Endoscopy
Screening endoscopy is performed for several reasons, primarily to rule out cancer. If the patient has a diagnosis of heartburn, screening for Barrett esophagus may be indicated as a precursor for early cancer. Cancer of the esophagus is on the rise in our country and we believe this is primarily related to the increase in heartburn. Barrett's esophagus comes in four grades; none, mild, moderate and high-grade. The time-frame for progression to high-grade (early cancer) is unknown. Barrett's esophagus requires repeat endoscopy in one year and if stable, three years and five years respectfully. However, surgery for heartburn does seem to halt the progression. Use of antiacid medications is highly controversial in the literature regarding its effect on Barrett's esophagus.
Colon Cancer
Screening for colon cancer is recommended for men and women over age 50. This can be done with stool studies for blood every year and a flexible sigmoidoscopy every five years. If polyps or other problems are identified, colonoscopy would then be recommended. In addition, individuals with a history of inflammatory bowel disease should undergo screening as cancerous deterioration can occur. Reasons for colon screening, outside of the above, are individuals with a family history of colon cancer, polyps or a personal history of polyps. If the study is normal, repeat endoscopy would occur in 3-5 years.
Lung Cancer
Screening for lung cancer is primarily indicated in individuals with a heavy smoking history and a new onset of chronic cough or coughing blood.
If you or someone you love has concerns about the need for screening, all of the above procedures are performed by DeKalb Clinic surgery department safely and conveniently at Kishwaukee Community Hospital.
Respiratory System
Bronchoscopy
Bronchoscopy looks down into the lungs to evaluate patients with chronic coughing, coughing blood, or look for cancer of the lung. Specimens can be obtained through this outpatient procedure. The risks are minimal.
Upper Intestinal Track
Esophagogastroduodenoscopy
This procedure is done under sedation to evaluate the esophagus, stomach and the first portion of the small bowel looking for ulcers, cancer, reflux disease (please see GI section), or hiatal hernias. Biopsies can be obtained to rule out cancer, precancer, or infection of the stomach as the cause of a patient's pain. It is performed either by your surgeon or gastroenterologist.
Lower Intestinal Track
Sigmoidoscopy
Sigmoidoscopy only evaluates the last two feet of the large bowel from the rectum. This is an excellent screening test for individuals with rectal bleeding and identifies 60-70% of any pathology present. It is generally recommended to be used every five years with a fecal occult blood test (done every year) in men and women over age 50. If a polyp is found in this approach, a full colonoscopy would be recommended. This is done at the Dekalb Clinic and requires no sedation, allowing an individual to drive themselves.
Colonoscopy
Colonoscopy is the use of a long flexible fiberoptic scope inserted via the rectum to evaluate the entire large intestine (colon). Colonoscopy is now recommended for individuals who have personal history of colon polyps or a family history of colon cancer. It is also indicated for rectal bleeding or a history of colon cancer. Sometimes, it may be recommended for an individual with abdominal pain in whom the source cannot be identified. Other individuals that would need screening would include people with ulcerative colitis or Crohn's disease. It is generally recommended to have colonoscopy one year after a polyp has been found and if negative, then every 3-5 years. Polyps can be biopsied or completely removed. However, if cancer is found, further surgery is almost always recommended. Complications of this procedure are 1:1,000 incidence of perforation of the bowel, which generally does not require a colostomy but does require surgery to repair. Bleeding is very rare. Occasionally the bowel prep is poor and adequate visualization can not be accomplished.
