I used to receive many queries from patients about colonoscopy… its procedure, food changes and much more. Today I decided to answer all of the questions those can arise in your mind while preparing for it. Here is the whole set of Lesser Known Colonoscopy Facts.

 

Colonoscopy Facts You Must Know.

 

1.    What Is It?

It is a medical procedure to check inner linings of the large intestine. The doctor uses a thin, smooth and flexible tube (called Colonoscope) to examine the walls of rectum and colon.

2.    How Is It Done?

As mentioned above, the doctor uses colonoscope for the procedure. It is a long tube of about 0.5” in diameter with a camera fitted on the top. The doctor inserts the colonoscope into the colon through the rectum and checks for the abnormalities.
Read more about it:  Colonoscopy Process from a patient’s view.

3.    Why Should You Get It?

It can detect many diseases as below.
A.    Colorectal Cancer or Colon Cancer.
B.     Detection and Removal of polyps.
C.    IBS (Irritable bowel syndrome).
D.    Internal Bleeding or inflammation.
E.    Tumor.

Therefore, if you are suffering from any of the symptoms of any of the above diseases, doctors suggest having a colonoscopy test.

4.    How Long Does It Take?

It takes around 60-90 minutes for the whole process. Anyway, if the patient already has a painful condition, it may take a little bit longer.

5.    Where Can I Get It?

Commonly, doctors perform it in the outpatient department, in the minor OT room. There is no indoor admission required if it is not critical.

6.    What Doctor Specialty To Contact?

A gastroenterologist does it. Even a surgeon with gastro experience can do it.

7.    What To Expect From It?

Doctors suggest it to the patients with long-term gastrointestinal problems like IBS, abdominal pain, black stool, blood in stool, etc. This medical test can help to diagnose actual problem behind those problems, and after a successful process, doctors can plan proper treatment procedure.

8.    What Can A Colonoscopy Find?

It helps to determine if there are any abnormalities inside colon and rectum. It is a reliable process to detect inflammation, bleeding, colon polyps, ulcers, tumor, and cancer.

9.    Types Of Anesthesia Used.

In typical scenarios, the process requires no anesthesia. Though, in some cases, doctors use local anesthesia to control the pain.
A.    You do not require being entirely unconscious to perform the test.
B.    It requires an anesthesiologist to perform and monitor.
C.    It increases total cost, as you need to pay the charge for the anesthesiologist.

The widely accepted sedation technique used is “Conscious Sedation.” It is a combination of sedative drugs, which will the block pain, mainly at the lower part of the body. However, it will keep you partially conscious during the procedure.

Special care is taken for the patients with other health issues like illness, high blood pressure, heart problem, obesity, diabetes, etc.

10.    What Is Twilight Sedation?

In the above questions, I explained this sedation process as “Conscious Sedation.” In this process, the doctor applies with a combination of mild sedatives. These fulfill the primary requirements as below.
A.    Blocks Pain.
B.    It relieves anxiety.
C.    Patients stay in a hypnotic state.
D.    Creates temporary amnesia where the patients cannot create memories.
E.    Partial sedation.

11.    Can You It Without Sedation?

Some patients prefer not to use any sedation during the process. According to them, the discomfort and anxiety increase the pain sensation. However, doctors advice twilight sedation for the first timers.

12.    What Happens During A Colonoscopy Procedure?

Please read Question:2.

13.    What Age Should You Have A Colonoscopy?

It depends on the physical issue reported. There was an Incident where a 14-year-old girl has to go for it for IBS (Irritable Bowel Syndrome). Usually, a suspected colon cancer patient should start Screening Process before the age of 50 as at this age both men & women fall under the high-risk category.

14.    What Is A Colonoscopy Screening?

Screening is mainly done for the patients where a colon cancer is suspected. In this process, a doctor collects tissue samples from the inner wall of colon and rectum (called Biopsy). Diagnosis labs perform tests to check if there is any presence of cancer cells.

15.    How To Schedule The Process?

There are three steps.
A.    Talk to your insurance company if you want to cover the process under health insurance. Ask them if the process will be Cashless (company pays to the doctor directly) or Reimbursement (you pay for the process, and the company repays you the amount on producing relevant documents). Also, inquire if they will pay full amount or part.
B.    The second step is to choose your doctor. As I said above, you can opt for a gastroenterologist or a surgeon with gastro experience. Decide hospitals with Minor OT facility.
C.    Call the hospital and make an appointment to discuss further procedures.

16.    How Often Should You Undergo It?

Normally, at the age of 50, you should have your first test. However, a patient needs to check earlier if there is a family history of colorectal cancer. Then after, it can repeat in every ten years.

17.   Is it Safe?

Overall, it is a safe procedure. If done properly, complications are almost negligible.

18.    What Are The Risks?

As mentioned above, the procedure is very safe and risk-free. Some rare complications are as below.
A.    Side effects of Sedative medicines used.
B.    Side effects of painkillers used.
C.    Internal bleeding can occur when the doctor collects tissue samples.
D.    There may be perforation (puncture of the rectum or large intestine wall).
E.    As air is pushed inside colon to keep it open, it may stay inside even after the process.

19.    How Much Does It Cost?

On an average, the whole process can cost around $2500-$3000. It includes…
A.    Operation cost.
B.    Doctor’s fees.
C.    OT charge.
D.    OT assistants’ charge.
E.    Medicines.
F.    Anesthesiologist charge (optional).

20.    What Is A Virtual Colonoscopy (VC)?

It is a type of high-end X-Ray test of the colon for any abnormalities. Usually, a Radiologist performs the process. Some refer it as “CT Colonoscopy” as it uses CT Scan (Computed Tomography) method.

The only difference from the regular procedure is there is no requirement of sedatives as the procedure is done from outside of the body.
Though it is easy to perform and cheaper, it is not efficient as the colonoscopy.

21.    How Much Does A Virtual Colonoscopy Cost?

It costs around $500-$600. Here you should know that the insurance companies do not cover Virtual Colonoscopy, so you may need to bear the cost.

22.    What is “Versed”?

Versed” is a group of sedative drugs, mainly used in the process. These are also called CNS Depressants (Central Nervous System Depressants). Drugs coming under Benzodiazepine class (e.g.- Diazepam, Lorazepam, etc.) are used for this.

23.    Why Does It Only Target The Large Intestine?

The name “Colonoscopy “refers to the colon (large intestine).

Pushing a colonoscope tube through the junction of the large and small intestine (Cecum) is tough. Even, it may cause internal ruptures if pushed too hard. Even if it crosses Cecum, it cannot reach far. Besides, the small intestine is narrow and getting a clear view is not possible.

24.    Are There Any Alternatives?

Yes, there are several options developed in recent years.

  • The first one is Virtual Colonoscopy (discussed in Q20)
  • Fecal Immunochemical Test (FIT):  It is a high-end stool test approved by FDA (Food and Drug Administration). It is many used for regular screening of colon cancer and done once every year. It is economical and costs around $20-$50 per test.
  • Stool DNA Test: It is also a stool test to check for the presence of blood or pre-cancer DNA in stool. Upon positive finding, You should go for a colonoscopy to re-confirm.
  • Fecal Occult Blood Test (FOBT): Highly sensitive version of FIT. It offers a more clear picture of the bowel. The patient should perform FOBT every year.
  • Cologuard: It is the most advance feces test available. The process is highly efficient, and the detection rate is around 73%. It provides detailed reports, which can be easily analyzed by the medical professionals.
    Cologuard costs around $600 and is covered by health insurance.
  • Barium Enema Test: It is another X-Ray procedure like Virtual Colonoscopy, but in this method, a Barium solution is pushed through anus for better X-Ray imaging. Barium is a concentrated dye that shows bright white in X-ray. (See Q26 for more details).
  • Sigmoidoscopy: The procedure of Sigmoidoscopy is almost same… the only difference is, it only checks the lower part of colon and rectum. (See Q25 for more details).

 

25.    Can Sigmoidoscopy Be Alternative To Colonoscopy?

As mentioned above that the process is very much similar to Colonoscopy and can be one of the better alternatives. The benefits of Sigmoidoscopy are as below.
A.    It takes lesser time of about 10-15 minutes.
B.    It is best for regular screening. You need to repeat it in every five years.
C.    Most of the patients do not require any sedative.
D.    Cost effective.

26.    Is A Barium Enema As Good For Detecting Cancer?

As it is high clarity X-ray image, it is easy for the doctors to detect any abnormalities in the colon. However, the presence of cancer is confirmed through Colonoscopy and then Biopsy. This process is suitable for regular screening.

27.    How Long To Fast before The Procedure?

A clean colon is required for the successful test. So it is suggested not to take any heavy food 3-4 hours before the process starts. However, you take clear liquids.

28.    Can I Eat Before It?

No, you cannot eat before. Even, you need to change your food habit during the prep. Read details about Diet Before Colonoscopy Surgery.

29.    What Can You Eat The Day Before?

You must avoid all types of solid foods the day before. Take liquids as much as possible, limited to clear liquids such as water, carbonated cold drinks, apple or grape juice without pulp, etc. You can take tea or coffee if you wish but that should be without milk or cream.

30.    What To Eat 2 Days Before?

Cut down fiber from your food. Foods with high fiber like nuts, raw fruits, dried fruits, seeds, whole grain, and green vegetables must be avoided. Drink clear fluids as much as possible.

31.    What Happens If You Eat Before A Colonoscopy?

Your colon must be clean before the process. That is why the doctor prescribes you a complete diet and medication chart for the prep. If you eat before the procedure, the doctor may cancel your schedule. You may need to start over again to prepare your bowl.

32.    Can You Eat After It?

Yes, you can eat after the process without any problem, but you should not take any spicy and thick food. However, you will lack appetite after the procedure due to the hangover from sedatives. Want to know What to Eat After Colonoscopy? Click the link.

33.    Which Liquid Foods To Eat Before the Procedure?

As I mentioned already, you can drink clear drinks like water, cold beverages, clear broth, tea & coffee without milk or cream, Gatorade, Popsicle, etc. In any situation, you must avoid any colored food item. Learn more about Colonoscopy Prep Diet here.

34.    Can I continue Smoking during Prep?

Yes, you can smoke during prep.

35.    Can You Chew Gum Before It?

Yes, you can.

36.    Can I Eat Jell-O Before It?

Yes, you can eat without any complication.

37.    Can I Drink Soy-milk During Prep?

No, you cannot have soy milk as it contains fiber (about 0.6g/100g). Please ask your doctor if you can have.

38.    Can You Drink Alcohol AFTER A Colonoscopy?

Yes, you can, but please wait until full recovery (it takes around 12-24 hours). There are 3 main reasons why you should avoid alcohol just after the process.
I.    Alcohol has sedation effect. So it can prolong your recovery.
II.    It can interact with sedative drugs you took during your prep.
III.    It dehydrates our body, which can worsen the situation.

39.    Can You Drink Alcohol BEFORE It?

As I just mentioned that alcohol dehydrates our body. Therefore, we must avoid it during prep.

40.    Can You Drink White Wine Before It?

You should not, but some doctors allow a glass of wine. Consult your surgeon before taking.

41.    When Can I Take First Meal After The Procedure?

You can have meal immediately after the process ends but as there is still some internal movement inside your GI tract, you should wait for 30-60 minutes.

42.    Can I eat Popcorn during Prep?

No, you should not. The popcorn hulls are indigestible and can stay in your colon for days. It can cause a problem while inserting the colonoscope. Even it can appear as a growth inside the colon.

43.    Can You Get A Colonoscopy While Pregnant?

No, you should not undergo the procedure during pregnancy. It is suggested to wait till you have your delivery. If there is any immediate health concern, doctors recommend Sigmoidoscopy.

44.    Can You Have It When You Have Your Period?

Yes, you can… of course, if you do not mind or feel uncomfortable.

45.    Can Colonoscopy Detect Parasites?

Yes, it can if the size of the parasites is large. However, smaller sized parasites may not be visible.

46.    Can It Detect Ovarian Cancer?

No, it cannot. However, it can detect if ovarian cancer has invaded to the colon.

47.    Can I Have It If I Have A Cold?

There is no issue if you do not have a fever or a severe cough. Coughing during the process can affect the process.

48.    Can It Cause Diverticulitis?

It is rare, but in some cases, patients develop Diverticulitis after the procedure.

49.    Can Hemorrhoids Be Removed During the Proceedings?

It can diagnose hemorrhoids, but it is not possible to remove.

50.    Can Colonoscopy Detect Colon Cancer?

Yes, it is one of the primary reasons why it is performed.

51.    Would A Tumor Be Removed During Colonoscopy?

It cannot remove the tumor, but it can detect and confirm the presence of a tumor. After that, it is removed through surgery.

52.    Can It Diagnose Celiac Disease?

No, it cannot. Celiac Disease is an autoimmune disease where the patient cannot tolerate gluten protein.

53.    Can I Take Aspirin Before The Procedure?

It is advised not to take any blood thinner (like Aspirin) during the prep period. Doctors recommend avoiding those at least for seven days before the test day.

54.    Why there is Gas After It?

Air is pushed during the process to keep the colon inflated so that better image can be found. The gas remains inside and creates discomfort for the patients. The situation normalizes within 12-24 hours.

55.    Can You Die From A Colonoscopy?

There are rumors on this. But believe me, there is no way you can die from it.

 

References:
www.cancer.org/
https://en.wikipedia.org/
https://www.nlm.nih.gov/
http://cancerutah.org/

Images:pixabay.com

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