Getting a colonoscopy is not something most people will look forward to. However, it is a very useful procedure for keeping up with your gut health. Widely regarded as the best procedure for colon cancer screening, colonoscopy is also frequently used to check out various gastrointestinal symptoms like piles, blood in the stools, constant stomach bloating or cramping, and more.
When the time comes to get your first colonoscopy, it is normal to feel nervous and worried about it. Yet, knowing that you have an experienced doctor with a wonderful track record can give you more confidence and help to allay your fears. Talking to your doctor and making sure you know what to expect can also go a long way in preparing yourself mentally for the procedure.
To make your colonoscopy experience as comfortable and worry-free as possible, here are some questions you should definitely ask your doctor before the colonoscopy:
- What is their adenoma detection rate?
Adenoma detection rate (ADR) is often taken as a strong indicator of how effective a doctor’s colonoscopies are. A doctor’s ADR is defined as the proportion of patients with at least one adenomatous polyp detected out of all the first-time colonoscopy patients over 50 years old that are screened by the doctor in a given time period.
A lower ADR may mean a higher chance of missed polyps or cancers, while higher ADRs are an indication of effective colonoscopy. A general guideline for a ‘good’ ADR is 20% or higher for women patients, and 30% or higher for men. However, you should also note that the demographics of a doctor’s patient base also affect their ADR. For example, a doctor who sees relatively higher numbers of young and female patients may have a lower ADR, but it might not mean they are any less competent in performing colonoscopies – rather, their patients are just less likely to have polyps in the first place.
- What is their average withdrawal time like?
A doctor performs colonoscopy by first inserting the scope fully into the colon, then conducting examinations as the scope is being withdrawn. Thus, common sense will have it that doctors who are more thorough in their examinations will take longer in their withdrawal time.
It is during this withdrawal time that precancerous polyps and other lesions are typically found, and studies show that doctors with a longer withdrawal time often also have higher ADRs. Experts recommend looking for a doctor with a withdrawal time of at least 6 minutes.
- What is their cecal intubation rate?
The cecum is the furthest point of the colon from the rectum, which is where the large intestine meets the small intestine. A total colonoscopy means that the cecal intubation rate is 100%, where the scope reaches all the way to the cecum. Having a lower cecal intubation rate will mean a higher chance of missing any polyps that are in the colon.
The average cecal intubation rate is about 90%, so if your doctor has a rate above that, you are likely to be in good hands. However, in some cases, low cecal intubation rates can be due to incomplete bowel preparation by the patient, which prevents the doctor from advancing the scope fully.
- What is the preparation process like?
Following the right preparation steps will help ensure that your bowels are completely cleared for the procedure. Inadequate clearing will affect the cecal intubation rate, and in the worst case, will mean you have to postpone your colonoscopy appointment – and go through the bowel prep again.
Different doctors may have slightly different instructions and colon-clearing solutions for their patients. So, make sure you hear it from your doctor on the right steps to follow, and commit to it diligently. Just remember, colonoscopy can save your life, so putting up with a few days of inconvenience will be worth it!
- What will the procedure be like?
Being nervous about an upcoming medical appointment can be truly nerve-wracking, but knowing what to expect at the procedure can at least help you prepare your mind for it. You can ask people you know who have gone through colonoscopy before on what to expect.
Most of all, ask your doctor directly about what will happen at the procedure. They will know best about how long the process will take, what kind of discomfort you will feel, and what sedation methods are available.
As with any medical procedure, it is always good to pick a doctor you are comfortable with and confident in. Asking the right questions can help you make the right choice!
Experiencing piles, flatulence, or blood in stool symptoms? If you have persistent gastrointestinal symptoms or a high risk of colon cancer, it might be time to set a colonoscopy appointment with your doctor.