Why get a colonoscopy?
The most common reason that someone gets a colonoscopy is to be screened for colon cancer. If you are at average risk for colon cancer, meaning you have no symptoms or family history, you should get your first colonoscopy at 50.
Colon cancer usually starts in the glands in the lining of the colon and rectum. And colon cancer usually begins as noncancerous polyps, which slowly develop into cancer.
Colon cancer is one of the leading causes of cancer-related deaths. However, studies have shown that if a colonoscopy is done and polyps are removed by a trained professional, the risk of developing colon cancer goes down by at least 50 percent.
In 2012, there will be an estimated 103,170 new cases of colon cancer and 40,290 new cases of rectal cancer in the U.S. It's estimated that 51,690 people in the U.S. will die in 2012 from colon and rectal cancer.
The death rate from colon cancer has decreased in both men and women for the past 20 years. There are a number of likely reasons for this. One is that doctors are finding polyps through colonoscopies and removing the polyps before the polyps can develop into cancer. Screening also is allowing more colon cancer to be found earlier when the disease is easier to cure.
Colon cancer grows slowly. From the start of a benign polyp to the formation of colon cancer takes on average 10 years. It's ideal to intervene before that process occurs.
Studies have shown that these can contribute to a person's likelihood to develop colon cancer: age older than 50, the presence of polyps, a family history of color cancer, Crohn disease, dietary decisions, sedentary lifestyle and smoking.
What happens when you get a colonoscopy?
Before getting a colonoscopy, you have to prepare your colon. Your colon has to be clean so that your doctor can have a clear passageway to look for polyps.
Preparing for a colonoscopy is probably the least pleasant part of the whole procedure. You must take a sizable amount of laxatives and drink plenty of clear liquids, such as water and sports drinks, for one to three days before the test. The preparation also might include enemas and not eating solid foods for two or three days before the test.
When you go in for your colonoscopy, the physician will sedate you. Then, the physician takes a flexible tube with a camera, inserts it into the rectum and looks at the lining of the colon all the way through.
If the physician finds any polyps, they will most likely be removed that day. Polyps are then sent to a pathologist who can check them for cancer.
Does it hurt?
It shouldn't hurt. Even if you're awake during the screening, you might not remember it because of the sedation.
You might feel pressure as the scope moves through your body. Sometimes air is inserted in the colon so that the physician can get a better view. This might cause you to feel brief cramping or gas pains. Passing gas is necessary and should be expected.
How long does it take to recover?
You shouldn't do much after the colonoscopy, primarily because the state of sedation alters your mental capabilities. You will want to bring someone with you who can drive you home after the screening. Once you're home, you will want to take it easy. The next day you should be fine.
Once you're home, if you feel severe pain, this might be a symptom of damage to the colon lining. You will want to go back to the hospital, especially if you feel pain and see blood in your stool.
You also might have gas after the colonoscopy because of the air the physician inserts into the passageway to see better. This is normal.
What are the risk factors?
The procedure is done sedated, so there's some risk that comes with sedation. The more problems you have medically, such as heart disease or lung disease, the more risk is associated with being sedated.
There is a one in 2,000 risk of perforating, or piercing, the bowel while the physician is examining the colon. This damage to the bowel would result in a surgery to close off the perforation.
When the physician removes polyps from the colon, there's a risk of persistent bleeding from the biopsy or polyp-removal sites.
Patients who develop severe abdominal pain, fever, bloody bowel movements, dizziness or weakness should contact their doctor immediately.
Do you need follow-ups?
It depends on what your risk for developing colon cancer is and what was found on your examination. For example, if you don't have a family history, you're 50 and you have a colonoscopy that produces normal results, it's recommended that you have another colonoscopy in about 10 years.
If the physician finds a large polyp, your doctor might recommend you have another colonoscopy the next year. The characteristics of the polyps found and the number of the polyps found also affect when your next colonoscopy will be.
With colon cancer, family history is very important to take note of.
There are some colon cancer family syndromes, such as familial polyposis syndrome. This syndrome is genetic and can lead to hundreds or thousands of polyps in the colon. Patients with this syndrome develop colon cancer between the age of 35 and 40.