What to expect when you have a colonoscopy

Cedrek McFadden, MD

Colon and Rectal Surgery

Colonoscopies can seem overwhelming, and that may lead you to avoid them. But they are an important part of preventive care and necessary if you are experiencing certain symptoms. Colorectal surgeon Cedrek McFadden, MD, shared what happens before, during and after a colonoscopy to help ease your mind.

There are two reasons to have a colonoscopy:

1. Diagnostic colonoscopy. You are experiencing symptoms such as bleeding, pain, changes in stools or bowel habits, or unexplained weight loss.
2. Screening colonoscopy. You have reached the age of 45 or have a family history of colorectal cancers or polyps, but you don’t have any symptoms. 

“In May 2018, the American Cancer Society changed its guidelines and now recommends people with average risk get an initial screening colonoscopy at the age of 45,” said Dr. McFadden.

The night before your colonoscopy

A colonoscopy begins with prep the night before. The prep includes a medication you will empty into a cup and mix in water, sports drink, tea or juice. It is easiest to drink when cold, like a regular beverage. You need to get the mixture down quickly, but there is no need to chug it. Just take sips. You may be instructed to split the prep into two doses with specific times to take them before the procedure. Be sure to closely follow the instructions and take the entire prep.

The morning of your colonoscopy

What will you need to bring with you?

• ID, like a driver’s license 
• Insurance cards
• The medication you are taking – prescriptions, over-the-counter medications and supplements, including herbal supplements

On the morning of your procedure, you’ll be taken to a prep room. You will have an IV placed and will provide your medical history while going over a few intake items.

“Please leave jewelry and valuables at home and leave your cell phone with your friend or family member,” said Dr. McFadden. “Then you’ll be rolled in your bed to the procedure room.”

During your colonoscopy

“We use propofol as anesthesia for most colonoscopies. This will ensure you are comfortable and don’t feel anything during the procedure. You probably won’t remember anything from the procedure room because you will be asleep,” said Dr. McFadden.

During the colonoscopy, the doctor will use a colonoscope, a lighted, flexible tube with video, to look around the large intestine for polyps, or bumps, in the colon. If a polyp is found, it is removed and sent to the pathologist, where it will be examined under a microscope.

“If the doctor can’t remove the mass or large polyp, he or she might talk to you about surgery or some other procedure,” said Dr. McFadden.

After your colonoscopy

After the procedure, you’ll be taken to a recovery room to awaken from the anesthesia until your care team determines it’s safe for you to go home. 

“When you leave, you’ll be in a wheelchair and a friend or family member will drive you home. When you get home, you can eat what you like. You can gradually advance your diet as you can tolerate more. Do not drive for 24 hours after your colonoscopy,” said Dr. McFadden.

A colonoscopy is a procedure with low risk. However, call your doctor if you experience bleeding, abdominal pain or fever after your colonoscopy. If your colonoscopy is normal and you have no family history of colorectal cancer or polyps, you may not need another colonoscopy for 10 years.