Indran Krishnan, MD
Dr. Indran Krishnan specializes in colon cancer screening and polyp removal by colonoscopy, acid reflux disease, peptic ulcer, IBS, colitis and all other digestive diseases related to the digestive system. He is board certified in Gastroenterology and Internal medicine and is a Clinical Associate Professor of Medicine at the Emory University School of Medicine. He is a fellow of American College of Gastroenterology, American college of Physicians, Royal College of physicians and surgeons of Canada & Royal College of Physicians of London, England.
Dr. Indran Krishnan has won many distinguished awards from national and international scientific organizations. He has published several clinical and basic science research articles in peer review journals. He is a past president and currently in the board of directors of Georgia Gastroenterological and Endoscopic Society. He served and has been serving in numerous committees in American College of Physicians, American College of Gastroenterology and the Medical Association of Georgia. He participates in the examination board activities for American Board of Gastroenterology and Royal College of Physicians of London, England. Dr. Krishnan is a peer reviewer for the Georgia Composite State Board of Medical Examiners. He has served in the Accreditation Association for Ambulatory Health Care, evaluating the ambulatory surgical centers for accreditation. He is in the board of Directors for Fight colorectal cancer- A national nonprofit patient advocacy organization which supports colon cancer patients . He is also in the Board of Directors of Third eye dancers – Another nonprofit organization in Georgia which helps to raise funds for charity through cultural dance programs.
University of Colombo, Sri Lanka
Kings College Medical School Affiliated Hospitals, London; Thanet General Hospital, Margate, Kent, U.K.
St. Louis University Hospital, St. Mary’s Hospital, University of Rochester Medical School and Dentistry
Queen’s University Group of Hospitals, Kingston, Ontario, Canada
Emory University School of Medicine
Gwinnett Digestive Clinic, PC. & GDC Endoscopy Center, LLC
475 Philip Blvd., #304
Practice phone number:
Are you 50 years or over? Do you have a family history of colon cancer or polyps? Do you have colitis or Crohn’s disease? Do you have a history of colon polyps or cancer? Do you have a history of prostate, breast, uterus, ovarian or cervical cancer? Do you smoke or drink excess alcohol? Are you Hispanic or African American in ethnic origin? Are you significantly obese?
If you answer yes to any of these questions , you may be at a higher risk for developing colon cancer & polyps.
If polyps are found during the colonoscopy, the specialist would have removed and sent it for microscopic examination - biopsy.
If the biopsy shows that the polyp
1. is cancerous- you may need surgery to remove the portion of the colon where the polyp was removed.
2. is precancerous - (all variety of adenomas) - you will need a periodic colonoscopy at a a regular interval depending on the number of other risk factors you may have -such as family history of colon cancer, number & size polyps you had & how "bad" the precancerous polyps were on biopsies.
3. Hyperplastic- usually of no concern. However, this subject has become a debate point lately & some scientists do believe that these polyps too may be a sign that you are at a risk of developing precancerous polyps later on.
There are other rare types too but that subject is beyond the discussion in this forum.
New answer by IndranKrishnanMD
(Physician - Gastroenterology (Verified)
) in topic(s) Colorectal Cancer
, Colorectal Cancer Process
, Rectal Cancer Risk Factors
, Colon Cancer High Risk
, Colon Cancer
, Colorectal Cancer Treatment Process
, Colon And Rectal Cancer
, Colorectal Cancer Risk Factors
, Cancer Treatment Process
, Next Steps
, Colon Cancer Risk Factors
, What Next
, Rectal Cancer High Risk
, Cancer Risk Factors
, Colorectal Cancer High Risk
The purpose of the screening colon test is 1. look for colon cancer 2. look for precancerous polyps & remove them so that cancer can be prevented.
Colonoscopy is the only test which can do the second task & it has the highest sensitivity & specificity out of all the other tests. As such the preferred test is colonoscopy. However, this test involves sedation with medications & has a slightly higher risk of complications than the other tests. As such, very frail, elderly people or people who have severe multiple medical problems or problems with sedation or worried about the risks may consider other "less " invasive tests such as testing for hidden blood in the stool, CT colography & Barium x rays etc. If these tests become abnormal, then colonoscopy will be indicated to find what this "abnormality" is.
If your PCP suspects colon cancer, the next step is to see a Gastroenterologist who will schedule a colonoscopy to confirm the diagnosis. Once this is done, surgery is likely the next step. Subsequent chemotherapy & radiation will depend on the extent of spread of cancer, age & the medical condition of the patient.
There are few promising treatment options available for IBS in men. However, they are not yet proven for safety & I do not recommend until further follow up studies are done on this aspect as IBS is not a life threatening condition but some drugs can be! We have witnessed this in the past on other IBS drugs which were discontinued by FDA only after being in the market few years.
There is no link whatsoever between colon cancer & IBS. However, the problem is that some of symptoms of colon cancer are similar to that of IBS. As such, it is important to evaluate the digestive symptoms by appropriate investigations by physicians if indicated. I have seen colon cancer patients being "labelled" as IBS patients for several months until the late stages of the cancer & finally diagnosed by colonoscopy. Again, please be assured that IBS never leads to colon cancer.
The word Screening means that this is done to detect any disease before that person experiences symptom/s related to that disease. Colon cancer screening test is to look for colon cancer & precancerous polyps. There are many tests available but the gold standard test is colonoscopy. Others include testing stool for occult/hidden blood by chemical, Barium enema xray, CT scan of the colon (also called virtual colonoscopy or colography) & flexible sigmoidoscopy. All have their own short comings & I will explain as to what a colonoscopy entails as colon screening is almost synonymous with colonoscopy.
Colonoscopy is a direct visual examination of the large intestine (colon) using a lighted flexible video endoscope. This flexible video camera ( looks like a 1cm diameter rubber tube) is introduced in to the rectum & advanced all the way to the entire colon, inspecting for polyps & cancer. This is done under sedation as an outpatient and takes usually 20-30 minutes to complete the procedure. Precancerous polyps can be removed during the colonoscopy. One needs to clean the colon with laxatives prior to the colonoscopy. As this is done under sedation, she/he cannot drive home on their own after this test. An adult needs to accompany & transport her/him home.
For more information on colon cancer & related issues please visithttp://www.fightcolorectalcancer.org
I assume that you are asking as to the qualifications of the physician & the facility where this being done.
A) Are you a board certified physician in Gastroenterology or board certified colorectal surgeon? The physician preferably should a board certified Gastroenterologist as she/he is the only specialty physician who is specifically trained for this purpose exclusively for 3 years or more after previously having completed training & then board certified in Internal Medicine for an extra 3 years. Not infrequently, there are other physicians who undergo short courses of training to do colonoscopy & after few years in practice they may become capable of detecting precancerous polyps & removing during colon cancer screening (i.e colonoscopy) but their expertise is very much variable. Some are excellent & others are not so. Board certified Gastroenterologists/ colorectal surgeons maintain a certain degree of standard & are up to date on colon cancer screening/colonoscopy across the board.
You may also want to ask the physician about their complication rates, years of experience & how many colonoscopies they do per year but these are subjective & may not help you to make up your mind.
B) What Facility? If it is a hospital, the safety/quality is not a big issue as hospitals undergo rigorous quality control & inspection by accrediting agencies like Joint commission on a regular basis. If done in a free standing centers or doctors office, please ensure that this facility is accredited by proper agencies, licensed by CMS (Medicare) & local department of community health of that state. Complication rates are high in non accredited/licensed facilities. They are not required report/document any complications to any authorities unless investigated by complaints.
C) Are you & Facility in network with my Insurance company? Most (please note, most & not all!) commercial insurance companies & Medicare cover the screening colonoscopy if you are 50 years or older without any deductible & co pay if the the physician & the facility are in their network (i.e "in network"). Please verify this prior to booking the appointment so that you do not incur any unwarranted expenditures.
These are basic questions one should ask when meeting with the physician, but there can be many more questions like type of anesthesia etc. too based on how sophisticate you want to be!