Healthy Colon Shared Decision Making

Know What to Expect:

Healthy Colon Shared Decision Making

We know that nobody wants to talk about their colon.

But when you need answers, it’s important to know your choices.

A healthy colon goes a long way. Located at the end of your digestive tract, the colon pulls water and waste from the food you eat.

Colorectal cancer often starts as a growth (or polyp) in the colon or rectum. Some of these polyps turn into cancer.

If you’re watching this video,

[You may have questions]

you’re probably thinking about having a test. Maybe you had an incomplete colonoscopy and are looking for another option. Or maybe you had a previous test that found blood in your stool and you’re trying to find out why it’s there. Either way, early colorectal cancers may not always show symptoms. This is why it’s important to talk to your doctor right away if you notice any of the following:

• A change in bowel habits — such as diarrhea, constipation, or narrowing of the stool — that lasts

for more than a few days

• A constant feeling of needing to have a bowel movement (even after you go)
• Blood in the stool
• Cramping or stomach pain
• Weakness and fatigue
• Or Unintended weight loss

The good thing is that when it comes to tests, you have choices. Some include stool tests such as a fecal occult blood test, the FIT test, FIT DNA test, a CTC also called a CAT scan of the colon, flexible sigmoidoscopy, colonoscopy or colon capsule endoscopy. Let’s talk about these options and the pros and cons of each.

First, your provider may offer a Fecal Occult Blood Test, or “stool guaiac” test. This is a test where stool is placed on a special cardboard paper to test for the presence of blood. It doesn’t see anything like a polyp or cancer, however, keep in mind, there may be other reasons for a positive test other than cancer.

Now, let’s discuss the fecal immunochemical test (or FIT). Using a kit at home, you collect a stool sample and send it to the lab. This test detects hidden blood in the stool, which can be an early sign of cancer.

[According to the American Cancer Society]

Collecting the sample is easy and inexpensive. No preparation or anesthesia is required, and there are no drug or dietary restrictions.

However, because colon cancers don’t always bleed, more than one test may be needed to make a diagnosis

FIT-DNA is new. You mail your stool sample and a DNA test detects any cancer cells in blood and the stool.

This is simple and easy to do.

But it may require multiple tests.

Flexible sigmoidoscopy can be used to detect colorectal polyps and cancer.

Using a sigmoidoscope —a flexible, lighted tube about the thickness of a finger with a small video camera on the end — your doctor can look at the inside of your rectum and part of your colon.

Camera images are displayed, allowing your doctor to detect (and possibly remove) any abnormality.

With this test, sedation is usually not required. If polyps are found, you have the option to biopsy or remove them.

The sigmoidoscope, however, is only about two feet long. So, while the doctor can see the entire rectum, the full length of your colon cannot be seen.

The colonoscopy is another option: During this test, your doctor uses a colonoscope — a longer version of a sigmoidoscope — to view the entire length of your colon and rectum.

Here’s how it works. A colonoscopy lets a doctor see the colon and possibly biopsy or remove polyps before they develop into cancer.

But some people find prepping for this is uncomfortable. Also, this test uses sedation and for some there are risks associated with that as well as the potential risk with perforation of the colon, and cardiovascular events.

The CTC is an advanced CT scan of the colon and rectum.

While you lie on a table, a CT scanner rotates around you and uses x-rays to take multiple images of your body.

A CTC is less invasive than other tests, but you are exposed to radiation during the scan. Plus, you’ll need a tube placed in your rectum to inflate your bowel with air And, you’ll still need a bowel prep.

If you and your doctor decide that it might be right for you, a visual exam of the colon to detect polyps can be performed with colon capsule endoscopy.

Colon capsule endoscopy may be right for you if you’ve had an incomplete colonoscopy with adequate bowel prep. It might also be best if there is evidence of lower gastrointestinal bleeding and if having a colonoscopy or undergoing sedation puts you at risk. But you could still undergo colonoscopy if something is identified.

Here’s how it works:

After you swallow the capsule, it travels naturally through your gastrointestinal tract. Two cameras inside the capsule take thousands of images that are transmitted to a recorder you wear in a pouch around your waist.

Your doctor reviews these images to look for any polyps or other abnormalities.

Pros: This non-invasive test can be done as an outpatient procedure at your doctor’s office and it does not require anesthesia or radiation. While the capsule is in your body, you can go home, continue most daily activities, and take your regular medications.

Cons: Bowel prep is still required and you will need to take an additional laxative during the procedure. If the test identifies a polyp, a colonoscopy may still be required to remove it.

The best test, of course, is the one you do! So, speak to your doctor about all options to see which one is right for you.

To learn more, ask your doctor for information or visit the American Cancer Society,

[www.cancer.org]

U.S. Preventive Services Task Force,

[www.uspreventiveservicetaskforce.org]

Centers for Disease Control and Prevention,

[www.CDC.gov]

and Pill Cam Colon websites for helpful resources.

[www.Pillcamcolon.com]

Now that you know more about your options, we invite you to take a survey and let us know what you think! Thank you very much!

[This information and content (collectively, “Content”) in these materials is for your general educational information only. The Content cannot replace the relationship that you have with your health care professionals. The Content in these materials should not be considered medical advice. IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, YOU SHOULD NOT RELY ON ANY INFORMATION IN THESE MATERIALS AND SHOULD SEEK APPROPRIATE EMERGENCY MEDICAL ASSISTANCE SUCH AS CALLING “911.” You should always talk to your health care professionals for diagnosis and treatment, including information regarding which drugs or treatment may be appropriate for you.]

[copyright 2018 Medtronic, used with permission]