HealthThe Stethoscope


It started the day before! 

The letter appeared in the post inviting me for a bowel screening program at the hospital. This is for anyone over the age of 45 years. Okay, don’t remind me! I certainly do not feel a day older than 21. However, feeling good about yourself can lull you into a state of illusion and carelessness. You see, regardless of how old you feel, the biological clock is ticking…relentlessly!

Age and baggage

Old age comes with its own issues of degenerative disease like arthritis and of course, the increased risk of cancer. For men, it is prostate cancer and for women, breast and cervical cancers. Whether you are male or female, you increase your chance of lung cancer if you smoke or are around people that smoke.

Both men and women are also prone to developing bowel cancer, which is what the letter was all about. The age requirement for the screening is even lower for patients with a personal or family history of colon cancer or inflammatory bowel disease.
Anyway, to the story.

It all started the day before when the letter came in the post along with an enema. The enema is a drug that makes you go to the toilet and clear out your bowels. This leads to a clean bowel so the doctors can see what they are doing.

The letter was an invitation to come to the hospital for a flexible sigmoidoscopy. A flexible sigmoidoscopy is a test performed by inserting a long camera (a bendable: flexible endoscope) into the anus and into the bowels to see the walls of the bowel. It is used to look for anything such as growths (polyps) and cancer.

A flexible sigmoidoscopy allows the doctors to check every inch of the left side of the bowel for early signs of cancer or things that can develop into cancer. This is vitally important to nip any problems in the bud. Studies have shown that polyps may develop into cancer if left in place.

The signs
The signs and symptoms of colon cancer are not always obvious, which makes colon cancer screening important. Somethings may point to colon cancer such as weight loss, rectal bleeding associated with changes in bowel habits, bloating, nausea and vomiting that may indicate a blockage of the colon.

Anyone can have the test especially those who notice the following problems which can all be early signs of bowel cancer:
1: Blood in the stool
2: Weight loss
3: A change in bowel habits

Prevention is great
Cancer is on the increase in many countries including Nigeria. It is perhaps more pertinent in Nigeria because of the poor state of our healthcare and our low fiber diet. Some studies have shown that excessive consumption of red meat as well as decreased intake of fruits and vegetables may increase your chance of colon cancer. Needless to say, preventing cancer is critically important in Nigeria! It improves the chances of a permanent cure of this much-dreaded cancer.

Okay, first things first!
I stopped eating solid food, drank lots of juice, water and used the enema to great assurance of a clean house. It worked and I was as clean as a whistle: an empty barrel. The hospital was great and the nurses were really nice. They made me feel welcome and happy to participate in such a shitty business. Of course, it’s for my own good but you know what I mean!
We went through explanations about the procedure and especially the benefits and risks involved. It is important to ensure you are not taking any medications that can complicate things, so drugs such as blood thinners are out (Warfarin, Clopidogrel and Xarelto, to name a few).
No sedation was necessary as this is a painless procedure. There is some degree of discomfort though as they need to pump some air into your bowel to be able to see things properly. It also makes you feel like popping back to the loo!

Anyway, the doctor inserted the endoscope into my anus and had a good look around. He was showing all on the video monitor and taking pictures for documentation. Turns out the procedure was normal and I had no problems of concern. Not yet anyway!

This test is important and I would like you to give it serious consideration. It is safe and usually done without any complications. This does not mean that shit cannot happen. It can and the risks are as follows:
There is a risk of serious bleeding especially after removing a polyp (1 in 3000), a risk of missing something serious (1 in 1000) and a risk of making a hole (perforation) in the bowel (1 in 40, 000). In the case of bleeding or perforation, blood transfusion and further surgery may be required to solve the problem.

It went well
The test went well and we got great pictures of my insides. You can see some of the images here. This test should be repeated every five years till the age of 75 years. Can’t wait!
Even better is getting a colonoscopy. This is like getting a flexible sigmoidoscopy but the doctor does not only look at the left side of your colon. They also look at the middle part called the transverse colon and the right side of your colon. The doctor may also be able to look at the part of your small intestine that attaches to your colon. This part of the small intestine is called the terminal ileum.

The risks and benefits of a colonoscopy are the same as a flexible sigmoidoscopy except the added benefit of looking at all aspects of the colon and that the test has to be repeated every 10 years if nothing abnormal is found until the age of 75 years.

Anyway, there you have it. Remember the above and share the information with friends and family.

This piece was contributed by Dr Biodun Ogunbo & Dr Iyore A-O James, MD/MALD

NB: More information can be found on the American Cancer Society Guideline for Colorectal Screening

Dr Biodun Ogungbo, MBBS, FRCS, FRCSEd, MSc, a Contributor to Newspackng, is a neurosurgeon with Brain and Surgery Consortium at 8 Buchanan Crescent, Off Aminu Kano Street, Wuse 2, Abuja.



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