If you’ve suffered from abdominal pain, bleeding and changes in bowel habits, or are potentially at risk of developing colon cancer, your doctor will likely recommend a colonoscopy. The procedure helps identify the causes of colorectal conditions and can aid in cancer treatment and prevention.
Colorectal cancer occurs in the colon, rectum, or both. It is the third-most-common cancer in adults in the United States. Regular screenings can identify colorectal cancer in its earliest stages when treatment is most likely to get the best results possible.
A colonoscopy, also known as a lower GI endoscopy, is a diagnostic procedure used to image, inspect and diagnose conditions within the lower gastrointestinal tract and digestive system.
Similar to an upper endoscopy, a colonoscopy uses a type of endoscope (a thin and responsive tube with a tiny camera at the end) called a colonoscope. The colonoscope is inserted through your rectum and displays images of your colon through a monitor in real-time.
With a colonoscopy, your doctor can carefully evaluate sensitive conditions like ulcers, polyps, cancer, or other colorectal issues such as inflammation and infections. The detailed images created by the colonoscope also allow for accurate diagnoses of colon cancer and help determine next steps for cancer treatment.
If no polyps are found, this test only needs to be done about once every 10 years.
In addition to colonoscopies, several screening options are available, including a simple, take-home option known as the fecal immunochemical test (FIT). The FIT tests (including Cologuard) detect hidden blood in the stool and use DNA to detect cancer cells. Your physician will give you the kit to take home with you, along with detailed instructions on how to use it. These tests require you to collect samples of your stool. If results come back negative, your doctor will probably recommend you repeat the test one to two times a year.
Both types of screenings can detect precancerous polyps in the colon. Regardless of which one you have, the most important thing is to follow your doctor’s recommendations afterward. If you have a colonoscopy and the doctor removes polyps, you'll need to return for follow-up colonoscopies on a regular schedule.
Because colonoscopies require entry into the gastrointestinal tract, your doctor will also ask that you prepare your bowels before the procedure. This preparation may take place up to three days before your colonoscopy and will require you to alter your diet and take medication that is designed to cleanse your colon. Having your colon completely cleansed and free of any matter will ensure your procedure is safe and yields accurate results.
During your procedure, your team of caregivers will insert an IV line into your arm in order to provide medication and necessary sedatives. You will also be given oxygen to breathe. Your doctor will ask that you lie on your left side in the fetal position (bringing your knees up to your chest).
Your doctor will then insert the lubricated colonoscope through your rectum. You may feel slight pressure or cramping. You will be given sedatives to reduce any discomfort you may feel.
As your doctor examines your colon, they may use the colonoscope to clean the colon lining, remove any liquid stool, or remove polyps. Should your doctor notice any abnormality within the colon, they may take a sample of tissue (biopsy) for further analysis.
Once the procedure is done, you will be taken to a recovery room. Depending on the type of sedatives and anesthesia provided, you will likely be discharged within an hour. Read more about what to know before your colonoscopy.
A colonoscopy is generally a safe diagnostic procedure. Despite the unlikelihood of a complication occurring, the procedure does carry certain risks. These risks include nausea, bloating and rectal irritation. There is also a slight risk of bleeding should a biopsy or polyp removal take place.
With a successful colonoscopy and a clean bill of health – meaning no polyps were found during your screening – you won’t need another colonoscopy for 10 years. If your doctor does find and removes polyps, you’ll likely need to get screened in five years.
Colorectal cancer can often be prevented with regular screenings and lifestyle choices that minimize your risk. But all too often, myths and misconceptions prevent you from getting the care you need. Separating the facts from fiction can help protect your health.
Myth: Only older people get colorectal cancer
Although the risk of developing colorectal cancer increases with age, the number of adults younger than 50 diagnosed with colorectal cancer goes up every year, according to the American Cancer Society. Additional risk factors include:
- Family history of colorectal polyps or cancer
- Personal history of inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis
- Moderate to heavy alcohol consumption
Myth: Only people with symptoms need regular colorectal cancer screenings
You need to get screened for colorectal cancer even if you don’t have symptoms. Colorectal cancer cells grow very slowly in most people, and symptoms often don’t arise until the disease is more advanced. The American Cancer Society recommends the following screening schedule:
- Start regular screenings at age 45 if you are at average risk of colorectal cancer. Talk to your physician about earlier screenings if you have factors that increase your risk.
- Continue regular screenings through age 75.
- From age 76 through 85, talk to your doctor about whether screenings should continue based on your personal preference, overall health, and prior screening history.
- Once you’re older than 85, you no longer require regular colorectal cancer screening.
Myth: A colonoscopy is the only form of colorectal cancer screening and it’s a difficult, uncomfortable procedure
Colonoscopies may have a bad reputation, but in reality, you’ll be given medication that helps you sleep and minimizes your discomfort during the procedure. Even the preparation has gotten easier as experts have refined the process over time.
In addition to colonoscopies, several screening options are available, including a simple, take-home option known as the fecal immunochemical test (FIT). Both types of screenings can detect precancerous polyps in the colon. Regardless of which one you have, the most important thing is to follow your doctor’s recommendations afterward. If you have a positive FIT test, you will need a colonoscopy. If you have a colonoscopy and the doctor removes polyps, you'll need to return for follow-up colonoscopies on a regular schedule.
Myth: I don’t need to get tested for colorectal cancer if I don’t have any symptoms
Even if you feel fine, you should still follow the American Cancer Society’s recommendations for screenings. Cancer does not always have recognizable symptoms when it’s just beginning and that’s when it’s easiest to treat. Symptoms to watch for include:
- Rectal bleeding (the most common symptom)
- Pain when using the bathroom
- Unintentional weight loss
- Unexplained new constipation or other changes in bowel habits
Speak with your primary care provider for more information on colorectal cancer screenings. Make sure they are aware of any family history of colorectal cancer. And if it's time for your first (or next) colonoscopy, don't put it off. It could save your life!
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