Bowel polyp: Are there risks to getting a colonoscopy over 80?

Posted by alison0 @alison0, Nov 4, 2022

I had a very nasty CT internal examination of my bowel and they found a polyp. Mu GP told me it was benign but the specialist rang on Friday wondering if he should do a colonoscopy. His reasons for not doing it were the difficulty of the pre prep, the possibility of bleeding and the sedation.
I am 83 but I was startled by his hesitancy. He sent me off to talk to my family and I am going to talk to my GP. I have had four colonoscopies but not for about 15 years. Only the first one showed any polyps and they were removed.
Any comments? Please? It is true the preparation is horrible and I didn’t get to the toilet the first time. We had to have the carpet cleaner.

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@alison0, there are risks with a colonoscopy and those risks increase with age. Here's some general information that might help you with your discussion with your family and primary care physician. Your GP will be able to discussion this general information with you more specified to you and your medical history.

Risks
- Procedural sedation is generally safe in older adults, though they may be at higher risk for oxygen desaturation. Older patients usually require lower doses of medications.
- Risk of GI bleeds can happen at any age and can be treated during the procedure.
- Elderly patients may be at a high risk for a perforation because the colorectal lining thins with age.
- Elderly patients may be more prone to feeling nauseous, weakness, and vomiting during the intensive bowel cleansing perparation required for a colonoscopy. Fainting is a serious issue because of the risk of breaking bones from a fall. Other complications of the cleansing is severe dehydration and electrolyte imbalance which can cause a cascade effect of problems, from heart arrhythmias and problems with kidney function.

As you can see, these concerns may be age related. But some of them will also depend on your general health status and medical history. For example the sedation issue might be a challenge for one 83 year old but not for another. It is something my mom has to consider seriously since she reacts strongly and not very well to sedation. My aunt has no issues with sedation and she is 91.

The other thing I would ask your doctor about is the shape of the polyp and the risk level of it becoming cancerous. Read more here:
- A Colon Polyp Primer: Know the Types and Your Risk Factors https://healthblog.uofmhealth.org/digestive-health/a-colon-polyp-primer-know-types-and-your-risk-factors

If the image of the polyp indicates that it is the type of polyp at low risk of developing into cancer, then your doctor may recommend an active surveillance approach rather than a colonoscopy.

Phew. That's a lot to read. In short, it sounds like you're ready to do the prep if a colonoscopy is necessary. But you want to have an informed discussion with your doctor to better understand the risks and benefits of removing the polyp. Do I have that right?

REPLY
@colleenyoung

@alison0, there are risks with a colonoscopy and those risks increase with age. Here's some general information that might help you with your discussion with your family and primary care physician. Your GP will be able to discussion this general information with you more specified to you and your medical history.

Risks
- Procedural sedation is generally safe in older adults, though they may be at higher risk for oxygen desaturation. Older patients usually require lower doses of medications.
- Risk of GI bleeds can happen at any age and can be treated during the procedure.
- Elderly patients may be at a high risk for a perforation because the colorectal lining thins with age.
- Elderly patients may be more prone to feeling nauseous, weakness, and vomiting during the intensive bowel cleansing perparation required for a colonoscopy. Fainting is a serious issue because of the risk of breaking bones from a fall. Other complications of the cleansing is severe dehydration and electrolyte imbalance which can cause a cascade effect of problems, from heart arrhythmias and problems with kidney function.

As you can see, these concerns may be age related. But some of them will also depend on your general health status and medical history. For example the sedation issue might be a challenge for one 83 year old but not for another. It is something my mom has to consider seriously since she reacts strongly and not very well to sedation. My aunt has no issues with sedation and she is 91.

The other thing I would ask your doctor about is the shape of the polyp and the risk level of it becoming cancerous. Read more here:
- A Colon Polyp Primer: Know the Types and Your Risk Factors https://healthblog.uofmhealth.org/digestive-health/a-colon-polyp-primer-know-types-and-your-risk-factors

If the image of the polyp indicates that it is the type of polyp at low risk of developing into cancer, then your doctor may recommend an active surveillance approach rather than a colonoscopy.

Phew. That's a lot to read. In short, it sounds like you're ready to do the prep if a colonoscopy is necessary. But you want to have an informed discussion with your doctor to better understand the risks and benefits of removing the polyp. Do I have that right?

Jump to this post

Yes you’ve got it exactly right. Thanks

REPLY

After hesitating about a colonoscopy, I was 81 at the time, I had the procedure and was diagnosed with anal cancer. I then went through chemo and radiation. Six months later I am not back to my former self, but I am glad I had the colonoscopy.

REPLY
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