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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!

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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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sunshinelife Jun 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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You really need to have a pre-procedure mtg with your GI doc. We can't dedtermine whether or not this is safe for you--they can.

My SIL is a GI doc and routinely does colonoscopies, obviously. He has said that he has a chat with his 'over 70' patients to see if they need one. The worries of problems really escalate with age, and he may actually deny someone one or opt for another procedure.

10 years between screenings is what is usually reccomended, unless you have problems.
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jakefix Jun 2021
Thanks! My pre-colonoscopy meeting was with the young, very nice physician’s assistant. Last Friday I received the Sutab prep prescription and started reading over the weekend. I became concerned about potentially serious side effects and then online-researched issues for over-70 year old seniors re colon prep and colonoscopies. Because I’d initiated the request for one out of fear (misplaced, I now believe) - and because 7 years have passed since my last colonoscopy, it occurred to me that the gastroenterologist office waa just rubber-stamping my thoughts. It was like asking for an optional medication and having it delivered without the warning insert. I felt guilty calling and canceling the procedure, but knew I had serious questions needing to be addressed before proceeding. My new primary care Dr talked with me today in a tele-Health call. He agreed with my decision, preferring to do a DNA Cologuard test first. If it comes back positive, then a colonoscopy is in order.

Right now I’m suffering on 2nd day with severe constipation because I started the pre-prep low-fiber/residue diet last weekend. Feels like my innards are about to burst. Miralax hasn’t kicked in yet - body’s poo-plumbing has stopped. Nothing’s moving - this was predictable, as this happens when I skip fiber. Drinking plenty of water, which runs out of me because I take a diuretic for bp. Mentioned constipation issues at pre-colonoscopy meeting with gastroenterologist’s office. Hoping I don’t end up in ER.

Thanks again!
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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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All my DH had to do is eat light 2 days before the procedure and the day before take a liquid that cleaned him out. Eating nothing more than jello and drinking Gator aid.

There is that box test. Maybe try that and if comes up positive then have the colonoscopy.
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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 2021
you're old hurry up and die...omg!
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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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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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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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sunshinelife Jun 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 believe you've answered your own question.
I wouldn't get one!
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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 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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