How Bad Is a Colonoscopy?

How Bad Is a Colonoscopy?

How bad is a colonoscopy? As with everything else, it depends on your attitude. I will go through the particulars of the two colonoscopies I have had. (I haven’t had my second one yet as I write this sentence, but I am in the middle of the prep for it and will update it as I go.)

Many think everyone over 45 or 50 should get a colonoscopy, but that is not the recommendation. If you are at average risk (no family history, chronic colon conditions, history of polyps, and a few other issues), then the recommendation is one of the following: colonoscopy every ten years if negative, a stool sample for occult blood every year, or a stool sample for blood and the DNA found in colon cancer. If either of the stool tests is positive, meaning that there is an elevated risk of cancer, then a colonoscopy is recommended. More tests show promise in studies and may add to our choices soon.

I was doing the yearly stool test for blood until earlier this year when I was found to have iron deficiency anemia. Since bleeding from the gut is the primary cause, I had an upper endoscopy, a long tube with a camera inserted through the mouth, much like a colonoscopy, but the other end. And I had a colonoscopy. 

Most people say that the prep is worse than the colonoscopy itself. I am in complete agreement. There are a few methods of preparation for the colonoscopy. In Minnesota, at the wonderful MNGI Digestive Health, they use the method I will describe, and I suspect you will get something similar. A week before the procedure, you stopped any supplements with iron or fiber. Easy. Three days before the big day, you go on a low-fiber diet. Not that big a deal. I gave up raw fruit and vegetables and a few of the cooked vegetables I like, such as Brussels sprouts. Still easy. Anyone can cook all their veggies and avoid fruit for two days. 

Now, it got harder. The day before the scope, you go on a clear liquid diet. A cup of coffee or tea is allowed, but no creamer. No solid food except Jell-O. No liquids that you cannot see through. You can drink Gatorade, clear soda, and juices without solids or pulp. That’s about it. I had some trouble, mentally, at least. I don’t drink juice or sugar. (see The Three Rules To Lose Weight and Keep It Off Forever, Second Edition) Even though no one gains weight prepping for a colonoscopy, mentally, it was difficult for me to drink the stuff, and I regret not drinking enough.

In the afternoon, you take two bisacodyl (Dulcolax) laxatives and drink a bottle of polyethylene glycol (PEG or Miralax), which is another laxative, in 64 ounces of sports drink. A bottle of PEG has fourteen standard doses. You drink 8 ounces every fifteen minutes until it’s gone. Some people gag or throw up, but most can drink it. Usually, during those two hours, you start to go to the bathroom. It starts normal and quickly becomes unpleasant. You probably shouldn’t leave the house or even the bathroom for a few hours until it settles down. It is not as bad as the stomach viruses because you usually don’t vomit, and cramping is not bad for most people.

The next day, you are still on liquids until about three hours before the colonoscopy. Then you take in nothing. If you drink, you are at risk of choking during the anesthesia. Four hours before the colonoscopy, you drink another half-bottle in 32 ounces of sports drink. There is less in you, so the diarrhea is not as bad.

You need a driver to take you home from the procedure. Once you get to the colonoscopy location, it is not so bad, except for the self-imposed anxiety. They take your information and guide you back to the procedure suite. They explain everything: you meet the doctor, the nurses, and the anesthetist, and you change into a gown. An intravenous line is put in your arm. In my experience, the nurses are superb, and you barely feel the needle. 

When everyone is ready, the anesthetist gives you the anesthetic. At MNGI, they use propofol. It’s great. You feel nothing, and a minute after they stop the drip, you are usually awake and feeling fine. They won’t let you drive or return to work, but you feel like you could. The doctor comes in, explains things, and your driver takes you home, or in my case, to Caribou Coffee for a latte and the breakfast I brought.

This colonoscopy was different. I had it today. My prep was less effective than they had hoped. That means there was still some fecal matter in the colon. That might have obscured findings. I had to do a double prep. Two days of a clear liquid diet and more laxatives this time. The procedure itself was the same. The IV was more difficult this time, but not bad. I was out for the procedure, and the doctor said the prep was good. I just had my first solid food. I have never had a better apple. 

The colonoscopy itself was fine. I was nervous, even with the second one, but there was no need. My wife thought I was complaining too much about the clear liquid diet, and she was right. It’s not that bad. I had no polyps, so I should not need another colonoscopy for ten years. If your doctor recommends you get one, don’t let the fear of the procedure stop you from having it. There are real risks, and your doctor can tell you about them, but for most people, it is like my experience. Unpleasant, mainly the prep. The procedure was so boring that I couldn’t stay awake.