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FAQ’s About Colonoscopy
This year, 75,700 women will be diagnosed with colon cancer, compared to 72,600 men. And 28,800 women will die of the disease. The reason – women are not getting screened for the disease as often as their male counterparts.

Colonoscopy is used to detect precancerous colon polyps before they become malignant. It takes approximately five to ten years for one of those polyps to become cancerous.

What is a colonoscopy?
In colonoscopy the large bowel is examined using a camera, which is a long, thin, soft, flexible instrument called a colonoscope. The camera is placed in the rectum and advanced under direct vision. Cancer can occur anywhere from the bottom of the colon (rectum) to the beginning of the colon, which is called the cecum. The colonoscopy can see this entire area. Polyps and even small tumors can be removed painlessly at the time of a colonoscopy so it is really “therapeutic,” and not just a “diagnostic” test.

What’s the difference between sigmoidoscopy and colonoscopy?
Colonoscopy allows examinations of the entire colon. Sigmoidoscopy is done with a shorter endoscope and only reaches the bottom part of the colon. Sigmoidoscopy will detect only 30 to 40 percent of polyps in the colon. If you have a problem in the other end of the colon, it will not be detected.

Do I have to drink a gallon of clean-out solution beforehand?
Over the last two years, some of the recommendations for the colonoscopy preparation have changed. For example, patients do not always need to drink a whole gallon of a clean out solution. Today, a Fleets Phospho-Soda prep involves drinking 1- ½ ounces of Fleets Soda Oral Solution (not the enema type!) twice along with a lot of clear liquids the day before the test to clean out the colon. While Fleets Phospho-soda is an oral solution there is also an enema type of product, which you may not need. Since the phospho-soda tastes salty, you might try mixing it with white grape juice.

What can be done during a colonoscopy?
During the colonoscopy a stool specimen can be obtained to send to the microbiology lab if the patient is having diarrhea. Or, a biopsy can be obtained of the area that looks abnormal. In addition, if there are any polyps or growths, these can be removed either with a biopsy forceps or with a looped metal “snare,” both of which use cauterization.

Are there any risks?
After a polyp is removed (polypectomy), one out of twenty polyps can bleed. Therefore, patients should not take aspirin or other non-steroidal anti-inflammatory drugs (such as ibuprofen) for seven to ten days prior to their procedure. Should bleeding occur after a polyp is removed, we advise you to call your doctor immediately so that the bleeding can be stopped, which is also done with a special probe that is easily placed through the colonoscope. Infrequently, something called a perforation can occur, which means that a small hole is created in the colon. This can be treated medically by admitting the patient and administering IV antibiotics, or surgically by repairing the perforated area through a small incision in the abdomen. This happens very, very rarely.

What if I have cancer?
If the colonoscopy reveals cancer, a consultation with the surgeon will be obtained. Sometimes a colon tumor can be removed very easily through a small incision. You may also be sent for a CAT scan of the abdomen, so that the proper surgery can be performed. The earlier a cancer is detected, the higher the cure rate. In some cases, chemotherapy might even be necessary.

Warning signs of colon cancer include: blood in stool, a change in bowel habits, anemia, family history of colon cancer, abdominal pain with either constipation or diarrhea, or any abdominal symptoms that begin after age 40. If you have any unusual symptoms, talk to your doctor.

When should I begin screening?
In patients with no gastrointestinal problems and no risk factors for colon cancer, the American Cancer Society recommends a first screening colonoscopy at age 50.

However, if you’ve seen blood in your stool, you should see a doctor right away. If you have any risk factors for colon cancer, such as a history of colon polyps, your doctor may want to order the colonoscopy long before you turn 50. If you have a first-degree family member, such as a sibling or a parent, with colon cancer, you should begin screening at least 10 years before the age your relative was when diagnosed. Every year after age 50, you should have three stool specimens tested for blood (called fecal occult blood testing). If blood is ever detected in the stool, you should definitely have a colonoscopy to see where the blood is coming from. An alternative to colonoscopy is a flexible sigmoidoscopy with a barium enema, an x-ray with contrast material that’s injected through the rectum into the colon. The flexible sigmoidoscopy has to be repeated every three years, but if you have a colonoscopy, you may need the procedure only every five to ten years.

Who pays for colonoscopy?
As of 2001, Medicare pays for a screening colonoscopy in patients 65 years and older. If you’re younger than 65, most insurance plans cover colon cancer screening, check with your insurer.