Colonoscopy for colorectal cancer

A colonoscopy is a vital medical procedure used to examine the inside of the colon, also known as the large intestine, and the rectum. It involves the insertion of a thin, flexible tube with a camera at its tip, called a colonoscope, through the rectum to provide a detailed view of the colon's lining. This procedure plays a crucial role in the early detection, diagnosis, and prevention of colorectal cancer and various gastrointestinal conditions.

Benefits of a colonoscopy

• One of the primary benefits of a colonoscopy is its effectiveness in detecting colorectal cancer at an early, more treatable stage. By identifying precancerous polyps or early-stage tumors during the procedure, doctors can initiate timely intervention, significantly improving the chances of successful treatment.

• During a colonoscopy, if polyps (small growths) are detected in the colon, they can often be removed immediately. This not only helps prevent the development of cancer but also eliminates potential sources of discomfort or bleeding.

• Colonoscopy is recommended for individuals with a family history of colorectal cancer or those at higher risk due to personal health factors. It is considered the gold standard for colorectal cancer screening for these individuals.

• Unlike some other screening methods, a colonoscopy provides a comprehensive examination of the entire colon. This thorough assessment ensures that no potential issues are missed.

• In addition to cancer screening, a colonoscopy can help diagnose various gastrointestinal conditions, such as inflammatory bowel disease (IBD), diverticulosis, and unexplained bleeding or abdominal pain.

• Early detection and intervention through colonoscopy have been shown to significantly improve the survival rates of individuals diagnosed with colorectal cancer.

• If a colonoscopy is not suitable for a particular individual due to medical reasons or personal preferences, other colorectal cancer screening methods, such as fecal occult blood tests (FOBT) or sigmoidoscopy, may be considered. However, it's essential to discuss the advantages and limitations of these options with a health care provider.

How to properly prepare for a colonoscopy

• Consult your physician:

  • Schedule an appointment with your gastroenterologist to discuss the colonoscopy and go over your medical history and any medications you are taking.

  • Inform your doctor of any allergies or medical conditions you have.

• Receive clear instructions: Your Dignity Health gastroenterologist will provide you with specific instructions for preparation. Follow these instructions carefully, as they are tailored to your individual needs.

• Dietary restrictions:

  • In the days leading up to the colonoscopy, you will likely need to follow a clear liquid diet. This may include water, clear broths, strained fruit juices, plain gelatin, and clear popsicles.

  • Avoid red or purple-colored liquids, dairy products, and any liquids with pulp.

  • Stay hydrated by drinking clear fluids throughout the day.

• Bowel preparation:

  • Your doctor will prescribe a bowel preparation solution, typically a laxative, to cleanse your colon. Follow the dosing instructions provided.

  • You'll need to start the bowel preparation the day before the colonoscopy. It often involves taking laxatives in divided doses and drinking clear liquids.

  • Expect multiple bowel movements as the solution works to empty your colon. It's essential to stay near a restroom during this time.

• Fasting:

  • Generally, you'll need to stop eating solid foods at least 24 hours before the procedure.

  • Avoid consuming any food, gum, or mints on the day of your colonoscopy.

• Medication adjustments:

  • Inform your doctor about any prescription or over-the-counter medications you take.

  • You may need to adjust or temporarily stop taking certain medications, such as blood thinners or iron supplements, in the days leading up to the procedure.

• Transportation and support:

  • Arrange for someone to drive you to and from the medical facility on the day of your colonoscopy, as you may be groggy from sedation.

  • Have someone available to accompany you, as you'll need assistance after the procedure.

• Follow pre-procedure guidelines:

  • Wear loose, comfortable clothing to the appointment.

  • Remove jewelry and avoid wearing makeup or nail polish, as these can interfere with monitoring equipment.

Different options for colonoscopy tests

People may opt for alternatives to a colonoscopy due to medical contraindications, anesthesia risks, age or health status, patient preference, incomplete colonoscopy, limited facility access, or prior experience. These alternatives include stool-based tests like FOBT, less invasive procedures like sigmoidoscopy, and imaging methods like virtual colonoscopy. It's essential to choose the most suitable screening method based on your circumstances and consult with a Dignity Health gastroenterologist for personalized recommendations.

• Fecal Occult Blood Test (FOBT):

  • A non-invasive test that detects blood in stool samples, which can be a sign of colorectal bleeding.

  • Does not provide direct visualization of the colon or detect polyps.

  • Requires annual testing for accurate results.

• Sigmoidoscopy:

  • Examines only the lower part of the colon (sigmoid colon) and the rectum.

  • Limited in its ability to detect issues higher up in the colon.

  • Generally recommended every 5 years as a screening option.

• Virtual colonoscopy:

  • Utilizes CT scans to create detailed images of the colon's interior.

  • Non-invasive and does not require sedation.

  • Polyps detected may still require a follow-up colonoscopy for removal or biopsy.

• Stool DNA testing (FIT-DNA):

  • Detects certain DNA changes and blood in stool samples.

  • Non-invasive but may have a higher rate of false positives.

  • Positive results often require a follow-up colonoscopy for confirmation.

• Capsule endoscopy:

  • Involves swallowing a pill-sized camera that takes pictures as it passes through the digestive tract.

  • Primarily used for examining the small intestine, not the colon.

  • May not be suitable for detecting colorectal issues.