What you should know about colonoscopies

Shudder at the thought of a colonoscopy?

You shouldn’t, according to Taylor Haag, RN, a colonoscopy nurse at M Health Fairview Southdale Hospital. Haag, a cast member on season 8 of the Netflix show “Love Is Blind,” used her platform to raise awareness for the procedure.

“I know it's a strange occurrence and maybe an odd day for you, but it's a very normal day for us,” Haag said. “We're highly trained and we do this all day, every day.”

A colonoscopy is a cancer screening done to remove polyps and diagnose colorectal cancer. Polyps are clusters of abnormal cell growth in the lining of the large intestine. Some are harmless. Some could develop into cancer, so removing them during a preventive screening could prevent future colon or rectal cancer.

“Would you rather put out a spark or a wildfire?” Haag said. “A spark may be a polyp that we can remove and take care of, whereas if those polyps stay in your colon for too long, they could potentially turn into the wildfire that is colorectal cancer.”

Haag, along with gastroenterologists Stuart Amateau, MD, PhD, and Byron Vaughn, MD, who are also professors with the University of Minnesota Medical School, tell us want to expect with a colonoscopy.

What is a colonoscopy and when should I get one?

A colonoscopy is a screening for signs of cancer or polyps in the rectum and colon. To do this, a doctor puts a thin, flexible tube with a tiny camera in your rectum. If the doctor sees signs of cancer or polyps, they can remove them. Polyps are then sent to the laboratory for testing to see if they are cancerous.

“Keeping you comfortable during your colonoscopy, as well as maintaining your dignity is a priority for us,” Haag said. “We do our best to make sure that you feel comfortable the entire procedure.”

People of average risk for colon cancer are recommended to get screened every 10 years beginning at age 45. If you have an immediate family member with a history of colorectal cancer, such as a parent or sibling, your doctor might recommend screening younger or more frequently.

What is colonoscopy prep like?

In order for your doctor to get a good look at your colon health, your colon needs to be empty. You will get instructions for prepping for the colonoscopy. It’s important to follow them carefully since the exam is only as good as the preparation, Vaughn said.

About a week before your colonoscopy, make sure to review the instructions to make sure you are prepared and have what you need. Your doctor might ask you to switch to a low-fiber diet that excludes whole grains, nuts and dried fruit several days before the screening. Usually the day before the exam, you will be asked not to eat solid foods and will be given a laxative – so you won’t want to be too far from a toilet. Your instructions might vary.

“The preparation for the colonoscopy is definitely the most daunting task of it all,” Haag said. “I've had patients tell me time and time again the procedure itself was nothing compared to the preparation they did to get there that day.”

What happens during a colonoscopy?

For a colonoscopy, your care team will ask you to lie on your left hip and shoulder. Once you are on your side, you may be given sedation medicine through an IV to keep you comfortable. Deep sedation is available for those who need it. We also offer un-sedated exams, if that’s your preference. Most people only feel minor discomfort, if any.

“The team that’s taking care of the patient really wants to make sure they have a comfortable exam,” Amateau said. “By nature, comfortable exams are more accurate and safer.”

The procedure typically only takes 20 to 30 minutes.

What if you have colon polyps?

Polyps are very common. About 30 percent of the time, doctors find polyps during a colonoscopy. Fortunately, doctors are often able to remove the polyps during the colonoscopy. Depending on the number and size of the polyps found, you might need more frequent colonoscopies. Colonoscopies are a rare procedure that can both detect and prevent cancer.

What are risk factors for colon cancer?

In addition to being over age 45, you should talk to your healthcare provider about colonoscopy if you notice:

• Unexpected weight loss
• Rectal bleeding
• Change in bowel habits.

If you have a history of inflammatory bowel disease (IBD), including ulcerative colitis or Crohn’s disease, you may also need more frequent colonoscopies because you are at a greater risk for colon cancer. Special techniques such as chromoendoscopy may help doctors find pre-cancerous lesions in people with IBD.

What about other colon cancer tests?

There are other screening methods, but colonoscopies are considered the best because they both find and remove polyps in one procedure.

“Other methods of screening are focused on preventing death from cancer, not preventing development of cancer,” Vaughn said. “For this reason, the colonoscopy is a highly effective method of preventive care. If another screening test is positive, generally the next step is a colonoscopy.”

Alternative screenings include:

• Sigmoidoscopy, which only evaluates the rectum and the lower third of the colon. Patients using this method should receive a sigmoidoscopy every five years, Amateau and Vaughn said.
• Mail-in kits. Less invasive than a colonoscopy, these tests look for blood in a stool sample, which is one sign of colon cancer. Because the tests aren’t as effective as a colonoscopy, they should be repeated every one to three years, depending on the test type.

Ultimately, the best colon and rectal cancer screening is the one you will do. Talk to your doctor about your options. Learn more or schedule your colonoscopy.