How Does A Colonoscopy Work?

June 06, 2019
Cl photo colonoscopy

A colonoscopy can help prevent colon cancer because a doctor will remove growths before they turn into cancer.

Most people who have no family history of colon cancer or other risk factors will get their first colonoscopy at age 50. Many people who have never had a colonoscopy have questions about the process.

Patients arriving for a colonoscopy at NHRMC Physician Group - Hanover Gastroenterology and The Endoscopy Center have already done the preparation required to clear the colon of stool.

That step is necessary so doctors using a scope can examine the inside of the colon for polyps, which are growths that are generally benign, however they are the most common cause of colon cancer, said Dr. Frederick Opper, a gastroenterologist with Hanover Gastroenterology. If detected, polyps are removed to prevent development of colon cancer.

“The procedure itself takes somewhere between 15 to 20 minutes,” Opper said.

Dr. Jack Ramage, also a gastroenterologist with Hanover Gastroenterology, said the Endoscopy Center performs about 7,000 procedures a year, many of them colonoscopies.

Patients are asleep during the procedure, thanks to the sedative propofol.

“The procedures are truly painless,” Ramage said. “The way I describe it to patients is it’s like a switch: They’re awake, they’re asleep and they’re awake afterwards.”

Patients are advised to take it easy the rest of day, including not driving or performing other strenuous activities because their reflexes might be impaired. Propofol is an improvement over past sedation techniques that left patients with a hangover sensation and forgetfulness.

Another improvement over previous colonoscopy techniques is the use of carbon dioxide rather than air to help inflate and distend the colon so the doctor can get a better look inside. Carbon dioxide is absorbed through the body’s capillaries, while air often caused bloating or gas before being expelled.

 “We always say once you get to our facility after having prepared for the procedure, the hard part is over because at that point we’ll take care of everything,” Opper said. “Your work is done. You just get a very restful sleep during the procedure.”

After the procedure, patients are taken to the recovery area where they are monitored as they wake up. There, they are joined by a friend or family member who will drive them home.

“The doctor that did the procedure comes over and tells you the main findings and what the plans are from that point,” Opper said.

While other techniques, particularly stool tests, screen for colon cancer, the colonoscopy is considered the gold standard for colon cancer screening, Opper and Ramage said.

“Colonoscopy is more of a preventive type of a tool where you can actually remove lesions that may become cancerous at a point where they’re still benign,” Opper said.

Ramage gave this example of the effectiveness of a colonoscopy: “If you are of average risk - you don’t have any family history of colon cancer, you don’t have a past history of colon cancer or polyps - and you have a negative exam, you have a 10-year interval before you have to have another colonoscopy performed.”

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