Colonoscopy

Colonoscopy Overview

A colonoscopy is a type of endoscopy examination that enables your doctor to examine the lining of your colon (large intestine). The doctor will slowly navigate an endoscope (a small, illuminated, flexible tube) into the rectum and through the colon to look for signs of cancer or precancerous lesions as well as other conditions involving the colon or large intestine.

What is a Colon Polyp?

Colon polyps are small growths on the inner lining of the large intestine that can vary in size and type. While most are not cancerous, some polyps have the potential to become cancerous. The gastroenterologist will remove polyps found during the colonoscopy to prevent colon cancer.

 

THE DIGESTIVE TRACT

COLON POLYPS

Five percent of all colon polyps progress to cancer. During your colonoscopy, doctors remove all adenomatous polyps that are found.

COLONOSCOPY

Colonoscopies allow for the detection of abnormalities in the colon and rectum.

 

Why is Screening for Colon Cancer Important?

Colorectal cancer is the second leading cause of cancer death among both men and women in the United States, but it does not have to be.** With proper screening, colorectal cancer can be stopped before it even starts. Colonoscopies are considered the gold standard for colorectal cancer screening, according to medical experts. That is because it gives the doctor performing the colonoscopy an up-close look at your gut and allows them to remove any abnormal growths, such as precancerous colonic polyps. Colorectal cancer, also referred to as colon cancer or rectal cancer, typically begins as a polyp on the inner lining of the colon or rectum. While not all polyps are cancerous, some can develop into cancer over a period of time.

Hattiesburg Clinic gastroenterologists urge those who are 45 years of age and older to begin routine colorectal screening, if they have not already.

Those who are at high risk for colorectal cancer have one or more of the following:

  • Personal history of colorectal cancer or certain types of polyps
  • Family history of colorectal cancer or advanced polyps
  • Personal history of inflammatory bowel disease
  • Confirmed or suspected hereditary colorectal cancer syndrome

In 90 percent of cases, colon cancer found before symptoms start is curable.

Before, During and After Your Colonoscopy

A colonoscopy is the best way to prevent colorectal cancer. Colon cancer screening – which is recommended for people who are 45 years of age and older – can catch colorectal cancer early or before it even happens. There are many people who should get a colonoscopy but do not due to concerns regarding preparation. This preparation requires you to abstain from food and certain beverages and use prescription laxatives before the colonoscopy. While it can be an inconvenient process, it is temporary and could potentially save your life.

Cleansing for a Colonoscopy

In order for your physician to get an accurate view of your colon, it has to be empty and clean. You will receive instructions on your bowel preparation from your physician. The preparation you receive is to be consumed in two parts. The night before the procedure you will drink the first part.

Guidelines and recommendations for prepping prior to the colonoscopy procedure vary depending on the bowel preparation you are prescribed. Your gastroenterologist will provide instructions based on the preparation you are given.

After Your Colonoscopy

Before leaving, you will receive a printed summary with instructions. These instructions include the recommendation to not drive or operate heavy machinery for 24 hours. You should also avoid consuming alcohol and making any important decisions, including signing paperwork, for 24 hours.

It is normal for you to feel bloated and have gas after the procedure. It may take several hours for these symptoms to be completely relieved.

Any pain, bleeding or fever of 101 degrees or higher should be reported to our office immediately by calling (601) 268-5680.

The Day of Your Colonoscopy

On the day of your colonoscopy, you should be finishing the second part of your preparation. Please follow the instructions you will receive from our office, which will include a specific time to finish your preparation and to stop drinking liquids. Take your medications before this cut-off time.

Remember, on the day of your procedure, smoking or use of smokeless tobacco products is not allowed. You may not chew gum or have a mint after this time. If you use an inhaler, you may continue using it as needed. Your licensed driver can wait in the lobby when the nurse calls you back to begin the pre-operative process.

A nurse will review some medical questions, check your vitals and start IV fluids. If you are a female of childbearing age, you will be required to provide a urine sample before the colonoscopy.

During the pre-operative process, you will speak with your gastroenterologist and an anesthesia provider. They will go over the colonoscopy procedure and answer any questions you have beforehand.

After this, a nurse will transport you to the procedure room where you will receive sedation. A nurse anesthetist will provide you with a custom sedation based on your needs.

The length of the procedure depends on the effectiveness of your preparation and the number of colonic polyps the physician removes – if any. We typically tell patients the colonoscopy procedure lasts 20 – 30 minutes on average.

Once your procedure is finished, a nurse will take you to post-op where you will recover for approximately 20 – 30 minutes. During this time, your gastroenterologist will review procedure findings and discuss next steps if needed.

If surgery is required to remove any precancerous or cancerous polyps during your procedure, your gastroenterologist will discuss this with you. Colonic polyps and other tissues removed during procedures are sent to our Pathology department for analysis. Once the pathology report is received and reviewed by your gastroenterologist, our office will communicate those results to you by either calling or sending a letter.

Colonoscopies: What to Expect Videos

Before Your Colonoscopy

During Your Colonoscopy

After Your Colonoscopy


Sources:
*American Cancer Society
**Mississippi State Department of Health

Myths About Colonoscopies

Many health care providers agree that the best option to screen for colorectal cancer or other GI-related issues is a colonoscopy.

Many people may not realize that a colonoscopy doesn’t just help diagnose cancer – it can help prevent it. During the procedure, the gastroenterologist is actually able to remove polyps before they turn into cancer.

The recommended age for people to start receiving their routine screening colonoscopy is 45 years of age. Unfortunately, many people put off their colonoscopy because they have misconceptions about it.

According to the providers with Hattiesburg Clinic Gastroenterology, there are eight common myths about colonoscopies and colorectal cancer they typically hear from patients.

1. I'm not at risk for colon cancer.

People say ‘nobody in my family has had colon cancer.’ But the majority of persons diagnosed each year have no family history of colon cancer. Five percent of adults in their lifetime will get colon cancer, and risk goes up after age 45.

2. I'm not having symptoms, so I don't need a colonoscopy.

If you find colon cancer after symptoms develop, a majority of the time it’s not curable. In 90 percent of cases, colon cancer found before symptoms start is curable.

3. Even if I had colon cancer, I don't want to know because I don't want a colostomy bag.

A colostomy bag is rarely needed with colon cancer, but the majority of people who end up with a colostomy bag are people who have not been screened. Of our patients who have colostomies, you wouldn’t be aware of it. And frequently, a colostomy can be reversed in a year. They are not always permanent.

4. There's no way I can drink the prep stuff.

We have several options for low volume preps now, not just the gallons anymore. Prep is much more effective when we split the prep up. You drink part of it the evening before and part of it the morning of the procedure. You can add flavor packets, but most are already pre-flavored, or there’s such a low volume you can drink it without a flavor additive. We also have a prep in pill form that only requires drinking water along with the pills if taste is a concern.

5. A colonoscopy is painful.

With the current sedation or anesthesia used, up to 99 percent of patients do not experience any discomfort. And the colonoscopy procedure is very brief. 20 – 30 minutes is normal.

6. It's too risky and dangerous.

Like with any procedure, there are risks. Some of these might include a perforated colon, bleeding from polyp removal or complications from anesthesia. The risks of a colonoscopy for most patients are minimal compared to the possible alternative.

7. Only older white men get colon cancer.

Actually, African American men and women have the highest rate of colon cancer. African Americans also have the lowest screening rates in the U.S. On average, they tend to get polyps five years earlier than other groups. In general, women are almost as likely to get colorectal cancer as men. And it’s happening even younger among earlier demographics. But, overall, we are seeing more decline due to screening.

8. I can't afford the cost of a colonoscopy.

The vast majority of insurance carriers now cover the cost of a colon cancer screening at 100 percent beginning at age 45 based on the United States Preventative Services Task Force. If you are not eligible for a screening benefit through your insurance company, or you are self-pay, our office offers payment plans to help with financial concerns.

Colonoscopy Testimonial: Matthew D. McClain, MD

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