What is a Colonoscopy?
A colonoscopy is a procedure where a physician uses a flexible, thin tube with a camera and light source to examine the inside of the rectum and colon.
Men and women who are at average risk for colon cancer are advised to schedule regular colonoscopies beginning at age 45 and at 10-year intervals thereafter. As of May 2018, the American Cancer Society revised the recommended age for a first-time colonoscopy to 45 due to an increased incidence of the disease among 45-49 year olds. Patients who have a family history of colon cancer, a condition such as inflammatory bowel disorder (IBD) or any other risk factor for colon cancer may need to begin screening earlier or to be screened more often.
Why is a Colonoscopy Done?
A Colonoscopy allows a gastroenterologist to examine the entire length of the large intestine. The procedure is used as a method of routine or diagnostic screening for colon cancer. It is also used to explore causes of abdominal pain, rectal bleeding, chronic constipation, chronic diarrhea and other intestinal issues.
How Does One Prepare for a Colonoscopy?
Thorough cleansing of the bowel is essential to have an effective procedure and to avoid retesting. Your gastroenterologist will provide specific instructions for bowel preparation which typically include a pill or liquid laxative and restriction from solid foods a day or two before the test. The following recommendations are general guidelines. Please confirm the details of your preparation instructions with your gastroenterologist.
You will not be permitted to eat or drink the day of the procedure. To avoid dehydration on the day prior to the colonoscopy, drink clear, fat-free bouillon or broth, gelatin, strained fruit juice (no grape juice or any liquid with red color) and water.
Your gastroenterologist will need to know if you have heart disease, lung disease or any other medical condition. Unless otherwise instructed, continue taking your regularly prescribed medication. You may be asked to stop taking blood thinners or iron supplements in the days before the procedure, but check with the doctor for precise instructions.
Finally, arrange for someone to drive you home afterward because the lingering effects of sedation will make it unsafe for you to drive until the next day.
Please visit our Colonoscopy FAQ page as a resource for commonly asked prep questions.
How is a Colonoscopy Performed?
When it is time to begin the examination, you will lie on your side, and the anesthesiology provider will begin intravenous (IV) sedation. Once sedation has taken effect, the gastroenterologist used a lighted, flexible tube called a colonoscope that will be carefully inserted through the rectum and moved gently around the bends of the colon. As the scope is guided through the colon, the gastroenterologist will view the interior lining on a monitor, remove colon polyps and sample abnormal tissue, which will be evaluated further in the lab. The scoping process typically takes 30 minutes.
After the procedure, the nurse will move you to a recovery area, where the sedation will wear off. The gastroenterologist will then visit you to discuss your procedure and immediate findings.
What Happens After the Colonoscopy is Done?
After the colonoscopy, the recovery period from anesthesia varies from 30 minutes to an hour depending on the type of sedation (moderate or deep). You will need someone to drive you home after the procedure as some effects from anesthesia can take up to a day to wear off. You should be able to resume normal activities the next day. Ask your gastroenterologist when you can resume taking medications.
If a biopsy is taken during your colonoscopy, you will be getting a follow-up from your doctor. If colon polyps are removed, your doctor might recommend a follow-up colonoscopy in as few as three months, depending on the size and number found. If no polyps are found, you will likely not need a colonoscopy for another 10 years if you are at average risk for colon cancer.
What are the Risks Associated With a Colonoscopy?
- Bleeding from biopsy or removal of a polyp or growth
- A puncture or tear in the colon.
- Risks of anesthesia