Atlanta doctors explain colonoscopy alternatives

Atlanta doctors explain colonoscopy alternatives

Patti saw blood in her stool for several years, but various doctors dismissed it as internal hemorrhoids. After all, people in their 30s, the statistics show, rarely get colorectal cancer.

At age 35 and five months pregnant, the Marietta resident mentioned her concerns to her ob-gyn. He immediately ordered a sigmoidoscopy, and the procedure identified a large precancerous polyp. After her daughter's birth, she returned for a full colonoscopy and removal of the polyp that she says her doctor told her "100 percent guaranteed" would have become cancer in five to 10 years.

For those age 50 and older, the Centers for Disease Control and Prevention recommends regular colorectal cancer screenings: a colonoscopy every 10 years, or a sigmoidoscopy every five years in conjunction with fecal occult blood testing annually.

Experts call colonoscopy the "gold standard" of colorectal screening - it's the only method that examines the entire colon and removes polyps during the same procedure. The CDC also recommends colonoscopies for patients with abnormal test results using other methods.

Dr. Bassel El-Rayes of the Winship Cancer Institute at Emory University in Atlanta says sigmoidoscopy offers a viable alternative for those with no family history or risk factors, but it only examines the lower third of the colon. The FOBT detects blood found in the stool, which may indicate bleeding tumors or precancerous polyps.

"The advantages of the sigmoidoscopy is that the prep is easier, the procedure is faster and the cost is less," he says.

Patti, now 43, says a follow-up colonoscopy in April by highly rated gastroenterologist Dr. Diane Wisebram found another polyp high in the colon. "I'm telling everybody I know to get a colonoscopy," says the Angie's List member, who asked that her last name not be used for medical privacy reasons.

Dr. Sherman Chamberlain, associate professor of gastroenterology at Georgia Health Sciences University, says he prefers colonoscopies for screening. "The more you do, generally the better you are," he says. "Ideally, they should be finding precancerous polyps at least 30 percent of the time."

Whichever procedure you choose, El-Rayes says the most important point is to get screened. "The take-home message is: we have multiple ways of screening and any method of screening is better than no screening," he says.

Angie's List member Jill Stasiak, 68, of Alpharetta [Ga.] resisted her doctor's advice to get a screening because of a previous one she received 20 years ago. "You drank gallons of this awful chalky stuff and you had a pipe rammed up you," she says. Finally, last year she agreed to see highly rated gastroenterologist Dr. Thomas Riddick in Roswell [Ga.] for a colonoscopy. Now she's a screening advocate. "It was like night and day," she says.

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Despite typically costing less and not requiring sedation or anesthesia, sigmoidoscopies are seen as less thorough than colonoscopies.

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