What to Do After a Colonoscopy

More often than not, people will characterize a colonoscopy as an unpleasant test that they have to plow through almost as a punishment—especially the prep. At the same time, many people will either forget or entirely ignore the fact that it's an invasive procedure that demands a period of watchfulness and recovery, particularly if it involves a biopsy or the removal of a polyp.

These long-standing attitudes are at the heart of why one in every 125 colonoscopies results in a complication. While unexpected findings or even medical error may play a part, failure to adhere to post-treatment recommendations and/or dismissing symptoms as "minor" remain key factors in raising the risk. For this reason, it's very important to talk about what to do after a colonoscopy.

A colonoscopy is an important procedure, and of all cancer screening tests, is one that clearly reduces your risk of dying from colon cancer. This risk is significant, as colon cancer is the third leading cause of cancer-related deaths in both men and women in the United States.

In our fast-paced society, most adults could use a few moments to pamper themselves anyway, and this might be just your opportunity. Let's review the basics of colonoscopy, and then talk about how you can best care for yourself (or a loved one) after the procedure has been completed.

A colonoscopy entails the insertion of a flexible scope through the anal canal into the rectum and colon. A colonoscope allows visualization of the colon structure as well as the removal of any suspicious growths that may suggest a developing malignancy.

Colonoscopy is considered the gold standard tool for visualizing the colon, far better than either flexible sigmoidoscopy or barium enema. While computerized tomography (CT) scans are emerging as an effective means to detect colorectal cancer; they aren't nearly as good at detecting flat lesions or polyps.

While most people who undergo the procedure will elect to be anesthetized, a skilled clinician can perform one without sedation if the person would rather avoid the after-effects of anesthesia. (Currently, only one percent of colonoscopies are performed without sedation.)

In the United States, it is recommended that all persons 50 years of age or older receive a colonoscopy every 10 years to screen for colorectal cancer. The frequency may be increased for persons at higher risk or those who have been previously treated for colon cancer.

Once the colonoscopic procedure has been completed, it is recommended that you be driven home by a friend or family member. If you were sedated for the procedure (which most people are), it's recommended that you have someone with your for the first 24 hours after you leave the endoscopy clinic or hospital.

If you have nausea, your doctor may prescribe medications to help alleviate symptoms.

If you're taking a daily aspirin to prevent heart troubles, you don't need to stop. Lower-dose aspirin is considered safe after a colonoscopy.

Complications are uncommon, but can occur. Call your doctor or clinic if you experience any of the following symptoms in the first 24 hours following your procedure:

• You have chills or fever.
• You experience rectal bleeding of more than a tablespoon.
• You experience swelling at the site where the IV needle was inserted.
• You experience severe abdominal pain or bloating (mild pain or bloating can be expected).
• You are vomiting.
• You are experiencing irregular heartbeats (arrhythmia).
• If you just don't feel right for any reason. Trust your intuition, and if you feel that something could be wrong, don't hesitate to call.

If polyps were removed during your colonoscopy, you will likely need to alter your activities for next seven days. This includes not running, not lifting anything over five pounds, avoiding unnecessary travel, and stopping any blood thinners you may be taking (but first, this should be discussed with the physician who has been prescribing the blood thinners, as sometimes using these after a colonoscopy outweighs the risk of not using them). In short, be careful and treat your body gingerly.

If you experience any of the following symptoms during the first week, call your doctor immediately or go to your nearest emergency room:

• You are unable to have a bowel movement or to urinate.
• You suddenly have trouble breathing.
• Your stools are black or bloody.
• Your vomit has blood or bile in it.
• Your abdomen becomes tender and hard.
• Any symptoms you have are getting worse.

In the United States, and around the world, we tend to see time as money, and push ourselves to the edge. It's not just us, as employers value employees who do so. But taking time to heal— even if your colonoscopy is just a routine screening test—is imperative. 

Taking the time to schedule, perform the prep for, and go through with your colonoscopy can seem like a nuisance. Yet, out of all of the cancer screening tests available, this is the one that is most likely to make a difference in your health and survival. Colonoscopies are unique among cancer screening tests in that they can be effective in both early detection and prevention. They may pick up a cancer in the earliest most treatable stages, well before you would have symptoms. But they may also be the key to preventing cancer if a precancerous polyp is found and removed before it can become cancerous.

Knowing the importance of this test, you owe it to yourself to take it easy for a few days. Many people forego this test and end up taking many more days off (for surgery, chemotherapy, and more) if they even survive. So pamper yourself. Eat well. Sleep well. And wait until you are feeling ready to face the world again before venturing out. You are worth it!