For reasons that are still not clear, incidence of colorectal cancer are on the rise in the United States among those who are younger than 50. This is also why gastroenterologists now recommend getting regular colonoscopies starting at the age of 45, or earlier if you have a family history or are at higher risk. The colonoscopy is a highly effective tool for early detection of cancer, but many people are hesitant because of fears over the procedure itself. With the right preparation, though, the experience of getting a colonoscopy can be much easier to handle.

What is a Colonoscopy?

A colonoscopy is essentially a sub-type of endoscopy, which is a diagnostic procedure that uses a camera mounted on the end of a flexible tube to look inside the body. More specifically, a colonoscopy is a procedure used to examine the inside of the large intestine. During a colonoscopy, the colonoscope is inserted through the rectum and advanced through the entire colon. As the camera passes through each area of the large intestine, the doctor is on the lookout for signs of disease or other abnormalities.

One of the most important purposes of a colonoscopy is to look for signs of colorectal cancer, the third most common type of cancer diagnosed around the world; while rectal and colon cancer are technically separate conditions, they are often lumped together because they are similar in how they progress and are treated. Colorectal cancer takes many years to develop, and any related symptoms usually don’t appear until the cancer is in late stages; this is exactly why it’s so important to get screened regularly.

Reasons for a Colonoscopy

Even though checking for colorectal cancer is one of the main reasons to get a colonoscopy, doctors often perform the procedure to confirm or rule out a variety of other gastrointestinal conditions. Polyps or other growths, for instance, may indicate a non-cancerous tumor or inflammatory problem like ulcerative colitis or diverticulitis. Colonoscopies can also be used to find a cause for blood or pus in the stool or to investigate the reason for a recent change in bowel habits. Additionally, if any abnormal growth or tissue is discovered, tools on the endoscope can be used to collect samples for biopsy.

Colonoscopy Preparation Recommendations

A colonoscopy is considered a minimally invasive procedure since no incisions are involved and it can be done with sedation rather than full anesthesia. Nevertheless, the act of inserting the tube into the rectum can be uncomfortable and anxiety-producing for the patient. This is why doctors provide a series of prep instructions: to make the procedure go as smoothly as possible and to empty the bowels so the doctor has a clear view of the interior. Leading up to the day of your colonoscopy, these are some of the preparations you should expect to make:

  • Low-fiber diet: The first step in the preparation process involves modifying your diet in order to prepare the bowels. This primarily means avoiding high-fiber foods like whole grains, nuts, and seeds, as well as raw fruits and vegetables. You should also cease taking any supplements unless your doctor gives you a green light.
  • Clear liquid diet: In the day before the procedure, you’ll need to stop eating solid foods and switch to only consuming clear fluids like water, clear fruit juices, carbonated beverages, clear broth or bouillon, and coffee or tea without cream or milk. Some other examples of acceptable drinks are Gatorade and other sports drinks, white grape juice, and ginger ale. In addition to not interfering with the procedure, it will be important to stay hydrated and to continue getting important electrolytes.
  • Other acceptable foods: Even though you have to stop eating solid food, there are some other options that won’t impact the procedure. Jell-O or other gelatin products are acceptable as long as they don’t contain any red or purple dyes; popsicles and hard candy are also acceptable.
  • Medication: As with supplements, you’ll also need to discuss with your doctor any current medications since some types (like blood thinners) may potentially cause a problem. You will also be instructed to avoid taking ibuprofen or other NSAIDs due to a risk of bleeding.
  • Bowel prep drink: Another important step in the process is to take a special bowel prep drink provided by the doctor. This prep solution is a laxative that is specially designed to flush out the bowels and make the environment as clear as possible for the examination; examples include Golytely, Suprep, or MoviPrep. Though it is typically a prescribed medication, the doctor may also allow the use of over-the-counter options such as Miralax.
  • Transportation: Finally, one important step unrelated to preparing for the procedure itself is arranging transportation. Because you will be sedated for the procedure, you’ll need to have someone drive you home afterwards.

The colonoscopy procedure generally takes anywhere from 30-60 minutes to complete, though of course the prep time and short recovery afterwards can make the whole process a bit more involved. Proper preparation for the procedure is crucial because it ensures that the colon is clean and free from obstructions; this enables the doctor to obtain the best and most useful results. Here at Cary Gastro, we have developed specific prep resources to help you prepare for your visit, available in both English and Spanish.

Possible Side Effects or Complications

Colonoscopies are generally safe and effective, but they do carry some potential risks and complications that need to be considered. And even if everything during the procedure went well, there is a chance of a problem arising later on. Below are some of the most common possible side effects or complications:

  • Bleeding: It's possible to experience minor bleeding, especially if a biopsy or polyp removal is performed during the procedure. This bleeding is usually minimal and stops on its own.
  • Perforation: In rare cases, the colonoscope can cause a tear or hole (perforation) in the colon wall. This is a serious complication that may require surgical repair.
  • Sedation reaction: The sedatives used for a colonoscopy are known to be safe, but there is a minor risk of an allergic reaction for some people.
  • Infection: Although colonoscopy equipment is regularly sterilized, there remains a low risk of infection associated with the examination or if a biopsy is performed during the procedure.
  • Gastrointestinal symptoms: Given that the endoscope is inserted into the rectum and all around the colon, there is a chance to experience symptoms like abdominal pain, bloating, cramps, or excess gas.
  • Additional concerns: In very rare cases, the patient may experience some kind of cardiovascular event due to stress on the heart. There are also some people who have reported having a poor reaction to the bowel prep solution.

    Schedule a Cancer Screening

    Getting a colonoscopy isn’t anyone’s idea of a good time, but it is one of the quickest and easiest ways to ensure that you don’t have colorectal cancer. If you’re 45 or older, or if you have a family history of colorectal cancer, you are an ideal candidate for the procedure. At Cary Gastro, we are passionate about cancer screenings because of how effective and relatively easy they are. Please contact us today to schedule a screening or request an appointment.