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June 21, 2025

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8 Letters to Editor

Letter to the Editor: Canary in the Colonoscopy Mill

July 23, 2022 by Letter to Editor

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I’m a person who has a mammogram once a year.  As part of routine preventative health care, I also have a colonoscopy procedure in accordance with the national standards for frequency. Although only 8% of newly diagnosed cancers are colon cancers, early detection and treatment dramatically reduces death rates.  So colonoscopies are very valuable and I would want to continue to have them as recommended. 

What I have discovered is while the procedure itself may have minimal complications, the anesthesia used may put patients at unnecessary risk for aspiration pneumonia. While I have since learned of two individuals in Easton who developed aspiration pneumonia after their colonoscopies, my own complication was nodules on my vocal cords and laryngitis because of severe coughing as I came out of the anesthesia.  Not being able to speak was finally alleviated after six months of steroid injections in my vocal cords (extremely unpleasant) and voice therapy at Johns Hopkins.  

It was only when I investigated what had happened to me that I learned I was lucky.  The documented most frequent complication from colonoscopy with deep sedation is not damage from the colonoscopy procedure itself but the aspiration pneumonia resulting from the anesthesia.  And not just any anesthesia but deep sedation that is in recent vogue at endoscopy centers since it’s possible to do more procedures in a day than with the previously popular but less risky moderate sedation. (Cooper et al, JAMA Internal Med/vol 173:7. Apr 8, 2013)

What’s the big deal about deep sedation vs. moderate sedation?

Moderate sedation makes you drowsy cognitively but the protective reflexes in your throat which allow you to clear your throat and cough to protect your lungs from inhaling stomach acid etc. continue to function.   With deep sedation those reflexes do not function during at least 20 minutes while you are lying flat on your side so that when you wake up you are at risk of coughing severely to clear your throat of what has accumulated there (like me) or much worse than that, your coughing is unsuccessful and you aspirate acid or other stomach contents into your lungs leading to aspiration pneumonia. 

What to do?  Before your colonoscopy talk to your Gastroenterologist about the anesthesia you require and make sure the endoscopy center is prepared to provide that when you make your appointment.

This is a cautionary tale as someone who didn’t go through a Gastroenterologist and didn’t have the anesthesia options explained as the anesthesia provider was required to do.  

Holly Wright
Easton

 

 

The Spy Newspapers may periodically employ the assistance of artificial intelligence (AI) to enhance the clarity and accuracy of our content.

Filed Under: 8 Letters to Editor

Mediation Corner: On Reaching Agreement Delmarva Review: Daddy’s Hands by Richard Tillinghast

Letters to Editor

  1. Clarke Douglas Bayne says

    July 24, 2022 at 7:31 AM

    Thankyou,Holly Wright

  2. JOHN KRAMER says

    July 24, 2022 at 4:25 PM

    Thank you Holly for this information. Your characterization of a colonoscopy “mill” is a spot on description of my reaction to my Digestive Health Association, Easton procedure 18 months ago. Minimal contact with the physician, no follow up on meds prescribed. The choice of anesthesia based on number of procedures sounds consistent with their industrial approach to medicine. I was happy to find an alternate, non-mill, provider in Chestertown. I’ll be sure to ask about the anesthesia.

  3. Ed Plaisance says

    July 25, 2022 at 11:47 AM

    Thanks for the heads-up.

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