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5 fun new facts about colonoscopies

March 21, 2017 | William E. Karnes, MD
colon cancer specialist dr. william karnes

OK, maybe describing these facts as “fun” in the headline is a bit of a stretch. As much as colonoscopy has improved in recent years, it’s still a bit of a bother. Neither you nor I would fuss with colonoscopies if they weren’t so good at preventing cancer.

And how many medical procedures have equal bragging rights? Colonoscopies don’t just detect, they actually prevent cancer by finding and immediately removing precancerous polyps.

But while not exactly fun, the colonoscopy of today is light years better than your grandfather’s, or even your father’s. Nimble new tools and updated practices are more comfortable for patients, require less recovery time and are better at finding potentially problematic polyps.

And get this: In many cases, you can keep eating right up to a few hours before your appointment. Goodbye daylong fasting.

Here’s the best news from recent advances in colonoscopy:

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Underwater colonoscopy

Colonoscopies typically use air to inflate the colon, allowing the scope to get a look-see at the walls.

Using water instead of air offers a couple of big advantages:

  • Flat polyps, hard to detect with regular colonoscopy, float up into the water, making them much easier to locate.
  • This method is also a lot more comfortable for patients. Air can cause gas pains both during and for hours after the colonoscopy. That doesn’t happen with water.

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Improved scopes

Modern scopes are more flexible and easier to maneuver, making them more comfortable for the patient during the procedure. In many cases, the tips of new scopes have flexible finger-like appendages that turn the folds of tissue in the colon wall so that the doctor doesn’t need to do so. That’s better for examining every fraction of an inch.

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Better screening

Newer equipment and underwater techniques don’t just make colonoscopy more comfortable, they’re also more effective at finding flat polyps, the problematic polyps that can turn cancerous over time. Higher resolution in the newer scopes allows us to see smaller polyps.

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Quicker recovery

Because many patients are sedated for their colonoscopies, they wake up groggy. They need someone to drive them home, and basically the rest of the day is lost. But underwater colonoscopy and more nimble scopes mean that you’re less likely to need sedation. Often, the discomfort people feel has more to do with anxiety than actual pain.

So I ask my patients about what they most want, and let them know that they can change their mind if the milder measures don’t work. An anti-anxiety medication might be enough for them; if that isn’t working for them, we can switch over to a pain reliever. Some of my patients prefer to be “out” for the procedure, with anesthesia from which they wake up feeling fresh, as though they’d just had a good nap.

Those who choose not to be sedated can drive right off to work or to the nearest restaurant or beach if they want.

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Eat and drink hearty(ish)!

If there’s one thing patients universally dread, it’s the prep before the colonoscopy. The laxative liquids to clean out the colon can taste awful. On top of that, the day-long clear-liquid fast leaves people hungry.

New research by my colleague, UCI Health gastroenterologist Dr. Jason Samarasena, is showing that you can eat right up to five hours before your procedure, if those foods are what’s called “low residue” — that is, foods like eggs and bacon, white bread and pasta with butter, that don’t leave any fiber for the colon to eliminate.

The study showed that this actually left the colon cleaner than a full-on food fast. An end to dieting before colonoscopy? ›

And certain over-the-counter laxative powders can be mixed with soda, sports drinks, flavored waters and the like to make that part of the prep taste the same as your favorite beverages.

Of course, consult your own doctor about the options for your own prep. I tell my patients, it’s important to take your last set of laxative beverages five hours before your procedure to leave the colon in the best possible condition. Not all patients realize how important a good prep is; I can use the latest techniques and the greatest care in finding problem polyps, but it’s even more important for you to do a good prep.

It really takes the two of us to prevent colon cancer.

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