Colon cancer is more serious and more common than you might think.
In fact, 5 to 6 percent of people will develop colon cancer in their lifetimes, according to Murtaza “Kittu” Parekh, MD, and Rig Patel, MD, of REX Digestive Healthcare. It’s the second leading cause of cancer death in the United States after lung cancer, when counting cancers that affect both men and women.
“But there is good news,” Dr. Parekh says. “Colonoscopy makes colorectal cancer one of the few cancers we can actually prevent.”
A colonoscopy is an examination of the inside lining of the colon, which is where colon cancer starts. During a colonoscopy, a long, narrow, flexible tube with an HD camera at the end is used to evaluate the rectum and colon.
Colonoscopies can detect conditions like colitis, inflammatory bowel disease and diverticulosis. But mainly, doctors are looking for precancerous or cancerous colon polyps, which are growths on the inside of the colon’s lining. If the doctors spot polyps, they can quickly and painlessly remove them during the same colonoscopy.
Talk to your doctor about having a colonoscopy if you are any of the following:
- Older than 45
- Older than 40 with a family history of colon cancer or colon polyps
- You’ve noticed a change in your bowel movements or have bleeding or pain, regardless of your age
There’s no reason to avoid this painless, quick and potentially lifesaving procedure.
Here’s why having a colonoscopy isn’t that bad:
1. A colonoscopy is painless.
Yes, the tube goes exactly where you think it does. But you won’t feel a thing.
Colonoscopies employ monitored anesthesia. You’ll be given medicine through an IV that will keep you comfortable, virtually pain-free and unaware of the procedure.
A nurse anesthetist will administer the medicine and watch you intently—monitoring your heart, breathing and blood pressure—for the duration of the procedure, so the doctors can focus on the colonoscopy.
The only soreness you might feel after would be associated with your IV site, but that typically doesn’t hurt, Dr. Parekh says.
You might pass gas with some startling force for a couple of hours after the procedure. This is normal and not painful.
2. A colonoscopy is quick.
It’s recommended you take the whole day off work to recover from sedation, but going and getting a colonoscopy only takes about half a morning. (The actual procedure can take as little as 15 minutes.)
At REX Digestive Healthcare, if you are healthy and without bowel symptoms, you don’t have to have a consultation and then go through the process of scheduling a separate appointment. You can meet your doctor and have the procedure in the same short session.
3. Forget what you’ve heard. Colonoscopy prep is NOT. THAT. BAD.
People like to talk about the unpleasantness of colonoscopy preparation. But over the past 15 years, colonoscopy preparation has been improved and refined. The truth is, it’s not that bad anymore.
Doctors use split prep, which means you drink a prescribed laxative that will cause diarrhea for a couple of hours, starting around 7 p.m. You should be done around 10 p.m. and able to get some rest. Then, in the morning, you take the second half of the laxative. You’ll need to visit the bathroom with some urgency, but it shouldn’t be as intense as the previous evening, since the majority of your fecal matter will have been flushed out.
Then—boom—you’re done and ready for the quick procedure. Plus, you’ve perhaps finished a crossword puzzle or two? Good job!
But seriously, proper preparation is the patient’s end of the bargain. After all, this procedure might save your life. It’s the most effective when prep is done as directed.
4. You’re not necessarily too young for a colonoscopy.
Guidelines call for colorectal cancer screening starting at age 50 if you’re at average risk. If you’re at increased risk, based on family history of colon cancer or other factors, you’ll want to start earlier, typically at age 40. No matter your age, if you have blood in your stool, weakness and fatigue, or a major change in your bowel habits, talk to your doctor. Recent research from the American Cancer Society found a sharp rise in colorectal cancer rates among adults in their 20s and 30s; in fact, a person born in 1990 has double the risk of colon cancer and four times the risk of rectal cancer compared with people born in 1950.
5. There are alternatives, but colonoscopies remain the most effective, long-term option for colon cancer screening.
There are screening methods besides a colonoscopy, but none comes with as many advantages. For one, a colonoscopy usually needs to be repeated only every 10 years if results are normal. Some other methods, like flexible sigmoidoscopy (a similar procedure that looks at only part of the colon and rectum), must be done every five years. A double-contrast barium enema involves putting barium in the rectum and taking X-rays; it, too, must be done every five years. With these and other alternatives, if a polyp or suspicious mass is found, a colonoscopy will be ordered to follow up. Long story short: Might as well start with the colonoscopy.
And watch out for those at-home colon cancer screening stool tests. Some people are tempted to try fecal immunochemical tests (FITs) because they think the colonoscopy prep and procedure are far worse than they actually are.
At-home colon cancer detection tests are highly sensitive for cancer only when you already have the disease. Colonoscopies detect precancerous lesions and prevent them from growing into anything detectable by a home stool test.
If you do a FIT test or fecal DNA (Cologuard®) test (which can be pricey and require repeat testing after the first one), and it detects cancer, you’ll need a colonoscopy anyway.
6. Colonoscopies can find more conditions than just cancer, and you might feel better as a result.
Colonoscopies also detect the inflammatory bowel diseases (IBD) Crohn’s and ulcerative colitis. Both are inflammatory diseases of the intestines. Identifying them early helps reduce the long-term damage they can do, including scarring and bleeding in the colon, malnourishment, pain and intestinal blockages that require surgery. These diseases also might increase risk of colorectal cancer.
Diverticulosis is a condition that arises when pockets form on the inside lining of the colon. Finding diverticulosis early allows doctors to make suggestions for simple dietary changes, such as eating more fiber, that can prevent the condition from ever causing painful symptoms. If left unaddressed, the pockets can become inflamed and infected, leading to painful complications.
7. Having a colonoscopy is not as embarrassing as you think.
The procedure is typically done at an endoscopy center, and all the patients are there for gastrointestinal care. In other words, everyone is in the same boat.
Yes, everyone is there to have something done that may feel embarrassing. But you can relax—this is regular, everyday work for the clinical staff that will be taking care of you. So don’t worry.
Also, the anesthesia will help you relax, it will be over before you know it, and did we mention it is a virtually painless procedure?
8. A colonoscopy could save your life.
Last but not least, right? Colonoscopies save lives. Lots of them.
A study published in the New England Journal of Medicine suggests that the removal of cancer-causing polyps during a colonoscopy reduces the chance of death from colorectal cancer by 53 percent.
Ultimately, a quick, easy and safe colonoscopy just might save your life.
If you’re 45 or older or have symptoms of a bowel disorder, talk to your doctor about scheduling a colonoscopy. You can schedule one at REX Digestive Healthcare in Wake County or at the UNC GI Clinic in Chapel Hill. If you’re looking for a gastroenterologist, find one year you.