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Medically reviewed and verified by Kate Burke, MD, MHA
While it is a famously dreaded procedure, a colonoscopy is an extremely important part of your health! To start with, they save lives. The most common reason people are given colonoscopies is to screen for colon cancer. Doctors can examine the colon and rectum for growths or polyps and remove them before they spread. This procedure is also an important part of treating ulcerative colitis (UC). This condition is characterized by inflammation of the lining of your large intestine and rectum. People with UC also often experience symptoms like chronic diarrhea, weight loss, and abdominal pain. Managing UC includes regular check-ups and tests, one of the most important being a colonoscopy. So, what exactly is a colonoscopy, how do you prepare, and what should you expect? Here is a complete guide to the procedure.
What is a Colonoscopy?
A colonoscopy is a medical test where a doctor uses a long, flexible tube called a colonoscope to look inside your colon and rectum. The tube has a small camera and light at the end. This lets the doctor see any signs of inflammation, ulcers, or abnormal growths called polyps. These polyps can be removed during the procedure. There are different types - some are cancerous, some are not. Finding a polyp is common, they show up in about 30% of colonoscopies. Most are benign and removing them is standard. The procedure itself usually takes 30 minutes.
Why Are Colonoscopies Important?
If you have symptoms of UC, a colonoscopy helps doctors confirm the diagnosis. During this procedure, the doctor can see the inside of your colon and identify any inflammation, swelling, or ulcers. After being diagnosed with UC, you will likely be prescribed medication to reduce inflammation. Regular colonoscopies allow doctors to monitor how well your treatment is working and adjust it if needed. People with UC also have a higher risk of developing colorectal cancer. In fact, they are six times as likely to develop cancer than someone without UC. Regular colonoscopies help detect precancerous cells or cancer early, making it easier to treat.
How to Prepare for a Colonoscopy
Preparation is key to ensuring the doctor gets a clear view of your colon. Here’s what you can do.
- Diet Changes: A few days before the test, you will need to switch to a low-fiber diet. Avoid raw fruits, vegetables, nuts, and seeds.
- Clear Liquids: The day before your colonoscopy, you will be asked to drink only clear liquids. This includes water, broth, clear juices, and clear gelatin.
- Bowel Prep: You will need to drink a special solution that helps clean out your colon. This is usually done in two stages: one in the evening before the procedure and the other a few hours before the test.
- Fasting: You will need to stop eating and drinking a few hours before the colonoscopy. Your doctor will give you specific instructions.
What to Expect During the Procedure
On the day of your appointment, you will usually need to show up with someone who can drive you home. Anesthesia is administered, and it takes a full day for it to completely wear off. Most healthcare facilities will not check you in unless you have a driver with you. After check-in, you will be brought to a room where you can change into a gown, then a nurse will put an IV in that will start delivering sedatives and pain killers to your bloodstream.
Depending on which form of sedation you are given, you may be awake for the procedure, or you may be asleep. General anesthesia is a controlled loss of consciousness, while conscious sedation is the more commonly used approach. This is more of a drowsy state, with no effect on breathing or heart rate. Ultimately the level that you want to be sedated is in your control! Talk to your doctor before the procedure about your options.
You will then be positioned on your side while the doctor inserts the colonoscope into your anus. They will slowly advance it through the colon until it reaches the small intestine. While it moves through your colon, the device is actually pumping small amounts of air to inflate it. This is done so the doctor has a better view and can identify any issues. After they reach the end, they will remove the colonoscope. The whole time they are looking for inflammation, ulcers, or polyps.
After the Procedure
A colonoscopy may be minimally invasive, but it still can take a toll! The sedative may take about 1-2 hours to wear off. After the procedure, you will be brought to a different room. There, a nurse will monitor you until you are awake, and then offer you something to eat and drink. You might experience some cramping, bloating, or discomfort, but these should resolve by the next day.
Generally, it is a good idea to take the rest of the day off following a colonoscopy. You can resume your regular diet, and make sure to drink plenty of fluids to replace what you lost during prep. Avoid any heavy lifting or strenuous activity. If you had any polyps removed during the procedure, you may experience some bleeding. This is perfectly normal and may not start until up to a week after the colonoscopy. Talk to your doctor if the bleeding is severe, persistent, or worrisome in any way.
How Often Should You Get a Colonoscopy?
According to the American College of Gastroenterology (ACG), screening colonoscopy should begin 8 years after the diagnosis of UC if the disease extends beyond the rectum. Subsequent surveillance intervals are determined based on individual risk factors and findings from previous colonoscopies, typically ranging from every 1 to 3 years. Your doctor will provide specific guidance based on your condition.
Regular colonoscopies are essential for managing ulcerative colitis. They help diagnose the condition, monitor treatment effectiveness, and screen for colorectal cancer. By following your doctor’s preparation instructions and having regular screenings, you can better manage your UC and maintain your overall health.
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