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Neal Shindel MD colonoscopy


Pre-emptive screening for colon cancer by undergoing a colonoscopy can detect early signs of any abnormalities. Dr. Neal Shindel of PIH Health in Whittier California explains the procedure and tells us what he is looking for during a colonoscopy. So when a patient is scheduled for a colonoscopy, the first part of the process is the preparation and possibly the most important. The patient is asked to stay on clear liquids for about 24 hours before the procedure, then the evening before the procedure there’s a preparation that they drink, liquid that they take by mouth, which will cause them to go to the bathroom multiple times and help start the process of cleaning out the colon and then the morning before the procedure, there’s a second part of the prep that they drink, which will finish the cleansing process. Ideally, they should finish the preparation about four to five hours prior to the scheduled start of the colonoscopy and that really gives the best results. When patients come in to the hospital, to the endoscopy center, an IV is started in the arm and then once they’re in the room, medication is given. In most cases we use propofol, which works very well, it works very quickly. So patients are asleep throughout the procedure they don’t remember the procedure, they don’t feel the procedure, but the beauty is they wake up very quickly after the procedure and feel pretty normal. So usually we keep them about 30 minutes after the colonoscopy is completed, then they can go home and pretty much resume normal activities, except for we tell them not to drive or operate heavy machinery till the next day. Anybody over the age of 50, some people before the age of 50, should start screening if they have risk factors. So if there’s a family history of colon polyps, family history of colon cancer, previous inflammatory conditions of the colon, such as ulcerative colitis and Crohn’s disease, increases the risk. So in those high-risk individuals, we’d recommend starting in an earlier age, usually by age 40. Sometimes even earlier. So even when cancer is present, studies show that if we find it in the earliest stages, we can cure ninety-five percent of the patients. Unfortunately, many times, people don’t go to the doctor until they have symptoms already and very often we find the cancers in more advanced stages and our treatments are not as effective. The reason that colonoscopy is so effective at preventing colon cancer is that virtually all colon cancers start out as polyps. Polyps are benign growths that start small. They grow slowly, but as they increase in size, they have the potential to turn into cancer. It takes between 5 and 15 years from when a polyp starts to grow to when it turns into cancer, so there’s a lot of time to interrupt that progression and not all polyps turn into cancer, but as I said, almost all cancers started out as polyps. So, removing the polyps removes the risk of cancer and that’s where the colonoscopy is such an effective tool. Many patients have the misunderstanding or misperception that number one, the test is painful and it isn’t, because they’re asleep for the entire procedure. Some people believe that if we find something, there’s nothing we can do anyway, and as we stated earlier, this is a very preventable cancer and even when cancer is present, if we find it early we can cure the vast majority of the individuals. So, it doesn’t really make sense to be afraid of having the test done. The last thing is that people find it embarrassing to think that they’re under going through that and what they have to realize is that the people in the room, the staff in the room, the doctors, they do this for a living, we do this every day. So patients just have to understand that they need to put their modesty aside and have the test done and if they won’t do it for themselves, they should do it for their loved ones. Remember, studies show there is no other form of cancer that’s as preventable or as treatable as colon cancer, but the key is screening and early detection. For the American Health Journal, I’m Laura Windsor.

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