ABOUT COLONOSCOPIES:A Colonoscopy is an outpatient procedure that lets your health care provider see inside the entire large intestine and rectum. If necessary, during the colonoscopy it is possible to remove small suspicious areas such as polyps or obtain biopsy samples. A colonoscopy may allow accurate diagnosis and some treatment without an operation.
WHAT IS A COLONOSCOPE:A colonoscope is an instrument used to perform a colonoscopy. It is a long flexible tube about ½ inch in diameter with a light and a small video camera at the end. Special instruments can be passed through the colonoscope to allow some surgical procedures. The scope also blows air into the colon to expand it for clear viewing of the colon by the doctor.
WHY HAVE A COLONOSCOPY:
- Your medical team wants to explore the cause of abnormal pain, rectal bleeding, unexplained weight loss, chronic diarrhea, or other internal digestive problems in the colon or rectum
- You have family that has a history of colon polyps or colorectal cancer
- A Colonoscopy is highly recommended for everyone even if there are NO symptoms. The purpose of a colonoscopy is for early detection of pre-cancerous stage 0 or 1 polyps that may be present on your intestine or rectum.
WHEN TO SCHEDULE YOUR FIRST AND FUTURE COLONOSCOPIES:
For a person who has average risks for colorectal cancer and NO symptoms, the recommendation by the American Cancer Society is to have your first screening test at age 45. If your risk is higher because of a family history of colorectal cancer, ethnically, or you have symptoms, your health care provider might suggest a colonoscopy or other screening test earlier than age 45 years.
Therefore, you should discuss when to start screening with your health care provider. Follow-up recommendations for future colonoscopies will depend on the results of the first one. If you have no polyps and low risk, you might be able to wait 10 years before having another one. If you do have polyps and are considered high risk, you might have to have a yearly procedure. Regular screening should be done through the age of 75. After that, you and your healthcare provider can decide on further screening needs.
WHO DOES THE COLONOSCOPY AND WHEREA special doctor called a gastroenterologist, or GI doctor usually does the colonoscopy. This type of doctor specializes in the digestive system. A Colorectal surgeon may also do the procedure. Your procedure medical team will also include a nurse and an anesthesia specialist. The procedure is typically done in a medical facility or hospital on an outpatient basis.
PAYING FOR COLONOSCOPY
The Affordable Care Act (ACA) requires both private insurers and Medicare to cover the costs of colorectal cancer screening tests because these tests are recommended by the United States Preventative Services Task Force (USPSTF). The law stipulates that there should be no out-of-pocket costs for patients, such as co-pays or deductibles, for these screening tests.
The ACA doesn’t apply to health plans that were in place before it was passed in 2010, which are called “grandfathered plans”. You can find out if your insurance plan is “grandfathered” by contacting your health insurance company or your employer’s human resources department. Even if you have a “grandfathered plan”, it may still have coverage requirements from state laws, which vary, and other federal laws.
You may also be eligible for a free screening colonoscopy through the organization stop cancer now. Take a free screening colonoscopy quiz and see if you are eligible for a free reduced-cost screening colonoscopy.
Independent Ambulatory surgery centers can save you a lot of money, especially when compared to hospital pricing. Out-of pockets costs will almost surely be higher if your procedure is performed at a hospital-owned facility. Studies have shown that prices at independent surgery centers are typically 40% less than at hospitals and hospital-affiliated surgery centers for the same procedures.
CDC’s Colorectal Cancer Control Program (CRCCP) provides funding year-round to certain states and indigenous people across the United States. The program provides colorectal cancer screening services and diagnostic follow-up to low-income men and women aged 50-64 years who are underinsured or uninsured for screenings when no other insurance is available. If you are not eligible for the program or live outside a CRCCP- funded state, you should call 1 (800) 4-cancer or call your local department of health to ask about other colorectal screenings options that may be available locally in your community.
During Cancer Awareness month normally in March, the CDC Colorectal Control Programs and Gastroenterologists with the American Gastroenterologists Association (AGA) are joint efforts to offer colorectal screening services That’s free Colonoscopies. Kits are available to qualified uninsured patients who may otherwise be in a position to get this life-saving test.
PREPARATION FOR A COLONOSCOPY
It is critical to prepare your bowel by clearing out your colon and rectum for the colonoscopy to be successful. It is the most unpleasant portion of the procedure. The discomfort is temporary and only lasts a short period of time normally less than 24 hours. A colonoscopy can result in early detection of cancer which may eliminate the need for future surgery, chemo, or radiation all of which are much more unpleasant. Preparation for Colonoscopy requires dietary modifications, bowel cleaning, and taking your medications.
Some medical providers may suggest you avoid corn, nuts, seeds, and popcorn for at least three days before the procedure. Others might suggest a low-fiber diet for two days before the colonoscopy. The day before the procedure you should not eat solid food or drink alcohol. Ask your doctor for specific instructions.
You will be able to drink clear liquids, including water, black coffee, tea, ginger ale, apple juice, white grape juice, and clear broths. You must avoid all foods that contain red, blue, or purple coloring.
You should not drink or eat anything at all for at least four hours before the colonoscopy. Be sure to drink plenty of fluids the day before while you are doing your bowel prep. If you are having your colonoscopy with general anesthesia, then you cannot drink anything after midnight on the night preceding your test.
There are a few different kinds of bowel preparations for colonoscopy, almost all of them liquid. Your doctor will tell you what kind is best for you based on your medical history and their particular preference. Some of these products are prescription-only, while others are available over-the-counter. They all have the same goal — to clean out the colon.
The time of day or night that you will have to start drinking the solution will depend on when your procedure is scheduled. You will be asked to consume the entire amount of liquid within a specific time period. There is also something called “split-dosing.” In split dosing, you will be asked to drink half of the bowel preparation the night before and then stop. You will get up in the morning and do the other half of the dose in the morning, finishing up at least four hours before the procedure itself. In general, split dosing results in cleaner bowel preparations.
There are things that might help you to drink the solution more easily. These include using a straw to drink the liquid and cooling the solution in the refrigerator before drinking it. You can add lemon drops or chew ginger candy. You will need to stay close to the bathroom during the bowel preparation period. A split dose might make the preparation easier. You will know you have completed the job when your diarrhea looks clear and yellowish, like urine.
You may experience skin irritation around the anus due to the passage of liquid stools. To prevent and treat skin irritation, you should:
- Apply ointment to the skin around the anus before drinking the bowel preparation medications. These products can be purchased at any drug store.
- Wipe the skin after each bowel movement with disposable wet wipes instead of toilet paper. These are found in the toilet paper area of the store.
- If necessary, wear “DEPENDS’ or similar to absorb leaking fluid.
You should consult with your prescribing doctor about whether you should continue or discontinue each of your medications and when. Do not stop these medications on your own. Restart these medicines after the procedure, as directed by your medical team.
THE COLONOSCOPY PROCEDURE
The procedure will take about 30 to 60 minutes. When you get to the medical facility you will change into a hospital gown. You will be in a private room with a sheet draped over your body.
A needle will be inserted into a vein in your arm to receive IV fluid. You might feel a sting from the IV needle when it goes in. Next, the anesthesia specialist will give you a sedative through an intravenous tube.
During the test, you’ll be asked to lie on an exam table on your left side with your knees pulled up. Your doctor might insert a gloved finger into the rectum to examine it before putting in the colonoscope. The colonoscope is lubricated with gel so it can be inserted easily into the rectum. To start the procedure the doctor blows some air through the small tube into your colon. This inflates the colon slightly so the doctor can see better. You might need to change your position during the procedure. This is to help the doctor move the colonoscopy tube or get a better view. The doctor or nurse will help with this.
It is then passed all the way up to the beginning of the colon, called the cecum. The doctor will look carefully on the monitor for any abnormalities or polyps on the inner walls of the colon and rectum as the colonoscope is slowly removed.
If an abnormal growth or polyp is detected in your colon or rectum during the procedure, the doctor will try to remove it. In addition, a biopsy will be taken if necessary. This is not usually painful, and the doctor will stop any bleeding. If the growth is too large or complicated to remove during the colonoscopy, it will be removed at another time. Any biopsy or tissue removal will be sent to a lab for further analysis. During the procedure, you may feel discomfit from lying still for a long time. If you are awake, you may have some cramps. If so, tell your nurse.
AFTER THE COLONOSCOPY
After the procedure, you will need to stay at the center until you are fully awake (about an hour) and until you urinate before you are able to go home. You will need a ride home because you cannot drive until the anesthesia fully wears off. Your doctor or nurse should give you specific instructions on what you can and can’t do after the test.
Because air is pumped into the colon and rectum during the test, you might feel bloated, have gas pains, or have cramping for a while after the test until the air passes out.
If biopsies are done as part of the procedure, the results will typically be available within a few days, although some tests on the biopsy samples might take longer. You will need to follow up with your doctor after the procedure to get your results.
If a polyp is removed or a biopsy is done during the colonoscopy, you might notice some blood in your stool for a day or two after the test. Serious bleeding is uncommon. Should that occur, notify your medical team right away.
You can resume your regular diet that day unless instructed otherwise.
It is estimated that worldwide 1,880,725 people will be diagnosed with colon cancer this year. The good news is that the five-year survival rate of patients diagnosed at an early stage and treated at an early stage is 91%. The 5-year survival may decrease to as low as 15% if the cancer spreads. Colonoscopies are very important in early cancer detection.
Avoiding the procedure may result in a missed opportunity to catch cancer at an early stage. Keep in mind, that treating cancer at a later stage may require extensive surgery, chemo, or radiation treatment all of which are much more painful and uncomfortable, for months. The preparation and having the colonoscopy may be inconvenient and somewhat unpleasant but all of it is temporary. It is a small sacrifice considering…. IT MAY SAVE YOUR LIFE!!! To learn more about cancer signs and symptoms, how to create a family history, and more, please visit our website.