Latest news with #colonoscopy
LBCI
2 days ago
- Health
- LBCI
Netanyahu 'successfully underwent routine colonoscopy' Friday: PM office
The office of Israeli Prime Minister Benjamin Netanyahu said the 75-year-old premier "successfully underwent a routine colonoscopy" at a hospital in Jerusalem on Friday. "Prime Minister Benjamin Netanyahu successfully underwent a routine colonoscopy this morning at Shaare Zedek Medical Center in Jerusalem," a statement from his office said. It comes after the United States said Thursday that Israel had approved a new Gaza ceasefire proposal submitted to Hamas, but the Palestinian militant group said it failed to satisfy its demands. AFP
Health Line
4 days ago
- General
- Health Line
Your Guide to Dysplasia Caused by IBD
Colon dysplasia is typically detected and removed during routine colon cancer screenings. Inflammatory bowel disease (IBD) is a risk factor for developing dysplasia in the colon. Dysplasia doesn't cause any symptoms. Having dysplasia doesn't mean you'll develop cancer. Dysplasia simply means there are cells that have the potential to become cancerous. It's important to have them removed and to discuss what they mean with a doctor. How is colon dysplasia diagnosed? Doctors use several methods to diagnose colon dysplasia. Often, dysplasia is found during screening for colon cancer and colon polyps. Testing and screening methods include: Colonoscopy: A colonoscopy is a test that uses a tiny camera on a long and flexible tube to examine the inside of the colon and rectum. The tube is inserted carefully through the anus. Flexible sigmoidoscopy: For this test, a slender tube with a tiny camera attached to the end is passed through your anus and into the bottom third of your colon. Management of dysplasia in IBD Generally, the affected area will be removed during a colonoscopy or sigmoidoscopy. If there's only one area of low-grade dysplasia, you likely won't need any further treatment. However, you'll still need routine colonoscopies to make sure new areas of dysplasia don't develop. If there are several areas of dysplasia or high-grade dysplasia, your doctor might take additional steps. For example, you may need to have a procedure called a bowel resection to remove part of your colon. Dysplasia is precancerous. This means it's not yet cancer and can't spread or cause harm. It is considered a sign that cancer could develop in the future. It's important to have any dysplasia removed and to ask your doctor about the grade, number, and location of your dysplasia. It's a good idea to know what a dysplasia finding means for you and how it may affect your IBD treatment in the future. Your doctor might also want you to start having regular colonoscopies to monitor for additional dysplasia. The first colonoscopy after detection of dysplasia is done within 3-6 months. If no dysplasia is seen, your doctor may schedule a colonoscopy every 12 months for surveillance. The exact frequency will depend on how severe the dysplasia was and on any other risk factors for colon cancer you have. How serious is dysplasia in the colon? Dysplasia can be low grade or high grade. Neither type is cancer, but both types are precancerous. High grade is more abnormal. It looks more like cancer under a microscope. Dysplasia can be treated by removing it during a colonoscopy or sigmoidoscopy procedure. In many cases, this is all the treatment that's needed. Some people might need more complex surgery and regular follow-up screenings. People who have IBD and dysplasia will need to have more regular colonoscopies to help prevent colon cancer from developing. Experts recommend that people who have had IBD symptoms for at least 8 to 10 years get a routine colonoscopy every 6 to 12 months. Living with IBD If you have IBD and need support, there are some great resources at your fingertips. Check out the links below: Crohn's & Colitis Foundation: Browse the Crohn's & Colitis Foundation site to find online support groups, local meetups, community events, and more. On this website, you'll find a message board where you can connect with both healthcare professionals and other people with IBD. IBD Support Foundation: The IBD Support Foundation offers a wealth of resources, including an online support forum, community support groups, crisis support, and more. Hoag Virtual Support: Attend monthly virtual support meetings for people with IBD with Hoag Virtual Support Groups. Meetings are run by a clinical therapist or nurse practitioner. Color of Crohn's and Chronic Illness (COCCI): People of Color with IBD and other digestive conditions can find support and community with COCCI. Girls with Guts: Women of all ages with IBD can find resources, community, events, and more on the Girls With Guts site.
Health Line
22-05-2025
- Health
- Health Line
What to Know About a Combined Colonoscopy and Endoscopy
A combined colonoscopy and endoscopy lets a doctor examine your upper and lower gastrointestinal tract, all in one procedure. Doctors use a combined colonoscopy and endoscopy to help diagnose the cause of gastrointestinal symptoms that you might be experiencing, such as abdominal pain, persistent heartburn, or unusual bowel movements. Colonoscopies and endoscopies are typically safe procedures with a minimal risk of complications. Keep reading to learn when a combined colonoscopy and endoscopy might be used and what to expect before, during, and after the procedure. What is the goal of a combined colonoscopy and endoscopy? Doctors use a combined endoscopy and colonoscopy to examine the lining of your esophagus, stomach, upper small intestine, and large bowel. The procedure helps doctors investigate the cause of specific symptoms you may be experiencing. For example, an endoscopy can help determine the cause of: bleeding pain persistent heartburn nausea and vomiting difficulty swallowing unexplained weight loss A colonoscopy can help your doctor determine the cause of: abdominal pain or discomfort diarrhea changes in your bowel activity anal bleeding unexpected weight loss During a combined colonoscopy and endoscopy, doctors can identify many underlying conditions, including: internal inflammation or swelling blockages or structures that are obstructing your gastrointestinal tract celiac disease ulcers gastroesophageal reflux disease (GERD) cancer What's the procedure like for a combined colonoscopy and endoscopy? Before the procedure Your healthcare team will typically give you a printed handout with the steps you must follow before your procedure. This may include information about stopping specific medications, such as proton pump inhibitors (PPIs) or constipating agents, about a week before the combined procedure. The day before you undergo a combined endoscopy and colonoscopy, you may need to take an oral laxative (called a ' bowel prep ') to clear your bowels. This makes it easier for the doctors to see the lining of your intestines. In addition, you may not be allowed to eat or drink anything for 8 hours before the procedure. During the procedure After you arrive at the clinic or hospital, a member of the healthcare team will ask you to fill out an assessment form. Your doctor or a nurse will review your assessment form with you, and they may take your blood pressure and pulse. They may also ask you to change into a clinic-provided gown and shorts. You'll then meet the endoscopist before the procedure starts. You'll have the opportunity to discuss what will happen during the colonoscopy and endoscopy. You can also ask them any questions you may have. During the procedure, you'll be given a light sedative through a needle in your arm so you won't feel any discomfort. Your healthcare team will stay with you throughout the entire process. They will monitor your pulse, blood pressure, and oxygen levels to ensure your safety. During the endoscopy During the endoscopy, the doctor will pass an endoscope down your throat, through your esophagus, stomach, and duodenum. The endoscope has a tiny camera mounted on its structure, which allows your doctor to view the inside of your gastrointestinal tract. The endoscope can also blow air into your GI tract, making the area easier to assess. During the exam, your doctor may also collect a tissue sample for testing (biopsy), stop any bleeding that they find, or complete other procedures, such as removing an obstruction. During the colonoscopy After completing the endoscopy, your doctor will insert a colonoscope through your anus and rectum to check your large intestine. The colonoscope will blow air into your intestine, making it easier to see. Some types of colonoscopy use a stream of water instead of blowing air into the intestine, which may be a more comfortable option for a person undergoing the procedure. Once the coloscope reaches the opening of your small intestine, the doctor will start examining the large intestine again while retracting the coloscope. As with the endoscopy, your doctor has the option to remove polyps or other tissues that they may want to biopsy. After the procedure If you're having your procedure done at an outpatient clinic, it may take a couple of hours after the procedure before you can go home. This time allows the anesthesia to wear off. You may not be able to drive for 24 hours, so it's a good idea to arrange for someone to drive you to and from the clinic. The entire procedure can last 5 to 90 minutes. An endoscopy usually lasts 15 to 30 minutes, while a colonoscopy may last 0 to 60 minutes. What's the recovery like for a combined colonoscopy and endoscopy? After a combined colonoscopy and endoscopy, you may experience symptoms including: a light blood discharge from your rectum if the doctor removed polyps during the examination abdominal pain caused by the air pumped in during the procedure nausea for a couple of hours after the end of the exam sore throat for a couple of days after the test After the combined colonoscopy and endoscopy, your doctor may give you the result of your test. However, a biopsy result may take a few days to get. What are the potential risks or side effects of a combined colonoscopy and endoscopy? The potential risks and side effects of a combined colonoscopy and endoscopy are rare but can include: abdominal pain bleeding perforation reaction to sedatives causing heart or breathing problems You should seek medical care if you experience any of the following symptoms after you have attended a combined colonoscopy and endoscopy: bloody vomit throat pain or difficulty swallowing bloody diarrhea or bowel movements blood discharge from your rectum that does not get better severe abdominal pain that gets worse chest pain dizziness or weakness How much does a combined colonoscopy and endoscopy cost? The average cost for a combined colonoscopy and endoscopy in the United States varies by state, city, and clinic. According to MDsave, costs range from $2,346 to $10,221, depending on where you have the procedure done. Generally, it's less expensive to undergo a combined colonoscopy and endoscopy on the same day during the same procedure rather than booking two different sessions. In most cases, a combined colonoscopy and endoscopy would be covered by medical insurance policies when recommended by a doctor. Contact your insurance company if you're unsure. Takeaway A combined colonoscopy and endoscopy can help doctors diagnose the cause of symptoms you might be experiencing, such as abdominal pain, persistent heartburn, or atypical bowel movements. The procedure allows doctors to examine the interior of your gastrointestinal tract. The risks of a combined colonoscopy are rare but can include perforation or internal bleeding. However, your healthcare team will constantly monitor you during the procedure to ensure your safety and to make you as comfortable as possible.
Medscape
14-05-2025
- Health
- Medscape
Post-Polypectomy Colorectal Cancers Common Before Follow-Up
SAN DIEGO — The majority of colorectal cancers (CRCs) that emerge following a negative colonoscopy and polypectomy occur prior to recommended surveillance exams, and those cases are more likely to be at an advanced stage, according to new research. Of key factors linked to a higher risk for such cases, one stands out — the quality of the baseline colonoscopy procedure. 'A lot of the neoplasia that we see after polypectomy was probably either missed or incompletely resected at baseline,' said Samir Gupta, MD, a professor of medicine in the Division of Gastroenterology, UC San Diego Health, La Jolla, California, in discussing the topic at Digestive Diseases Week (DDW) 2025. 'Therefore, what is key to emphasize is that [colonoscopy] quality is probably the most important factor in post-polypectomy risk,' he said. 'But, advantageously, it's also the most modifiable factor.' Research shows that the risk for CRC incidence following a colonoscopy ranges from just about 3.4 to 5 cases per 10,000 person-years when baseline findings show no adenoma or a low risk; however, higher rates ranging from 13.8 to 20.9 cases per 10,000 person-years are observed for high-risk adenomas or serrated polyps, Gupta reported. 'Compared with those who have normal colonoscopy, the risk [for CRC] with high-risk adenomas is increased by nearly threefold,' Gupta said. In a recent study of US veterans who underwent a colonoscopy with polypectomy between 1999 and 2016 that was labeled negative for cancer, Gupta and his colleagues found that over a median follow-up of 3.9 years, as many as 55% of 396 CRCs that occurred post-polypectomy were detected prior to the recommended surveillance colonoscopy. The study also showed that 40% of post-polypectomy CRC deaths occurred prior to the recommended surveillance exam over a median follow-up of 4.2 years. Cancers detected prior to the recommended surveillance exam were more likely to be diagnosed as stage IV compared with those diagnosed later (16% prior to recommended surveillance vs 2.1% and 8.3% during and after, respectively; P = .003). Importantly, the most prominent reason for the cancers emerging in the interval before follow-up surveillance was missed lesions during the baseline colonoscopy (60%), Gupta said. Colonoscopist Skill and Benchmarks A larger study of 173,288 colonoscopies further underscores colonoscopist skill as a key factor in post-polypectomy CRC, showing that colonoscopists with low vs high performance quality — defined as an adenoma detection rate (ADR) of either < 20% vs ≥ 20% — had higher 10-year cumulative rates of CRC incidence among patients following a negative colonoscopy ( P < .001). Likewise, in another analysis of low-risk vs high-risk polyps, a higher colonoscopist performance status was significantly associated with lower rates of CRCs ( P < .001). 'Higher colonoscopist performance was associated with a lower cumulative colorectal cancer risk within each [polyp risk] group, such that the cumulative risk after high-risk adenoma removal by a higher performing colonoscopist is similar to that in patients who had a low-risk adenoma removed by a lower performer,' Gupta explained. 'So, this has nothing to do with the type of polyp that was removed — it really has to do with the quality of the colonoscopist,' he said. The American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy Quality Task Force recently updated recommended benchmarks for colonoscopists for detecting polyps, said Aasma Shaukat, MD, director of GI Outcomes Research at NYU Grossman School of Medicine, New York City, in further discussing the issue in the session. They recommend an ADR of 35% overall, with the recommended benchmark being ≥ 40% for men aged 45 years or older and ≥ 30% for women aged 45 years or older, with a rate of 50% for patients aged 45 years or older with an abnormal stool test, Shaukat explained. And 'these are minimum benchmarks,' she said. 'Multiple studies suggest that, in fact, the reported rates are much higher.' Among key strategies for detecting elusive adenomas is the need to slow down withdrawal time during the colonoscopy in order to take as close a look as possible, Shaukat emphasized. She noted research that her team has published showing that physicians' shorter withdrawal times were in fact inversely associated with an increased risk for cancers occurring prior to the recommended surveillance ( P < .0001). 'Multiple studies have shown it isn't just the time but the technique with withdrawal,' she added, underscoring the need to flatten as much of the mucosa and folds as possible during the withdrawal. 'It's important to perfect our technique.' Sessile serrated lesions, with often subtle and indistinct borders, can be among the most difficult polyps to remove, Shaukat noted. Studies have shown that as many as 31% of sessile serrated lesions are incompletely resected, compared with about 7% of tubular adenomas. Patient Compliance Can't Be Counted On In addition to physician-related factors, patients themselves can also play a role in post-polypectomy cancer risk — specifically in not complying with surveillance recommendations, with reasons ranging from cost to the invasiveness and burden of undergoing a surveillance colonoscopy. 'Colonoscopies are expensive, and participation is suboptimal,' Gupta said. One study of high-risk patients with adenoma shows that only 64% received surveillance, and many who did receive surveillance received it late, he noted. This underscores the need for better prevention as well as follow-up strategies, he added. Recommendations for surveillance exams from the World Endoscopy Organization range from every 3 to 10 years for patients with polyps, depending on the number, size, and type of polyps, to every 10 years for those with normal colonoscopies and no polyps. A key potential solution to improve patient monitoring within those periods is the use of fecal immunochemical tests (FITs), which are noninvasive, substantially less burdensome alternatives to colonoscopies, which check for blood in the stool, Gupta said. While the tests can't replace the gold standard of colonoscopies, the tests nevertheless can play an important role in monitoring patients, he said. Evidence supporting their benefits includes a recent important study of 2226 patients who underwent either post-polypectomy colonoscopy, FIT (either with FOB Gold or OC-Sensor), or FIT-fecal DNA (Cologuard) test, he noted. The results showed that the OC-Sensor FIT had a 71% sensitivity, and FIT-fecal DNA had a sensitivity of 86% in the detection of CRC. Importantly, the study found that a positive FIT result prior to the recommended surveillance colonoscopy reduced the time-to-diagnosis for CRC and advanced adenoma by a median of 30 and 20 months, respectively. FIT Tests Potentially a 'Major Advantage' 'The predictive models and these noninvasive tests are likely better than current guidelines for predicting who has metachronous advanced neoplasia or colon cancer,' Gupta said. 'For this reason, I really think that these alternatives have a potentially major advantage in reducing colonoscopy burdens. These alternatives are worthwhile of studying, and we really do need to consider them,' he said. More broadly, the collective evidence points to factors that can and should be addressed with a proactive diligence, Gupta noted. 'We need to be able to shift from using guidelines that are just based on the number, size, and histology of polyps to a scenario where we're doing very high-quality colonoscopies with excellent ADR rates and complete polyp excision,' Gupta said. Furthermore, 'the use of tools for more precise risk stratification could result in a big, low-risk group that could just require 10-year colonoscopy surveillance or maybe even periodic noninvasive surveillance, and a much smaller high-risk group that we could really focus our attention on, doing surveillance colonoscopy every 3-5 years or maybe even intense noninvasive surveillance.'
