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Cancer
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Colonoscopy is the diagnostic procedure of choice in patients with a clinical history suggestive of colon cancer. This procedure permits biopsy for pathologist confirmation of malignancy. Virtual colonoscopy uses CT to generate 2D and 3D images of the colon. This test may be good for people who cannot tolerate or are unwilling to have an endoscopic colonoscopy. A colonoscopy should be done every 10 years. However, if a patient has a family history, with a first-degree relative having had colon cancer before the age of 60, a colonoscopy should be done every 5 years starting at age 40 – or every 10 years. When a fecal occult blood test is positive, a colonoscopy is required. A colonoscopy is also required after a lesion is seen in an imaging study or during sigmoidoscopy. All lesions are completely removed and examined.
Gastrointestinal diseases and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Murtaza Arif, Anjana Sathyamurthy, Jessica Winn, Jamal A. Ibdah
There are limited data regarding the safety of endoscopic procedures during pregnancy. In those patients with un-diagnosed abdominal pain, diarrhea, or rectal bleeding in whom IBD is suspected, flexible sigmoidoscopy under either minimal or no sedation appears to be safe (70). Complete colonoscopy usually requires a greater degree of sedation and is avoided when possible, although it is safe with appropriate monitoring of vital signs and oxygenation. In the pregnant patient, all efforts should of course be made to avoid fetal exposure to radiation, and radiologic procedures are not recommended. However, in emergent situations (when bowel perforation, abscess, or toxic megacolon are being considered), radiologic examinations may be necessary; there is some evidence to suggest that a very low dose of irradiation may have no long-term harmful effects (71).
General Surgery
Published in Kelvin Yan, Surgical and Anaesthetic Instruments for OSCEs, 2021
This is a colonoscope (Figure 7.8). It is a fibre-optic, flexible, thin tube that is used for the examination of the entire colon. It has a light source, a light bundle, a proximal handle, an instrument channel, a water/air channel and, depending on the model, a camera at the distal end or a fibre-optic camera at the proximal end to visualise the colon. It is inserted into a patient’s colon, typically in the left lateral position, through the anal passage. It is capable of examining the entire large colon up to the caecum. Bowel preparation is needed before a colonoscopy.
Fecal calprotectin level in microscopic colitis: a systematic review and meta-analysis
Published in Baylor University Medical Center Proceedings, 2023
Busara Songtanin, Chanaka Kahathuduwa, Kenneth Nugent
MC can be difficult to differentiate from IBD and IBS-D in patients who initially present with chronic diarrhea. Colonoscopy with histologic tissue remains the gold standard and is used to distinguish CC from LC.21 However, colonoscopy has several possible disadvantages, such as bleeding, infection, adverse reactions from sedation, and perforation.22 In MC patients, the absence of neutrophils in colonic mucosa but the presence of neutrophils only in the lamina propria can affect the FCP levels.23 There are several benefits of FCP compared with colonoscopy. For example, it is a convenient tool that can be used at home or in outpatient clinics, is noninvasive, has no adverse side effects, and is inexpensive.24 Currently, the 2020 European guidelines on MC state that FCP is not useful to exclude or monitor MC due to low predictive value,25 and these guidelines note that FCP has been used to differentiate IBS from IBD since 2013.26
Improving the quality of bowel preparation by smartphone education platform prior to colonoscopy: a randomized trail
Published in Annals of Medicine, 2022
Kai Zhao, Ruonan Dong, Suhong Xia, Lina Feng, Wangdong Zhou, Mingyu Zhang, Yu Zhang, Dean Tian, Mei Liu, Jiazhi Liao
Colonoscopy is considered as an important tool of screening, diagnosis, and treatment of colorectal lesions, such as adenoma, polyp, and early cancer, which has shown great potential to reduce the burden of advanced colorectal cancer [1]. Colonoscopy requires adequate bowel preparation, which contributes to the improvement of the identification of colorectal neoplasia and the decrease of the risk of missing lesions and post-colonoscopy colorectal cancer. Failed bowel preparation, on the other hand, could result in a lower likelihood of colorectal adenoma, a longer colonoscopy procedure time, a shorter interval between examinations, and a higher risk of colonoscopy-related adverse events [2,3]. Unfortunately, up to 20–25% of colonoscopies are reported to have failed bowel preparation [4].
Association between Dietary Fiber Intake and Colorectal Adenoma
Published in Nutrition and Cancer, 2022
Hyojin Kim, Jiyoung Youn, Sun Young Yang, Ji Hyun Song, Young Sun Kim, Jung Eun Lee
One of the major strengths of this study is that participants were required to respond to the FFQ moments prior to the colonoscopy. Compared to case-control studies, following this procedure lowers the risk of potential recall bias. In addition, a thorough colonoscopy allowed for detection of polyps throughout the entire colon as well as being able to classify adenomas by location of incidence. However, there were also some limitations in the study. First, as a cross-sectional study, a causal relationship between intakes of fiber and colorectal adenoma cannot be determined. Second, the generalizability of the results from this study may be difficult because the participants were recruited solely from one hospital. However, the hospital where participants were recruited from provides service to patients from all over the country. Third, the inherent possibility of measurement error from taking dietary assessments may still be remaining. Lastly, despite having adjusted for possible confounding variables, such as BMI, smoking status, and alcohol intake, residual confounding might still be present.