Frequently Asked Questions

Do I Need a Colonoscopy?

We need to "take a peek" if any one or more of these describe you:

  • You are 50 years or better, male or female. Even without any of the increased risk factors listed below, you still have a 6% risk of colon cancer, our #2 cause of cancer death.
  • You have chronic diarrhea, or have noticed a change in bowel habits (shape, size, frequency).
  • Your stool tested positive for the presence of blood, or you have seen blood on toilet tissue or in the commode.
  • You had colon polyps removed in a colonoscopy at least three to five years ago that were of the "adenoma" type. If no polyps on your last colon, repeating every ten years is fine, unless you have a family history of colon cancer.
  • You yourself have had colon cancer. Think about it: your remaining colon was subjected to the same carcinogens and genetics as the portion that was removed.
  • A blood relative has had colon cancer. If a first degree relative had a colon cancer younger than age 60 you need to have colonoscopy ten years before their age at diagnosis, or at age 40, whichever is earlier. Repeat colonoscopy is due every five years.
  • You have an inflammatory bowel disease such as Ulcerative Colitis or Crohn's Disease.
  • You have had ovarian or uterine cancer, or had radiation to your pelvis ten years ago for cancer of the cervix, prostate cancer, or any other reason.
  • Blood relatives have had a constellation of cancers such as ovarian, uterine, stomach, colon and/or pancreas cancers. This may indicate a "Cancer Family Syndrome" (FNPCC) and may need early colonoscopy as well as genetic testing of the blood.
  • You have had an abnormal virtual colonoscopy, barium enema, or other large intestine x-ray examination.

What To Expect

Consent Form

You will be asked to sign consent forms for the procedure. Dr. Raymond and the staff will be happy to explain these tests or procedures in more detail if requested. If you do not understand the test or procedure you are asked to consent to, tell your nurse and he or she will call Dr. Raymond to explain it further. It is important for you to understand the risks, benefits and alternatives available to you whenever you are undergoing a procedure, test or treatment.

Visitor Information

Simply Screening encourages your family and friends to accompany you to your procedure, because we value their assistance. This individual will care for your things while you are in procedure. Because you will be sedated, this person will help you with doctor instructions and will need to drive you home as you will not be able to do this yourself.

Designated caregivers, as determined by the patient and family, will be educated along with the patients as you will be groggy following your procedure.

Who will take care of you?

Your care will be delivered by a highly trained team consisting of Dr Raymond and center staff Registered Nurses and/or Endoscopy Technicians.

On the Day of Your Procedure

On the day of your procedure you will be asked to arrive one (1) hour before your colonoscopy The endoscopy suite has many steps to ensure your safety and comfort for your procedure, and we don't wish to rush them or you. You will be escorted into the Pre-Procedure area to prepare you for your procedure. The nursing staff will assist you with changing and securing your personal belongings. Your nurse will then obtain needed signatures for consent of your procedure and start an IV (intravenous access to give you fluids and medication to relax you during the procedure) . You will then be taken into one of the procedure rooms. Dr. Raymond will greet you there, we'll confirm the medical questions that you have already answered and ask for clarifications, and perform a brief physical examination to verify your safety and the appropriateness of the upcoming procedure. Dr. Raymond will explain the procedure to you, and you will be given adequate time to ask any remaining questions that you have prior to the procedure. We know that everyone gets anxious, especially regarding the unknown, so there will always be a staff member with you. We are here for your safety and comfort so please ask your nurse if you need or want anything.

Will the procedure hurt?

Patients having an endoscopy procedure receive I.V. sedation (usually Fentanyl and Versed). The medication takes effect quickly promoting relaxation, drowsiness and forgetfulness. You may feel bloating when air is injected to improve visibility and cramps when the colonscope is rounding a turn and a hand pressing your abdomen to straighten the colonoscope. You should not experience pain. Many patients have no recollection of their procedure afterward

Recovery Following Your Procedure

After your procedure you will be taken to the Recovery Area for close monitoring. Specially trained nurses will frequently monitor your blood pressure, heart rate, and breathing, encourage you to release the intestinal gas, and will care for you until you are ready to be discharged. You can expect frequent checks of your pulse, breathing, and blood pressure. You will be allowed liquids by mouth only if so ordered by Dr. Raymond. Be sure to tell your nurse if you are uncomfortable in any way. Please inform your nurse if you become nauseated or are having discomfort of any kind. You may be discharged from the Recovery area only in the care of a responsible adult. Once you leave, you may eat and drink in a regular manner. If you feel queasy, eat only as much as you can tolerate.

Biopsy and Polyp Removal Results

Dr. Raymond personally reviews all laboratory and pathology results. This data is then reviewed in the context of your personal medical record. Recommendations are made after review of the information. Pathology results are usually available approximately 10-14 days after they have been sent to the pathologist. These results are then reviewed, and a card is completed and mailed to you for your files, telling you about the polyp and the proper time to have a repeat procedure. Occasionally, Dr. Raymond may wish to see you in the office to discuss these results or wait until your next office visit. This approach allows you and your physician to have dedicated time to address these issues and provide detailed information regarding the diagnosis.

Why Do We Look For Colon Polyps?

Colon cancer is our second most common cancer. It attacks men and women equally. Most colon cancers start as polyps, and take 10-12 years to grow.

A colon polyp is a protrusion from the lining of the large intestine (colon) caused by an abnormally rapid growth of cells. It may be a small raised area, look like a mushroom, or lie flat like a piece of shag rug carpet.

What are the symptoms of polyps? Most polyps cause no symptoms. Sometimes they bleed easily and the blood can be seen mixed with the stool or on the surface. A polyp may also secrete clear mucous which is passed with the stool.

How do you treat a polyp? When polyps are detected, they are removed painlessly during your colonoscopy. When using a colonoscope, a wire loop or "snare" is maneuvered down the scope, out the end, and around the polyp. The snare is tightened around the base of the polyp, and the polyp is removed from the bowel wall using a small electric current. Very small polyps are simply removed by pinch biopsy. The polyp tissue is retrieved for testing.
Occasionally, for especially large polyps, an operation is necessary for their safe removal.

What happens after removal of a polyp? The tissue removed will be examined by a pathologist using a microscope. The microscopic appearance will help decide whether the polyp has been removed completely and what kind of polyp it is.

There are two main types of polyps: benign and pre-cancerous.

  • Benign polyps (like "hyperplastic" or "juvenile" ) do not develop into cancer. If you have this kind of polyp, often no further treatment or follow up is necessary. Repeat colonoscopy is routinely performed in ten years.
  • There are other colon polyps which carry a risk of becoming cancerous. This kind of polyp is called an "adenoma" . It has a risk of becoming a cancer over a eight to twelve year span. If an adenoma was present and was fully removed at colonoscopy, no further treatment at this time is necessary. After complete removal of an adenoma there is a risk of developing new adenomas, so you will need repeated colonoscopies. We currently recommend a repeat colonoscopy every three to five years after removal of an adenomatous polyp.

    • Occasionally the microscopic analysis of the polyp will suggest that there is a risk that the polyp was not completely removed, or had cancerous cells within it. A second colonoscopy or even an operation may then be needed to try to ensure that the abnormal tissue is completely removed.

    Call now to schedule your screening.

How Can I Prevent Polyps and Colon Cancer?

In addition to having a colonoscopy and removal of polyps as appropriate, there are many simple strategies which will reduce your personal risk of colon cancer. Take charge of your health!

Colon cancer is usually without symptoms until late in its development. Get your colonoscopy now, and prevent this common cancer.

  • Moderate exercise and weight control: A recent study from Harvard (Ann Int Med 1995) showed that as little as three hours of walking per week may drop the risk of developing colon cancer; the more activity, the lower the risk. Weight control and moderate exercise will also reduce cancers of breast and uterine as well as cardiovascular disease.
  • Low dose aspirin: Some studies have shown that low dose aspirin therapy, at doses used for prevention of heart disease, seems to reduce risks of colon polyps and cancers. Ask your physician if you should be on low dose aspirin therapy.
  • Limit your alcohol intake: Higher rates of colon cancer are seen in people who are regular drinkers of alcohol, especially in women, than in non-drinkers. The risk of colon polyps in regular drinkers are increased four times.
  • Take your calcium: Several studies have shown that calcium supplements may moderately reduce the recurrence of colon polyps. Check with your doctor if you have kidney problems or stones before starting this OTC.

What about increased dietary fiber? Recent studies have found no association between eating additional fiber and a reduction of colon polyps and colon cancer. Our recommendations of the past regarding decreased risk of colon cancer with increased fiber intake have not been proved.

At present, it appears that general good health practices do reduce your risk of colon cancer.

Current recommendations are that you should eat more leafy green vegetables, and eat less than two servings per week of red meat.

Given our epidemic of obesity in this country as well as studies showing a 40 percent reduction in colon cancer risk with moderate exercise of 30 minutes daily, my strongest recommendations are to simply take better care of yourself with both diet and exercise.

Don't forget to return for regular screenings as directed to see if you've grown more polyps.

Call now to schedule your screening.

What About Repeat Colonoscopy?

These are standard intervals found in the medical literature, but nothing is written in stone. Recommendations change frequently and are adjusted by any additional risks. If you had a BIG polyp or a polyp which had begun to transform into a cancer, or a diagnosis of inflammatory bowel disease, your physician may choose a different interval.

Take the Cheek Check Challenge!

Recommend colonoscopy to family, friends, and co-workers over the age of 50 for 25 consecutive days. Tell 2 per day, one in honor of the left cheek, and one in honor of the right.
If these 50 people in your life get their screening, THREE people close to you will have early detection or prevention of a colon cancer!

  • Average Risk at 50 - Every 10 years starting at 50, age 45 if you are African-American.
  • Family History of Colon Cancer
    • 2nd or 3rd Degree Relative - Every 10 years starting at 50
    • 1st Degree Relative with polyps or cancer diagnosed at or after age 60 - Begin screening at 40, then every 10 years
    • Two or more 1st degree relatives with colon cancer or one 1st degree relative with colon cancer or polyps diagnosed before age 60 - Every 5 years beginning at age 40, or 10 years before the earliest diagnosis in the family, whichever is sooner
  • Prior History of Polyps
    • Average Risk - Every 5 years
    • Family History of Colon Cancer - 3 years, then every 5 years
    • Large or Multiple Polyps - 3 Years, then every 5 years
  • Reflux, with one or more of:
    • 10 Years History, Nocturnal Symptoms, Tobacco use or Esophageal Warning Signs - "Once lifetime" EGD to screen for Barretts, then every two years if detected.

Date from Rex GE 1997, Burt Gastro 2000

Call now to schedule your screening.