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A colonoscopy, one of the most widely recognized screening procedures in the U.S., is used for screening, surveillance, and treatment in the fight against colon cancer, the third most diagnosed cancer in America.
The American Cancer Society (ACS) recommends that people who are at average risk of colorectal cancer begin screening colonoscopies starting at age 45. Unfortunately, fear of the procedure leads many individuals to get screened years later, delaying the process of spotting cancerous polyps and tissue and reducing the effectiveness of treatment. Through the years, we’ve heard a number of misconceptions regarding the process of having a colonoscopy. Let’s discuss the most common myths—and what you can really expect from the procedure.
Most Common Colonoscopy Myths
1. A Colonoscopy is Painful
A colonoscopy is not a painful test, even when we remove polyps or obtain biopsies in the colon. The most common symptom patients experience following a colonoscopy is bloating. During the procedure, the colon is filled with air to better visualize the entire colon, which may cause some temporary bloating and flatulence. Fortunately, with advances in the last five years and changing to the use of carbon dioxide, patients experience much less bloating today than years ago.
2. There’s Serious Risk Involved With the Procedure
A colonoscopy is a minimally invasive procedure, so it does carry some risk—mostly due to anesthesia. However, for most people, the risks are relatively low, and we perform colonoscopies in a closely monitored environment in which our gastroenterology and anesthesiology teams care for you before, during, and after your operation. Your medical history also is reviewed closely by your gastroenterologist and anesthesiologist prior to undergoing a colonoscopy to ensure any risks are minimized.
As with any procedure, you should make sure the benefits of a colonoscopy outweigh the risks before having one.
3. A Colonoscopy Isn’t Necessary If You Don’t Have Symptoms
Colorectal cancer typically develops from polyps of the colon or rectum, which occur in about 20 to 30 percent of people. These polyps usually don’t cause symptoms until they develop into advanced stages of colorectal cancer. We know that by removing polyps and undergoing periodic surveillance via a colonoscopy, you can substantially diminish the risk of developing colorectal cancer.
How Does a Colonoscopy Work?
Preparing for a colonoscopy begins the day before the test when we ask you to cleanse the colon of stool and residue, so we can clearly see inside the colon. We recommend you consume a clear liquid diet for the entire day prior to a colonoscopy. This diet consists of food you can see through, such as:
- Apple or cranberry juice
- Beef, chicken, or vegetable broth
- Clear gelatin
- Coffee without cream
Your gastroenterologist also will recommend you take a laxative medication at some point during the day before your colonoscopy, which helps empty the colon by increasing bowel movements. Your gastroenterologist will provide you with exact details on this medication prior to your colonoscopy, as they may have a specific bowel regimen they prefer.
On the day of your colonoscopy, you will be asked to arrive at the hospital 60 to 90 minutes before your appointment time to complete registration and pre-procedure nursing evaluations, as well as to discuss any concerns and review the risks of the procedure with your anesthesiologist and gastroenterologist.
A colonoscopy takes about 15 to 20 minutes and begins with you receiving intravenous sedation, or monitored anesthesia that relaxes you through an intravenous (IV). We then insert a small flexible tube—which contains a video camera that transmits images to a video screen— into the rectum and advance it through the large intestine to examine your entire large intestine, obtain tissue samples through the scope, and remove polyps using a small wire.
Following a colonoscopy, we require you to have a friend or family member accompany you home due to possible side effects of anesthesia, such as drowsiness, which make it dangerous to drive. Once you are home, we recommend taking the day off and resting before returning to your everyday activities. We also recommend you avoid the following situations until the day after your colonoscopy:
- Giving professional advice
- Making important business decisions
- Operating machinery
Closing Thoughts on Colonoscopy
While having a colonoscopy may be perceived as an inconvenience (which does require preparation and planning), the test itself is not lengthy and involves minimal risk. When considering the benefits of a colonoscopy, notably how it can help prevent and even treat colorectal cancer, it becomes apparent why the U.S. Preventative Services Task Force recommends screening and surveillance colonoscopies.
We often encounter patients who delay a colonoscopy only to later regret not getting their colonoscopy at a younger age. Too often we see a patient who finally decides to have their recommended screening colonoscopy because a significant other or loved one continuously pestered them to do so. And in many of these cases, we identify and remove multiple polyps, successfully preventing the progression of colorectal cancer in these patients.
It is often recommended that you begin undergoing screening colonoscopies at age 45 if you are considered at average risk of colorectal cancer. However, your doctor may recommend you have a screening colonoscopy before age 45 if you’re considered at increased risk of colorectal cancer, due to factors such as your family or medical history. Make sure to speak to your doctor to estimate a screening colonoscopy timeline that works for you.
If you are a candidate for a colonoscopy and are hesitant to have one, consider the benefits of the procedure and make sure to discuss your concerns with your doctor. A colonoscopy is an exceptional technique that can help prevent most people from developing colorectal cancer.