Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Colorectal cancer is the third most common cancer found in men and women and a leading cause of cancer-related deaths. Screening tests for colorectal cancer include using simple tests to detect the presence of blood in the stool (feces). These tests are called fecal occult blood tests. Doctors may also use an instrument -- the flexible sigmoidoscope -- to examine the lower parts of the bowel directly (where cancers are most commonly found).
It is suggested that tests to look for blood in the stool should be conducted annually in everyone over 50 years
of age. If there is a strong family history of colorectal cancer, then not only should testing be started much earlier, in the 30s or 40s, but testing may need to be more invasive. The doctor can take a small sample of stool and test it in the office. Sometimes it may be easier for you to provide a stool sample at home using a test kit and mailing the samples to your doctor for testing.
For more invasive screening, a colonoscopy is performed. This test uses a long narrow flexible tube to view the
entire colon. Talk with your doctor about the use of this test because the doctor will take all factors into account (for example, your family history and past medical history) to determine when you need it.
Your doctor may require you to use a strong laxative (called a bowel cleanser) to clear your bowel of fecal contents before colonoscopy. Several medications are available for bowel cleansing, including polyethylene glycol 3350 (GoLYTELY, NuLYTELY), magnesium citrate (Citroma), and senna (X-Prep). These medications produce diarrhea, which can be uncomfortable, but unless the bowel is empty of stool, the test can be limited and may need to be repeated at a later date. Your doctor may also require a special diet, such as a clear liquid diet, starting
one to two days before your scheduled colonoscopy.