Is a colonoscopy ever too risky?

Posted by Ray Kemble @ray666, Jan 2 6:48pm

How cautious should a 79-year-old man with peripheral neuropathy and the symptoms of post-sepsis syndrome be if his PCP has suggested he get a colonoscopy? Since colonoscopies require a preliminary interview when a patient is over 75, and septic re-infection is all too common, I’m wondering how cautious I should be when I sit down for a preliminary interview. Has anyone else been in a similar situation with anything resembling a similar medical history?

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@vic83

I understand your concern.
The first question is what is your past hisotry of colonoscopies? Have you had precancerous polyps in the past? If so, then fecal tests are not recommended
Why is your PCP recommending a colonoscopy for you?
At 82 I was due for a five year followup colonoscopy (I have history of polyps). Since I now have lung cancer and breathing issues, I was concerned about anesthesia and wondered if I really needed to do it given my age and issues. And my local primary care doctor was not the right person to confirm if I was healthy enough.
I decided to do a consult at Mayo Clinic since I am a patient there. The MD (not PA or NP) I saw reviewed my previous colonoscopies and noted that I had had pre-cancerous polyps in the past and in fact one they had mislabelled. He recommended I do the colonoscopy in the hospital, my Pulmonologist said Monitored anesthesia care (MAC) was OK and I went through with it. They found 1 small and 2 large polyps all precancerous. I am due back in 3 years.
Be sure your preliminary interview is with an MD specialist who reviews your history and not someone with lesser training who does not have the expertise to make a judgement call.

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Hello, @vic83

Thank you! This is precisely the sort of advice I'm looking for. I had my last colonoscopy six years ago when a polyp was found and dealt with. The doctor advised returning in five years, but then sepsis intervened. That's why it's now six years. I'll be sure to meet with someone knowledgeable and who'll carefully review my history. My caution, which some might think a bit overwrought, is the result of conversations with various specialists who have been forthcoming enough to say they've only a limited understanding of sepsis's after-the-fact symptoms and the risk of reinfection.

Cheers!
Ray (@ray666)

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@ray666

Hello, @vic83

Thank you! This is precisely the sort of advice I'm looking for. I had my last colonoscopy six years ago when a polyp was found and dealt with. The doctor advised returning in five years, but then sepsis intervened. That's why it's now six years. I'll be sure to meet with someone knowledgeable and who'll carefully review my history. My caution, which some might think a bit overwrought, is the result of conversations with various specialists who have been forthcoming enough to say they've only a limited understanding of sepsis's after-the-fact symptoms and the risk of reinfection.

Cheers!
Ray (@ray666)

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Happy to be of help. To make intelligent decisions we need to have a complete picture of the risks and benefits. I too have learned from experience to drill down in these things!

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Hi, Ray!

I would personally not get a colonoscopy at age 75, especially with your conditions, unless you’re having symptoms or you have a family history. I think it’s risky the older we get and I believe the prep and procedure are very stressful on the body and can disrupt our natural gut microbiome. I’d say keep on keeping on, eat well, walk daily, think positive and stay blessed! Also, in Europe they test much less frequently, and I think worry and invasive tests stress the body; medicine should focus more on prevention in the forms of meditation, healthy eating, and exercise, instead of more testing. Hope this helps!! Blessings to you!!! Mia

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@pianist3

Hi, Ray!

I would personally not get a colonoscopy at age 75, especially with your conditions, unless you’re having symptoms or you have a family history. I think it’s risky the older we get and I believe the prep and procedure are very stressful on the body and can disrupt our natural gut microbiome. I’d say keep on keeping on, eat well, walk daily, think positive and stay blessed! Also, in Europe they test much less frequently, and I think worry and invasive tests stress the body; medicine should focus more on prevention in the forms of meditation, healthy eating, and exercise, instead of more testing. Hope this helps!! Blessings to you!!! Mia

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Hi, Mia!

Thank you for your perspective. I'm certainly not eager to get a colonoscopy. I've had my share over the years. I believe the only reason my PCP thought it might be a good idea, even at my age, is my only slightly low red blood count.

But for several years, I've been taking delayed-release diclofenac, prescribed by my orthopedist to reduce arthritic pain in my knees (it's worked wonders, by the way), plus a daily 81 mm aspirin, both of which may cause GI bleeding.

A hematologist, looking at my low RBC, advised I quit both the diclofenac and the aspirin. He suggested that those two drugs may have been suppressed my RBC. Otherwise, I can report no signs of any GI trouble.

I agree with what you say: fewer tests, a good diet, exercise, and insofar as possible a stress-free life.

Cheers!
Ray (@ray666)

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@ray666 I wonder if this would be applicable to you. It says it’s for small bowel, but the capsule also passes through the large bowel so …🤷🏼‍♀️ Might be worth discussing with the doctor scheduled to do your colonoscopy.
https://my.clevelandclinic.org/health/diagnostics/16829-capsule-endoscopy

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@rashida

@ray666 I wonder if this would be applicable to you. It says it’s for small bowel, but the capsule also passes through the large bowel so …🤷🏼‍♀️ Might be worth discussing with the doctor scheduled to do your colonoscopy.
https://my.clevelandclinic.org/health/diagnostics/16829-capsule-endoscopy

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@ray666 after watching this on the news last night, I understand your fear - totally! I had no idea sepsis can be this aggressive!
https://www.ctvnews.ca/video/c3062472-ctv-national-news--amalies-mission?binId=1.810401

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@rashida

@ray666 after watching this on the news last night, I understand your fear - totally! I had no idea sepsis can be this aggressive!
https://www.ctvnews.ca/video/c3062472-ctv-national-news--amalies-mission?binId=1.810401

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OMG! That's pretty dramatic! It makes me think thank god my symptoms have never seemed so threatening. But of course "seemed so threatening" means you can never be too cautious. Reading the life stories of people who suffered re-infections after some routine clinical procedure, I decided, at 79, to approach the prospect of another traditional (not non-invasive) colonoscopy with as much information as I could amass, especially about possible alternatives to traditional colonoscopies.

Thank you, Rashida, for sending this to me!

Ray (@ray666)

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@ray666

OMG! That's pretty dramatic! It makes me think thank god my symptoms have never seemed so threatening. But of course "seemed so threatening" means you can never be too cautious. Reading the life stories of people who suffered re-infections after some routine clinical procedure, I decided, at 79, to approach the prospect of another traditional (not non-invasive) colonoscopy with as much information as I could amass, especially about possible alternatives to traditional colonoscopies.

Thank you, Rashida, for sending this to me!

Ray (@ray666)

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@ray666 I wonder if you would be eligible for that capsule colonoscopy …?

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I plan to ask about both non-invasive and capsule colonoscopies. I imagine I'll find out pretty quickly whether the doctors at the GI I'll be going to for my interview will either believe or not believe in such alternative procedures. ––Ray

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