What is a colonoscopy?

A colonoscopy is a test performed to examine the mucosa (inner lining) of your colon and the most distal part of the small intestines.  It is performed by a specialized physician (Dr. Perryman) who received additional training.

Why is a colonoscopy done?

A colonoscopy can be done as a routine screening for colon and rectal cancer, family history of some malignancies or diseases, or surveillance after previous history of cancer, polyps, or colitis.

How common is colon cancer?

Colorectal cancer is the second leading cause of cancer death in the United States.  Cancer usually develops from a precancerous lesion called adenomatous polyp or adenoma.  Polyps are very common and can occur in more than 30% of the population 50 years or older.

Why is a colonoscopy important?

Colon cancer can be prevented in most patients with appropriate screening and surveillance.  The destruction of polyps is directly related to cancer prevention.  Colon cancer usually has no symptoms.  Colon cancer, if discovered early, can be cured in most patients.

How is a colonoscopy done?

You need to do a bowel prep the day before your exam to cleanse your colon. The nurses at the endoscopy center will admit you and check your vital signs. Dr. Perryman will meet you in the room and ask you some questions before an anesthesiologist administers intravenous sedation. With the room lights down and in the presence of a nurse who specializes in endoscopy, the procedure should take about 30 minutes. You should be comfortable during the exam.

Dr. Perryman will talk to you and your family once the procedure is completed. A report will be sent to your primary care doctor and you will be given follow-up instructions.

When should I schedule my first colonoscopy?

A screening colonoscopy should first be done when you are 50 years old (or 45 years old for African Americans). Basically, “screening” means you are asymptomatic, or not having any issues. You are doing this as a preventative measure. Importantly, if you have risk factors such as family history of colon cancer or polyps (parents or siblings), you may need to start at a younger age. Ask Dr. Perryman for these guidelines.

A diagnostic colonoscopy should be done at any age for symptoms such as rectal bleeding, change in bowel habits, unexplained weight loss or anemia. You are doing this to rule out and/or address potential problems.

Be sure to tell Dr. Perryman what you are experiencing. Don’t be embarrassed, don’t hold back. It could be nothing, and it could save your life.

How often do I need to undergo a colonoscopy?

If you have a normal colonoscopy, have no risk factors that may increase your likelihood of developing colon cancer or polyps, and are having no bowel problems, you only need to repeat the procedure every ten years. If you have risk factors, the interval will be shorter, and Dr. Perryman can advise you on when you need to repeat the procedure.

What is a ‘bowel prep’ and what can I do to ensure that it works?

Bowel prep is what most people fear most about a colonoscopy, but it’s short term and manageable. Remember, you are doing this for you and your loved ones. The bowel prep is critically important; it gets your colon completely cleaned out so Dr. Perryman can do a thorough exam. Most polyps are small, so any retained stool in the colon could cover and hide lesions that need to be removed.

Tips to follow for the best bowel prep:

3 days before your colonoscopy, stick to a low fiber diet

(AVOID nuts, seeds, popcorn, grains, raw vegetables).

2 days before your colonoscopy, eat light

(DON’T load up on a lot of food because you can’t eat the next day). Eating light the day before your prep will make the prep day easier.

On the day of your prep, stay well hydrated

Drink plenty of clear liquids before, during and after drinking the bowel prep solution. The colon cleansing process will cause your body to lose a significant amount of fluid. If you become dehydrated, you may experience nausea, headache, dizziness, cramping, and chills. Drink fluids that contain electrolytes such as Gatorade, Propel, coconut water, and chicken broth. Drink clear liquids that are light in color (yellow or colorless ONLY); no red or purple colored liquids.

IMPORTANT: If you become nauseated while drinking the bowel prep solution, stop drinking it until the nausea resolves. If you vomit the prep, it will not work. You need to consume the entire volume of the prep, so drink slower or try using a straw if you do not like the taste. You may suck on mints in between drinking the prep, or you can try drinking ginger ale to settle your stomach. Alternating sweet and salty clear liquids may help as well. Some bowel preps are very palatable and gentle, so it may not be as bad of an experience as you may fear.

A Note About Insurance

The Affordable Care Act (ACA) requires coverage of colorectal cancer screening tests by health plans that started on or after September 23, 2010 (see “Federal law” section). Although many private insurance plans cover the costs for colonoscopy as a screening test, patients may be charged for some services. You may have to pay part of the costs of anesthesia, bowel prep kit, pathology costs, and a facility fee (where the procedure is performed). Patients should review their health insurance plan for specific details including if the doctor is within their insurance company’s list of “in-network” providers. If the doctor is not considered in the plan’s network, the patient may face significantly higher cost-sharing. Before you get a screening colonoscopy, ask your insurance company how much you should expect to pay for the exam. Find out if this amount could change based on findings during the procedure. This can help you avoid surprise costs. If you’re hit with large bills afterward, you may be able to appeal the insurance company’s decision.