What to Expect Before, During and After a Colonoscopy

Colorectal cancer is the second leading cause of cancer-related deaths in the United States, but it’s largely preventable through regular screenings like colonoscopies.

Despite their life-saving potential, many people delay or avoid colonoscopies due to embarrassment, fear or misunderstanding. However, regular screenings can detect issues early, often before they become cancerous, making them a crucial step in cancer prevention. While the preparation and procedure may seem daunting, the benefits of early detection far outweigh the temporary discomfort.

“Studies show that regular colonoscopies can reduce the risk of dying from colorectal cancer by 68%,” says Shria Kumar, M.D., a colorectal cancer researcher at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine. “Early detection allows for treatment when cancer is most treatable.”

To help raise awareness about colorectal cancer, we are addressing some important questions about colonoscopy and its role in prevention and early detection.

What is a colonoscopy?

A colonoscopy is a minimally invasive procedure that uses a flexible tube with a camera to examine your colon. Sedation ensures comfort, while real-time images help doctors detect abnormalities inside the colon.

The procedure allows doctors to identify and remove polyps or growths that could lead to colorectal cancer. By removing these during the colonoscopy, doctors can prevent cancer from developing.

“Polyps are common, affecting about 20% to 30% of adults,” says Dr. Kumar.

“Detecting precancerous polyps or early-stage cancer enables early intervention, improving outcomes, and preventing cancer.”

What age should I begin screening?

Colorectal cancer rates in individuals under 50 have risen 2% annually since 2011, prompting the American Cancer Society to lower the recommended starting age for routine screenings from 50 to 45.

If you have a family history of the disease, genetic conditions or risk factors like obesity or alcohol use, your doctor may recommend earlier screenings.

What can I expect during a colonoscopy?

The procedure takes about 30 minutes. Here’s what to expect:

Before: You’ll follow a special diet and take a bowel-cleansing solution the day before to ensure a clear colon.

During: A sedative will relax you as the doctor inserts the colonoscope to examine your colon. If needed, polyps or tissue samples will be removed.

After: You’ll be monitored briefly until the sedative wears off. Most people go home the same day, but you’ll need someone to drive you. Mild bloating or gas is common, and you can return to normal activities the next day — avoid heavy lifting or strenuous exercise until cleared by your doctor.

What follow-up is required?

If polyps or abnormal tissue are removed, you’ll need to follow up with your doctor to review the pathology results. Your doctor may recommend more frequent screenings if polyps are found.

If no issues are detected, your doctor will typically recommend a follow-up colonoscopy in 10 years, providing peace of mind and long-term health assurance.

Are there alternative screening methods?

Colonoscopy is the gold standard for colorectal cancer screening. While generally safe, it carries some risks, though serious complications are rare.

For those unable or unwilling to undergo a colonoscopy, alternatives like the FDA-approved fecal immunochemical test can detect blood in stool samples. These tests are low-risk, cost-effective, and require no bowel prep, diet restrictions or sedation.

“While colonoscopy is preferred for its ability to remove polyps, the key is getting screened – whichever test you choose, it’s the right choice,” says Dr. Kumar.

Can I prevent colorectal cancer?

While the exact cause of colon cancer is unclear, lifestyle changes can significantly reduce your risk. Dr. Kumar recommends limiting red meat and alcohol, avoiding smoking, maintaining a healthy weight and living a healthy lifestyle. But the most crucial step is getting screened.

“Colonoscopy isn’t just for early detection; it’s actual cancer prevention,” says Dr. Kumar. “If you’re due for a colonoscopy or have risk factors, don’t delay — talk to your doctor and schedule the procedure.”

Debby Teich is a contributor for Sylvester Comprehensive Cancer Center.

Tags: Cancer Prevention Tips, Colorectal Cancer Screening, Dr. Shria Kumar, Early Cancer Detection, Preventive Health Measures, Sylvester Comprehensive Cancer Center