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Writer's pictureNorberto Estanislao IV

The Large Polyp

It was just 4 in the morning, and Louise was already in front of her laptop. She opened the lid but could not press any keys. She was deep in thought and just kept staring at the thin bezels of the screen. She did not know what to type. She wanted to do a search, but subconsciously she was scared. Scared to know what the results might say. She had just undergone a colonoscopy two days ago.

It all started six weeks ago at her best friend's wedding. The buffet was irresistible, and Louise had happily indulged. The following day, however, she had tummy aches and was passing watery stools four times a day. "Just a bit of food poisoning," she'd thought, sipping electrolytes and taking loperamide.

After a week, her symptoms persisted. She was a bank manager and lived in a condo unit with her mom. During breakfast, she told her mom that she wanted to visit a clinic because she was still having diarrhea. They knew a gastroenterologist, so they scheduled an appointment.

Dr. Ramirez, their family gastroenterologist, was reassuring. "Acute gastroenteritis," he declared, prescribing antibiotics and advising rest and hydration. "Come back if it doesn't clear up in a week."

Another week passed, and she still had episodes of loose bowel movements. Her abdominal cramps were now less frequent. She thought, "What is happening? I followed all the doctor's instructions and took the antibiotics without fail." She then made another appointment and went to the doctor's office.

This time, the doctor told her that she would need a colonoscopy. He explained that acute diarrhea should not last more than two weeks. "If your loose bowel movements extend beyond two weeks, that is already considered 'chronic diarrhea,'" the doctor added. He further explained that intestinal infections do not usually last more than two weeks, even without antibiotic treatment. She was reassured that the procedure would only take a few minutes, and since she was young, the risk of finding a more severe disease was less.

"Yes! I am still young!" she told herself. "I am just 40 years old," she thought. She kept thinking of ways to avoid the colonoscopy, but eventually, she decided to go through with it. During the procedure, a polyp was found. It was 2.5 cm and flat.  The doctor elaborated that based on the polyp's appearance, it was not cancer. She was told that these polyps should be removed because they are the precursors to colon cancer. Furthermore, she was informed that it could be removed during a colonoscopy, and there was no need for it to be removed by surgery. He explained the removal options, using words like "endoscopic mucosal resection and endoscopic submucosal dissection" that sounded like a foreign language to Louise.

Back to her laptop, she shifted her gaze from the bezels to the screen. She typed "colonic polyp removal" in the search bar. She read something about cold snare polypectomy, hot snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal resection. She also browsed YouTube and searched for this procedure to familiarize herself with what she was supposed to undergo. She then looked at the piece of paper beside her laptop. It was a written document – the consent form for the procedure, which she read the night before. She turned to the last page and signed it.

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