Potential Benefits Outweigh Colonoscopy Fears
Fears of undergoing the prep process for a colonoscopy often keep patients from scheduling the preventive procedure, according to Amy Foxx-Orenstein, DO, a gastroenterologist and professor of medicine at Mayo Clinic College of Medicine in Scottsdale, Arizona.
Having a clear idea of what to expect can help allay some of these fears and help the process go as smoothly as possible, Dr. Foxx-Orenstein says.
DOs, or osteopathic physicians, focus on prevention by gaining a deeper understanding of your lifestyle and environment as they partner to help you get healthy and stay well.
How a colonoscopy works
A thin, flexible tube is inserted through the rectum into the lower gastrointestinal tract. The colonoscope, which has a camera with a light on the end, is used to examine the lining of the colon for any abnormalities, such as polyps or diverticula. You will be given medications to keep you comfortable throughout the procedure.
Why have a colonoscopy?
“A colonoscopy is an excellent screening tool to identify colon polyps and colon cancer which typically cause no symptoms,” Dr. Foxx-Orenstein explains.
Your doctor also might recommend a colonoscopy if you have:
- Abdominal pain
- Changes in bowel habits
- Change in appearance of stool
- Unexplained weight loss
“A colonoscopy can help disgnose or eliminate several conditions. For example, blood on the tissue paper or in your stool could indicate hemorrhoids, diverticulitis, cancer or colitis,” says Dr. Foxx-Orenstein.
Step 1: Preparation timeline
A high quality examination can occur when the colon is cleared of stool. Preparing in advance can help.
Three days before exam
- Begin a low fiber, low residue diet that limits milk and milk products.
Day before exam
- Consume only clear liquid items, such as gelatin, apple juice, broth-based soup and lemon lime soda. “Because it is more difficult to clear the colon of solids and protein, the clear liquid diet helps your doctor get the best readings,” says Dr. Foxx-Orenstein.
- Take a prep solution mixed fluid to clean out your colon. Typically you will drink an 8 ounce glass every 15 minutes until half the mixture is gone.
Day of exam
- Take the other half of the prep solution in the morning. “Multiple studies have found splitting the prep between the night before and the morning of the procedure leads to a cleaner colon,” says Dr. Foxx-Orenstein.
- Be sure you have a ride home. Because the sedatives can make you feel relaxed after the examination is complete, you will be asked to have a driver take you home.
What if I can’t drink all the prep?
Split preps are of modest volume and are generally well tolerated. Dr. Foxx-Orenstein suggests asking your pharmacist if flavorings are available if you are concerned about the taste.
Step 2: Getting a colonoscopy
Once you arrive at the endoscopy suite, you will check in, and be shown to a changing area. If you opt to be sedated for the procedure, a nurse will start an IV.
On average, the procedure should take around 30 minutes to complete. If you feel discomfort during the colonoscopy, take deep breaths to relieve any cramping, and let the physician know.
After the colonoscopy, you will have a discussion with the doctor or medical staff about the procedure, which will include a report on the findings and any recommendations for follow up.
Step 3: Getting the results
Any polyps removed will be sent to a pathologist for testing within 24-48 hours. After the pathologist sends the results to your doctor, you might get a phone call or have an appointment scheduled to go over results with your physician.
Typically, if no polyps are found and you have no family history of colon cancer or inflammatory bowel, you won’t need to be another colonoscopy for 10 years.
“If polyps are found, a recommendation for when to follow up will be based on the number, size and types of polyps. Five-year follow up for polyps is most common,” Dr. Foxx-Orenstein says.