Let’s Talk Colonoscopy

If you’re in or approaching your 40s, your ObGyn may encourage you to schedule your first colorectal cancer screening (typically a colonoscopy). We know patients often dread these recommendations, but this valuable screening isn’t as scary as you may think— and it is an important part of your health and wellness.

When Should I Schedule My First Screening?

If you have a family history of colorectal cancer, inflammatory bowel disease, or specific genetic syndromes, your doctor may recommend earlier screening. Otherwise, the recommendation is to begin screening at age 45.

What Type of Screening is Available?

A colonoscopy is the most common of several screening options. Your healthcare provider will help you understand what type of test is appropriate for you and the pros and cons of each. Talk with your doctor about any risks and relevant family history. Screening options may include stool tests, flexible sigmoidoscopy, colonoscopy, or a CT (virtual) colonoscopy.

What Happens During a Colonoscopy?

Before the procedure, you will be offered a mild sedative to prevent discomfort. Next, you’ll lie on your side and draw your knees up to your chest while a gastroenterologist inserts a thin, flexible tube into your rectum. This tube— colonoscope —has a camera on the end to view and take pictures of the colon and will allow your doctor to gently pump air into the colon to provide a better view as necessary. The doctor will navigate the entire large intestine looking for polyps or abnormal tissue. If necessary, some polyps can be removed through the scope, and your doctor can also perform a tissue sample (biopsy) during the same procedure.

After your procedure, you will begin to recover from the sedative, but it can take up to a day for the effects to fully wear off. It’s important to give yourself time to recover from the sedative, so plan to set aside all of your important responsibilities for the day and ensure you have assistance getting home after the procedure.

Before your colonoscopy, your gastroenterologist will discuss any other potential side effects from the procedure, which may include some bloating, gas, or mild discomfort. Small amounts of blood may also occur with your first bowel movement. If you have concerns, it’s always a good idea to check in with your healthcare provider.

How Do I Prepare for a Colonoscopy?

Your doctor will discuss the specifics of your colonoscopy before the test. You may be asked to:

• Follow a special diet before the exam, and stop eating at midnight the day of your exam
• Take a laxative or enema to empty the colon of stool the night before your test
• Adjust your medications before the exam (talk to your doctor about all the medications you take before the procedure, including prescription and over-the-counter remedies)

What Are the Results of a Colonoscopy?

If your results are negative, your doctor has found no abnormalities in your colon. Depending on your personal health history, you may be able to wait another ten years before undergoing another procedure. Your doctor will create personal recommendations for you based on their findings.

If your results are positive, your doctor may have found some abnormal polyps or tissues in your colon. Your doctor will discuss their findings and recommendations with you. Most polyps are not cancerous, but some can be precancerous. Therefore, your doctor may recommend a follow-up procedure or may simply recommend another screening sooner than the typical 10-year recommendation for negative results.

If your procedure is incomplete in any way (most commonly from stool blocking the scope), they may recommend another form of screening or sooner follow-up.

Colorectal cancer screening is an essential part of your health and wellness checks. Catching precancerous cells and cancers early is important. Your ObGyn will recommend colorectal screenings, mammograms, and other appropriate wellness checks as appropriate during your annual exams. Importantly, share any fears with your doctor. They can help to alleviate your worries with information or alternative options.