Blog | Friday, September 23, 2011

New colonoscopy recommendation makes gastroenterologist consider his options

The right side of the colon seems to be the Achilles heel of colonoscopy because polyps there tend to be flat and harder to find, and we confer the least protection from later colon cancer in that zone.

A recent article summary in Journal Watch Gastroenterology concludes that when we see a right-sided colon polyp, we may have missed another, so we should go back and look again.

This provocative recommendation represents a major change in the way we normally perform colonoscopy. But the issue is, and always has been, how to identify and remove all polyps from the colon.

So the questions I have for you are:
1) Should we routinely reexamine the right colon in everyone, only those with a polyp, or no one?
2) Have you already changed the way you inspect the right colon, or will you now?
3) If you do inspect the right colon differently, do you use retroflexion, repeat examination, or narrow-band imaging?

I look forward to your response.

This post by M. Brian Fennerty, MD, appeared at Get Better Health, a network of popular health bloggers brought together by Val Jones, MD. Better Health's mission is to support and promote health care professional bloggers, provide insightful and trustworthy health commentary, and help to inform health policy makers about the provider point of view on health care reform, science, research and patient care.