When your doctor says you might need a colonoscopy—and you find out what it is—it’s understandable to get some jitters. Colonoscopies certainly sound uncomfortable, if not a little awkward.
A colonoscopy is an imaging procedure that uses a scope (hence the name) to look inside your colon and rectum to check for problems, such as inflammation or polyps that could become cancerous. The scope is a long and flexible tube that has a tiny video camera at the end, which allows the doctor to view the inside of your colon.
And yes, it’s true that the scope is inserted through the anus. Despite that, colonoscopies are not nearly as scary as they seem, especially if you know what to expect before going into the procedure. Here’s what you need to know to make your first colonoscopy less intimidating:
1. You’ll need to “clean yourself out” first.
TBH, the worst part of a colonoscopy is actually the prep, not the colonoscopy itself. Your doctor will give you specific instructions for the day before (or multiple days before) your appointment to get your colon as spiffy as possible, which makes it easier to identify problems in your digestive tract.
Colonoscopy prep may vary, but usually it requires taking a large amount of strong laxatives the night before or the morning of. This might include an entire bottle of something called “magnesium citrate solution.” Most docs will suggest mixing it with another drink, such as Gatorade or lemon-lime soda, to mask the unpleasant flavor of the laxative.
Fair warning: You’ll want to just stay home and take it easy, because you’re going to be spending a lot of time in the bathroom. (Just trust us.)
Additionally, your doctor may request you follow a clear liquid diet in the day or days before your colonoscopy. That means white grape juice is good to go, and red or purple grape juice is not.
2. You will get an IV to make the procedure easier and more comfortable.
What’s in the IV will vary. Some people receive general anesthesia so they can “sleep” through the colonoscopy. The benefit is that you are completely unaware of the procedure, so you don’t have to endure any of the awkwardness. The downfall is that it takes the body a while to recover from general anesthesia, and you'll have to stick around for a couple hours after the procedure. And of course, general anesthesia comes with a bigger price tag.
Otherwise, some people just receive pain medication during their colonoscopy, so they are aware of what is happening throughout the procedure but the scope doesn’t cause them pain. Whether you get anesthesia or pain medicine (or both) depends on several factors, so talk to your doctor about what’s right for you and if you have a strong preference.
3. The procedure itself takes just 30 to 60 minutes.
You’ll be dressed in a hospital gown and will be laid out on a table. An anesthesiologist may be present to monitor your vital signs throughout the procedure. Once you’re “under” (if you’re receiving anesthesia), a doctor will insert the colonoscope carefully through your anus.
Yes, it sounds unpleasant, but colonoscopies may be worth the mental discomfort. The scope sends a video image to your doctor’s monitor, allowing them to check for inflammation, polyps, ulcers, and more—which could help you catch problems like inflammatory bowel disease or even colorectal cancer.
A colonoscopy can also help make a diagnosis of irritable bowel syndrome. IBS causes no visible changes or damage to the colon, but if a doctor suspects IBS, they may choose to do a colonoscopy to rule out inflammatory bowel disease or colon cancer. If a patient has chronic digestive distress but a clear and healthy-looking colon, they may have IBS.
Finally, your doctor may also take a biopsy during the colonoscopy. This means they’ll remove a tiny sample of tissue (using a tool attached to the colonoscope) to test under a microscope, which can help investigate any abnormalities seen during the colonoscopy. (Don’t worry: You won’t feel this either.)
Although the colonoscopy only takes an hour tops, you’ll have to hang around for a couple hours after the procedure ends to recover from the anesthesia. You’ll also be required to have someone with you to give you a ride home (driving under the influence of anesthesia is a recipe for highway calamity).
Colonoscopies might be intimidating, but they’re very beneficial for catching common colon crises. Think of it this way: You get to take a nap, and in return, you get to learn potentially life-saving information about your health. Not bad, right?
Colonoscopy. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on December 9, 2021 at https://www.niddk.nih.gov/health-information/diagnostic-tests/colonoscopy.)
Patient education: colonoscopy (beyond the basics). Waltham, MA: UpToDate, 2019. (Accessed on December 9, 2021 at https://www.uptodate.com/contents/colonoscopy-beyond-the-basics.)