Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
To help screen for colorectal cancer, we recommend that you take an annual fecal immunochemical test (FIT). You can take this test at home and then mail it to our laboratories for analysis. To stay up to date on your screening, you'll need to take the test every year. If you have had a colonoscopy or flexible sigmoidoscopy, please check with your doctor before doing a FIT test.
FIT can detect small amounts of occult (hidden) blood in your stool. The test is quick and easy to take and requires no special preparation. It is most commonly used to screen for colorectal cancer, though occult blood can sometimes be caused by other conditions of the digestive tract, like Crohn's disease or ulcerative colitis.
There are several similar tests on the market that all screen for occult blood in stool. One is the fecal occult blood test (FOBT), which is very similar to the FIT kit. We prefer the FIT kit over similar tests due to its accuracy in detecting hidden blood and because it's easy to take and convenient for our members.
Colorectal cancer often begins as polyps, which are small growths inside the lining of the colon. While most polyps are harmless (benign), they may turn into cancer, and thus should be monitored, especially in adults over the age of 50.
Since these polyps grow on the inside of the lining of the colon, they sometimes bleed when brushed by stool moving through the colon. Blood in the stool could be an indication of these polyps, which is why testing for this kind of blood is an effective way to screen for colorectal cancer.
A stool test is a very quick test with no known side effects. The test is done with a sample of your stool (feces) that you collect yourself. It is most common to do this test at home with a kit you receive in the mail.
You do not have to make any special preparations for this test or change your diet beforehand. We will provide all the supplies you need to do this test at home.
After you have a bowel movement, you place a small sample of your stool in a tube. Then you mail the tube to a Kaiser Permanente lab, where we analyze the sample and look for traces of blood that may be an early sign of colorectal cancer.
To stay up to date on your screening, you'll need to take this test every year.
There are several ways to screen for colorectal cancer. We can discuss the options and decide together which is best for you, including one of the following screening tests:
A flexible sigmoidoscopy is similar to a colonoscopy, but only part of the colon is examined. The entire colon is 4 to 5 feet long, but a flexible sigmoidoscopy examines only the lowest 2 feet of the colon, called the sigmoid and descending colon. Because this test examines a shorter part of the colon, it is usually done in our offices instead of in the hospital. This procedure does not require any sedation.
There is less preparation needed for a flexible sigmoidoscopy than for a colonoscopy. You will need to take several enemas or an oral laxative 2 hours before the exam to clear your lower colon and rectum. We'll also ask you to change your diet for several days before the exam.
During a colonoscopy, the entire length of the colon is examined from your small intestine to your rectum. While you are under sedation, we insert a long, flexible tube into your rectum and move it slowly through the length of your colon. A video camera at the tip of the tube allows us to search for abnormalities, which we can then sample or remove for analysis. If we find abnormalities (polyps, for example), we may take a small biopsy (sample for testing) or remove the abnormal tissue.
A colonoscopy is usually considered an outpatient procedure, meaning that you will not have to stay in the hospital overnight. You are sedated for the procedure and will need someone to drive you home afterwards. You will need time to prepare for the procedure by altering your diet and drinking a strong laxative the day before your procedure to clear your colon of waste.
For people at higher risk of colon cancer, a colonoscopy is the preferred method of screening for colorectal cancer because it allows the doctor to see the entire colon.
A barium enema is an X-ray of your colon. During the exam, we insert a thin tube into your colon through your anus. With this tube, we fill your colon with barium, a liquid that shows contrast during an X-ray. Then we take a standard X-ray of your abdomen. This allows us to see any abnormal tissue or growths in your colon wall.
You will need to prepare for this exam just as you would for a flexible sigmoidoscopy. We may recommend laxatives or enemas to clear the colon in preparation for the exam and changes to your diet in the day or two before the test.
If you are a healthy adult between 50 and 75 years of age, you should have regular screening tests for colorectal cancer. There are many screening options for you. Your personal physician can help you choose between the different tests and decide how often you would like to be screened.
If you have no risk factors you should have a FIT Test every year or a flexible sigmoidoscopy every 5 years.
If you are over 40 with one or more of the following risk factors you should have a colonoscopy every 10 years. Risk factors include:
The FIT test is usually done at home with a kit you receive in the mail from Kaiser Permanente. You mail the sample back to a Kaiser Permanente Lab. Your results are usually available on line in a few weeks. If blood is found in your stool your personal physician will contact you and recommend a follow up test called a colonoscopy.
If you have not received a FIT test in the mail you can pick one up at any Kaiser Permanente facility, either in the adult medicine department or at the lab.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
I will recommend that you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
• View and compose secure e-mail messages.
• Manage your prescriptions.
• View your past visits and test results.
• View your Preventive Services to see whether you are due for a routine screening or updated immunization.
• Read about causes, symptoms, treatments, and procedures.
• Find interactive health tools, videos, and podcasts to help you manage your condition.
• View programs to help you decide on or prepare for a surgery or procedure.
• Locate health education classes and support groups offered at every medical center.
• Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
• View your Preventive Services to see whether you are due for a routine screening or updated immunization.
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.