By Bob Condor

You might say a successful colonoscopy is all in the entrails, er, details

This screening test is a rite of passage for anyone over 50—and earlier if there is family history. While it is mildly invasive—and not more than that—it tends to be the test most of us put off, well, the most.

Bad idea. The DHB (Daily Health Blog) is not about marching out statistics to make you feel guilty or scared enough or both to schedule a colon screening. Just know this: It is difficult enough for doctors to discover potential problems, so not even setting up a colonscopy makes it basically impossible to spot cancerous polyps or lesions early. The earlier, the better for both mortality and quality of life when colon cancer is “caught.”

Researchers are buzzing this year about new studies showing that flat lesions might be up to 10 times as likely to be cancerous than polyps, which are the more common target of colonscopies and the doctors that screen them. Along with that potency, flat lesions are harder to see because they blend more with the intestinal lining. Stanford physician and researcher Dr. Roy Soetikno likens it to “pancake just lying on the floor.”

Soetikno is lead author of a March study published in the Journal of the American Medical Association highlights the dangers of missing flat lesions in screenings. Soetikno and colleagues urge medical centers to seek out the newest technology that better spots these flat lesions, which lay flat on the surface or sometimes even depress into the surface like a pothole.

Querying your doctor about whether your colonoscopy will best spot flat lesions goes on the must-ask list. Citing the Journal of the American Medical Association, which is not exactly the most progressive of all health journals (translation: understatement), works in your favor here.

There some other important details that should be discussed with your doc before the colon screening. Past studies indicate that morning colonoscopies produce better results in terms of spotting cancerous lesions and polyps than afternoon tests. The reasoning was patients practice better colon preparation in the morning groups. Go with the numbers here and schedule yours for the morning.

One more thing: A German paper in the April issue of the American Journals of Gastroenterology reported that a new two-liter bowel cleansing solution appears to work as well as the standard four-liter drink. The four-liter drink doesn’t taste very good and it’s hard for some people to get it all consumed. Patients said the drink tasted better and researchers noted that the two-liter group experienced less nausea.

Both groups in the German study drank half the solution (one liter) the night before the colonoscopy and the other half (one liter) the morning of the test. Another 2008 study conducted by Spanish researchers suggests that consuming the colon-preparation drink all in the morning is best for clearing the gut and making it most likely flat lesions and polyps will be spotted. Talk it over with your doctor, see what s/he says.

Step one is make the appointment. Step two is follow instructions, get the gut clear and clean. Then step three won’t have to be repeated due to inconclusive results. Nobody wants that.

“Bob Condor is the Daily Health Blogger for Barton Publishing. He is also the Living Well columnist for the Seattle Post-Intelligencer. He covers natural health and quality of life issues and writes regularly for national magazines, including Life, Esquire, Parade, Self, and Outside. He is a former syndicated health columnist for the Chicago Tribune and author of six books, including “The Good Mood Diet” and “Your Prostate Cancer Survivors’ Guide.” He lives in the Pacific Northwest with his wife and two 11-year-old kids.”

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