Are there alternatives to colonoscopies?

There are other ways to screen for colon cancer. These include:

  • Stool tests, such as the fecal immunochemical test (FIT), fecal occult blood test (FOBT), stool DNA tests (like Cologuard®). These tests let you collect your stool samples at home and then return them to your healthcare provider or mail them to a lab. You will have to do these more often than a colonoscopy.
  • CT colonoscopy (also called a virtual colonoscopy).
  • Flexible sigmoidoscopy, a test similar to the colonoscopy but covering a smaller part of the colon and the anus. It does not visualize the first part of the colon.

You and your healthcare provider should discuss the type of colon cancer screening that you should have. The choice will be based on your overall risk of colon cancer, general health, any symptoms you might be having and your personal preference. You should contact your health insurer about the costs of these less conventional tests.

You should know that some of the options that are not actual colonoscopies still call for the same type of preparation (cleaning out the colon by causing diarrhea). If polyps or other abnormalities are found on the alternative testing, they cannot be removed or treated. So it is likely that you will still have to have a colonoscopy. In addition, the costs of a screening colonoscopy may be less than of a colonoscopy completed after another, positive screening test other than colonoscopy.

Can you swallow a camera in a pill to take pictures of your colon?

Currently, the pill camera test is used to view the small intestine because the small intestine is easier to clean (for visibility) (the part of your bowel between your stomach and colon). Also, the camera passes through the small intestine in two to three hours.

The pill camera is being studied for colonoscopy. There are issues, though:

  • The large intestine (colon) is wide and has folds and creases.
  • It can take as long as 36 hours to pass the pill camera through the colon.
  • The colon is not as easy to get and keep as clean as the small intestine.

Can you have a colonoscopy while you have your period?

The answer to this question is yes. You might want to wear a tampon if you have your period.

Can you have colonoscopy when you are pregnant?

A pregnant woman should always consult her obstetrician before having any kind of procedure. If you are having a colonoscopy for screening, it is best to wait after pregnancy. However, colonoscopy is generally believed to be safe during pregnancy.

What are the recommendations for scheduling your first and later colonoscopies?

If you are a person of average risk for colorectal cancer, the recommendation is to get your first screening test at 50, unless you are African American, which means you should start at age 45. This might be a colonoscopy or a stool test. If your risk is higher or you have certain symptoms, your healthcare provider might suggest a colonoscopy or other screening test earlier than age 45. The incidence of colorectal cancer in African Americans has been increasing, and survival rates in those with colon cancer are worse than those for other groups.

You should discuss when to start screening with your healthcare provider. There are other sets of guidelines. For instance, the American Cancer Society suggests that screening for average risk people and African Americans start at age 45.

Follow-up colonoscopies will depend on the results of the first one. If you have no polyps and low risk, you might be able to wait 10 years before having another one. If you do have polyps and are considered high-risk, you might have to have a yearly procedure. (A colonoscopy every 10 years is the general rule for people who are not at high risk.)

Regular screening should be done through the age of 75. After that, you and your healthcare provider can decide on further screening needs.

Can a colonoscopy find parasites?

In the case of some parasites, like whipworms, the answer is yes. However, a colonoscopy is not the usual way to diagnose parasites.

Can a colonoscopy be used to diagnose endometriosis?

If you are a woman with endometriosis, you may have symptoms that affect your bowel, such as pain or bouts of constipation mixed with diarrhea. Your gynecologist might suggest a colonoscopy to rule out bowel problems. Usually, the endometrial tissue does not protrude through the bowel so it cannot be seen on a colonoscopy. Such tissue often sticks to the outside of the bowel or to other tissue in the area.

Can a colonoscopy be used to diagnose prostate cancer?

No. A colonoscopy is not designed to find prostate cancer. However, some doctors may choose to perform a digital rectal examination and a prostate examination before inserting the colonoscope. Men may believe that that their prostates have been examined, but this might not be true. It is a good topic to bring up with your doctor before a colonoscopy.

Here is a final thought about colonoscopies. Many people avoid them because they find the idea embarrassing and the preparation to be unpleasant. However, people often ask themselves and their care providers how we can prevent something from happening. Here is one way: colonoscopies can stop colon cancer before it starts.

Last reviewed by a Cleveland Clinic medical professional on 10/27/2019.

References

  • Expert knowledge and experience of healthcare providers at Cleveland Clinic.
  • American College of Gastroenterology. Colonoscopy. Accessed 1/31/2020.
  • The National Institute of Diabetes and Digestive and Kidney Diseases. Colonoscopy. Accessed 1/31/2020.
  • Endometriosis.org. Bowel symptoms. Accessed 1/31/2020.
  • American Society for Gastrointestinal Endoscopy. Understanding Bowel Preparation. Accessed 1/31/2020.
  • Gies A, Cuk K, Schrotz-king P, Brenner H. Direct Comparison of Diagnostic Performance of 9 Quantitative Fecal Immunochemical Tests for Colorectal Cancer Screening. Gastroenterology. 2018;154(1):93-104.
  • World Health Organization. Colonoscope. Accessed 1/31/2020.
  • De lima A, Galjart B, Wisse PH, Bramer WM, Van der woude CJ. Does lower gastrointestinal endoscopy during pregnancy pose a risk for mother and child? - a systematic review. BMC Gastroenterol. 2015;15:15.
  • Bechtold ML, Mir F, Puli SR, Nguyen DL. Optimizing bowel preparation for colonoscopy: a guide to enhance quality of visualization. Ann Gastroenterol. 2016;29(2):137–146. doi:10.20524/aog.2016.0005
  • Fang JC, Faerber G, Samadder J. Digital rectal examination for prostate cancer screening performed with colonoscopy for colon cancer screening: 2 for the price of 1. Gastrointest Endosc. 2017;86(6):1147-1150.
  • Baffy G. Digital Rectal Examination: Is It Warranted in the Endoscopy Suite?. Am J Gastroenterol. 2019;114(2):355.
  • Lab Tests Online. Fecal Immunochemical Test and Fecal Occult Blood Test. Accessed 1/31/2020.
  • American Cancer Society. American Cancer Society Guideline for Colorectal Cancer Screening: For people at average risk. Accessed 1/31/2020.
  • American Society for Gastrointestinal Endoscopy. Colorectal cancer screening: Recommendations for physicians and patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Accessed 1/31/2020.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy