Colonoscopies: What can you expect?

It's March - Colon Cancer Awareness Month - so we have been sharing information about colon cancer in this space, on Facebook and Twitter, and in our monthly e-newsletter. We've emphasized the need for awareness of the risks and symptoms, and provided information on recommended prevention methods. But we know that one of the most important things an individual can do to prevent colon cancer is also one of the least likely things an individual will do, simply because the thought of having it done makes most people uncomfortable.

Many of the misconceptions and fears regarding a colonoscopy stem from a basic ignorance of what the procedure entails, and how it's performed. To help ease some of those fears, we thought it might help to share a briefing on how to prepare for, and what to expect from a colonoscopy from the U.S. Department of Health & Human Services website:

How to Prepare for Colonoscopy

The doctor usually provides written instructions about how to prepare for colonoscopy. The process is called a bowel prep. Generally, all solids must be emptied from the gastrointestinal tract by following a clear liquid diet for 1 to 3 days before the procedure. Patients should not drink beverages containing red or purple dye. Acceptable liquids include:

• fat-free bouillon or broth
• strained fruit juice
• water
• plain coffee
• plain tea
• sports drinks, such as Gatorade
• gelatin

A laxative or an enema may be required the night before colonoscopy. A laxative is medicine that loosens stool and increases bowel movements. Laxatives are usually swallowed in pill form or as a powder dissolved in water. An enema is performed by flushing water, or sometimes a mild soap solution, into the anus using a special wash bottle.

Patients should inform the doctor of all medical conditions and any medications, vitamins, or supplements taken regularly, including:

• aspirin
• arthritis medications
• blood thinners
• diabetes medications
• vitamins that contain iron

Driving is not permitted for 24 hours after colonoscopy to allow the sedative time to wear off. Before the appointment, patients should make plans for a ride home.

How is colonoscopy performed?

Examination of the Large Intestine

During colonoscopy, patients lie on their left side on an examination table. In most cases, a light sedative, and possibly pain medication, helps keep patients relaxed. Deeper sedation may be required in some cases (Tip: don't hesitate to ask your doctor about this option if you are interested). The doctor and medical staff will monitor vital signs and attempt to make patients as comfortable as possible.

The doctor inserts a long, flexible, lighted tube called a colonoscope, or scope, into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the large intestine to a computer screen, allowing the doctor to carefully examine the intestinal lining. The doctor may ask the patient to move periodically so the scope can be adjusted for better viewing.

Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again. Bleeding and puncture of the large intestine are possible but uncommon complications of colonoscopy.

Removal of Polyps and Biopsy

A doctor can remove growths, called polyps, during colonoscopy and later test them in a laboratory for signs of cancer. Polyps are common in adults and are usually harmless. However, most colorectal cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer.

The doctor can also take samples from abnormal-looking tissues during colonoscopy. The procedure, called a biopsy, allows the doctor to later look at the tissue with a microscope for signs of disease.

The doctor removes polyps and takes biopsy tissue using tiny tools passed through the scope. If bleeding occurs, the doctor can usually stop it with an electrical probe or special medications passed through the scope. Tissue removal and the treatments to stop bleeding are usually painless.

Recovery

Colonoscopy usually takes 30 to 60 minutes. Cramping or bloating may occur during the first hour after the procedure. (This is due to the carbon dioxide used to inflate the colon.) The sedative takes time to completely wear off. Patients may need to remain at the clinic for 1 to 2 hours after the procedure. Full recovery is expected by the next day. Discharge instructions should be carefully read and followed.

Patients who develop any of these rare side effects should contact their doctor immediately:

• severe abdominal pain
• fever
• bloody bowel movements
• dizziness
• weakness

There are many stories in the news this month about the value of getting a colonoscopy, and some, like this one, that detail personal experiences with the screening test. Across the board, the most common complaint patients share about the procedure is the colon prep that requires patients to drink a gallon of less-than-delightful liquid to clean out the colon. Colon cancer is the 2nd most deadly form of cancer, and the 3rd most diagnosed form of cancer in men and women in the United States. Surely a day of unpleasant preparation is worth the effort when compared to the alternative - a diagnosis of colon cancer.

For information about our Save-A-Life program that assists patients with the costs of colonoscopies and other cancer screening tests, contact Christina Bostian at 479-361-5847 or by email.