By Rear Adm. Joyce Johnson, D.O.

Colorectal cancer kills around 50,000 people each year in the U.S., but these deaths could be prevented if everyone were screened appropriately, enabling early diagnosis and treatment.

Colonoscopy is one of several procedures to screen for colorectal cancer — others include testing fecal matter for blood (currently the subject of a VA study), fecal DNA testing (under the trade name Cologuard), flexible sigmoidoscopy, and “virtual” colonoscopy (computed tomographic colonography).

For most people, initial screening is recommended at age 50, continuing until age 75. Talk with your primary health care provider to determine what the most appropriate screening schedule and procedures are for you. 

If a colonoscopy is recommended, the step-by-step guide below will help you through the process.

Step 1: Work with your primary care provider to identify a gastroenterologist (the physician specialist who will do the colonoscopy).

Step 2: Contact your insurance company to make sure you understand any physician network issues and what your insurance will pay. 

Step 3: Schedule an appointment for the procedure. Choose a day when you have nothing else scheduled. It’s also easiest if you can spend most of the previous day relaxing at home, to facilitate your colonoscopy prep.

Step 4: Plan for a friend or family member to drive you home from the procedure. Driving yourself (or taking a taxi) isn’t permissible.

Step 5: A few days before the procedure, read the instructions provided by your gastroenterology (GI) clinic. Be sure to read all of them, and read them again the day before the procedure. These instructions will tell you how to take the bowel prep the day before the procedure and what to do the day of the procedure. Foods and most fluids are restricted the day of the procedure. If you take regular medications, talk with your health care provider about when to take them.

Step 6: Two days before the procedure, reduce your food intake. This will make your bowel easier to clean.

Step 7: The day before your colonoscopy is scheduled, begin the bowel prep as directed by your GI clinic. Typically, you either will be prescribed a liquid laxative to drink or pills to swallow. If you have other medical problems or sensitivity to aspartame, let your GI clinic know; that can affect which bowel prep your clinic prescribes. The bowel must be perfectly clean so your gastroenterologist can examine the walls of the entire area.

Step 8: The day of the procedure, after you arrive at the clinic, you will be asked to change into a hospital gown. A sedative will be administered by IV, so you are relaxed and comfortable during the procedure. The procedure itself usually takes about 30 minutes and includes inserting a small tube with light and camera attached through the anus and into the rectum and colon. The area will be examined carefully. If small polyps are found, they might be removed during the procedure. If there are larger growths, a biopsy might be taken for further examination. The tube is removed and the procedure is over.

Step 9: A short time after the procedure, you’ll start to wake up. When you are fully awake, it’s time to return home. There usually are no eating restrictions for the rest of the day.