Overcoming Barriers to Life-Saving Colonoscopies

MedicalResearch.com Interview with:

Dr. Michael Epstein

Dr. Michael Epstein

Dr. Michael Epstein MD
Dr. Epstein has over 30 years of experience in the field of Gastroenterology with extensive medical training as a practicing clinician, including treating patients with a range of gastroenterological conditions, such as Inflammatory Bowel Disease (IBD), Crohn’s disease, Ulcerative Colitis, Hepatology and Liver diseases.

Dr. Epstein is also the founder and principle physician at Digestive Disorders Associates and is the president of the Maryland Diagnostic and Therapeutic Endo Center, both in Annapolis, Maryland. He is board certified by the American Board of Internal Medicine with a sub-specialty in Gastroenterology. He is a fellow of the American Gastroenterology Association and the American College of Gastroenterology, and a member of the Society of Gastrointestinal Surgeons. 

MedicalResearch.com: What is the importance of colonoscopy

Response: We lose more people to colon cancer each year than who have died in the Vietnam WarI believe that colon cancer has become a public health issue and there is a great need to increase public awareness around screening.

It is so important for patients to take part in routine screenings as the symptoms of colon cancer are often silent. Sadly, often times people do not know they have colon cancer until the cancer is in an advanced state.

A colonoscopy is important because it is the only test that can currently detect and treat this type of cancer that is also one of the leading killers in the United States. Not only can we often detect pre-cancerous polyps, but we can often remove these polyps during the procedure. 

MedicalResearch.com: Who should be screened?

Response: The American Cancer Society recently updated its guidelines recommending that people at average risk of colon cancer start regular screening at 45, and no longer at 50 years of age. That is because we are also seeing colon cancer in a younger population, which is quite scary.

MedicalResearch.com: What are the current barriers to colonoscopy screening?

I believe there are several barriers to screening.

    1. Myths and rumors – Patients sometimes say to me that they did not undergo a colonoscopy because they were dissuaded by a friend, through casual conversation, who said they had a negative experience with their colonoscopy. These innocent conversations can be fatal to someone who chooses against the procedure. We need to get the public involved in having positive conversations about their colonoscopies.
    2. Perception that the colonoscopy preparation process is burdensome– Some complain about the volume of fluid that is necessary to consume prior to the colonoscopy. Others complain about the taste of the liquid as well. However, the reality is there has been innovations in the space. These bowel preparations are decreasing in volume and the tastes has improved. I recently tried the latest FDA-approved bowel prep on the market, during my own colonoscopy, and can tell you that I was comfortable and it worked very well.

MedicalResearch.com: What are the recent innovations that may make the procedure more comfortable or accessible? 

Response: First, medications of the past didn’t allow patients to gently fall asleep during the procedure. Today, most patients are not even aware they are undergoing the procedure due to fast-acting sedatives that are administered in a safe setting.

Second, the colonoscopy preparation process has improved a lot. There are now low-volume preparations that are better tasting. These new innovations are making the procedure easier. I am now hearing a lot more patients saying that the procedure was no big deal.

MedicalResearch.com: Are there acceptable alternatives? 

Response: One acceptable alternative to a colonoscopy is called a computer tomography colonography (CT colonography). The specialized x-ray exam gives us a view of the interior colon, but patients must still undergo a preparation process for that test. Also, if a polyp is spotted during this test, a follow-up colonoscopy is required to remove the polyp. 

MedicalResearch.com: Is there anything else you would like to add?

Response: I participated in clinical trials for PLENVU® (polyethylene glycol 3350, sodium ascorbate, sodium sulfate, ascorbic acid, sodium chloride and potassium chloride for oral solution) the first and only 1-L PEG-based bowel prep clinically proven to provide a positive bowel prep experience and with a positive taste experience. 

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