Taking the Scary out of Colonoscopies: Debunking Common Myths

When patients hear “colonoscopy” it is common for feelings of uneasiness or even fear to arise.  The very prospect of having a colonoscopy for the first time is worrisome. For many, the idea alone of an invasive procedure involving the rectum is enough to cause them to postpone this important screening or some to not schedule at all. Thankfully however, many myths about this procedure are just that. Myths.

Overcoming these fears gets you more than halfway to your colonoscopy appointment.

To help ease some common fears regarding the procedure, here are some common myths we have debunked. . .

I Can’t Handle The Prep. The most common patient complaint isn't about time spent in the bathroom or the actual colonoscopy; it’s about how much they had to drink and the taste of the prep. Spacing out the portions, cooling the prep, drinking through a straw, and adding flavored packets are all options that will make the cleansing process no problem at all. 

Remember: the cleaner your colon, the better the physician can detect polyps, which is, after all, why you are there.

It Will Hurt. Prior to the procedure, patients are given either a combination of a narcotic and sedatives called "conscious sedation” (aka -“twilight sedation”), or MAC anesthesia.  With these drugs, most patients will sleep through the entire procedure and wake up with no memory of the experience. About 5% of people experience slight pressure or cramping, and state that it felt similar to the urge to have a bowel movement. 

If you are worried about discomfort, or have any fear related to the procedure, please tell your nurse or physician. They can help alleviate your fear and discuss options with you.

I Will Have To Stay In The Hospital. Colonoscopies are outpatient procedures, meaning, you will go home the same day. The procedure itself takes no more than 15-45 minutes and altogether you will be at the facility no longer than 2-3 hours, from start to finish.

I Will Have to Take A Week Off of Work. At the very most, you will need to take off the day before your procedure, to provide ease during the cleansing process and of course the day of your procedure. After you have completed your procedure, the facility will inform you not to drive or operate any heavy machinery for the remainder of the day. It is also advised, in general, to take the remainder of that day to rest, as you will be drowsy from the sedation and a little weak from the prep and clear liquid diet from the day before. Most patients are perfectly fine to resume normal activities the following day.

Virtual Colonoscopies Are The Same As Regular Colonoscopies. If you opt for a less invasive test — such as a virtual colonoscopy, capsule endoscopy, flexible sigmoidoscopy, air contrast barium enema, fecal occult blood test — and your provider finds something suspicious, guess what? You will need a colonoscopy. And that means more prep.

More importantly, studies show that depending on the resolution used, virtual colonoscopies are only useful in detecting polyps 10mm or greater in size. Looking at the reports for patients scheduled through the ColonoscopyAssist program, a vast majority of polyps found are 5-8 mm in size. In summary, not only do virtual colonoscopies not allow excision of any polyps, they also do not allow the best visualization in detecting them.

You Don't Need a Colonoscopy Until You Have Symptoms. This is perhaps the scariest of all myths. A vast majority of colon cancers are found in patients who did not have any pain or symptoms. Additionally, preventative screens help physicians find polyps before they develop into cancer. Unless you have previous symptoms or family history of colon cancer, schedule your first colonoscopy at age 50 and then follow your doctor's recommendation for follow up procedures. The risks of not having a colonoscopy far outweigh any concerns. 

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Ali Poonawala is the Program Director at the Colonoscopy Assist Program. The program assists uninsured and underinsured patients with colonoscopies.