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Time for a colonoscopy? Here’s what to expect (and why it’s not that bad)

Colonoscopies sometimes have an undeserved reputation, especially among those who haven’t had one before. I hear my patients say they’ve heard something bad from their neighbor, their family or an online search. But often, these negative misconceptions go away once they have their first screening.

As a physician, I believe in the scientific data behind colonoscopy. And as someone who has had a colonoscopy, I believe in it from personal experience. This important screening allows your medical team to not only diagnose colon cancer—the third most common type of cancer for both men and women—but also potentially prevent it.

Most people with an average risk of colon cancer should have their first colonoscopy at age 45. However, it may be earlier if you have other risk factors or symptoms like bleeding, mucus discharge, changes in bowel habits or weight loss.

No matter your situation, if your doctor recommends a colonoscopy, here’s what you can really expect. Don’t worry, it’s not as bad as you think.

What to expect before your colonoscopy

Colonoscopy prep isn’t a one-size-fits-all approach anymore. There are many options in terms of preparing and cleaning out your colon before your procedure. Your doctors will recommend what they consider the most appropriate for you.

The details of your prep before a colonoscopy depend on the type prescribed. In general, you will stay on a liquid diet the day before your procedure. You’ll also drink a cleansing solution and/or use pills to clear out your colon. The goal of the prep is to allow your doctor to adequately see and detect any problems during your colonoscopy. The better the prep, the better the exam.

For most people, the prep is only an inconvenience. It’s not painful. It’s something you can do from the comfort of your home. And it’s only one day. You deserve to take that day for yourself.

What to expect during your colonoscopy

When you arrive at the center the next day, your care team is there to make you feel relaxed and calm. You’ll get an IV, check your medical information and talk to your providers. To make you comfortable, you’ll put on some soft socks and a gown and get a nice, warm blanket. If indicated, your team can give you medication to ease anxiety, too.

Once in the procedure room, a nurse anesthetist gives you medication to help you slowly drift to sleep. Then, the actual colonoscopy can be as quick as 10 minutes. Your doctor will use a thin tube with a camera to view your colon, starting at the top and slowly working backward.

During the procedure, your provider can take a biopsy and help diagnose other colon conditions such as inflammatory bowel disease, diverticulosis or venous malformations. Even more, the beauty of a colonoscopy is that small polyps—which could lead to colon cancer if left untreated—can be removed right then and there. We can diagnose and treat with one procedure.

Colonoscopy does come with a small risk of perforation of the colon or bleeding. But the risk is very low for the average person. In general, it’s a routine procedure where the benefits outweigh the risks.

What to expect after your colonoscopy

Once you’re awake and alert after your procedure, you will get an initial report from your doctor almost immediately. The care team will keep you for a short time to make sure you’re ready to leave. Then, they will release you with your ride to go home and rest.

Typically, you can eat right after your procedure and go back to work the next day. If a biopsy was taken, you will get a pathology report in a couple of days. Then, in most cases, you’re set for the next five to 10 years, depending on your doctor’s recommendation.

Above all, remember that your doctor is there to help you understand the science behind a colonoscopy, but personal health is a two-way street. You have to do your part too. Listen to your trusted medical provider, make getting a colonoscopy a priority and take care of yourself.

The first colonoscopy is often the most challenging for people because of the unknown. But after the first one, you realize it really isn’t that bad.

 Ready to schedule your colonoscopy? Find a gastroenterologist near you today.

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About the author

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Alessandro Fichera, MD, is a colon and rectal surgeon. He is the surgery safety and quality officer and the division chief of colon and rectal surgery at Baylor University Medical Center. Connect with Dr. Fichera today.

Time for a colonoscopy? Here’s what to expect (and why it’s not that bad)