Dr. Brian Viviano: Don’t let anxiety prevent you from getting a colonoscopy

This article was originally published online at GoErie.com on Feb. 26, 2023.

Everyone’s first colonoscopy can create some anxiety. Gastroenterologists recognize that. We try to adapt our process to make it as smooth as possible and provide resources to help alleviate any fears.

Know that complications are extremely rare. Fewer than 1% of procedures have any complication and the death rate of colonoscopies is extremely low because we take all the necessary precautions.

If your anxiety is about being exposed, you can rest assured we are extremely professional in the room. We try to minimize any anxiety by keeping patients covered all the way up until they are asleep and comfortable.

If you worry about what we could find during a colonoscopy, understand that early identification is important. If we identify it, we can attack it. This is one cancer you can actually prevent.

Don’t wait until it’s too late. If something is obstructing you, or you’re feeling symptomatic, then most likely that cancer has already traveled outside of the colon.

Treating colon cancer after it has spread is much more invasive. It often involves chemotherapy and radiation as compared to just removing it through the scope, or with a surgery and recovering without any treatment afterward.

What is most important is that you have a screening test done once you reach the age of 45. A colonoscopy is the gold standard because it allows gastroenterologists to look for polyps, and we can remove them most of the time, right there during the colonoscopy, before they become a colon cancer.

Other possible tests involve stool-based testing, which looks for blood or DNA in the stool. This is inferior to a colonoscopy, but still effective for average-risk individuals who do not have a family history of colon cancer or colon polyps, nor any symptoms consistent with possible colon cancer.

The only way we can prevent colon cancer is by doing the screenings at the appropriate intervals. Stool-based tests should be done yearly and colonoscopies should be done every 10 years.

If you have a first-degree relative (mother, father, brother, sister, child) with colon cancer:

• You should never go more than five years without having a colonoscopy.
• Start your colonoscopy screenings at 40 years old or 10 years prior to the diagnosis in that family member, whichever is earlier. For example, if a sibling was diagnosed at 44 years old, a younger sibling or child should be scoped at the age of 34.

A colonoscopy is slightly invasive and does require some preparation such as dietary modifications and a laxative the day before.

Here is what you can expect during a colonoscopy:

• Some light anesthesia to keep you comfortable.
• Possible cramping, though it is rare. In order to see the colon, we have to inflate or insufflate it with air. That air can get trapped.
• If we find a bigger lesion or colon polyp and we have to remove it, there can be some bleeding involved. Typically, it’s very self-limiting. It will go away on its own once the body heals itself.
• No driving or heavy lifting. Someone will need to transport you to and from the procedure.
• Plan for a groggy day, but you’ll be back to yourself by the next day.

Finally, the healthiest thing you can do for your gut is eat a high-fiber diet, and avoid those high carcinogen products such as smoking, vaping, chewing tobacco, etc. Good overall gut health includes consuming 20 to 30 grams of dietary fiber daily.

Make this the year you take action and put yourself on the path to wellness.

Dr. Brian Viviano is a LECOM Health gastroenterologist at Plaza 38 Gastroenterology.