A colonoscopy is a vital screening procedure that allows a doctor to examine the inside of the entire large intestine, or colon. This examination enables the physician to detect and potentially remove polyps, inflamed tissue, abnormal growths, and ulcers. It is most often used to look for early signs of cancer in the colon and rectum and is the mainstay screening modality for colon.
Preparing for a Colonoscopy
Before undergoing a colonoscopy, patients receive detailed instructions on how to prepare. A completely empty colon is essential for the procedure to be thorough and safe. Preparation typically involves following a liquid diet for one to two days beforehand, as directed by the physician. This thorough cleansing of the bowel is necessary for optimal visualization during the colonoscopy. The medical staff also needs to be informed about any pre-existing medical conditions, such as heart or lung disease, that may require special attention.
The Colonoscopy Procedure
During the colonoscopy, the patient lies on their left side on an examining table. Pain medication and a moderate sedative are administered to ensure comfort and relaxation. The doctor then inserts a long, flexible, lighted tube, called a colonoscope, into the rectum and gently guides it into the colon. The colonoscope transmits an image of the colon's interior onto a video screen, allowing the doctor to carefully examine the lining.
The scope blows air into your colon and inflates it, which helps give the doctor a better view. Patients may be asked to change positions to facilitate the scope's movement and improve visibility. The doctor can remove most abnormal growths in your colon, like a polyp, which is a growth in the lining of the bowel. Polyps are removed using tiny tools passed through the scope. Most polyps are not cancerous, but they could turn into cancer. The polyps are sent to a lab for testing. The doctor can also remove tissue samples to test in the lab for diseases of the colon (biopsy). In addition, if any bleeding occurs in the colon, the doctor can pass a laser, heater probe, electrical probe, or special medicines through the scope to stop the bleeding. The tissue removal and treatments to stop bleeding usually do not cause pain. The procedure usually takes about 20 to 40 minutes.
Immediate Post-Colonoscopy Experience
After the colonoscopy, patients may experience mild cramping or a sensation of gas, which typically subsides within an hour. In rare cases, severe abdominal pain, fever, bloody bowel movements, dizziness, or weakness may occur, requiring immediate medical attention. It's crucial to carefully read and follow all discharge instructions provided by the medical staff. Medications, especially blood thinners, may need to be temporarily discontinued, particularly if a biopsy was performed or polyps were removed.
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Dietary Recommendations After Colonoscopy
In the hours immediately following a colonoscopy, a doctor may recommend that you eat sparingly or not at all. They may suggest a soft or liquid diet that’s low in residue. Following dietary safeguards is typically required for 1 day only, but everyone is different. It’s estimated that 34% of people experience symptoms like bloating, cramping, and changes in bowel movements for up to 2 days after a colonoscopy, which could make eating and drinking feel challenging.
Initial Liquid Diet
During the first few hours after colonoscopy, consider starting with a liquid diet to help avoid dehydration. This may include drinking water, electrolyte beverages, and clear-liquid foods like soups. This is because you’ll most likely be dehydrated due to the preparations underwent for the colonoscopy. As such, consuming a liquid diet and slowly incorporating soft foods that won’t irritate your colon could help you replenish your body with important fluids, vitamins, and electrolytes.
Clear liquids include: apple and white grape juice or other non-citrus juices without pulp, Gatorade, ginger ale, diet or regular 7-Up, Sprite or colas, Kool Aid, water, clear broth, popsicles and hard candies without filling. Black coffee or tea without cream or powdered creamer and Jell-O without added fruit (no red/purple coloring) are also OK. Avoid anything colored red or purple, like grape soda or cherry Jell-O. The food dye can cause misinformation during the colonoscopy.
Transitioning to a Soft, Low-Residue Diet
If these foods don’t irritate your colon, try following a soft, low residue diet. This consists of a limited amount of dairy plus low fiber foods. This diet may help ease gastrointestinal activity because the foods are easy to digest and produce less stool. Some meals to consider eating after a colonoscopy may include: mashed potatoes and a skinless chicken breast, white toast and scrambled eggs, white rice and a piece of white fish.
Foods to Avoid
To aid healing, it’s beneficial to avoid foods that are hard to digest the day after. This may include anything that might irritate your bowels, such as spicy, greasy, and fried foods, as well as those high in fiber.
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Foods and drinks to avoid the day after your colonoscopy may include: carbonated drinks, such as soda, alcohol, and sparkling water, steak, or any tough, hard-to-digest meat, whole grains, such as breads and crackers, raw vegetables, corn, legumes, brown rice, fruit with the skin on, dried fruit, such as raisins, coconuts, spices, such as garlic, curry, and red pepper, highly seasoned foods, crunchy nut butter, popcorn, nuts.
Additional Dietary Guidelines After Polypectomy
If you had a polyp removed (polypectomy), a doctor may recommend additional dietary guidelines.
Gut Microbiome and Colonoscopy Complications
Minor complications that might occur after colonoscopy, including abdominal discomfort, bloating, diarrhea, and constipation, could a barrier for patients to undergo a screening colonoscopy. The gut microbial composition and diversity before and after bowel preparation could be considered as one of the causes of minor complications after colonoscopy.
A total of 24 healthy subjects provided their stools before bowel preparation and on the 7th and 28th day after colonoscopy. On the 7th day after colonoscopy, the presence of minor complications was investigated using a questionnaire. We divided patients into 2 groups, the no complication group and complications group. Five of the 24 subjects reported that they had undergone minor complications after colonoscopy. Most of the symptoms were mild and self-limited, but 1 patient needed medication.
Interestingly, the Firmicutes/Bacteroidetes ratio of the initial stool samples before bowel preparation in the complication group was significantly higher than that in no complication group. After bowel preparation, the Firmicutes/Bacteroidetes ratio of the complication group decreased, but not in the no complication group.
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In this study, the initial gut microbial composition and diversity before bowel preparation between groups that had or did not have minor complications after colonoscopy was different. The Firmicutes/Bacteroidetes ratio in the group who had minor complications decreased after bowel preparation. Based on these results, it is proposed that the distinct change of Firmicutes/Bacteroidetes ratio after bowel preparation in subjects who have initially possessed Firmicutes dominantly could affect the occurrence of minor complications after colonoscopy. Before bowel preparation, these subjects might need to correct their gut microbial composition that consists dominantly of Firmicutes.
Lifestyle Habits for Colon Health
Taking care of your colon requires more than just regular screenings. According to the Centers for Disease Control and Prevention (CDC), the following lifestyle habits may help prevent colon cancer: getting regular exercise, maintaining a healthy-for-you weight, quitting smoking, if you smoke, limiting alcohol, if you drink. The CDC also recommends eating a well-balanced diet, which may include: eating whole grains, lean proteins, fruits and vegetables, and low fat dairy products, limiting animal fats.
Addressing Common Questions
- Are you hungry right after a colonoscopy? You may feel hungry after a colonoscopy because you most likely haven’t eaten food for at least 24 hours. That said, you may find it difficult to eat immediately due to symptoms like bloating, intestinal gas, and abdominal pain.
- How long after a colonoscopy can you eat normally? You can resume eating right after a colonoscopy, but it’s a good idea to introduce food slowly and begin with liquid foods.
- What should I eat to restore my gut after a colonoscopy? Some research suggests that probiotics may help restore your gut microbiome after a colonoscopy.
- What is the fastest way to recover from a colonoscopy? Most people recover quickly from a colonoscopy, but it’s important to follow all your doctor’s instructions. These may include avoiding any strenuous activity and taking a day off work before returning to your normal routine. If you experience any unusual symptoms, tell your doctor right away.
The Importance of Colonoscopy
Part of what makes colonoscopy the gold standard for colon cancer screening is its safety profile. The risk of serious complications is low (perforations and post-procedure bleeding occur in only 0.05% and 0.3% of colonoscopies, respectively). The most frequent complaint among patients returning to the ER after colonoscopy was abdominal pain. In fact, it was the cause of almost 50% of these visits. The most widely acknowledged cause of post-colonoscopy abdominal pain is gas and bloating.
Colonoscopy is a useful method for detecting and removing colorectal polyps, thereby reducing the incidence of colorectal cancer. The U.S. Preventive Service Task Force recommends screening colonoscopy for colorectal cancer from the age of 50 years old.
Overcoming Fear and Procrastination
It's completely understandable to feel nervous about a colonoscopy. However, the risks of colon cancer far outweigh the discomfort of a screening. Don't let fear of the unknown prevent you from taking control of your health. Schedule your routine colonoscopy today. Early detection is key to preventing colon cancer and ensuring successful treatment. Remember, your health is worth it.
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