Colonoscopy pricey but valuable test

Dear Dr. Gott: When you’re writing about unnecessary expenditures in the Medicare system, why don’t you disclose the uselessness of the routine colonoscopy? First, a simple fecal test could eliminate the profitable colonoscopy by determining whether irritable bowel syndrome is the culprit. Come on, doc, do it!

Dear Reader: OK, I’ll do it.

The routine colonoscopy test is far more vital than you realize. Its primary value is in diagnosing colon cancer at its earliest stages, when biopsy and removal of polyps and other growths will virtually ensure a cure. If ever there was an effective cancer-preventive, this is it. Using modern techniques, specialists can essentially prevent colon cancer.

Irritable bowel syndrome, a constellation of intestinal symptoms (including constipation/diarrhea, abdominal distress and excess gas) is diagnosed partially on the basis of a normal colon study. IBS is no longer a diagnosis of exclusion.

Although valuable in certain situations, the stool blood analysis has its drawbacks: Not all colon cancers bleed, and IBS patients almost never do. Therefore, this test is for screening only, unlike the colonoscopy, which is the gold standard.

All men and women should, in my opinion, have colonoscopies every five to 10 years, starting at age 50. Please don’t criticize colonoscopy irresponsibly; the good it does more than compensates for its cost.

To give you related information, I am sending you a copy of my revised Health Report “Irritable Bowel Syndrome.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: Can you explain to me the controversy about vitamin E? Some say 200 milligrams is fine, others say 400 milligrams is OK, and others say stay away. Are there any pluses or minuses to vitamin E?

Dear Reader: You raise an important question that has, in my opinion, yet to be answered.

A few years ago, vitamin E supplements were encouraged. People were told that this antioxidant, in doses of 400 to 800 international units per day, would protect against heart disease and vascular disorders by helping the body to burn fat and achieve a better metabolic balance.

Now, recent studies have purported to show the opposite, and people are being encouraged to avoid supplemental vitamin E. Nonetheless, men with prostate disorders are still encouraged to take vitamin E.

There are your pluses and minuses. The question is still open to debate. But, until further investigation sheds more light on this topic, I encourage my patients to avoid taking the vitamin in daily quantities exceeding 400 IU. I’ll keep my readers posted.