PREVENT COLON CANCER: Alternatives to colonoscopy

[@AustinChiangMD]

Hope you found this informative. Please share with your loved ones and leave your questions here :)

[@nirnimeshkoted]

Recently I have a sonography test and results says my intestine got big ulcers ..

[@pp2072]

It’s always best to get this procedure done in the hospital. There’s a lot that can go wrong. Surgical/ endoscopy centers are all privately run. Cutting corners and shortcuts are almost universal in the US, as healthcare costs keep rising. The procedure is best done with anesthesia, but in a stand-alone facility, there’s usually only one anesthesiologist on duty. That means there’s no backup help. It also means that supplies are usually inadequate. Every single doctor has varying skill levels he can perform. In a hospital setting, there’s always backup available, and cost cutting/ shortcuts are harder to get away with. Patient safety is more regulated and reinsured. Gastroenterologist often prefer to do procedures in an endoscopy center because they often own them (u aren’t supposed to know that), there’s no competition regarding time slots (they can do them all dat if they want)., but the real reason is all about money. Gastroenterologist who own the endoscopy centers collect the facility fee. They often create an anesthesia corporation, hire an anesthesiologist, but make a huge income on this angle by billing the insurance company directly for the anesthesia, and paying the anesthesiologist a fraction of proceeds with a small salary. They do the same for taking biopsies, and sending them to pathology lab corporations they create and own. So, a gastroenterologist can now do one colonoscopy, and be paid for the procedure, paid for use of the facility, the anesthesia, and the pathology fee. That’s more money in 20 minutes than what most people make in a month. Incidentally, this is illegal. This way of doing business break “Stark laws”. It’s illegal to refer work to yourself. Sad to say, the law will jail you for a much minor crime, but this is known but no state has acted on making an example of medical fraud.

[@loubino18]

@@pp2072 Great Pro tip - thx!

[@mkolso2]

Thank you for defining how far into family history is worrisome. I always struggle with that .

[@AustinChiangMD]

You’re welcome!

[@Eagle-eagle1]

I did not catch that part pls explain ?

[@DaRyteJuan]

Yeah. It’s pretty funny how the colonoscopy is 100% covered by insurance IF it’s done as “a screening” for colon cancer. But if you decide to go for the FIT test (which costs only $50) and it comes back positive, then to have a colonoscopy to investigate if you really have colon cancer, then none of this covered. Of course, when people see the potential for the medical costs, there’s a good probability the patient won’t proceed with the colonoscopy. They’ll just risk dying of cancer (which is the best outcome for insurance companies).

[@ursulasmith6402]

Well, another reason for universal health care. These insurance companies are a joke!

[@biff5856]

The best info on colon cancer tests yet. Thanks Doc for being to the point.

[@DaRyteJuan]

Your video is pretty good, but unfortunately like most doctors, you don’t bother comparing the statistics of dying from complications from the colonoscopy vs the small set of people who are actually saved by performing “the gold standard” on the entire universe of patients who undergo it. There’s a 1/2,000 chance of incurring a perforation from the procedure. Assuming someone doesn’t die from this tear, they have to have surgery to address it. Of course, this again involves life-threatening risks to the patient. Doctors are always painting a rosy picture of procedures because most of them are biased towards their own sense of competence.

[@emilyjane1011]

I agree with you to some respect but, for my current family history colon cancer mom having it 4 times my aunt 2 times uncle 2 times now deceased my nan 1 time, and having lynch syndrome, I have to argue with my family doctor cause seeing a specialist I had a scope at 17 and again at 19 and again when I was 21, and I’m fighting my doctor I have ulcerative colitis raising my risks to 50% higher to get cancer and having the lynch syndrome gene causing colon cancer, but my doctor is so on I’m to young and come back in a couple of years The youngest diagnosed with colon cancer in my family is my moms brother at age 30, I’m 25, I know the risk for perforation but I’d rather not die or risk getting cancer and saying also I’ve had polyps removed each time I had a colonoscopy! I wish they would get rid of the stigma you’re to young when our family has a risk!!! I’ve had endoscopy as well 2 times It’s frustrating and I’m not in good health saying I pass blood in stool daily still don’t mind says it’s normal with colitis,,

[@Madolehag]

Vanderbilt Medical Center is currently notifying individuals who had a colonoscopy, they may have been exposed to HIV and hepatitis.

[@susantaylor9135]

You rock! This video is amazing. My advanced adenoma was found via Cologuard (the FIT test done a few months prior came back negative). Two previous colonoscopies (at 50/60) were perfect - not one polyp found. Thankful every day that I chose Cologuard which probably saved my life; the partial colectomy surgery went fine. SCREENING is a vital tool. Just do it.

[@budmangt2]

You said the cologuard test showed up positive, but the colonoscopy showed no polyps, which tells me that the cologuard was a false positive. which i heard is common with that test.

[@jennibean71]

Thank you for all this great information. My friend passed in 2019 of colon cancer. She was only 39 and had 3 young boys. She fought for 3 long hard years. There was no history in her family so they caught it too late. History has to start some where.

[@oooh19]

So sorry for your loss. However what made them do a screening to find out if there was no family history? Also she was so young!

[@njjen3953]

Would you do a video on Gastroparesis? I was first diagnosed with it 5 years ago and it is one of the most debilitating diseases I know of. Many people I have shared this with, have never heard of it and unfortunately, many doctors, ie ER docs, pass it off as mental health-related. There needs to be awareness and I am doing what I can to spread the word. TIA

[@AustinChiangMD]

Thank you for this wonderful suggestion!

[@jimmysavage258]

Capsule colonoscopy seems like the way to go

[@nataliemcmanus5528]

Hi, I recently (March 2020) had a colonoscopy for other reasons and it saved my life.The. following day my. Appendix ruptured so I had emergency surgery. It was found to be neuroendocrine carcinoid cancer.Two months later I had another tumor removed from my small intestine, 6" I've been misdiagnosed for years. Now I'm waiting for a bowel resection and removal of 20 lymph nodes in each area. As well as thyroid and the adrenal glands on kidneys Thank. You for your your page & the shout out on your last live

[@nataliemcmanus5528]

@@rizwancarr7515 they. Took the sample so it helped move along and saved my life

[@cleof1503]

In south africa, literally none of these are an option. Preventative tests here are never covered by health insurance. Self payments are completely unaffordable. Health insurance companies have no interest in saving lives.

[@soulsrforfools7511]

I'm so glad I found your channel on here! I don't use tiktok often.

[@nirnimeshkoted]

It's informative and educational ✨✨

[@Sprouht]

Hey Austin! Found you on Yes Theory's channel! Your editing is sick! I'm super impressed by your storyline, you absolutely deserve so many more subs. A bit on me, I'm Will & I make Canadian travel and personal growth videos. Hope you're safe & never forget that you are awesome 🙂

[@drjennale]

I’m FM and had no idea colonoscopies could potential not be covered after positive FIT!! Have you seen many insurance decline colonoscopies for patients at age 45?

[@AustinChiangMD]

Varies by region I’d say!

[@stellam5872]

Thanks so much Dr. Chiang!!! This helps a lot with my question on stool tests vs. colonoscopies from your recent community post about screening!!!

[@stevendewey8134]

Thanks Doc for the video. Very informative. Great channel.

[@ronieltan88]

Great content, thanks for sharing.

[@RspsTywy]

Your the most education channel I have seen in past years. I love the content! I have been looking into gastronology to study the gut and ibs / chrones and I'm wondering if there is a smaller career path to get there besides doing 12 years then to specialize in just the gut. I'm not interested in throat and the other avenues of the field. I'm not educated in the schooling sciences. Is there a different science/ doctoret for just focusing on gut?

[@yassir8562]

Is there an induced chance to suffer from colon diseases by eating spicy food? Maybe idea for a video? I find it fascinating. Nice vid!

[@dacisky]

I did not know there was more than one at home test. A friend suggested I get my first colonoscopy without sedation. He said he had one sedated and one unsedated and thought I'd find it interesting. He was right.. Water was used instead of gas and I found it fascinating. All my followups have always been unseadated.

[@AustinChiangMD]

Yes we try to use water as much as possible as well!

[@dacisky]

@@AustinChiangMD Excellent! I moved to a different state and my new GI only uses gas. I feel water is far better than gas.

[@dianethoroughman9541]

This was informative. I had a colonoscopy 5 years ago. They found 2 benign polyps. So I am trying to get another one, but I must work with the VA and community care that is part of the VA. I get my care in the community. Because I had polyps the VA is calling the colonoscopy a diagnostic one rather than a screening one. So I have to get more permissions from the VA before I can have it done. Sighs.

[@aspenjade2454]

When would someone with IBS want to start getting screenings or colonoscopy? Was it 40, or was that just for family history?

[@kelly1827]

Do you still need to do the prep if you do the capsule test?

[@RspsTywy]

so many different sciences for health. im interested in a new career path regarding trying to learn about digestion track because i have stomach problems for past 4 years with no resolution to the problem, seeing every doctor and specialist around. and i dont want others to go through this discomfort either. what type of schooling would be best for that? is the only option be Gastroenterologist or is there more specific study that im looking for?

[@johnkimble2361]

how long does it take for polyps to regrow?

[@ashleighflood6262]

I have dealt with chronic constipation on and off all my life. I'm 33. No history of colon cancer (stomach cancer, heart disease, diabetes, cervical cancer does run in the family). Since the beginning of March i have been constipated. I had maybe 4 good bowel movements the last 3 weeks , rest of the days it's just pieces or balls of stool and feels like something at the opening of my rectum. I get big urges to poop but then nothing once I sit or it is just little balls or pieces of stool. I should add the week before I noticed this constipation after one good bowel movement I had some aching in my rectum for a few minutes. I dont know if that's related to the constipation or if that is anything serious? (I had that happen twice in my life never though to much of it until now) I have no abdomen pain or fullness or any bleeding. I have been worrying alot about colon cancer because I saw a video of young lady dying with it recently she was told she just had constipation and nothing was done for a long time. So i worry that will be me and i won't get to see my kids grow up. I have bad general anxiety & hypochondria and I know stressing isn't helping this constipation at all. I'm thinking of trying to relax continue to just naturally increase my fiber and water. If it doesn't help in another 2 weeks then I will talk about a CT colonography if I'm a candidate. I really don't want a colonoscopy due to fear of sedation. Does any of this sound like a red flag?

[@bobjohnson7280]

Dr. : I have had 2 Colonoscopies and am in TX. However, I have also had 24 Chemo infusions and 3 Radiation sessions over the past 2 1/2 years. Sigmoid Colon cancer was discovered in the 1st Colonoscopy and some cancer has metastasized into the Prostate area. A 4th PETScan will determine if the Prostate metastasis is still active after the radiation. Now, my Gastroent. wants to do a 3rd Colonoscopy. My Oncologist seems noncommittal about this. Is a 3rd Colonoscopy really needed?

[@slowcake1354]

Hello I really need your feedback. I am way to embarrased to see a doctor irl and confront my mother. I have not properly pooped in 3 years. My poop leaks when I sleep and when I'm awake and I'm afraid to poop because of the pain. I talked to someone online and they said to see a gi doctor about miralax treatment. I'm an under weight 14 year old and I cant go outside and play because I will leak in my pants and smell.

[@lorilong3454]

so sorry you dont feel you can tell your mother… hope you are doing better

[@Laura-qx1cu]

my step-dad has was diagnosed with colon cancer 2 years ago. he’s stage 4 right now, and the cancer has also spread to his liver. he’s been getting chemotherapy. how is it that he’s been able to still do normal daily activities and continue his job? sometimes i forget he even has cancer. do you know why that is? :o

[@neptunes297]

I have a question and I'm not sure if it's gastrointestinal related but I cannot swallow pills. At first I thought it was it was psychological bc I was just afraid to swallow them but the more I try the more I realize I cannot physically swallow them. My tongue blocks the pill from going down and when I try make it go down after it gets past a certain point my gag reflex forces it back up. Is there an actual medical condition that causes this? And if so is there any treatment I can get for it?

[@laberintoon2]

My sister had that and it turned out she was extremely low in iron and she ultimately had a blood transfusion and now she could swallow pills fine. And she also had iron infusion

[@patanddanadavis8847]

Assuming alternative options are not a good idea if you have a history of tubular adenomas with positive pre-cancer cells?

[@AustinChiangMD]

Yes, at that point surveillance colonoscopies are recommended! Thank you for bringing this up!

[@patanddanadavis8847]

@@AustinChiangMD bummer ;) I had always wondered about the pill camera and if that was an alternative for me. But I will 100% choose a colonoscopy over cancer.