You might be considering having a colonoscopy. A colonoscopy is a diagnostic procedure used to see the inside of your rectum and colon. Doctors recommend a regular colonoscopy to screen individuals for colorectal cancer.
Recent 2008 guidelines state that men and women over fifty years old should have a colonoscopy every ten years. If a colonoscopy is impossible, they should have one of the following:
- Flexible sigmoidoscopy (examines just the rectum and lower colon) every five years
- Double-contrast barium enema (involves infusing an enema containing contrast medium, followed by X-rays) every five years
- CT colonoscopy (low-dose computerized tomography of the large intestine) every five years
A colonoscopy is an invasive procedure, like surgery. It is performed only by doctors and can be done only in a clinic or hospital. Note that the procedure does not cause any pain, unless a biopsy or surgery is performed through the colonoscopy.
Obviously, the procedure might make you uncomfortable, because a long, slender, thin device is inserted into the anus and moved about while it is inside; it is understandable that a colonoscopy is a big deal to many individuals.
In addition, a good deal of preparation is needed for a colonoscopy. You have to prepare and arrange your work and family, therefore, we will help by discussing everything important about the colonoscopy and how you can successfully prepare for it.
What Is Colorectal Cancer?
Colorectal cancer is any cancer that arises in the colon and rectum, and it is one of the most common types of cancer. According to worldwide statistics, colorectal cancer is the third most common type of cancer, more common than leukemia or cancers in the liver and bladder. Only lung and prostate cancers are more common. In the United States, colorectal cancer is considered a deadly form, along with lung, breast, and prostate cancers.
According to recent studies, colorectal cancer is common because it is caused by a combination of genetics and lifestyle, including high-fat, low-fiber diets, a sedentary lifestyle, diabetes, inflammatory intestinal diseases, obesity, and the use of alcohol and tobacco. These factors are very common in people in the United States and other developed countries.
Most cases of colorectal cancer do not cause symptoms and do not do so until very late. Sometimes, its only symptom is a change in bowel habits or constipation, which is easily dismissed by most patients. Lack of symptoms is a factor as to why many patients fail to recognize its presence and die from it. Since it is common, doctors recommend routine colonoscopies to check the health of the large intestine and detect early signs of colorectal cancer.
Early stage colorectal cancer starts as a growth, or polyp, inside the large intestine. Not all growths in the large intestine are automatically cancerous. The growth can take ten to fifteen years to become cancerous. If these growths are detected early using a colonoscopy, they can be removed and save you from cancer.
Colorectal cancer tends to affect and cause death in patients older than sixty-five. That is why doctors recommend having routine colonoscopies or other imaging procedures in the large intestine when you reach fifty.
How Colonoscopies Work
A colonoscopy makes use of a device called a colonoscope. One end of the colonoscope has a light source and a camera. The other end is hooked to a TV screen where the doctor watches and sees the inside of your large intestine.
In the colonoscopy procedure, a doctor will insert the colonoscope into your anus. Depending on your wishes and the recommendations of your doctor, you may be given a sedative that will keep you at ease, but still conscious during the procedure, or deep anesthesia that will knock you unconscious.
The anus is the entry inside a part of the large intestine called the rectum. The rectum, unlike the rest of the large intestine, is mostly smooth. After the rectum lies the sigmoid colon, the looped part of the large intestine. Its looped shape has an important purpose; the loop becomes sort of a “kinked” hose when standing, so poop in your large intestine does not go down your rectum and make you squirm. A colonoscopy goes through the entire length of the large intestine, which measures around 166 centimeters (1.22 meters, or 4 feet).
The colonoscope does not treat diseases. Doctors use it to screen and check for diseases that affect the colon, notably colon and rectal cancer (often called collectively colorectal cancer). However, a colonoscope can be used for treatment, specifically by removing growths found in the large intestine. A surgeon can add instruments to the inserted end to perform a biopsy or other surgical procedure in the colon. The growth can be examined in the laboratory for the presence of cancer cells. Surgery through colonoscopy is preferable to open surgery, because there is no need to make large incisions in the skin.
If cancer is present, it can be immediately categorized and treated. Colorectal cancer detected and treated at early stages has very high cure rate–the five-year survival rate for it is 90%. The cancer is harder to treat once it spreads from the colon and rectum, so early treatment is important.
What Is a Virtual Colonoscopy?
Some individuals choose to have a procedure called a virtual colonoscopy. It is a CT scan procedure focused on the large intestines. A CT scan is an X-ray procedure that requires the use of a large machine packing an X-ray source and connected to the computer. The computer guides the X-ray device and takes several images from different angles, which create sharp cross-sectional images of organs and tissues inside the body. The virtual colonoscopy creates images of your large intestine, as if they were sliced very thinly and then photographed. The procedure also creates three-dimensional images of your large intestine.
Virtual colonoscopy uses low-dose X-rays is non-invasive, unlike an actual colonoscopy. Based on guidelines, you must have it every five years if you are fifty years old or older. Although it does expose your body to radiation levels equivalent that of several X-rays, it is largely safe and does not put you at risk.
Do Colonoscopies Require Prep?
You need to prepare your bowels for the procedure. Good bowel prep for colonoscopy ensures that your large intestine is largely free of poop when the colonoscope is inserted.
Poop obscures the camera (note that the camera lens has no wipers), and a dirty lens may cause the doctor to miss polyps and lesions. The presence of feces also prolongs the procedure, which increases the chance of complications. It may also block the large intestine, and the colonoscope cannot just “push” through.
Days before the colonoscopy, your doctor will give you a set of instructions to achieve clean and clear bowels for the procedure. The instructions will be given as a prescription, so you really have to follow it to the letter.
How to Do a Colonoscopy Prep Diet
A colonoscopy prep diet is designed to clear the intestines. This diet is only meant to clear the intestines and should not replace everyday diet. The first thing you must do is read the doctor’s instructions and understand them fully. Many patients still fail to do this and end up with problems on the day of the procedure. If you have questions, ask your doctor.
Next, stock up on supplies. The colonoscopy prep diet basically means you will be subjected to explosive and high-volume diarrhea, sometimes for a few days. This means you might have no opportunity to shop around for supplies once the countdown starts, so be ready. Make sure you have the following stocked up:
- Lots of high-quality moist wipes (with moisturizers) to wipe your butt a lot
- Low-fiber foods, such as white bread, white-polished rice, refined cereals, pancakes, or other baked goods made from refined flour; red meats; fish; poultry; eggs; tofu; dairy; oils; fruit and vegetable juice (no pulp); and canned and cooked fruits and vegetables
- Lots of sports drinks, juices, and broths so you can stick to a liquid diet and avoid dehydration
- Lots of clean drinking water
- Diaper cream, in case your skin breaks from repeated diarrhea
Over the next few days before the procedure, you will eat low-fiber foods only. A lack of fiber means there are fewer residues left in your large intestines after digesting food. Any residue left in the large intestine will be flushed out. To be successful, make sure to avoid items such as whole wheat bread, brown rice, quinoa, oats, dried fruits, prune juice, berries, corn, beans, coconut, popcorn, nuts, and seeds.
Make sure you have easy access to the toilet (and make sure the plumbing is okay, too), because you will poop a lot. Diarrhea inevitably happens because there is no fiber in the intestines. Drink plenty of fluids to replace fluid loss and prevent constipation. If plain water becomes tiring, switch to juices.
A day or two before the colonoscopy, your doctor will order you to stop eating any solid food and stick to liquids. That means there should be nothing solid making its way into your mouth. You will only consume water, tea, and clear juices (no cloudy or thick soups), plus Jell-O and flavored ice pops. A liquid diet helps clean your bowels further and ensures there is nothing in there during the procedure. The liquid fast should only last for a maximum of two days.
Make sure not to consume anything red or purple, which can be mistaken in the colonoscopy as a sign of bleeding. Remind yourself about the foods to avoid.
The night before the procedure, your doctor may prescribe a laxative to clean your bowels further. This laxative, which could be Nulytely or Golytely, is packaged in a powder or liquid form mixed with a set amount of water, usually around a gallon. These laxatives are powerful and will trigger explosive diarrhea, so be ready and do not stray far from the toilet.
You need to drink half of the laxative solution the night before the colonoscopy, and the other half the day of. You probably will not like the taste of the solution. Here are a few tips to help you at least tolerate the taste:
- Sip the solution using a straw, so it will go past your taste buds.
- Drink it chilled, which is more tolerable.
- Follow it with a tasty liquid, like juice.
- Drink and then suck on a lemon slice or hard candy to make it more tolerable.
In most cases, you will literally stay inside the bathroom due to the diarrhea. Make sure to help your family members prepare. Wear loose clothing and have diaper cream ready in case your skin breaks. Since you will stay inside the bathroom for hours, consider entertaining yourself by bringing your TV, laptop, books, or phone inside.
On the day of the procedure, note that you have to stop drinking liquids six to eight hours before the colonoscopy. Be ready for any “accidents” by bringing wipes, adult diapers, and extra clothes with you. Your healthcare provider will give you a sedative and pain reliever through the vein just before the procedure.
You will be naked during the procedure, except for a hospital gown. You will lie on your left side, where the doctor will insert the colonoscope. Because of the sedative, it is unlikely you will remember anything of the procedure.
A colonoscopy is an essential procedure that will save your health in the long term. Think of it as a “cleansing” therapy, as your bowels will be flushed out completely during the procedure.