I get asked this one a lot! People say, “Doc, should I get a colonoscopy?” Now that really depends. If you have bleeding or something urgent going on, a colonoscopy can provide a good diagnostic picture. Most of the time people are asking if they should get a colonoscopy because it’s a standard of care and once they reach a certain age, they are told they have to. They are told a colonoscopy is necessary to prevent cancer. So they are wondering the benefits of colonoscopies.
Let me ask you this question, how does a colonoscopy prevent cancer? Think about that. We will get back to that a little later, but first I want to share some information with you. Once you hear the information I have to share, you’ll probably come to the same conclusion about colonoscopies that I have. Then you can decide for yourself the answer to the question, “Should I get a Colonoscopy?”
What Happens When You Get a Colonoscopy?
Well, they take a picture of the large intestine and they get that camera there via the back door. No, it doesn’t sound fun. That’s why you are wondering if you really need a colonoscopy. I have had patients that after some testing, I tell them they have some inflammation. They say, “No Doc, my GI is good. I had a colonoscopy and they said everything was just fine.” I have to tell them it doesn’t check the small intestine which is an important part of your GI. The scope goes through about 4-5 feet of large intestine but stops short of the small intestine. Their GI is not just fine.
What are they looking for? One of the major things they are looking for is cancer. They are also looking for polyps. A lot of times they’ll perform a colonoscopy if the patient has long-term GI symptoms like poop problems, bleeding or bloating. That makes sense but when they have you take an invasive test just because you turn a certain age that makes me stop. There is other technology that can do a better job, but it’s a standard of care. It’s the way everyone does it, so everyone gets their colonoscopy at 50.
When a Colonoscopy Finds Something
Here’s the major problem with the standard of care being prevent colon cancer by getting a colonoscopy when you’re 50, you should be taking care of your GI way before you are 50 to prevent cancer. You should be taking care of that intestinal tract your whole life before you have been told you are sick. If it comes back with cancer you have cancer. It’s not preventing cancer to get a colonoscopy.
What if they find polyps? Polyps is just a benign growth of cells. If they find one, they snip it off. It’s just an abnormal cluster of cells. But if you keep on creating inflammation over and over again it won’t be a surprise if that happens again. If I were to consistently lift weights with no gloves, I’m going to build up abnormal cells called callouses. Your GI is no different. You keep beating up on it with inflammation you’re going to build some abnormal cells. That doesn’t mean they’re cancerous. That inflammation though could create an environment that leads to cancer.
If your colonoscopy comes back with inflammation that is inflammation you have potentially been living with for some time that could lead to cancer. Taking care of your GI and getting rid of inflammation should have happened a long time before 50.
Other Tests That Can Be Done
As a standard, there are other tests that can be done. There is something that is better basic stool test that will tell you a lot about the health of your gut and will measure fecal occult blood. Having a healthy microbiome will set up your body to prevent disease. Now if you’re bleeding rectally, I would have no problem with a patient getting a colonoscopy but if we want to know how to support your gut, a stool test is a good start.
I think one of the most amazing tests that I tell my patients to do on a regular basis is called a fecal immunochemical test. Or a FIT test. You can google search it. I know they all say they’re the best but they’re all really good. It’s actually a stool test that is good at picking up cancers and other things like that. If it comes back positive there is a high rate of probability that you have cancer.
Should I Get a Colonoscopy?
So, should I get a colonoscopy? If you’re bleeding rectally and have some bad things happening, I have no problem with that. It does come with some risks. There have been instances where they have perforated, poked or otherwise harmed the intestinal tract. As a standard, I don’t recommend it because there are other labs that can be done that are so much more effective at finding cancers than a colonoscopy. The most important takeaway is to take care of your GI and get rid of inflammation so your need for a colonoscopy will go down. We need to change our mindset on what prevention is and instead of early detection we need to set the body up to prevent it.
Don’t wait for disease to happen to you. You need to be proactive. Figure out what is causing inflammation in the body, what’s messing up that microbiome, and then work with a proficient provider to get that body back to normal function. That way you don’t show up to your colonoscopy to find out you have cancer.
Written by Dr. Patrick Flynn
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