No one looks forward to a colonoscopy. But it’s one of the few screening tests that can really save your life—if you get it at the right time, the right way, and with the right follow-up. Here are key questions to ask your doctor about your colonoscopy…*
At what age should I start screening for colon cancer? According to the American Cancer Society (ACS), most people should get their first screening test at age 45—but based on your health profile and family history, your doctor might recommend an earlier age.
Which colon screening test should I get? Colonoscopy, which allows a physician to examine your entire colon while you are sedated, is the most widely recommended screen for colon cancer. Other tests such as flexible sigmoidoscopy, which examines only the lower part of the colon, and virtual colonoscopy, which uses a noninvasive CT scan, are available. Your doctor can review the pros and cons of each test—but colonoscopy is the gold standard.
What about a stool test? Stool tests look for blood in the feces, which can be a sign of a digestive problem or colon cancer. The ACS suggests getting this test every year—or the multitargeted stool DNA test (MT-sDNA) every three years. Ask your doctor whether a stool test should be part of your colon cancer-screening regimen.
Is there any way to make the “bowel prep” less unpleasant? There are a variety of products and tricks to make the bowel-cleansing process more bearable. Your doctor can explain which he/she uses and which might be best for you.
What can I eat and drink prior to my colonoscopy? Not all doctors are still requiring pure clear-liquid diets the day before the test. Check with your doctor for his recommendations.
Should I stop taking my medications and supplements? Antiplatelet drugs, such as clopidogrel (Plavix)…anticoagulants, such as warfarin (Coumadin)…and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin), naproxen (Aleve) and aspirin, are the medications most commonly stopped a few days prior to a colonoscopy. But there are others. Ask your doctor for advice on stopping any medication or supplements that you take.
Do you offer a choice of sedation type? Most patients are given a “twilight” sedative that leaves them conscious but relaxed—and typically pain-free during the procedure. Other patients receive full anesthesia and are not conscious during the procedure. Ask your doctor what type of sedative you may receive and discuss how deeply you prefer to be sedated.
What is your complication rate for colonoscopy? The main risk of colonoscopy is perforation, a small tear in the colon wall. In research, the incidence of perforation during screening colonoscopy was 0.01%. It’s perfectly reasonable to ask your doctor what his complication rate is for the test, and if it is higher than the statistic above, consider working with another doctor whose track record is better.
What is your plan if you find any abnormalities while doing my colonoscopy? If the doctor finds a growth (polyp), it will be removed and sent to a lab to determine whether cancer cells are present. Ask your doctor after the procedure if any polyps were detected, whether they were removed completely and when you’ll get the lab results.
* Nongastroenterologists are five times more likely than gastroenterologists, who have specialized training in performing colonoscopies, to miss colorectal cancer during this test. To find a gastroenterologist near you, consult the website of the American College of Gastroenterology at Patients.GI.org.