Do I Really Need a Colonoscopy?

Do I really need a colonoscopy? The purpose of a colonoscopy is to detect and/or evaluate the health of the large intestine, otherwise known as the colon. How do you know if you really need one?

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Colon Function 101

The primary purpose of the large intestine (colon) is to absorb water and facilitate regulation of defecation. The large intestine, with a diameter of approximately 7 cm (approx. 2.75 inches) and a length of approximately 1.5 m (approx. 59 inches), is also responsible for the absorption of metabolites formed by natural bacteria in the intestine.

Thousands of different types of naturally occurring bacterial flora reside in the large intestine and are essential in the recovery of energy from foods that have not yet been digested by the stomach or absorbed by the small intestine.

As we age, digestive processes and activity slows down, resulting in reduced production and absorption of digestive juices. The activity in the gastrointestinal tract declines, slowing down the storage of digestive juices. Peristalsis, a wavelike motion of the colon moves waste through the large intestine, also slows down, often resulting in chronic constipation in older people. Increased risk of diverticulosis and polyps – and for some – the development of colorectal cancer are common ailments of an aging gut.

When detected early, cancers within the colon are treatable.  Approximately 80% of colon cancers can be observed and removed during a colonoscopy, while 50% of rectal cancers are felt during a rectal exam.

Signs and Symptoms of Colon Issues

A  colonoscopy is a procedure that enables a physician to get an inside look at the large intestine. Some patients associate colonoscopies to only inspect for colorectal cancer, but this isn’t always the case.  Your doctor may recommend a colonoscopy if you suffer from occasional or chronic bouts of constipation or diarrhea, difficulty evacuating the bowel, or abdominal pain. The procedure aids the physician in determining what’s wrong.

An individual who experiences a change in bowel habits should schedule a checkup with their physician. As with many illness and disease processes, the sooner an issue is diagnosed, the sooner it can be treated, improving outcomes. A few indications that you may need to undergo a colonoscopy include:

  • Any unusual change in your daily toileting or bowel habits. For example, unusual, frequent constipation or diarrhea.
  • Difficulty or pain passing a bowel movement.
  • Feeling that you still have to empty your bowels even though you’ve just finished.
  • Any indication of blood in the stool.  Very dark stools should be tested for blood, typically with a fecal occult blood test (FBOT).
  • Pain or cramping in the lower abdominal region that lasts more than a few days
  • An explicable weight loss.
  • Increased sense of fatigue or weakness, limiting physical activity, which may be an indication of anemia or the intestines not absorbing nutrients correctly.

Processes like cancer can develop slowly and spread throughout the body before symptoms appear. For this reason, physicians recommend screening tests for a variety of illnesses and disease processes on a routine basis. The American Cancer Society recommends colon cancer screenings for individuals 50 years of age or older. For those with a history of cancer in their family, a screening may be recommended even sooner.

What Exactly Can a Colonoscopy Find?

A colonoscopy serves a number of purposes for diagnostics. For example:

  • To determine the origin of lower gastrointestinal bleeding.
  • Effective in the evaluation of the colon to identify polyps or malignant lesions.  It’s also beneficial post-operatively to determine any recurrence of polyps or lesions.
  • To detect as well as evaluate inflammatory and ulcerative bowel diseases.
  • To determine the presence of colonic strictures in addition to benign or malignant lesions.

A colonoscopy can provide a physician with information including normal as well as abnormal results. For example, a normal, healthy colon contains mucosa that appears a shiny, pale pinkish-orange color along the interior of the vessel, through which blood vessels are visible. The shiny appearance is due to a healthy amount of mucosal secretions.

Abnormal results may also be viewed through a colonoscopy, such as:

A colonoscopy is only one of several tests that a doctor may request in order to determine a diagnosis, including suspicions of colon cancer.  X-rays and/or CT scans of the colon may also be recommended. If you’re 50+ years of age and have never undergone a colonoscopy, call your doctor and ask about benefits and risks.

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