A colonoscopy is a medical procedure that involves the examination of the large bowel, also known as the colon, and the lower part of the small bowel. This examination is performed using a flexible tube with a camera attached, called a colonoscope, which is guided through the anus. The primary goal of a colonoscopy is to visually inspect the inner lining of the colon wall to identify abnormalities such as ulceration, inflamed tissues, or precancerous growths called polyps. This procedure is widely recommended for screening colorectal cancer, often starting at age 45 or 50, depending on individual risk factors and guidelines. A thorough bowel preparation is a necessary step to ensure the success and accuracy of the procedure.
Impact on the Colonoscopy Procedure
Incomplete bowel preparation directly affects the colonoscopy procedure. If the colon is not adequately cleansed, residual stool or fluid can obstruct the view of the colon lining, making it difficult or impossible for the endoscopist to properly examine the area. This poor visibility can lead to a suboptimal study, where portions of the bowel may not be visible, or the procedure may need to be aborted entirely.
Attempting to proceed with a poorly prepped colon can also prolong the procedure time and potentially increase patient discomfort. Studies have shown that inadequate bowel preparation is associated with lower rates of cecal intubation, which is the ability to reach the end of the colon. This means the doctor may not be able to examine the entire colon, leaving parts unchecked.
Health Risks of Inadequate Screening
A compromised or missed colonoscopy due to incomplete preparation carries significant health consequences. If the colon cannot be fully visualized, polyps, including those that are precancerous, or early-stage cancers can be missed. The risk of missed lesions increases with poor preparation.
The primary purpose of a colonoscopy is prevention and early detection, which is undermined when the procedure is incomplete. Missed polyps can grow and potentially develop into more advanced cancer over time, leading to delayed diagnosis and treatment. This delay can result in more extensive and invasive treatments, and potentially poorer long-term outcomes for the patient. For instance, the risk of dying from post-colonoscopy colorectal cancer can be more than twofold higher with fair or poor bowel preparation, and over fourfold higher with inadequate preparation.
What to Do if Your Prep is Incomplete
If you realize your bowel preparation is incomplete, it is important to contact your doctor’s office or the endoscopy unit immediately, even before your scheduled procedure. They can assess the situation and provide specific guidance. Depending on the timing and the extent of the incomplete prep, the medical team might suggest adjusting the preparation, such as taking an additional laxative or enema if there is enough time.
In many cases, an incomplete prep will necessitate rescheduling the colonoscopy. It is important to be honest and communicate openly with your healthcare providers about any difficulties you experienced with the prep. They can offer solutions or modify the prep regimen for your rescheduled procedure to improve the chances of a successful cleansing.