Dear Dr. Roach: I have a question about the results of a colonoscopy I had yesterday. I have a twisted colon. Since I was under a twilight pain medicine for the procedure, the doctor couldn’t complete the last portion, because it was too painful for me. He recommended that I return in three to four months to have another colonos-copy under general anesthesia so he can complete the procedure. He said all looked fine, and he saw no polyps or anything else alarming.
After researching what a twisted colon is, I am very concerned. I do suffer from occasional constipation and have noticed other mild digestion problems during the past few years, but nothing major. This diagnosis scares me and, from what I have read, looks like it could become a serious problem.
What causes a twisted colon? Could it be scar tissue from two C-sections and a hysterectomy? Genetics? My doctor doesn’t seemed concerned, and said to carry on as usual. Thanks for any information you can give me on this subject. It’s hard to find anything online that isn’t of the doom-and-gloom variety. T.S.
I think this is a case of poor communication due to imprecise language. There are two turns the colonoscopist has to make when doing the procedure. One is where the colon makes a turn around the spleen (splenic flexure) on your left side, and the other is around the liver (hepatic flexure) on your right. These “twists” in the colon are normal, but if the turn is somewhat sharper than average, the scope may have a tough time passing, and he wanted to have you more sedated rather than cause you pain.
I suspect your online searches lit on volvulus, a twisting of the colon on its axis, like a sausage link. This is a medical emergency — it causes an obstruction of the colon and can interrupt the blood flow, and may require urgent surgery. The time course is variable: sometimes catastrophic, but often slow, with patients presenting three or four days after symptoms began. A volvulus often happens at points of weakness, such as scar tissue.
Your doctor wouldn’t wait three or four months to treat a volvulus.
Dear Dr. Roach: My daughter was diagnosed with Lyme disease. I’m from Michigan, in a county with open spaces and lots of animals. Probably a tick caused it. Are there doctors who treat this disease in our area? Lots of people in this area have it. P.A.
Lyme disease is caused by a bacteria, Borrelia burgdoferi, which is spread by the black-legged deer tick, Ixodes scapularis.
Most cases of Lyme disease start with a characteristic rash, sometimes with fever or other symptoms. It can be treated effectively, usually in the early stage, with oral antibiotics, such as doxycycline.
An infectious-disease expert can help confirm the diagnosis and ensure proper treatment.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column when possible. Readers may email questions to ToYourGoodHealth@ med.cornell.edu or write him at P.O. Box 536475, Orlando, FL 32853-6475.
