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Article Category: Highlights

Let’s Get to the Bottom of Your Colonoscopy Questions

Published on March 26, 2024

Last updated 09:29 AM March 25, 2025

Got questions? A panel of GI health experts and a survivor answer questions about colorectal cancer screening and treatment.

In people under 50, colorectal cancer is now the number one cancer-related killer of men and the number two killer of women. Black communities are 20% more likely to get colorectal cancer and 40% more likely to die from it. But this doesn’t have to be the case—colorectal cancer is preventable. When people have a screening colonoscopy, doctors can remove pre-cancerous polyps, stopping them from ever becoming cancer.

Colonoscopies are now recommended starting at age 45 for the general population, and younger for people at higher risk or with a family history. But you have questions:

I’m above average healthy—do I really need a colonoscopy?

How do I know my risk level?

Will the procedure be painful?

How much time should I take off of work?


A panel of gastrointestinal health experts and a patient answer your questions and more here.

Image of colorectal cancer experts and patients including Samantha McInturff, colon cancer survivor; Nancy Page, Wellstar oncology nurse navigator; Dr. Sahir Shroff, Wellstar surgical oncologist; and Dr. Shani Clay, Wellstar gastroenterologist.

Who needs a colonoscopy

I eat well, exercise and am in good general health. Do I really need to go through the hassle of a screening colonoscopy?

Dr. Shani Clay, gastroenterologist: Unfortunately, we discover colon cancer in quite healthy individuals. While it is true that smoking and consumption of red meat increases your risk, we also see colorectal cancer in patients who follow very healthy diets and exercise regularly, hence the need for all people to get screened for colon cancer.

Samantha McInturff, colon cancer survivor: The screening age used to be 50 before they changed it to 45, so I had never had a screening. I was 48 when I had symptoms that led to a colonoscopy and I was diagnosed with stage 4 colon cancer. I am a rule follower. I always get my mammograms. I never smoked. I have no family history. I thought, ‘How can I have cancer?’ What I’ve been through really highlights the importance of screening early. Don’t be scared. Getting screened for colon cancer is a small inconvenience that’s completely worth it. 

When should I start having colon cancer screenings and how often will I need to have one?

Dr. Clay: For people at average risk, meaning people with no alarm symptoms and no family history of colon cancer, screening begins at age 45. 

How frequently you should have a colonoscopy depends on a few things, including family history, the number and type of polyps that are found during your colonoscopy and how clean the colon is at the time of the procedure. Repeat procedures can be anywhere from six months up to 10 years, depending on the results.

Colon cancer is in my family. When should I start screening? 

Dr. Sahir Shroff, surgical oncologist: We’re seeing more and more young patients with colon cancer. If a patient has a strong family history, the screening should start sooner than 45 years of age. For example, if your parent died of colon cancer, you should begin colonoscopies at the age of 30. It depends on the risk factor. Talk to your primary care doctor about your personal risk level.

Dr. Clay: If you have high-risk factors, you should be screened earlier. For example, if a person has a first-degree relative with colon cancer who was diagnosed at less than 60 years of age, that individual should get a screening colonoscopy at either 40 years of age or 10 years younger than the age at the relative’s diagnosis. Additionally, there are certain genetic syndromes that also warrant earlier colon cancer screening with a colonoscopy at less than 45 years of age. Wellstar has a Genetic Risk Assessment Program for people with hereditary risk factors or a family history of cancer.

 

Should I see a doctor if my stool looks different than before? 

Nancy Page, oncology nurse navigator: If you’re having changes in your bowel habits like blood in or on your stool or black stool, you need to let your doctor know soon. Consistent changes like constipation, diarrhea and, it may sound gross, but skinny stools that look like a pencil for a few weeks or more are signs to talk to your doctor. Other changes to be aware of are unexplained weight loss, unexplained fatigue, abdominal pain and even anemia. Don’t put it off. Don’t think, ‘I work a lot. I have kids. I’m busy.’ Let your doctor know now. If it’s colon cancer and it’s diagnosed early, there’s a 90% cure rate.

The majority of patients who get colonoscopies tell me at the end of the procedure that they do not remember a thing and that the procedure was not bad at all.

- Dr. Shani Clay

Wellstar gastroenterologist

What to know about having a colonoscopy

I’ve never had a colonoscopy before. What should I expect?

Dr. Clay: Patients often tell me that the worst part of the entire process is prepping for the procedure. Patients are typically advised not to eat solid foods the day before the procedure, and the evening before they must start taking the prep. The purpose is to clean the colon so that no solid stool is left that could possibly prevent the detection of polyps or cancer. This means many bathroom trips during the hours leading up to the procedure. The clearer the stool, the better my view will be. During the procedure, the patient typically receives sedation and gets great sleep—and, most importantly, does not feel a thing.

Nancy: Colonoscopies aren’t as bad as they used to be. The prep is not as bad at all. You drink clear liquids the day before your procedure. There are different preps but the easiest is a combination of Miralax, Gatorade and Dulcolax. For the colonoscopy, you’ll be sedated with propofol. You don’t even know it’s being done. You close your eyes, and the next thing you know, a kind voice is awakening you, saying, ‘It’s over.’ It’s an outpatient procedure. From beginning to end, it is only two to three hours, with the actual colonoscopy usually being 15 minutes or less.

Spending a day and a half doing colon prep and having the colonoscopy sure beats a year of going to doctor appointments and having chemotherapy and radiation treatments followed by surgery.

How long will the procedure last and do I need to take time off of work for recovery? 

Dr. Clay: The only day required to take off work is the day of the actual procedure.

Will the colonoscopy hurt? How long will recovery take?

Dr. Clay: After the procedure is over, in rare cases the patient may have very mild abdominal cramping that lasts for a few minutes—this is due to the insertion of air into their colon. Sometimes patients feel a little groggy for 15 to 20 minutes or so after the procedure is over from the effects of the anesthesia. About 30 minutes after the procedure is over, most patients feel completely normal. No driving or drinking alcohol is permitted on the day of the procedure. However, the next day, the patient is able to resume normal activities.

The majority of patients who get colonoscopies tell me at the end of the procedure that they do not remember a thing and that the procedure was not bad at all.  

What if you find cancer? Do you remove it during the colonoscopy? What’s next?

Dr. Clay: Sometimes we remove polyps that are pre-cancerous. This does NOT mean that you have cancer. However, there’s a chance the polyp could have turned into cancer in the future. This is the exact reason that we do colonoscopies—to detect these polyps and remove them during the colonoscopy so that they do not lead to cancer. Colon cancer is preventable. This is why colon cancer screening is so important. Everyone should get screened.

If your gastroenterologist sees something abnormal, such as a mass, they will take a sample of it and send it off to the pathology lab. The lab will typically send the results back within a few days, at which time we will inform the patient as to whether they have cancer or not. 

If diagnosed, patients are typically referred to cancer doctors, such as a medical oncologist, a cancer surgeon and sometimes a radiation oncologist. At Wellstar, these specialists discuss each person’s specific case and share perspectives on the best course of action to treat the cancer. They then communicate this to the patient, so the patient understands the next steps.

I am passionate about helping patients get screened for colon cancer because it is a preventable disease. I cannot stress that enough. My hope is that with increased knowledge and awareness, the number of people getting colon cancer will drastically decrease.

Schedule a colonoscopy

Schedule a colonoscopy or find a gastroenterologist near you.

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A woman holds both hands to her stomach in pain

Highlights

What You May Not Realize About Gut and Digestive Health

The Weekly Check-up Atlanta


We’ve all done it—taken an over-the-counter pain reliever for a headache, popped an antacid after a heavy meal or ignored bloating because it “comes and goes.” But some of these everyday habits can quietly damage the digestive system over time.

The gut is more connected to overall health than most people realize. “The digestive system reflects what’s happening in the rest of the body,” said Wellstar Gastroenterologist  Dr. Manjusha Das. “When something feels off, it’s often your body’s first warning sign.” Scientists now know that the gut and brain communicate through a complex network of nerves and hormones—meaning stress, mood and even sleep can influence how well your digestive system works.

Here, we share key ways to protect your gut and overall digestive health, as well as insights from Dr. Das’ experience in treating and preventing gastrointestinal disease.

1. Can common medications harm your stomach and gut?

Over-the-counter doesn’t always mean risk-free. Pain relievers such as ibuprofen, naproxen, aspirin or Goody Powder can irritate the stomach lining and lead to ulcers or internal bleeding when taken too often or on an empty stomach.

“Most people have no idea that ibuprofen causes peptic ulcer disease,” said Dr. Das. “All of these things we call non-steroidal, they help my headache, they help my back pain, but they are extremely caustic to the intestinal lining,” she said. “Even small doses taken regularly can cause problems over time. If you rely on these medications often, talk with your provider about safer long-term options.”

2. What really builds a healthy gut?

A healthy gut depends more on daily habits than on any single capsule.

What really matters:

  • Eat more fiber from vegetables, fruits and whole grains.
  • Drink plenty of water each day.
  • Get enough good sleep and find ways to manage stress.
  • Limit processed foods, sugary drinks and alcohol.

Probiotics can play a role, but they’re not a cure-all. Persistent bloating, diarrhea or abdominal pain could signal  irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD)—conditions that require professional medical care. “If your symptoms last more than two weeks or keep returning, schedule a GI evaluation,” Dr. Das advised.

3. Can colon cancer screening wait?

Don’t wait to schedule your colorectal cancer screening, such as a colonoscopy. Colon cancer often grows quietly, which is why screening can save lives. Colon cancer is also showing up in younger patients, which is why national guidelines now recommend you start screening at age 45—and earlier for anyone with a family history or concerning symptoms. “A colonoscopy doesn’t just detect cancer—it prevents it,” Dr. Das said. “We remove pre-cancerous polyps before they become dangerous.”

4. How do you protect your liver before problems start?

Liver disease often develops silently, with no obvious symptoms until significant damage occurs. Dr. Das has seen a sharp increase in fatty liver disease —both alcohol-related and non-alcoholic—since the pandemic, often tied to higher stress, poor diet and inactivity.

The encouraging news: The liver can heal when damage is caught early.

To protect your liver:

  • Drink alcohol in moderation—or skip it altogether.
  • Stay active and maintain a healthy weight.
  • Choose fresh, whole foods instead of processed ones.
  • Ask your provider for a simple blood test to check your liver health, especially if you have diabetes, high cholesterol or obesity.

“Most liver conditions are preventable,” Dr. Das said. “Small lifestyle changes make a lasting difference.”

5. When should you listen to your gut—literally?

Your digestive system is a built-in feedback loop. Bloating, reflux or bowel changes are signals worth listening to—not ignoring or masking with over-the-counter remedies. Frequent self-treatment can hide underlying issues such as ulcers, celiac disease or inflammatory conditions that need targeted care. “When symptoms repeat, they’re trying to tell you something,” Dr. Das explained. “The earlier we investigate, the easier it is to treat.”

Prevention starts with awareness

Digestive health doesn’t require complicated cleanses or trendy supplements. What truly matters is awareness, balance and consistent preventive care—habits that support the gut, liver and entire body. “The best medicine is preventive medicine,” Dr. Das said. “When you know your risks and act early, you can avoid most GI complications.”

What can you do next?

  • Schedule your screening colonoscopy if you’re 45 or older.
  • Ask your primary care provider about your liver health.
  • Find a Wellstar gastroenterologist near you for guidance that fits your needs.
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A friendly image of team

Highlights

One-Stop Treatment Clinic for Patients with Thoracic Cancer

If you had to guess which cancer took the most lives in America, what would your guess be?

“Lung cancer is the No. 1 cancer killer in the U.S. for both women and men since 1986,” said Dr. Daniel Miller. Dr. Miller is the chief of thoracic surgery and the director of the Wellstar Georgia Cancer Center lung cancer screening program.

About 80% of lung cancer cases are associated with cigarette smoking, including secondhand smoke. Unfortunately, when symptoms begin showing, the cancer has already spread, making treatment very time-sensitive. When a patient is diagnosed, their care team typically includes not just one, but four doctors: a thoracic surgeon, an interventional pulmonologist, a medical oncologist and a radiation oncologist. There are many benefits to having a large care team, but a huge drawback can be the wait time between appointments with each doctor.

“When you have cancer, you want to be seen now and be treated now,” Dr. Miller said.

The speed of treatment time for patients is what inspired the creation of the Thoracic-Oncology NOW (New Oncology Workgroup) Clinic at Wellstar Georgia Cancer Center. The multidisciplinary clinic is staffed by specialized physicians in the treatment of thoracic malignancies. 

The clinic treats not just lung cancer, but also esophageal cancer, metastatic disease to the lungs and malignant pleural effusions.

“You’re cutting back on treatment time, waiting time, travel time and, more importantly, you have a group of doctors, rather than a doctor, who are talking about your care,” said Hematologist and Oncologist Dr. Girinda Raval.

The clinic operates on Wednesdays and acts as a one-stop shop for patients, saving their time and the time of their loved ones who join them for treatments. Patients also have access to Wellstar Georgia Cancer Center’s registered dietitians and social workers, along with a scheduler, financial personnel and medical assistants, creating one large care team ready to help them on their treatment journey.

“There is a degree of reassurance for the patient that there is a team who are all engrossed in caring for that patient,” Dr. Raval said.

To learn more about the Thoracic-Oncology NOW Clinic or make an appointment, call (706) 721-6744 for more information.

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A friendly image of Kathy

PeopleCare

KathyCare

Kathy DeJoseph delights in making and giving away thousands of soft and cheerful hats to Wellstar cancer patients through a nonprofit she founded called Happy Caps. It’s all in the name of bringing a little light and comfort to people during a hard time.

Where did the idea come from? It started with Kathy’s own lung cancer diagnosis.

A commitment to yearly lung cancer screening

A cancer survivor for more than a decade, Kathy said regular lung cancer screenings were the key to her survival. With a long history of smoking and growing up around relatives who smoked, she decided to join an early detection lung cancer study at Wellstar.

Even though she felt fine and had no symptoms, committing to the study meant having an annual low-dose CT scan every year. After several years of clean scans with no signs of lung cancer, Kathy told a nurse that she was going to quit. But the nurse persuaded her to come in for another screening.

“Thank goodness she did,” Kathy said. “I was diagnosed the very next day.”

Quick and efficient treatment at the STAT Clinic

Being a part of the study and getting screened early allowed Kathy to move immediately to Wellstar Lung Cancer STAT Clinic at Wellstar Kennestone Regional Medical Center.

STAT stands for Specialty Teams and Treatment, highlighting the collaboration of multiple cancer experts. Together, they come to a consensus on a treatment plan and meet with the patient on the same day. This puts the patients at the center of their care plan, allowing them and their families to get immediate answers to questions, make decisions and start treatment faster.

“The biggest benefit for me with the way the STAT Clinic works is that I didn’t have to worry about whether the doctors had actually talked to each other,” Kathy said. “They’d come in one after another and tell me what they thought from their expertise.”

Immediate communication and mutual agreement among medical experts mean treatment plans are established and started faster, which is proven to improve long-term survival. On average, it takes 60 to 90 days from the time of diagnosis to treatment in the U.S. With the STAT Clinic at Wellstar, patients go from diagnosis to treatment in 14 to 20 days.

Kathy’s treatment started quickly—she had a lung biopsy the day after her STAT Clinic appointment and started chemotherapy a week later.

“I wasn’t as terrified for as long as most people are because I had answers within a short period of time,” Kathy remembered.

She had surgery once she completed chemotherapy. Throughout the process, she had the support of an entire cancer team, including a medical oncologist, a lung cancer surgeon, a pulmonologist and a nurse navigator.

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