A Clearer Picture:

Alleviating Fears of Colonoscopy

by Aaron Becker

The “C” Word
I know the benefits of early detection, and chances are that you do, too. I am lucky enough to speak to and spend time with loved ones who have benefited from the early detection of serious ailments such as cancer.

An abundance of reference material, word of mouth, and professional medical recommendations are increasingly easy to come by. Yet many people are still hesitant to go through with or even schedule a test as standard and safe as a colonoscopy.

Is it the fear of the big “C” that keeps you from entering a waiting room at your local gastroenterologist? Or is it the discomforting thought of a gastroenterologist’s invading camera? Whatever your reason, the risks of being tested really do not outweigh the reassurances that come long after the procedure. A colonoscopy could detect an ailment early enough for you to seek treatment and continue to live comfortably, but more common, it results in the simple reassurance that everything is fine. Isn’t that worth putting up with a little discomfort once every 10 years for most people?

Prep and Procedure
I recently discussed the procedure, the risks, and the advantages of this highly recommended, regular method of screening and testing with David Ford, MD, MSc, FRCPC, Chief of Gastroenterology of William Osler Health Centre, Etobicoke Campus in Etobicoke, Ontario, Canada, and Vice President of the Vaughan Endoscopy Clinic in Woodbridge, Ontario, Canada.

Dr. Ford described the procedure in this way: A colonoscopy is a visual examination of the inside of the colon through the use of a colonoscope, a video camera attached to a long, flexible tube approximately half an inch wide. The procedure is conducted to detect and remove polyps, identify any abnormalities, coagulate bleeding, and obtain biopsies to detect benign or malignant growths.

Preparation is pretty clear cut—first, and most important, Ford recommends that you consume only clear fluids 24 hours prior to the procedure. (The recommended length of time may vary from practice to practice.) He also suggests preparing three days before a colonoscopy by refraining from eating high-fiber fruits and vegetables, grains, or any food with seeds. (When was the last time a doctor told you not to eat your fruits and vegetables?!) You will also require a laxative to cleanse your bowel. You should consult with your own gastroenterologist for more specific prepping instructions.

During the procedure, a gastroenterologist may detect abnormalities such as growths or polyps. These can be removed during a colonoscopy and are tested for abnormalities. This process allows effective diagnosis and treatment of an ailment, many times without leading to major surgery.

A colonoscopy typically lasts less than 30 minutes. Patients are sedated during the procedure. According to Dr. Ford, a colonoscopy is routine and safe, and rarely causes complications. In fact, he says that about 90 percent of his patients who have had a colonoscopy would be comfortable with having one again. In most cases, Ford notes, (no pun intended), “The day of the test goes really smoothly.”

Why Have It?
If patients are sedated and testing usually is accomplished without a hitch, are your concerns about having the procedure valid? It is important to note that your worries about testing are common and understandable. However, embarrassment regarding the delicate nature of the test and the fear of finding something serious can hopefully be eased with solid education and preparation.

Dr. Ford urges a colonoscopy for anyone over 50 years of age, as recommended by a referred gastroenterologist or physician (depending on your medical history), but also if you encounter drastic changes in bowel patterns, or unprompted or unexpected weight loss. Numerous other sources also suggest a colonoscopy for blood in stool or abdominal pain. However, Ford cautions that pain alone is not necessarily an indication that the procedure should be performed to detect a serious ailment. Most possible indications and a referral for a colonoscopy or any other medical screening should come from your physician. “It is important to get referred to a good endoscopy center,” says Ford. In fact, Ford suggests that you see a gastroenterologist with significant experience—at least five years regularly performing colonoscopies—and then address your concerns with him or her. An experienced specialist will be able to allay fears regarding testing and serious findings such as colon cancer.

If you are concerned about the possibility of dire news as a result of a colonoscopy, delaying or refraining from testing makes even less sense. If you do the research on your own, you will find what experts such as Ford already know—the chance of diagnosing something serious and untreatable is very low. Ford notes that only about one percent of those who have a first-time screening colonoscopy ever encounter a serious condition. And, a serious condition found early can be more successfully treated. So, why not follow general, global medical advice and reassure yourself?

Note that colon cancer is only one ailment among those that are extremely treatable if detected early. Colonoscopy detects diverticulosis (pouches that form on the colon wall), which can be treated with a high-fiber diet. Diverticulitis, which occurs when these pouches become inflamed or infected, is often treatable with antibiotics. Polyps are found most commonly—about 30 percent of the time, according to Ford—and are easy to remove during the procedure. Since colon cancer starts as a polyp, removal of the polyp prevents colon cancer. In fact, most of the common abnormalities or ailments your gastroenterologist may find are manageable. In addition, “if detected in the early stages, colon cancer has a 95 percent cure rate,” reassures Ford.

Regular testing leads to better outcomes and greater reassurance for yourself and your loved ones. By educating yourself and speaking with an experienced gastroenterologist about the benefits of having a colonoscopy, apprehension and fears can be reduced. The benefits really do outweigh the risks, anxieties, and discomfort. The few days of uneasiness every few years pale in comparison to the reassurances of living longer, and living well.

David Ford is a Fellow of the Royal College of Physicians and Surgeons of Canada (FRCPC) and an Executive Member of the Toronto Digestive Disease Association. For more information about the colonoscopy procedure, visit the Vaughn Endoscopy Clinic website, and please, consult your physician.

Aaron Becker holds a BA in English and is a freelance writer based in Pittsburgh, PA, specializing in health care and human interests. He has written and edited more than 300 articles that have appeared in at least 10 print and online publications. Aaron can be reached at ambecker77@gmail.com.