Colon Cancer Screening: Your Colonoscopy Guide

Colon cancer is one of the most common and most deadly cancers. Colon cancer is the third most common cancer, and the third most common cancer killer, among both men and women. Colonoscopy remains the most effective way to not only detect early colon cancer but also to prevent colon cancer from ever being an issue. Since the widespread adoption of colonoscopy as a means of screening for and preventing colon cancer, colon cancer-related deaths have drastically declined in both men and women. Overall, though, far too few men and women undergo life-saving colon cancer screening.

Adults neglect this important cancer screening for many reasons. Sadly, some adults simply don’t have access to colon cancer screening. Some adults don’t understand how important it is. Others bypass this screening due to embarrassment, concerns over safety or issues with cost. Colon cancer screening, however, is safe, effective and covered by every insurance provider as a preventive medical test.

Colonoscopies are safe and effective, but safe doesn’t mean they are risk-free. In the hands of a skilled gastroenterologist, however, colonoscopy complications are very rare—far less than 0.1 percent of colonoscopies end in a complication. Most complications, if they do occur, are minor and treatable. Choosing an experienced gastroenterologist is vital; make sure your doctor is specially trained to perform your screening procedure. Just as you’d want an experienced, skilled heart surgeon performing your heart surgery, you want an experienced, skilled gastroenterologist performing your colonoscopy.

What does preparation for the procedure look like?

The procedure itself is safe and simple; the preparation prior to the procedure can be more uncomfortable. However, no amount of discomfort from a colonoscopy can compare with the devastation that accompanies a diagnosis of colon cancer.

The day before:

Beginning the day before your procedure, most doctors will encourage you to focus on a mostly liquid diet including:

• Jell-O
• Water
• Broth
• Similar clear-liquid foods

Adequate hydration during this day is a key part of all preparations. The more you drink, the less likely you are to suffer from dehydration or other problems that can lead to a miserable colonoscopy preparation.

The night before:

The night before your procedure, usually around 6:00 p.m., most doctors will recommend a special cleanse to help you prepare for your procedure. Colonoscopy cleanses range from salty, high-volume (usually around a gallon) liquids to tasteless, low-volume laxatives. Most cleanses are the worst part of a colonoscopy. Due to following a liquid diet, most people feel hungry around the time they start their cleanse; sadly, the cleanse does little to fix that hunger. Instead, the cleanse does exactly what its name implies—it cleanses your colon to allow for a careful inspection during your procedure. What that means, for most people, is a night full of frequent trips to the restroom.

Following your cleanse instructions is a key part to your colonoscopy. The cleaner your colon is, the easier it is for your doctor to find and remove small polyps from your colon. Nearly all colon cancer starts as a small polyp, and removing these polyps when they are small, long before they even start to turn into cancer, is why colonoscopies are so effective at not only screening for but also preventing colon cancer.

The most successful cleanses are two-part cleanses. The first part, as above, is done the night prior to your procedure. The second part is usually done a few hours before your procedure. If your procedure is early in the morning, that can mean a night lacking in sleep. However, the two-part cleanse has been shown time and again to be the most effective way to clean your colon and prepare for your colonoscopy.

What will happen the day of my procedure?

Same-day prep:

The day of your colonoscopy, with the exception of any extra cleansing that needs to be done, is typically the easy part of the procedure. Most patients are asked to arrive for their procedure 30 to 60 minutes ahead of the start time to complete a basic check-in process. As part of that process, you’ll answer a few medical questions and talk with a specially trained nurse to help prepare for your procedure. You’ll also get the opportunity to talk to your doctor and ask any questions you may have. For most patients, this check-in process usually involves the placement of an IV. Although the IV isn’t 100 percent necessary, the IV is usually the means to the nice part of the procedure—medication to help you relax and to keep you sleepy.

During your procedure:

During the procedure, your heart, blood pressure and breathing are constantly monitored to make sure you are safe. The IV you had placed earlier receives medication. Although the medication isn’t always necessary, the bloating and discomfort some patients have with colonoscopies aren’t usually an issue with the medication. The medication used for most colonoscopies is different than that used for a traditional surgery. It works very fast, and it wears off very fast, to keep you safe, comfortable and sleepy. Most patients enjoy a short nap—usually a nice, needed one after the cleanse the night before—during their procedures.

During your colonoscopy, your doctor uses a special camera to slowly and carefully examine your colon for cancer, polyps or other abnormalities. Nearly all polyps can be safely removed during the same procedure. Complications are uncommon but can include:

• Abdominal pain
• Bloating
• A missed polyp (although colonoscopies are fantastic procedures, no procedure is perfect)
• Bleeding
• An unexpected medication reaction
• An infection (very uncommon)
• Perforation (a small hole or tear opening in the colon.)

Again, in the hands of a skilled doctor, the risk of an unexpected, serious complication is extremely low—far less than 0.1 percent.

Many patients worry about modesty or what, exactly, doctors and nurses will be seeing during their procedure. Colonoscopies mostly involve specialized cameras and computer equipment, and although a careful inspection of your bottom is part of the procedure, this is done while all attempts at preserving modesty are employed. Patients are kept carefully covered by blankets. Most of the exam itself involves your doctor looking at a large computer monitor and the inside of your colon—not your bottom or other private areas. The doctors and nurses involved in your procedure are careful to keep you safe— and covered—at all times.

What is the recovery process like?

As soon as your procedure is finished, you’ll be transported to a recovery area where your doctor and nurses will monitor you while you wake up. You’ll be given a chance to talk with your doctor, as well, to discuss the results of your colonoscopy. The sedation medication typically wears off very fast, and although you might feel sleepy for a few hours, most patients are ready to return home to food, naps and rest quickly. Most routine activity can be safely resumed as you feel up to it—usually within a few hours—but driving, alcohol consumption and major decisions (e.g. decisions regarding finances) are best left to the following day. The time after a colonoscopy is usually best for relaxing, napping, catching up on a TV show or movie, or otherwise letting your body recover from your cleanse and procedure.

After your procedure, if polyps are found and removed, they will be examined by a specially trained doctor to determine what type of polyps were removed and to help your doctor know when you need a follow-up procedure.

Colon cancer is awful—all cancer is. However, most colon cancer can be prevented through colonoscopies performed by a skilled gastroenterologist. If you have any questions about colon cancer screening or colonoscopies, talk more with your doctor or call and make an appointment to meet with one of the many skilled gastroenterologists at Revere Health. Colonoscopies can be embarrassing, the cleanse can be rough, and the procedure can be a bit scary at first. But nothing associated with a colonoscopy will ever approach the disaster of colon cancer. Save a life—possibly your own—by scheduling or helping someone you love schedule a colonoscopy today.

About the Author

I grew up in Utah County and graduated from Brigham Young University. I received my medical degree from the University of Virginia, and I finished my residency in internal medicine at the University of Utah where I also served as chief medical resident. As a doctor, I recognize the tremendous trust my patients place in me, and I do my best to help them understand not only their medical issues but also the plan—the how and why—behind helping them feel better. I love the challenge posed by all gastrointestinal disorders but especially enjoy the challenges and intricacies of Crohn’s disease and Ulcerative Colitis.