Colorectal Cancer Screening

A colorectal cancer screening is a screening test is used to look for a disease when a person doesn’t have symptoms. (When a person has symptoms, diagnostic tests are used to find out the cause of the symptoms.)

Colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Screening tests can find precancerous polyps, so that they can be removed before they turn into cancer. Screening tests can also find colorectal cancer early, when treatment works best.

Screening Guidelines
Regular screening, beginning at age 50, is the key to preventing colorectal cancer. The U.S. Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer using high-sensitivity fecal occult blood testing, sigmoidoscopy, or colonoscopy beginning at age 50 years and continuing until age 75 years.

When Should I Begin to Get Screened?
You should begin screening for colorectal cancer soon after turning 50, then continue getting screened at regular intervals. However, you may need to be tested earlier than 50 or more often than other people if—

– You or a close relative have had colorectal polyps or colorectal cancer.
– You have Inflammatory bowel disease, Crohn’s disease, or ulcerative colitis.
– You have genetic syndrome such as familial adenomatous polyposis (FAP)External Web Site Icon or hereditary non-polyposis colorectal cancer (Lynch syndrome).

Speak with your doctor about when you should begin screening and how often you should be tested.


Upper Endoscopy (EGD)

What is an upper endoscopy?

An upper endoscopy lets your doctor examine the lining of the upper part of your gastrointestinal tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). Your doctor will use a thin, flexible tube called an endoscope, which has its own lens and light source, and will view the images on a video monitor. You might hear your doctor or other medical staff refer to upper endoscopy as upper GI endoscopy, esophagogastroduodenoscopy (EGD) or panendoscopy.

Why is an upper endoscopy done?

An upper endoscopy helps your doctor evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It’s the best test for finding the cause of bleeding from the upper gastrointestinal tract. It’s also more accurate than X-ray films for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum.

Your doctor might use upper endoscopy to obtain a biopsy (small tissue samples). A biopsy helps your doctor distinguish between benign and malignant (cancerous) tissues. Remember, biopsies are taken for many reasons, and your doctor might order one even if he or she does not suspect cancer. For example, your doctor might use a biopsy to test for Helicobacter pylori, the bacterium that causes ulcers.

Your doctor might also use upper endoscopy to perform a cytology test, where he or she will introduce a small brush to collect cells for analysis.

Upper endoscopy is also used to treat conditions of the upper gastrointestinal tract. Your doctor can pass instruments through the endoscope to directly treat many abnormalities – this will cause you little or no discomfort. For example, your doctor might stretch (dilate) a narrowed area, remove polyps (usually benign growths) or treat bleeding.

What preparations are required?

An empty stomach allows for the best and safest examination, so you should have nothing to eat or drink, including water, for approximately six hours before the examination. Your doctor will tell you when to start fasting as the timing can vary.

Tell your doctor in advance about any medications you take; you might need to adjust your usual dose for the examination. Discuss any allergies to medications as well as medical conditions, such as heart or lung disease.

Can I take my current medications?

Most medications can be continued as usual, but some medications can interfere with the preparation or the examination. Inform your doctor about medications you’re taking, particularly aspirin products or antiplatelet agents, arthritis medications, anticoagulants (blood thinners such as warfarin or heparin), clopidogrel, insulin or iron products. Also, be sure to mention any allergies you have to medications.

What happens during an upper endoscopy?

Your doctor will start by  giving you a sedative to help you relax. You’ll then lie on your side, and your doctor will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope doesn’t interfere with your breathing.

What happens after an upper endoscopy?

You will be monitored until most of the effects of the medication have worn off. Your throat might be a little sore, and you might feel bloated because of the air introduced into your stomach during the test. You will be able to eat after you leave unless your doctor instructs you otherwise.

Your physician will explain the results of the examination to you, although you’ll probably have to wait for the results of any biopsies performed.

If you have been given sedatives during the procedure, someone must drive you home and stay with you. Even if you feel alert after the procedure, your judgement and reflexes could be impaired for the rest of the day.

What are the possible complications of upper endoscopy?

Although complications can occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test. Bleeding can occur at a biopsy site or where a polyp was removed, but it’s usually minimal and rarely requires follow-up. Perforation (a hole or tear in the gastrointestinal tract lining) may require surgery but this is a very uncommon complication. Some patients might have a reaction to the sedatives or complications from heart or lung disease.

Although complications after upper endoscopy are very uncommon, it’s important to recognize early signs of possible complications. Contact your doctor immediately if you have a fever after the test or if you notice trouble swallowing or increasing throat, chest or abdominal pain, or bleeding, including black stools. Note that bleeding can occur several days after the procedure.

If you have any concerns about a possible complication, it is always best to contact your doctor right away.



Your doctor will give you more specific directions about colonoscopy or endoscopy preparation, but there are some general recommendations that are made for most cases.  Most doctors ask that you:

– Fast before the procedure. You will most likely be asked to stop drinking and eating at midnight before the procedure. This is done to ensure that your stomach is empty for the procedure.

– Stop taking certain medications. You may be asked to stop taking certain medications such as blood thinners and medications dealing with diabetes, heart disease, or high blood pressure.

Upper Endoscopy (Egd)

Fast before the endoscopy. Stop eating/drinking at midnight before the procedure. This is done to ensure that your stomach is empty for the procedure.

You should tell your doctor about any medications and supplement that you’re taking before your procedure.


Your doctor will prescribe a bowel preparation to be taken the day before your procedure along with a clear liquid diet. In some cases, your doctor may prescribe a two-day preparation. Be sure to read your instructions carefully.

Clear liquid diet

A clear liquid diet consists of clear liquids, such as water, broth and plain gelatin, that are easily digested and leave no undigested residue in your intestinal tract. Your doctor may prescribe a clear liquid diet before certain medical procedures or if you have certain digestive problems. Because a clear liquid diet can’t provide you with adequate calories and nutrients, it shouldn’t be continued for more than a few days.


A clear liquid diet is often used before tests, procedures or surgeries that require no food in your stomach or intestines, such as before colonoscopy. It may also be recommended as a short-term diet if you have certain digestive problems, such as nausea, vomiting or diarrhea, or after certain types of surgery.

Diet details

A clear liquid diet helps maintain adequate hydration, provides some important electrolytes, such as sodium and potassium, and gives some energy at a time when a full diet isn’t possible or recommended.

The following foods are allowed in a clear liquid diet:

  • Plain water
  • Fruit juices without pulp, such as apple juice NO red or purple
  • Strained lemonade
  • Clear, fat-free broth (bouillon or consomme)
  • Clear sodas
  • Plain gelatin
  • Honey
  • Ice pops without bits of fruit or fruit pulp
  • Tea or coffee without milk or cream

Any foods not on the above list should be avoided. Also, for certain tests, such as colon exams, your doctor may ask you to avoid liquids or gelatin with red or purple coloring.

A typical menu on the clear liquid diet may look like this.

1 glass fruit juice
1 cup coffee or tea (without dairy products)
1 cup broth
1 bowl gelatin

1 glass fruit juice
1 bowl gelatin

1 glass fruit juice
1 glass water
1 cup broth
1 bowl gelatin

1 ice pop (without fruit pulp)
1 cup coffee or tea (without dairy products) or a soft drink

1 cup juice or water
1 cup broth
1 bowl gelatin
1 cup coffee or tea


If you receive anesthesia/sedation you will not be allowed to drive for 24 hours or leave the center without a responsible adult to accompany you home.

You will be asked to acknowledge receipt of a notice on the day of your procedure.

On the day of your procedure please bring the following:

  • Notice of visit
  • All of your Medical Insurance cards
  • One of the following:
    • Driver’s License
    • State ID
    • Or other Legal Photo Identification

Please bring completed paperwork from your doctor’s office.

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