During the exam, a long, flexible tube with a camera attached to it is inserted into the rectum to allow a doctor to look at the inside of the colon. If necessary, the scope can also be used to remove polyps or other tissues, according to Mayo Clinic. After your initial diagnosis, you’ll need colonoscopies approximately every 1 to 3 years to monitor, treat, and manage the disease, says Jessica Philpott, MD, PhD, a gastroenterologist at the inflammatory bowel disease center at Cleveland Clinic. While there’s no denying the importance of a colonoscopy, the process can take some getting used to. Here are a few reasons your doctor may order the exam, plus ways to make the experience a little easier.
How Colonoscopies Can Help Manage Crohn’s Disease
The average digestive tract is about 30 feet long, according to the American Society for Gastrointestinal Endoscopy. Crohn’s can appear in many different ways and have differing levels of severity, but the most common form is ileocolitis: inflammation of the colon and the ileum, the small bowel right above the colon. Your doctor may recommend a colonoscopy to:
Treat complications from Crohn’s “Some patients with Crohn’s develop strictures, or narrowing of the colon, and this can be treated by dilating the stricture [with an instrument called an endoscope],” says Dr. Philpott.Check for other abnormal growths or precancerous changes in polyps This is especially important for people with Crohn’s, who have an increased risk of colon cancer.Monitor your progress after a procedure About 6–12 months after procedures such as stricture dilation, biopsy, or resection (removal of tissue), your doctor will want you to get a follow-up colonoscopy to check for healing. If you respond well, most doctors recommend a colonoscopy every 2–3 years after for monitoring.
Ways to Prepare for Your Colonoscopy
Use these tips to make the colonoscopy process easier.
Educate yourself
Philpott stresses the importance of being an informed health care consumer. The more you know in advance, the easier it will be for you and your doctor. Rely on resources such as the Crohn’s & Colitis Foundation and the American Gastroenterological Association for more information about your condition and treatment options.
Know your prep
“A good colonoscopy preparation is very important so that your gastroenterologist can clearly see the intestinal lining and monitor for things like inflammation, complications, or precancerous cells,” Iskandar explains. It’s critical to follow your doctor’s prep instructions exactly. The day before the procedure, you’ll be asked to drink a fluid that may have an unpleasant taste to clear out your colon. You may also be put on a restricted, clear liquid diet. Other forms of prep include a pill or over-the-counter laxatives. As you get more colonoscopies, notice how you respond to prep. Some people find that they do better with one method versus another, Philpott explains. “This is another example of why communicating with your provider in advance is so important.”
Communicate with your doctor
Communication with your doctor is key. “I recommend having a frank discussion with your doctor,” Iskandar says. Share any concerns you may have before the procedure. For example, “If your Crohn’s is active and you’re experiencing nausea, you may have a hard time taking the preparation,” says Philpott. “Communicate that to your doctor so you can receive anti-nausea medicine or discuss a way to drink the prep more slowly.”
Make arrangements to get home
You should have a friend or family member accompany you, or ask someone to help get you home after the procedure. You won’t be allowed to drive after being sedated, and it’s likely your doctor will not discharge you without anyone there to assist you.
Avoid activities for 24 hours
As with any procedure that involves sedation, Philpott and Iskandar say to avoid any activities for 24 hours that require you to be in your right state of mind. This includes driving or operating any heavy or dangerous machinery, climbing high ladders, and even signing important documents or contracts. “Expect to rest the day of the procedure and not work,” Iskandar says.
Avoid gassy or irritating foods
According to Philpott, most people feel fine after the procedure and can go right back to eating normal foods. But she advises avoiding any gassy, high-fiber foods for a day or two. “Gassy foods won’t injure you, but they might make you uncomfortable, because you’re going to have a little gas after the procedure,” she explains. Iskandar adds that some mild cramping, gas, and bloating are normal due to the air that enters the colon during the procedure. Loose stool and small streaks of blood also aren’t cause for alarm, but if you experience severe pain or bleeding, see your doctor immediately.
Keep diligent records
Maintaining a file of medical care records is key for anyone with a chronic condition. “When people have a colonoscopy, we print out the pictures for them,” says Philpott. “These pictures often aren’t included in electronic medical records.” A folder with records of your medical history and pictures from your colonoscopies can help you understand your prognosis over time and will be especially helpful if you switch to a new doctor.
Know it gets easier
If you’ve already been diagnosed with Crohn’s, the good news is that the most challenging colonoscopy you’ll experience is likely already out of the way. “When you have inflammatory bowel disease, your first colonoscopy is often the roughest, because it’s being done while you’re sick,” says Philpott. Subsequent colonoscopies are often easier, because you’re aware of the process and being treated. She also notes that there isn’t any increased stress to your body from having multiple colonoscopies. While a colonoscopy may disrupt your routine and require prep beforehand, Iskandar says that it’s essential for successfully managing Crohn’s, reaching remission, and preventing any long-term Crohn’s-related complications.
