DR. HOOK- Bottoms up!: Colonoscopy can save your life

"Don't give me lip, child!"

I used to hear parents saying that to children all the time. However, I don't seem to hear anyone saying that anymore. Maybe parents are too afraid of their kids in our litigious country? I never gave any "lip" to my parents. Any "lip" would have led to me pushing up "tulips" from six feet under.

I also learned growing up not to give lip service. You practice what you preach. So when some of my patients question my medical suggestions, I always back them up with current medical literature, my lifestyle, or my medical experience.

When someone turns 50 years old, I always smile and suggest a screening colonoscopy. Trust me, I'm not the dentist from Little Shop of Horrors. I smile because a frowny face usually isn't convincing. Most patients are agreeable to being screened for colon cancer, but I have a handful who say, "Doc, I feel fine. Don't go fixing something that isn't broken."

Well, most people never sense having a colon polyp. Most of the time, polyps don't cause any belly pain, and they rarely bleed. Unless they are huge-ola, they normally don't block bowel movements. So when someone tells me their stools have gone from being Lincoln Logs to Tootsie Rolls, I consider colon polyps or cancer to be responsible for the change of consistency. (Oh, get over it! Oprah Winfrey dedicated a whole show to poop.)

Now get this: about 30-40 percent of Americans 50 and older have colon polyp(s). By age 70, fully half of Americans have them. (Now if I had a dime for every colon polyp out there...) A colon polyp is a protuberance from the colon lining into the lumen– kind of like stalactites in a tunnel.

There are four main categories of colon polyps: hamartomatous (sounds like banging on a harpsichord), nonneoplastic, submucosal, and neoplastic. If you have to have a colon polyp, the type to get is a hyperplastic polyp because it's benign like Academy Award winner Reese Witherspoon (I wish Felicity Huffman had won, but you have to love Reese!). Hamartomatous polyps include juvenile polyps (which usually bleed) and Peutz-Jeghers polyps (that can be associated with venous pools in the mouth).

The bad boys of polyps are the adenomatous ones. Not all of them progress to cancer, if you look at the figures. But there's a higher chance of developing colon cancer if you have them. Age is the major risk factor for adenomatous polyps (getting old is tough! I'm going to be 40 years old this year. Call the paramedics!). Also, men are more likely than women to have them.

There are three types of adenomas: tubular (not a surfer dude expression), villous (as in villain because they're the most likely to become cancer), and a combination of the two, tubulovillous. The size and shape can be associated with the risk of cancer development. In general, sessile polyps (meaning flat like Joan Rivers' chest) are more likely to become cancerous than pedunculated polyps (meaning protruding on a stalk like Dolly Parton's chest– who, by the way, should have won the Oscar for best song).

Large studies have shown screening colonoscopy is the best way to detect these polyps, cut or burn them off, and prevent colon cancer. In general, those who have a colon cancer screen live longer than those who don't.

University of Michigan researchers found that after UVA grad and NBC journalist Katie Couric underwent a colonoscopy on live television in March 2000, colonoscopies rose 20 percent.

Maybe she'll will repeat her Today Show colonoscopy, and I can do it beside her when I turn 50. We can hold hands and sing, "The good old song of Wahoowaaaa ah, ah, ah!"

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