Every year, over 50,000 Americans die from colorectal cancer. Unlike some cancers, colorectal cancer can be prevented. Routine screening allows early detection and removal of precancerous polyps.
Still, many people delay their colonoscopies due to fear, misconceptions, or concerns about the prep process. The good news is that colonoscopy prep has improved, making it more manageable and less uncomfortable.
Who needs a colonoscopy?
Current guidelines recommend starting colorectal cancer screening at age 45 for individuals at average risk. If you have higher risk factors, you may need to start earlier. This includes people with:
- A family history of colorectal cancer or precancerous polyps
- A personal history of inflammatory bowel disease (Crohn’s or ulcerative colitis)
- Genetic conditions like Lynch syndrome or familial adenomatous polyposis (FAP)
- A history of abdominal radiation therapy
African Americans and certain Jewish populations (such as Ashkenazi Jews) have an increased risk and should discuss screening options with their doctor.
Colorectal cancer symptoms: The silent threat
Colorectal cancer often develops with no symptoms in its early stages. That’s why routine screening is so critical. When symptoms do appear, they may include:
- Changes in bowel habits (constipation, diarrhea, or narrowing of stool) lasting more than a few days
- Blood in the stool (dark or bright red)
- Unexplained weight loss
- Persistent abdominal pain or cramping
- Fatigue or weakness
If you notice any of these signs, don’t ignore them—talk to your doctor.
Colonoscopy prep tips
A successful colonoscopy depends on proper bowel preparation. If your colon isn’t fully cleaned out, polyps and abnormalities may be missed, and you may have to repeat the procedure.
One week before: Adjust your diet
Start a low-fiber diet to reduce residue in your intestines.
The day before: Switch to a clear-liquid diet
This step ensures your bowel is completely clean.
The prep solution: The most important step
Your doctor will prescribe a bowel prep solution. Follow the instructions exactly. Drinking it in small doses often makes it easier to tolerate. Many patients find the taste unappealing, but chilling it, drinking through a straw, or sucking on a lemon slice afterward can help.
Plan to be at home for this part of the preparation process. If you have small children, be sure there is someone to help watch them.
What to expect on the day of your colonoscopy
- Arrive with a driver—you won’t be able to drive home after anesthesia.
- Bring your ID, insurance card, and any medical devices (like an inhaler).
- Expect sedation—most people sleep through the procedure and don’t remember a thing.
- If no abnormalities are found, you likely won’t need another colonoscopy for 10 years.
Take control of your health
Think of this as an investment in your future. A screening today could prevent a life-altering diagnosis tomorrow. With medical advancements making the process easier than ever, there’s never been a better time to prioritize your health.
If you’re 45 or older, or at higher risk, talk to your doctor and schedule your screening.
Dr. Michael Kaczanowski of Foundation Gastroenterology is board-certified in internal medicine and gastroenterology and has served the southern New Hampshire community for over 15 years. He received his medical degree from St. George’s University School of Medicine, Grenada, and completed his residency at Norwalk Hospital, Yale University teaching affiliate, Norwalk, CT. There, he was a chief medical resident and obtained a fellowship in gastroenterology and hepatology.
Dr. Kaczanowski has published on the use of wireless capsule endoscopy for the diagnosis of small bowel neoplasms, and his area of special interest is in the detection of colon cancer, esophageal disease, and swallowing disorders. He is a fellow of the American Gastroenterological Association and has been named Top Doctor in Gastroenterology by New Hampshire Magazine for several years.