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Can Colonoscopy be Painful? If I have no Symptoms, do I Still Need it?

By Medical Expert Team

May 24 , 2017 | 5 min read

It is estimated that about 1.93 million people were diagnosed with colorectal cancer in 2020. The disease caused about 0.94 million deaths in the same year. Colorectal cancer is one of the leading causes of cancer-related deaths worldwide. Awareness, screening, and early detection can reduce the burden of the disease and its associated mortality.

A colonoscopy is the gold standard when it comes to screening for colorectal cancer, pre-cancerous polyps, or tumours in the colon.

A colonoscopy is a medical procedure that involves using a long, flexible tube or scope to look for abnormalities, polyps, and growths in the rectum and colon (large intestine).


What is Colonoscopy?

The large intestine helps in the digestion and absorption of food and eliminating waste. The colon empties into the rectum, and the waste leaves the body through the anus.

A colonoscopy is a medical procedure where your doctor will use a long thin scope to look inside your rectum and colon. This scope is fitted with a camera that makes it possible for the doctor to visualise the insides of the colon. The procedure is also used to remove polyps and take biopsies of abnormal tissue. Colonoscopy can help prevent colorectal cancers by removing polyps that could grow malignant.


What are the symptoms of Colon Cancer?

  • Bleeding from rectum(bright red or dark)
  • Recent change in bowel habits which troubles persistently.
  • Incomplete evacuation (sensation of not able to pass stools completely.
  • Stools that are narrower than usual
  • Weight loss for no known reason
  • Feeling very tired (weakness and fatigue)

Any or a combination of these symptoms can be present in a patient. The signs and symptoms will also differ in severity based on the cancer’s location in the colon, size, and growth.

Find the best cancer specialist hospital in Delhi.


Why Does one Need Colonoscopy Test?

Your doctor at Max Hospital may recommend a colonoscopy to investigate lower gastrointestinal problems. If you present with the following symptoms, colonoscopy is recommended -

  1. Change in bowel movements (chronic constipation or diarrhoea)

  2. Cramping or pain in the lower abdomen that is not resolved

  3. Bleeding from the rectum or blood in the stools

Colonoscopy is the most reliable procedure that helps screen for colorectal cancer and polyps. Your doctor may recommend a colonoscopy even if other imaging tests do not reveal abnormalities.


Even if you do not experience any of the above symptoms, a colonoscopy may be recommended in the following cases –

  1. If you have a history of polyps in previous colonoscopies

  2. If you have a family history of colorectal cancer

  3. If you have a genetic condition associated with colorectal cancer

  4. If you suffer from conditions such as inflammatory bowel disease, ulcerative colitis, or Crohn’s disease

  5. If you are over the age of 50


Who should undergo a Colonoscopy?

Dr Neeraj Goel, Consultant-GI Surgeon at Max Super Speciality Hospital, Patparganj says, Colonoscopy is recommended to any patient having bleeding from rectum or have recent change in the bowel habits.

It is used as screening procedure for normal individuals after age of 50 years and earlier if there is strong family history of large intestinal cancer. Colonoscopy can be used for removal of small polyps and biopsy of the tumorous growth.

It is also used bowel diseases such as ulcerative colitis and Crohn's disease. It is used after treatment of bowel cancer for keeping a watch on any growth that may arise again.


How Do You Prepare For a Colonoscopy?

Your gastroenterologist at Max Hospital will explain how to prepare for a colonoscopy. Preparation for the procedure involves cleaning or emptying your colon, making it possible for the scope to pass through and for the doctor to get an unobstructed view of the colon.


These are some of the instructions that your doctor may ask you to follow -

  1. Follow a special diet - You will be asked to avoid solid foods on the day before the exam. You will need to restrict your diet to clear liquids such as water, clear broth, coffee or tea (without milk), sports beverages etc. You will need to avoid liquids that are red or purple.

  2. Take the laxative - Your doctor will recommend a laxative to be taken on the night before the colonoscopy. This could include pills and a liquid. You will need to prepare and take the laxative the night before and may also need to take some on the morning of the procedure.

  3. Stay close to the restroom - The laxatives recommended during the preparation are strong ones. You may want to avoid going out or driving during the preparation period.

  4. Know your medication - You must inform your doctor about any regular medication and check if it is safe for consumption before a colonoscopy.

  5. Bring a friend - You should bring a friend who can take you home after the procedure, particularly if you opt for a sedative.


How Is A Colonoscopy Performed?

Before the colonoscopy, you will need to change into a hospital gown and remove all jewellery. If you opt for sedation, you will be administered one intravenously. You will need to lie on your side with your knees pulled towards your chest.

The doctor will now insert the scope into the rectum and extend it through the colon. This scope has a light and camera, which allow the doctor to see the insides of the colon. The doctor may click images or take a video of the procedure. Through the colonoscopy, air or carbon dioxide is pumped into the colon, which allows for better viewing.

If the doctor finds any polyps, these are removed, and biopsy samples of any abnormal tissue are taken. Once the colonoscopy is done, the effect of the sedation wears off within an hour.


Can colonoscopy be painful?

If you opt not to take sedation, you may experience some cramping and pain as the scope is introduced and extended through the length of the colon. You can talk to your doctor about any apprehensions that you may have.


What Are The Side Effects And Risks Of Colonoscopy?

Undergoing a colonoscopy involves a few risks including -

  1. Allergic reaction to the sedative

  2. Bleeding when a polyp is removed or a tissue sample removed for biopsy

  3. Perforation of the colon wall

It is normal to expect some cramping, gas, and discomfort following the colonoscopy. This usually gets resolved within a few hours.


What are the Alternative Methods To Standard Colonoscopy?

Colonoscopy is widely accepted as the best way to screen for colorectal cancers. In situations where the health, risk factors, or inhibition of the patient does not allow for colonoscopy, doctors may recommend one or more of the following -

  1. Sigmoidoscopy

  2. Virtual colonoscopy

  3. CT colonography

  4. Double-contrast barium enema

  5. Faecal occult blood testing

However, none of the above procedures and tests offer complete visualisation of the rectum and colon as offered by a standard colonoscopy. Colonoscopies and sigmoidoscopies also offer an added advantage of removing pre-cancerous polyps before they turn malignant, thus preventing colorectal cancer.

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Written by:

Medical Expert Team