Healthy Living Newsletter
Colonoscopy – should you have one?
 When her doctor suggested that she have a colonoscopy to screen for colorectal cancer, Pam said she wanted time to think about it. A year later, as she makes an appointment for her yearly checkup, she’s uneasy about having to come up with a new excuse.
Pam has heard all the anecdotes; she’s uncomfortable even at the thought of having a camera exploring the inside of her bowels. On the other hand, she has a cousin who was treated successfully for colon cancer and credits colonoscopy as saving his life.
Colonoscopy uses a thin, flexible tube with a light and camera attached to examine the lining of the large intestine (rectum and colon). The procedure can be used to help diagnose abnormalities such as ulcers, polyps, tumors and areas of inflammation or bleeding.
Not all abnormalities in the colon are cancerous, but all cancers start as adenomatous polyps. If detected early enough, these polyps can be removed before they become malignant.
Generally recognized as the best way of detecting polyps, colonoscopy is one of three widely used and recommended screenings for colon and rectal cancer.
As opposed to fecal occult blood testing (FOBT), colonoscopy is more invasive but capable of detecting actual polyps as opposed to hidden bleeding in the bowels that might or might not be caused by a polyp.
Compared to sigmoidoscopy, which examines just the rectum and the lower third of the colon, colonoscopy gives a doctor a chance to observe the lining of the entire large intestine.
Persons with a moderate to high risk of colon or rectal cancer are advised to have more frequent screening. Most at risk are person who have already had a precancerous polyp removed or who have a close relative diagnosed with colorectal cancer.
Don’t Die of Embarrassment
Pam knows her decision should be an easy one. But even though a colonoscopy is not painful, it does involve significant discomfort that may last several days.
To prepare, it’s necessary to clean the bowels, and many consider this the most difficult part. Pam’s friend told her about not being able to eat solid foods for a day or two followed by use of laxatives and enemas, “not a very pleasant experience,” she noted. Fortunately, the preparation has been considerably simplified since that time.
Now doctors prescribe a variety of preparation methods based on patient needs, and enemas are no longer necessary.
The colonoscopy itself takes about a half an hour and is performed under sedation, usually given intravenously. Even though you’re conscious, you’re likely to be groggy and not remember much of the procedure.
As with bowel preparation, Pam could expect significantly less discomfort than her friend remembers. The trend is toward deeper sedation and, with improving technology, the test can be performed more efficiently with fewer complications.
One major advantage to colonoscopy is that when cancerous or precanerous polyps are detected, they can be removed or biopsied on the spot.
If the tests are normal, it can be performed less frequently. Polyps generally take about five years to develop, and another five years to become cancerous. So, normal results from colonoscopy offers the patient a pretty clean bill of health for the colon for about 10 years.
The American Cancer Society has identified March as Colorectal Cancer Awareness Month, which makes this an excellent time to obtain your referral or get an appointment for your colonoscopy. Talk to your doctor about a screening program that’s right for you.
Need help in finding a doctor near you? Go the “Find a Physician” section of this website.
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