It's the prep, not the procedure that is most invasive

SALT LAKE CITY — Many who have had a colonoscopy would agree, doctor-prescribed preparations to clean the bowels are almost always worse than the actual procedure.

"The cleaner the colon is, the better the examination can be," said Dr. Robert Jones, a gastroenterologist at the Intermountain Medical Center and Mountain West Gastroenterology. He said technology has come a long way to help detect precancerous polyps, or growths in the lining of the large intestine, but it can't see through roughage in the digestive process.

Patients are instructed to eat and drink only clear liquids the night before the procedure, as well as ingest a sometimes foul-tasting medication regimen, which helps to clear the colon. The dosing and medium varies, but Jones said most bowel prep formulas are effective in helping to evacuate the bowel.

The colonoscopy, however, he said, is "tolerated quite well."

Jones, and Dr. Tae Kim, a colorectal surgeon at Intermountain Healthcare's LDS Hospital, will be taking questions from the public during this month's Deseret News/Intermountain Healthcare Health Hotline. From 10 a.m. until noon, individuals are welcome to call 1-800-925-8177 or post questions on the Deseret News' Facebook page, www.facebook.com/desnews.

Doctors use a thin, flexible, tube-like camera to scan the lining of the colon, looking for polyps, which Jones said "come in all shapes and sizes." Polyps are located in about 20 percent of all patients, but not all polyps have the potential to turn into full-fledged cancer.

When they are discovered, doctors typically remove the polyps during the colonoscopy for testing, but also to avoid having to go back inside the colon for another surgery at a later date, should the polyps be found to be cancerous.

"Virtual" colonoscopy, performed by a CT scan of the colon, is getting the job done more quickly and definitely less invasive; however, Jones said a colonoscopy procedure would still be necessary if the X-ray is concerning.

High-definition scopes that have become available over the years are allowing doctors to see more and more polyps, which is helping to detect more cancer in its curable pre-stages, Jones said. Of any cancer screening measure, colonoscopy has been proven to be the only one that has been effective in decreasing the incidence of cancer.

"Screening is improving outcomes," Jones said.