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Colorectal Cancer Screening: Colonoscopy – The Prep is the Hard Part

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Colorectal Cancer Screening: Colonoscopy – The Prep is the Hard Part

Getting a colonoscopy is not usually at the top of people’s to-do list as they age, but if you ask someone how theirs went, they may say it’s not as bad as you think. In fact, you’ll probably hear they don’t remember a thing about the procedure. And, since colon cancer is the third leading cause of cancer death, it is definitely worthwhile to undergo this valuable test.

During a colonoscopy procedure, a gastroenterologist checks the inside of the large intestine (colon) and rectum for changes like irritated tissues, polyps or cancer. It is done with a long, flexible tube called a colonoscope. The tube has a light and a tiny camera on one end that is inserted into the rectum and moved up into the colon. If necessary, polyps or other types of abnormal tissue can be removed through the scope and tissue samples can be taken for biopsy. Colonoscopies are done while the patient is under sedation, so they are generally not aware of what is happening and do not feel any discomfort.

“The overall colonoscopy patient experience has improved and we have made it convenient for people to schedule their procedure,” said Washington Township Medical Foundation (WTMF) gastroenterologist Arun Srivatsa, MD, “Now, people who meet screening guidelines and are referred by their insurance company can ‘direct schedule’ their colonoscopy without a visit to the gastroenterologist first, or if they prefer, we can meet to discuss the process before scheduling. There are also alternative options for colorectal cancer screening like stool sampling. However, colonoscopy remains the most reliable test and the only one that can actually prevent cancer, not just detect it.”

The recommended age to begin colorectal cancer screening is 45 for average-risk patients, which includes people with no personal or family history of colon cancer. Higher-risk patients with genetic predisposition or a family history of colorectal cancer are advised to start younger than 45 and may require colonoscopies more frequently.

What to Expect When Having a Colonoscopy

When you make an appointment to have a colonoscopy, you will be provided instructions to prepare for the procedure. Colonoscopy preparation (prep) usually entails restricting your diet to low-fiber foods for several days, then going on a clear-liquid diet one day prior to the procedure. The evening or several hours before, you will take laxatives (either pills or a prescription laxative drink) to clean out your colon. People often say the colonoscopy prep is the most unpleasant part of the whole process. This is because once the laxatives take effect, you will have numerous bowel movements until all the stool is removed, at which point you will pass only clear yellowish liquid.

Once you check in for the outpatient procedure, you will change into a hospital gown and an IV will be inserted to administer anesthesia. When it is time for your colonoscopy, you will be instructed to lay on your side on the procedure table. The anesthesiologist will begin to administer the medicine, and that, typically, is the last thing people remember until they awaken in the recovery room. The doctor who performed your procedure will check in to make sure you’re feeling well and provide preliminary results. In most cases, the whole appointment takes an hour to an hour and a half.

At least one precancerous polyp is found and removed in about 40% of colonoscopies, but cancer is diagnosed less than 1% of the time. If your doctor reports that you had no polyps, you likely will not need another colonoscopy for up to 10 years. If you did have precancerous polyps removed, you might receive a recommendation for another colonoscopy in three to five years. Either way, you can enjoy peace of mind that you have done everything you can to protect yourself from colorectal cancer.

On Tuesday, March 5, at 2 p.m., Dr. Srivatsa will present a live online seminar, “United Against Colorectal Cancer.” During the presentation, Dr. Srivatsa will discuss colorectal cancer statistics, risk factors, signs and symptoms, screening options, and treatments. To watch this presentation on Facebook, sign in to your account then go to Or you can watch it without an account at If you cannot watch it live, the seminar will be available beginning the following day on YouTube.