A colonoscopy is a common procedure done to help detect colon cancer and other abnormalities in the large intestine. According to the Centers for Disease Control (CDC), nearly 15 million colonoscopies were performed in the U.S. in 2012.1 The procedure is recommended for people over age 50, but it may be done in younger patients if they have a personal or family history of disease.2 This test is also done to evaluate a range of lower gastrointestinal symptoms, such as anemia, pain, bleeding, or a change in bowel habits, or for general cancer screening.
What Is a Colonoscopy?
Lasting about 30 to 60 minutes,3 the procedure involves the use of a long, flexible instrument called a colonoscope. The device is about ½ to 1 inch in diameter and about 5 feet long. It has a fiber optic camera at one end and can transmit images from inside the colon to a television monitor. A physician can visually detect any abnormalities on the inner lining of the colon.
Prior to the procedure, you will fill out a medical history and physical questionnaire and change into a gown. Usually, patients receive an intravenous line to manage sedation and are monitored by an anesthesia personnel for the duration of the exam.
A small tube is inserted gently into the rectum and eased along until it extends the length of the large intestine. It can be bent to navigate the curves of the colon. Patients are generally sedated during the procedure. To provide a clearer view, air is blown into the colon to expand the interior space.
While viewing the lining of the colon and bowel, a doctor may be able to see swollen or irritated tissue or abnormalities, such as polyps and tumors, that can be biopsied or removed using the instrument during the procedure. They may find ulcers as well. Evidence of conditions such as diverticulitis, Crohn’s Disease, or ulcerative colitis may also be detected.
Before the test, your doctor will discuss colonoscopy prep prior to the appointment. The success of the exam largely depends on your commitment to preparation. If you have medical conditions such as a heart or lung condition; allergies to medications; diabetes; are on medications such as blood thinners (or for diabetes, arthritis, or inflammation); or are pregnant, alert your doctor beforehand.
Prescribed and over-the-counter medications, and even some vitamins and supplements, may have to be adjusted before the procedure.
Dietary or fluid restrictions are common in advance of a colonoscopy. Although they may vary, from case to case, common indications include eliminating solid foods or taking oral laxatives for some time before the appointment.
Follow clear liquid diet instructions for 24 hours; broth, gelatin, fruit juice, and coffee or tea or usually allowed as part of a liquid diet.
Other types of preparation recommended by Gastrointestinal Specialists of Georgia include Miralax Prep, MoviPrep, Nulytely or Trilytely Prep, Prepopik, and Suprep. These gastroenterology preparation methods are explained on the clinic’s website.
What to Expect Afterward
After the procedure, patients are often kept in recovery for observation. This is often for not more than 30 minutes. You can expect some cramping or gas, but it should ease up quickly. However, the sedatives given during the procedure can result in drowsiness. Wait eight hours before driving a vehicle or operating machinery.4
In most cases, you can resume a normal diet. You may need to avoid blood thinners and other medications temporarily, especially if polyps were removed or the physician took a biopsy.
Complications include rectal bleeding, fever, chills, or severe abdominal pain. Call a doctor and seek medical attention if any of these occur. In rare cases, puncture of the colon is possible.
Why Is It Important to Get Screened for Colon Cancer?
In terms of deaths from cancers in the United States, it ranks second.6 Once small growths form, it can take five to ten years for them to become malignant. There are often no symptoms during this period and, by removing abnormal growths early, more serious health problems can be avoided entirely.
The American College of Gastroenterology, American Gastroenterological Association, American Cancer Society, and the US Preventive Services Task Force recommend that screenings be done every ten years after an individual turns 50. If there is a family history of colon cancer or precancerous polyps, the guidelines recommend starting screening at a decade younger than the youngest age of the person in your family who had it. For some people, screenings are recommended by age 40.
The risk factors for colorectal cancer are not limited to age and personal or family history. Individuals with a family member diagnosed before age 60 are at a higher risk, as are people who themselves have had been so and treated before.
African-American individuals and people of eastern European descent have a greater risk than the general population. People who are overweight, drink alcohol heavily, eat a diet high in red meat, smoke, and have inflammatory bowel disease (i.e., Crohn’s disease or ulcerative colitis) do, as well.
Treatments for Colon Cancer
There are several treatments available should a colonoscopy find any malignancies. These include:
Surgery: If the cancer is localized, surgery is the most often recommended course of action. Most cases of colorectal cancer are localized. Usually, such a procedure involves removing the section of colon where the tumor is, along with lymph nodes surrounding the area.
Chemotherapy: Patients often receive a combination of chemotherapy and radiation to shrink tumors beforehand, to make an operation easier. Post-surgical chemotherapy may be administered to kill off non-detectable malignant cells. Treatment may be provided intravenously or in pill form.
Targeted therapy: Vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), or kinase protein inhibitors may be used to disrupt mechanisms thought to support the growth and survival of cancer cells. In general, the side effects are less severe than chemotherapy, and healthy tissues are usually not affected.
Immunotherapy: Focusing on the body’s ability to fight cancer, this includes immune checkpoint inhibitors to shut off mechanisms that hide malignant cells from the immune system. As a result, natural immune processes take over and attack those cells. Vaccines have been developed to provide an immunity boost to treat tumors or prevent them from recurring later. There are different types, including acquiring immune cells from the patient’s blood, altering them to target cancer cells, and re-injecting them.
A lot of new colon cancer treatments are focused on the biological makeup of tumors and their genes. Tumor markers such as RAS genes have been identified in 40% of people with colorectal cancer, which helps determine what treatments may or may not be most likely to work.
Another area doctors look at include BRAF gene mutations; research to block this gene is ongoing. Microsatellite instability, a trait found in a small percentage of metastatic colorectal cancers, leads to a high number of mutations in tumors. It is the focus of some other immunotherapy treatments being studied.8
There are several established and emerging treatments. However, routine cancer screenings are the best means of prevention and staying healthy.
GI Specialists of Georgia: Colonoscopy Specialists You Can Trust
Gastrointestinal Specialists of Georgia has a staff of physicians experienced in digestive tract disorders, test procedures, and clinical research. We specialize in preventative care and the treatment of various diseases, including colon cancer. Our team is experienced in providing general and advanced GI procedures and top-quality anesthesia, imaging, and pathology lab services.
To learn more and schedule an appointment for a screening, contact us by submitting your information online or by calling us at 678-741-5000.