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Colon prep requires several days of low-fiber diet, causing constipation and possible painful diverticulitis flare-up. Last colonoscopy was 7 years ago, no polyps. Anxiety motivated me to ask for another one after 3 family members diagnosed with colon cancer. However, all were determined to be sporadic cancers, ie, not genetic. And colonoscopies are recommended every 10 years. I’m now re-thinking if I should proceed; I’ve read about the elevated risks of colonoscopy for those over 70 (the recommended cut-off for these screenings is age 75). I'm obese, have high blood pressure (well controlled) and pre-diabetes (controlled with diet). Sometimes my pulse dips to 40-42 momentarily, but heart monitoring two years ago indicated nothing serious. My resting pulse is 60-65, though I’m not an active person. I read where the fluid loss during the prep, even while trying to stay hydrated, can cause an electrolyte imbalance. In seniors, that could lead to a cardiovascular event. Then there’s the risk of a perforated colon with the procedure or even with a diverticulitis flare. I decided to cancel my appointment for the scheduled procedure and instead, made an appointment to discuss these issues with my primary care doctor. Perhaps a less invasive screening would be preferable? Would love to know folks’ thoughts and experiences. Thanks!

For goodness' sake.

The OP IS taking screening seriously. The recommendation is that he should have a colonoscopy every ten years, his last was seven years ago, he was clear. So, conclusion 1, it can wait three years at least.

Any symptoms, any changes, any weight loss, any clinical signs causing concern? No. Even the family history, which often would be a reason for extra precautions, has been ruled out as an issue - there are no genetic factors in the other family members' disease.* So, conclusion 2, no occasion for a (non-routine, actually) colonoscopy.

In the absence of any clear reason to go ahead with a colonoscopy now, the OP should cancel this appointment.

If he is still concerned, and I agree that we all of us should be alert to risks, there are other things he can do.

He could consult a dietitian about minimising his risk.
He could ask for a stool sample to be investigated.
He could ask his PCP to keep an eye on basic statistics including, I agree again, his blood count.

*Just a thought: genetics has been ruled out, but what about other factors these family members and you yourself might have in common? Traditional foods, environmental exposures, anything like that?
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Reply to Countrymouse
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I was reading some of the answers that people have given you here. When it comes to cancer screening you should take it seriously, no matter what you read in these forums and even what doctors say to you. Some doctors brush it off believe it or not and those patients have been found to have cancer. You should not put your life at risk by letting someone else decide for you. Cancer is a killer which doctors cannot control when it is in an advanced stage. Doctors have made mistakes by ordering tests that will not pick up the cancer. CT scans or a " CT enterography " or virtual colonoscopy as it is commonly called will not pick up polyps or obstructions by cancer. I have been told this by other doctors and I have seen it first hand. A local GI did this to my mother and he made a mistake, a big mistake. He told her the test was negative and to continue with the mild laxative. He was wrong. She had a blockage in her rectum and the tumor was causing her to bleed in the stool and causing her lot of pain in addition to those changes in her blood such as low hemoglobin, low red blood cells, etc. He was an idiot !!!!!!!!!! She was having these changes in her blood before and as a GI he should have foreseen this. This was a red flag. He only ended up causing more harm to my mother. A good doctor would never choose a virtual colonoscopy because of the reasons stated here to you. A good doctor will choose the regular colonoscopy because that is the " Gold Standard " as some of them call it. To you I say if you want to play with fire just because the procedure is heard to be uncomfortable for some go ahead don't do it. You will only have yourself to blame later on, or may be you are just tired of life or don't want to live anymore. I dont know. I had it done two years ago. I am 50 now and they found two small polyps in my large intestine. I plan to have another one soon because I want to live. If by chance they find 20 or 50 polyps then I might even having my colon removed if that is what it will take to stop it. People have done it. My grandmom lived beyond 100 and she had it done three times incredibly all three times she was negative for polyps. You have to be vigilant about your health. No one else will give a crap and if you bump into a boring and indifferent doctor who thinks you have lived enough he will of course say to you why do you need it . A lot of doctors discriminate if you are old, if you are too sick, if you are in a wheelchair, etc. Believe me I have been taking my parents to them for many years every single week. I have seen it. They prefer to see only young patients with not too many problems or else they will say to you to go back to the hospital. I have heard everything. When it comes to cancer screening you don't have time to play because cancer does not play no matter what you hear. Cancer is death. Period. Don't play with Cancer. You may play around with other diseases, but with cancer once it declares war on you it will not stop. Good luck.
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MargaretMcKen Jun 16, 2021
Robert, there are many different types of cancer that affect many different parts of the body. No-one gets tested regularly for all of them. Of course, when a cancer is found, you would wish that you had had that particular test earlier, but that doesn’t mean it was a practical option. I get tested regularly for breast cancer, cervical cancer and (up to now) bowel cancer, but there are many more tests which I don’t have - and just as many tests that you too don’t have.

I’m sure that you mean well, but your post doesn’t really help with the decision that OP has to make.
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Regarding colonoscopies, I wanted to add what had happened to my late uncle. He was urged to get a colonoscopy especially since he had a hereditary factor as my FIL (his brother) had colon cancer. My FIL then passed from Parkinson's Disease. But my uncle refused to get a colonoscopy at about age 77. He passed away from colon cancer.
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Reply to Llamalover47
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I just read through everyone's replies and found it interesting that several folks will choose to forego colonoscopies at around my current age of 69. To me, that seems too young for otherwise relatively healthy individuals to stop having the procedure. 

Colorectal polyps may turn cancerous in 10 years, while today's 69 year old woman will average living an additional 17 years to age 87. (https://www.ssa.gov/oact/population/longevity.html.

My mother had never had a colonoscopy when she was diagnosed with stage 3 colon cancer at age 82. Surgery and chemo were successful in her case and she lived cancer-free to age 99.  Her last colonoscopy was at age 89, probably influenced by her own mom's age at death being 98.

The ideal cut-off age for colonoscopies is probably a decision best made jointly with your doctors, considering health, medical issues, family longevity, and the very small possibility of intestinal perforation.
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Reply to Linzy6
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A "virtual colonoscopy" is non invasive. No toxic drink...no instruments inserted. The pre procedure drink has caused serious kidney damage, and in some patients kidney failure. A radiologist reads the colon ct (aka virtual colonoscopy) to identify any polyps. Polyps 'may' be malignant, however usually are not. I got my Grandpa to start having colonic irrigations weekly at 74. He's 85 now and still going most weeks. The times he doesn't go, he gets down, depressed, muddy illogical thinking etc etc. He knows himself the difference the colonic irrigations make. ..and catches the car service across himself. your md will no doubt speak in strong negative tones about colonic irrigations if you bring up the subject. despite the fact he/she will have no training or experience in this regard. The Max Gerson MD program for the used primarily for ill, & cancer patients is structured on daily coffee enemas & raw vegetable juices. It is also an excellent preventative and health building program. The Gerson program has been in existence for over 80 years now. Gerson wrote a clinical book on his experience of excellent results with 50 patients using the above. You can watch videos on youtube about the program if it is of interest. "The bowel is the first thing to get sick, and the last to get well" Hippocrates
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Reply to sunshinelife
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Imho, you should discuss these issues with your specialists. Btw, I am 74 years of age and DO get my routine colonoscopies.
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Reply to Llamalover47
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It is wise of you to consider all you mention here. Because I know of issues sustained by people over 70, including my husband, I would speak with your PCP discussing your concerns. If you are on blood thinners, I believe that is also a consideration.
I would research dr’s who have a successful record of performing this procedure. Perforations do happen & can be very dangerous.
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Reply to sixyears
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Not sure if a CT scan will diagnose everything, but it is an expensive way to avoid a colonoscopy.
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Reply to Sendhelp
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These days it is easier to have a colonoscopies. It is thorough. It really helps and can show any sign of cancer. I have had 3 over the years. The last one I was put to sleep and had no recollection of. Pain. Hope you get your answer
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sunshinelife Jun 14, 2021
was it a polyp that was removed and malignant cells were identified by the lab?
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My 2 cents:
Talk with your PCP AND your cardiologist about the risk. No genetic predisposition for cancer or polyps? Why bother if your last screening was good and clear? If they find something, what are the options for treatment and are you willing to follow through with those options, and what are the risks of those possible options for you?
I'd ask those questions.

My Mom is 91 and has GI issues, but an endoscopy is a high risk that her PCP, pulmonologist and cardiologist say NO WAY. She couldn't risk any surgery to correct whatever they might find anyway. Only doc gunho about the endoscopy was the GI doc, of course. All her other docs were like WHY and what's the point.

Personally, I had a routine colonoscopy and concurrent endoscopy about 5 years ago, all clear and even though I have GI issues and IBS, I will never have another colonoscopy unless you put a gun to my head. The after effects of it made me poopy incontinent for over a year because, with IBS my colon closes up, but the doctor rammed the thing up my yahoo to get it in there and damaged my sphincter nerves where I had no control. I was only 50 y.o. Took 2 years to regain total control of my poops. No colon cancer or polyps run in my family either. So, it's a hell no for me.

Talk with your drs about the necessity and the risks.
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sunshinelife Jun 14, 2021
sorry for your suffering. One gets a more impartial viewpoint to google : risk factors of.... or complications of....With all due respect (you sound like a kind & sincere lady) medics do and will sell whatever they have to sell..procedures, particular meds etc. Even if/when it runs contrary to the best interests of the person/patient . This is my experience "Question everything" Euripides
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No.
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Reply to Chellyfla
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People here can only give opinions, since we are not doctors, we aren't your doctor, and we certainly aren't you. I would say NO, you do not need one, especially if you had them in the past and did not have any cancer. I bet everybody has polyps, but doctors act like every polyp is going to turn into cancer. I don't think there is any proof of that.

Find the book "Rethinking Aging: Growing Old and Living Well in an Overtreated Society" by Nortin Hadler.

Here is a review:

"For those fortunate enough to reside in the developed world, death before reaching a ripe old age is a tragedy, not a fact of life. Although aging and dying are not diseases, older Americans are subject to the most egregious marketing in the name of successful aging and long life, as if both are commodities. In Rethinking Aging, Nortin M. Hadler examines health-care choices offered to aging Americans and argues that too often the choices serve to profit the provider rather than benefit the recipient, leading to the medicalization of everyday ailments and blatant overtreatment. Rethinking Aging forewarns and arms readers with evidence-based insights that facilitate health-promoting decision making.

Over the past decades, Hadler has established himself as a leading voice among those who approach the menu of health-care choices with informed skepticism. Only the rigorous demonstration of efficacy is adequate reassurance of a treatment's value, he argues; if it cannot be shown that a particular treatment will benefit the patient, one should proceed with caution. In Rethinking Aging, Hadler offers a doctor's perspective on the medical literature as well as his long clinical experience to help readers assess their health-care options and make informed medical choices in the last decades of life. The challenges of aging and dying, he eloquently assures us, can be faced with sophistication, confidence, and grace."

In the end (pun intended), you have to decide what is best for you. Nobody can make that decision for you.
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Reply to OkieGranny
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sunshinelife Jun 14, 2021
Wise lady. Less than 1% of polyps under 1cm are found malignant. Almost 40% of polyps over 2cm malignant cells are identified. There are risk factors for colon cancer. eating red meats is the highest risk factor... Medicine is a business of suffering for the greatest part. Death is essential . Suffering is optional.
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Some doctors recommend 5 year intervals if there is any kind of a risk factor for colon cancer. For those who are in good health, there is nothing unusual about having a colonoscopy over 70. (If I recall correctly, my parents were in their early 80s when they had their final one.) Although I don't particularly love colonoscopy preps, I'll have them as long as I can because I don't want to die of a disease that could have been prevented or arrested at an early stage.
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Reply to jacobsonbob
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Because of a family history of colon cancer, I had a colonoscopy last October at age 83. I have a history of diveticulitis and have had polyps on previous screenings. My gastroenterologist felt that because I am very healthy for my age I should proceed. I had the same prep which I had previously. At 3:00 am the morning before the procedure (appointment was for 7:00 am), I started vomiting. My son took me to the GI center and they gave me some IV medication for the severe nausea which helped. I did have the procedure and everything went well. After arriving home, I started vomiting again. I couldn't keep anything down, even ice chips. At this point, the gastroenterolgist said I should go to the emergency room. Even with IV medication, the nausea persisted. The ER doctor sent me for a CAT scan in case I had a bowel obstruction. Everything was normal on the scan. I had to be admitted to replace my electrolytes. I was in the hospital overnight and was able to leave the next day. The doctors felt I had a reaction to the bowel prep. I feel I was too old to undergo this procedure. My son has used Cologuard (sp) which is very easy and evaluates the DNA in your stool. That might be an option you might try.
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Reply to Grannie9
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I would think twice before having it done and make sure it is absolutely necessary and all other tests prove it necessary. A friend at church had it done and they accidentally poked a hole in her colon, she developed peritonitis and died. I think I would rather deal with diarrhea and mild pain before taking a chance with a colonoscopy. It is always good to get a second opinion if you don't feel comfortable with a doctors recommendation.
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Reply to grannynanny01
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I am older - will be 88 - with many physical problems. There is NO way in hell I would go through that at this age - just wouldn't and I doubt I would in this case either. But this is something that you, along with the medical pro's must decide based on reasons why you might want it done. This is a tough one.
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Reply to Riley2166
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I am going to take the last part of your post first.
The less invasive tests often lead to false positives resulting in you having to go through what you want to avoid. OR it can lead to a false negative and that leaves you with the same result as if you do not have the colonoscopy.

Personally....
Given the reasons you state.
The health concerns you have.
I would opt not to have the colonoscopy.
Given that you showed no signs previously, no precancerous polyps or none at all.
The fact that colon cancer is slower growing, sometimes taking 10 years to grow putting you in your 80's if it does develop. From then there is the choice to A) do noting or B) seek treatment. It would depend on the stage that it is in when discovered. If early again option is to do nothing or treat. If it is late stage, same option treat or not. (personally I would opt for no treatment if I am late 80's and late stage)
Ok...all that rambling on leads me to
Cancel the test, talk to your doctor.
If there are non invasive tests that are pretty accurate go for that.
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Reply to Grandma1954
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First of all, the last time I had a colonoscopy, it was just clear liquids the day before along with a HUGE bottle of go-lytely and some dulcolax tabs, maybe some miralax. The next day, the colonoscopy.

But, because you sound very (maybe overly?) concerned, you should ask your doctor these questions, the GI doc, or even your primary care doc. I don't mean to make light of your situation, but you really sound stressed and I think it would be the best for reassurance from one of your docs who knows you best.
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Reply to Myownlife
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I believe you've answered your own question.
I wouldn't get one!
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Reply to bevthegreat
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After 2 negative colonoscopies over the years, I decided to do the Cologuard this time.It came back positive so I needed a colonoscopy anyway.
Cologuard has many false positives AND false negatives.
Like my GI doctor said, It's the false negatives you have to worry about.
Is a negative truly negative or a false negative?
I would never use Cologuard again.

As far as a CT virtual colonoscopy, the prep is the same as a colonoscopy,
You have to be cleaned out. If polyps are found, they can't be removed.
You still need a colonoscopy. I was a CT tech for 40 years.

My advice to anyone would be to just get the colonoscopy.
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Reply to Outback
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"Diverticulitis is not associated  diverticulosis is not associated with an increased risk of advanced colorectal neoplasia. "

Read here:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216380

However, diverticulitis can cause complications; if you are having symptoms, it would probably be a good idea to get one.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265196/

There is no such thing as "pre-diabetes". You are diabetic.
https://www.cdc.gov/diabetes/library/features/truth-about-prediabetes.html#:~:text=Prediabetes%20Is%20a%20Big%20Deal,%2C%20heart%20disease%2C%20and%20stroke.

Be more concerned with weight control and lifestyle changes.
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sunshinelife Jun 14, 2021
diabetes is broken down into catagories. pre diabetic (stage 1) is a stage where the blood sugar can be regulated with diet & exercise You are correct lifestyle changes are the key. ..easier said than done. Most people need education (support groups/class on nutrition & exercise from their hospital system) re the studies you quoted: "always consider your sources" ie the financial incentives directing a study towards a specific finding. 90% of medical studies are funded by the pharmaceutical industry. The highest risk factor for colon cancer is eating red meats. There has been a great deal of research & clinical studies in this area. Many by the Seventh Day Adventist Medical system. Best regards
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My wife had her last colonoscopy 2 years ago because she was anemic and they couldn’t find where she was losing blood. They still don’t know. However she ended up in the hospital for 10 days because of dehydration due to continuing vomiting. Followed by 3 weeks in nursing rehab. Her kidneys were also involved. She was in and out of the hospital because of dehydration brought about by vomiting. Now they want to do another colonoscopy do to blood in her stool and a thickening of an area in her colon(CT Scan). This time we tried the pills, but she immediately started vomiting after getting the first dose down. I forgot to mention if she doesn’t eat something every 2 hours she get extremely nauseous. Apparently she is prep intolerant and I don’t know where to go from here.
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Reply to Foxhole82
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sunshinelife Jun 14, 2021
please reconsider your wife taking the prep. Kidney damage & even kidney failure. due to the crystals in the drink are common. As are many other serious health problems, ongoing. Additionally, the vomiting is a clear sign of an allergy to the prep. A substance that causes an allergic reaction, when taken again causes a stronger reaction. Please dont take any more of the prep drink whatever anyone tells you. Let experience be your teacher in this regard. The body does have a breaking point. Google : "common side effects & complications of pre colonoscopy drink" The goal of the drink is to clear enough waste from the colon for the camera on the instrument to get clear pics of the bowel walls. A colonic irrigation the day before will achieve the same objective, without any of the risks of the drink Google: Colonic irrigation clinics in my area" The color of the blood being passed is important in diagnosis. The brighter red the color, the closer the bleed is to the rectum ie. hemorrhoids. Hemorrhoids are also found Inside the rectum...not only on the outside of the anus. A 2oz enema of white oak bark tea will cause no harm at all. However, if the bleeding is indeed hemorrhoids, this will reduce the bleeding If done each day for 10 days it will shrink the enlarged irritated hemorrhoids & stop the bleeding. Do use a thick oil like cold pressed castor oil, or vaseline prior to a BM each time. & for enemas,(not mineral oil enemas from the store...they are irritants. I hope this is of help to you. Medicine was my life for many years. I am pleased if I can assist to alleviate or minimize suffering along the way these days. "Experience is the only true knowledge" Albert Einstein
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I HATE!!!!!!!!!!!!!!!!!!!!colonoscopies, but my Dad died of colon cancer (I still think his chronic, severe constipation led to the cancer, complicated by Parkinson's disease which may have "frozen" that part of his bowel muscles. I had one doctor laugh at me for saying this, but I truly do believe it. I am 70 and get them every 5 years; have had a precancerous, tiny polyp and have diverticulosis (not inflammation, just pouches or pockets in the intestines). I am supposed to get another one in about 2-3 years, only due to family history. Now that I'm 70, my health if excellent but not perfect - I am 10 pounds overweight and take meds for high blood pressure, high cholesterol and thyroid, but all are under control. My current doctor retires soon, and she said many over 70 continue with the colonoscopies - in her case, they caught cancerous polyps and saved her life. I am meeting with my new doctor (PA-C) soon, and will discuss with her. I don't want to die of colon cancer or have a poo bag at any age. By the way, check with your doctor first, but when I started having mild constipation in my mid-fifties, I went to a probiotic, and that solved the problems. I had to try a few to get one that worked for me, but basically, the one I use now replaces the biome we normally have in our system when we are young and perfectly healthy. Hope some of this helps with questions - I do know that after 70, it has to be an individual decision.
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Reply to KBHKBH
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It depends on how severe her diverticulitis is. As long as there is no history of a diverticular bleed.
She will have gas due to the nature
of how many diverticuli she has
You are not suppose to eat any popcorn or nuts anything that could get stuck in the divericili.
They look like swiss cheese that is the way diverticuli form. Even with
diverticuli you can still follow
the no colonoscopies after a certain
age.
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Reply to infogirl14
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When an elderly person reaches the age of 75 and older then gi doctors
say the elderly do not need anymore
colonoscopies for the rest of their lives. Unless they are having rectal
bleeding or pain that isnt gas, My mother’ GI doctor told her even with small polyps she doesnt need anymore followup Colonoscpies😌
due to her age.
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sunshinelife Jun 14, 2021
you're old hurry up and die...omg!
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My wife had her last colonoscopy 2 years ago because she was anemic and they couldn’t find where she was losing blood. They still don’t know. However she ended up in the hospital for 10 days because of dehydration due to continuing vomiting. Followed by 3 weeks in nursing rehab. Her kidneys were also involved. She was in and out of the hospital because of dehydration brought about by vomiting. Now they want to do another colonoscopy do to blood in her stool and a thickening of an area in her colon(CT Scan). This time we tried the pills, but she immediately started vomiting after getting the first dose down. I forgot to mention if she doesn’t eat something every 2 hours she get extremely nauseous. Apparently she is prep intolerant and I don’t know where to go from here.
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Reply to Foxhole82
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My mom had her last colonoscopy at around age 69 and it was very, very harsh on her. Colon cancer runs thru my family on my dad's side (dad diagnosed at around age 43, died at 48 and cousin at 36 and he is fine), and I have one of the two cancer genes. I have to have scopes every 3 years....including this year. I have had polyps at all but my last one. This past winter I decided that I was going to stop having them at 69 at the latest. I am 60 now. They are just so brutal on my body. I will accept a less invasive type of screening but not one that requires a prep like the colonoscopy. We can send a man to the moon.... 🙄
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Reply to Monica19815
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On my last colonoscopy, the laxitive that was recommended was very harsh. it took a couple of weeks after the colonoscopy to get my digestive tract back to normal. For the next one, I'm planning to ask if there is a more natural way to do it, even if it takes more days. I think you're wise to talk to your doctor about the pros and cons first.
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Reply to NancyIS
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The problem with the Cologuard vs. the colonoscopy is that the Cologuard detects cancer only, while a colonoscopy can find polyps that can be removed during the colonoscopy and thus prevent cancer from developing. I'm 76 and had my last colonoscopy 9 years ago. I saw my gastroenterologist, who's retiring, last week, and she gave me a Cologuard prescription to use next year. I had asked whether we needed to do any testing and that was what she recommended.

I have almost a lifetime history of irritable bowel syndrome with constipation. However, I'm on 2 medications--one a prescription, Amitiza, and the other generic Miralax--so reducing fiber for a few days does not create a problem. However, I don't remember having to do a pre-prep low-residue diet for recent colonoscopies. And for actual prep, I do a Miralax prep, which is very gentle. Regardless of the prep, I have to do a 2-1/2 day prep because 1 day is not effective enough. It's irritating to spend that much time but not awful! I usually sucked on a lot of hard candy, which is OK to have (yes, I often use sugarless candy), which makes things a little better.

I understand your decision is made. I do think, however, that you could do a good prep without getting constipated by using other ways to reduce/prevent constipation. In any case, I hope all goes well!
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Reply to caroli1
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As other family members who have had colon problems have been concluded as non genetic, why would you even contemplate having an invasive and currently unnecessary procedure carried out?
Your state of health sounds from your description to be normal for you, so leave well alone, no point having something done that may cause problems where none exist.
Why do you want any screening done, if your Dr thinks there may be a cancer present from other symptoms then they will suggest an appropriate test/screen, I don't see the point of you screening for something you are no more likely to have than the rest of us.
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