A colonoscopy may be one of the more dreaded routine tests. All told, however, it will usually last for less than 15 or 20 minutes and your colorectal surgeon will make it as comfortable as possible for you both before and during the minimally-invasive procedure. Knowing what to expect in advance can help to reduce the stress and anxiety you feel about this simple, effective test.

Do I Really Need A Colonoscopy?

Even for those who have no increased risks of colon cancer, a routine screening is recommended at age 50 and once every five to ten years afterward if your colonoscopy is normal. For those who have a family history of gastrointestinal cancers or who have had previous abnormalities during a colonoscopy, more frequent testing is recommended.

In addition to being the best way to identify and remove polyps before they become cancerous, a colonoscopy is also used to determine the cause of changes in bowel habits, rectal bleeding and some types of abdominal pain. Because this type of screening allows doctors to find, diagnose and remove most growths during a short, minimally-invasive procedure, it is a much better alternative to most other methods of detecting abnormalities in the colon.

What Will I Have To Do To Prepare?

For many people, the preparation before a colonoscopy is the most uncomfortable part. Because of the nature of the screening, it is important to empty your colon before the procedure. Each doctor has a protocol to follow before a colon screening.

In most cases, the preparation will begin with diet restrictions. Sometimes doctors ask patients to avoid solid food for up to 48 hours before a colonoscopy, although a 48 hour liquid diet is used very rarely. Most likely, you will  be asked to limit yourself to only clear liquids for 24 hours.

Some doctors will prescribe laxative medications to ensure all solid foods have cleared your system. This may be in the form of pills, although it is often a salty-tasting solution that must be swallowed at the rate of 8 ounces every ten minutes until it the entire dose is taken; usually two hours. Other doctors may opt for enemas instead.

Will I Be Sedated During The Procedure?

After you arrive on the day of the screening, you will be taken into the procedure room and asked to change into a gown. Once changed and in the endoscopy suite, the closely monitored sedation process will begin. Some doctors rely on a mild sedative in pill form. More commonly, an IV is placed in your hand and a sedative is given intravenously. Pain medication may also be added to the IV. This will reduce any discomfort that could be caused by the colonoscopy.

What Can I Expect During The Procedure?

In the procedure room, you will notice a viewing screen, which often looks like a small television or a computer monitor. During the procedure, the light and camera on the end of the long, flexible scope will relay images to this screen. This allows the doctor to detect abnormalities, take biopsies and remove any growths that could be causing problems.

The scope itself is only about half an inch in diameter, and looks like a long tube. At the tip, you will see a light and an open channel. In order to make it possible to see the intestinal walls, air is gently and slowly pumped (insufflated) through this channel and into your colon. This channel may also be used to insert tiny instruments to sample or remove questionable or abnormal tissue.

Most of the screening will be performed while you are lying on your left side on the exam table. Your doctor may ask that you pull your knees toward your chest.  With sedation, you should not feel any discomfort.

If your doctor finds an area that looks unusual, a biopsy may be performed. This means that  a small sample of tissue will be removed using a biopsy forceps inserted through the scope and the sample will be sent to the pathology lab for results. Colon polyps and other abnormal, but identifiable growths may be removed entirely.

What About Recovery?

In most cases, a colonoscopy only takes between 10 and 20 minutes. After the screening, you will be taken to an observation room where you will rest for 30 minutes to two hours, depending on the sedation you were given. Even though most people will feel better within an hour, you’ll still need someone to drive you home. Sedation may slow your reaction time and impair decision-making capabilities for up to 24 hours.

After not eating for several days, many people are ready for a big meal after a colonoscopy. This is fine, as long as you haven’t had polyps or other abnormal growths removed. If you have, your doctor may advise you to follow a special diet for a few days. Your colorectal doctor may also tell you to avoid taking some prescription drugs, especially blood thinners, until the site has had time to heal.

Some people do report slight abdominal cramping or bloating for two or three hours after a colonoscopy. This is caused by the air that was introduced into your colon. Passing gas will offer instant relief, and walking or other low impact exercise may also help.