Is it possible this was a more individualized recommendation tailored to your medical history? If so, it would be unfortunate to present it as a fact on a public forum.
Ima may have been concerned about
too many colonoscopies because of her thread 2 years ago. Anesthesia and outpatient facilities were responsible for much of the risk:www.healingwell.com/community/default.aspx?f=38&m=3116202
Bottom line: anesthesia is a big and rising risk factor due to more people having c-scopes and endo-scopes in outpatient locations.
from the article:
Mortality rates have been reported to be 0.3% to 1.4% for ASA 2, 1.8% to 5.4% for ASA 3, and 7.8% to 25.9% for ASA 4 (Wolters U et al. Br J Anaesth 1996;77:217-222). In a more recent study, Bishop et al reported that major injury and death occurred in the outpatient setting 36.1% and 30.6% of the time, respectively (JAMA 2011;305:2427-2431)
I do not know what the ASA scale refers to but essentially there is more mortality or complications for the patient the greater their disease is and anesthesia is the reason given.
The article is written by an anesthesia nurse who is concerned that there is a move to "robot assisted" anesthesia rather than a real person. But the mortality figures given are for professionally assisted anesthesiology.
Here's the link but you may need to register to read it. I get email news from gastroendonews.com about 2 times a month or less.
My take: go to a hospital not outpatient location if possible, lower mortality than outpatient settings. Don't use anesthesia if you do can do that (not sure that I can) especially with higher level of IBD involvement.
There's been some debate about whether a nurse (or a even a GI) should administer propofol at all. Many nurses would prefer that an anesthesiologist administer it. The dosage is tricky, and there is a fine line between enough and too much. Once too much has been administered, there is no reversal. Advanced measures must be taken to maintain an airway until the effects wear off. All these safeguards are limited at a basic outpatient center.
A lot of people think a puncture will be the end of the scope coming through the colon, like a needle through cloth. That's not the case. When the scope gets "stuck," it needs to be reduced (unkinked), and sometimes the pressure of the side of the scope puts too much pressure on the side of the colon, like a curve in a curve. Effectively and safely reducing the cope takes times.
At some outpatient centers, propofol is used to speed up the scope so that as many scopes as possible can be performed in a day. The more sedated a patient, the less feedback, and the more likely that reducing the scope will lead to a puncture.
The general population should seriously reconsider surveillance scopes after a certain age. Without any extra risk factors, sedation is more likely to cause death than colon cancer. There are safer methods of screening colon cancer and more on the way.
Therefore, at this time, most gastroenterology societies recommend that patients with at least 10 years of pancolonic ulcerative colitis undergo a surveillance colonoscopy every 1-3 years (depending on the society).
American Cancer Society says:
Inflammatory bowel disease
-Chronic ulcerative colitis
Cancer risk begins to be significant 8 years after the onset of pancolitis (involvement of entire large intestine), or 12-15 years after the onset of left-sided colitis
Colonoscopy every 1 to 2 years with biopsies for dysplasia
These people are best referred to a center with experience in the surveillance and management of inflammatory bowel disease.
Seems we have to walk a fine line between risks of colon cancer and anesthesia.
And those over 70 or obese walk an even finer line
Post Edited (Coffeemate) : 4/12/2016 5:47:01 PM (GMT-6)