Know Before You Go: Colonoscopy Screening

Female doctor talking with patient.

Colonoscopies can find cancer and save lives, plain and simple. Although you may not look forward to this procedure, it is a relatively easy and effective way to catch colon cancer before it catches you. Alleviate your concerns and eliminate confusion by knowing what to expect before, during and after your colonoscopy.

Who Needs One

According to the American Cancer Society, men and women at average risk should begin colonoscopy screening at age 45 and repeat it once every 10 years (at least) until age 75 or 85, depending on overall health.

People with either a first-degree relative who was diagnosed with colon cancer or adenomatous polyps before the age of 60, or two first-degree relatives diagnosed at any age should be screened starting at age 40 or 10 years before their relative was diagnosed, whichever is earlier.

Some people with diseases that predispose them to cancer, such as ulcerative colitis, hereditary nonpolyposis colon cancer (HNPCC) or familial adenomatous polyposis (FAP), may require colonoscopies earlier.

Before the Colonoscopy
Starting a day before your procedure, you should stop eating solid foods and only have clear liquids, including water, broths, tea, black coffee, clear juices and Jell-O. A good general rule is that if you can read the newspaper through it, it’s a clear liquid. Avoid anything with red, blue or purple coloring. Your doctor may also want you to temporarily stop taking or change the doses of certain medications prior to the procedure (such as blood thinners), so be sure to check with him or her ahead of time. Rarely, your doctor may ask you to take an antibiotic beforehand.

In order for the doctor to get a clear view of your colon, you will need to complete a bowel prep before your colonoscopy. The type of bowel prep varies depending on your doctor, so be sure to ask them what kinds they offer, as you may have a choice. They may also ask you to combine different forms of bowel prep. The bowel prep will usually start the day before your procedure, but your doctor will give you explicit instructions about when and how to prepare. Options include:

  • Pre-prepared laxative solutions or laxatives that you mix in with electrolyte solutions or sports drinks.
  • A laxative pill that you will take along with plenty of fluids to keep from getting dehydrated or disrupting your electrolytes.
  • An enema that uses water to wash out your colon.

Be sure to complete the entire prep per the instructions – if you don’t, your doctor may not be able to see your entire colon and may have to repeat the colonoscopy. You should make sure you have easy and fast access to a toilet after you start the prep, as it will cause diarrhea.

During the Colonoscopy
You will likely be given sedation and anesthesia to ease any discomfort during the procedure, and most people do not remember very much (if anything) afterwards. The doctor will use a long flexible tube with a camera on the end to search for any concerning polyps that may represent cancer.

If your doctor is worried about any areas within your colon, he or she will take a biopsy and send it off to be examined by a pathologist. Some precancerous or early cancerous polyps may actually be completely removed during the colonoscopy. Expect the procedure itself to last about 20-60 minutes, but the entire process from arrival to departure usually takes several hours and may last as long as five hours.

After the Colonoscopy
After the procedure, you will rest for about 30-60 minutes while the sedation wears off. Because of the medication you received during the procedure, you will be drowsy and should NOT drive, so make sure you have a ride home. You should not drive or work for the rest of the day.

Discomfort after the procedure should be minimal, but may include mild cramping, bloating or flatulence. It’s possible that you will notice a small amount of blood in your first bowel movement after a colonoscopy, especially if your doctor removed a polyp. If you have large amounts of blood in your stool or you continue to pass blood, or if you have persistent abdominal pain or fever over 100° F, call your doctor.