...Running head: HOW IMPORTANT IS COLON PREPARATION FOR COLONOSCOPY? 1 How Important is Colon Preparation for Colonoscopy? Wendi McDonough Western Governor’s University HOW IMPORTANT IS COLON PREPARATION FOR COLONOSCOPY? 2 How Important is Colon Preparation for Colonoscopy? Gastroenterologists perform screening colonoscopy to exam the colon for precancerous polyps, with the intent of removing them before they have a chance to develop into colon cancer (Cohen, Kastenberg, Mount, & Safdi, 2009), (Lichtenstein, 2009), (Nguyen & Wieland, 2010). Physicians prescribe bowel preparations prior to colonoscopy to cleanse the colon of stool. Colonoscopy has a number of primary risks involved. These include complications from anesthesia, side effects from preparation, perforation, missing a lesion, and being unable to complete the exam (Hendry, Jenkins, & Diament, 2007). Complications that arise because of poor preparation include increased complexity of the exam, decreased detection of colonic lesions, and increased healthcare spending (Roberts-Thomson & Teo, 2009), (Athreya, Owen, Wong, Douglas, & Newstead, 2011), (Nguyen & Wieland, 2010). The most important function of the colon is to absorb sodium, water, and some fats from the food we eat (Adamcewicz, Bearelly, Porat & Friedenberg, 2011). Complications arise from colon cleansing for a number of reasons. The patient may experience a suboptimal exam with multiple possible complications from poor preparation. These include...
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...Enteritis which is also referred as Crohn’s disease. Crohn’s disease is an inflammatory bowel disease that can affect any area of the digestive tract from the mouth to the anus. Since there has not been any diagnosis made, the diagnosis that I would offer is to request lab tests and x rays to determine if the disease seems to appear in Barbara’s body. The types of test that I would run are barium x rays and other x rays for showing where and how severe Crohn's disease is. It’s helpful for finding any problems in parts of the small intestine that can't be easily viewed by other techniques. CT scans for usage of computer-aided X-ray techniques to produce more detailed images of the abdomen and pelvis than can be seen in traditional X-rays, colonoscopy or sigmoidoscopy to allow for to directly viewing the large intestine, which is the lower part of the digestive tract , and a video capsule endoscopy in which Barbara will swallow a small capsule or pill that holds a miniature video camera. As it travels through her small intestine, it sends images of the lining to a receiver in which she will wear a belt around her waist. The images are downloaded and reviewed at a computer. The images can provide detailed information about early, mild problems associated with Crohn's disease. When Crohn’s disease is diagnosed after the tests are completed being that there is no cure for Crohns disease, I have various ways to treat it such as prescribing medications, giving...
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...symptoms are more often caused by conditions other than colorectal cancer, such as infection, hemorrhoids, or inflammatory bowel disease. Still, if you have any of these problems, it's important to see your doctor right away so the cause can be found and treated, if needed. (“FITWAY,” 2013) Colorectal cancer would be diagnosed after having a colonoscopy that would hopefully reveal the cause of the bleeding, change in bowels, etc. If there is colon polyps the surgeons will remove the polyps during the procedure. If the polyps and/or mass are too big to remove during the colonoscopy the surgeons will schedule patient for an abdominal procedure to remove it. Men and women both can equally be affected by colorectal cancer as they increase in age. This type of cancer occurs more often in people age 50 and over but is not limited to these ages. . The U.S. Preventive Services Task Force recommends these screening test for ages 50 and over; annual high-sensitivity guaiac fecal occult blood test (gFOBT), or fecal immunochemical test (FIT/iFOBT); sigmoidoscopy every five years, with FOBT every three years; or colonoscopy every 10 years. Fecal Immunochemical Test (FIT) should be done once a year, if a...
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...type of appointment scheduled for a patient can predict patient absenteeism (Zeber, Pearson, & Smith, 2009). Zeber et al. found that colonoscopy appointments are the most commonly missed appointments (Zeber et al., 2009). Furthermore, previous missed appointments is one of the most significant predictors of no-show appointments (Dove & Schneider, 1981). Studies have also shown that patients’ various psychosocial diagnoses are indicators of missed appointments (Goldman et al., 1982). Patients diagnosed with at least one psychological diagnosis, including mood disorders, such as depression and bipolar disease, anxiety disorders, such as panic attacks and posttraumatic stress disorder, and thought disorders, such as schizophrenia and personality disorders, were more likely to miss appointments compared to patients without psychological diagnoses (Savageau et al., 2004). Finally, Perron et al. showed that patients with substance abuse disorders are more likely to miss appointments (Perron et al., 2010). In order to reduce no-show rates in a hospital gastrointestinal (GI) clinic this project analyzed potential indicators of missed appointments. Based on a conceptual model grouping various barriers that lead to missed appointments (Figure 1, Appendix A), patient level factors were the main focus. The patient-level factors analyzed are colonoscopy procedure, previous GI appointment absenteeism, mood disorder, personality disorder and other substance abuse disorder among patients...
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...involve many different screening methods or a combination of these methods. The effort to reach more patients for CRC-S is a group effort among all disciplines and education levels. Keywords: colon cancer, colorectal screening, patient participation, screening methods CRC-S Increasing By Various Methods In the United States, Colorectal cancer can be prevented by the detection and removal of adenomatous polyps. Whenever possible, providers should educate and discuss with their patients the various methods available. Background and Significance The U.S. Preventive Services Task Force (USPSTF) currently recommends screening for colorectal cancer using high-sensitivity fecal occult blood testing, flexible sigmoidoscopy or colonoscopy beginning at age 50 years and continuing until age 75 years, for both men and women (American Cancer Association [ACA], 2014). The recommended screening frequency improves the chance that CRC will be detected at an earlier age, when it is more likely to be cured by a single surgical procedure featuring less...
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...REASON PROCEDURE: Colonoscopy. INDICATIONS Surveillance colonoscopy. Personal history of colonic polyps. Previous colonoscopy greater than three years ago. DESCRIPTION OF PROCEDURE Timeout was called. Consent signed. Perianal exam normal. Rectal exam normal. Preparation was adequate. The forward-viewing colonoscope was advanced to the cecum necessitating change in body position as well as abdominal wall pressure. In the right colon residual stool was present. FINDINGS Cecum and ascending colon: In the proximal ascending colon, along the medial wall I was lucky to find what appears to be a 1-2 cm carcinoma. This appears to be infiltrating, therefore, only biopsies were taken. The lesion was not removed. The area also was tattooed...
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...Pt identified x3 (Name, DOB, Last 4 of SSN) Pt given biopsy results: 5 small colon polyps were removed completely, 3 were precancerous (tubular adenoma) which means they have the potential to develop cancer if not removed within 10-20 years. The other 2 were lymphoid aggregate which is completely benign and has no significant malignancy potential. Pt encouraged to repeat colonoscopy in 3 years due to the 3 precancerous polyps that were removed. All of pt’s questions/concerns were answered and addressed. Pt verbalized understanding of all discussed. The polyp that we removed during you colonoscopy was called a tubular adenoma, this is a pre-cancerous polyp that was completely removed and poses no further threat to you. It was not cancer. You are at risk for having more polyps like this, and the current guidelines recommend that you have a repeat colonoscopy in 5 years. Unable to reach pt. Left message for pt to call GI clinic at 915-742-2222 or 742-1741 IOT receive message. Pt identified x3 (Name, DOB, Last 4 of SSN) Pt notified Rx is ready for pickup. Reminded pt to have labs drawn this week. Pt verbalized understanding. No questions or concerns at this time. Pt identified x3 (Name, DOB, Last 4 of SSN) Pt informed of biopsy results. Most likely gastritis non-h.pylori, but with focal activity we are unable to rule out the h.pylori with these biopsies. Esophagitis is the most likely cause for your symptoms. Dr. Goldberg recommends you stop the Nexium for 2 weeks...
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...She was scheduled for colonoscopy the next day and orders were placed for NPO (nothing by mouth) after midnight and GoLytely (bowel cleanser) to be finished within three hours before midnight. As a third year medical student, I picked up this patient the morning of her colonoscopy. She was in mild distress after a difficult night. She had not been given a bed-side commode and was told to just get up to use the restroom despite her risk for falls; the patient had debilitating arthritis, needed a walker to ambulate, and was morbidly obese Given the difficulty in physical maneuvering, she decided not to complete all of her GoLytely. In addition, she spent the night NPO without IV fluid replacement and was feeling light-headed by morning. The patient expressed her difficulties to me that morning during my pre-rounds, stating in tears how poorly she was treated and how judged she felt because of her morbid obesity. She had no intention of returning to our medical center after her current visit. The Internal Medicine (IM) team – including the attending physician, residents, and medical students including myself – addressed the patient’s concerns during rounds by apologizing for the failures of her care and advising her to get a hold of the floor supervisor in order to reach her attending physician in times of need. This was not the end of her ordeal in the hospital setting. She was then transported to a neighboring hospital where she had her colonoscopy. I accompanied her to...
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...BSBMED301B: Assignment 1 What you have to do Using the learning resource provided answer the following questions: Question 1 Using your knowledge of word components, give the correct medical term for each of the definitions below. Definition Medical Term 1. rectal hernia Rectocele 2. excision of the stomach Gastrectomy 3. inflammation of the kidney Nephritis 4. enlargement of the liver Hepatomegaly 5. incision to remove a stone Lithotomy 6. fixation of the intestine Enteropexy 7. artificial opening in the colon Colostomy 8. incision into the abdomen Laparotomy 9. absence of one or both testes Anarchism 10. rupture of the uterus Hysterorrhexis 11. excision of the prostate gland Prostatectomy 12. visual examination of the vagina Colposcopy 13. surgical repair of a testicle Orchiopexy 14. discharge of milk Galactorrhea 15. difficult labour or delivery Dystocia 16. suture of the tongue Glossorrhaphy 17. surgical puncture of the abdomen Abdominocentesis 18. pus in the urine Pyuria 19. pertaining to above the kidney Suprarenal 20. narrowing of the urethra Urethral Stricture Question 2 Give the meaning of each of the abbreviations below. Abbreviation Medical Meaning 1. LUQ Left upper quadrant 2. GI Gastrointestinal 3. OGD Oesophago-gastro duedenoscopy 4. CVS Chorionic villus sampling 5. STD Sexually transmitted disease 6. IUD Intrauterine device 7. TURP Transurethral resection of the prostate 8. DRE Digital rectal...
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...Medical Bulletin VOL.14 NO.11 NOVEMBER 2009 Management of Peptic Ulcer Bleeding Dr. Carmen Ka-man NG MBBS, MRCP, FHKCP, FHKAM(Medicine) Associate Consultant, Department of Medicine and Geriatrics, Princess Margaret Hospital Dr. Carmen Ka-man NG This article has been selected by the Editorial Board of the Hong Kong Medical Diary for participants in the CME programme of the Medical Council of Hong Kong (MCHK) to complete the following self-assessment questions in order to be awarded one CME credit under the programme upon returning the completed answer sheet to the Federation Secretariat on or before 30 November 2009. Upper gastrointestinal bleeding (GIB) is defined as haemorrhage proximal to the ligament of Treitz. Peptic ulcer bleeding accounts for 60% of the cases.1 Despite advances in endoscopic treatment and pharmacotherapy, the mortality of upper GIB remains unchanged. In-hospital mortality was found to be 7.1% in 3220 patients admitted for bleeding peptic ulcers from 1993 to 2003 to a teaching hospital in Hong Kong.2 History taking and physical examination help to define the underlying cause. It should be followed by a detailed haemodynamic assessment. Resting tachycardia (pulse 100/min), hypotension (sBP 6 favours platelet aggregation, clot formation and inhibition of fibrinolysis.3 The effect of preemptive PPI before endoscopy was studied. Daneshmend had conducted a randomised study in 1147 unselected patients presenting with upper gastrointestinal bleeding...
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...People have always thought that there waste is something we don’t need. Research has shown that this fecal matter can help prevent many infections, including C. difficile. Newer technology is allowing people to take fecal transplant pills instead of having a colonoscopy. The pills are proving to be a better solution than a colonoscopy. Colonoscopies can slow down breathing and can also risk breathing in the fecal matter. It can also puncture an intestinal wall. Taking a pill would also be easier than having a feeding tube shoved down your throat and then having fecal matter propelled down your throat. Around 70-90% of people that had a colonoscopy did not experience further infections. The other 10-30% of the people did have more infections...
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...Describe your evaluation question There are many barriers that prevent patients from undergoing a colonoscopy. Barriers may include the process to empty the bowel, the patient is oblivious to the significance of the screening or feeling exposed and defenseless especially in women patients (McLachlan, Clements, & Austoker, 2012). Patients are extremely uncomfortable about this procedure. Is there an alternative to conducting the traditional Optical Colonoscopy? Also, how likely is it that the alternative (Visual Colonoscopy) procedure will be reimbursed? FINER Criteria Feasible: This study is feasible because patients can fill out a questionnaire form using the Likert scale to determine if they prefer to undergo a Virtual Colonoscopy versus the conventional Optical Colonoscopy....
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...data about what to eat before a colonoscopy, however, there isn't as much data on what to eat after a colonoscopy. A colonoscopy is a kind of colon test that distinguishes polyps or lesions in the colon and rectum. Amid the test, an adaptable tube with a camera appended to it is entered into the butt and moved till the end of the large intestines. In case that polyps are found or a biopsy is required, the specialist can remove the polyp or cut off bits of tissue utilizing tools. You can feel drowsy after the colonoscopy process because of the abiding impacts of the sedating medicine. You haven't eaten solid meals for over 12 hours or more, so you will probably have a hunger. You'll be cheerful to comprehend that you can continue eating usually quickly after your test. After the process, your bowels will be void, so the patient can eat the same day. In any...
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...different ways to diagnose colorectal cancer is by get a fecal occult blood test (FOBT), Sigmoidoscopy, and Colonoscopy. “If your doctor learns that you do have colorectal cancer, more test will done to see if the cancer has spread. This is called staging” (Colon Cancer: MedlinePlus Medical Encyclopedia). In this case, a PET scan can to use to see where the cancer had spread to. When get treatment for colorectal cancer, it usually depends of the stage of cancer you might have. The common treatment for a patient that has colorectal cancer is surgery, chemotherapy, and radiation. The first way that a person can possible be diagnose for some type of colon cancer is by a fecal occult blood test, also known as FOBT. “A fecal occult blood test (FOBT) is a non-invasive way to screen blood in your stools, which can be a symptom of colon cancer” (Dixon). For this test you can get a kit from your doctor. During this test you will have to collect three different samples of your stools and then send it to a laboratory to be tested for blood. Before you do a test like this, you should avoid red meats and medications like ibuprofen because these things could cause the test show a false positive. This test is usually done once a year. If the test where to come back positive, than you would need to follow-up with your doctor and he would tell you needed to get a Sigmoidoscopy or Colonoscopy done. The next test after a FOBT would most likely be a...
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...Today I shadowed a CRNA. I was very excited after they put me with a nurse anesthetist. We observed more colonoscopies. Just like most procedures, a colonoscopy requires anesthesia (MT1). Typically, it's performed with a drug called propofol. Propofol allows the pt to be fully sedated but wake up faster. Anytime anesthesia is needed it must be administered and monitored by an anesthesiologist. Sometimes the anesthesiologist has to administer special medications to fit the pt’s needs. Each time the CRNA grabbed a medication they had to go through a passcode. All the medication in the room was locked.(S) The first pt was in for a routine screening. The physician removed multiple polyps from the sigmoid colon. The polyps were placed in a solution...
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