The colonoscopy: Invasive? Yes - but an internal checkup can save your life

An associate clinical professor of medicine at Mount Sinai School of Medicine, Lawrence Cohen is a gastroenterologist who specializes in endoscopy and cancer screening.

Who’s at risk

Gastrointestinal endoscopies are some of the most frequently performed medical procedures done today, with over 10 million colonoscopies performed every year in the U.S.

"Endoscopy is a general term for any examination performed using a tube that has a light on the end of it," says Cohen. "Gastrointestinal endoscopies examine the gastrointestinal, or GI tract, a long conduit that carries food from the mouth to the anus."

The most common GI endoscopy is a colonoscopy, which is often used to screen for colon cancer. GI endoscopies are divided into two major categories: upper and lower.

"The upper endoscopy examines three organs: the esophagus, the stomach and the first portion of the small bowel, called the duodenum," says Cohen. "The lower endoscopy, or colonoscopy, is an exam of the colon, also known as the large bowel."

Upper endoscopies are most often done for patients suffering from chronic acid reflux, unexplained abdominal pain or a swallowing disorder. Lower endoscopies are sometimes done for patients who have symptoms of colon cancer, but are most often done as part of a routine screening for all Americans over the age of 50.

Doctors have set guidelines calling for universal colon cancer screening, because 1 in 18 Americans will have the disease during their life. “We use colonoscopies for cancer prevention, because everyone is at risk of colon cancer,” says Cohen. "It’s a disease that affects men and women, regardless of family history, and it can be deadly."

In many cases, colon cancer can be prevented entirely if caught while still in a precancerous state.

Signs and symptoms

Although the goal of a colonoscopy is to catch polyps before they can develop into full-blown cancer, it’s a good idea to keep an eye out for the symptoms colon cancer can cause once it progresses.

"The warning signs most likely to trigger a doctor to call for a GI endoscopy are painless rectal bleeding, a persistent change in bowel pattern [persistence of symptoms is important] and unexplained abdominal pain or swelling," says Cohen.

Traditional treatment

It’s important for patients to know what to expect from gastrointestinal endoscopy. "First of all, the patient will be asked to come in fasting to prevent stomach contents from fluxing upward, and possibly getting into the lungs," says Cohen. "The bare minimum is ­nothing by mouth for two hours beforehand," he says.

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