stethoscope

What Really Happens During A Colonoscopy

Don’t put off this important test. Colorectal cancer is the second deadliest form of cancer, bested only by lung cancer. Doctors say that this form of cancer is preventable and, if detected early, has a high cure rate. Polyps found during a colonoscopy can be removed, which can prevent such tissue from becoming cancerous. What really happens during a colonoscopy? What can you expect? If you have fears or concerns, even after discussing them with your doctor, I hope reading the story of my first colonoscopy will put those to rest. 

An interesting note, though the rates of colon cancer are falling in people over the age of 50, colon cancer rates are skyrocketing in young people, something the proctologist who performed the colonoscopy and I discussed right before my procedure. Though there is no one conclusive reason for the rise, it is clear that African-Americans are diagnosed more frequently and much later than other populations. Obesity and low-fiber food intake are also correlated with cancer of the colon.

In the course of the annual medical visit following my 50th birthday, my doctor strongly recommended that I undergo a routine colonoscopy. At that time, I decided to kick that can down the road, so to speak. But less than a year later, a member of my high school class mentioned on Facebook that she’d undergone hers. Fortunately, all was well, and she encouraged the rest of us to also get screened. At my next annual visit, my doctor arrived at the point where she would urge me to undergo the screening. This time, I asked how to get it scheduled. She referred me to a specialist.

I was definitely not looking forward to the preparation I knew I’d have to do, because my husband had his first colonoscopy done a few years earlier. The doctor’s office provided me with written instructions on how to prepare and what I could expect. In order to get a clear view of the colon’s walls, it is necessary to completely empty it. To do this, I was restricted to consuming only clear liquids the day before. Because red and purple dyes can stain the colon walls, they were also forbidden. Also, foods like corn, seeds and berries are discouraged several days before. 

I was very nervous, because I’d have to go without solid food for an entire day, plus sedatives and the like make me very apprehensive. But, I drank chicken broth and herbal tea most of the day prior and  consuming only an all-liquid diet for a day was not nearly as bad as I’d feared. I even went to a group exercise class and all went well. 

To be certain the colon was a clear as possible, I was prescribed a laxative solution to be taken the evening before and the morning of the procedure. When mixed with water, it amounted to having to drink sixteen ounces of liquid, which I chased with two 16-ounce glasses of water. The pharmacist told me that in the past, the prescription involved drinking two liters of the solution. Everyone, she said, prefers the decreased water volume. I was grateful for not having had to drink that much liquid, but must admit that the solution was not altogether unpleasant. But, it was still a very potent laxative and its effects continued for over two hours following each dose. A word of advice: be prepared to remain close to the toilet until the prescription has run its course!

pre-colonoscopy-laxative-kit
The first of the two-dose laxative prescription.
the-author-sitting-in-hospital-connected-to-IV
The author, IV tube in place.

Because patients are required to be accompanied by someone after, my husband drove me. The day of, I reported to the hospital, where staff checked me in. Once I was dressed in a hospital gown, a nurse had me climb into a hospital bed in the ambulatory surgery area. A team of nurses asked me a whole slew of questions, took my vitals and connected an intravenous solution to a vein in my hand. 

Following a wait, I was wheeled to the room where the colonoscopy itself was performed. A different team of two nurses and a doctor, all clad in surgical garb and masks, were waiting. The doctor explained that a camera would be inserted into my rectum to view the colon’s lining. Though there are no pain receptors in that part of the body, it’s standard practice to sedate patients. I suspect that it’s to prevent them from squirming, if not bolting altogether, though the information they provided, and other sources said it is “to take the edge off.” 

I confessed that along with many other concerns, I was worried that I might poop all over the hospital bed. To their credit, all three of them nodded after the doctor assured me that–poop and all–what happened in the room, would stay in the room. But he also stated that the procedure is not without risks, and he outlined them for me. Because I like information and chatting, it was around this time that he shared the statistics I mentioned previously. 

When it was time for my colon’s on-camera “close up,” one of the nurses deftly injected sedative into the IV, which burned mildly. The other nurse placed a firm wedge shaped pillow beside me, and it was the last thing I recalled. 

When I woke up, I was still in the hospital bed and the colonoscopy was over. I was being wheeled out of the procedure room and back to the first room. I was in no pain, but felt very groggy. My husband came back into the room and helped me get dressed. In between the nurse explaining that it was all good and bringing me a pudding cup and water, I dozed. A nurse pushed me out to the car in a wheelchair in which I sat clutching a report that included a few color photos taken inside my colon. My next one will be in ten years. Once home, I slept most of the afternoon and all through the night.  

While you should know that having a colonoscopy is not without risks, you should also know that the incidence of complications is quite low. Talk to your doctor and do your own research so that you will know if you have unique risk factors for colon cancer. Regular wellness care and health care are a huge part of thriving during midlife. If you have been screened, please share this post and let the people you care about know that you did!

Photos: Stethoscope by Hush Naidoo via Unsplash, all others by my husband and me.