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Gastroenterology (Expert Forum)
Should I have a colonoscopy prior to Bariatric Surgery
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Should I have a colonoscopy prior to Bariatric Surgery
by Muffincakes3, Sep 09, 2005 12:00AM
In October, I am scheduled for a Bariatric Surgery—Gastric Bypass.My question is: should I have a colonoscopy prior to the surgery?”Last May, during a visit with my PCP, I asked if the colonoscopy that would normally be scheduled for July 2006 should be performed prior to the Bariatric Surgery. He stated it was possible to have the colonoscopy after Bypass Surgery, and he was not sure if the procedure would be authorized.
For some reason, this is a great concern to me. Possibly, I am worrying or obsessing over this too much. Since the PCP visit, I have new information regarding my father's mother and information from the Bariatric Surgeon.The new information is:
1) In June, during a visit with my father’s older sister, my aunt said she had taken care of her mother prior to her death. My father’s mother, age, 51, had colon surgery, a colostomy and died four months later. Her diagnosis was adenocarcinoma of the colon with metastasis to multiple abdominal organs. This was new information to me. My young father knew his mother had cancer; however, he did not know or want to know the specifics.
2)The Bariatric Surgeon stated: “it would be better to “get the procedure out of the way” prior to the upcoming surgery. And “if anything was found, it could be taken care of during the surgery.” 3)The surgeon also discussed the ratio of children having more or less of their parent’scharacteristics. He stated studies indicate children tend to have more maternal characteristics then fraternal. This influences hereditary traits, illness, etc. My youngest brother (age 39), and I, the oldest child (age 57), are more like our father then any of the other 4 siblings—We were like 3 peas in a pod in relationship to body structure, personality, logical thought processes, character traits, etc. 4)After the surgery, and the major weight loss, it may be difficult to handle the procedure preparations. During support group meetings, post operative patients state their need to have a daily strict mealtime schedule with protein to avoid dizziness, headaches, and sudden tiredness. It seems that only drinking (sipping) clear liquids for 2-3 days, and sipping the gallon of preparation medication the day before the procedure may be a arduous task. Also, during the preparation-days of clear liquids, sweet and refined sugar liquids can not be used as source of energy due to the “Dumping Syndrome.” This is the infor in my chart. 5)The results of the June 2001 colonoscopy were “suboptimal” due to remaining stool in the large colon. The bowel preparation was followed as directed. However, the gastroenterologist. stated I had a longer large colon then the norm. (I assume having this history; the preparation process will need to be longer to ensure an empty colon).6)The gastroenterologist recommended the colonoscopy be repeated in 5 years (July 2006). I am hesitant to approach my Dr. again. Does this information provide rationale for an early colonscopy? thank you
For some reason, this is a great concern to me. Possibly, I am worrying or obsessing over this too much. Since the PCP visit, I have new information regarding my father's mother and information from the Bariatric Surgeon.The new information is:
1) In June, during a visit with my father’s older sister, my aunt said she had taken care of her mother prior to her death. My father’s mother, age, 51, had colon surgery, a colostomy and died four months later. Her diagnosis was adenocarcinoma of the colon with metastasis to multiple abdominal organs. This was new information to me. My young father knew his mother had cancer; however, he did not know or want to know the specifics.
2)The Bariatric Surgeon stated: “it would be better to “get the procedure out of the way” prior to the upcoming surgery. And “if anything was found, it could be taken care of during the surgery.” 3)The surgeon also discussed the ratio of children having more or less of their parent’scharacteristics. He stated studies indicate children tend to have more maternal characteristics then fraternal. This influences hereditary traits, illness, etc. My youngest brother (age 39), and I, the oldest child (age 57), are more like our father then any of the other 4 siblings—We were like 3 peas in a pod in relationship to body structure, personality, logical thought processes, character traits, etc. 4)After the surgery, and the major weight loss, it may be difficult to handle the procedure preparations. During support group meetings, post operative patients state their need to have a daily strict mealtime schedule with protein to avoid dizziness, headaches, and sudden tiredness. It seems that only drinking (sipping) clear liquids for 2-3 days, and sipping the gallon of preparation medication the day before the procedure may be a arduous task. Also, during the preparation-days of clear liquids, sweet and refined sugar liquids can not be used as source of energy due to the “Dumping Syndrome.” This is the infor in my chart. 5)The results of the June 2001 colonoscopy were “suboptimal” due to remaining stool in the large colon. The bowel preparation was followed as directed. However, the gastroenterologist. stated I had a longer large colon then the norm. (I assume having this history; the preparation process will need to be longer to ensure an empty colon).6)The gastroenterologist recommended the colonoscopy be repeated in 5 years (July 2006). I am hesitant to approach my Dr. again. Does this information provide rationale for an early colonscopy? thank you
Doctor's Answer
by Kevin Pho, MD, Sep 09, 2005 12:00AM
, Sep 09, 2005 12:00AM
There are no strict guidelines regarding the time of a colonoscopy in relation to the upcoming bariatric surgery. The decision of whether to do it before and after will be dependent on your individual situation, and can be discussed with your personal physician.
As you know, a colonoscopy is a day procedure, and should not have an effect on the upcoming surgery. You are correct that the post-op course of bariatric surgery may be daunting, and may put off the colonoscopy.
That being said, it is difficult to make a concrete recommendation - there will be doctors who will do it either way. There are pros and cons to each side - and should be discussed with your personal physician or surgeon.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
As you know, a colonoscopy is a day procedure, and should not have an effect on the upcoming surgery. You are correct that the post-op course of bariatric surgery may be daunting, and may put off the colonoscopy.
That being said, it is difficult to make a concrete recommendation - there will be doctors who will do it either way. There are pros and cons to each side - and should be discussed with your personal physician or surgeon.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
I have several close relatives with colon cancer, and have had probably 4 colonoscopies by the time I was 50. The prep is the worst part, and I have a normally functioning gastric system. I can't imagine it once your surgery is complete.
Get it done and over, and you won't have to worry for another 5-10 years, depending on what they find and your doctors recommendations. By then you'll be well healed from your surgery and will have adjusted to your stomach capacity issues.