Colonoscopy Q & A

Colorectal cancer screening helps people stay well and saves lives. Regular colorectal cancer testing is one of the most powerful weapons for preventing colorectal cancer. Removing polyps prevents colorectal cancer from ever starting. And cancers found in an early stage, while they are small and before they have spread, are more easily treated. Nine out of 10 people whose colon cancer is discovered early will be alive 5 years later. And many will live a normal life span.

But too often people don’t get these tests. Then the cancer can grow and spread without being noticed, like a silent invader.

Early stage colorectal cancer does not usually have symptoms. In most cases, by the time people do have symptoms the cancer is very advanced and very hard to treat. Regular screening is necessary to find these cancers in the early stages. Ask a doctor about the best screening plan for you.

Colonoscopy (ko-lun-AH-skuh-pee) is an exam that lets a doctor closely look at the inside of the entire colon. The doctor is looking for polyps (pah-lips) or signs of cancer. Polyps are small growths that over time can become cancer. The doctor uses a thin (about the thickness of a finger), flexible, hollow, lighted tube that has a tiny video camera on the end. This tube is called a colonoscope (ko-LAHN-uh-scope). The colonoscope is gently eased inside the colon and sends pictures to a TV screen. Small amounts of air are puffed into the colon to keep it open and let the doctor see clearly.

The exam itself takes about 30 minutes. Patients are usually given medicine to help them relax and sleep while it’s done.

Your doctor decides how often you need this test, usually once every 10 years, depending on your personal risk for colon cancer. It’s important for you to talk with your doctor to understand your risk for colon cancer, the guidelines you should follow for testing, and whether you need to start having the tests at age 50 or earlier.

Will it hurt?

No, these exams are not painful. In most cases, patients are given medicine to sleep through the colonoscopy, so they don’t feel anything. Sigmoidoscopy doesn’t require medicine to make the patient sleepy. Air is pumped into the cleaned-out colon to keep it open so that doctors can get the best pictures. While the air pressure may cause some discomfort, it should not hurt.

Who will do the exam?

Colonoscopy is almost always done by a doctor, usually a gastroenterologist (a doctor whose specialty is the digestive tract) or a surgeon.

Will I be in a private room?

Colonoscopy is done in a private area; it may be a hospital outpatient department, a clinic, an ambulatory surgery center, or a doctor’s office. The patient’s privacy is very important. If you have concerns, talk with the doctor about where and how the procedure will be done.

Sigmoidoscopy typically is done in a private room, with no other patients nearby. Doctors and nurse specialists are professional and very careful to respect the patient’s privacy.

How do I prepare? Will I need to miss work?

Preparation for colonoscopy or sigmoidoscopy makes you to go the bathroom a lot! Your doctor will give you instructions. Read them carefully a few days ahead of time, since you may need to shop for special supplies and get laxatives or enemas from a pharmacy. You may also need to change your plans for the preparation day. You will need to be near your bathroom as soon as you start the laxatives. If any of the instructions are not clear or you do not understand them, call the doctor’s office and go over them step by step with the nurse.

Many people consider the bowel preparation (often called the bowel prep) the worst part of the test. You follow a special diet for one or more days before the exam and take very strong laxatives before the procedure. You may also need enemas to clean out your colon. In order for the doctor to see the inside of your colon clearly and get good pictures, it should be as cleaned out as possible.

Because colonoscopy is usually done with drugs that make you sleepy, most people miss a day of work. Ask your doctor if you’ll need to miss work before a sigmoidoscopy. For either test you’ll need to stay close to a bathroom for a number of hours. You might want to schedule the test the day after a regularly scheduled day off, so you can be at home the day before without taking an extra day off.

How will I feel afterward? Will I need someone to drive me home?

Most people feel OK after a colonoscopy. They may feel a bit woozy from the drugs (anesthesia). They’ll be watched and given fluids as they wake up. They may have some gas, which could cause mild discomfort. Because of the medicines given for the test, most facilities require that you bring someone to take you home.

After a sigmoidoscopy, you get up and walk out. There should be no problem driving yourself home, as long as you have not had any drugs to make you sleepy during the test.

What if they find something?

If a small polyp is found, your doctor will probably remove it. Over time some polyps could become cancer. If your doctor sees a large polyp, a tumor, or anything else abnormal, a biopsy (by-op-see) will be done. For the biopsy, a small piece of tissue is taken out through the colonoscope or sigmoidoscope. It is sent to a lab to be checked under a microscope for cancer or pre-cancer cells.