Here's Looking at You: Colonoscopy

May 10, 2010, By Greg Paeth 2 comments

Given the choice between spending an evening at the ballpark with your buddies or undergoing a colonoscopy, the ballpark and the buddies win 10-0. But then again, there’s little chance that the evening at the ballpark could save your life, unless you happened to be at the game when an asteroid wiped out your house.

Like plenty of other things that many people know little about, colonoscopies have gotten an undeserved reputation as a procedure that’s just slightly worse than spending 90 minutes in a nest of black mambas. Keep in mind that the Center for Disease Control and Prevention reports that colorectal cancer is the second leading cancer killer in the United States and that nearly 140,000 Americans were diagnosed with the disease in 2006, the last year for which comprehensive statistics are available. More than 53,000 people died of the disease that year, the CDC warns.

Most doctors recommend that anyone 50 or older should have a colonoscopy. However, a patient’s health history and/or a family health history of colorectal cancer could dictate testing long before the 50th birthday.

Because most people are sedated during their colonoscopy, which lasts 30-60 minutes, few people recall anything about the procedure. Once the anesthetic begins to kick in and the patient is asked to count backwards from 10, most people are out by 7 and awaken a couple hours later in the recovery room.

The test itself involves inserting a colonoscope, a flexible tube that houses a video camera, through the rectum and into the colon, which is also identified as the large intestine. During the procedure, the doctor operating the colonoscope examines the interior walls of the colon and the rectum and may remove some tissue for further testing – a biopsy. The doctor also may remove polyps, growths on the intestine wall that could become cancerous in the future.

For most people, the most demanding part of the colonoscopy is the preparation for the test. Some sources recommend altering your diet two or three days before the test, avoiding foods such as popcorn, nuts and whole-grain products. Switch to a clear liquid diet the day before the test, limiting your intake to items such as clear broths, apple or white grape juices, coffee or tea without milk or cream or soft drinks. A doctor’s orders – which should be followed with precision – can vary from patient to patient. But the day before the test typically involves cleaning out the colon so that the intestine walls are clearly visible during the test. Cleaning the colon usually requires using some “bowel preparation” solutions that work like potent laxatives. Your doctor will probably recommend one solution over another and most of them (Fleet 1 Preparation, Lo-So Preparation and Golytely are commonly prescribed) are available over-the-counter at most pharmacies for a nominal cost.

Don’t take any of these products until you’re home for the day and within a few steps of the bathroom. They affect everyone differently, but typically speaking you’re going to be hustling to a bathroom frequently as you gradually clean out your system to a point where your colon is as clean as the inside of a new copper pipe.

After the test, you will not be able to drive because of the lingering effects of the anesthetic and you will need someone to help you get home. Some facilities won’t even do the test unless it’s clear that there’s someone available to assist you afterwards.

Remember, proper preparation is critical, so don’t try to take any pre-test shortcuts. If fecal matter in the colon obstructs the physician’s view, the whole process may have to be repeated.