Ask an Expert: Do You Really Need a Colonoscopy?

ElliotDETurning 50 is an important milestone. From a health perspective, that’s typically the age when men and women are encouraged to get a colonoscopy. But the prospect of having the test—and the at-home preparation necessary to clean out the colon beforehand—can cause some adults to delay, or even skip, the procedure altogether. We asked University of Iowa gastroenterologist David Elliott, MD, PhD, to explain colon screening and why some people are “colonoscopy-averse.”

For the uninitiated, please describe what happens during a colonoscopy.

During this procedure, a gastroenterologist uses a long, flexible tube with a tiny camera at the end to look inside your rectum and colon for irritated or swollen tissue, polyps, or cancer. Tissue samples or polyps can be removed during this procedure, as well. The procedure generally takes about 20 minutes, but it may go longer if polyps or other abnormalities are found. It’s worth noting that there are different ways of screening for colorectal cancer—a virtual colonoscopy and fecal occult blood testing are two examples—but if a polyp is found with these tests, a patient will still need to have a regular colonoscopy.

Is a colonoscopy really necessary?

Colorectal cancer is the third most common type of cancer in the United States. If it’s diagnosed early, it has a mortality rate of around 10 percent. If it’s discovered late, it has a mortality rate of around 90 percent. The medical community has established age 50 as the time to get a colonoscopy because, generally speaking, that’s when a person’s risk of colorectal cancer really begins to develop. For an adult with a general risk of colorectal cancer—no family history, for example—it’s a test that can be done once every 10 years.

So why do some adults hesitate, or even neglect, getting a colonoscopy?

Some people are simply nervous about any rectal procedure, even though most patients are sedated, and often asleep, during a colonoscopy. For others, it’s the prep to clean out the colon that’s the worst part. Generally speaking, this involves drinking up to a gallon of a liquid laxative the day before the test, which means spending a lot of time in the bathroom. The prep can be burdensome, but it’s important. The ‘cleaner’ the patient, the better look we’ll have. The better look we have, the more assurance we have of detecting any problems.

How do you overcome these barriers?

Information about the cancer-prevention benefits of colonoscopy is always helpful. With a well-done procedure and a well-prepped patient, we should be able to practically nullify a patient’s risk of developing colorectal cancer. A patient-friendly environment also is important, which is why we offer these procedures at Iowa River Landing (see below). With a colonoscopy, a patient’s apprehension can easily outweigh the test itself, so it’s good to perform these procedures it in the most efficient manner and convenient setting possible.

GI care at UI Health Care–Iowa River Landing

University of Iowa Health Care–Iowa River Landing in Coralville now offers colonoscopies and other gastrointestinal procedures. With five new multipurpose procedure rooms and 18 new preparation and recovery rooms, patients can expect high-quality, individualized care in a private, comfortable, and convenient setting. colo

— Fall 2015