Colonoscopy 101

May 21, 2014 Providence St Mary Regional Cancer Center

Some cringe at the mention of it: colonoscopy. It’s understandable. It’s a bit daunting and discussing it can be uncomfortable. But understanding what to expect and why it’s important can reduce anxieties about this common – and possibly lifesaving – procedure.

What is a Colonoscopy?

A colonoscopy is an exam that allows doctors to see inside your large intestine to diagnose and treat medical problems in the colon. It’s used to detect inflamed issue, ulcers, polyps or other abnormal growths. And, a colonoscopy is one of the most effective ways to screen for colon cancer.

What are Polyps?

Polyps are growths on the mucus membrane. They can pop-up throughout the body, but are commonly found in the colon, nose, stomach and uterus. Not all polyps are cancerous, but most colon cancers start as polyps. If your doctor finds a polyp during your colonoscopy, it’ll usually be removed during the procedure.

Who Needs a Colonoscopy?

The American Cancer Society recommends the following guidelines:

  • Men and women with no family or personal history of polyps or cancer should have a colonoscopy at age 50 and every 10 years afterward.
  • African-American men and women are at greater risk of developing colon cancer and should have their initial colonoscopy at age 45, and every 8 years afterward.

Patients with a greater risk of colon cancer typically need earlier or more frequent screenings. Talk with your primary care provider about your risk factors, such as:

  • Family history of cancer or polyps
  • Previous polyps in an exam
  • Bowel diseases, such as Crohn’s Disease

Early warning signs for colon cancer are rare, but talk with your provider right away if you notice blood in your stool, or significant changes in your bowel habits.

What to Expect

Preparation: Before the exam, your colon needs to be completely empty to make sure nothing will obstruct the doctor’s view. A day or two before the procedure, you’ll likely be limited to a clear-liquid diet and prescribed a laxative. You’ll have to skip your morning coffee – all food and drink is restricted after midnight the evening before your colonoscopy. For some patients, an enema is also recommended.

Procedure: A typical colonoscopy lasts 30-60 minutes. You’ll likely receive “conscious sedation,” which might make you doze. It’ll also help block pain and make you forget some details of the procedure.

During the exam, a physician uses a long flexible instrument, called a colonoscope. It’s about a half-inch in diameter and is inserted through the rectum and into the large intestines. A tiny light and camera on the end allow the doctor to see the inside of your colon. The procedure might be a little uncomfortable, but it shouldn’t be painful. If the doctor finds suspicious or abnormal-looking tissue, a small sample may be excised for biopsy. Or, if your doctor discovers a polyp, it may also be removed at that time.

Post-procedure: Gas pains and cramping are common after a colonoscopy, but are short-lived. The recovery room staff will encourage you to pass gas to help the side effects resolve quickly. You’ll need a ride home as you’ll be groggy from the sedative.

Follow your doctor’s discharge orders. Take it easy the rest of the day and pay attention to your body. A small amount of spotting after your colonoscopy is normal. A teaspoon of blood or more, severe cramping, tarry stools or a fever is not normal, and you should contact your doctor immediately.

Don’t Procrastinate

Probably no one looks forward to a colonoscopy. Some patients may procrastinate when it comes to scheduling the procedure. In fact, according to the Centers for Disease Control, nearly one-third of American adults who should have a colonoscopy haven’t. If you fall into that category, keep in mind, both the preparation and the procedure itself have improved a lot over the past 20 years. They aren’t nearly as unpleasant as they used to be. And, take heart in knowing a colonoscopy is far and away the best method to detect colon cancer in its early stages – when treatment is the easiest and most effective.

If you notice blood in your stools – or wonder if you’re due for a colonoscopy – talk to your primary care provider or cancer care team.

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