If you’re dreading your next colonoscopy because you remember what it was like the last time, take heart. Times have changed, and, in recent years, so has the colonoscopy procedure.
“A colonoscopy is vitally important to help prevent colon and rectal cancers or to detect them in the earliest, most-treatable timeframe. And, the best kind of screening is the one that people will get done. So, there has been a greater emphasis on making the procedure more pleasant for patients,” said Dr. Michael “Derek” Williams, of Samaritan Surgical Clinic – Lincoln City.
With new prep solutions that taste better, options that allow for two smaller doses of the solution rather than one huge dose and sedation that some compare to a satisfying nap, the procedure has improved for patients.
Why Get a Colonoscopy?
Colorectal cancer is a cancer that starts in the colon or rectum, and, excluding skin cancer, is the third most common cancer diagnosed in both men and women in the United States. Most colorectal cancers start as polyps, which are growths found on the inner lining of the colon or rectum.
A colonoscopy allows physicians to detect polyps and remove them to prevent further growth.
“Typically, polyps start small and as they grow, they can potentially change into cancer. So, the first benefit of a screening colonoscopy is to remove the polyp before it turns into cancer. Colonoscopy beats colon cancer every day of the week,” said Dr. Williams.
What Happens During a Colonoscopy
A colonoscopy is considered a low-risk procedure that takes less than an hour. A patient can be awake, but most choose to be mildly sedated.
A long, flexible instrument called a colonoscope is inserted into the rectum and advanced through the colon and large intestine. A tiny camera and light on the end of the colonoscope allow the physician to visually inspect the colon on a digital monitor. Pictures can also be taken for future comparison and small tissue samples are occasionally removed for biopsy.
“A colonoscopy allows us to see the entire colon, and when we find a polyp it can be removed right then,” Dr. Williams said.
The preparation before the procedure involves drinking a mixture of clear liquids and laxatives to empty the colon.
“To allow our camera to get the best view of the entire colon, it must be completely empty. If not, we cannot see well enough to determine if there are problems,” explained Dr. Williams.
New Options Make Colonoscopy Prep Better
For years, patients were told to drink the entire four liters (about a gallon) of the laxative-fluids solution at one time the night before the procedure.
Now, there are a variety of prep solutions to choose from, some available without a prescription, all more palatable than previously. Additionally, drinking the liquid can now be done over two days and in smaller doses, making it more tolerable for patients.
“Preps are never fun, but there are now lots of different options and even a pill form,” Dr. Williams explained. “The important thing is to stay hydrated and follow the instructions as best as you can. It’s not as bad as it used to be.”
Prep solutions used vary from surgeon to surgeon and can include Suprep in liquid form and Sutab in pill form, as well as over-the-counter options such as Miralax and Dulcolax mixed with clear fluids.
While the cherry-flavored taste of Suprep will not entice you to drink it regularly, it does taste better than earlier versions of bowel prep solutions. You’ll drink six ounces of liquid at two different times followed by clear fluids. Sutab involves taking 12 tablets at two different times with large amounts of water. Both require a prescription. If your insurance doesn’t cover the prep, it can cost $100 to $150.
An option that can be purchased without a prescription is Miralax liquid and Dulcolax tablets, often taken together. The Miralax can be mixed into Gatorade or another clear liquid to make the solution tastier.
“The preparation for a colonoscopy is a critical step and cannot be skipped,” Dr. Williams said. “We work closely with a patient to find the best prep solution that works for their situation.”
Sedation Begins Quickly & Doesn’t Linger
A patient can choose to be awake for the test, but because the procedure can feel uncomfortable, many choose mild sedation.
“We use a short-acting anesthetic that allows patients to fall asleep quickly and wake up quickly without feeling groggy the rest of the day. There’s no recovery from colonoscopies, but we can’t let you drive home,” Dr. Williams explained.
Many patients are surprised when they wake up and learn the procedure is over, he noted.
“The number one thing I hear when a patient wakes up is, ‘when are we going to do this thing?’ They haven’t even realized the test is over,” Dr. Williams said. “Others tell me it was the best sleep they ever had.”
Patients will spend about 30 minutes in the recovery room as the sedative wears off, and although they will need to have someone drive them home, they will likely feel normal soon after the procedure.
Check Insurance for Coverage
Most insurance plans cover a colonoscopy as a preventative screening, even if a polyp is found and removed.
However, depending on your insurance company, the prep solution and the anesthesiologist may not be covered. Check your policies carefully and be sure and discuss options with your clinician.
Colonoscopy Is Good Preventive Medicine
While a colonoscopy is a valuable tool that can be used to diagnose and evaluate a wide variety of gastrointestinal disorders, most people will get a colonoscopy as an important step in preventing colorectal cancer.
The test is strongly recommended for those age 50 and over. If no problems are found during the test, you won’t need an additional one for 10 years.
“Don’t let fear or dread of the colonoscopy prevent you from getting one. Early detection for cancer can make a significant difference in recovery and can potentially cure the cancer that you would have had in the future. Be open with us about your hesitation so we can try to answer your concerns,” he said.
Learn more about a colonoscopy and talk with your doctor about a referral.
Read the the difference a colonoscopy screening made in the life of Lincoln City resident Vallie Gibby.