A colonoscopy is the best test for finding and removing colorectal polyps, which can become cancerous if not removed. A colonoscopy is done for a variety of reasons including screening for colon cancer, examine causes to symptoms like abdominal pain or diarrhea and to treat tissue such as placing a stent. Current guidelines recommend a screening colonoscopy starting at age 45 for those with average risk, with screening sooner if you have risk factors like a family history of colon cancer. Discuss with your physician if you have any questions.
Before the colonoscopy, your colon will need to be cleaned out in order for your physician to look for any polyps, lesions and any abnormalities. You will follow prep instructions given to by your physician before the procedure which you need to follow carefully. These instructions include following a clear liquid diet and drinking a prep solution. During the colonoscopy, you will receive IV sedation and then a flexible, lighted tube is inserted into the rectum and guided through the entire large intestine and rectum. Images of the colon are viewed on a screen and polyps that are found are removed and sent to a lab for further testing. Your physician will discuss the findings with you after the procedure. Having a colonoscopy presents with little risks but there is a possibility that you could have a reaction to the anesthesia, excess bleeding from polyp or tissue removal or perforation of the colon. These risks are minimal and the benefits largely out weight the risks. After your procedure, the physician and staff will discuss the results and restrictions, if any. You generally can resume a normal diet but you are not allowed to drive after the procedure due to anesthesia. You will need someone to drive you to and from the center. If any polyps are found, they will be sent to the lab for testing. Most polyps are not cancerous but some can be precancerous. You will be notified of your biopsy results in 1-2 weeks.
What to Expect Before, During, and After a Colonoscopy
Before the Procedure
Before a colonoscopy, proper preparation is essential to ensure accurate and complete results. Your care team will provide detailed instructions, which typically include dietary adjustments and a bowel preparation process to clear the colon.
This preparation may involve a temporary change in diet, avoiding certain medications, and drinking a prescribed solution. While preparation can feel inconvenient, it plays a critical role in allowing your doctor to clearly evaluate the colon and identify any abnormalities.
During the Procedure
On the day of your colonoscopy, you will be guided through each step by your care team. The procedure is usually performed with sedation to help you remain comfortable and relaxed.
During the exam, a thin, flexible instrument called a colonoscope is gently inserted to examine the lining of the colon. The procedure is closely monitored, and most patients do not feel discomfort during the process.
After the Procedure
After the procedure, you will spend a short time in recovery while the effects of sedation wear off. Because sedation is used, you will need someone to drive you home.
Most patients are able to resume normal activities the following day. Your provider may discuss initial findings with you before discharge, and any additional results or follow-up recommendations will be shared as needed.
Common Questions About Colonoscopy
Is a colonoscopy painful?
Most colonoscopies are performed under sedation, so patients typically do not feel pain during the procedure. Some mild bloating or cramping afterward is possible but usually resolves quickly.
How long does a colonoscopy take?
The procedure itself is usually completed within a short period of time, although total time at the facility may be longer due to preparation and recovery.
Are there risks?
Colonoscopy is a commonly performed and generally safe procedure. As with any medical procedure, there are potential risks, which your provider will review with you based on your individual health history.
Will I need time off work?
Because sedation is used, most patients take the rest of the day off and return to normal activities the following day.
Image courtesy of Mayo Clinic
Reference: Mayo Clinic. 2024. Colonoscopy. https://www.mayoclinic.org/tests-procedures/colonoscopy/about/pac-20393569