Nobody wants to deal with an unwanted surprise, least of all when it comes to their health. WHile all medical procedures involve a certain level of risk, colonoscopy, sigmoidoscopy, and endoscopy procedures are relatively low-risk for as inherently invasive as they are.

If you feel more comfortable with a male or female gastroenterologist, then you should make such a request. Usually, a facility will have more than one gastro on site.

The risks associated with colonoscopy are very rare. They include sedation-related complications, bleeding, and perforation (poking a hole in the colon). Sedation-related complications are rare especially when the sedation (propofol) is administered by an anesthesiologist. Bleeding is a very rare complication, occurring rarely after a large polyp is removed.

For large polyps, often your doctor will place Hemoclips (small clips) over the polyp site to prevent bleeding. Perforation occurs about once every 2,000 to 5,000 procedures.

Typically, the more experienced your gastroenterologist, the less likely perforation is to occur. Suffice it to say, complications are exceedingly rare. The benefits of undergoing a colonoscopy to prevent the second leading cause of cancer-related deaths far outweigh the small risks of complications.

A lot of the anxiety surrounding the entire process of being screened for colorectal polyps, or just regular checkups on our bodies has to do with the 24-hour period prior to the actual tests. Instead of reading about the prep phase, or listening to their doctor, people often assume the worst with regards to how their bodies are going to act and react to the flushing process.

What will actually happen is never the horrorshow we work up in our minds. The reality of prepping for a sigmoidoscopy or a colonoscopy is very simple, though many people consider the bowel preparation (often called the bowel prep) the worst part of these tests.

For the doctor to see your insides clearly and get good pictures, your bowels need to be as cleaned out as possible. You probably will be told to avoid certain foods and medicines and might be put on a clear liquid diet for one or more days before these exams. You will take very strong laxatives and you might also need enemas to clean out your colon. If you can choose a day for your exam, pick one that will make it easy for you to be at home the day or evening before the test, when you do the preparation.

You will get instructions from your doctor’s office ahead of time. Read them carefully since you will probably need to buy special supplies (like clear liquids, soups, and gelatin) and get laxatives or enemas. If any of the instructions are not clear or you do not understand them, call the doctor’s office and go over them step-by-step with the nurse. This is your chance to discuss any concerns about the bowel prep you might have.

Spoiler alert, as if you didn’t already know:

Preparing for colonoscopy or sigmoidoscopy makes you to go the bathroom a lot! As soon as you take the laxatives, you’ll need to stay close to a bathroom. They usually start working pretty quickly. They might still be working the next morning when you go for your colonoscopy appointment. Don’t be embarrassed to ask for a bathroom when you get there. People have to ask this all the time and the staff is used to it.

Nobody likes talking about it, but it’s a fact of getting older, and for some, a fact of heredity.

Despite the fact that colonoscopy saves lives, only about 60% of people who should get the test actually do so. The reasons include lack of access to colonoscopy, primary providers not recommending the test, and fear of colonoscopy due to myths.

Dr. Frank Farrell has written extensively on the subject, and prepared a list of myths to bust around the dreaded procedure…to make it less dreadful. We are here to answer your questions one at a time, in order to comfort and ease you through your procedures.

Myth: The Colonoscopy Will Hurt. Facts: People don’t find these exams painful.

Although some people have more discomfort than others. Patients are given medicine to make them sleep through a colonoscopy, so they don’t feel anything. Medicine usually isn’t used for a sigmoidoscopy.

During both of these tests, air is pumped into the cleaned-out colon to keep it open so that doctors can get the best pictures. The air pressure may cause some discomfort and cramping. As with most medical tests, complications are possible with both of these tests. Some can be serious – for instance, bleeding and puncture of the colon – but they’re very uncommon. Make sure you understand how these tests work, how you can expect to feel during and after the test, and how to watch for possible problems that could come up afterward.

Dr. Ferrell’s take: Colonoscopy should not hurt. OK, the only thing that might hurt is the intravenous needle that is inserted into your arm. Colonoscopy is typically performed with either of two types of intravenous sedative medications: conscious sedation or propofol.

Conscious sedation refers to the use of a benzodiazepine such as midazolam (Versed) along with a narcotic such as fentanyl (Sublimaze). The vast majority of patients do well with conscious sedation. However, patients who are taking narcotics, sleep medications, or anti-anxiety medications are often difficult to sedate with conscious sedation. It is often difficult to predict who will not do well with conscious sedation; that is, these patients will either require large dosages of the medications or who will simply not be able to be adequately sedated.

The problems with conscious sedation have led to the increasing use of propofol (Diprivan). Don’t be frightened to learn that propofol is the drug that Michael Jackson was receiving. What happened to Michael was gross negligence and malpractice. When used properly, propofol is a wonder drug that is effective and safe. Propofol is typically administered by an anesthesiologist or nurse anesthesthetist. Having another provider administer the propofol allows the gastroenterologist to focus completely on the colonoscopy. With conscious sedation, the gastroenterologist administers the medications and has to monitor the patient’s vital signs in addition to focusing on the colonoscopy. Propofol guarantees that you will go to sleep. It is impossible to not be adequately sedated with Propofol. With propofol the patient typically wakes up very quickly after the colonoscopy and the overall recovery time is quicker than with conscious sedation. Moreover, unlike with conscious sedation, one does not have a ‘hangover’ feeling and post-procedure nausea is non-existent. Most patients wake up and describe having some of the best sleep they’ve ever had.

Some patients experience abdominal discomfort after a colonoscopy due to retained air. This really shouldn’t happen and typically results from the inadequate suctioning of air from the colon as the colonoscope is withdrawn. More often, we are using carbon dioxide (CO2) instead of air to insufflate (or fill the colon) to maximize visualization. Any residual carbon dioxide in the colon is absorbed and this helps to prevent abdominal pain and distention after a colonoscopy.

In closing, the possibility of extremely minor pain associated with a colonoscopy which screens for polyps, cancer, precancerous growths, and other intestinal diseases and problems, is a small risk to take when you look at the big picture.

Taking into account the risk of colon cancer and the advent of polyps as we age, a colonoscopy procedure is relatively speaking, minimal upkeep when compared with the possibility of colorectal surgery to remove cancerous growths.

Treating your body correctly with preventative screenings may be a little uncomfortable, but it can’t hurt you.