Had my first colonoscopy 4 months ago, after going for a couple of years with every red flag symptom under the sun.
The procedure was a piece of cake. As the standard is where I'm from (Norway), I was only administered some sedatives - but honestly I couldn't feel much difference. I watched the procedure on the screen, which was quite fascinating.
The worst part, by far, was the emptying / prepping. A month prior to the colonoscopy I took a stool sample (negative for blood), but my doc wanted to be safe.
In the end they nothing was found, not even polyps.
EDIT: I had put of going to it for the longest time, but a friend of mine (35 years old) was diagnosed with stage 4 last year, which pushed me to get it checked out. He had experienced prolonged constipation, that's it. When the tumor was found, the cancer had spread to both of his lungs and liver. He's still alive, and fighting it.
My doctor recommended a combination FIT+DNA test instead of colonoscopy (brand name "Cologuard"). She said it's not quite as good as the "gold standard" colonoscopy, but it also doesn't have the risks of colonoscopy.
And the FIT+DNA test is so cheap and easy, you can do it every year or three instead of every 10 years with the colonoscopy.
She still recommends colonoscopies for high-risk patients, but she thinks the risks outweigh the benefits for low-risk patients, so she recommends Cologuard in those situations.
I appreciate this risk-adjusted and probabilistic approach rather than one-size-fits all recommendations.
> The worst part, by far, was the emptying / prepping.
This. The procedure itself was a snap (I was completely sedated; I'm in Canada), but it was NOT a fun 2 days of "pooping" pure liquid and being hungry. I don't think I was away from the toilet for more than 20 minutes at a time.
I didn't actually mind the prepping too much personally. Just to be safe I started early to go on the long end of what they suggested with the diet and basically just ate baked, unseasoned chicken for 10 days. Then did the bowel prep; a lot of people hate the drink, but idk. I thought it was fine. Maybe better to assume it will suck though, that way you at least can't be disappointed.
> In the end they nothing was found, not even polyps.
I just had my hole inspected and all the preparation was with over-the-counter supplies. My prep drink was gatorade with some flavorless powder mixed in. It made no change in the taste or texture of this drink. Having the squirts for a day was no fun, but other than that it was a breeze.
> The worst part, by far, was the emptying / prepping.
Protip to those who have it coming up: Ask for the pill prep instead of the "sludge" prep. You end up spending the day on the toilet either way, but at least it doesn't taste as bad with the pills.
It depends, if you want the best possible colonoscopy quality, do the liquid/"sludge" prep, the general consensus is it cleans you out the best and gives the best possible view during the procedure. However that's only true if you actually do it properly and drink all the liquid.
A decent number of patients can't/don't get through all the liquid in which case the pills are far better.
> Oral sodium sulfate in a single dose has been found to cause increased gastrointestinal (GI) events
> Sodium phosphate is no longer recommended as a bowel preparation regimen due to its serious side effects
Essentially, put in the effort and do the liquid bowel prep.
Consider adding flavour drops to your drink, icing it or turn it into a slushie to make it slightly more interesting to drink. The PEG will make the ice crystals slightly more smoother.
Essentially, put in the effort and do the liquid bowel prep.
It's not just about effort. I must do the liquid prep due to my Crohn's disease. And while I am able to get the liquid down (as you note, it helps to make it as cold as possible; also, suck on an ice cube before drinking to numb the taste buds), I can't keep it down. Within an hour it has me evacuating from both ends.
For my last test, I barely slept at all the night before on account of the vomiting, and even once I got to the hospital I was lying on the wonderfully cold tile of the floor between rolling over to vomit in a trash can.
They know it affects me badly, but still assess that it's necessary due to my risk factors. And because I'm losing much of the drug due to the vomiting, the prep is poor, so I have to start fasting a day early to ensure that I get sufficiently cleaned out. It's torture all around.
These are best practices guidelines that are ultimately implemented (or rejected) by surgeons who still go by feel, whether following the latest-and-greatest or by what they are used to.
I can’t compare the two, but fwiw, in my experience, while the drink is mildly unpleasant it’s only the texture of the drink itself that’s bad and the fact that you have to drink quite a bit of it. It doesn’t taste bad per se (and you can add flavored drink mix to help) and the “purging” part is painless, ie no cramps or anything.
I had a colonoscopy without any sedatives and I agree, the prepping was worse. Not eating for 24 hours was easy, drinking the solution the night before was unpleasant, and drinking the solution the day of was awful.
My pro tip would be to take the day off work. Trying to work while drinking the solution in the morning didn't really work.
Seeing young adults around me going through this made me change my dietary habits 1 year ago. I went to the extreme by modern food industry standards, but now:
- I take 100g proteins, 30g fibers daily
- Red meat once a week but never fried
- Most of the protein comes from eggs, yoggurt, chicken and various plant based sources
- No white bread
- No added sugars, no deserts except fruits
- Nothing fried
- No added salt
- No canned food
- Saturated fats kept at minimum.
- No spicy food
- No alcohol
The results are incredible. I lost 8 kg, my blood samples are perfect, my pulse dropped with 10, I sleep better, no migraines (I had those for years). Also this year I was the only one in the family that didn't got any cold, and that's quite hard with two kids going to kindergarten.
It's hard in the first two weeks, but afterwards it's becoming your daily routine. I also use an app to track various stats. The gameification of the diet also helped me a little.
I urge you to try this. To make it more manageable start small. For example avoid fast food for 2 weeks. Don't put any mayonnaise in your food for 1month. Stop eating white bread. And then add more and more restrictions. The hardest fight is the urge to eat sugar and drink alcohol, give it time.
Glad you’re feeling better, but you could have just stopped at increase fiber intake and decrease red meat and alcohol consumption. None of the rest is linked to colorectal cancer, certainly not mayonaise, which is just oil and egg.
I've explained why I don't have mayonnaise. Also it was just an example. I avoid it because I can eat more meaningful stuff without bombing my calories and saturated fats stats. The mayonnaise I find in the shops has terrible composition.
If I track the salt, a lot of the salt I need comes already from various types of yoggurts (like ayran, or light cheeses and meat), if you actually track it and scan the barcodes of what you eat, you will find out there's already enough to add more.
I was eating spicy food and it irritated my intestines. I have enough fibers to never get constipated.
I’ve done the same. Lately the increased fiber is making me think I have colorectal cancer with all the abdominal bloating LOL. Hope it settles soon! Been like a month
I've increased the fiber intake from close to nothing to 30g gradually. After a few months into the game the bloating doesn't appear anymore. Also some probiotics can work in the beginning, but usually the best ones are more expensive and the science behind them is disputed.
In the morning I have boiled eggs, or yoggurt with cereals that don't have sugar, I also add various type of seeds and maybe I have a fruit or two.
At lunch I usually have chicken breast or fish and some carbs (usually rice, or baked potatoes, rarely some simpla pasta). Salads, carrots, tomatoes, cucumbers, cooked vegetables, home made soups.
Then I have smaller meals with more fruits, or yoggurt with less fat. Or soups.
Mayonnaise is just oil, egg, and some vinegar, salt, and mustard. All of those things you have in your new diet so you lost me on why you wouldn’t eat it.
Sure but you should be counting your saturated fats if you’re counting your fiber and protein intake as well as everything else. I make my own mayonnaise.
Ok. Maybe it wasn't the best example, but my reason I avoid things like mayonnaise is because they add lots of fats and calories without making me feel full. Most of the commercial mayonnaise, in my part of the world, doesn't have a lot of proteins (even if in theory the eggs should be there), and have lots of saturated fats. So I prefer to fill the calories counter with more meaningful choices. For example I very much prefer having 20g of nuts instead of adding mayonnaise.
All in all. That was an example to make a point. I also don't eat butter.
What’s the no spicy food about. Capsaicin has a lot of benefits especially as an anti inflammatory and (less researched) anti oxidant. Plus, it makes a lot of bland food incredibly palatable.
Had my first colonoscopy at 46. Found cancer, stage 2b. Resection and chemo. I was completely asymptomatic. I put a post on FB and I now know about a dozen people who that prompted to get their colonoscopy done. Get it done, the prep isn't bad, get the pills if you can, otherwise make sure you get a Zofran along with the prep. If found early, it's easy to treat. Get It Done.
One thing I can't figure out from the content or the graphs (where I can read the legends with my 1975 eyes) is whether this adjusts for overall mortality rate, which is to say, is any of this effect due to the fact people are more and more likely to wear seat belts, not die of (now-)preventable diseases, etc.?
EDIT: having thought that over a third time, I am not sure it makes any sense.
People should be reminded that colonoscopy is not just a screening, it is also preventative. They often find growths that may develop into cancer, and remove them during the procedure.
Does insurance see it this way? I've had a couple precancerous moles (melanoma in situ) removed, which seems similar, and my health insurance provider billed me more than I was expecting because they didn't categorize it as preventive care.
I did a colonoscopy at 38, because I saw something in the toilet that looked like the lingonberries at Ikea. Everyone was like "Man that seems early" but when I woke up, the doctor expressed some surprise when he told me they removed a couple of polyps.
A week or two later, I got a bill for several thousand dollars, and I just had to roll with it. I believe that in the US, there is a certain age, after which, they're covered.
> “Hey! CRC is going up! You should get screened!”
Try asking a doctor for asymptomatic screening (for anything), they usually say "There's a schedule for such screenings at age X, you're too young for that. There's also proven negative effects of excessive screenings."
Which kinda makes sense, as they supposed to have protocols/schedules for all kinds of healthcare. We're talking here about changing that protocols/schedules. But doctors (and insurances) are generally reluctant.
So my actionable question is "How do I convince my doctor to get the screening?"
I have UC and will get colonoscopies to confirm it is well-controlled for the foreseeable future. It also increases risk of colorectal cancer, something I am actively thinking about. Rates of UC, IBD, and similar digestive issues are up across the board, also for a mixed and seemingly inscrutable set of reasons.
IMO, the fundamental issue for preventative screening is there is basically no amount of money I would not part with (of my money, the insurer's money, or private debt) to not die. I expect this is true for most people, and it makes preventative screening a tricky topic. In recommending screening for those >x age, you will miss some detectable, preventable and treatable cancer risk for those <x age, purely for cost. No one wants to be explicit about that though!
I think the only way out of that uncomfortable conversation is making screening so cheap via automation that you can basically run it for very low incremental cost as often as individual risk tolerance permits. This would be paid for on the back of earlier interventions vs late-stage, expensive interventions.
A colonoscopy is more than screening, if they see a polyp they remove it. Left alone that polyp will very likely eventually become cancer. Routine colonoscopies for someone with IBD is multi purpose, you screen for active disease, fistula, strictures, cancer, while simulatenously treating active disease (polyp removal)
Similar things happen in any general surgery, for example you can get your tubes removed and send up with all your endometriosis that you weren't able to diagnosis removed as well
> We don’t yet know if colonoscopies are better than other methods of screening
My Gastroentrologist told me just recently that the stool test (Cologuard) is very accurate but must be repeated every 3 years as opposed to getting a Colonoscopy which should be repeated every 7 to 10 years
What is better? My colonoscopy came with a dose of propofol that made me understand why Michael Jackson went out the way he did. Best sleep I've ever had.
I recommend getting a colonoscopy if you have any symptoms. There is a lot of stigma that prevents people from being proactive about this type of issue.
My anecdote (M, 35) is that I got one after experiencing symptoms that turned out to be unrelated, but they did find pre-cancerous polyps so now I will be getting them more regularly. I received received meaningful early detection and peace of mind. Also aside from the prep, its a very convenient procedure. You get put under anesthesia and do a quick time travel.
Nice to have a good data-based take on this question make it to the front of HN!
One of our better microscopes these days is DNA sequencing, especially for cancer, and the particular base mutations and the sequences in which they occur give heavy clues about the types of mutagens that are going on. The DNA damage from UV radiation from the sun and bulky adduct repair from smoking damage are vastly different. Even when cells have a defect in a repair mechanism, you can tell which repair mechanism is broken based on the particular base changes in which context.
A study from 2025 reapplied these Alexandronv signatures to colorectal cancer with a global set of cohorts, and suggests that colibactin, a mutagen produced by some strains of E. coli and related bacteria, could be driving some of the increase in early age colorectal cancer:
Of course we don't know exactly how much of the increase, or the other explanations; causality is multi-causal and I bring this particular cause up because it's one of the stronger leads so far. But when we've lost our keys in the night, even if its easiest to look under the light of the streetlamp, that doesn't mean its the only place we might find them.
There was some discussion about this on HN recently. Supposedly something to do with less blood going to the bowels during prolonged exercise. Apparently the risk was largest in people who ran 5+ marathons.
Various kinds of cancer are going up in later generations. (Definitely at younger ages, possibly at all ages.)
Reminder
This blog endorses colorectal cancer screening. We don’t yet know if colonoscopies are better than other methods of screening (sigmoidoscopy, stool tests), but we do know that screening is better than not screening. When caught early, CRC is highly treatable, often with only surgery (no chemotherapy or radiation) and a return to normal activities within a couple weeks.
All this talk about different groupings (and overlapping kinds of time) makes me think of Simpson's Paradox [0], where how we slice things can be very important to what trend we see.
what is rate per 100.000 tracking? I guess it means among living persons at every datapoint. If so decreasing mortality overall and final diagnosis specifically plays a large role in the numbers
Very good visualization repair. I particularly appreciate the TL;DR at the end. In a world of mostly bad popular medical advice this seems competent and at least facially correct.
Did you miss the BILLIONS in lawsuits against RoundUp and other herbicides?
Did you miss all the deregulation by the first and now second Trump administration allowing crazy levels of pollution and toxicity among all the industries?
They are still using leaded fuel in prop aircraft at hundreds of airports around the country and world, spraying it on unknowning population
Our environment has never been more dangerous yet people never more ignorant or carefree
One can always count on Trump being brought up in any discussion. Trump is definitely not the Second Coming as his proponents believe, but the previous admin is not the Saint Incarnate either, on this particular subject.
Biden's EPA filing:
The agency says it is standing by its conclusions that, as registered, glyphosate doesn't pose major risks to human health..."
Any US admin always serves the Big Business, and people's health is just a bump on the road.
Personally I am hesitant to do colonoscopy after a relative had a botched procedure. Just this month two celebrities revealed botched colonoscopies. I hope they figure out ways to make this procedure safer.
Those articles don't really say what the "botch" is. Was it the anesthesia? The actual endoscopic examination? Removal of polyps?
If its the polyp removal, I can certainly see how that could lead to problems. But you're a little stuck: even if you use another technique to do the scan, you still have to remove any polyps you find, don't you?
yes I've had both a colonoscopy and a sigmoidoscopy (less invasive colonoscopy).
I'm not sure what the botches are here. In the sigmoidoscopy they took out a couple of polyps, in the colonoscopy (more recently than the sigmoidoscopy) they just did a cancer check-up given family history.
I wish those articles discusses the "botches", I'd like to know since from my understanding these are pretty safe procedures
I did mine without anesthesia/sedatives. There were moments of discomfort when they pump gas to expand the area - feels like a big fart is stuck in your gut - but otherwise no big deal, especially knowing that the pain is not dangerous. Recommend. It eliminates recovery time afterwards (you can drive yourself home) and increases safety.
Might try that this time. OTOH, I get the greatest nap of my life shaking off the sedative (get the lighter, cheaper option like Versed instead of anesthesiologist-administered propofol) and my spouse makes me a milkshake.
As someone with colon cancer, I'd rather the complications than what I'm going through. 8" of colon removed, 6 weeks of recovery then 7 months of chemo treatments. If I could go back in time and get my colonoscopy at 35 instead of 46 and get only do a night in the hospital, I would in a heartbeat. Colon resection and chemo suuuuuuuuuuuuck.
Healthy skepticism of procedure over-prescription is reasonable and maybe even wise, but I wouldn't really take the celebrities section of USA Today as a data point, maybe not even as a reliable anecdote.
Based on your concern, the question is whether 'botched' procedures are more or less of a risk (both in incidence and consequence) than non-screening.
I had to start getting colonoscopies ahead of schedule because my dad never did, until it was too late. He was scared of doctors after he associated them with family members' unpleasant deaths.
Read the safety statistics and let it override the anecdotes. Colon cancer is easy to prevent and a horrible way to die.
It is one of the most common procedures and is generally very safe. Even a botched procedure probably just means some temp discomfort after the procedure. Much better than the alternative.
My doctor actually doesn't recommend colonoscopy until age 50. But starting at age 40 they have you do the "poop in a box" test instead, and then only have you come in if that shows anything.
The complication rate for colonoscopy is about 3 in 1000, and that is skewed towards people who have polyps, which in and of themselves could be dangerous if not removed.
So it's always a risk tradeoff. You can skip the procedure and risk the effects of the disease it's supposed to detect instead. But if you do the math, you're statistically better off doing the procedure.
Human biology is such a horror...I've been through it with enough loved ones that I've been left with two obsessions: a) a dignified way to go when my time comes, and b) we should either fix human biology, go post-biological, or simply surrender as a species and be replaced by AI. I know there are many counter-arguments to the above, but I've come to suspect the integrity of our species' rationality under the savage ravaging of Dog.
I’m not sure if this comment is AI generated but I’d like to make a point either way.
Human biology is orders of magnitude more efficient than AI; that’s in regards to intelligence and processing the world around us.
It is not only more efficient but more complex but yet simple. Therefore, the complexity of our biology is a result of efficiency. An efficiency that allows us to process the world and achieve homeostasis in the most simple way. I’d like to see a machine achieve the same without having any type of vulnerability or weakness to corruption.
Had my first colonoscopy 4 months ago, after going for a couple of years with every red flag symptom under the sun.
The procedure was a piece of cake. As the standard is where I'm from (Norway), I was only administered some sedatives - but honestly I couldn't feel much difference. I watched the procedure on the screen, which was quite fascinating.
The worst part, by far, was the emptying / prepping. A month prior to the colonoscopy I took a stool sample (negative for blood), but my doc wanted to be safe.
In the end they nothing was found, not even polyps.
EDIT: I had put of going to it for the longest time, but a friend of mine (35 years old) was diagnosed with stage 4 last year, which pushed me to get it checked out. He had experienced prolonged constipation, that's it. When the tumor was found, the cancer had spread to both of his lungs and liver. He's still alive, and fighting it.
My doctor recommended a combination FIT+DNA test instead of colonoscopy (brand name "Cologuard"). She said it's not quite as good as the "gold standard" colonoscopy, but it also doesn't have the risks of colonoscopy.
And the FIT+DNA test is so cheap and easy, you can do it every year or three instead of every 10 years with the colonoscopy.
She still recommends colonoscopies for high-risk patients, but she thinks the risks outweigh the benefits for low-risk patients, so she recommends Cologuard in those situations.
I appreciate this risk-adjusted and probabilistic approach rather than one-size-fits all recommendations.
Risks? The risks of a colonoscopy are crazy low though.
They are until they aren't. My grandmother had a puncture and almost died
There is still the rush of perferating the colon, but I assume it doesn't happen very often. Cologuard has got to be cheaper though.
>"Risks? The risks of a colonoscopy are crazy low though."
Not at the statistical level. Death rate from complications is about 1 in 10,000: https://www.endoscopy-campus.com/ec-news/risk-of-death-from-...
2 to 3 colonoscopies per ~1k to 2k people cause severe rupture of the intestines that require urgent surgery.
Yeh if you want to improve the screening rate then someone needs to figure out how to make the prep easier.
> The worst part, by far, was the emptying / prepping.
This. The procedure itself was a snap (I was completely sedated; I'm in Canada), but it was NOT a fun 2 days of "pooping" pure liquid and being hungry. I don't think I was away from the toilet for more than 20 minutes at a time.
I didn't actually mind the prepping too much personally. Just to be safe I started early to go on the long end of what they suggested with the diet and basically just ate baked, unseasoned chicken for 10 days. Then did the bowel prep; a lot of people hate the drink, but idk. I thought it was fine. Maybe better to assume it will suck though, that way you at least can't be disappointed.
> In the end they nothing was found, not even polyps.
Same here, thank god.
These days, in the USA, they're starting to give you an over-the-counter laxative rather than that nasty drink.
I just had my hole inspected and all the preparation was with over-the-counter supplies. My prep drink was gatorade with some flavorless powder mixed in. It made no change in the taste or texture of this drink. Having the squirts for a day was no fun, but other than that it was a breeze.
> The worst part, by far, was the emptying / prepping.
Protip to those who have it coming up: Ask for the pill prep instead of the "sludge" prep. You end up spending the day on the toilet either way, but at least it doesn't taste as bad with the pills.
It depends, if you want the best possible colonoscopy quality, do the liquid/"sludge" prep, the general consensus is it cleans you out the best and gives the best possible view during the procedure. However that's only true if you actually do it properly and drink all the liquid.
A decent number of patients can't/don't get through all the liquid in which case the pills are far better.
I’m doing it this year. Does the pill work as effectively as the drink?
> Oral sodium sulfate in a single dose has been found to cause increased gastrointestinal (GI) events
> Sodium phosphate is no longer recommended as a bowel preparation regimen due to its serious side effects
Essentially, put in the effort and do the liquid bowel prep.
Consider adding flavour drops to your drink, icing it or turn it into a slushie to make it slightly more interesting to drink. The PEG will make the ice crystals slightly more smoother.
https://www.ncbi.nlm.nih.gov/books/NBK535368/
Essentially, put in the effort and do the liquid bowel prep.
It's not just about effort. I must do the liquid prep due to my Crohn's disease. And while I am able to get the liquid down (as you note, it helps to make it as cold as possible; also, suck on an ice cube before drinking to numb the taste buds), I can't keep it down. Within an hour it has me evacuating from both ends.
For my last test, I barely slept at all the night before on account of the vomiting, and even once I got to the hospital I was lying on the wonderfully cold tile of the floor between rolling over to vomit in a trash can.
They know it affects me badly, but still assess that it's necessary due to my risk factors. And because I'm losing much of the drug due to the vomiting, the prep is poor, so I have to start fasting a day early to ensure that I get sufficiently cleaned out. It's torture all around.
> Sodium phosphate is no longer recommended as a bowel preparation regimen due to its serious side effects
Well in my country, it's still wildly used for people without renal issues.
These are best practices guidelines that are ultimately implemented (or rejected) by surgeons who still go by feel, whether following the latest-and-greatest or by what they are used to.
Some doctors will say yes, some no. Best bet is to do what your doctor suggests, but at least ask if the pills are an option.
I can’t compare the two, but fwiw, in my experience, while the drink is mildly unpleasant it’s only the texture of the drink itself that’s bad and the fact that you have to drink quite a bit of it. It doesn’t taste bad per se (and you can add flavored drink mix to help) and the “purging” part is painless, ie no cramps or anything.
I did one two years ago without sedation, I wanted to work afterwards. I didn't feel any pain, so sedation is really not necessary
> The worst part, by far, was the emptying / prepping.
As described in one of the great modern tales of legend:
https://singletrackworld.com/2009/02/the-picolax-thread-retu...
I ended up paying 15000 usd due tó complications.. that was the worst part for me
Which country are you in? Did you have insurance? What kind of complications? Have you recovered completely?
How old are you? I’m 37 and my doc says you get one at 45
I had a colonoscopy without any sedatives and I agree, the prepping was worse. Not eating for 24 hours was easy, drinking the solution the night before was unpleasant, and drinking the solution the day of was awful.
My pro tip would be to take the day off work. Trying to work while drinking the solution in the morning didn't really work.
Seeing young adults around me going through this made me change my dietary habits 1 year ago. I went to the extreme by modern food industry standards, but now:
- I take 100g proteins, 30g fibers daily
- Red meat once a week but never fried
- Most of the protein comes from eggs, yoggurt, chicken and various plant based sources
- No white bread
- No added sugars, no deserts except fruits
- Nothing fried
- No added salt
- No canned food
- Saturated fats kept at minimum.
- No spicy food
- No alcohol
The results are incredible. I lost 8 kg, my blood samples are perfect, my pulse dropped with 10, I sleep better, no migraines (I had those for years). Also this year I was the only one in the family that didn't got any cold, and that's quite hard with two kids going to kindergarten.
It's hard in the first two weeks, but afterwards it's becoming your daily routine. I also use an app to track various stats. The gameification of the diet also helped me a little.
I urge you to try this. To make it more manageable start small. For example avoid fast food for 2 weeks. Don't put any mayonnaise in your food for 1month. Stop eating white bread. And then add more and more restrictions. The hardest fight is the urge to eat sugar and drink alcohol, give it time.
How do you get enough calories while avoiding fats? What do you usually eat in a day?
Glad you’re feeling better, but you could have just stopped at increase fiber intake and decrease red meat and alcohol consumption. None of the rest is linked to colorectal cancer, certainly not mayonaise, which is just oil and egg.
I've explained why I don't have mayonnaise. Also it was just an example. I avoid it because I can eat more meaningful stuff without bombing my calories and saturated fats stats. The mayonnaise I find in the shops has terrible composition.
Why no spice? And why no salt assuming you balance properly with potassium and limit intake overall?
If I track the salt, a lot of the salt I need comes already from various types of yoggurts (like ayran, or light cheeses and meat), if you actually track it and scan the barcodes of what you eat, you will find out there's already enough to add more.
I was eating spicy food and it irritated my intestines. I have enough fibers to never get constipated.
I’ve done the same. Lately the increased fiber is making me think I have colorectal cancer with all the abdominal bloating LOL. Hope it settles soon! Been like a month
I've increased the fiber intake from close to nothing to 30g gradually. After a few months into the game the bloating doesn't appear anymore. Also some probiotics can work in the beginning, but usually the best ones are more expensive and the science behind them is disputed.
I think the hard part for me about doing something like that is not forgoing those things, it's figuring out what to eat instead. Any tips?
In the morning I have boiled eggs, or yoggurt with cereals that don't have sugar, I also add various type of seeds and maybe I have a fruit or two.
At lunch I usually have chicken breast or fish and some carbs (usually rice, or baked potatoes, rarely some simpla pasta). Salads, carrots, tomatoes, cucumbers, cooked vegetables, home made soups.
Then I have smaller meals with more fruits, or yoggurt with less fat. Or soups.
Why no canned foods? Sodium concerns?
Cans also have linings made of material that can contribute to ingesting microplastics and other uncertainties
Yes. Too much sodium, or oil. Or other nasty substances.
Plenty of canned things that don’t have added sodium or oil though.
In my part of the world this is the norm.
Mayonnaise is just oil, egg, and some vinegar, salt, and mustard. All of those things you have in your new diet so you lost me on why you wouldn’t eat it.
The one you find in shops has terrible stats. If you make it at home I guess it's manageable, still it can really bomb your fats stats for the day.
Sure but you should be counting your saturated fats if you’re counting your fiber and protein intake as well as everything else. I make my own mayonnaise.
Ok. Maybe it wasn't the best example, but my reason I avoid things like mayonnaise is because they add lots of fats and calories without making me feel full. Most of the commercial mayonnaise, in my part of the world, doesn't have a lot of proteins (even if in theory the eggs should be there), and have lots of saturated fats. So I prefer to fill the calories counter with more meaningful choices. For example I very much prefer having 20g of nuts instead of adding mayonnaise.
All in all. That was an example to make a point. I also don't eat butter.
What’s the no spicy food about. Capsaicin has a lot of benefits especially as an anti inflammatory and (less researched) anti oxidant. Plus, it makes a lot of bland food incredibly palatable.
Had my first colonoscopy at 46. Found cancer, stage 2b. Resection and chemo. I was completely asymptomatic. I put a post on FB and I now know about a dozen people who that prompted to get their colonoscopy done. Get it done, the prep isn't bad, get the pills if you can, otherwise make sure you get a Zofran along with the prep. If found early, it's easy to treat. Get It Done.
> Yes, if you are currently young, you face higher CRC risk than previous generations did when they were young. That’s the bad news.
Unlike the usual Bettridge's law, the answer to the headline is only a qualified "No".
It is a "So is all other cancers!", which is pretty bad news for folks who are young and healthy right now.
One thing I can't figure out from the content or the graphs (where I can read the legends with my 1975 eyes) is whether this adjusts for overall mortality rate, which is to say, is any of this effect due to the fact people are more and more likely to wear seat belts, not die of (now-)preventable diseases, etc.?
EDIT: having thought that over a third time, I am not sure it makes any sense.
Thanks for the PFAS old codgers.
People should be reminded that colonoscopy is not just a screening, it is also preventative. They often find growths that may develop into cancer, and remove them during the procedure.
Does insurance see it this way? I've had a couple precancerous moles (melanoma in situ) removed, which seems similar, and my health insurance provider billed me more than I was expecting because they didn't categorize it as preventive care.
I did a colonoscopy at 38, because I saw something in the toilet that looked like the lingonberries at Ikea. Everyone was like "Man that seems early" but when I woke up, the doctor expressed some surprise when he told me they removed a couple of polyps.
A week or two later, I got a bill for several thousand dollars, and I just had to roll with it. I believe that in the US, there is a certain age, after which, they're covered.
I think so, even with shitty U.S. providers. I've never had a problem.
Most US insurance has very strict guidelines about what is diagnostic vs preventative for a colonoscopy. And its almost certianly diagnostic.
> “Hey! CRC is going up! You should get screened!”
Try asking a doctor for asymptomatic screening (for anything), they usually say "There's a schedule for such screenings at age X, you're too young for that. There's also proven negative effects of excessive screenings."
Which kinda makes sense, as they supposed to have protocols/schedules for all kinds of healthcare. We're talking here about changing that protocols/schedules. But doctors (and insurances) are generally reluctant.
So my actionable question is "How do I convince my doctor to get the screening?"
Just say you saw blood in your stool. You can also google some of the symptoms and say you have some of the more ambiguous ones.
> So my actionable question is "How do I convince my doctor to get the screening?"
I guess we have to pay for it ourselves. It's not exactly cheap, but perhaps worth it.
I have UC and will get colonoscopies to confirm it is well-controlled for the foreseeable future. It also increases risk of colorectal cancer, something I am actively thinking about. Rates of UC, IBD, and similar digestive issues are up across the board, also for a mixed and seemingly inscrutable set of reasons.
IMO, the fundamental issue for preventative screening is there is basically no amount of money I would not part with (of my money, the insurer's money, or private debt) to not die. I expect this is true for most people, and it makes preventative screening a tricky topic. In recommending screening for those >x age, you will miss some detectable, preventable and treatable cancer risk for those <x age, purely for cost. No one wants to be explicit about that though!
I think the only way out of that uncomfortable conversation is making screening so cheap via automation that you can basically run it for very low incremental cost as often as individual risk tolerance permits. This would be paid for on the back of earlier interventions vs late-stage, expensive interventions.
A colonoscopy is more than screening, if they see a polyp they remove it. Left alone that polyp will very likely eventually become cancer. Routine colonoscopies for someone with IBD is multi purpose, you screen for active disease, fistula, strictures, cancer, while simulatenously treating active disease (polyp removal)
Similar things happen in any general surgery, for example you can get your tubes removed and send up with all your endometriosis that you weren't able to diagnosis removed as well
> Left alone that polyp will very likely eventually become cancer
I don't think so. You have a reference?
https://pmc.ncbi.nlm.nih.gov/articles/PMC9924026/
Though I regurgitate this information based off conversations with gastroenterologists not one off studies.
> We don’t yet know if colonoscopies are better than other methods of screening
My Gastroentrologist told me just recently that the stool test (Cologuard) is very accurate but must be repeated every 3 years as opposed to getting a Colonoscopy which should be repeated every 7 to 10 years
What is better? If the stool test can find something that isn't in the colon but isn't as good for things that are in the colon which is better?
The important part is both are good, so get one.
What is better? My colonoscopy came with a dose of propofol that made me understand why Michael Jackson went out the way he did. Best sleep I've ever had.
My doctor makes me do one every year
I recommend getting a colonoscopy if you have any symptoms. There is a lot of stigma that prevents people from being proactive about this type of issue.
My anecdote (M, 35) is that I got one after experiencing symptoms that turned out to be unrelated, but they did find pre-cancerous polyps so now I will be getting them more regularly. I received received meaningful early detection and peace of mind. Also aside from the prep, its a very convenient procedure. You get put under anesthesia and do a quick time travel.
Nice to have a good data-based take on this question make it to the front of HN!
One of our better microscopes these days is DNA sequencing, especially for cancer, and the particular base mutations and the sequences in which they occur give heavy clues about the types of mutagens that are going on. The DNA damage from UV radiation from the sun and bulky adduct repair from smoking damage are vastly different. Even when cells have a defect in a repair mechanism, you can tell which repair mechanism is broken based on the particular base changes in which context.
A study from 2025 reapplied these Alexandronv signatures to colorectal cancer with a global set of cohorts, and suggests that colibactin, a mutagen produced by some strains of E. coli and related bacteria, could be driving some of the increase in early age colorectal cancer:
https://www.nature.com/articles/s41586-025-09025-8
Of course we don't know exactly how much of the increase, or the other explanations; causality is multi-causal and I bring this particular cause up because it's one of the stronger leads so far. But when we've lost our keys in the night, even if its easiest to look under the light of the streetlamp, that doesn't mean its the only place we might find them.
Also increased, or we're now aware of, higher rates in long distance runners.
I'd love to know the causation for that correlation
There was some discussion about this on HN recently. Supposedly something to do with less blood going to the bowels during prolonged exercise. Apparently the risk was largest in people who ran 5+ marathons.
No one knows for sure. One hypothesis is chronic inflammation, perhaps linked to diet or mechanical stress.
Perhaps higher sugar consumption from fueling techniques?
TLDR from the post itself.
No:
Colorectal cancer is going up in young people.
Yes:
Various kinds of cancer are going up in later generations. (Definitely at younger ages, possibly at all ages.)
Reminder
This blog endorses colorectal cancer screening. We don’t yet know if colonoscopies are better than other methods of screening (sigmoidoscopy, stool tests), but we do know that screening is better than not screening. When caught early, CRC is highly treatable, often with only surgery (no chemotherapy or radiation) and a return to normal activities within a couple weeks.
All this talk about different groupings (and overlapping kinds of time) makes me think of Simpson's Paradox [0], where how we slice things can be very important to what trend we see.
[0] https://en.wikipedia.org/wiki/Simpson%27s_paradox
"None of the experts seem to agree on which of these is the culprit, so I figured that I (person with blog) should help."
In case you aren't aware of dynomight yet, there is a great backlog of posts to read.
FYI there are other options besides a full scope for screening now, especially if you are low risk
what is rate per 100.000 tracking? I guess it means among living persons at every datapoint. If so decreasing mortality overall and final diagnosis specifically plays a large role in the numbers
Free tip: take not too little, not too much... of
(1) Vitamin-D (drops)
(2) Magnesium (as Magnesium aspartate hydrochloride trihydrate)
(3) Psyllium shells (you won't take too much)
(4) Move your body!
I’ve been getting scared of psyllium due to lead risk. Any thoughts?
Get it done!
But not at Kaiser.
$17k later…
Why did Kaiser’s insurance not pay out here?
It did, but my contribution for procedure + pathology was still over $5k. My out of pocket max is ~$8k.
Oh, OK. But you didn’t pay 17K yourself? (I’m also on Kaiser, but never had any major procedure done.)
Is "medical term" used "appropriately"?
Yes. Nothing to see here. And stop abusing quotation marks.
Maybe they're all running too many marathons.
Very good visualization repair. I particularly appreciate the TL;DR at the end. In a world of mostly bad popular medical advice this seems competent and at least facially correct.
I guess cancer is the new climate denial
Did you miss the BILLIONS in lawsuits against RoundUp and other herbicides?
Did you miss all the deregulation by the first and now second Trump administration allowing crazy levels of pollution and toxicity among all the industries?
They are still using leaded fuel in prop aircraft at hundreds of airports around the country and world, spraying it on unknowning population
Our environment has never been more dangerous yet people never more ignorant or carefree
Less MTTF and more MTTR
One can always count on Trump being brought up in any discussion. Trump is definitely not the Second Coming as his proponents believe, but the previous admin is not the Saint Incarnate either, on this particular subject.
Biden's EPA filing:
The agency says it is standing by its conclusions that, as registered, glyphosate doesn't pose major risks to human health..."
Any US admin always serves the Big Business, and people's health is just a bump on the road.
Why are the "critical terms" in "that headline" in quotes?
Then some clown downvotes this straightforward question. Brilliant.
Probably because one of the main explorations of the articles is quantifying "young people."
If the headline merely had quotes around "young," that would make sense.
Personally I am hesitant to do colonoscopy after a relative had a botched procedure. Just this month two celebrities revealed botched colonoscopies. I hope they figure out ways to make this procedure safer.
https://www.yahoo.com/entertainment/celebrity/articles/kathy...
https://www.usatoday.com/story/entertainment/celebrities/202...
Those articles don't really say what the "botch" is. Was it the anesthesia? The actual endoscopic examination? Removal of polyps?
If its the polyp removal, I can certainly see how that could lead to problems. But you're a little stuck: even if you use another technique to do the scan, you still have to remove any polyps you find, don't you?
yes I've had both a colonoscopy and a sigmoidoscopy (less invasive colonoscopy).
I'm not sure what the botches are here. In the sigmoidoscopy they took out a couple of polyps, in the colonoscopy (more recently than the sigmoidoscopy) they just did a cancer check-up given family history.
I wish those articles discusses the "botches", I'd like to know since from my understanding these are pretty safe procedures
Maybe just don’t worry yourself with anecdata.
I did mine without anesthesia/sedatives. There were moments of discomfort when they pump gas to expand the area - feels like a big fart is stuck in your gut - but otherwise no big deal, especially knowing that the pain is not dangerous. Recommend. It eliminates recovery time afterwards (you can drive yourself home) and increases safety.
Might try that this time. OTOH, I get the greatest nap of my life shaking off the sedative (get the lighter, cheaper option like Versed instead of anesthesiologist-administered propofol) and my spouse makes me a milkshake.
As someone with colon cancer, I'd rather the complications than what I'm going through. 8" of colon removed, 6 weeks of recovery then 7 months of chemo treatments. If I could go back in time and get my colonoscopy at 35 instead of 46 and get only do a night in the hospital, I would in a heartbeat. Colon resection and chemo suuuuuuuuuuuuck.
Healthy skepticism of procedure over-prescription is reasonable and maybe even wise, but I wouldn't really take the celebrities section of USA Today as a data point, maybe not even as a reliable anecdote.
Based on your concern, the question is whether 'botched' procedures are more or less of a risk (both in incidence and consequence) than non-screening.
I had to start getting colonoscopies ahead of schedule because my dad never did, until it was too late. He was scared of doctors after he associated them with family members' unpleasant deaths.
Read the safety statistics and let it override the anecdotes. Colon cancer is easy to prevent and a horrible way to die.
It is one of the most common procedures and is generally very safe. Even a botched procedure probably just means some temp discomfort after the procedure. Much better than the alternative.
Nothing you do is risk free.
My doctor actually doesn't recommend colonoscopy until age 50. But starting at age 40 they have you do the "poop in a box" test instead, and then only have you come in if that shows anything.
The complication rate for colonoscopy is about 3 in 1000, and that is skewed towards people who have polyps, which in and of themselves could be dangerous if not removed.
So it's always a risk tradeoff. You can skip the procedure and risk the effects of the disease it's supposed to detect instead. But if you do the math, you're statistically better off doing the procedure.
You can do a FIT test instead which can be done at home.
Human biology is such a horror...I've been through it with enough loved ones that I've been left with two obsessions: a) a dignified way to go when my time comes, and b) we should either fix human biology, go post-biological, or simply surrender as a species and be replaced by AI. I know there are many counter-arguments to the above, but I've come to suspect the integrity of our species' rationality under the savage ravaging of Dog.
I’m not sure if this comment is AI generated but I’d like to make a point either way.
Human biology is orders of magnitude more efficient than AI; that’s in regards to intelligence and processing the world around us.
It is not only more efficient but more complex but yet simple. Therefore, the complexity of our biology is a result of efficiency. An efficiency that allows us to process the world and achieve homeostasis in the most simple way. I’d like to see a machine achieve the same without having any type of vulnerability or weakness to corruption.