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sigmoidoscopy vs colonoscopy

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click4it posted 9/30/2013 16:25 PM

If you had an option to choose which one? Which would you do?

I don't know what the hell to do.

MovingUpward posted 9/30/2013 16:36 PM

The colonoscopy will check your entire colon while the sigmoidoscope only get the rectum area. So it really depends on what they are trying to find. Depending on family history and age, a routine colonoscopy might be on the horizon anyway.

Clarrissa posted 9/30/2013 16:52 PM

Moo has it right. About 20 years ago I was having... problems with that area and the doctor had suggested a sigmoidoscopy. The specialist changed it to full colonoscopy once he had my family history. My mother had died of colon cancer and the specialist wanted to be sure that wasn't the problem with me. My problem is much more mundane.

So which procedure you get depends on what your issue is.

tushnurse posted 9/30/2013 18:22 PM

Actually sigmoidoscopy is no longer an acceptable standard for scoping the colon. The only time it's acceptable is for evaluating specific things. Look where a polyp was removed, check rectum on someone that had rectal cancer, get general biopsies for ulcerative colitis.

It is NEVER acceptable to interchange a colonoscopy for a sigmoidoscopy. The colon is about 6 feet long. A sigmoidoscopy only covers the distal portion aprox last foot to 3 feet MAYBE. You generally get no sedation for a sig either so at te first sign of discomfort your dr will/should stop. With technology today unless it's for a specific reason you should not be given the option and if you are you need a new dr.

This is stuff I know check the username. Send me a pm if you have specific questions.

click4it posted 9/30/2013 18:27 PM

So you are saying...doctors should only routinely order colonoscopies for preventative care?

Clarrissa posted 9/30/2013 18:34 PM

tushnurse, mine was changed after the specialist learned my family history (mother succumbed to colon cancer). Why my family doctor didn't order a full colonoscooy, I don't know - he had the same history.

As Moo and I both said, it depends on what the doctor is looking for.

tushnurse posted 10/1/2013 10:51 AM

Nope I am saying if a Dr recommends a sigmoid there better be a very specific reason. The colonoscopy is the Standard of Care. If they are doing a sigmoid to look for bleeding, thinking it's hemmorhoids, and they don't find it, guess what, you still get to do a colonoscopy. That's two procedures that you had to go through, pay for, and prep for (even though the prep for a sig is much less than a colon). Or they do the sig, and say yup it was this, then you essentially have a false sense of wellness, because the rest of your colon has not been evaluated, and polyps live anywhere in the colon.

I did this a long time, and there are really only a handful of times when a sig was indicated, and most of those were on patients that no longer have a colon. Or to go double check where something was done, removed etc.

ETA - I am very passionate about this, as Colon Cancer is preventable, treatable and beatable, however only if you get the right care. There are still too many Dr's out there that don't push for screening colons, or don't think you need one because it's just hemmorhoids. Well about 1 in 50 of just hemmorhoids turns out to be more.

[This message edited by tushnurse at 10:53 AM, October 1st (Tuesday)]

Clarrissa posted 10/1/2013 12:51 PM

'Rhoids are my problem. I imagine I was referred to the specialist since they were bleeding. I had the colonoscopy (clean) then had them banded. They're a problem again since I'm on my feet all day. I think at this point I'll need surgery to fix the problem.

purplejacket4 posted 10/1/2013 19:01 PM

You either need a complete colonoscopy or a sigmoidoscopy with an abdominal CT or barium enema. In reality the prep is the worst part and you have to do it for both so why not just do the colonoscopy and get it over with. Getting through the sigmoid is the hard part; turning the last two corners (at the splenic and hepatic flexures) are a piece of cake. I've done about 35 sigmoidoscopies and 6 colonoscopies in my training. I stopped doing them because I thought it was cruel to do these without conscious sedation. The way it's done now though you pretty much sleep through the whole thing AND YOU'RE DONE!

Clarrissa posted 10/1/2013 20:11 PM

I slept through my procedure. The only problem I had was the reaction to the Demerol. Woke up trying to empty my already empty stomach. Part of the prep is fasting for at least 12 hours if I remember correctly, no solid (or semisolid) food and nothing to drink. It's literally a fast. The prep is by far considered the worst part of the whole thing.

click4it posted 10/1/2013 22:48 PM

I worry about the fasting with no foods for 12 hours. I really do.

If I don't eat any sort of protein and have something with sugar in it for most of the day, I will become faint, dizzy, have the sweats and unable to really move. I haven't let it get to the point of "what could happen" when I feel like that because I will start to eat a bunch of protein to feel better.

tushnurse posted 10/2/2013 08:01 AM

click just make sure you don't eat a huge amount of sugar at any one time. If you keep your blood sugar levels stagnant then you should be ok.
This is actually a pretty common fear/concern, but most folks (99.9%) do just fine.

Clarrissa I hate to hear that you had to have the Demerol for it. That does make you feel yucky. The standard these days is sedation with anesthesia, they give you the Michael Jackson juice. Propofol or Diprivan. IT is THE BOMB!!!

It puts you to sleep almost immediately, and when they stop giving it you wake up in about 30 seconds to 3 minutes. It has an antinausea compnent to it. When we switched to it in the Ednoscopy center I worked in it was awesome!!!! No more puky people after, everyone woke up and were ready to go in 15-30 minutes instead of an hour.

Clarrissa posted 10/2/2013 16:57 PM

tushnurse, as I said, my procedure was about 20 years ago. Don't know if Propofol or Diprivan were even options. All I know is the dry heaves must have started *before* I woke up because when I did I was sitting up, bent over a bedpan.

@click, if you have problems with your blood sugar (diabetes?) make sure you let your doctor know about it. Most procedures require fasting beforehand. I had to fast before my wrist surgery. No solids, semisolids or liquids for 12 hours before surgery.

click4it posted 10/2/2013 17:04 PM

12hrs is fine - its the 24hrs that's worrying me. The paper says no solid foods 24 hours before. I will find out more next week.

Clarrissa posted 10/2/2013 17:11 PM

What your usual way to raise your blood sugar? Candy bar? Soda? Something else? I'm sure your doctor will have some suggestions on how to keep your sugar within limits without breaking the fast.

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