Colonoscopy

A colonoscopy is a routine and commonly performed procedure that lets a doctor check the inside of your colon and rectum. During colonoscopies, a gastroenterologist inserts a flexible tube with a camera on the end, called a colonoscope, into your rectum so they can inspect your large intestines. The scope is about the width of your finger, and the procedure is typically painless. Most colonoscopies take about 20-30 minutes.

The most common reason to have a colonoscopy is to screen for colorectal cancer, which is the third leading cause of cancer deaths in the United States. This screening helps detect diseases like inflammatory bowel disease and can reduce your risk of colon cancer by 60-90%. Colonoscopies are a safe, effective way to detect and prevent colon cancer. Colonoscopies can also be useful for the evaluation of conditions, such as bleeding, chronic diarrhea and anemia (low blood counts).

Current guidelines advise you should have your first colonoscopy at age 45, then screen every 10 years. You may need a colonoscopy earlier or require more frequent screenings if you have:

• Advanced polyps before age 60
• A relative who has had colon cancer
• An inflammatory bowel disease such as Crohn’s disease, Lynch disease or ulcerative colitis

Polyps are abnormal growths that form on the colon lining. While many polyps are harmless, some are considered precancerous, meaning they could turn into cancer.

Almost all colorectal cancers start as small polyps. During a colonoscopy, doctors can detect and remove these polyps, which is why colonoscopy is an effective way to prevent colorectal cancer. The removal of polyps (polypectomy) is a painless procedure.

Most risks linked to a colonoscopy are minor and uncommon. The most serious complication is a perforation, or a tear of the wall of the colon. In some cases, this can require emergency surgery. Bleeding is another possible complication that can occur when a polyp is removed, but this typically stops on its own.

Your primary care doctor’s office will let you know if you’re due for a colonoscopy. Your doctor will then refer you to a gastroenterologist, who will contact you to schedule the procedure. You can also reach out to your doctor if you have questions or want to schedule an appointment.

Yes, you need to drink all the prep. The most effective way to cleanse your colon is to take the entire bowel preparation solution in two separate doses. This helps make sure your colon is clean and reduces the chances you’ll have to reschedule your procedure.

To improve the taste of your preparation medication, try these tips:

• Add a citrus-flavored powdered drink packet
• Chill the prep before drinking
• Lick a lemon or lime wedge after sips
• Use a straw

Yes. If you’re diabetic or take medications related to diabetes or weight loss, like Mounjaro (tirzepatide) or Ozempic (semaglutide), talk to your doctor about your colonoscopy prep and instructions.

The general rule: If you can see through it, you can have it. You need to stay well hydrated while drinking the prep, so please drink as much of the clear liquid diet detailed in your prep instructions. Just make sure what you’re drinking isn’t red, purple or blue.

Applying petroleum jelly or diaper rash ointment before starting the prep and after each bowel movement can lessen irritation from bowel movements. You can use nonalcoholic baby wipes or nonalcoholic wet wipes for cleansing.

Please take all medications as prescribed unless your doctor or gastroenterologist tells you otherwise. Talk to your doctor if you take medication for diabetes or weight loss.

Because you’ll be under light sedation during your procedure, you’ll need to arrange for someone over age 18 to bring you to your procedure, drive you home and be with you after.

Most colonoscopies last 20 to 30 minutes, followed by another 30 minutes in the recovery area. Several steps you can expect include: 

• Before the colonoscopy, you’ll meet with a nurse to review any questions and a gastroenterologist to review the procedure. 
• Your vital signs (blood pressure, heart rate and oxygen saturation) will be monitored closely before, during and after the procedure.
• You’ll receive a sedative and pain medication through an intravenous line placed by a nurse.
• Typically, you’ll lie on your left side during the procedure, although in some cases you may be repositioned. 
• During the colonoscopy, your doctor will carefully inspect your colon and may remove polyps (polypectomy) or take biopsies (the painless removal of a small tissue sample).

You’ll be closely monitored in the recovery area as the sedatives wear off. Because sedatives may impair your judgment and coordination, you must have someone drive you home and stay with you for a short time after the procedure.

After your procedure, a nurse will call to see how you’re doing and if you have any questions. You’ll receive your test results by phone or can view them in your My Health Online account. 

Generally, there are no restrictions on what you can eat after a colonoscopy. Your doctor will give you specific instructions on whether you should take or avoid certain medications, depending on the findings of your colonoscopy. If your doctor took biopsies or removed polyps, you’ll be contacted later with those results. If you screen positive for colon cancer, your doctor will discuss the next steps to treat and remove the cancer.

Even light sedation can temporarily impair your judgment and coordination. To stay safe, please take it easy for the rest of the day. Some bloating, gas or mild cramping is normal and should go away gradually.

You should be back to normal the day after your procedure.

There’s a small risk of bleeding for up to two weeks after a polyp is removed. Talk to your doctor before your colonoscopy if you plan to fly within a couple of weeks post-procedure. We discourage booking any international travel by plane within two weeks after your colonoscopy. If a large polyp is removed, your doctor may recommend canceling the flight.