If you’re putting off your first colonoscopy, don’t. Take it from me: my first colonoscopy saved my life.
It’s normal to be apprehensive before a medical procedure, especially this one: the prep is annoying and it’s easy to tell yourself you don’t have any risk factors. But you can’t let your anxiety win. Part of smart prevention is early detection.
I had absolutely no risk factors and my doctor found a pre-cancerous polyp that could have morphed into cancer had it not been removed.
I’m sharing my story to highlight the importance of getting screened on time. Here’s what you need to know about the process – as well as one adjustment to make the prep a bit easier.
When should people get their first colonoscopy?
The American Cancer Society issued new national guidelines, recommending that people at average risk of colorectal cancer start regular screening at age 45, because of the increase in colon cancer in younger people.
The major risk factors for colorectal cancer are a family history of the disease and older age, but several other factors have been associated with increased risk, including excessive alcohol use, obesity, being physically inactive, cigarette smoking, and, possibly, diet.
This new age to start screening isn’t yet agreed upon by everyone though, since the prestigious US Preventive Services Task Force still recommends starting at age 50 and screening until age 75. The task force is currently reviewing its own guidelines, so we may see a change in the next iteration.
If you are debating the options, talk to your doctor if you’re between ages 45-50. Recognize that the method of screening is essential. Your choices include, but are not limited to, at-home stool-based screenings like FIT, visual exams like a virtual colonoscopy — which uses relies on a CT scan of the colon and rectum — or the gold standard: colonoscopy.
When it comes to what I prefer, it’s always colonoscopy. Why am I biased? Because a colonoscopy can diagnose and treat the problem in one setting, which is a unique advantage.
Is a colonoscopy a surefire way to prevent colon cancer?
This year roughly 145,000 people in the United States will be diagnosed with colorectal cancer. More than 50,000 will die from the disease. It doesn’t have to be this way — colonoscopy can reduce the risk of death from colorectal cancer by about 65 percent. Colonoscopy is an ideal tool since it can diagnose and treat the problem.
Colonoscopy can’t prevent all cancers, but it gives you and your doctor the best shot at early detection. Just because you have a clean scope doesn’t mean you don’t have to do it again. This test needs to be done every 10 years. Here’s why: even if a small pre-cancerous growth is missed, these polyps may take years to grow up into cancer and could be caught at the next screening, before they spread and cause havoc.
What if you dread the prep?
I have one message for anyone delaying their colonoscopy because they can’t stand the prep: Chemotherapy is harder and longer than one night in the bathroom.
The risks of colonoscopy are minimal and the prep relatively easy, especially when compared to palliative therapy and hospice. The math is pretty simple.
Is there anything I can do to make the prep easier?
I learned my favorite prep tip from numerous doctors who have undergone the procedure, including my own GI specialist, Dr. Jonathan Lapook.
People often think they should eat extra food before the prep, stuffing themselves so they won’t be hungry when it’s time to go on a liquid diet. That’s the worst thing you can do!
Instead, on the day before your colonoscopy, eat a very light and early breakfast (one egg, plain Greek yogurt, and a banana). You can have white, low-grain bread, but avoid any bread with grains or fiber. Avoid seeds and beans (don’t ask!) which can mimic a polyp and confuse the gastroenterologist (as happened to me once). After this, you should follow your prescribed clear liquid diet until four hours before your procedure the next day. Do not take liquids that are red, purple, or blue in color since they mess up the colonoscopy view. No drinking anything for four hours before the procedure so you don’t regurgitate and aspirate fluid while sedated. The gurgling can be unsettling for the entire healthcare team.
In my case, at 12:00 p.m. the day before the procedure, I take two Dulcolax laxative tablets with eight ounces of water or other clear liquid. At 5:00 p.m. I add clear liquid to the entire jug of Golytely and drink eight ounces every 10 to 15 minutes until the entire solution is finished.
In the end, you need to go for it. The prep is manageable, and the procedure itself is incredibly important.