Gastroscopy and Colonoscopy
"It is equally important for us to identify the diseases that cause complaints in the digestive tract and to carry out gastroenterological screening," says Dr. Péter Fuszek, gastroenterology specialist at Dr. Rose Private Hospital, summing up the most important tasks in his field.
BBJ: What does the science of gastroenterology deal with?
Dr. Péter Fuszek: The total length of our alimentary canal can reach up to 8 meters. Of this, what we can easily take a look at is the oral cavity, the esophagus and the stomach and the initial part of the small intestine, and we can also examine the large intestine in great detail. This is what gastroenterology care is all about: gastroscopy (gastroscopy of the stomach) and colonoscopy (colonoscopy of the colon), which is performed with a gastroscope or colonoscope. The longest part of our alimentary canal, the small intestine, which is up to 6 meters long, is not easily accessible and is examined using other diagnostic tools.
BBJ: What kind of problems can occur?
PF: It is equally important to identify the diseases that cause complaints in the digestive tract and to carry out gastroenterological screening. Although screening for gastric tumors is not common in Hungary, statistics show that it is certainly necessary, with 4,000 gastric tumors and 9,000 colon tumors occurring every year.
BBJ: When is gastroscopy recommended?
PF: Endoscopic examination is recommended for people over 45 years of age, because most diseases affecting our digestive tract can be detected and more serious consequences can be prevented. Weight loss, bloody stools and significant abdominal pain can be a warning sign, but most patients present with reflux symptoms.
BBJ: How is a colonoscopy performed?
PF: We distinguish between one-step and two-step screening. The two-step screening is that a stool blood test is done first and if positive, then the endoscopy is performed. However, this means we lose 30% of patients who have a tumor but do not test positive at the time of screening. One-step screening detects all abnormalities and, in many cases, provides an immediate solution, such as removing colon polyps. Statistics show that 90 out of every 100,000 people will have colon cancer, so 9 out of 10,000 people will have an advanced precancerous condition, a polyp. Reducing this rate would be the point of screening.
BBJ: How successful is cancer screening in Hungary currently?
PF: In Hungary, more than one in four colorectal tumors are discovered on the operating table as a result of immediate abdominal surgical intervention for an intestinal obstruction. In such cases, the diameter of the bowel is narrowed by the tumor and this causes the intestinal obstruction. This should not happen in a disease that can be prevented by screening.
BBJ: What do you recommend for forward-looking patients?
PF: If you are just a little bit health-conscious, you should go for a one-step gastroenterology screening after the age of 50. But my professional experience over the years shows me that the safety of our patients is even greater if it is carried out after the age of 45.
BBJ: How should a patient prepare for a gastroscopy?
PF: We usually recommend that our patients come with a ’six-hour fast’. Fluids can be consumed within two hours of the examination unless the gastroscopy is planned under general anesthesia, in which case we recommend four hours.
BBJ: Is the preparation for a colonoscopy similar?
PF: Preparation for a colonoscopy is slightly more complicated because you have to arrive having followed a special diet and with a completely empty bowel, which means a three-day process: the first day involves very little food, the second day is a laxative day, with day three being the day of the examination. In addition, it is recommended to avoid any medication that may cause bleeding complications. If someone wants to have a colonoscopy under anesthesia, the preparation is the same, plus they should not drink for four hours before the procedure and should not drive after the procedure.
BBJ: Does a family history of stomach or bowel disease matter? How often is the test recommended?
PF: For colonoscopies, it is very important to know what kind of diseases family members have been diagnosed with. If there is no history of cancer in ancestors or direct relatives, a colonoscopy is recommended every 10 years from the age of 50. If there has been a family history of colon cancer in at least one generation, it is recommended every five years from the age of 40. If there have been two generations with colon cancer, we start screening much earlier and recommend genetic testing. If a polyp is found during the test, we recommend a control colonoscopy within 3-5 years, depending on its characteristics.
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