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

By Medical Expert Team

May 24 , 2017 | 9 min read

Colonoscopy test is the endoscopic examination of the large intestine and the distal part of the small intestine with a camera A CCD or fiber optic camera is passed through the anus in a flexible tube.

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

What is Colonoscopy?

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).

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 test 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)
  • A recent change in bowel habits which troubles persistently.
  • Incomplete evacuation (sensation of not being 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 cancer’s location in the colon, size, and growth.

Find the best cancer specialist hospital in Delhi.

Why Does One Need Colonoscopy Test?

Investigate signs and symptoms of the gut. A colonoscopy can help your doctor identify possible causes of abdominal pain, rectal bleeding, chronic diarrhea, and other bowel problems.

Colon cancer screening: If you are 45 or older and have an average risk of colon cancer (you have no other risk factors for colon cancer other than your age); your doctor may recommend earlier screening if you have other risk factors.

Colonoscopy is one of the few ways to prevent colon cancer. Consult your doctor about the best diagnosis.

Check for more polyps: If you have had polyps before, your doctor may recommend a follow-up colonoscopy to check for polyps and find them to remove extra polyps. Colonoscopy is done to identify the risk of colon cancer.

Treatment issue: Sometimes a Colonoscopy can be performed for treatment purposes, e.g. to insert a stent or remove an object from the colon.

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 diarrhea)

  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, Crohn's disease, or ulcerative colitis. 

  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 for any patient having bleeding from the rectum or having a recent change in bowel habits.

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

It is also used for bowel diseases such as ulcerative colitis and Crohn's disease. It is used after the 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?

A doctor performs a colonoscopy in a hospital or outpatient setting. A colonoscopy usually takes half an hour to one an hour.

A doctor inserts an intravenous (IV) needle into a vein in your arm or neck to give you sedatives, anesthetics, or painkillers so that you do not notice or feel any pain during the procedure. Hospital staff will monitor your vital signs and make you comfortable.

For the procedure, you lie on a table while the doctor inserts a colonoscope through your anus and into your rectum, colon. The oscilloscope inflates your colon with air for better visualization.

The camera sends a video image to a monitor so the doctor can examine your colon.

The doctor can move you around the table several times to adjust the scoping for Better Once the endoscope reaches the opening of your small intestine, the doctor slowly withdraws the endoscope and examines the lining of your colon again.

Before your colonoscopy

Your doctor will give you written bowel preparation instructions at home before the procedure to help you have little or no pouring in your belly. Complete bowel preparation allows you to have clear, liquid stools.

Stool in your intestines can prevent your doctor from seeing the lining.

You can eat a clear liquid diet 1 to 3 days before the procedure. You should avoid red and purple colored drinks or jelly. The instructions provide details on when to start and stop the clear liquid diet. In most cases, you can drink or eat:

  • Broth or fat-free broth
  • Gelatine in Flavors such as lemon, lime, orange
  • Without milk or cream can have Tea or coffee
  • Energy drinks in flavors like lemon, lime, or orange
  • Strained fruit juice such as apple or grape; Avoid orange juice
  • Water

After a colonoscopy

After a colonoscopy you can expect:

  • It takes time for the anesthesia to wear off completely.
  • You will stay in the hospital or outpatient center for 1 to 2 hours after the procedure.
  • Abdominal cramps or bloating may occur in the first hour after the procedure.
  • After the procedure, you or a friend or family member will be given instructions on how to take care of yourself after the procedure. You must follow all instructions.
  • You will need a pre-arranged ride home as you will not be able to drive after the procedure.
  • You should expect a full recovery and return to your normal diet the next day.
  • After the effects of the sedatives or anesthetics have worn off, your doctor can, or if you wish, tell you what was found during the procedure, with a friend or family member.

Results of the colonoscopy

Your doctor will review the Colonoscopy results and then inform you about the result.

Negative result

The colonoscopy is observed as negative if the doctor does not find any abnormalities in the colon.

Your doctor may recommend another Colonoscopy:

In 1 to 7 years, depending on a variety of factors: number, size, and type of polyps removed; if you have a history of polyps from previous colonoscopy procedures; If debris was present in your colon that prevented a thorough examination of your colon, your doctor may recommend a repeat colonoscopy If you have a family history of colon cancer or certain genetic disorders.

The speed is determined by the amount of stool and the amount of colon visible. To ensure that your intestine is empty before your next colonoscopy, your doctor may recommend a new bowel preparation.

Positive result

If the doctor finds polyps or abnormal tissue in the colon, the colonoscopy is termed positive.

Although most polyps are not malignant, some of them might be precancerous. Polyps removed during colonoscopy are sent to a laboratory for testing to determine if they are cancerous, precancerous, or noncancerous.

Depending on the size and number of polyps, you can need to follow a strict monitoring program in the future to check for more polyps.

If your doctor finds a polyp or two smaller than 0.4 inches (1 centimeter) in diameter, the doctor may recommend a new colonoscopy in 7 to 10 years, depending on your other risk factors for colon cancer.

Your doctor will advise you to get another colonoscopy as soon as possible if you:

  • Have More than two polyps
  • A larger, larger polyp than 0 .4 inches (1 centimeter)
  • Polyps and also residual feces in the colon prevent a full colon examination
  • Polyps that have specific cellular traits that point to an elevated risk of cancer in the future cancer polyps
  • If you have a polyp or other abnormal tissue that could not be removed during colonoscopy, your doctor may recommend a repeat visit to a gastroenterologist who has particular expertise in removing large polyps, or Surgery.

Problems with your test

If your doctor is concerned about the quality of the review of the endoscope, the doctor may recommend a repeat colonoscopy or a shorter time until your next colonoscopy. If your doctor was unable to advance the endoscope through the entire colon, a virtual colonoscopy may be recommended to examine the rest of the colon.

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 is 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 visualization of the rectum and colon as offered by a standard colonoscopy. Colonoscopies and sigmoidoscopies also offer the added advantage of removing pre-cancerous polyps before they turn malignant, thus preventing colorectal cancer.

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Medical Expert Team