Colonoscopy Questions & Answers

We have compiled a list of the most popular patient questions and concerns regarding colonoscopy and colon cancer. If you have additional questions, please contact us.

General Questions

Colonoscopy Prep

Colonoscopy Procedure

After the Colonoscopy

Scheduling and Cost Questions

General Questions

At what age should I get a colonoscopy?

Men and women that are 50 years of age and older should undergo colonoscopy screening. If you are a high risk patient, the recommended age is typically at age 40, but may occur earlier depending upon your medical history. Patients are considered at high risk if there is a family history of colon cancer and/or polyps, or if there is a personal history of colon polyps, ulcerative colitis or Crohn’s disease, breast cancer or uterine cancer.

What are symptoms of colon cancer?

Typically there are NO symptoms.  The colon is a large capacity organ that can accommodate stool and tissue growths without your being aware.  Stool can accumulate in your colon without your awareness until your body decides to eliminate the feces by signaling a bowel movement. This is the rationale for recommending a screening colonoscopy for everyone at average risk (i.e. no family history of colon polyps or colon cancer) beginning at age 50. If colon cancer is allowed to grow, eventually symptoms will occur and may include rectal bleeding, abdominal pain, the onset or worsening of constipation, narrow caliber stools, weight loss, weakness and fatigue from anemia related to slow blood loss.

What is a colon polyp?

A colon polyp is an abnormal tissue growth that arises on the inner surface of the colon.  Polyps are caused by genetic mutations in the DNA of the cells that line the colon.  Individuals can grow single or multiple polyps. What causes these mutations is not clearly understood, but genetics as well as diet likely play a role. Most colon polyps are non-cancerous and are almost always silent or asymptomatic (produce no symptoms). However, a large percentage of polyps have the capacity to continue to grow and evolve into a colon cancer and are, therefore, referred to as pre-cancerous polyps. It is felt that almost all colon cancers begin as polyps. At the polyp stage, we cannot tell which polyps are actively cancerous or are pre-cancerous. Only by removing the polyp at the time of colonoscopy can we then analyze the polyp microscopically to determine if the polyp is cancerous, pre-cancerous, or truly benign.

Why is it important to remove polyps?

Colon polyps are important to identify and remove, since the polyps may turn into colon cancer over time. While not every colon polyp turns to cancer, it is felt that almost every colon cancer begins as a small non-cancerous polyp. Polyps that are cancerous, pre-cancerous, or non-cancerous can all look the same. Therefore, when any polyp is encountered during a colonoscopy it needs to be removed for testing. It is only by analyzing it microscopically that we can determine the exact type of polyp.

Are women also at risk for colon cancer?

Absolutely. Colon cancer is the number three leading cause of cancer-related deaths among women, behind lung and breast cancers. Women tend to form more polyps in the upper or more proximal part of the colon compared to men underscoring the importance of achieving an excellent colon prep and doing a full colonoscopy (vs. a sigmoidoscopy).

What is a Sigmoidoscopy?

Sigmoidoscopy is a test that allows the doctor to examine the inside of the lower one-third of the colon. This part of the colon is known as the “sigmoid colon.” A sigmoidoscope, which is a small caliber tube with a light source and camera, is inserted into the rectum and advanced up through the sigmoid colon where the lining is inspected. The image is projected onto a TV screen. The doctor is able to visualize the lining of the colon and also to take biopsies (samples of the lining or a polyp) if necessary. Sigmoidoscopy is basically a shorter version of a colonoscopy.  Sigmoidoscopy was formerly the primary test for colon screening, but it has been replaced by colonoscopy because colonoscopy is a more complete and thorough test.

Which is better, a colonoscopy or sigmoidoscopy?

A colonoscopy provides a more thorough screening because the entire colon is examined. A sigmoidocopy only examines the lower one-third of the colon. Polyps can occur anywhere within the colon and it is important to examine the entire colon. For women it is especially important to undergo a full colonoscopy since women tend to form more polyps in the upper or more proximal part of the colon compared to men.  The upper or more proximal part of the colon is not examined during a sigmoidoscopy.

What is a “virtual colonoscopy” and is that better to have?

Virtual colonoscopy, also known as CT (computed tomography) colonography is a radiology test that examines the colon using x-ray technology. The radiology images are reconstructed to create a ‘virtual’ tour of the colon. Researchers have concluded that virtual colonoscopy is less reliable than previously thought and not ready for widespread use. According to a study of 600 patients at nine major clinics, its accuracy varies considerably, depending on the training and methods of the doctors performing the exam. Moreover, should a virtual colonoscopy reveal polyps or other suspicious tissue you would have to make an appointment for a conventional colonoscopy and go through the preparation process all over again. The American College of Gastroenterology recommends that people get a conventional colonoscopy, calling it the “gold standard” of colon cancer screening.

Colonoscopy Prep

Tell me about the prep solution

We have diligently researched all of the prep solution options available. Our colonoscopy prep solution is a low volume solution that provides the most tolerable and cleanest bowel prep for patients. We prescribe our prep solution via the ‘split dosing method’ which means you will drink half of the solution on the day before the colonoscopy and the other half several hours before your colonoscopy. Split dosing of the prep solution is considered the gold standard.

What can I eat the day before a colonoscopy?

You can only consume clear liquids the day prior to your colonoscopy. This would include soup broth, water, any liquid that is clear, tea, black coffee (no cream or milk), Gatorade or any sport drink and jello (no red, purple, or blue liquids).

What should I avoid the day before a colonoscopy?

Do not consume solid foods on the day prior to your colonoscopy. Some liquids that should be avoided are: opaque liquids (not clear or able to see through), liquids with red, blue or purple dye, and all dairy and drinks with pulp. There is no restriction on activity, however, we recommend low activity levels due to the dietary restrictions.

Colonoscopy Procedure

Are there any side effects, pain or discomfort associated with a colonoscopy?

The sedation medication that we utilize is known as Propofol. Propofol will guarantee that you are appropriately sedated during the procedure. Unlike traditional methods of sedation, Propofol ensures that you will not “wake up” in the middle of the procedure which may cause you unnecessary pain or discomfort. Some patients may experience abdominal bloating or distention after the colonoscopy; this is due to retained air in your colon. Once you pass this air/gas, you will feel more comfortable.

Why is an anesthesiologist involved in a colonoscopy?

Only anesthesiologists are licensed to administer Propofol which is the medication administered during the colonoscopy. Our board-certified anesthesiologists are fully trained and experienced in administering Propofol.

What is Propofol?

Propofol is a safe and effective medication that is being used with increasing frequency for endoscopic procedures, such as colonoscopy. Unlike conventional medications used during a colonoscopy (e.g. Versed or Fentanyl), Propofol will guarantee that you are appropriately sedated. You will not wake up in the middle of the procedure! With Propofol you will also recover more quickly after the procedure and are able to eat sooner after the colonoscopy. Propofol does not lead to post-procedure nausea that occurs with conventional medications (e.g. Versed or Fentanyl).

After the Colonoscopy

What is the recovery time after a colonoscopy?

With the use of Propofol, patients wake up more quickly than with conventional sedatives (e.g. Versed or Fentanyl). Patients are typically awake enough to have a coherent conversation with their physician 5-10 minutes after the colonoscopy. Many of our patients have reported pleasant dreams upon waking up and often feel refreshed and energized.

Can I return to work and/or drive after a colonoscopy?

You should not drive within 12 hours after the completion of your colonoscopy. It is also advisable that you do not return to work on the day of the colonoscopy. You may resume your normal diet; however, we suggest that your first meal following the colonoscopy not be too rich or heavy.  A turkey sandwich, vegetable soup, or a light breakfast would be reasonable foods to consume after your colonoscopy.  You should be able to resume your normal diet and activities on the day following your colonoscopy.

Scheduling and Cost Questions

Where is the procedure performed?

Your colonoscopy will be performed at Golden Gate Endoscopy Center which is located on Geary Boulevard in the inner Richmond district of San Francisco. The facility is accessible via public transportation and there is metered and non-metered street parking around the center.

Does my insurance plan cover this procedure?

The Center for Colonoscopy Excellence is contracted with nearly all major medical insurance carriers. While our office can offer you some general guidance regarding insurance coverage, it is ultimately your responsibility to ensure that any tests, procedures, medication and professional referrals are covered by your insurance plan. Click here for more information about colonoscopy insurance coverage.

How much does a colonoscopy cost?

The cost to you for the colonoscopy will depend upon your insurance coverage.  For individuals that do not have health insurance or coverage for a colonoscopy on their health plan, the Colonoscopy Center for Excellence will work with you to craft an affordable payment method. We do not want financial hardship to stop anyone from receiving proper medical care. Click here for more information about colonoscopy costs & payment options.

How do I schedule a procedure?

If you have symptoms such as constipation, abdominal pain or rectal bleeding, or would like to discuss other symptoms or concerns with your physician prior to your colonoscopy, we recommend that you schedule an office consultation. You can start the process by contacting San Francisco Gastroenterology.

Otherwise, you can just click the button below to get the process started:

Schedule a Colonoscopy