Your Colon Called. It’s Time.

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Ok. It’s March.

It’s Colon Cancer Awareness Month.

Let’s get into this shit…literally.

The colon (also known as the large intestine) is about 5 feet long. That’s almost as long as me! You may remember from high school biology that the colon is the organ that absorbs water and some vitamins from waste as it moves through your body. And at the end of that long, noble journey?

Poop.

(And yes, one of my biggest pet peeves is when people say “poo” instead of “poop.” I don’t know why, but it makes me viscerally ill- every time.)

Illustration of the human digestive system highlighting the large intestine encircling the small intestine. Photo created by AI.

Why is it important to talk about colon cancer?

Colon cancer is the third most commonly diagnosed cancer and the second leading cause of cancer death in the United States. It’s expected that more than 55,000 people will die from colon cancer this year alone. The good news is that overall, rates of colon cancer have been decreasing since the 1980s.

BUT.

(You knew there was a “but” coming in a colon post.)

In people younger than 50, colon cancer rates have increased by 2.9% per year from 2013 to 2022. In adults ages 50–64, rates have also increased, though more slowly, at 0.4% per year during that same time period.

Why is this happening?

Colon cancer rates have decreased overall because screening has improved tremendously, and colonoscopies often catch and remove polyps before they turn into cancer.

As for why rates are rising in younger adults, there’s no single answer. Possible reasons include:

·       processed foods and the Western diet

·       rising obesity rates

·       chemical exposures

·       changes in gut bacteria, possibly related to antibiotic overuse

In other words: the usual “modern life is trying to kill us, but in a subtle way”.

What are the recommendations for colon cancer screening?

Well, let’s go ahead and get the elephant in the room out of the way first.

Artist's depiction of the inside of a colon, highlighting its structure through a cross-sectional view. Image created by AI.

The dreaded colonoscopy.

Colonoscopies are now recommended starting at age 45 for people at average risk of colon cancer. And yes, you’ve probably heard the horror stories: drinking a giant amount of disgusting liquid and then spending hours on the toilet questioning all of your life choices.

The good news? The prep liquids have gotten slightly better.The bad news? You still end up in the bathroom for a while.

So… what exactly is a colonoscopy?

A colonoscopy involves placing a small camera connected to a long thin tube into the rectum and through the colon so the doctor can look at the lining of your large intestine. It is very difficult to see the walls of the colon if there is poop covering them, which is why you have to empty your colon completely before the test.

That’s also why you really do need to drink the special prep solution your doctor prescribes. I’ve seen people try their own DIY “cleaner” preps, and to be honest, I haven’t heard of one that truly works well. Sure, you might be partially cleaned out—but for a colonoscopy, partially clean is not the goal. The prescribed prep solutions have been studied and are designed to get the job done in most cases. No freestyling, because it usually means repeating the process with the prescribed prep!

The prep: not fun, but not impossible

Usually, the day before your colonoscopy, you’ll start a clear liquid diet: broth, Gatorade, Jell-O (I truly can’t believe there was a time in my life when I ate Jell-O willingly), popsicles, tea, apple juice, etc.

A depiction of my imagined facial expression while having a bite of vibrant green jello. Image created by AI

A clear liquid is basically anything you can see through.

And no, apparently vodka does not count.

Depending on what time your colonoscopy is scheduled for the next day, you’ll usually start the prep in the early evening. The one I drank was a 6-ounce bottle (gone are the days of forcing down an entire liter), followed by 4–5 glasses of water.

Was it pleasant? No.

Was it doable? Yes.

My colon started self-cleaning around 6 p.m. and continued until about 9 p.m. I actually managed to get some sleep before my alarm went off for the second dose of prep at 3 a.m. I repeated the same routine, then went back to sleep. When I woke up around 6 a.m., I had a few more bowel movements. By the time I was ready to leave for the procedure, I was basically expelling clear liquid— Which, if you’re wondering, is the glamorous sign that you’ve done it right.

A clear glass containing a light, watery liquid with a small floating particle, illustrating an representation of colon content after a proper colonoscopy prep. Image created by AI.

The day of the procedure

While you can drive to your colonoscopy, you must have a ride home, which is why it’s recommended to bring someone with you.

I arrived at the facility at 9:30 a.m. for my 10:30 a.m. procedure. I changed into a gown, an IV was placed in my arm, and then they wheeled me into the procedure room. The anesthesiologist told me there was nothing to worry about and before I could say “how do you know?”

…I was out.

Usually, anesthesia is given through the IV, and you fall asleep almost immediately. The actual colonoscopy typically takes 15–30 minutes (depending on the number of polyps you have).

And here is the most important part to know:

If the doctor sees a polyp, they will remove it right then and there.

That means if the polyp is precancerous, you may have just prevented cancer before it ever had the chance to develop. That’s a pretty amazing thing.

Waking up afterward

You wake up from the procedure, and there is a decent chance you’ll say something mildly unhinged to the nurse while the anesthesia wears off.

Like singing the lyrics to Landslide. <facepalm>

The staff will usually give you something to drink and a few crackers once you’re more awake. Once you can tolerate food and liquids and are steady on your feet, you can get dressed and go home.

Because of the anesthesia, it’s recommended that you take the rest of the day off. No driving, no operating heavy machinery, and probably no making major life decisions.

A perfect day to Netflix and chill.

A woman enjoys a cozy evening on the couch, watching TV against a backdrop of a serene cityscape through the window. Image created by AI.

Why colonoscopy is such a good test

A colonoscopy has about a 90–95% detection rate for colon cancer and a relatively low false-positive rate. All in all, it is one of the best cancer screening tests we have—not just because it can find cancer, but because it can actually prevent it by removing precancerous polyps before they become dangerous.

Final thoughts

Look, nobody wakes up excited to schedule a colonoscopy. The prep is annoying, the jokes write themselves, and yes, there is literally a camera involved. But this is one of those rare medical tests that can truly save your life before anything is even wrong. If you’re 45 or older, or if you have symptoms like rectal bleeding, unexplained weight loss, persistent abdominal pain, or a family history of colon cancer, don’t put it off out of fear or embarrassment. We talk a lot about “listening to your body,” but sometimes your body is saying, “Please stop ignoring me and schedule the poop test.” 

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(If you’re absolutely terrified of getting a colonoscopy, don’t worry—we’ll talk next time about common fears, other screening options and how they compare.)