Not all endoscopists are created equal


Q: The news seems to be bombarded with naywaysers of gluten sensitivity/intolerance recently, saying that a gluten-free diet only helps people with celiac disease. What are your opinions? Aisha L., Belleville

A: I actually don’t agree that anyone should eat a gluten-free diet for the sake of just being gluten-free; it’s not sensible. However, I do have patients who have tested negative for celiac and experience improvement in their digestive health after gluten elimination trials. If you think you have a gluten sensitivity (abominal pain, bloating, gas, etc.), then yes, it would be good to do a trial to see how it affects you.

Q: Are all endoscopists equally effective at finding polyps and cancers during colonoscopy? Roger V., Melvindale

A: They are not. Gastroenterologists offer greater experience and skill operating a scope, identifying and removing adenomas or polyps within the colon and providing specialized treatment. The most effective endoscopists: 1) Find more precancerous polyps when they take at least six minutes to examine the colon while they withdraw the scope; 2) Keep quality measures of their adenoma detection rates. Per national quality standards, at minimum, the doctor should be detecting one or more adenomas in at least 15 percent of their female patients and 25 percent of male patients undergoing a screening colonoscopy. Another factor that impacts the endoscopist’s effectiveness is the quality of the patient’s bowel preparation.

Q: I am having a follow-up colonoscopy soon and I want to insure a really clean bowel preparation for the best results. Any advice? Sybil D., Trenton

A: You will receive the best results by following the prep instructions exactly as given by your physician. Drink plenty of fluids and avoid solid foods. If you have constipation, share this with your doctor because you may need to be on clear liquid for more than one day.

Rana Sabbagh, M.D., is board-certified in internal medicine, gastroenterology and nutrition. She is the founder of GastroCenter of Michigan and Experior Weight Loss Clinic, 23500 Park St., Suite 2B in Dearborn. Do you have a health question for Dr. Sabbagh? Submit it by email to:

All information provided in Ask The Doctor is intended for your general knowledge. Consult with your personal doctor or pharmacist for any specific health or nutrition issues. Never disregard professional medical advice or delay seeking medical treatment because of information you have read in any publication.