It’s no secret that Colonoscopies have had a bad reputation for a long time. However, the benefits of undergoing this very important procedure far outweigh the short term discomfort and temporary awkwardness that can be associated getting a colonoscopy. The process allows your doctor to check your large intestine for diseases, tumors, ulcers, inflammation, or any other abnormalities, thus creating an opportunity to confront any diseases about which you may not be aware. After all, prevention truly is the best medicine. Of course, getting a colonoscopy is not glamorous, our doctors at Bumrungrad International have the tools and training to help make sure that each patient feels comfortable and well cared for from start to finish. In this article, we’ll explore some of the questions you might have about colonoscopies, and hope to shed some light on this very important preventative procedure.
Why Are Colonoscopies Important?
Simply put, a colonoscopy is a great step in the early detection of disease and cancers. Knowing about an ailment before it manifests into something more serious, and possibly untreatable, is the first step in a proper preventative health care routine. In the case of a colonoscopy, this screening is especially important for patients over 50 years old (who have no colon cancer risk factors other than their age) and those who have a family history of colorectal diseases or cancer. Moreover, a colonoscopy can help the doctor explore the possible causes of abdominal pain, rectal bleeding, chronic constipation, chronic diarrhea, and other intestinal problems.
Although preventative exams such as dental checkups, eye exams, general physicals, and women’s Pap smears and mammograms are usually done without hesitation, patients oftentimes are reluctant to schedule a colonoscopy. Many patients are anxious or afraid of undergoing anesthesia or are embarrassed by someone examining a part of the body that is often considered to be taboo.
Are There Any Risks Associated with Undergoing a Colonoscopy?
A colonoscopy poses a few risks. Rare complications with a colonoscopy can include: an adverse reaction to the sedative agent, bleeding from the biopsy (in small amounts during or with bowel movement after the procedure), bleeding from an interventional treatment such as a polypectomy, or a tear in the colon or rectum wall.
How do I Prepare for a Colonoscopy?
The day before the colonoscopy, patients will have to clean out their colon, which is also known as the large intestine. This preparation is essential because it provides the doctor with an unobstructed view during the procedure.
To empty the colon, the doctor will ask you to undergo the following process:
- One day before the colonoscopy, eat only light soft foods – no vegetables, fruit, dairy or dairy products. For example, you can eat soups (with fish or chicken), rice, and porridge. Drink only plain water or clear liquids. Avoid red or dark colored liquids, as it can be confused for blood during the procedure.
- Take a laxative: generally, laxatives come in both pill and liquid forms. You may be asked to take a laxative the night before the procedure or in the morning of your colonoscopy. The process generally takes 3-6 hours, with 5-10 bowel movements in order to clean out your large intestine. There is no need to worry if feeling a bit tired, and it unlikely that you’ll feel any symptoms similar to those of diarrhea.
- Lastly, it is vital for you to inform the doctor at least one week before the colonoscopy of any medications you are currently taking, particularly for diabetes, high blood pressure, heart disease, or blood thinner medications, as you may need to adjust or stop taking medication temporarily.
What Happens During the Procedure?
On the day of the exam, the specialist will take you to a room where you’ll get dressed in a hospital gown and asked to lay on your side. Sedation will be used in order to minimize any pain or discomfort.
The large intestine is then inspected with a colonoscope. This device is a thin, flexible tube with a small camera and light attached to one end, with a side channel (tube) in which the doctor can pump air through in order to inflate the colon. The doctor may insert instruments through the channel in order to take a tissue sample, or to perform treatment. During a colonoscopy, the doctor (gastroenterologist) carefully examines the entire inner surface of the large intestine and looks for polyps or small growths and any existing signs of colorectal cancer. The procedure takes roughly 20-30 minutes as the doctor gently guides the colonoscope around these bends looking for polyps and other abnormalities.
Once the procedure is complete, you will be sent to the recovery room for monitoring until you recover from the sedation, which can take around 1-2 hours. (Afterwards, you’ll be able to go home, get some rest, and of course enjoy some food. Some patients can be worried about the pain they may feel after the procedure is conducted, but in most cases only mild discomfort such as feeling bloated or tender in some areas due to the inflated air during the procedure may follow the exam. After the exam, you may need a friend or family member to take you home as it may take up to a day for the sedative agent to fully wear off.
What You Can Expect
Negative result – Assuming that you are of average risk of colon cancer, with no other risk factors other than age, a negative result indicates that the findings are normal and the doctor doesn’t see any abnormalities in the colon. In this case, the doctor may recommend another colonoscopy in 10 years’ time.
Positive result – Colonoscopic findings are positive if polyps or any other abnormalities are found. Usually, polyps are non-cancerous, and the doctor will remove them during the colonoscopy. If one or more polyps are removed, the doctor will recommend follow up colonoscopies, depending on the polyp sizes, cell characteristics, and quantity. The duration of the procedures may last between 5-10 years, 3-5 years, or as little as 3-6 months. If the polyp has a high potential of becoming cancerous or is already at an early cancer stage, the doctor will inform you after the procedure with the full pathology report.
A potential issue after the colonoscopy is if the doctor is concerned with the condition of the large intestine due to a poor view quality from poor bowel preparation. In this case, the doctor may suggest an additional colonoscopy.
Talk to Your Doctor
You may feel uneasy or anxious bringing up the subject of a colonoscopy with your doctor, but don’t worry! They’ve talked about this topic with many first-time patients before and know how to calm fears and offer reassurance. If you still feel reluctant to schedule a colonoscopy, remember that this is the best method in detecting intestinal diseases and cancer, and that it’s worth the temporary discomfort.
By Dr . Poungpen Sirisuwannatash , Gastroenterologist and Hepatologist, Digestive Disease Center, Bumrungrad Hospital
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