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At your annual checkup, your doctor recommends a colonoscopy to rule out colorectal cancer. You begin to sweat. Your imagination runs wild. You know a little about the procedure and what you know fills you with fear and embarrassment. Understanding more about this lifesaving procedure can calm you and give you the confidence to schedule your exam.

What is a colonoscopy?

It's an important screening tool for colorectal cancer, which is cancer of the large intestine (colon). It is the second leading cause of cancer death in the U.S. and potentially the most preventable. Many needing this simple and painless procedure have a misplaced sense of modesty and decide against it—with devastating effects.

What happens during the procedure?

During a colonoscopy, a flexible tube with a light and camera is inserted into the rectum where it examines the entire length of the intestine. The scope allows the doctor to see and closely inspect for polyps, and remove them before they become cancerous. The exam takes approximately 30 minutes and patients are typically put into a light sleep for this outpatient procedure. Because anesthesia is used, patients will need someone to drive them home.

How do I prepare for a colonoscopy?

You go to the bathroom—a lot! To get the clearest pictures possible, the colon must be completely cleaned out. We ask our patients at Lincoln Hospital to follow a special diet the day before and take a strong laxative. We also now have a better selection of laxatives that don't require you to drink a gallon of water.

How will I feel afterwards?

Physically, patients generally feel a little woozy due to the anesthesia and may experience mild gas discomfort. However, you can eat afterwards, and it is suggested you drink lots of fluids.

Mentally, patients say they feel relieved and empowered. Most say the anticipation of the colonoscopy was much worse than the actual procedure. When it's over, they realize they've taken a great step toward protecting their health. Women, especially those who've had children, say having a colonoscopy is not a big deal. And if you feel embarrassed having a colonoscopy, just imagine what you'd go through with full-blown colon cancer.

What are the signs of colorectal cancer?

Colorectal cancer begins as a polyp—a small growth in the colon wall. Like any growth, if it continues to get bigger, it can keep your colon from working properly and become cancerous. If you have any of these symptoms, see a doctor immediately:

  • Bleeding from your rectum.
  • Blood in your stool or in the toilet after a bowel movement.
  • Change in stool shape.
  • Change in bowel habits.
  • Cramping or pain in the lower stomach.
  • A feeling of discomfort or an urge to have a bowel movement when there is no need to have one.

Even if you have none of these symptoms, most physicians begin screening for colorectal cancer at age 50. Screening may include a digital rectal exam, fecal occult blood test, double-contrast barium enema, sigmoidoscopy or colonoscopy.

If you have risk factors that make you more susceptible at a young age (family history, past polyps, ulcerative colitis or Crohn's disease or a hereditary colon cancer syndrome), you should be checked earlier and more often.

In general, colonoscopy is a simple, painless procedure. The vast majority of patients say the peace of mind it gives is well worth any momentary or imagined embarrassment.

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