Colonoscopy is a test that allows your doctor to look at the inner lining of your large intestine (rectum and colon). He or she uses a thin, flexible tube called a colonoscope to look at the colon. A colonoscopy helps find ulcers, colon polyps, tumors, and areas of inflammation or bleeding.
During a colonoscopy, tissue samples can be collected (biopsy) and abnormal growths can be taken out. Colonoscopy can also be used as a screening test to check for cancer or precancerous growths in the colon or rectum (polyps).
The colonoscope is a thin, flexible tube that ranges from 48 in. (122 cm) to 72 in. (183 cm) long. A small video camera is attached to the colonoscope so that your doctor can take pictures or video of the large intestine (colon). The colonoscope can be used to look at the whole colon and the lower part of the small intestine.
Q. What are the symptoms of colon cancer?
Often, the early stages of colon cancer do not have symptoms. That is why preventive screening is very important. Every year, millions of adults help prevent the development of colon cancer by having a routine colonoscopy. During a colonoscopy, when doctors find pre-cancerous growths called “polyps,” they can easily remove the polyps – greatly lowering your risk of developing colon cancer. Symptoms can include rectal bleeding, anemia, a change in bowel habit, abdominal pain and weight loss, but these symptoms are common for other illnesses as well. When the symptoms are caused by cancer, the disease may be in a late stage.
Q. Who is at risk of colon cancer?
Age is the No. 1 risk factor – more than 90% of colon cancer cases occur in people (men and women equally) age 50 and older. There are other risk factors:
• Family history of colorectal cancer or adenomas (polyps)
• Cigarette smoking – which can increase the risk of colon cancer death by 30% -40%, possibly accounting for up to 12% of colon cancer fatalities
• Sedentary lifestyle
• High-fat diet, especially one from mostly animal sources
• Heavy alcohol intake
• Ulcerative colitis or Crohn’s colitis
• Cancer of the uterus or ovaries before age 50
• Past removal of the gall bladder
• Past radiation therapy of the abdomen
• Diabetes – which can increase the risk of developing colorectal cancer 30% – 40%
Q. Who should be screened and when?
The American Cancer Society recommends that adults be screened for colon cancer beginning at age 50 – or even earlier if there is a family history of the disease.
Q. Will I receive sedation for the exam?
You will receive “conscious sedation” for the exam, which means that an intravenous line is placed and medications are given intravenously. This is not general anesthesia, although almost all patients are comfortable during the procedure. Because of the sedation, you will need a driver to take you home.
Q. What do I need to do to prepare for a colonoscopy?
Preparation is a critically important part of the exam. If your bowel is not adequately cleaned out before the exam, the doctor will not be able to identify polyps, the pre-cancerous lesions. Before the procedure, you will have to take an oral laxative solution (called “a bowel prep” or “preparation”) to clean out your bowel. Specific prep instructions vary, but the prep usually begins 1 to 2 days before your procedure. Please read your prep instructions (given separately) to understand what you should do 1 day or 2 days before your colonoscopy. Visit our patient guide for having a colonoscopy page or download the printable PDF to get more details on preparation. Download our patient guide for having a colonoscopy to get more details on preparation.
Q. Are there any complications or risks associated with having a colonoscopy?
In general, colonoscopy is a safe procedure. As with any medical procedure, however, there are some risks associated with the procedure and with the sedation used. You should contact your doctor if you feel severe abdominal pain, dizziness, fever, chills or rectal bleeding after the colonoscopy. Perforation and bleeding are two of the major complications associated with colonoscopy. Perforation is a tear through the wall of the bowel that may allow leakage of intestinal fluids. Perforations are generally treated with hospitalization, antibiotics, and possible surgery. There may be bleeding at the site of a biopsy or polyp removal. Most cases of bleeding stop without treatment or can be controlled at the time of the procedure. Rarely, blood transfusions or other treatments may be required to stop the bleeding. There also is a risk of having a reaction to a sedative given during the exam. In most cases, medications are available to counteract this reaction. Although complications after colonoscopy are rare, they can be serious and life-threatening. It is important for you to be aware of early signs that something might be wrong.
Q. How long does the procedure take?
How long will it take for me to recover? The procedure itself usually takes from 15 to 60 minutes, but you should plan on spending 2 to 3 hours total to account for preparation, waiting and recovery time.
Q. How many days do I need to take off work?
You will need to take off work the day of the procedure. Some patients who work evenings also take off work the day before the procedure to do the bowel prep.
Q. Is there anyone who should not have the procedure?
Colonoscopy is not recommended in pregnant patients, in patients with limited life expectancy, or in patients with severe medical problems making them high risk for sedation.
The colon must be free of solid matter for the test to be performed properly. For one to three days, the patient is required to follow a low fiber or clear-liquid only diet.
On the day before your procedure, DO NOT eat solid food or drink milk. Please exclude food with seeds (poppy, sesame, etc), nuts and berries form your diet for 1 week before procedure. Drink clear liquids only. Clear liquids include apple juice, chicken and/or beef broth or bouillon, lemon-lime soda, lemonade, sports drink, and water, coffee or tea (without milk or nondairy creamer), gatorade and fizzy or nonfizzy soft drinks.
Take your regular medication unless the doctor tells you otherwise. Please, stop any blood thinner (Coumadin, Plavix) for 3 days before the procedure and ASA (Aspirin) for 1 week prior to the procedure.
It is recommended to remove nail polish and take a shower before procedure.
If you have any questions, please feel free to call Dr. Gottesman at (718) 934-4842.