Digestive Health

Frequently asked questions about colonoscopies

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Young Caucasian woman stretching by the river with confidence knowing what to expect from her colonoscopy procedure.


Find comprehensive answers to frequently asked questions about colonoscopies so you can feel confident about your digestive health.


By  Scott Estabrook, MD, Section Chief and Medical Director, Gastroenterology, Nuvance Health


Getting a colonoscopy can be an overwhelming procedure for many people. You might be asking yourself many questions about what to expect during the procedure and that is OK. Here are some frequently asked questions about colonoscopies and what you should know to better understand this critically important procedure used for early detection and prevention of colorectal cancer.


What is a colonoscopy?


A colonoscopy is a diagnostic procedure that allows a doctor, usually a gastroenterologist, to examine the inner surface of your large intestine or colon. It involves the insertion of a long, flexible tube, known as a colonoscope, through the rectum into the colon. The colonoscope, fitted with a light and a camera, captures images that enable the doctor to evaluate the colon lining for any irregularities or signs of disease.


Learn more about colonoscopies in this video: See what it’s like to get a colonoscopy screening


The primary goal of a colonoscopy is to screen for colorectal cancer and detect any precancerous polyps. As the third most common cancer diagnosed in both genders in the U.S, early detection of colorectal cancer is crucial for effective treatment. A colonoscopy can also assist in diagnosing and monitoring other conditions such as inflammatory bowel disease (IBD), diverticulosis and gastrointestinal bleeding.


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For individuals with an average risk for colorectal cancer, start a colonoscopy screening at age 45. However, based on your family history of colorectal cancer or other risk factors, your doctor may advise earlier or more frequent screenings.


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How do I prepare for a colonoscopy?


The preparation process typically includes a few critical steps.


Your doctor will provide detailed instructions on how to prepare, which may include dietary restrictions and medication adjustments. Following these instructions carefully is vital for a clear view of the colon during the procedure.


Commonly, colonoscopy prep involves a clear liquid diet and laxatives to empty the bowels, ensuring a clean colon and an unobstructed view for the doctor. Before the procedure, you may need to modify your diet, usually by avoiding foods with seeds, nuts or high fiber a few days prior to the colonoscopy. Your doctor will provide a comprehensive list of foods to avoid and the specific timeline for these restrictions.


Always inform your gastroenterologist about any allergies or medical conditions before the procedure. This will help them tailor the preparation process to your specific needs, ensuring your safety during the colonoscopy.


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What happens during a colonoscopy?

One of the most common questions asked is if you are awake for a colonoscopy. During the procedure, a colonoscope is used to examine the lining of the colon and rectum. A gastroenterologist, a digestive health specialist, performs this procedure and you typically receive sedation to ensure relaxation and minimize discomfort. Once sedated, the colonoscope is gently inserted through the anus and slowly advanced through the colon. The doctor meticulously examines the colon lining for any abnormalities such as polyps or signs of inflammation.


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Your doctor may want to take a biopsy during your colonoscopy which is standard practice. During the biopsy, a small piece of tissue is removed from the inside of your intestine for further testing and analysis. Your biopsied tissue will be analyzed in a pathology laboratory and screened for diseases such as cancer. Biopsies are also used for colorectal cancer screening. While a biopsy sounds scary, medical advances have made this procedure virtually pain-free.


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The duration of a colonoscopy can vary based on the complexity of the procedure and the patient. On average, it takes around 30 to 60 minutes. However, additional time for preparation and recovery may be needed, so plan for a few hours for the entire process, including pre-procedure instructions, the procedure itself and the post-procedure recovery period.


What happens after a colonoscopy?


After a colonoscopy, there are important considerations to ensure you have a smooth recovery. Here are some insights to guide you:

  • Recovery and post-procedure care: After the colonoscopy, you will be observed in a recovery area until the effects of sedation wear off. As drowsiness is common after the procedure, it is important to have someone accompany you home. Plan to rest and recover for the rest of the day. Mild discomfort, such as bloating or cramping, is common after a colonoscopy but should diminish within a few hours. If you experience persistent or severe pain, bleeding, or any concerning symptoms, contact your doctor immediately.


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  • Potential complications or side effects: While complications from a colonoscopy are rare, potential risks include bleeding, infection or a tear in the colon. Though these complications are uncommon, it is important to inform your doctor about any unusual symptoms or concerns immediately.


  • Resuming regular activities: Most individuals can return to their regular activities, including work and exercise, the day after a colonoscopy. However, follow your doctor's instructions and avoid strenuous activities for a short period. Your doctor will provide specific guidelines based on your individual situation.

Is a colonoscopy covered by health insurance?


Most insurance plans cover colonoscopy. However, coverage can vary based on several factors:

  • Insurance provider: Different insurance providers have different policies regarding colonoscopy coverage. Reach out to your insurance company directly to understand your plan's specifics.


  • Plan type: The type of insurance plan you have, such as HMO, PPO, or Medicare, can affect coverage. Some plans may have specific requirements or limitations for colonoscopy coverage.


  • Medical necessity: Whether a colonoscopy is considered medically necessary can affect insurance coverage. Routine screenings for individuals at average risk are often covered, while diagnostic colonoscopies for specific symptoms or conditions may have different coverage.


If you are concerned about colonoscopy cost, financial assistance options are available. Nuvance Health offers financial assistance programs. Contact your doctor or the facility where you plan to have the procedure and ask about any available assistance programs they may offer.


Find a gastroenterologist near me.


The bottom line: You might have many questions about getting a colonoscopy and that is completely normal. Getting a colonoscopy is crucial for the early detection and prevention of colorectal cancer and other gastrointestinal conditions. It allows gastroenterologists to examine the colon for abnormalities and precancerous polyps, which can be removed during the procedure.


While the thought of undergoing a colonoscopy can be daunting, understanding the process and preparing properly can help alleviate anxiety. By following your doctor's instructions for preparation and post-procedure care, you can ensure a smooth and successful colonoscopy experience.


Remember, early detection through regular screenings can significantly increase the chances of successful treatment for colorectal cancer.


Learn more about the Digestive Health Institute at Nuvance Health.