Colonoscopy

Colonoscopy is the most accurate test to detect colon polyps and colon cancer, and is the only screening test where polyps can be removed. It allows direct visual examination of the colon lining by means of a flexible tube called a colonoscope. When found in its early stages, colon cancer is 90% curable. Removal of a precancerous colon polyps during colonoscopy can prevent colon cancer from developing. That is why a screening colonoscopy is recommended at the age of 50 (45 for African Americans) or earlier if you have a personal or family history of colon cancer.

Preparing For The Procedure

Preparing for a colonoscopy begins with complete cleansing of the colon prior to the procedure. This is very important as a colon that is poorly prepared can result in important findings such as precancerous polyps being missed.  The preparation involves dietary restriction to only clear liquids for most or all of the day prior to the exam in addition to taking a large volume bowel cleansing preparation.

There are several preps for a colonoscopy; make sure to follow the one your doctor has prescribed.

Before The Procedure

Your medical history will be reviewed with you by your healthcare team including a nurse, your gastroenterology physician, and an anesthesia provider, who is a certified registered nurse anesthetist (CRNA). An IV line will be placed to administer sedation.

During The Procedure

The certified registered nurse anesthetist (CRNA) will administer sedation medications and monitor vital signs in a process known as Monitored Anesthesia Care (MAC). This allows the patient to remain safe and comfortable during the duration of the procedure. Once the patient is sedated, the gastroenterologist will insert the colonoscope into the rectum and advance through the various portions of the colon (also known as the large intestine). The doctor will carefully examine the tissue looking for colon tumors, polyps, or abnormal appearing tissue lining. Maneuvers that may be performed during colonoscopy include tissue biopsy, removal of polyps, and occasionally cauterization or treatment of bleeding sites. The exam generally takes 20-30 minutes to perform.

After The Procedure

The physician will talk with you about the initial results of your procedure and will prepare a full report for the health care provider who referred you for the colonoscopy. You may experience some bloating or cramping after the procedure, which is normal and should disappear with passage of gas. Any polyps that are removed or tissue sampled during the procedure will be sent to a pathology lab for evaluation. It typically takes 5 working days for you to be notified of the results by mail or through the patient portal.

Download our colonoscopy brochure for more information about what to expect before, during and after your colonoscopy.

Learn why AGA's Dr. Angela Meyer believes colonoscopies save lives. 

Watch this video to understand how colonoscopies work.

View these common questions about what to ask a physician when considering a colonoscopy.

Understanding the Different Types of Colonoscopies

Wording is Important
There is a great misunderstanding about the different categories under which a colonoscopy can be classified. These categories will determine your insurance benefit coverage and can make a difference in your personal out-of-pocket expenses. In order to avoid an unexpected change, it is important that you educate yourself on your specific category and your insurance policies coverage.

Diagnostic/Therapeutic Colonoscopy:
Patient has past and/or present gastrointestinal symptoms, polyps, GI disease, iron deficiency anemias, and/or any other abnormal tests.

Surveillance/High Risk Screening Colonoscopy:
Patient has no current gastrointestinal symptoms, but has a personal history of GI disease, personal and/or family history of colon polyps, and/or cancer. Patients in this category are required to undergo colonoscopy surveillance at shortened intervals (e.g., every 2-5 years)

Preventative Colonoscopy Screening Diagnosis:
Patient is asymptomatic (no present GI symptoms), age 50 and over, has no personal or family history of GI disease, colon polyps, and/or cancer. The patient has not undergone a colonoscopy within the last 10 years.

Your primary care physician may refer you for a “screening” colonoscopy but there may be a misunderstanding of the word screening. This will be determined in the pre-operative process. Before your procedure, you can ask what category your procedure falls under and can contact your insurance company for details of coverage.

Can my GI doctor or nurse change my records so that I can be considered eligible for colon screening?
Absolutely not. This would constitute insurance fraud. Your visit is documented as a medical record based on information you or your referring physician have provided as well as what is obtained during our pre-procedure history and assessment. It is a binding legal document that cannot be changed in order to obtain better insurance coverage.

There are strict government and insurance company documentation and coding guidelines that prevent a physician from altering a chart or bill for the sole purpose of coverage determination.