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What's stopping you from getting a colonoscopy?

Let this gastroenterologist dispel your fears

Colorectal cancer is the third most common cancer diagnosed in both men and women in the United States.

The American Cancer Society estimates that in 2018, 97,220 cases of colon cancer and 43,030 new cases of rectal cancer will be diagnosed. Despite these staggering statistics, many people will not undergo the procedure based on fears or preconceived notions.

Dr. Willis Parsons, medical director of the Northwest Community Healthcare Gastroenterology Center, addresses some of the concerns people have about the procedure.

And, contrary to what you may have heard, getting a colonoscopy is not nearly as bad as you think.

Read below to see Dr. Parsons' answers to our top 10 fears.

Fear #1: My family has a history of cancer, so I haven't had the courage to have a colonoscopy.

Dr. P: As colonoscopy often finds and removes the precursor to colon cancer (a polyp), it is a great opportunity to lower your risk of getting a cancer. And, as there is a familial tendency for many colon cancers, if a close family member has a history of colon cancer, then you are more likely to benefit from getting a colonoscopy.

Fear #2: I'm embarrassed to have someone look at my backside.

Dr. P: We respect each patient's privacy and sensitivity during their experience in the NCH GI Center. You will be positioned comfortably and covered appropriately during the procedure.

Fear #3: It's going to be painful.

Dr. P: Thanks to modern anesthesia, you will feel nothing and remember nothing. Many patients wake up in the recovery room and ask, "When is the colonoscopy going to start?"

Fear #4: The prep is going to be horrible. I'll be on the toilet cramping all night, and then I'll be so hungry.

Dr. P: Yes, taking the prep is the hardest part of the experience. Ninety-five percent of patients get through it. If you have a tendency toward nausea or vomiting, please ask your physician to prescribe an anti-nausea medicine to take during your prep to maximize the chance of an effective colon cleansing. The better the prep, the better your doctor's ability to see polyps will be.

Fear #5: I'm afraid they're going to damage my colon. I heard of someone getting nicked.

Dr. P: Gastroenterologists do their best to minimize the risk of perforation. The overall risk of perforation is 0.01 percent. I tell patients that there is a higher chance of getting into a serious car accident driving to the hospital than having a perforation during the colonoscopy.

Fear #6: Why should I go through all this? I'm sure I don't have colon cancer or I'd have symptoms.

Dr. P: Most patients who have colon cancer don't have any symptoms. This underlines the importance of colonoscopy as a screening test to remove pre-cancerous polyps and to detect early stage cancers.

Fear #7: I can't afford to have a colonoscopy because my insurance plan probably won't pay for it.

Dr. P: Screening colonoscopy at the appropriate age is covered by most insurance carriers. They would rather pay for a preventive colonoscopy than for a surgery and chemotherapy to treat an advanced colon cancer.

Fear #8: I'll have to take a whole bunch of time off of work to do this.

Dr. P: You will need to take a day off from work on the day of the procedure. Unless you work an evening or night shift, you will be able to work the day before and the day after the procedure.

Fear #9: I don't have anyone who can pick me up after the test is over.

Dr. P: As you will be sedated, the hospital requires that you have a driver to take you home. This is for your safety. This has become the standard of care.

Fear #10: I'm afraid they're going to find a tumor. Then what will I do?

Dr. P: Most colon cancers that are found on screening colonoscopy are found at a stage that is curable.

There have been many advances in colonoscopy in the last 10 years, Dr. Parsons said. These include:

Anesthesia: Most colonoscopies are now done with an anesthesiologist giving short acting intravenous sedation agents - usually Propofol, Versed, and Fentanyl

Prep: Most gastroenterologists have switched to a "split prep" wherein half of the prep is given the evening before the procedure and half given the morning of the procedure

Colonoscopes: The optics of the colonoscopes have improved significantly, allowing for better detection of smaller and harder-to-see polyps

Polypectomy devices: We now have better devices to allow for removal of larger or more difficult polyps that previously would have required the patient to have surgery

Length of stay: Thanks to advances in anesthesia and other technology, the total time at the endoscopy center is shorter - with an average length of stay of 2.5 hours.

• Dr. Willis Parsons has been on staff at NCH since 2004. He does approximately 1,000 colonoscopies per year. In addition to performing regular screenings for patients, he is recognized by his peers as a physician who can successfully remove large or difficult polyps.NCH has earned multiple awards from Healthgrades for colorectal care.

Dr. Willis Parsons
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