Sh*tty news: Colorectal cancer is on the rise in young people. And millions of adults are affected by other types of GI issues like IBS. For those reasons and more, you might need to schedule a colonoscopy in the near future to screen for certain conditions.
But if that word “colonoscopy” concerns you, we’re here to help. Let’s break down what the procedure actually means and how to prep for it.
It’s when — you guessed it — a scope is put in your colon. The goal: to detect abnormalities in the colon (aka large intestine) and rectum. So it’s mostly preventative. How it works: Typically, carbon dioxide is pumped into the colon to inflate it so doctors can get a better view. They might remove abnormal tissue and/or take samples.
A doc might recommend a colonoscopy if you’re dealing with GI issues (think: abdominal pain or chronic diarrhea) or have a family history of colon cancer. Thing to know: The US Preventive Services Task Force recommends screening for colorectal cancer at age 45, lowered from 50 last year. And the American College of Physicians (another legit panel of doctors) suggests that Black people — who are about 20% more likely to get colorectal cancer than other groups — get screened by 40. The Affordable Care Act requires private insurance and Medicare to cover colorectal cancer screening tests if you’re between the age of 50 and 75, which can include colonoscopies. But it’s worth checking with your insurer about your coverage.
Once you’ve booked your appointment (you got this) make sure you take the day off work. Because you could be woozy from anesthesia. Another to-do list item: Secure a designated driver. Even if you’re Ubering, you’ll need a buddy to help escort you home. Because helping your sedated self get back out into the world is what friends (or parents) are for.
One to three days out, get ready to empty your colon. That means you’ll want to steer clear of high-fiber foods (whole grains, nuts, lentils, corn) and go with low-fiber options (white rice, chicken, applesauce). Because those foods can pass easier through your body. And you’ll also need to pick up your laxative liquid, aka the “prep” medication that you’ll be drinking before your appointment. (It’s the thing that will get your bowels moving.)
You’ll be asked to eliminate solid foods about 24 hours before your appointment. (Pro tip: scheduling a morning procedure could make for an easier fast.) And then get ready to drink up. You’ll be ingesting plenty of prep, per your doctor’s instructions — which could be a certain amount of cups per hour. Prep is typically a liquid mix that you have to sip on, steadily, the evening/morning before your appointment. It can come in a gallon jug. And it can be… less than delicious. One person at Skimm HQ called it “liquid chalk.” Another: “barf.”
One strategy for taking down the not-so-tasty drink: Alternate sips of prep with something fizzy like seltzer. Note: Do not chug it if not instructed to. And don’t ask why.
Then, let the prep do its job. It will. Soon you’ll be spending plenty of time on the toilet pooping. It will be liquidy and it will be a lot. So make sure you have plenty of phone battery and an available bathroom. Perhaps access to a bidet or some baby wipes, too. Know that you can get through this. Especially when you think about the potential future problems you’re avoiding by letting a doctor explore your gut. Knowledge is power.
Make sure you finish the prep. Two hours before your appointment, stop sipping liquids altogether. And if you aren’t already, make sure you’re wearing comfy clothes.
You might be asked to take a COVID-19 test, and then to undress and put on a gown. After that, you’ll get an IV with anesthesia. It will work soon. Your doc will probably have you lying on your side on the exam table. If you’re under heavy sedation, you’ll be knocked out, and the doc will go in. The whole procedure can take an hour or less.
After much of the sedative wears off (it could take another hour), head home to recover. You should be able to rehydrate and eat normally post-op, unless your doctor tells you otherwise. You might want to revisit those low-fiber foods because they’re not so hard to digest (and don’t make you poop as much). An electrolyte drink isn’t a bad idea, either. Feeling a little bloated and gassy is normal. And there’s a small risk of blood in your stool. But if you have that and/or persistent stomach pain or fever, you should call your doc. You should be able to return to work the next day. Results could be available as soon as that day, or after a few weeks.
Getting a colonoscopy isn’t exactly a walk in the park. More like a run to the bathroom. But it’s an important screening exam that can help you identify if you have any colorectal or GI issues early. And, hey, it’s great fodder for a scatological story to laugh about with friends later.
Skimm'd by Carly Mallenbaum, Anthony Rivas, Alicia Valenski, and Sagine Corrielus
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