You’re sitting in the pastel-walled examination room and your doctor just told you he wants to schedule a colonoscopy. What? Will it hurt? The technical explanations and pre-procedural instructions were probably lost as you entertained an internal dialogue of questions.
Before you toss your prep instructions in the trash and avoid making that appointment, know this: Almost 60 percent of colon-cancer related deaths might have been avoided with early screening.
Do I Have To?
Look at the people around you –- if they are over 50 years old, one of them has already had a colonoscopy. Subjective symptoms, such as chronic diarrhea, or observable problems, like bloody bowel movements, do not provide a definitive diagnosis. Your doctor has ordered a colonoscopy as a routine screening exam or a diagnostic tool.
Routine screening colonoscopies find problems before they start. The doctor can find and possibly remove polyps or abnormal tissues before they have the chance to become cancerous, which can take up to 10 years.
Diagnostic colonoscopies are performed when there are symptoms, positive test results, or a strong familial history of colon cancer. Colonoscopies are not without risk; if your doctor prescribed this test, it was not ordered arbitrarily.
The preparation for a colonoscopy cleans out your colon. Your bowels must be squeaky clean to help the doctor see the lining clearly. Stay close to a bathroom; you will probably be in there quite a bit. As uncomfortable as the constant toilet trips may be, follow the preparation orders to the letter. If your bowels are not cleaned out, there is a chance you will have to repeat the procedure.
The doctor may order laxatives, enemas, and a clear liquid diet to induce bowel movements and clean out the colon. You may have frequent, watery stools. If you are placed on a clear liquid diet, do not eat or drink anything with red or purple food coloring, such as purple sports drinks or gelatin, as they can stain the colon.
If you want to breeze through the dreaded colonscopy prep, ask your doctor these questions before you begin:
- Can you prepare a couple days in advance or does the laxative solution need to be taken on the night before the procedure?
- Can the solution be refrigerated?
- Is it okay to add flavoring, such as commercial drink powders or sports drinks, to improve the taste?
You may be instructed not to eat or drink four to six hours prior. This helps prevent vomiting, and possibly choking, while you are sedated for the procedure.
What to Expect on Test Day
Arrange for someone to drive you home from the procedure and leave your jewelry and expensive items at home. Bring your wallet; you will need at least one form of identification to check in at the facility.
You will be asked to remove your clothing and change into a hospital gown, but you may get to keep your socks on, so be sure they don't have holes. Your nurse will obtain a written consent for the procedure; this is a good opportunity to ask any remaining questions or concerns, such as when to expect test results.
The procedural room may contain a couple television-like monitors, emergency equipment, and other assorted medical devices. The nurse will connect a blood pressure cuff on your arm, a probe on your finger, and electrodes on your chest. This allows the nurse to monitor your well-being during the exam.
An intravenous catheter, inserted into your arm or hand, will pinch a bit at first but is necessary for the medications to help keep you relaxed during the procedure. Try taking deep breaths while the catheter is being put in to relieve discomfort. Feel free to tell the nurse where your best veins are if you know -- that may help decrease the number of pokes you experience.
A flexible probe will be gently inserted into your rectum. You may feel pressure or an urge to bear down, which should pass shortly.
The procedure will take approximately 15 to 20 minutes, while the doctor advances the scope through the entire colon looking for unhealthy tissues.
You may spend an hour or two in a recovery area while the sedative wears off. It is okay if you feel groggy; this feeling should pass shortly. Your nurse will continue to monitor you closely until you are safe to go home with a responsible adult.
Following the procedure, you may pass more gas than usual; this is a normal effect, as air was introduced into your colon during the procedure. You may also notice some bright red blood in your stool, which may be normal if the doctor took a tissue sample or removed polyps.
It’s Over – What Now?
Whatever your test results bring, your doctor will have a plan for you. Whether it involves a referral to a specialist, or a clean bill of health and a promise of no more colonoscopies for five to 10 years, you made it through this exam. Take a walk, a deep, cleansing breath, or vent to loved ones. You made it through the dreaded colonoscopy; you can make it through your next challenge as well.
American Cancer Society. (2008). Colorectal Cancer. What You Need to Know – NOW. Atlanta: American Cancer Society Health Promotions.
Centers for Disease Control and Prevention. (2010). Screening and Risk Factors Report. State Cancer Profiles. Retrieved from http://statecancerprofiles.cancer.gov/risk/index.php?risk=09&sex=0&type=risk&stateFIPS=00&sortVariableName=default&sortOrder=default