By Dr. Shellie L. Rosen, PhD, DOM, L.Ac.
Colorectal cancer is the second leading cause of cancer-related deaths in the United States. However, it is highly preventable and treatable with early detection.
Age 45 is the recommended time to begin regular screenings for colorectal abnormalities, but those with gastrointestinal symptoms or a family history of colorectal disorders may choose to begin sooner. At-home stool sample testing can be a cost-effective and convenient routine method to monitor colorectal health, but it is inferior to colonoscopies. A colonoscopy is a gold standard for colorectal cancer detection. Knowing your preparation and examination choices may help you schedule your next exam.
A colonoscopy is an exam that uses flexible tubing with a camera to investigate colorectal health. Additional tools remove irregular tissue (polyps) to test for potential cancer during an exam. Colonoscopies have an advantage over stool testing because they offer a form of detection, treatment, and prevention. The highly sensitive fecal immunochemical test (FIT or Cologuard) uses stool samples to detect blood, precancerous polyps, or abnormal DNA. They are convenient but can be limited in detecting polyps (benign or cancerous) and can produce worrisome false positives or dangerous ease with false negative results. Using Cologuard annually between colonoscopies can be helpful. Since colorectal cancer is highly preventable and treatable with accurate early detection, getting a colonoscopy (recommended every 10 years for those without risk factors) is a must.
The burden of colonoscopy preparation, fear of the procedure, and anesthesia issues may contribute to procrastinating the exam. Ask your doctor to prescribe a preparation that matches your needs to help clear your gut so your doctor can see the walls of your intestines and prevent a repeat exam.
Anesthesia for a colonoscopy is an important decision. Colonoscopies are personal, invasive, and uncomfortable. However, the activities of the inner gut do not induce pain sensations. Without anesthesia, you can drive yourself, immediately resume normal activities, and reduce complications. Staying awake for the exam means you will feel many odd sensations. You will need to relax and breathe. If you begin the process and cannot manage it, you will likely have to reschedule the exam.
I did my colonoscopy awake. The initial discomfort is the awkwardness of being vulnerable with medical professionals. Next, a burst of air is pumped into the intestines to expand it for the scope; you then adjust to the discomfort of the urge to “go” and the sensation of uncomfortable bloating. There are a few more moments where the scope is guided through the gut with external pressure. The sensations are unique but not painful. Awake, you can hear findings (if there are any), and if you wish, you can watch the monitor as the scope travels through your large intestines. Deep, slow breaths and a positive mindset helped me through little uncomfortable moments, and before I knew it, I was dressed and on the road. Whichever choices you make for your exam, do get one. We can prevent many colorectal-related injuries and deaths if we do. Abundant Blessings!