Don't ignore your bowel

By Jillian Rosenstengel

I’m a gastroenterologist, it would be professionally embarrassing to be diagnosed with bowel cancer.  So I dutifully fronted up for my second colonoscopy recently, and I bought my sister along with me to support her through her first time.  She can’t quite reconcile that I work and socialise with the doctor who performs my colonoscopy, that I have the procedure performed at the endoscopy unit where I work each day, or that I return the favour every 3-5 years for several nurses, doctors and friends when they are due for their colonoscopy.  She feels the same way about my GP who is a good friend and doesn’t turn a hair when I turn up for my PAP smear. 

Here’s the thing, doctors and nurses think about this stuff differently to everyone else.  We aren’t looking at your bum, we don’t care if you fart and we aren’t even remotely interested in whether you have recently had a Brazilian.  We’re too busy to think about that stuff.  The anaesthetist is keeping you asleep and alive, the gastroenterologist is looking for abnormalities and the nurses are doing EVERYTHING else.  You are having a lovely sleep while we are working like mad so you wake up and ask when the colonoscopy will occur.

Embarrassment and fear are the biggest impediments to having a colonoscopy.  Colorectal cancer is one of the commonest and most treatable conditions affecting Australian women and it is entirely preventable with a simple test, a colonoscopy.

Who should have a colonoscopy?

Screening for colorectal cancer should begin at age 50 for asymptomatic women without a concerning family history of colorectal cancer.

Younger women with symptoms or a family history of colorectal cancer that places them at high risk should start having colonoscopies earlier.  The age at which an individual commences screening depends on their personal and family history.

What happens at colonoscopy?

Most people have twilight sedation for a colonoscopy.  This means you are deeply asleep, breathing for yourself and not in any discomfort.  The gastroenterologist will carefully look for any abnormalities in the colon.  If there are polyps, they will be removed.  If there are cancers or other abnormalities, biopsies will be taken to confirm the underlying pathology.

What can go wrong?

There is always risk with sedation and procedures.  In general, the risk is higher in people with other medical problems.  Healthy women tolerate the entire procedure without problems.  There are some specific issues related to colonoscopy and polyp removal; the risk of bleeding is 1:1,000 and perforation or a hole in the bowel 1:10,000.  Additionally, it is not a perfect test and there is a small chance that a polyp or cancer could be missed.

Talk to your GP about what is best for you but don’t ignore your bowel.  Remember, the thing that will make us remember you is not the tattoo on your right buttock, it’s whether you did your bowel preparation properly.

More information for consumers is available at the GESA website – www.gesa.org.au

Dr Jillian Rosenstengel works as a gastroenterologist in private practice in Brisbane.