The Ins and Outs of a Colonoscopy
Colorectal Cancer is the fourth most common cancer in the United States, a disease that impacts over 135,000 people per year and causes more than 50,000 deaths — a shocking number considering Colon Cancer has a 92% survival rate if detected early on.
It’s no surprise that doctors recommend that all adults over 50 undergo a colonoscopy exam.
What is a colonoscopy?
Colonoscopy is a diagnostic test that lets your doctor look at the interior lining of your large intestine (your colon and rectum) through a thin, flexible viewing instrument called a colonoscope. Colonoscopy is useful for identifying and removing colon polyps and also for detecting colon cancer, diverticular disease, and colitis. Moreover, colonoscopy is used as a screening test (colon screening) to identify and remove precancerous growths in the colon or rectum.
Why is a colonoscopy performed?
A physician may recommend a colonoscopy to:
- Examine the intestinal canal for problems and to help determine potential causes of abdominal pain, rectal bleeding, chronic constipation, and persistent diarrhea
- Screen for polyps (tissue growths in the colon) and colon cancer
- Detect and remove any additional polyps in patients that have had polyps before to reduce the risk of colon cancer
- Investigate the cause of iron deficiency anemia (a lowered blood count stemming from the loss of iron)
Who should get a colonoscopy?
Although colorectal cancer can affect people in any age group, your chances of receiving a colorectal cancer diagnosis increase progressively from age 40 and rise sharply after age 50; over 90% of colorectal cancer patients are over 40-years old.
Other colorectal cancer risk factors include:
- A family history of colorectal cancer and polyps
A personal medical history of:
- Ulcerative colitis
- Intestinal polyps
- Breast, uterine, or organ cancer
If you experience any of the following common symptoms of colorectal cancer you may want to consider having a colonoscopy:
- Rectal bleeding
- Fluctuations in your bowels like chronic constipation or diarrhea
- Abdominal discomfort and weight loss (indicators of advanced stage of colon cancer)
Many polyps and early-stage cancers do not cause any symptoms making it imperative that you incorporate colorectal cancer discovery measures into your routine physicals after the age of 50.
If you have a parent or sibling that has had colon cancer or polyps, it is a good idea to begin your colon cancer screening when you reach 40-years old.
How to prepare for a colonoscopy?
Before undergoing a colonoscopy, you will need to empty your colon completely. Any residual content in your colon obscures the viewing process and increases the chances your doctor may miss irregularities during the exam.
To clean out your colon, your physician may ask you to:
- Refrain from eating solid food the day before the procedure and not to eat or drink anything after midnight the night before your exam
- Use a laxative the night before your exam or the morning of your colonoscopy
- Purchase an enema kit to use before the procedure
- Adjust your medication — it is essential that your doctor be aware of any medicines you are taking especially for diabetes, high blood pressure or heart problems (such as blood thinners)
How is a colonoscopy performed?
Colonoscopy is performed in your physician’s office which is fully-equipped and designed for the procedure. You’ll be sedated for the colonoscopy, so you will need to arrange for someone to drive you home as you may feel sleepy or dizzy after the exam. The procedure lasts about thirty minutes but may take longer if polyps are found and need to be removed.
During a colonoscopy, you will typically lie on your side with your knees close to your waist. You will be covered with a sheet, and your doctor will monitor your blood pressure, heart rate, and breathing throughout the procedure. A lighted, flexible instrument is inserted through the entire length of the colon. This allows direct visualization of the inner lining of the colon for diagnostic, therapeutic purposes. If a polyp is detected, it may be removed and sent to the laboratory for analysis.
After your exam, you’ll rest in a recovery room for about an hour until the sedative wears off. Colonoscopy is a safe procedure with a rare incidence of complications.
What should you expect after a colonoscopy?
Your physician will go over the results of your colonoscopy and sit down with you to explain them.
If no irregularities were found in your colon, your colonoscopy is considered negative. In the absence of any common risk factors (not including age), your doctor may suggest you wait ten years before repeating the exam.
However, if your doctor was unable to completely visualize the lining of your colon due to residual stool, you may be asked to repeat the procedure sooner.
A positive outcome:
A colonoscopy is deemed positive if unusual tissue or polyps were found in your colon. The majority of polyps are not cancerous. However, some may represent the warning signs of cancer. The polyps extracted during colonoscopy are analyzed in the lab to conclude if they are malignant or benign.
The size, characteristics, and the number of polyps will determine if you will be required to undergo a more frequent and comprehensive future screening regimen.
Depending on your other general risk levels for colon cancer, if just a few small polyps are found (less than half an inch in diameter), you may only need to repeat the procedure in five to ten years. If larger and more numerous polyps are discovered with particular adverse cellular properties, your doctor may call for a repeat colonoscopy in three to five years.
If your physician removes one or more cancerous polyps during your colonoscopy, you could need a second exam in just three months to a year.