Gut feeling: colonoscopies are a marvel of modern medicine

About 10 years ago, suffering from some stomach troubles, my family doctor recommended that I do a colonoscopy. I was barely 40 years old, and just the thought


Not even ‘pixelated’ — my ‘gut feeling’ is that these images showing my healthy colon are pretty high resolution images.

of having someone explore my inner workings, by shoving a small camera affixed to a flexible rod — well, you get the picture — made me lose my appetite for a month. When I asked the doctor, whose overall bedside manner (not to mention qualifications for dealing with a mild hypochondriac) was brash at best, “what if the colonoscopy doesn’t find anything,” his answer was: “Then we’ll go in from the other direction and do an endoscopy.”

I ‘freaked out,’ and decided that this doctor was not a good fit for me. When a few months later I read an article in the local Jewish rag about this doctor being part of a team that visited archaeological sites in Israel that used medical endoscopic tools, I realized that I had been dealing with an endoscopy-obsessed physician, and lauded myself for running away from him. Let him use his tools on the archaeological digs — not on me!

Well, for the past ~10 years, I have been dreading the 50 y tune-up. Dreading, fearing, and wondering if I should pass. It’s easy to find pseudo-science to “support” not doing the procedure: Many claim that it’s invasive, and can do more harm than good. After all, some people end up bleeding from a punctured colon. I assume that many of these who oppose this test for screening purposes probably also deny the importance of vaccinations.

Over the years, I have followed the development of the “PillCam Colon,” a pill that carries a miniature camera that will traverse the digestive tract when swallowed and obtain photos of the colon before being excreted (and recovered). But most insurance plans do not yet cover this type of (expensive) procedure, and it is still deemed a weak alternative of the colonoscopy. An additional problem is that during many colonoscopies, small (or larger) polyps are discovered. These are considered to be potential precursors of tumors, and their removal (and pathology testing) is an essential part of the colonoscopy process.

So, I sucked it in and acquiesced to a regular colonoscopy.

Everyone I talked to told me that the procedure itself was ‘nothing,’ that one doesn’t feel a thing, and that it’s easy and no big deal. But it scared the hell out of me. On the other hand, my friends and colleagues all lamented on the horrible “prep” — the need to drink buckets of the laxative to cleanse the colon, and the cleansing itself. That, for some reason, did not scare me.

Well. I was wrong, and they were right. The prep was AWFUL. The same polyethylene glycol that I used years ago to make liposomes was the main laxative in the dense, disgusting-tasting prep. There was about a gallon of “Nu-Lytely” that had to be drunk, in two sittings: from 5-9 pm, and from 2-4 am before the morning of the procedure. Nauseating stuff. I wasn’t sure I could actually do it. But, I did not want to go through the fasting and be forced to eat green ‘Jello’ and clear broth on another day.

On the other hand, the procedure was a piece of cake. They hooked me up to an iv. Put a warm, heated blanket on me until the doctor was ready. They asked me to lie on my side, and the next thing I knew I was waking up after a nice nap. With a clean colon (see images above) and 10 years until the next one!

I did have a tiny 2 mm polyp removed, but the lab found it to be benign.

All in all, I think modern medicine can chalk up a victory (this coming from a hypochondriac), and I hope everyone who can will take advantage of this opportunity for screening.

About Steve Caplan

I am a Professor of Biochemistry and Molecular Biology at the University of Nebraska Medical Center in Omaha, Nebraska where I mentor a group of students, postdoctoral fellows and researchers working on endocytic protein trafficking. My first lablit novel, "Matter Over Mind," is about a biomedical researcher seeking tenure and struggling to overcome the consequences of growing up with a parent suffering from bipolar disorder. Lablit novel #2, "Welcome Home, Sir," published by Anaphora Literary Press, deals with a hypochondriac principal investigator whose service in the army and post-traumatic stress disorder actually prepare him well for academic, but not personal success. Novel #3, "A Degree of Betrayal," is an academic murder mystery. "Saving One" is my most recent novel set at the National Institutes of Health. Now IN PRESS: Today's Curiosity is Tomorrow's Cure: The Case for Basic Biomedical Research (CRC PRESS, 2021). All views expressed are my own, of course--after all, I hate advertising.
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2 Responses to Gut feeling: colonoscopies are a marvel of modern medicine

  1. Thanks for the insight, Steve. I’m teed up for this surveillance regimen, having one relative with Crohn’s Disease and another who had a bout with colon cancer. Have yet to have my first but it’s coming soon (I am a couple of years younger than you, but not much!).

    • Steve Caplan says:

      Well, if you didn’t get IBD or Krohn’s by our age — okay, well even your age — I think you’re out of the woods. It’s a young person’s disease. As or colon cancer, yes, definitely do the scope. I was embarrassed afterward at how frightened I had been. As for the prep: just grin and bear it. Or at least try…

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