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What You Need to Know About Colonoscopies in the Elderly

Crystal Jo
By Crystal JoOctober 25, 2018

Colonoscopies are one of the most dreaded medical procedures and understandably so. They have a risk of bowel perforation, are invasive and require sedation. Nobody wants to get a colonoscopy, yet there are over 40,000 done each day.

Is a colonoscopy always necessary? Here is what you need to know before scheduling one for an elderly loved one.

Colonoscopies in the Elderly

A colonoscopy is a procedure that allows a doctor to look inside the entire colon and rectum.

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During a colonoscopy, the doctor is looking for abnormal growths, inflamed tissue and ulcers.

A colonoscopy will be ordered for a variety of reasons but are usually for:

  • Screening to check for cancer or inflammatory disease like ulcerative colitis
  • Surveillance to follow up if you have a history of cancer, colon polyps or inflammatory bowel disease
  • Therapeutic purposes to seal off intestinal bleeding or to treat a blockage or narrowing in the colon

Colorectal cancer is one the diseases screened for during a colonoscopy and polyps (small growths) may also be removed during that time.

The National Cancer Institute reports that there were 140,250 new cases of colorectal cancer in 2018. Out of those cases, there was a 64.5% survival rate at five years after diagnosis.

The Cancer Treatment Centers of America estimates that there are 40,000 colonoscopies performed each day.

Is a Colonoscopy Necessary?

Despite the high number of colonoscopies that are done, there may be situations where a colonoscopy may not be necessary.

Research has begun to question the practice of colonoscopies in the elderly if:

1. You are age 75 or older.

The U.S. Preventative Services Task Force (USPSTF) has made the recommendation that colonoscopies are no longer the best idea for people over the age of 85. For people 75-85 years old, the USPSTF recommends that colonoscopies be ordered on a case by case basis. Not everybody over 75 will benefit from a possible early cancer detection.

2. You had a colonoscopy in the last 10 years.

Harvard Medical School reports that it typically takes 10 years or more for the precancerous polyps found during a colonoscopy to develop into full-blown cancer. If you have no known risk factors and have no symptoms of colon problems, it may be unnecessary to do a colonoscopy more than every 10 years.

3. You would be more fit to do another test instead.

Although a colonoscopy is the most thorough way to assess the health of your bowels, there may be situations where a less invasive test would be a better fit for an elderly person.

Other tests that may include:

  • CT colonography, which is a CT scan of your entire colon
  • Double contrast barium enema, which involves an x-ray of your colon
  • Fecal DNA, which is a lab test done on a stool sample
  • Fecal occult blood test, which is performed on a stool sample
  • Sigmoidoscopy, which is an internal scope of the lower third of your colon only

Preparing for a Colonoscopy

It is important that you talk to your doctor about whether a colonoscopy is the best test for your age and health situation.

Once you have discussed it with your doctor, you might both decide a colonoscopy is necessary.

The U.S. National Library of Health offers this advice for preparing for your colonoscopy:

Before

The day before the procedure, your doctor will recommend a laxative that will clean your system out. You will also need to not eat for a set amount of time. To be able to get a clear picture of your insides, your colon needs to be completely emptied.

Tip: If your elderly loved one is being prepped for a colonoscopy, make sure that they have the support necessary to get to the bathroom in a timely fashion. Move furniture that may be a tripping hazard when they need to get to the washroom quickly.

During

On the day of the procedure, your elderly loved one will go to the hospital set up by their doctor and typically be admitted for four hours from start to finish.

Once checked in, your loved one will be set up on the bed and then given a sedative through an IV line. They will either become drowsy and fall asleep or just feel “out of it” and not remember the procedure.

The actual procedure takes from 15-60 minutes. The doctor will use a scope to view the inside lining of the colon and surrounding areas. There is a small amount of gas or air also inserted to puff up the intestines to make it easier to move the scope around. If there is any abnormal tissue or polyps, they can be removed during the procedure.

Afterward, they will stay in the recovery room for about 30-90 minutes until they are awake enough to head home. It is recommended that they take the remainder of the day off, not drive or return to work.

Tip: Plan for extra time to get your elderly loved one to the hospital and to get set up. Than add another half hour. Feeling rushed and pressured will make the procedure more stressful.

The Day After

Start with a light meal when your loved one gets home. Within two to three days most people will be feeling back to normal.

Let the doctor know if your loved one is having any bleeding, fevers, nausea, severe pain or shortness of breath.

Tip: Set your loved one up with easy-to-eat meals. If your loved one has any confusion or weakness, make a plan to have someone stay with them (or be close by) for a few days after a colonoscopy to help clean up, help make meals and help with personal hygiene as needed.

Nobody wants to get a colonoscopy, but if it is medically necessary, a colonoscopy can help your elderly loved one to catch cancer early and make a full recovery.

Have you or an elderly loved one been recommended to have a colonoscopy? What steps did you take to make it go more smoothly? We’d like to hear your suggestions in the comments below.

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Crystal Jo
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Crystal Jo
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