Colonoscopy FAQ (frequently asked questions)
1. When should I have my first colonoscopy?
Everybody will need a colonoscopy at some point in their lives. When you have the first one depends on age. 45 is the recommended age for screening colonoscopy, however there are other risk factors to consider such as family history of colon or related cancers, symptoms (bleeding, abdominal pain, change in bowel habits, etc) or personal history (such as inflammatory bowel disease, previous history of polyps or cancer). These factors are important, as they may indicate that you should start even younger. It is best to discuss this with your doctor or Dr. Eytan Irwin and Dr. Edwin Empaynado at Advocare Colon & Rectal Surgical Specialists for advice.
2. Are all colonoscopies the same?
No. While the procedure itself is standardized, differences in physician experience, technology, safety standards, surgical centers and quality metrics can significantly impact how thorough and effective the exam is.
3. Does the doctor’s experience really matter?
Yes. Physicians who perform colonoscopies frequently and are board-certified in colorectal surgery or gastroenterology tend to have higher polyp detection rates, lower complication rates and greater expertise with polyp removal. Drs. Irwin & Empaynado at Advocare Colon & Rectal Surgical Specialists are Board-Certified Colon & Rectal Surgeons with over 20 years of experience, performing thousands of colonoscopies. As surgeons, they are comfortable and competent with complex problems, have deep knowledge of colon and rectal anatomy, and have the skills necessary to remove polyps with minimal risk.
4. What is Adenoma Detection Rate (ADR), and why should I ask about it?
Colon & rectal cancers generally start as benign polyps. Removing polyps during a screening colonoscopy will lower the risk of future cancer development. Therefore, it is important to carefully examine the colon during the exam & remove all polyps.
ADR measures how often a doctor finds precancerous polyps during screening exams. The higher the ADR, the lower risk of future cancer development. A minimum ADR of 25% is considered the standard.
Drs. Irwin and Empaynado consistently exceed the minimum by careful examination, using advanced imaging techniques and timed withdrawal to achieve maximum results.
5. Does technology make a difference?
Drs. Irwin & Empaynado do all their procedures at Centennial Surgery Center. Centennial Surgery Center is a QUAD A (a global accreditation authority) accredited outpatient facility with a patient satisfaction rating of 99.2%.
The center employs the latest Olympus colonoscopy equipment. This includes high-resolution optics, narrow-band imaging and GI Genius AI (artificial intelligence) polyp detection to aid the doctor during the performance of the procedure. This may help detect subtle or flat polyps more effectively.
Centennial also uses CO2 (carbon dioxide) instead of air during the performance of the procedure. This is a safe, inert gas that minimizes the bloating and discomfort that was previously common after the colonoscopy.
6. Why is facility accreditation important?
Accreditation means the center meets strict safety and quality standards.
Look for accreditation from a global organization. QUAD A (American Association for Accreditation of Ambulatory Surgery Facilities) has worked with thousands of healthcare facilities to standardize and improve quality of care.
Accredited centers follow rigorous safety procedures, infection control and emergency protocols.
7. Does bowel prep instruction vary between practices?
The type of bowel preparation is determined by the individual physician or group.
High-quality practices will:
• Provide clear written instructions
• Recommend split-dose prep (best for colon cleansing)
• Offer support if patients have questions
• Try to find the most effective and affordable option for you.
Proper prep is essential for an accurate exam.
8. What about sedation options?
Depending on your medical condition, you may be asked to have a consultation with your Primary Care Physician or other treating provider prior to the day of your procedure.
At Centennial Surgery Center, you will be evaluated by an anesthesiologist and the admitting nurse upon arrival. An IV will be placed for administration of the sedative.
In the procedure room, a Certified Nurse Anesthetist will typically be the one administering the sedation. This is usually accomplished with propofol. This provides a quick, comfortable, pleasant sleep. After the procedure you will be transferred to the recovery area for a light refreshment prior to discharge.
9. Can all centers remove large or complex polyps?
Not always. The physician may decide that under certain circumstances difficult polyps may need to be removed in an operating room or in the hospital with specialized equipment. Although it is possible that this may occur, it is very unusual and almost all polyps can be removed safely and effectively at the Surgical Center.
10. How can I tell if the exam will be thorough?
You will receive a full report, including pictures, that document the thoroughness of the procedure. The most important thing that you can do is carefully follow all preparation instructions, as residual colon contents can significantly influence the completeness and accuracy of the procedure, including when you might need to repeat the procedure.
11. Do I need to have an office consultation to schedule a routine colonoscopy?
We are the first in South Jersey to offer Open Access Colonoscopy. If you are 45 years old or older, you should have a screening colonoscopy. Screening colonoscopy is considered preventative by the medical insurance industry, and is typically covered 100% (meaning no out of pocket expense). If you are in good health and not having any worrisome symptoms, you may be a good candidate for Open Access colonoscopy, which would eliminate the need for an office consultation prior to the procedure. Click here or on the Open Access tab & read the directions to decide if this is right for you.
12. What else should I consider?
• Ease of scheduling
• Communication of results
• Follow-up planning
• Patient reviews and referrals
Bottom Line
Choosing the right colonoscopy center is about more than convenience.
It’s about selecting a provider and facility committed to quality, safety, and cancer prevention.
