Colonoscopy
Colonoscopy
Understanding Colonoscopy
- A colonoscopy is a medical procedure performed under mild anesthesia by Dr. Anubha Sinha, a triple board-certified gastroenterologist
- A thin, flexible tube (colonoscope) with a camera is inserted through the rectum into the colon
- CO₂ or air is used to inflate the colon for better visibility
- Images are displayed on a monitor during the procedure
- Typically takes less than 30 minutes
- Used to detect and remove polyps and screen for colorectal cancer
- Biopsies may be taken of suspicious tissue
Procedure Locations
- Location depends on patient preference, insurance coverage, and patient medical condition
What is a Direct Access Colonoscopy?
- Allows healthy, age-appropriate patients to schedule screening
- Initial consultation is required for all patients
- Consultation includes:
- Medical and surgical history review
- Physical exam
- Determining if colonoscopy is appropriate
- Ensuring patient safety before, during, and after procedure
Consultation FAQ’s
Scheduling a Colonoscopy
- Call (908) 788-8200 to schedule an initial consultation
- Request an appointment through our website
Make an appointment in person at either or Flemington or Hillsborough Office
What to Bring to Your Consultation
- List of:
- Current medications
- Allergies
- Past surgeries
- Family history
- Important to disclose:
- Chronic conditions (diabetes, heart disease, etc.)
- Medications (NSAIDs, blood thinners, supplements, etc.)
- Antibiotics may be required for certain conditions (e.g., artificial heart valve)
- Medication adjustments may be needed (especially for diabetics or blood thinners)
Why an Initial Consultation is Required
- Colonoscopy is not appropriate for everyone
- Ensures safe use of anesthesia
- May require:
- Clearance from primary care or specialists
- Pre-op testing (EKG, chest X-ray, etc.)
- Additional considerations:
- Obesity, sleep apnea, CPAP use
- Prior anesthesia complications
- Patients may need anesthesiology consult before procedure
Colonoscopy Preparation
- Modify diet several days before
- Clear liquid diet 24 hours prior
- Take prescribed bowel prep to clean colon
- Purpose:
- Ensure clear visibility of colon lining
- Detect abnormalities like polyps, ulcers, or masses
During the Procedure
- Patient lies on left side
- May be asked to reposition
- Procedure lasts less than 30 minutes
- Total time at facility: 1-2 hours at Hospital/Surgical center including recover
Sedation & Comfort
- MAC sedation is used (monitored anesthesia care)
- Benefits:
- Faster recovery
- Fewer side effects
- Better comfort and pain control
- Older sedation methods (e.g., fentanyl, midazolam) are less commonly used
- Patients are monitored before, during, and after
Comfort Measures
- CO₂ used instead of air (at Hillsborough location)
- Benefits:
- Less bloating and discomfort
- Reduced gas after procedure
- Improved patient experience
- Tube
- Sedation
Can You Skip Sedation?
- Not recommended (procedure can be painful)
- Alternative sedation options available if needed
- Discuss options during consultation
After Sedation
- Patient lies on left side
- Quick recovery, but:
- Driver required
- No driving or important decisions for 24 hours
- Most patients can resume light activities same day
- Recommended to take the day off from work
Bowel Prep
- Requires:
- 24-hour liquid diet
- Laxatives → causes diarrhea
- Must stay near a bathroom
- Tips:
- Stay hydrated
- Use Vaseline or wipes for comfort
- Goal: completely clean colon for accurate results
ASC Bowel Preparation
AMBULATORY SURGICAL CENTER OF SOMERSET (ASC) BOWEL PREPARATION:
- SUPREP - Click to print
- SUTAB - Click to print
- GAVILYTE/NULYTELY - Click to print
- MIRALAX - Click to print
HMC Bowel Preparation
HUNTERDON MEDICAL CENTER (HMC) BOWEL PREPARATION:
- SUPREP - Click to print
- SUTAB - Click to print
- GAVILYTE/NULYTELY - Click to print
- MIRALAX - Click to print
Types of Bowel Prep
- Liquid-based (large or small volume)
- Pill-based options
- Selected based on:
- Medical history
- Preference
- Insurance
Why Bowel Prep is Critical
- Poor prep can:
- Obscure polyps/lesions
- Lead to missed diagnoses
- Some patients may need extended prep
- Call office if prep isn’t working
After the Procedure
- Recovery time: ~30 minutes
- Possible symptoms:
- Mild cramping
- Gas (reduced with CO₂ use)
- Usually can resume normal diet immediately
FAQ
Returning to Work
- Not the same day
- Resume work next day if no complications
Possible Complications
- Bleeding
- Perforation
- Reaction to anesthesia
- Missed lesions
- Seek immediate care if:
- Severe pain
- Bleeding
- Fever, chills, or sweats
Transportation Requirements
- Must have a trusted driver
- No taxis or rideshares like uber allowed (safety/liability reasons)
Follow-Up Care
- Necessary even if no cancer is found
- Helps:
- Review results
- Discuss biopsy findings
- Plan future screenings
- Screening helps:
- Detect cancer early
- Remove polyps before cancer develops
Pathology results take up to 2 weeks
Is Colon Cancer Only a Disease of Older Adults?
- No.While colorectal cancer is more common with age, it is no longer considered only a disease of older adults.In recent years, there has been a concerning rise in young-onset colorectal cancer (diagnosed in adults under 50).Key facts:
- Rates of colon cancer in adults under 50 have increased significantly over the past few decades
- Many younger patients are diagnosed at more advanced stages
- Symptoms in younger individuals are often mistaken for benign conditions like hemorrhoids or IBS
- About half of colorectal cancer cases are now diagnosed in people under age 66
This is one of the main reasons screening now begins at age 45 instead of 50.Bottom line: Do not ignore symptoms just because of age.
Questions Every Patient Should Ask Before a Colonoscopy
Topic
What You Should Ask
Why It Matters
Age to Start Screening (45 vs 50)
Why did guidelines change to age 45? Am I high-risk or average-risk? Should I start earlier?
Should I start earlier?Colon cancer rates are rising in younger adults, which is why screening now starts at 45 instead of 50.
Complication Rate & Experience
How many colonoscopies do you perform each year? How long have you been doing them? What is your complication rate?
Experience and procedure volume are strongly linked to safety and detection quality.
Sedation & Comfort
Will I be asleep? Who administers anesthesia? Is a board-certified anesthesiologist present? Will I feel anything?
Most patients are fully asleep and comfortable when anesthesia is properly administered.
Bowel Preparation
What prep do I need? Are pill or low-volume options available? Is it split-dose? What if prep is not good enough?
Proper bowel prep is essential for detecting polyps and preventing missed lesions.
Can I Drive Home?
Will I need someone to drive me? When can I resume normal activities?
Sedation affects judgment and reflexes, so patients cannot drive after the procedure.
Insurance Coverage
Is this screening or diagnostic? Is it covered at age 45? What will my out-of-pocket costs be?
Coverage depends on insurance type and medical necessity. Most screening colonoscopies are covered.
Location of Procedure
Will this be done in a hospital or outpatient center? Which is preferred by my insurance? What are the costs?
my insurance? What are the costs?Facility setting can significantly affect cost and convenience.
Why the Procedure Is Needed
Am I due for screening? What are my risk factors? What happens if I delay or decline?
Helps ensure appropriate timing and prevents missed or delayed diagnosis.
Physician Experience & Quality
How many colonoscopies do you perform yearly? What is your ADR? Are you triple board certified?
Higher experience and quality metrics improve detection and reduce complications.
Request Appointment
Contact Us
Our Locations
Find us on the map
Hours of Operation
Our Regular Schedule
Hunterdon Digestive Health Specialists
Monday
8:00 am — 6:00 pm
Tuesday
8:00 am - 7:00 pm
Wednesday
8:00 am - 5:00 pm
Thursday
8:00 am - 6:00 pm
Friday
8:00 am - 7:00 pm
Saturday
*Contact office to confirm Saturday hours and availability*
Sunday
Closed