A refresher on colon health

Fewer than half of Canadians are up-to-date on their colon cancer screening.This is a disheartening statistic considering that nine out of 10 colon cancers can be cured if they’re caught early. Colon cancer screening starts at age 50 for people at average risk but this may be reevaluated given the rapid rise in colon cancers in younger patients.If you’re in the business of colon cancer screening, you know that the FIT test for average risk people is incredibly simple. Patients can see their primary care provider or call 811 to have a FIT test kit mailed to their home. The kit includes a cardboard poop collector to put in the toilet bowl and a collection wand to scoop a little sample of poop and mail it off to the lab. Tell your patients not to freak out if the FIT result screens positive. A whopping 96% of people with abnormal FIT results do not have cancer. About 10% of people will screen positive and those folks will be booked for a colonoscopy to look for cancer or precancerous polyps in the bowel. The most important thing about the FIT test is that it must be repeated every two years until age 74. The false negative rate is significant, and 7% of people with cancer had a normal FIT result before their diagnosis. It’s important to flag patients to encourage them to do their two-year follow-up tests. FIT tests only work if you actually do them. What about people under 50 who are worried about cancer? If they have any rectal bleeding, new onset diarrhea that lasts more than two weeks, fewer than three bowel movements per week, black stools or pencil-thin poops it is reasonable to refer for colonoscopy regardless of age. A parent or sibling with colon cancer changes the risk category and colonoscopy is recommended to start at age 50 or 10 years earlier than the age of the relative’s diagnosis, whichever is younger. Many of us will need a colonoscopy at some point in our lives. Emptying your bowels for optimal visualization during colonoscopy is a messy and uncomfortable business, but I have crowd-sourced some techniques to make it more tolerable.Book your scope for the afternoon so you're not on the toilet all night doing your prep. Ask for the cranberry flavoured Pico Salax prep (not PEG). Request a prescription for Zofran to take in case you experience nausea. While you’re at the pharmacy, pick up diaper cream with 40% zinc like zincofax plus to protect your bum. Make sure you’ve got a heating pad or barley bag at home to help with cramping. Avoid using ibuprofen or naproxen, but Tylenol is OK.The day before your procedure you can have a light breakfast and lunch but no dinner. You can eat white bread, rice, pasta, mashed potatoes, cheese, eggs, lean meat, peanut butter, yogurt, cake and cookies. Avoid salads, nuts and veggies. Drink lots of clear fluids. White wine is ok! 🥂Start with half your prep at 5 p.m. the day before, then take the other half of the prep five to six hours before your appointment. Stay close to a toilet.Mix three sachets of cranberry Pico Salax with cold white cranberry juice. Chill for an hour, remix and drink FAST through a straw. Having a white or yellow Lifesaver in your mouth while drinking the liquid through a straw helps.Chase it with clear Gatorade or salty chicken broth. The more clear fluid you drink the better you will feel. You can drink coffee, tea and coke. Order pho and just drink the broth. Try ginger beer, lychee juice and club soda, G zero glacier Cherry, white cranberry mixed with peach Bubly, pineapple coconut juice mixed with pineapple Bubly and mint tea. You can eat gummy bears, popsicles and jello while prepping for a colonoscopy! BUT ABSOLUTELY NO RED OR PURPLE LIQUIDS OR FOODS. Orange, yellow and green are OK.Stop drinking all fluids two hours before your test. Congrats! You have completed your bowel prep. A colonoscopy may not be pleasant, but it can save your life.

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A refresher on colon health

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Kim Alexander

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