People with intellectual disabilities are living longer and, as with the wider population, increasingly experiencing serious illnesses such as cardiovascular, respiratory diseases, and cancer, showing how important to do a health checkups very often and included a colonoscopy when is necessary.
What is colonoscopy?
“A colonoscopy is an exam used to look for changes — such as swollen, irritated tissues, polyps or cancer — in the large intestine (colon) and rectum.
During a colonoscopy, a long, flexible tube (colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.
If necessary, polyps or other types of abnormal tissue can be removed through the scope during a colonoscopy. Tissue samples (biopsies) can be taken during a colonoscopy as well.” [1]
Why would we all need a colonoscopy?
“People with intellectual disabilities (PWIDs) are living longer and, as with the wider population, increasingly experiencing serious illnesses such as cardiovascular and respiratory diseases [1]. However, cancer is an age-related disease and has not received the same attention as other medical problems in this population [2, 3]. Evidence on overall cancer incidence in PWIDs is limited due to the lack of reliable epidemiological data [4] but is currently estimated to be as frequent as in the general population.” [4]
“A colonoscopy may be preventive, diagnostic or therapeutic — and often, it’s all of these. The healthcare provider may advise to have a colonoscopy for routine cancer screening if there is a statistically higher risk of developing colorectal cancer. Since anyone can have colorectal cancer at any time without warning or symptoms, screening is the best way to stay ahead of it. While screening, the gastroenterologist may also remove suspicious tissues for testing and prevention.” [2]
How to Prepare for a Colonoscopy?
“Preparation is a critically important part of the exam. If the bowel is not adequately cleaned out before the exam, the doctor will not be able to identify polyps, the pre-cancerous lesions. Before the procedure, the patient will have to take an oral laxative solution (called “a bowel prep” or “preparation”) to clean out the bowel. Specific prep instructions vary, but the prep usually begins 1 to 2 days before the procedure. It is important to read the prep instructions (given separately) to understand what the patient should do 1 day or 2 days before the colonoscopy.” [5]
Will I receive sedation for the exam?
The patient will receive “conscious sedation” for the exam, which means that an intravenous line is placed, and medications are given intravenously. This is not general anesthesia, although almost all patients are comfortable during the procedure. Because of the sedation, the patient will need a driver to take him/her home.
Managing Comorbidities
“Disabled adults often have multiple chronic conditions, such as heart disease, diabetes, or respiratory issues. These comorbidities need to be carefully managed before, during, and after the colonoscopy to prevent complications.
• Pre-Procedure Assessment: A thorough assessment of the patient’s health status can identify any potential risks. This includes evaluating heart and lung function and ensuring stable blood sugar levels for diabetic patients.
• Post-Procedure Care: After the colonoscopy, disabled adulst may require additional monitoring to manage any lingering effects of sedation or to address any complications that arise.” [7]
How often should I do a colonoscopy or at-home screening for colon cancer?
“It’s recommended that people have a colonoscopy performed every 10 years, beginning at age 45 and up to age 75. This is the recommendation for people who aren’t at increased risk of colon cancer. If someone have personal or family history of colon cancer or other cancers, it is important to talk to a personal provider. They may recommend more frequent screenings.” [3]
Emotional and Psychological Considerations
“Addressing Anxiety
Many seniors/disabled adults may feel anxious or fearful about undergoing a colonoscopy. This anxiety can stem from concerns about the procedure itself, potential findings, or previous negative experiences with medical procedures.
- Communication: Open and honest communication between the healthcare provider, patient, and their family is crucial. Explaining the procedure, its benefits, and what to expect can help alleviate fears.
- Support Systems: Encouraging the presence of a family member or caregiver can provide emotional support and reassurance. Additionally, discussing any past experiences and addressing specific concerns can help ease anxiety.”[7]
Cognitive Impairment
Adults with cognitive impairments, such as dementia, may face additional challenges when preparing for and undergoing a colonoscopy. Special care and considerations are necessary to ensure their safety and comfort.
- Tailored Communication: Using simple, clear language and providing information in small, manageable segments can help people with cognitive impairments understand the procedure.
- Caregiver Involvement: Involving caregivers in the preparation and recovery process is essential. Caregivers can assist with following preparation instructions, monitoring the patient’s condition, and providing post-procedure care.” [7]
Conclusion
“Colonoscopy is a vital screening tool for seniors and disabled adults, playing a critical role in the early detection of colorectal cancer and other gastrointestinal issues. However, it requires special considerations and care due to the unique challenges associated with aging.
By addressing these considerations, such as medication management, effective bowel preparation, and tailored post-procedure care, healthcare providers can ensure a safe and effective colonoscopy experience for them.
Open communication, proper support systems, and careful management of comorbidities and cognitive impairments are essential components of the care process. With these measures in place, disabled adults can undergo colonoscopy with greater comfort and confidence, ultimately benefiting from early detection and improved health out.” [7]
Resources
[1] https://www.mayoclinic.org/testsprocedures/colonoscopy/about/pac-20393569
[2] https://my.clevelandclinic.org/health/diagnostics/4949-colonoscopy
[4] file:///C:/Users/Staff/Downloads/Willis%202018%20Colon.pdf
[7] https://curasia.com/colonoscopy-for-seniors-special-considerations-and-c/