Screening tests for colon cancer

In recent years as our understanding of colon cancer has progressed several screening methods have been developed. They can be as simple as Fecal occult blood testing (FOBT) which involves checking your stool for trace amounts of blood. This requires you to obtain samples from 3 separate stools on 3 separate days and to return them to your doctor's office or laboratory in a special collection kit. If traces of blood are found in your stool, your physician will likely recommend further evaluation including a colonoscopy (see below).


A second method is with a barium enema which is an x-ray test. During this procedure a contrast material, barium, is introduced into your large intestine as an enema. This is followed by several abdominal Xrays. The barium adheres to the walls of your colon and also to polyps and other suspicious lesions. This helps highlight abnormalities on the Xrays. Any suspicious lesions require further evaluation which likely will include a colonoscopy.


The third and fourth methods involve the use of long flexible cameras. Sigmoidoscopy involves inserting a small flexible camera through the anus and into the lower third of your large intestine. Colonoscopy is similar to sigmoidoscopy but the camera is longer which enables the entire length of your colon to be inspected. Through both devices pictures can be taken, polyps can be removed, and suspicious lesions can be biopsied. Colonoscopy is currently the preferred screening method for colon cancer.







Preparing for your colonoscopy

The most important part of the colonoscopy procedure is the preparation that occurs in the days prior. For simplicity I break it down day by day. Talk to your doctor before stopping any medication.


14 days before your procedure

  •  Stop taking all anti-inflammatory medication. This includes Aspirin, ibuprofen, naprosyn, diclofenac, etc.  Acetaminophen (Tylenol) is not an anti-inflammatory and is fine to take leading up to your colonoscopy


5 days before your procedure

  •  Stop taking fish oil
  •  Stop taking clopidogrel(Plavix)
  •  Stop taking warfarin(Coumadin)


One day before the procedure

  •  Clear liquid diet only. Soda, coffee, tea, broth, and water are all okay.
  •  At 2PM take four 5mg Bisacodyl tablets by mouth. These oral stimulative laxative tablets are available over the counter at your pharmacy.
  •  At 6PM start drinking the Nulytely solution. This is a prescription that you will have to pickup at your pharmacy. Drink 8oz every 10 minutes until the entire 4 liters has been consumed.

 You did it, Good job!







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