Dr. Keith Roach

DEAR DR. ROACH: Could you explain the difference between the delta variant and the common cold? How is one to know if an illness is the common cold with cough for weeks or the virus! — Anon.
ANSWER: The virus that causes COVID-19 — SARS-CoV-2 — is a coronavirus that can cause many different symptoms, some of which are similar to the cold. Some people have very mild symptoms that can seem like the cold. The strain that is circulating now, called the delta variant, seems to have somewhat different symptoms from the previous variants.
Cough and loss of taste and smell are reported less frequently, while headache, sore throat, runny nose and fever are more common. Since these symptoms (except fever) are common in the cold, I would encourage people to get tested even if they have only mild symptoms. This will help slow the pandemic by reducing the number of people an infected person could be exposing.
There are many different families of viruses that can cause cold symptoms. This includes rhinoviruses but also, confusingly, different types of coronaviruses, but only SARS-CoV-2 causes COVID-19.
DEAR DR. ROACH: I had a colonoscopy yesterday, something I have held off since getting my first one 15 years ago at age 46. The dreaded prep wasn’t as horrible as I remembered, so I am now less resistant to the next one. Is this because I’m getting older and more tolerant, or has the prep process improved? I think it’s the latter but wanted to check with you.
Some of my friends brag that they don’t need to have them done. When I was getting the procedure done, I overheard another patient getting ready for the procedure say he was getting it done because they found blood in his stool test. My primary physician told me that colonoscopy is the gold standard and I’m glad that my insurance supports it. — S.K.
ANSWER: Colonoscopy is indeed what most doctors choose for themselves as a screening test for colon cancer. However, for people at average risk for colon cancer, there are alternatives.
A fecal immunochemical test looks for blood and has been proven to be better than no screening. A multitarget stool test (such as Cologuard) looks both for blood and for the abnormal DNA associated with colon cancer. A CT colonography, formerly called “virtual colonoscopy,” is an option, but many of my patients noted discomfort with the gas distention used in that procedure. All of these alternatives, however, will ultimately require a colonoscopy if they are positive, just as the person you overheard did. It is my practice to recommend colonoscopy as the best screening test, but to offer the others as an alternative to a person who really doesn’t want a colonoscopy, while still being sure the person understands that if the screening test is positive, a colonoscopy may still be necessary.
There are many more preparation alternatives now compared with decades ago. My experience has also been that the prep is much less onerous than it used to be, thankfully.
Colon cancer screening in average-risk people should begin at age 45 and continue at least through age 75, unless there is a reason to stop screening, such as a very serious illness likely to shorten a person’s life.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.


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