Fast Facts:

  • Everyone should start routine screening for colorectal cancer beginning at age 45, and younger if you have risk factors for colon cancer.
  • Colonoscopy is considered the gold standard screening test for detecting colon cancer. Colonoscopy allows your doctor to biopsy any abnormalities they see and to remove worrisome polyps.
  • You have a choice of how to prepare for your colonoscopy. An expert team will take care of you during and after the procedure.

There are multiple tests to screen for colon and rectal cancer. Some simple tests check for cancer markers or blood in the stool (stool-based tests). More high-tech tests involve doing a CT scan. And recently, a new blood test (a ctDNA or liquid biopsy test) has been developed. 

But the gold-standard test for detecting colorectal cancer at its earliest and most treatable stage is a colonoscopy. Let’s take a look at what you can expect before, during and after you have this potentially life-saving procedure.

What can I expect before having a colonoscopy?

Having a clean bowel will give your doctor the best chance of seeing the smallest changes in your colon lining. The smaller a cancer is when it’s detected, the better chance you have of beating it. Of course, your colon isn’t normally nice and clean inside.

Your big assignment before arriving to have your colonoscopy will be a thorough bowel prep. Your doctor will give you instructions to start a special diet a few days before your procedure. Here’s what our partners at NorthEast Digestive Health say to do before your colonoscopy:

2-3 Days before the procedure:

You’ll start the process of cleaning out your colon by eating food that’s easy to digest. This is called a low residue diet.

  • Eat a low-fiber diet. Avoid foods like nuts, seeds, and raw vegetables. You may be required to stop consuming solid foods a day or two before the procedure.
  • Make sure to stay hydrated, drinking plenty of fluids.
  • Take all medications as prescribed.
  • You can eat any type of meat, pasta, rice, and cooked fruits and vegetables (without skins/peels) during these 3 days.
  • No alcohol. It can cause dehydration.

1 Day before the procedure:

Usually you’ll start your bowel prep the day before the colonoscopy. Sometimes your doctor might ask you to start earlier. This is usually the part most people dread. But you can work with your doctor to find a bowel prep that you can tolerate based on how it tastes, how much you have to drink and how long it takes. 

  • The morning before your procedure, have a light breakfast.
  • After breakfast, begin a “clear liquid diet.” This means broth, jello, clear sodas, water, popsicles, Italian ice, juice, gatorade and coffee or tea without creamer. 
  • Keep in mind that none of your clear liquids should be colored red, purple or blue.
  • No dairy is allowed the day before your procedure.
  • Make sure you stay hydrated, drinking plenty of clear liquids.
  • Make sure you finish all of your prep medicines and liquid as instructed.

Your doctor will instruct you on what time to start your bowel prep medications and give specific directions for the prep you’ll be doing. The goal is to have clear liquid stools when you complete the bowel prep.

The morning of the procedure:

You might be a little nervous on the morning of your colonoscopy. But the hard part is really over! Your doctor and nurses do this procedure every day and they’ll take good care of you. This is what to expect the morning of the procedure

  • Your doctor will tell you if you should take your normal medications.
  • You can usually drink small amounts of clear liquids up until 2 hours before your procedure.
  • Someone needs to drive you to your procedure and back home, since you’ll be groggy for a while afterwards.
  • Wear comfortable clothes and shoes.

Most facilities will check that you have a driver and ask that they stay until the procedure is finished.

What happens during the colonoscopy?

You won’t remember much about the time surrounding your colonoscopy. But this is how the procedure goes:

  • A nurse will check you in and verify who you are and what you’re having done.
  • An anesthesia provider or nurse will start an IV and fluids. 
  • They’ll also attach monitors to make sure your heart rate, blood pressure and breathing are all normal.
  • You’ll be asked to breath through a mask as you receive a sedative and drift off to sleep.
  • Your doctor will use a special camera and light on a long tube to look inside your rectum and colon. The tube also holds surgical instruments that can be used to cut and scrape, if needed.
  • If the doctor sees any areas of concern, they will take biopsies (cut off tiny pieces of colon lining). If they see a polyp (a large finger-like projection from the colon wall), they may decide to remove it.
  • When the doctor has looked at the entire colon, they will remove the tube. Any tissue they removed will be sent to a pathologist to check for cancer.
  • The anesthesia provider will wake you up after the procedure. 
  • After you’re awake and talking, you’ll be allowed to drink some clear liquids.
  • When you’re cleared by the anesthesia provider and your GI doctor, you’ll be discharged from the facility to go home.

What can I expect after I’m discharged?

You’ll start to feel like your old self pretty quickly. Most people are back to normal within a few hours. Here’s what to expect after the procedure:

  • You can begin to eat normally as soon as you feel up to it. Start off with small bites and see how you tolerate the food.
  • You probably won’t feel any pain after a colonoscopy. You might have some nausea, bloating or gas. You might also have a small amount of bleeding from your rectum.
  • Remember to stay hydrated. Drink plenty of fluids.
  • Avoid alcohol and heavy lifting for a day or two.
  • If you feel bloated or gassy, try taking a walk to help get your bowels moving normally.
  • You should feel back to normal within a few hours and can return to normal activities the next day. 
  • Your doctor should call you within about a week to share your biopsy results. If you haven’t heard from them, call their office and ask for the results.

When should I call my doctor after a colonoscopy?

Most people have no complications after colonoscopy. But there are a few things to look out for, including:

  • Bleeding: A small amount of blood in your first bowel movement is normal. If there’s significant blood or if it continues after the first day, you should alert your doctor.
  • Abdominal pain: Bloating and gas are normal, but severe pain or pain that lasts more than a couple of days is not. 
  • Fever: You should not run a fever after a colonoscopy. If you have a temperature higher than 100.4 degrees, let your doctor know.
  • If you haven’t heard from your doctor’s office within a week, give them a call to get your pathology report. 

Most people need to get a repeat colonoscopy in 10 years. But some people will need one sooner. Make sure you find out when you need to get your next screening.

Bottom Line:

Colonoscopy is the gold-standard for colorectal cancer screening. It takes several days to prepare for, undergo and recover from the colonoscopy procedure. There are several bowel prep options available to you and your doctor. Colonoscopy is a safe, routine and effective screening tool that has been proven to save lives. Recovery is usually quick, easy and uncomplicated. It’s a great way to get checked for colon cancer. Check it for your loved ones. CheckIt4Andretti.

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