[msg type=notice] What is colonoscopy? And how to prepare for it?[/msg]
Colonoscopy can be a dreadful procedure for some and inconvenient for others.
For my mother, it was both.
[msg type=default] Define colonoscopy[/msg]
With family history of colorectal cancer, my mother had to undergo her second colonoscopy two weeks ago.
The procedure is a widely recommended colorectal cancer screening by physicians. It’s performed to patients who are 50 years old and above.
This is an invasive procedure making it a dreadful experience yet effective in spotting polyps, which are signs of colorectal cancer. When they’re found, they can be removed, thereby, cutting the risk for colon cancer significantly.
The cost and hassle of this examination discourage people from undergoing it.
Despite that, colonoscopy can save lives. Remember that colorectal cancer is on the top five list of common cancers in the Philippines.
It’s a slow-growing cancer. The good thing is that colon cancer is curable, if it’s caught early. This is the reason colonoscopy is necessary.
Because of what happened to the former President of the Philippines, Corazon Aquino, screening for this type of cancer has been on the rise. Doctors in the Philippines saw an increase in Filipinos, who are in the right age for the screening, to get the test done.
Despite the rise of people getting screened through colonoscopy, there are still those who don’t undergo such.
People, who are advised by their primary care doctor to undergo this examination, are (sometimes) obstinate. There are only a few them who go through such procedure.
But a higher percentage of them submit a fecal specimen for stool-based colorectal cancer screening.
[msg type=notice] What this procedure is about? [/msg]
Colonoscopy is a screening examination for colorectal cancer. The doctor, who’s usually a gastroenterologist, looks into your colon or large intestine.
Your doctor will insert the colonoscope, which is a thin but flexible telescope into your anus to your colon. It’s pushed round the colon and as far as the cecum, which is the part where the small and large intestines meet.
The said telescope has fiber-optic channels allowing light to shine down so the doctor can look into your colon.
The side channel is used by your doctor to take a sample of your colon by grabbing using said instrument.
[msg type=notice] How long does a colonoscopy take? [/msg]
The examination can take up to an hour to complete. In some cases, the time for the procedure to complete will be extended. That is, if your doctor saw polyps or some abnormalities inside your colon.
My mother’s procedure lasted 45 minutes or less.
You don’t need to be hospitalized to prepare for this procedure. It’s done as an outpatient case.
A sedative will be given to help you relax. It’s usually given through IV. Although it can make you feel drowsy, it won’t put you to sleep. But it depends on your situation. My mother said that she couldn’t remember what was going on during the procedure. This means that she slept while the exam was ongoing.
Once you’re relaxed or, in my mother’s case, asleep, your doctor will insert the colonoscope into your anus to start looking into your colon.
The insertion will cause you to feel as if you want to go to the bathroom and pass.
The procedure may also cause you to feel bloated during and after the procedure because of the air. Thus, expect to pass wind. You don’t need to be embarrassed as it’s expected.
Small samples or biopsies are taken from the inside lining of your colon. It’s painless. The samples will be taken to the laboratory for testing. If polyps are found, they are removed using the instrument that’s attached to the colonoscope.
The entire procedure can take two hours, although the actual examination will only take 30 minutes to 45 minutes. But you have to remember that nurses will still prepare you for the procedure. Then, your doctor will still give a few minutes to make sure that the sedative is working.
Plus, you’ll be given time to recover.
According to my mother, the colonscopy, per se, doesn’t hurt. However, the entire procedure was a little uncomfortable because of the colonoscope inserted into the anus.
[msg type=notice] How to prepare for colonoscopy? [/msg]
My mother was given two days to prepare. However, she still got a medical clearance from her cardiologist if she could undergo such procedure.
Her cardiologist charged her PHP1,500 ($34+) for the clearance.
She also had blood examination for FBS, SUA, creatinine, CBC, etc. Then, she underwent ECG.
Before your doctor will give clearance that you can safely undergo the examination, your blood examination and ECG results must return normal.
After that, you’ll return to your gastroenterologist’s or doctor’s clinic to make a schedule for colonoscopy and obtain specific instructions on how to prepare for the actual procedure.
- Soft diet. You’ll be in soft diet for two days. By soft diet, it means you only have to eat oatmeal, porridge, fruits and some vegetables. My mother was advised not to eat leafy vegetables as they are difficult to be completely eliminated before the procedure.
- Laxatives. Mother had to take eight tablets of laxatives. Four tablets for the first day and another four at the second day.
- Suppositories. They were inserted hours before the examination.
- NPO. As the colon needs to be as empty as possible during the examination, you must not eat and drink eight hours before the procedure.
You’ll be advised to drink beverage that can replenish electrolytes from your body. Bear in mind that during those two days of preparation, you’ll be defecating several times a day causing you to lose sodium.
[msg type=notice] Do you need someone to be with you during the examination? [/msg]
You should consider having someone to be with you during and after the examination. As mentioned earlier, the sedative will cause you to be drowsy. So, you might need someone to accompany you home.
You should rest after the procedure. Apart from the drowsiness, you’d also be passing wind a few times after the procedure. You’re also expected to defecate a few times after undergoing colonoscopy.
My advice based on my mother’s experience? Go straight to your home. You don’t want to go to the mall or somewhere else with a feeling like you want to defecate or pass wind every now and then, do you?
[msg type=notice] What to expect after your colonoscopy? [/msg]
My mother was ready to go home after an hour of resting.
However, for some patients, they are advised to stay a little bit longer, especially if their doctors had removed polyps from their colon.
You should not drive home. Remember that the effects of sedatives can last up to 24 hours. For your safety, you should only drive or resume your normal activities 24 hours after the procedure.
Before we left, we were given the result. Fortunately, my mother’s gastroenterologist didn’t see polyps or abnormalities in her colon.
We also requested to obtain a copy of the examination to view the inside of my mother’s colon at home. We did and it was gross. We saw feces and some stuff. Ugh!
Although mother’s doctor allowed me to stay in the room during the examination and observe, I opted to go out as I already saw it before, about six years ago, during my mother’s first colonoscopy.
[msg type=fail] Side effects or complications[/msg]
- Sleepy or tired. This can be the result of the sedative being given during colonoscopy.
- Frequent passing of wind or stool. It’s expected. This side effect could last up to 24 hours after inserting the suppositories and taking the last dose of laxative.
- Passing of blood. It’s just a small amount of blood from your anus. There’s nothing to worry of.
In rare cases, the colonoscope can cause damage to your colon. Bleeding, infection and perforation may arise. If these symptoms happen, you should consult your physician within 48 hours. This is especially true if you experience the following symptoms:
- Passing large amount of blood from your anus
- Abdominal pain
Fortunately, my mother didn’t experience any of these symptoms. That’s probably because her gastroenterologist is a renowned doctor in the Philippines. She’s also said to be the overall consultant in this department.
Thus, you should choose the right doctor who’ll perform this procedure. Make sure that he/she has years of experience in this matter.
[msg type=notice] Why some people hate colonoscopy? [/msg]
As mentioned earlier, the entire procedure can be uncomfortable and the preparation can be inconvenient.
Some people also hate the fact that the procedure is invasive and it’s very unpleasant.
Plus, the cost can be too expensive. My mother’s colonoscopy costs around PHP20,000, including doctor’s fees. The amount could be higher if you don’t have health insurance.
My mother being a senior citizen helped in reducing significantly the overall cost.
Apart from the expensive cost of undergoing the procedure, the 24 hours of being uncomfortable can be daunting for some.
Then, there’s the bland diet you have to undergo for two days. It can be tiring for some as they have to go to the toilet to defecate a few times, day and night.
You also have to drink liters of water to help in cleaning the colon. Drinking lots of water and eating soft diet could help in inducing intense diarrhea.
Because of the overall unpleasantness, people would think twice to undergo colonoscopy. If they feel fine, why should they go through it? They’d start talking themselves out of it.
People also hate colonoscopy because they have to take a one day off work. They also have to find someone to accompany them during and after the examination.
The full cost of the procedure isn’t covered by all insurance plans. And if your doctor found a polyp, you might have to pay more.
If you have high deductibles, you’d surely be hit with expensive hospital bill.
Because of the expensiveness of the procedure, people without insurance won’t undergo the procedure, even if they’re at high risk for colon cancer.
Those low-income patients are also discouraged because of the cost of pre-procedure diet and other stuff.
[msg type=notice] Why you must undergo colonoscopy? [/msg]
Colon cancer cases are increasing. And screening is important in preventing it.
You must remember that colorectal cancer sometimes doesn’t show signs and symptoms when it’s still in its early stage.
My grandmother, who died of colorectal cancer, didn’t develop symptoms until the cancer has already spread and grown.
The cancer will develop from polyps in the colon.
This is one of the reasons you should get screened, especially if you are 50 years old or above. However, most people older than 75 years of age aren’t recommended to undergo screening.
[msg type=notice] Is colon cancer curable? [/msg]
Yes, it is. The importance of colonoscopy will help doctors in catching the colorectal cancer as early as possible so it can still be treated.
It’s still curable, as long as it’s in the early stage. Most patients, about 95% of them, diagnosed with early stage of this cancer are still alive, five years after.
However, if the cancer is caught during its late stage, i.e. it has already spread and grown, it’d be difficult to treat.
It may not be a comfortable test but it’s an excellent test to detect colon cancer.
[msg type=success] Alternatives to colonoscopy[/msg]
There are alternatives to colonoscopy.
One of them is the fecal immunochemical test or FIT. It’s an approved test by the FDA. This is a stool test that can be ordered by your doctor. It’s covered by most health insurance plans and it costs less than PHP800.
You need to repeat the test a year later, if the first one is negative.
Sigmoidoscopy is another alternative procedure to colonoscopy. But it requires cleaning prep. Nevertheless, it’s cheaper than colonoscopy.
It’s better to ask your doctor about the alternatives to colonoscopy. Although my mother wasn’t advised to undergo fecal occult blood test each year, she might consider it. But her doctor did recommend her to eat high-fiber diet and increase water intake.
Whatever test you choose, it’s important that you get screened. This is especially true if you have a family history of colorectal cancer.
There’s no such thing as a perfect test. But colon cancer screening is essential. There are alternatives to colonoscopy but you have to ask your doctor of which test is right for you.
Colonoscopy can prevent colon cancer. So, get screened, now!