Are you looking forward to getting your next colonoscopy? Isn't it amazing how quickly those five to ten years between procedures can pass? If you're like many Americans, you may be trying to stretch the time between screenings just a little bit longer. And you'll probably be even more inclined to do so once I share the latest news with you. It turns out, having a colonoscopy can increase your risk of having surgery shortly after the procedure is complete - and the surgery won't be on your colon.
A doctor and researcher at the University of North Dakota, Dr. Marc Basson, has picked an unusual part of the body to focus his studies on: the appendix. And he noticed that several of his patients had an interesting complaint: after they'd undergone a colonoscopy (from a number of different doctors), they suffered from appendicitis, occasionally within just a few days of the screening. Dr. Basson wondered if this was just a strange coincidence or if there was a true correlation. So he gathered a research team to find out.
For a study ultimately published in the journal JAMA Surgery, the researchers analyzed data gathered from nearly 400,000 veterans who had undergone colonoscopies between January 2009 and June 2014. Because the veterans' healthcare data was tracked through the Veterans Administration, the researchers were able to see how many of them experienced appendicitis shortly after their colonoscopies.
Sure enough, rates of appendicitis and appendectomies went up fourfold in the first week following colonoscopies compared to the 51 weeks after that. And since different providers code procedures in various ways, the researchers believe the true increase could be as much as 12-fold. The researchers don't yet know why this connection exists, but it's clear that it does! It's possible that the bowel preparation process alters the bacteria in the colon in a way that causes the appendix to become inflamed or that the air pressure required for the procedure affects the appendix
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That's the bad news. However, there is some good news: you may not have to have a colonoscopy at all. Now, you do still need to be screened for colorectal cancer. When this cancer - the second-leading cause of cancer death in the US - is caught and treated early, the cure rate is 90%. But since colonoscopies are so unpleasant, many people put them off until it's too late.
Fortunately, there's a new way to screen for colorectal cancer markers. And it doesn't involve bowel prep or air pressure. In fact, you just have to do something you do every day anyway, so you won't increase your appendicitis risk either, no matter what causes that risk to increase with colonoscopies.
This screening process is called Cologuard. You can check the archives for more information, but it's a risk-free process in which you simply collect a stool sample at home and mail it to the lab. The latest tests have found that its detection rates of early cancers are just as good as those of colonoscopies.
There are a few exceptions. People with an elevated risk for colorectal cancer, such as those with IBS, Crohn's disease, or a history of colon cancer or polyps, unfortunately aren't good candidates for Cologuard. So they should go ahead and get colonoscopies on their doctors' recommended schedule. They should also be quick to report any lower-right abdominal pain they experience after the procedure, as early detection is important for appendicitis as well. However, if you don't have any elevated risk factors, talk to your doctor about using Cologuard instead.
Yours for better health,
Frank Shallenberger, MD