Understanding your colonoscopy procedure

You may be wondering when to get a colonoscopy. If you’re in your mid-40s, it might come as a surprise to hear it’s already time to have a screening for colorectal (colon) cancer. With colon cancer on the rise in people under 50, the American Cancer Society recommends your first screening at age 45 (assuming you’re at average risk). You may need a screening earlier in life if you have a family history of polyps or other medical conditions that raise your risk of colon cancer. Read on to learn what a colonoscopy is and how to prepare for it.1

What is a colonoscopy?

A colonoscopy is a preventive screening to test for colon cancer and other colorectal illnesses. It typically takes 30 minutes and is usually done as an outpatient procedure, which means you don’t have to stay the night in a hospital. During a colonoscopy, your provider examines your rectum and large intestines using a flexible scope that’s inserted through the anus. This special scope has a video camera on the end so your provider can see if there are any suspicious growths (called polyps) along the lining of your colon. If something abnormal is found, your provider can take pictures or even remove a piece of tissue (a biopsy) to check for cancer. To help your provider get a clear picture, carbon dioxide is used to expand your colon. (Feeling bloated or crampy afterward is normal.)

Details to know before a colonoscopy

Many people choose to be sedated during their colonoscopy, but you’re able to stay awake if you prefer. After the procedure, your provider may tell you their findings before sending you home. You may need to wait for final results if a piece of tissue was taken as a sample for closer inspection. Keep in mind, you’ll need a pre-arranged ride after your procedure (no driving). If tissue was biopsied, your provider will let you know when to expect results. Plan on taking it easy the rest of the day and give yourself a pat on the back for completing an important screening. While there’s a very small risk of bleeding, a colonoscopy is generally considered a safe procedure. You should be able to return to your normal routine the next day.2

Why is a colonoscopy important?

Colon cancer is the second leading cause of cancer-related deaths worldwide, and it’s the third most common cancer worldwide.3 A colonoscopy is considered the gold standard for finding colon cancer early. Many people will not have symptoms in the early stages of the disease, and if colon cancer is diagnosed at an advanced stage, treatment options are limited. 3 It can take years for polyps to become cancerous, so the earlier your provider finds and removes them, the better. This quick screening could save your life.3

How do I prepare for my colonoscopy?

Bowel preparation is an important step in making sure you have an effective procedure and your provider can see the intestine lining. If your provider doesn’t have a clear, high-quality picture of your colon, there’s a greater chance they could miss something. Your provider will give specific instructions, but this is generally how it goes: you’ll eat a low-fiber diet for a few days before your appointment and then drink only clear liquids the day before. 

The night before your procedure, you’ll drink part of a laxative solution (which causes frequent diarrhea) to thoroughly clean out your intestines. Then, you’ll finish that drink a few hours before your appointment. You’ll spend a lot of time in the bathroom, so make sure you stay close to one. Bowel preparation may sound unpleasant, but you get to decide which type of prep to take:

  • Polymer-based formulas: These are over-the-counter laxatives (usually powders) you typically mix with an electrolyte drink. This is a popular colonoscopy prep because the powder is low cost, easy to swallow and tasteless.
  • Saline-based formulas: These are laxative pills you can get with a prescription. If you don’t want to drink a ton of liquid, this may be a good option.

Whichever option you decide, be sure to read your colonoscopy prep instructions carefully. Talk with your doctor about which prep is best for you, along with 5 questions to ask before scheduling your colonoscopy.

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