Surveillance Intervals

According to WHO guidelines, if biopsies are classified as negative or indefinite for dysplasia then surveillance colonoscopy should be repeated every 1 to 2 years. The current AGA guidelines suggest annual colonoscopy for IBD patients. If the physician is only taking 8 to 10 biopsies per procedure, I think this is sage advice. If, however, you perform a more thorough sampling of the colon, with more

*Editor's Note: Oh, that all colonoscopists and pathologists were as compulsive and experienced as the Seattle groups. Incomplete preps, rushed endoscopy schedules, variable patient compliance, and increasing risk with time would seen to justify more frequent surveillance after 20 years of colitis, especially with childhood onset or with advanced chronologic age. It is also difficult to set the date of onset for patients with Crohn's colitis diagnosed after age 40 or, as below, patients with coexistent primary sclerosing cholangitis.

than 33 biopsies taken per procedure, the clinician and the patient can have confidence that dysplasia is less likely to have been missed. Our current recommendations are outlined in Table 83-1 and are based on the histologic findings at colonoscopy, with the intervals longer for patients who are negative for dysplasia. This approach has several advantages; it costs less and it focuses the physicians time and effort on those patients who are most likely to progress to cancer (Provenzale et al, 1998).

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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