What test to take before seeing gastroenterologist?

[Canadian]

Hello,

I am a 71 years old man and am suffering from chronic lower abdominal pains that keep me awake at night. It looks like it may take months before I can see a gastroenterologist, and much longer to get a colonoscopy. The long wait makes me nervous and I would like to request other tests from my GP to give me an idea of how urgent the colonoscopy is. This would help me decide on whether to go for private medical care in the US (no insurance).

I am thinking of a stool test to check for blood, should I also ask for a stool culture test?

Then there is the CEA test. I see this test as being similar to the PSA test (which BTW, when I took it against medical advise 12 years ago, saved my life as I had aggressive prostate cancer!).

I have had an abdominal US, basic blood counts, and a urine test.

What other test could I request from a GP?

I hope you can suggest test that can help me decide on whether to seek private care.

Many thank for you suggestions!

This is a great forum! Good luck to all of you in your struggle,
Canadian

[nkoske]

A colonoscopy is really the only sure fire way to find tumors. You can do Fecal Occult Blood Test (FOBT) to look for blood in the stool. There's also the CEA blood test, but it only works for some (didn't work for me). Then there's the Sigmoidoscope which is basically a short Colonoscope, which can only see a bit past the sigmoid colon.

Are colonoscopies every 10 years after 50 a standard thing in Canada as they are in the states?

Just as a point of reference my colonoscopies were $5-6k, but that's with insurance in the U.S., not sure what a cash payer would pay.

[some]

This seems like an important issue. I'm having trouble understanding why you have to wait so long.

If you do decide to pursue in the US, get yourself a cash price. It should be much less. I think that insurance only pays a fixed amount of less than $2000, so you should be able to negotiate for that too.

I think colonoscopy first, then CT scan if they see anything.

Have you considered going to ER for pain and see if they might push for a colonoscopy to diagnose the origin of the pain?

I hope it's nothing!

Good luck.

Serena

[Cat]

Hi Canadian. I'm Canadian too, and I think what you mean is that you have no insurance in the States, right? Because it would be covered here. If you want to talk more about where you are, feel free to private message me.
Wishing you all the best.
Cat

[smokeyjoe]

What province are you in, if you are in Ontario you should be able to get in to get a colonoscopy fairly quickly. Did you mention to your primary you want a colonoscopy? I don't think you have to get one through a G.I. doc. appt. first.

[Voxx66]

You need to get a colonoscopy ASAP. I'm not familiar with the Canadian healthcare system but surely there are provisions for getting tests done when time is of the essence. This is the only way to really see what is going on for sure as CEA isn't always elevated and blood can be in the stool for many reasons.

[Mastan]

When I was first diagnosed I wanted to get operated on immediately. My surgeon indicated that CRC is not a raging fire, it takes a long time to develop. As such I took a planned vacation before starting treatment. The same reasoning applies to your situation. I suggest scheduling the colonoscopy at your earliest convenience and then try to get some guidance from the GP on symptom management. Once the colonoscopy is scheduled, relax until you get the data.

Mark

[Canadian]

Thank you all for your replies, you are very kind to respond. I appreciate the various suggestions.

I had a colonoscopy/CEA about 15 years ago (10 year is the norm), they were unremarkable. I had a colon resection 40+ YEARS ago; tumor removed but no biopsy as they 'lost' the specimen.

My GP is approachable on short notice however the Gastroenterologist who is to perform the colonoscopy is slow to book. I phoned a week after the fax went out and was told they are booking for February, but that I could check back in January if I hadn't heard anything. She mention that some appointments are 4-5 months away. The problem is that they could not give me a firm date. In a week I will call again, perhaps they surprise me or find another specialist... I am also considering ER (thank you!). I am not overly worried but the system here tends to wait until you get really sick and then spend $200-$400K trying to keep you alive. At my age friends are dying from preventable causes, and I prefer not to join them yet

fwiw, In Ontario we have no private hospitals - queue jumping is done but illegal. I contacted the Cleveland Clinic in Toronto and they will give me a Colonoscopy as part of their Executive Health Exam in about three weeks ($2K-$3K) - I will check whether the will provide this service by referral only. Part of this may be covered by our OHIP system, OHIP doesn't normally cover across-border medical care, however medical expenses are tax deductible.

Thank you again, and best to all of you,
Canadian