Colonoscopy: What You Need to Know
A colonoscopy is a procedure that no one wants to think about having done yet yet everyone, at some point in their lives, will need. It's is a diagnostic test that screens for colon cancer. It also provides the ability to remove any overgrowths, polyps, that could potentially turn into cancerous lesions if left and allowed to grow. Because this test is so readily available, colon cancer can be prevented and lives saved which is why this test is so important (and why your doctor continually nags you to have it done)!
The instrument used for this test is a long, flexible tube with several internal chambers called a scope. One of which houses a camera to enable visualization of the inside of the colon as well as picture taking for documentation of the examination. Another contains a light tto provide better visualization. Another chamber is a port for which a long wire guided forcep or wire loop called a snare is introduced to be used as extension of the hands to physically remove polyps before they have the opportunity to become cancerous. These devices can also be used to take samples of the deeper layers of tissue to be sent of for lab testing for more thorough testing if indicated due to prior history of cancer, family history of colon cancer, rectal bleeding or blood found in the stool.
Sedation is given prior to the start of the procedure to provide comfort as the scope is lubricated and then past into the rectum and manipulated through the twists and turns of the colon to visualize the entire colon for a complete exam. Medication given as sedation for this test is not the same as for a major surgery and will not give the same kind of 'sleep'. Patients of this procedure wake approximately 45 minutes to an hour after the first dose of medication feeling as if they had taken a short. After fully awake and able to swallow without any problems, the patient may resume eating and drinking as before the test. Results from the lab samples taken are generally available within 1-2 weeks and available from the office of the doctor that performed the test.
Colon cancer is the 2nd largest cause of cancer in the United States. However, this type of cancer is highly preventable when screenings are done as recommended. Most doctors agree that age 50 is when everyone should begin having colonoscopies done and once every 10 years after that unless there are extenuating circumstances. A family history of colon cancer or multiple polyps from one or more 1st degree relatives requires a repeat screening every 3-5 years and the initial procedure at 40 years old or 10 years before the age the relative was diagnosed with colon cancer.
Any ongoing symptoms of bowel dysfunction (rectal bleeding, diarrhea, abdominal pain) would indicate that screening is needed regardless of age. Other conditions besides colon cancer could be present and causing the symptoms experienced. Early detection allows for quicker diagnosis and treatment.
As with any invasive procedure, there are risks. Adverse reactions to the medication given for sedation can occur as well as a slight chance of perforation to the colon. The percentage of these risks occurring are extremely rare and immediate treatment can be given to counteract the effects of these events should they occur.
Those who are at higher risk for the above complications are pregnant women and those who suffer from ulcerative diseases of the bowel. Your doctor will advise you of risks during your initial exam in the office.
You've finally committed to an actual date for your colonoscopy. Now, for your prep work! Homework before a medical test? Really? Yes! Considering WHERE the test will be performed you will definitely want to stick to a clear liquid diet the day before the test. Clear liquids are considered anything that you can see through such as clear soup broth, jello, or popsicles (if you melted a popsicle you could see through it like Kool-Aid). No solid foods, ice creams or creamy soups permitted. Also, you will be given a strong laxative either as a liquid, pills, powder that is mixed with liquid or a combination thereof. The day of the procedure you will not be permitted to have anything by mouth until the test is completed. All this pre-test activity is necessary to clean out the colon in order to visualize all of the anatomy of the large intestine unimpeded by stool.
Another reason that you are not allow to have anything by mouth the day of the procedure is because, due to the sedation you will receive, having even a small amount of food or drink on your stomach can cause you to vomit while asleep. If this occurs, there is a large risk that the vomitous can enter the lungs causing pneumonia. This is a serious complication that would require an extended hospital stay for treatment and can be avoided by simply following your doctors instructions to refrain from having anything by mouth until after the test.
You also may be advised to stop certain medications for a specific amount of time prior to the procedure. Blood thinners are sometimes stopped 2 days before to reduce the risk for bleeding from irritation of the scope or endoscope being passed through the colon.Your doctor will provide you with detailed instructions regarding your daily medications as well as diet and activity before and after your test.
Things to Remember
- Colon cancer is preventable-Screening IS Important!
- Proper prep means better visualization of colon
- Clear liquid diet the day before (no reds)
- Nothing to eat or drink day of procedure
- Provide a complete health history to your doctor
- List any close relatives with a history of cancer
- Discuss any allergies to foods, medications or latex
- Provide a complete list of medications including over-the-counter and herbal supplements
- Talk with your doctor about any history of complications with anesthesia
- Don't hesitate to ask questions if unsure of instructions
An Ounce of Prevention
No one looks forward to having medical procedures done, especially colonoscopies. Although, when you consider how effective this fairly simple procedure can be in preventing cancer, it is worth the hassle. Take note of your personal history, family history and doctor recommendations regarding health screenings to fight cancer before it starts!