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Colonoscopy: Why, When & How This Life-Saving Test Works

Colonoscopy: Why, When & How This Life-Saving Test Works

Published on: 20 June 2025

A colonoscopy procedure is more than just a test; it's a life-saving medical intervention that can detect and prevent colon cancer—a condition rapidly rising among Indians in their 30s and 40s. So, what is colonoscopy, and why is it gaining so much attention in preventive healthcare?

This blog will walk you through the essential aspects of colonoscopy: why it's done, how it's performed, how to prepare, and most importantly—whether it's painful. We'll also break down what to expect after the procedure, clear common misconceptions, and answer real patient questions in a relatable, no-jargon style.

What is Colonoscopy? Understanding the Colonoscopy Procedure

Colonoscopy is a diagnostic and preventive procedure where a gastroenterologist uses a long, flexible tube called a colonoscope (with a camera and light at its tip) to examine the inside of your colon and rectum. This allows them to check for:

  • Polyps in colon (small growths that can turn cancerous)
  • Ulcers or inflammation
  • Bleeding, tumors, or other abnormalities

Unlike other imaging tests, colonoscopy allows for real-time diagnosis and even treatment. For example, if a polyp is found, it can be removed on the spot. If suspicious tissue is detected, a biopsy is taken. That makes colonoscopy both diagnostic and therapeutic.

In India, the popularity of this test is slowly rising, thanks to increased awareness about colon cancer screening and gastrointestinal disorders like IBD, chronic constipation, and rectal bleeding.

Colonoscopy has an advantage over imaging studies like CT scans because it offers the dual benefit of visualizing and intervening in the same sitting. It's like calling the plumber who not only finds the leak but fixes it immediately!

Why Is Colonoscopy Done? Colonoscopy Test for Cancer and More

Colonoscopy isn't just for detecting cancer. It has a wide range of indications:

1. Colon Cancer Screening

The most important reason to get a colonoscopy is for early detection of colon cancer. Most guidelines, including those followed in Indian hospitals, recommend starting screening at age 45. If you're at higher risk (e.g., family history, history of polyps, or IBD), you may need to begin earlier.

In urban centres, more corporate health check-up packages are now including colonoscopy, especially for people over 40. That's a welcome change, given how silent colon cancer can be in its early stages.

2. Investigating Symptoms

If you're experiencing any of the following, your doctor may recommend a colonoscopy:

  • Unexplained weight loss
  • Persistent abdominal pain or bloating
  • Blood in stool
  • Chronic constipation or diarrhea

Even one or two episodes of rectal bleeding shouldn't be brushed off. Many Indian patients delay testing thinking it's just piles or fissures.

3. Removing Polyps in Colon

Many polyps are benign, but some can become cancerous. Colonoscopy allows doctors to remove them early. These polyps are sent for histopathological examination to determine their nature. Early removal is prevention, plain and simple.

4. Monitoring Chronic Conditions

Patients with conditions like Ulcerative Colitis or Crohn's Disease may need regular colonoscopies to monitor the disease and rule out complications.

5. Follow-Up After Treatment

If you've had surgery for colorectal cancer or polyps removed earlier, colonoscopy is essential for follow-up. It helps ensure that the disease hasn't recurred.

Is Colonoscopy Painful? What Patients in India Need to Know

This is the most common question patients ask: "Is it going to hurt?"

The honest answer? Not really.

Most people report mild cramping or pressure, but not pain. That's because sedation or anesthesia is almost always used. In India, midazolam and fentanyl are commonly used for conscious sedation. In more advanced setups like Bangalore Gastro Centre, propofol (deep sedation) is preferred for a smoother, nap-like experience.

While you're sedated:

  • You won't be aware of the insertion
  • You won't feel the camera's movement inside the colon
  • You'll likely wake up with little to no memory of the procedure

But what about after the colonoscopy?

You may feel:

  • Mild bloating or gas (from the air inserted during the procedure)
  • Slight cramping
  • Very rarely, light rectal bleeding if a biopsy or polyp removal was done

These side effects usually resolve in a few hours.

In fact, many patients are surprised how quick and easy the process was. As one 52-year-old Bengaluru-based techie said after his first colonoscopy: "I slept through the whole thing. When I woke up, it was already done!"

What Happens During a Colonoscopy Procedure?

Let's demystify the steps:

1. Admission & Consent

Once you arrive, you'll change into a gown and lie on your side. A nurse will insert an IV line for sedation. Your vitals will be monitored throughout.

2. Sedation

You'll receive sedation through the IV. This ensures comfort and relaxation. You'll likely fall asleep and won't feel the tube insertion.

3. Scope Insertion & Examination

The colonoscope is gently inserted through the anus. It travels through the rectum and colon while sending real-time video to a monitor. Air or CO2 is introduced to inflate the colon and improve visibility.

4. Polyp Removal or Biopsy

If any abnormal tissue or polyps are found, small tools can be inserted through the scope to remove or sample them. Most polyps are painless to remove and are less than 1 cm in size.

5. Withdrawal

After full examination, the scope is withdrawn. The whole procedure usually takes 20 to 45 minutes.

6. Recovery

You'll be taken to a recovery area and monitored until the sedation wears off—usually within 30 to 60 minutes. You can go home the same day.

Family members are usually briefed about the findings before discharge.

Colonoscopy Preparation Tips -- How to Prepare for a Colonoscopy

Preparation is key for a successful colonoscopy. The cleaner your colon, the easier it is for your doctor to get a clear view.

Here's a typical colonoscopy prep plan in India:

1. Three Days Before the Test

Switch to a low-fibre diet:

  • White rice
  • Plain curd
  • Eggs
  • Chicken (boiled or grilled)
  • Well-cooked vegetables without skin

Avoid:

  • Pulses and dals
  • Whole grains
  • Nuts and seeds
  • Raw fruits or vegetables

This helps reduce residue in the colon.

2. One Day Before the Test

  • Stick to a soft diet: Take a light dinner with less fibres
  • Avoid: Red or purple liquids (they resemble blood in the colon)
  • After dinner, take the laxative solution your doctor prescribes (commonly polyethylene glycol)

The laxative induces several bowel movements to empty the colon. Don't worry—it's unpleasant but temporary.

3. Day of the Procedure

  • No solid food
  • Complete the second dose of laxatives 4–6 hours before your appointment
  • Don't drink anything at least 2 hours before the test
  • Wear loose clothing and arrange someone to accompany you

Prep Tips:

  • Drink the laxative cold to improve taste
  • Use wet wipes or petroleum jelly to avoid soreness
  • Keep a toilet close—expect multiple bowel movements

What to Expect After a Colonoscopy Procedure

Most people are fine within a few hours, but here's a quick recovery timeline:

1. Immediately After

  • You'll be monitored as you wake up
  • A bit of grogginess or nausea is normal
  • You'll be given light snacks and fluids

2. At Home

  • Mild gas or cramps are common
  • Avoid driving, alcohol, and heavy exercise for 24 hours
  • Stick to bland foods like khichdi, rice, curd, bananas

Many patients are back to work the next day.

3. When to Worry

Call your doctor if you experience:

  • Heavy bleeding
  • Severe abdominal pain
  • Fever or chills
  • Dizziness

Though rare, complications like perforation or post-polypectomy bleeding may occur.

4. Results Timeline

  • Visual findings are shared immediately
  • Biopsy reports take 5–10 days

Colonoscopy vs Other Screening Tests

Colonoscopy is the gold standard, but here's how it compares to others:

Colonoscopy vs Other Screening Tests

Other tests may be less invasive but can't remove polyps. A positive result on any of them requires follow-up with a colonoscopy.

Common Patient Questions (Q&A Format)

Q1: When should I get my first colonoscopy?
Answer: If you're 45 or older, or have a family history of colon cancer, you should schedule a screening. High-risk individuals may need earlier screening.

Q2: Can colonoscopy detect all cancers?
Answer: Colonoscopy is highly accurate. However, small or flat lesions may occasionally be missed, which is why quality of prep and expertise matter.

Q3: How often should I repeat it?
Answer: If normal—every 10 years. If polyps are found—every 3 to 5 years. Your doctor will guide you.

Q4: Can I go to work the next day?
Answer: Yes, most people resume normal activities within 24 hours. But avoid strenuous work for a day.

Q5: Is it safe during pregnancy?
Answer: Colonoscopy is generally avoided during pregnancy unless urgently needed.

Q6: Do I need colonoscopy even if I have no symptoms?
Answer: Yes. Many cases of colon cancer develop without symptoms initially. Early detection is key.

Q7: Is colonoscopy expensive?
Answer: The cost varies based on the hospital and city. In India, it generally ranges from ₹6,000 to ₹15,000. Government hospitals may offer it at subsidised rates.

Choosing the Right Centre: Why It Matters

Colonoscopy isn't just about the equipment—it's about:

  • Skilled endoscopists
  • Safe anaesthesia practices
  • Infection control
  • Accurate biopsy and lab analysis

At trusted centres like Bangalore Gastro Centre, you'll receive care tailored to your needs. From proper prep instructions to thorough aftercare, having the right team makes a huge difference.

Ask about:

  • Sedation options
  • Polyp removal facilities
  • Same-day discharge protocols
  • Emergency care access

Key Takeaways

  • Colonoscopy is the most reliable method for colon cancer screening
  • It is safe, usually painless, and takes under an hour
  • Proper preparation is crucial for accurate results
  • Sedation makes the experience smooth and anxiety-free
  • Colonoscopy can detect and remove polyps, reducing cancer risk
  • Even without symptoms, screening from age 45 is recommended
  • It's an outpatient procedure with minimal downtime

Final Thought

Whether you're a 45-year-old professional in Bengaluru or a concerned parent noticing rectal bleeding, don't ignore signs. And even if you're symptom-free, screening saves lives.

Don't let embarrassment, fear, or myths hold you back. Talk to your gastroenterologist and take the first step towards protecting your digestive health.

For more information, visit Bangalore Gastro Centre.

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