If you are a bit intimidated by the thought of having a colonoscopy, you’re not alone. A recent study found that 70 percent of Americans ignore recommendations for screening colonoscopies simply due to fear. The procedure and prepaerations can hardly be described as fun, but putting it off can leave you at risk for colon cancer, which is the second leading cause of cancer-related deaths in the country.

During a colonoscopy, the doctor inserts a flexible, lighted tube, called a colonoscope, into the rectum and guides it around the entirety of the colon, searching for abnormal growths. If any are found, the doctor can remove them during the procedure before they pose any health threat. Many fear that a colonoscopy will be a painful, uncomfortable procedure, when in fact, the sedative patients receive prior to the examination prevents pain or discomfort. The simple facts are that colonoscopy's are quick, painless, and most importantly can save your life.

Colon cancer has a 90 percent survival rate when it is detected early, and a colonoscopy is considered the best type of colon cancer screening because it can remove tumors before they develop into cancer. The colonoscopy itself is the easiest part of the screening experience. The bowel preparation process the day before the procedure, which consists of a liquid-only diet and the use of laxatives, is the hardest part. And while the bowel preparation may be unpleasant, it is not painful. 

Don’t let fear get in the way of having a colonoscopy. The procedure itself lasts only 30-60 minutes, and patients may resume normal activities the next day.

The Basics

A colonoscopy is a visual examination of the entire large intestine (colon) using a lighted, flexible colonoscope. To be certain you are comfortable and relaxed, you will be sedated through an I.V. In fact, most patients are asleep during the entire process and remember little to nothing about it.

What to Expect: During the Screening

When it's time to start the screening, you will be asked to lie on your side. Once sedation takes effect, the colonoscope is inserted through the rectum and moved gently around the bends of the colon. As the colonoscope makes its way through the colon, the gastroenterologist can see the lining of the colon on a television screen. Typically, the physician looks all the way to the end of the large intestine, and back, for anything unusual. The entire scoping process typically takes between 15 and 30 minutes. When complete, your nurse will take you into a recovery area, where the sedation quickly wears off. Your physician will talk to you about your test and any findings.

What can be found?

If polyps (very small growths of tissue) are found, your doctor can perform a biopsy immediately. The biopsy involves passing an instrument through the scope to remove the polyp, which is sent to a pathologist at a laboratory to be analyzed.

Typically you should feel nothing when a biopsy or polyp is taken, and you should experience no recovery pain. While the overwhelming majority of polyps are harmless, your physician will have it tested and confirm your results with you, usually within 24-72 hours depending on the day of the week of the procedure. Furthermore, since most colon cancer starts as a benign polyp, when these are removed, the possibility of them growing into cancer is removed as well.

What happens afterwards?

Once your recovery nurse determines that most of the effect of the sedation has worn off, you will be released, however, you cannot drive. Even though you will feel fine, the lingering, subtle effects of the sedation will make it dangerous for you to drive, so a responsible adult must be there to take you home. You should be able to resume normal activity the next day. You will feel hungry after the procedure but try to eat light for a day or so.

How to Prepare

Thorough cleansing of the entire bowel is essential for effective results so there will not be a need for retesting. Instructions for doing this will be given by your physician, but this can include a combination of the following: enema, restriction from eating solid foods a day or two before the test and taking pill-form and/or liquid laxatives. You may be told to stop taking aspirin or other blood-thinning medications for several days before the test as well.

To avoid dehydration, patients should drink clear, fat-free bouillon or broth, gelatin, strained fruit juice (no grape juice or any liquid with red color), water, plain and unsweetened coffee or tea, or diet soda. Unless otherwise instructed, continue taking any regularly-prescribed medication. Your physician may also ask you to stop taking iron preparations a few weeks before the test if you are on them. Finally, you need to arrange for someone to drive you home afterward because lingering, subtle effects of the sedation will make it unsafe for you to drive until the next day.