Dispelling Colonoscopy Myths: Debunking Misconceptions For Better Health - Dr Sundeep Shah

Modern medicine involves diagnosing and treating active diseases, as well as identifying certain conditions at an early stage and take appropriate actions before they can advance to full-fledged dreaded disease condition. Colonoscopy is one such medical procedure which fulfils both these aims of modern medicine.

Few common symptoms for which colonoscopy is carried out includes evaluation of patient’s symptoms like diarrhoea with or without blood, bowel movement abnormality, abdominal pain and for screening of colon cancer in high-risk patient.

Colonoscopy is the study of the inner lining of the large intestine (also called as colon) by the passage of a long flexible tube called as colonoscope through the anus/rectum of a patient. This is the reason for fear, apprehension and misconceptions about colonoscopy in general public and hence they would prefer to avoid the procedure at the first mention of it. Let’s try to debunk a few of the common myths about colonoscopy in this short article.

Myth 1

Blood tests, stool test, sonography etc will help to arrive at diagnosis of my bowel complaints, so I don’t need colonoscopy.

Fact

These tests are very preliminary tests and are insufficient to diagnose colonic diseases. Colonoscopy is generally a more accurate test for diagnosing colonic diseases as it can visualise the inner lining of the colon for any abnormality and directly take material from them (called as biopsy) for further analysis, which then provide diagnosis.

Myth 2

I am perfectly healthy, so I don’t need a colonoscopy

Fact

The incidence of colon cancer is very high in the Western world, especially after the age of 45 years. If this disease is identified at an early stage, near complete cure can be obtained. However, patients are perfectly healthy at an early stage of colon cancer and only colonoscopy can identify this disease at a very early stage (called as screening colonoscopy).

In the Western world, screening colonoscopy is recommended for all (even healthy adults) after the age of 45 years to identify colon cancer at an early stage. Those having family history of colon cancer, cancers in other areas of the body and polyps in the digestive system will be recommended screening colonoscopy even earlier.

Because of the western lifestyle which is now prevailing in India, the incidence of colon cancer is also on increasing trend in our country. Though screening colonoscopy is not yet recommended in India, it could be a norm in the future.

During colonoscopy, if small growths called as polyps are seen in the colon, then these polyps can be removed at the same time. Polyps are generally considered as pre-cancerous lesions. If they are not removed, then may grow over years and turn into cancer. Thus, removal of polyps during colonoscopy prevents development of colon cancer in the future.

Myth 3

I am scared as colonoscopy will be a painful procedure and need hospitalization

Fact

Thanks to modern anaesthesia – sedative and short-acting anaesthetics which are given intra-venously during colonoscopy, makes the procedure a painless experience. Patients sleep through the entire procedure and may not even remember that the procedure is done on waking up.

Most colonoscopies are over within 20–30 minutes with a subsequent observation time of 1–2 hours in the hospital/clinic and the patient can resume all normal activities including work the next day. Some patients can tolerate colonoscopy even without sedatives.

Myth 4

I will need to have a lot of dietary restrictions before colonoscopy and will I have to drink a lot of tasteless cleaning solution a day prior to colonoscopy. Will taking only laxatives before colonoscopy not be sufficient to clean my colon.

Fact

It is absolutely essential to remove all the fecal matter (stool) from the colon before doing colonoscopy to get a clear view of the lining of the colon. Residual fecal matter in the colon will lead to incomplete study and missing out on any colonic abnormalities.

Laxatives will not be able to achieve complete colonic cleaning and hence one needs to drink colonic cleaning solutions (also called as colonic lavage solutions) few hours prior to colonoscopy. It will be preferable to have only liquid diet and avoid high fibre/high residue diet one day prior to colonoscopy.

Presently available colonic lavage solutions are flavoured and between 1.0 – 2.0 Litres of the solution needs to be taken either as a single dose or as a split dose spread over a few hours. After colonoscopy is over, one can return to routine diet same day.

Myth 5

Colonoscopy is a dangerous procedure and has lots of side effects

Fact

Colonoscopy is a very safe procedure and the benefits of the procedure far outweighs the rare, occasional, fearful risk of perforation (tear) of the colon. This occurs in 1 in 1000 to 2000 procedures. A few patients experience some abdominal bloating and cramping after the procedure, which generally settles down in a few minutes as flatus is expelled out.

Myth 6

Colonoscopy is an unhygienic procedure, embarrassing to me and my privacy will not be maintained

Fact

Colonoscopy is done in special rooms called as endoscopy suites, which are specially designed to carry out such procedures. Highest level of hygiene and sterilization are maintained in these suites. Special care is also taken to maintain patient’s privacy and dignity without much exposure of body parts.

Myth 7

Colonoscopy is a very expensive procedure

Fact

Though the cost of the colonoscopy can vary from hospital to hospital, colonoscopy is generally an affordable procedure and based on the indication for which it is done, it is also covered under Mediclaim insurance.

Since there is never a “one size fits all” in medical procedures; it is best for patients to consult a gastroenterologist prior to undergoing a colonoscopy. The Gastroenterologist can thoroughly evaluate you with respect to the need for colonoscopy, timing and prior preparation, and can clarify all your doubts and myths of colonoscopy.