Posted by: yourhealthradio | June 16, 2011

Colonoscopy at 4 pm?

Okay- we agree…colonoscopies are often uncomfortable, unpleasant and at best inconvenient. No one really looks forward (literally) to having one done (unless you are a gastroenterologist). But as we are approach the age of 50 (okay- so what if one of is over that age already and one of is way under), we have to start thinking about the procedure. We came across a study that will make you (and us) think twice about when you schedule your next appointment.

The American Journal of Gastroenterology did a study that looked at when a physician/nurse does a procedure over and over again, whether their diligence may becomes a little less as the day progresses. For colonoscopies, can someone doing 5,7, 10 or even 15 procedures in a day start to miss anything…polyps, for example, that they would have noticed earlier in the day or their first or second procedure, at a time when they weren’t so tired or just used to the repetition.

In this case, the doctors were looking for polyps to detect and remove before they could result in cancer. They looked at procedures over four months, among 28 different doctors, and they found that at the beginning of the day, the doctors found a lot more polyps than they did in the 12th procedure of the day.

On average, they detected about only half of the polyps near the end as compared to the first procedure of the day. It’s highly unlikely that it’s because the people with all the polyps just happened coincidentally to be coming early in the day. What this tells us is that as the day goes on, doctors likely get a little more tired with performing a semi-invasive procedure. We do not know if this truly a large clinical issue, but we are concerned that some important early signs of pre-cancer could be missed.

As patients one thing you can do is talk to your doctor. Ask them what they are doing to compensate for this possibility of fatigue in performing procedures as the day goes forward. It doesn’t mean you can’t have a colonoscopy later in the day, but some protocol should be put in place to account for this possibility. Or, simply ask for your colonoscopy to be scheduled earlier in the day or by someone who is doing less overall procedures that day.

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