Endoscopy after 40

Understanding the Silent Threat

Our bodies are complex machines. Sometimes, parts of this machine can develop problems without showing any early warning signs. This is especially true for your digestive system.

One such silent problem is cancer of the gut. While it might sound scary, the good news is that we can often find it early which makes it much easier to treat. This is where a screening endoscopy comes in.

The Indian Context

In India, unfortunately, many people are diagnosed with gut-related cancers at advanced stages. This often makes treatment difficult and reduces the chances of a full recovery. To change this, it's crucial to adopt preventive measures.

The Importance of Screening

A screening endoscopy is a simple procedure where a thin, flexible tube with a camera is gently inserted into your digestive tract. This allows us to examine the lining of your food pipe, stomach, and intestines for any abnormalities.

• Early Detection: We can often spot tiny, precancerous changes or even early-stage cancers that cause no symptoms. This gives us a chance to treat them before they become a bigger problem.
• Prevention: Removing precancerous growths can prevent cancer from developing altogether.
• Peace of Mind: Knowing your digestive system is healthy can significantly reduce worry and anxiety.
• Incidental findings: We can pick up non-cancerous ailments which could be causing you problems and treat them effectively 

When to Consider a Screening Endoscopy

While general recommendations suggest starting screening at 40, it’s essential to discuss your personal risk factors with your doctor. If you have a family history of gut-related cancers or other risk factors, you might need to start earlier.

Remember, prevention is always better than cure. A simple endoscopy can save your life. Don’t delay this important step in taking care of your health.

The reason for writing this at this time:

I came across a rare case of the Melkersson-Rosenthal Syndrome. 

That’s patient incidentally came for his endoscopy to check for Crohn’s disease.

The symptoms of Melkersson-Rosenthal Syndrome (MRS) present as a triad of:

1. persistent or recurrent upper lip oedema (oedema is a build-up of body fluid), 

2. relapsing facial paralysis and 

3. a fissure tongue. 

MRS is commonly associated with the more well known Crohn’s disease, a form of inflammatory bowel disease, diagnosed with a colonoscopy on routine investigations.

If you or your loved ones are diagnosed with Crohn’s, make sure to keep a look out for the triad of symptoms and ask your doctor about if any present themselves. 

A little extra caution goes a long way!

IBD - Inflammatory Bowel Disease / Idiotic Brainless Doctor!

Coming off from my previous post on P.U.O. wherein I fully supported doctors saying they did not know what to do, this week came a rather unpleasent situation wherein a Doctor did not know what to do even though he should have. While P.U.O. is an unknown entity (in relative terms) the fact that so many Doctor's seem to be shying away from their responsibilities when it comes to emergency situations is a trend we need to nip in the bud.

Someone's mother is suffering from Ulcerative Colitis ( a part of inflammatory bowel disease) in which there is tremendous suffering caused by numerous ulcers in the intestines causing fair amounts of bleeding and subsequent anemia. This mother was diagnosed with it and was under the treatment of some doctor at H.H. Unfortunately for her, she lived in a distant suburb (even further than the regular suburbs) approx. 2 hours away from H.H.

When she became seriously ill, she was taken to a small nursing home for her complaints of severe anemia and bleeding last night. The doctor there told her to go back to H.H. and get admitted immediately as the situation was critical. I respect that opinion, as sometimes these emergencies cannot be handled in smaller hospitals.However, as luck would have it, there were no beds in H.H. free and numerous calls around the city couldn't arrange for one in that particular hospital. In this case, the doctor should have made alternative arrangements for admission at a bigger hospital elsewhere, more importantly close by and not 2 hours away.

The advice given was wrong to begin with, because if it was an emergency, how was the patient supposed to travel 2 hours in Mumbai traffic to reach a hospital. The daughter who works with my wife called me up for help. All I could think of at that time was to get her admitted to any reputed Intensive Care Unit around her area at that time and control the situation following which we could wait for a bed at H.H. where she was originally being treated and her history was known.

The shocker came when she told me that the doctor who had advised her to go to H.H. was himself attached to the wok hospital branch in her area, but he said she couldn't get admitted there as there was no gastroeneterologist at that hospital.
The reason this is shocking is this, (all gastroenterologists reading this may comment here) -  What exactly is a G.E. doc gonna do in an emergency when all she needed was supportive care and monitoring of her anemia and extreme weakness. She could have been stabilised and then a call could have been taken as to where to shift her.

That is exactly what I advised her daughter to do and fortunately she was educated enough to grasp the situation and handle it well (unlike the doctor).Point being made - Think logically and patiently, don't just get the patient out of your way because you think her situation is bad. Help, compassion, understanding and most important support to relative is what makes a doctor, not a diagnosis of emergency and referral to a higher centre.