Six frequently asked questions about colonoscopies

Updated guidelines from the American Cancer Society now recommend colon cancer screening at age 45

If you only had to do something every five or 10 years, and it could help prevent one of the most commonly diagnosed cancers, wouldn’t you do it?

Then it may be time for you to schedule a colonoscopy.

A colonoscopy is where a specialized doctor called a gastroenterologist uses a flexible tube with a camera and light – called a scope – to look inside your large intestine (the rectum and colon), explains Dr. William Mansour, gastroenterologist with Gastroenterology Consultants of Savannah. The scope moves from the rectum to the very end of the colon and then is removed to look for polyps in the lining of the colon.

Polyps are small growths that are not typically cancerous but over time can become malignant and lead to colorectal cancer.

Related Article: What exactly is a polyp?

Colon cancer is the third most common cancer in the United States, Dr. Mansour says. About 52,000 Americans die annually from colon cancer. The lifetime chance of developing colon cancer is about four percent for average-risk Americans. Those with a family history of colon cancer are at a higher risk.

“Colonoscopies are important because colon cancer can be prevented with screening,” Dr. Mansour says. “Because of the increasing awareness of colon cancer screening, over the past 20 years, the US has seen a decline in colon cancer diagnosis by two percent every year.”

Related Article: Five ways you can reduce your risk of colorectal cancer

To help better understand the screening process and its importance, Dr. Mansour answers some frequently asked questions of patients:

1. When should I begin screening?

   The American Cancer Society’s newest guidelines recommend that colon cancer screenings begin at age 45. The recommended age was lowered from 50 to 45 because colorectal cancer cases are on the rise among younger people, Dr. Mansour says.

2. If I don’t have a family history of colon cancer, is it really necessary to get a colonoscopy?
   

   Yes. When polyps are found early, they can be removed before they turn cancerous. A lot of people put off or don’t get colonoscopies because of the thought of the scope entering their rectum or they are worried it will be painful, Dr. Mansour says. The procedure itself is completely painless, and most patients wake up from the screening feeling like nothing ever happened.

   “I recommend for all my patients over 45 or who have not had a colonoscopy in the past 10 years to undergo a colonoscopy. Colonoscopies are low-risk procedures and safe. After the procedure most people go about their normal routine.”

3. What do you say to ease concerns about the bowel preparation?
   

   Another reason people don’t want to have a colonoscopy: the bowel prep. In fact, Dr. Mansour honestly tells patients that the bowel prep is the worst part about a colonoscopy. However, over the years bowel preps have become smaller in size from the original gallon jug of liquid, Dr. Mansour says. If insurance approves it, Dr. Mansour recommends a smaller prep, which is two 16-ounce bottles of laxatives. Remember this only has to be done every five or 10 years and it can prevent cancer.

4. Does a colonoscopy hurt?

   An average colonoscopy takes 20 minutes, and you won’t feel a thing. A certified nurse anesthetist or anesthesiologist will administer anesthesia throughout the procedure to ensure patients are comfortable and asleep, Dr. Mansour says. Your vitals and breathing are monitored throughout the entire procedure and recovery period.  Following the procedure you may feel a little bloating and gassy but that subsides.

5. What if you find a polyp during the screening?

   When a polyp is identified in the colon, your doctor will use a tool that goes through the scope like a lasso, Dr. Mansour explains. The polyp is removed and sucked into the scope and sent to the pathologist to ensure that it is benign (not cancerous). The lining of the colon has no pain fibers so this process is not painful to the patient, Dr. Mansour says.

6. How frequently should I get a colonoscopy?
   

   If there are no polyps found during your colonoscopy, it should be repeated every 10 years. If polyps are discovered, depending on the size and how many, a repeat colonoscopy may be recommended every one, three or five years, Dr. Mansour says. Colonoscopies should be repeated until you have reached 75 or 80 years old. After that, it is recommended that you discuss with your primary care doctor or GI doctor the risk versus benefit of continued screening, Dr. Mansour says.