What is Colonoscopy? Purpose, Procedure & Results

A colonoscopy is a medical procedure where your doctor uses a thin, flexible tube with a camera to examine the inside of your large intestine (colon) and rectum. This screening tool helps detect problems like polyps, inflammation, or cancer early when they're most treatable.

Think of it as a thorough inspection of your colon's health. The procedure typically takes 30 to 60 minutes, and you'll be given medication to help you relax and feel comfortable throughout the process.

What is colonoscopy?

Colonoscopy is a diagnostic and screening procedure that allows doctors to see the entire length of your colon and rectum. The doctor uses a colonoscope, which is a long, flexible tube about the width of your finger with a tiny camera and light at the end.

During the procedure, the colonoscope is gently inserted through your rectum and guided through your colon. The camera sends real-time images to a monitor, giving your doctor a clear view of your colon's lining. This helps them spot any abnormal areas, take tissue samples if needed, or remove polyps on the spot.

The procedure is considered the gold standard for colon cancer screening because it can both detect and prevent cancer by removing precancerous polyps before they develop into cancer.

Why is colonoscopy done?

Colonoscopy serves two main purposes: screening for colon cancer in healthy people and diagnosing problems in people with symptoms. Most adults should start regular screening at age 45, or earlier if they have risk factors like family history of colon cancer.

For screening, the goal is to catch problems early when they're easier to treat. Your doctor can remove polyps during the procedure, which prevents them from potentially becoming cancerous later. This makes colonoscopy both a diagnostic and preventive tool.

If you're experiencing symptoms, your doctor might recommend a colonoscopy to investigate what's causing your discomfort. Let's look at the specific reasons your doctor might suggest this procedure:

• Persistent changes in bowel habits lasting more than a few weeks
• Blood in your stool or rectal bleeding
• Unexplained abdominal pain or cramping
• Chronic diarrhea or constipation
• Unexplained weight loss
• Iron deficiency anemia without an obvious cause
• Family history of colon cancer or polyps
• Personal history of inflammatory bowel disease
• Follow-up after previous polyp removal

Your doctor will consider your individual risk factors and symptoms to determine if colonoscopy is right for you. The procedure can help diagnose conditions like colon cancer, polyps, inflammatory bowel disease, diverticulitis, or other colon disorders.

What is the procedure for colonoscopy?

The colonoscopy procedure happens in several phases, starting with preparation at home and ending with recovery at the medical facility. The actual examination usually takes 30 to 60 minutes, though you'll spend several hours at the facility for preparation and recovery.

Before the procedure begins, you'll receive sedation through an IV to help you relax and minimize discomfort. Most people don't remember the procedure due to the sedation, which makes the experience much more comfortable.

Here's what happens during the procedure:

1. You'll lie on your left side on an examination table
2. The doctor gently inserts the colonoscope through your rectum
3. The scope is slowly advanced through your colon while air is pumped in to expand the colon for better viewing
4. The doctor examines the colon lining as the scope moves through
5. If polyps are found, they're removed using special tools passed through the scope
6. Tissue samples may be taken for laboratory analysis
7. The scope is slowly withdrawn while continuing to examine the colon walls

During the procedure, you might feel some pressure or cramping as the scope moves through your colon. The sedation helps minimize these sensations, and most people find the procedure much less uncomfortable than they expected.

How to prepare for your colonoscopy?

Proper preparation is crucial for a successful colonoscopy because your colon needs to be completely clean for the doctor to see clearly. Your doctor will give you specific instructions, but preparation typically begins 1-3 days before your procedure.

The most important part of preparation is taking a bowel preparation solution that cleanses your colon. This medication causes diarrhea to empty your colon completely, which is necessary for an accurate examination.

Here are the key preparation steps you'll need to follow:

• Stop eating solid foods 24 hours before your procedure
• Drink only clear liquids like water, broth, and clear juices
• Take the prescribed bowel preparation medication as directed
• Stop taking certain medications if your doctor advises
• Arrange for someone to drive you home after the procedure
• Follow any specific dietary restrictions for several days before
• Stay near a bathroom after starting the bowel preparation

The bowel preparation can be challenging, but it's essential for your safety and the accuracy of the test. Most people find that staying hydrated and following the instructions exactly helps them get through the preparation more comfortably.

How to read your colonoscopy results?

Your doctor will discuss your colonoscopy results with you shortly after the procedure, though you might not remember the conversation due to sedation effects. You'll receive a written report that explains what was found during your examination.

Normal results mean your colon appears healthy with no signs of polyps, cancer, or other abnormalities. If this is a screening colonoscopy with normal results, you typically won't need another one for 10 years, depending on your risk factors.

If abnormalities were found, your results might show:

• Polyps that were removed during the procedure
• Inflammation or irritation of the colon lining
• Diverticulosis (small pouches in the colon wall)
• Areas of bleeding or ulceration
• Suspicious tissue that requires further testing
• Signs of inflammatory bowel disease

If polyps were removed or tissue samples were taken, you'll need to wait for laboratory results, which typically take 3-7 days. Your doctor will contact you with these results and discuss any necessary follow-up care or treatment.

What are the risk factors for needing colonoscopy?

Several factors increase your risk of developing colon problems and may make colonoscopy screening more important for you. Age is the most significant risk factor, with most colon cancers occurring in people over 50, though rates are increasing in younger adults.

Family history plays a major role in your risk level. If you have close relatives with colon cancer or polyps, you may need to start screening earlier and have more frequent examinations than the general population.

Common risk factors that might indicate earlier or more frequent screening include:

• Family history of colon cancer or polyps
• Personal history of inflammatory bowel disease
• Previous colon polyps or cancer
• Genetic syndromes like Lynch syndrome or familial adenomatous polyposis
• Diet high in red meat and low in fiber
• Smoking and excessive alcohol consumption
• Obesity and sedentary lifestyle
• Type 2 diabetes
• Radiation therapy to the abdomen or pelvis

Your doctor will assess your individual risk factors to determine when you should start screening and how often you need colonoscopy. People with higher risk factors often need to begin screening before age 45 and may need more frequent examinations.

What are the possible complications of colonoscopy?

Colonoscopy is generally very safe, with serious complications occurring in less than 1% of procedures. Most people experience only minor discomfort and recover quickly without any problems.

The most common side effects are mild and temporary, including bloating, gas, and cramping from the air used to expand your colon during the procedure. These symptoms typically resolve within a few hours as the air is absorbed or passed.

Rare but serious complications can include:

• Perforation (tear) of the colon wall (occurs in about 1 in 1,000 procedures)
• Bleeding, especially after polyp removal (occurs in about 1 in 1,000 procedures)
• Reactions to sedation medications
• Infection (extremely rare)
• Heart or lung complications related to sedation

Your doctor will monitor you carefully during and after the procedure to watch for any signs of complications. Most complications, if they occur, can be treated successfully, especially when caught early.

The risk of complications is generally much lower than the risk of not detecting colon cancer early. Your doctor will discuss your individual risk factors and help you understand the benefits and risks of the procedure.

When should I see a doctor for colonoscopy?

You should discuss colonoscopy with your doctor if you're 45 or older and haven't had screening, or if you're experiencing symptoms that could indicate colon problems. Early detection significantly improves treatment outcomes, so don't delay seeking medical attention.

For routine screening, most people should start at age 45, but you may need to begin earlier if you have risk factors like family history of colon cancer. Your doctor can help determine the right screening schedule for your situation.

You should contact your doctor promptly if you experience these symptoms:

• Blood in your stool or rectal bleeding
• Persistent changes in bowel habits lasting more than two weeks
• Unexplained abdominal pain or cramping
• Unintentional weight loss
• Persistent fatigue or weakness
• Feeling that your bowel doesn't empty completely
• Narrow stools or changes in stool consistency

After a colonoscopy, you should contact your doctor immediately if you experience severe abdominal pain, fever, heavy bleeding, or signs of infection. These could indicate complications that need prompt medical attention.