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It's no joke; a colonoscopy can provide a lifesaving picture of your insides

J. Gish

Of course you don't want to go for a colonoscopy. You have to take a day off work, you'll be sick the night before during the “cleaning out” process, and a stranger is going to stick 6 feet of flexible tubing up your not-so-best side.

But a colonoscopy could save your life. Consider The New England Journal of Medicine report late last year that said potentially cancerous polyps are found in up to 40 percent of people by age 60. A colonoscopy allows doctors to detect polyps and remove them all at once, preventing the abnormal tissue from developing into cancer.

JAVIER MANZANO / Associated Press Ned Calonge, chief medical officer with the Colorado Department of Public Health and Environment, had a colonoscopy to demonstrate the process.

So maybe you need to go for that test. Besides, it's not only about you. Whether you have polyps dictates how soon your siblings and children need to go for screenings.

So you could be saving them from cancer, too. And to make you a little more comfortable with the procedure, William Notis, a gastroenterologist with Albany Gastroenterology Consultants P.C. in Albany, N.Y., walks you through a typical screening.

Step 1. The process begins at home. The day before your colonoscopy, you'll eat a light breakfast and then fast the rest of the day, drinking only clear liquids such as water and ginger ale and eating only Italian ice, Popsicles or gelatin.

Step 2. That afternoon, you'll use a kit the doctor has prescribed, which includes some tablets and a drink mix. You'll take four laxative tablets, which will cause you to go to the bathroom within one to six hours. After you've gone to the bathroom, you'll begin drinking the solution, which is made by adding two liters of lukewarm water to powdered medication and fruit flavoring. You can take your time drinking it, but should finish it by midnight or very early in the morning.

(People who can't drink the liquid can be prescribed tablets instead.)

The medication causes “significant diarrhea,” Notis says. But you shouldn't have a lot of cramping, and it will be over in about three hours. For many, this is the worst part of the procedure, but it is necessary so the doctor can get a clear picture of what's going on in your colon.

Step 3. The next morning, you'll skip breakfast, again drinking only clear liquids. If you take medications, you are permitted to have your daily dose, taken with some water. You'll have to get a ride to the colonoscopy center because you won't be permitted to drive afterward (you will be sedated but conscious during the procedure and could still be groggy). You can expect the entire process, from check in to checkout, to last about 2-½ hours. Once you arrive, you'll change into a hospital gown and a nurse will take a brief medical history. The nurse will also record your vital signs and insert an IV in your arm.

Step 4. You'll then be taken in for the colonoscopy. You'll be hooked up to several machines to monitor your blood pressure, oxygen levels, heart rate and pulse during the procedure. You will receive a low level of oxygen, standard procedure during the test. You'll also be given two medications through your IV, one to relax you and leave you with no memory of the procedure, and another to eliminate any discomfort you might feel during the process.

Step 5. You'll lie on your stomach, covered by blankets. Once the sedation medication has taken effect, the doctor will look inside your colon by inserting a sterilized 6-foot-long flexible tube about the width of a finger into your rectum. There is a camera in the tubing that allows the doctor to see the inside of your colon on a monitor. The doctor steers the tubing around the turns of your colon (at least three of them). You'll be in a light sleep, and likely won't feel anything other than perhaps some gaslike discomfort or pressure. If you do, the doctor can increase the levels of medication.

The doctor is primarily looking for polyps, which are growths of abnormal tissue that are usually not malignant but have the potential of becoming malignant. The doctor also looks for cancer or other intestinal problems. If a polyp is found, the doctor can feed instruments through the tubing to remove the polyp. The doctor cauterizes the growth, using heat to detach it from the colon and then extracting it from the body through the same tubing. The polyp will then be sent to a pathologist for study under a microscope. At the same time, if the doctor notices signs of cancer, he or she can take samples for a biopsy. Results usually come back from the pathologist within a week. It takes the doctor about 30 minutes to navigate the entire colon.

Step 6. After the procedure, you'll be taken to a recovery area, where you'll continue lying down and a nurse will monitor your vital signs. Depending on how you're doing, you'll remain there for about 10 to 15 minutes. You'll then move onto the next area, where you'll be allowed to sit up. Your vital signs will still be monitored and the nurse will offer you something to drink, such as ginger ale, juice or coffee. By now, you should begin to feel more like yourself. Meanwhile, your doctor will likely share the results of your colonoscopy with either you or with the family member or friend who brought you to the procedure. You'll also receive a written report of what was or was not found, and pictures of your colon taken during the colonoscopy.

Step 7. After 10 to 15 minutes in the second recovery area, you should be ready to go. You'll be feeling good, and will probably be looking forward to eating, which you can do as soon as you leave. But you won't be permitted to drive the rest of the day, just in case the medication has left you a little foggier than normal. If the doctor doesn't find any polyps and you have no family history of polyps or colorectal cancer, you won't have to have another colonoscopy for 10 years. Otherwise, you may be asked to return within five years.

 

>STATISTICS MAY MOTIVATE THE HESITANT ONES

If you or someone you care about has been told by a doctor to get a colonoscopy, it's natural to want to put the yucky procedure off. These statistics may provide motivation for getting it done sooner than later.

Until age 50, men and women have similar incidence and mortality rates of colorectal cancer; after 50, men are more vulnerable.

7.1 More men than women die from colon and rectal cancer (per 100,000)

32.9 Hispanic women with colon and rectal cancer (per 100,000)

44.0 White women with colon and rectal cancer (per 100,000)

47.5 Hispanic men with colon and rectal cancer (per 100,000)

55.0 Black women with colon and rectal cancer (per 100,000)

60.4 White men with colon and rectal cancer (per 100,000)

72.6 Black men with colon and rectal cancer (per 100,000)

5,500 Colon and rectal cancer deaths in California (2006)

55,170 Colon and rectal cancer deaths in the U.S. (2006)

$8.4 billion spent annually in the U.S. on treatment of colorectal cancer.

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