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Colonoscopies becoming regular part of preventive health careNew technology makes procedure easier, more comfortableJust like blood pressure checks and mammograms, colonoscopies have become part of standard healthcare in America, according to Karl Papierniak, MD, a general surgeon at New Ulm Medical Center. Papierniak generally performs 25 to 27 colonoscopies a week and says there is no question about the advance in technology, and therefore an improvement in outcomes and patient comfort level. Endoscopy, which is the term that covers both EGD (Esophagogastroduodenscopy), a scope of the esophagus, stomach and intestines, and colonoscopy, a scope of the colon, was first developed in the 1960s. It gained momentum in the 1970s. When Papierniak came to New Ulm in 1984, Sioux Valley Hospital (now New Ulm Medical Center) purchased two colonoscopes and two EGD scopes. Fiber optics have improved, images have improved and the scopes themselves have improved over the last few decades. Four years ago, NUMC purchased three video colonoscopes and two video EGD scopes. “We have a new generation of video scopes here,” Papierniak said. “What that does is give us a better chance of moving the scope more smoothly all the way around to the colon. 98 or 99 percent of the time, we get all the way around.” “Colonoscopy is a bigger procedure than a flex sig (a flexible sigmoidoscopy),” Papierniak said. A flex sig scopes only part of the colon. The colon is five feet long and a colonoscopy scopes the entire organ. “We were finding that if we don’t look at the whole colon, we were missing things.” Most flex sigs were also done without sedation and therefore usually uncomfortable. For the majority of colonoscopies sedation is used, Papierniak said. “Most patients wake up and say ‘when are you going to start?’” Patient Melissa Ellanson was awake for most of her colonoscopy and felt that the procedure itself was uneventful. “It felt a little crampy when they were going around the corners,” she said. “But, all in all I didn’t think it was too bad.” The primary reason for undergoing a colonoscopy is screening for colon cancer. After 50, it is recommended that, if there is no family history of colon cancer, a person should have a colonoscopy every ten years. If there is a family history of colon cancer or if a person is having symptoms, they should have the procedure done earlier. “The whole reason for the screening is like that old saying ‘a stitch in time saves nine,’” said Papierniak. “If we catch it early enough we can save a lot of trouble. I have 10 or 20 people in my practice who we caught the colon cancer so early they did not need surgery. We were able to remove the tumor during the colonoscopy.” The data showing the benefits of colonoscopy for colon cancer screening is so strong that several years ago Medicare and Insurance companies included coverage for screening colonoscopy. In addition to removing tumors or polyps, which can become cancerous, during the procedure, Papierniak can also perform biopsies of suspicious areas or sometimes stretch a narrow area of the colon, saving the patient from having to undergo surgery. Patients will often say that the preparation is the toughest part of the procedure, said Joni Nachreiner, LPN, who meets with patients before their procedure to provide education about the procedure itself. But, following the procedure, she often hears from those same patients surprise at how easy the bowel prep was, she said. “We really want people to understand the procedure,” Nachreiner said. The bowel preparation is an important part of the procedure. The patient’s medical history is reviewed, they are given all the information pertaining to the procedure, and they are given the laxative, “We make it very confidential because patients don’t have to go purchase anything at the drug store.” In addition, any questions or concerns that the patient may have are directed to Papierniak for review. “A colonoscopy examination is only as good as the bowel prep,” Papierniak said. Ellanson felt the bowel preparation was the most difficult part of the entire process, having to take laxatives and the resulting effect that has on the body. “But, I’m so glad I had it done. Had I not gone through this, I still wouldn’t know what is going on with my body,” she said. Nachreiner said she sees astonishment in patients every day. “People will say they’re relieved they’ve had the procedure done. They were amazed at how easy the prep was and they are so grateful to have it done and have the results.” Ellanson had a polyp and some ulcerated tissue biopsied. Supporting tests in addition to her colonoscopy ultimately revealed Crohn’s Disease. “I think it’s just miraculous how, from a scope, they can take pictures and do biopsies,” Ellanson said. Although she now has a diagnosis that will mean changes in her life, she is relieved to have been able to arrive at a diagnosis so she can get back on the path to good health, she said. Patients receive a preliminary report the day of the procedure telling them if they have polyps that have been removed, if they had anything that was biopsied, or if there were no abnormalities found. “That gives patients big peace of mind to get those results right away,” Nachreiner said. Giving patients and staff a more peaceful atmosphere are the two new endoscopy suites that were constructed as part of the recent renovation and expansion of the medical center’s Emergency Department. “When we were in the developmental stage of the building project, a team of us went to three different endoscopy suites around the state so we could incorporate the best design ideas into these new rooms,” Papierniak said. The new suites afford patients and staff much more room and the fact that the rooms are dedicated just to these procedures, the correct equipment is always where it needs to be when it is needed. “The bottom line is that the data has shown that proper screening for colon cancer with colonoscopy (and removing any pre-malignant polyps that are discovered) significantly decreases the chances of dying of colon cancer – in short – it’s worth it,” Papierniak said. |
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New Ulm Medical Center
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