Does a Colonoscopy Hurt and What Is the Prep Like?

Let’s face it, no one looks forward to a colonoscopy. Aside from a disruption in your life and a reminder that you are, in fact, mortal—the whole idea of a colonoscopy to most people is just, well, yuck!

But here’s the thing—it’s your single best defense against colon and rectal cancer, which are #4 on the most common types of cancer list. An estimated 135,000 new cases of colorectal cancer will be diagnosed in 2017 and it will be the cause of roughly 50,000 deaths.

We asked two local colorectal surgeons to weigh in on why getting your colonoscopy screening is so important and how to make both the procedure and prep easier. Dr. Lina O’Brien and Dr. Benyamine Mizrahi both perform colonoscopies. They also surgically treat cancer and other diseases of the colon and rectum, and are pioneers of colorectal robotic surgery. So they have a unique perspective on the benefits of early detection and treatment.

Colonoscopy Both Detects & Prevents Cancer

Most people think of a colonoscopy as a screening or diagnostic tool. But it also plays a key role in prevention and treatment.

“Colon cancer universally starts off as a polyp that’s been allowed to grow and to generate into a cancer,” said Dr. O’Brien. “So if you can remove the polyp before it has a chance to change, you can eliminate the cancer from forming.”

A polyp is a small growth that forms in the lining of the colon. When you have a colonoscopy, the surgeon is inspecting the entire colon, the rectum and part of the small bowel. If they find a polyp along the way, they remove it. If it is too big to remove, they biopsy it. Since even benign polyps can turn into cancer later, any polyp too large to be removed during the colonoscopy will require surgery (at a later date).

No Pain – Seriously

Modern colonoscopies are not like they were in the past. Patients are put under light sedation and there is no pain from the procedure for most patients.

“I tell patients you’re going to take the best nap of your life,” said Dr. Mizrahi. “The procedure itself takes anywhere from 15 to 30 minutes, and when you’re done half the time patients are like ‘What? You’re finished?’ They don’t even realize that it’s done.”

“It’s very safe. There are very low risks associated with colonoscopy,” said Dr. O’Brien. “The procedure itself is not painful. It’s done under sedation.”

Don’t Sweat The Prep

If you’ve heard horror stories about colonoscopy prep from people who had the procedure years ago—you are getting a very outdated picture.

“We’ve adapted a bit in terms of the prep,” said Dr. Mizrahi, adding that it’s not as bad as it used to be. “It’s Gatorade and a laxative. You drink it and you do clear liquids the day before… that is absolutely the hardest part.”

Fear of the prep is more common than fear of the procedure itself. But it isn’t as bad as most people think.

“I had my first colonoscopy this year as well,” said Dr. O’Brien, “and I was able to work the whole day, go to parent-teacher conferences and do my prep – so it’s very, very doable.”

They offered these tips:

• Prep day is the day before your colonoscopy. Two days before (the day before you prep), don’t eat like it’s your last day on the planet. Keep your meals lighter and there will be less to flush out of your system on prep day.
• If you get a little nauseous, take the prep liquid more slowly. It’s a lot of volume to drink all at once for some patients. Taking it more slowly is ok. As long as you ingest all the medication, eventually it will clear you out.
• Plan a post-colonoscopy treat. Dr. Mizrahi tells patients that after their procedure, the person who gives them their ride has to take them wherever they want to eat.

View more colonoscopy prep tips.

Get Past the “Ewww” Factor

Yes, there is a tube involved. And yes, it involves taking laxatives and “cleaning yourself out” the day before. But that’s a small price to pay for something that could save your life.

“It’s the number one screening tool to help prevent and detect colon cancer,” said Dr. O’Brien.

Being comfortable with your surgeon can help.

“Being a woman, I tend to see a lot of female patients who are sometimes just really nervous about seeing a man for that particular procedure,” said Dr. O’Brien.

“It goes back to the taboo about talking about your butt or your pooping problems,” said Dr. Mizrahi. “Once you get over that, you realize it’s not a big deal.”

If you need to find a colorectal surgeon or colonoscopy provider, use our free service at 1-800-386-9355 or our online physician finder. You can also talk to a registered nurse 24 hours per day, 7 days per week, free of charge at the same number.