoscopies. It is thorough. It really helps and can show any sign of cancer. I have had 3 over the years. The last one I was put to sleep and had no recollection of. Pain. Hope you get your answer
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sunshinelife Jun 2021
was it a polyp that was removed and malignant cells were identified by the lab?
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Not sure if a CT scan will diagnose everything, but it is an expensive way to avoid a colonoscopy.
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It is wise of you to consider all you mention here. Because I know of issues sustained by people over 70, including my husband, I would speak with your PCP discussing your concerns. If you are on blood thinners, I believe that is also a consideration.
I would research dr’s who have a successful record of performing this procedure. Perforations do happen & can be very dangerous.
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