What to Expect from a Colonoscopy

Smile! It’s time for your colonoscopy. That’s one of those words we hate to even hear, isn’t it? Colonoscopy. But it’s an important diagnostic tool for detecting colon cancer and other bowel disorders. Plus, during the procedure, your doctor can even identify and remove precancerous polyps before they present any health risk.

Yes, it does involve having a camera inside your intestine. But most people choose to be sedated for the procedure and don’t remember anything after the anesthesia. And based on all the information it provides, and its benefits, a colonoscopy is considered among the best and most effective screening tools in medicine.

You should definitely ask your doctor about a colonoscopy if you’re over 50 and haven’t had one before. (If you have had one before, your doctor can tell you when you’re due for the next one.) And, if you’re between the ages of 45 and 50, know that last year the American Cancer Society updated its guidelines to recommend screenings for those over 45. (The American Academy of Family Physicians is standing by its ages 50–75 recommendation.)

Here’s what you can expect, and why you should consider getting a colonoscopy if you meet the guidelines:

Exam Precautions

Before scheduling your colonoscopy, your doctor will want to be aware of any medical conditions or circumstances that might affect the procedure. These include pregnancy, lung and heart conditions, drug allergies, and any medications you’re taking, such as for diabetes or blood thinning. Some medications may need to be adjusted ahead of time.

Preparing for the Exam

To make a colonoscopy possible, you first have to empty your colon. A lot of people think this—not the procedure itself—is the most unpleasant part, but with a little planning you can relieve some of the hassle.

Step One. Restrict your diet for 24 hours before the exam: no solid foods. You can usually have clear liquids such as coffee, broth, water, or sports drinks, but follow whatever your doctor recommends. Avoid red, blue, or purple coloring in liquids like drinks, Jell-O, or popsicles, as these colors can make is difficult to see the lining of the colon and interfere with the test results.

It may also be helpful to reduce your dietary fiber in the days leading up to your 24-hour fast. Though they’re ordinarily healthy foods, spend a few days avoiding whole grains, nuts, seeds, dried fruits, and raw fruits and vegetables.

Step Two. Typically, you’ll be prescribed a strong laxative that will help you empty your bowels. Patients are typically advised not to stray too far from the bathroom during this step, and to arrange for someone else during this time to care for children or other relatives who regularly need your assistance. Though not common, an enema may be necessary before the procedure to remove any excess contents. 

During the Exam

You’ll be sedated during the exam, which means you won’t be able to drive home afterward. Make sure you arrange to have someone there after the procedure who can take you home, and that you don’t have to drive yourself anywhere else—or operate heavy machinery—for at least eight hours.

You’ll be asked to lie on your side on an exam table and will likely be given sedatives through an IV in your arm. This will put you to sleep. When you wake up, your colonoscopy will be over!

For the curious, here’s what happens while you’re asleep: The doctor will use a a long, flexible instrument called a colonoscope to look at the inside of your colon. The colonoscope has a tiny light and camera that make this possible. It also has a pump that allows your doctor to very slightly inflate your colon to get a better look. Finally, it has a small snare that can be used to take a small sample of the colon for testing (called a biopsy) or to remove any abnormal growths (called polyps) that are found. This is part of what makes the colonoscopy such a top-notch exam: It’s possible to come out healthier than you went in.

After the Exam

The colonoscopy usually lasts between 20 and 30 minutes. After that, you’ll recover from the sedative for a half hour to an hour. A little cramping or gas is normal after the procedure. Apart from any discomfort that may cause, you can eat and drink normally.

Make sure you understand the follow-up instructions before you go home—especially if you had any special instructions regarding medications. You may need to continue to alter your dosage for a time.

Complications from colonoscopy are very rare, but call your doctor if you experience more than a little bleeding or bleeding that lasts a long time, or if you have severe pain in your abdomen, fever, or chills.

Usually within a week or two after your colonoscopy, you’ll receive a report of any biopsies that were taken during the course of the exam. Your doctor will help you read the results. If you show any sign of cancer or pre-cancer, you may need to have follow up tests or procedures, and you will mostly likely be recommended for a follow-up colonoscopy in two to three years.

However, if your test indicates no concerns, your next colonoscopy likely won’t be for another 10 years. In which case, you can celebrate with one of those leftover popsicles.

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