136 N Washington Ave. Ste. 204 Bergenfield, NJ 07062 T: (201)384-3323 F: (201)384-6237

Treatments and Procedures
Colonoscopy, Colon Cancer, Polyps
Non-Steroidal Anti-Inflammatory Drugs
What are Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?
What is the most important information that I should know about medicines called Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?
Who should not take Non-Steroidal Anti-Inflammatory Drug (NSAID)?
What are the possible side effects of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?

Treatments and Procedures

Will I have a procedure on my first visit?
Procedures are not performed on the first visit. The physician needs to perform a complete physical examination on the patient prior to scheduling a procedure so as to ensure patient safety.
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How often should I have a colonoscopy?
Most guidelines encourage that an individual should have a baseline colonoscopy at the age of 50 while 45 is recommended for African Americans. Additionally some circumstances may increase the risk of early colon cancer such as family history. When should you return for a repeat colonoscopy will depend on the findings of your previous colonoscopy and on your family and personal history.
Your physician will be best able to inform you as to when to repeat your exam.
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In preparing for my procedure, my instructions state that I should not drink anything red when I am on a clear liquid diet, why?
Food or drink containing red or purple colored dyes may temporarily cause discoloration of the mucosal lining of the gastrointestinal tract, making it harder for the physician to identify potential problems.
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How long will my procedure take?
The actual procedure only takes 30-45 minutes; however, several steps must be taken before and after your procedure.
This usually includes
Review of your medical records including consent forms
Review of pre-procedure orders
Nursing staff starting an intravenous line (IV) in your arm for the administration of fluid and medications.
After your procedure you will be in the recovery area until you are
fully awake and able to drink. Your physician will discuss, with you and your family member, the findings of procedure.
We have found for most procedures, 4 hours is sufficient.
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When will I get the results of the procedure?
Results will be given to you or your companion after the procedure.
If biopsies were obtained, then you will require a follow-up appointment so as to discuss the pathology results
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Will my menstrual cycle affect having a colonoscopy?
No, you will still be able to have the procedure; we do ask that you notify the nurse when you arrive.
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What constitutes as a clear liquid diet?
The clear liquid diet is composed of foods with low residue content which are liquid in form to minimize the load of food needing digestion in the intestines. This diet is also below the RDA in all vitamin and mineral components except vitamin C, and can promote deficiency if not supplemented with an absorbable micronutrient preparation.
This diet should not be continued beyond two days without protein, calorie, vitamin, and mineral supplementation.
An example of foods included in the clear liquid diet is: apple juice, gelatin, and chicken or beef broth. Milk products or coffee cannot be taken while on a clear liquid diet.
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Are gastroenterology procedures painful?
No, they are not painful. During the procedure the patients are sedated.
Most patients can sleep comfortably throughout the entire procedure.
Occasionally a gassy sensation, pressure or cramps may be felt.
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Colonoscopy, Colon Cancer, Polyps

What are colorectal cancer symptoms?
Colorectal cancer often develops without symptoms, but some individuals with particularly advanced stages of the disease may suffer from any of the following:
Rectal bleeding
Blood in or on the stool (bright red)
Change in bowel habits
Stools narrower than usual
General stomach discomfort (bloating, fullness, and/or cramps)
Diarrhea, constipation, or feeling that the bowel does not empty completely
Frequent gas pains
Weight loss for no apparent reason
Constant tiredness
Vomiting
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Which are the causes of polyps?
Polyps seemed to be caused by both genetic and lifestyle factors.
Inherited factors may determine a person's susceptibility for the disease while diets high in fat and low in fruits and vegetables may increase the risk of polyps.
Lifestyle factors such as smoking, a sedentary lifestyle, and overweight may also increase the risk.
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How can I prevent polyps?
Lifestyle modifications such as reducing dietary fat, increasing fiber, ensuring adequate vitamin and micro-nutrient intake along with exercising may improve your general health and decrease the risk for colorectal cancer.
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Exactly what is a “pre-cancerous” polyp?
There are two possible interpretations. The first one describes the evolution of the lining of the colon from normal colon cells to colon cancer.
In this evolution, the patient first develops a polyp, the cells on the polyp then become atypical or dysplastic.
Next, the polyp degenerates into an early cancer, still contained within the polyp itself. Ultimately this polyp may become invasive colon cancer.
The second interpretation is related to classification of polyps and their malignant potential.
There are two broad categories of polyps we can find when screening: adenomatous polyps and hyperplastic polyps.
Adenomatous polyps are the type of polyps associated with an increased risk of colon cancer and are sometimes referred to as “pre-cancerous”.
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If the polyp is removed, does it mean that I’m cured?
Removing a benign polyp can prevent a cancer from developing at that one location, but the patient may develop polyps at other locations.
We recommend a close follow up for these patients.
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May polyps take care of themselves or fall off?
A true polyp will never “fall off”.
They need to be removed before they continue to grow so as to prevent cancer.
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Is it possible to have colon cancer without having polyps?
Yes, but it is an uncommon event. Individuals with long-standing inflammatory bowel diseases, such as chronic ulcerative colitis and Crohn's colitis, are at increased risk for developing colorectal cancer which occurs in the absence of polyps.
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Is it possible to have blood in your stool without having colon cancer?
Yes, it is possible. Hemorrhoids, anal fissures or tears, infections of the colon, inflammatory bowel disease colonic diverticula and abnormal blood vessels may all be associated with bleeding from the rectum or colon. But the presence of blood in the stool has to be investigated further, because colon cancer is also a possibility - and early diagnosis and treatment is essential.
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What diet should I follow to avoid colorectal cancer?
Although there is no food that causes colorectal cancer, there appears to be a slightly increased risk of developing this disease in countries where there is higher consumption of red meat or non-dairy fat intake.
Conversely, there has been an association with decreased rates of colorectal cancer in populations with increased fiber intake.
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Non-Steroidal Anti-Inflammatory Drugs

What are Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?
NSAIDs can cause ulcers and bleeding within the stomach and intestines Ulcers and bleeding:
different types of arthritis
menstrual cramps and other types of short-term pain
Sports injury
Headaches
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What is the most important gastrointestinal information that I should know about medicines called Non-Steroidal
Anti-Inflammatory Drugs (NSAIDs)?

NSAID medicines can cause ulcers and bleeding in the stomach and intestines at any time during treatment. Ulcers and bleeding:
can happen without warning symptoms
may cause death
The chance of a person getting an ulcer or bleeding increases with:
taking medicines called “corticosteroids” and “anticoagulants”
longer use of Nsaids
smoking
drinking alcohol
older age
having poor health
Concomitant H pylori infection

Who should not take Non-Steroidal Anti-Inflammatory Drug (NSAID)?
NSAID medicines should only be used:
exactly as prescribed
at the lowest dose possible for your treatment
for the shortest time needed
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Keep a list of your medicines since Nsaids are ubiquitous and frequently taken under a wide variety of names. Show to your healthcare provider and pharmacist your medicine list and talk with your doctor.
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What are the possible side effects of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?
Serious side effects include:
heart attack
stroke
high blood pressure
heart failure from body swelling (fluid retention)
kidney problems including kidney failure
bleeding and ulcers in the stomach and intestine
low red blood cells (anemia)
life-threatening skin reactions
life-threatening allergic reactions
liver problems including liver failure
asthma attacks in people who have asthma

Other side effects include:
stomach pain
constipation
diarrhea
gas
heartburn
nausea
vomiting
dizziness
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NSAID medicines that need a prescrip

Generic Name Tradename
Celecoxib Celebrex
Diclofenac Flector, Cataflam, Voltaren, Arthrotec (combined with misoprostol)
Diflunisal Dolobid
Etodolac Lodine, Lodine XL
Fenoprofen Nalfon, Nalfon 200
Flurbirofen Ansaid
Ibuprofen Motrin, Tab-Profen, Vicoprofen (combined with hydrocodone), Combunox (combined with oxy codone)
Indomethacin Indocin, Indocin SR, Indo-Lemmon, Indomethagan
Ketoprofen Oruvail
Ketorolac Toradol
Mefenamic Acid Ponstel
Meloxicam Mobic
Nabumetone Relafen
Naproxen Naprosyn, Anaprox, Anaprox DS, EC-Naproxyn, Naprelan, Naprapac (copackaged with lansoprazole)
Oxaprozin Daypro
Piroxicam Feldene
Sulindac Clinoril
Tolmetin Tolectin, Tolectin DS, Tolectin 600

This Medication Guide has been approved by the U.S. Food and Drug Administration.
Date created: June 15, 2005, updated April 19, 2007