5 Alternatives To A Colonoscopy

Regular cancer screenings help a healthcare provider detect the disease early on. 

This makes the disease easier to treat and the growths simpler to remove before they become cancerous. 

Colonoscopy testing is a standard procedure for examining the inside of the large intestine. 

It is a screening tool that can evaluate the colon, anus, and rectum. 

Most colonoscopies are used to evaluate patients with symptoms such as abdominal pain, rectal bleeding, cramping, bloating, sudden weight loss, a change in bowel movements, etc. 

But, because of the risks associated with a colonoscopy exam, people often look for alternatives to colonoscopies. 

In this guide, you can learn more about the different types of colonoscopy, what a colonoscopy can detect, and the currently available colonoscopy alternatives. 

What is a colonoscopy?

A colonoscopy looks for changes in the rectum and colon. So it can identify cancer, polyps, and irritated or swollen tissues. 

During colonoscopy testing, a colonoscope is inserted into the rectum. This is a long flexible tube with a small video camera. 

There are two types of colonoscopy: diagnostic and screening. 

  • Diagnostic colonoscopy is recommended when the healthcare provider has to take a sample tissue to diagnose an abnormal growth. Other symptoms before the procedure, such as rectal bleeding, anemia, diarrhea, or constipation, might indicate that you need a diagnostic colonoscopy. 
  • Screening colonoscopy is often suggested as a preventive option for patients without symptoms of colorectal carcinoma. A healthcare provider may recommend screening colonoscopy for people over the age of 50.

What can a colonoscopy detect?

Many people want to know what diseases can be detected by a colonoscopy. Colonoscopy can detect ailments such as diverticulosis, inflammatory bowel disease, and colitis. 

But, most of the time, healthcare experts use a colonoscopy to detect any cancerous or precancerous polyps.

What colonoscopy can detect are abnormalities in the colon. It can pinpoint the causes of chronic diarrhea, changes in bowel habits, rectal bleeding, or other gastrointestinal problems. If a doctor detects any abnormality during the procedure, they can remove it.

Colonoscopy is different from a prostate exam. Although they both involve the backside and can detect cancer, colonoscopy is used for detecting polyps in the colon. While a prostate exam can help detect prostate cancer.  

RELATED: Prostate Exam vs Colonoscopy: What’s The Difference?

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Side effects and risks of a colonoscopy

Now that you know what a colonoscopy can detect, it’s important to talk about the risks and side effects. Many research advancements have been made to minimize the risk of adverse reactions. But, just like any medical test or procedure, this one can come with side effects. 

Some of the colonoscopy dangers include:

  • Bleeding
  • Reaction to anesthesia
  • Bacterial infection
  • Belly pain
  • Post-Polypectomy Electrocoagulation Syndrome

One large-scale study evaluated the rate of colonoscopy-related serious side effects. More than 78,000 patients were contacted after their colonoscopy

Based on the statistics, serious adverse reactions occurred in 350 colonoscopies. Bleeding was one of the most commonly recorded side effects. 

Contact a healthcare provider if you experience any of these symptoms after your test:

  • Severe cramping or stomach pain
  • Hard belly
  • Dizziness
  • Vomiting
  • Severe or frequent bloody stool
  • Increased rectal bleeding that doesn’t subside
  • Fever
  • Difficulties pooping or passing gas

Because of these side effects and possible complications, many patients are interested in trying colonoscopy alternatives.

Reasons people might not need to have a colonoscopy 

Doctors may suggest alternatives to colonoscopies for patients older than 75 or those with medical issues that could put them at risk of complications. 

Before a colonoscopy, it is necessary to do a bowel prep. This means you will need to restrict your diet and use a laxative to clear the colon. The preparation can be a problem for elderly patients as it can cause an electrolyte imbalance or dehydration. 

Patients with congestive heart failure might have a bad reaction to prep products that have polyethylene glycol. These products can enhance intravascular water volume and trigger complications like edema. 

Talk to a doctor if you have any underlying health conditions. 

Is there a non-invasive alternative to colonoscopy?

There is a new colonoscopy procedure called Virtual colonoscopy or CT colonoscopy. Unlike conventional colonoscopy, which uses a scope, CT colonoscopy uses a CT scan to create cross-sectional images of the organs in your abdomen. 

CT colonoscopy can help screen for colon cancer in patients who are at least 45 years of age. Doctors may recommend this new colonoscopy procedure if you:

  • Are reluctant to have a traditional colonoscopy
  • Have an average risk of colon carcinoma
  • Would like to avoid sedation
  • Have obstructed bowel movements
  • Are prone to complications from standard colonoscopy (i.e., a bleeding disorder in which the blood doesn’t clot properly)

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5 alternatives to a colonoscopy

Patients want to know how to detect colon cancer without a colonoscopy. Other alternatives to colonoscopies are available and effective methods for identifying colorectal cancer. Here is a list of the currently available options.

1) Sigmoidoscopy

Sigmoidoscopy offers a way you can test for colon cancer without a colonoscopy.

This procedure is less invasive and checks the lower area of the colon. Whereas a colonoscopy helps evaluate the entire colon. 

Sigmoidoscopy can help diagnose specific problems in the lower colon like: strictures, ulcers, hemorrhoids, inflammation, tumors, polyps, and diverticula.

Some side effects can include stomach pain, trouble passing gas, chills, fever, and bleeding.


  • Patients often don’t need an anesthetic.
  • The preparation and the test itself take less time than a colonoscopy.
  • Has fewer side effects than colonoscopy.


  • It can only check the lower part of the colon.

2) Fecal immunochemical testing (FIT)

FIT is another test alternative to colonoscopy. It can detect blood from the lower intestines. You can use the test at home and follow the instructions when collecting a sample. 

But, because colon cancers don’t always bleed, patients might have to do the test a couple of times to make sure there is no blood in their stool. 

Since these are just stool sample tests, there are no side effects.

Even though FIT is one of the colonoscopy alternatives, it has lower detection rates of advanced adenoma or any adenoma compared to colonoscopy. An adenoma is a tumor that isn’t cancer. 


  • You can collect a sample in the comfort of your home.
  • It might detect colon cancer in its early stage.


  • It doesn’t check the entire colon.
  • It can’t diagnose carcinoma.

3) Stool DNA

Stool DNA testing looks for abnormalities in the DNA in colorectal cancer. This test uses a stool sample to detect any changes in the genetic material of the cells. Some DNA changes could be a sign of colon cancer. 

A healthcare expert might use a stool DNA test together with FIT. If the test does detect an abnormality, your doctor might recommend a colonoscopy. 


  • It requires just one stool sample.
  • Prep isn’t necessary.


  • It is more expensive than a stool-based test.

4) Fecal occult blood testing (FOBT)

FOBT evaluates a sample of your stool. It looks for blood that you can’t see with the naked eye. If there is any bleeding in the digestive tract, it could be a sign of:

  • Colorectal cancer
  • Colitis
  • Ulcers
  • Diverticulosis
  • Hemorrhoids
  • Polyps

This test is typically recommended prior to developing symptoms. But, FOBT alone is not enough for diagnosing a particular health problem. If the test does show blood, you might have to do another test to find the exact cause.

Some experts might do a gFOBT. They place a small stool sample on special cards and coat them with a chemical substance. The card can change color if there is blood in the stool sample.

There are no side effects or risks to getting FOBT.


  • It is a non-invasive testing method.
  • It can detect blood from different areas of the GI tract


  • More stool samples might be necessary.
  • Some diet restrictions and medication adjustments may be needed before testing.

5) Double contrast barium enema

DCBE, or barium enema, relies on X-rays to detect any abnormal growth in the colon. This is one of the available alternatives to a colonoscopy test.

This option doesn’t require sedation. It can identify lesions in the entire colon and detect carcinoma in its early stage. 

Since this test uses X-ray radiation, it does come with risks. Patients are exposed to small amounts of radiation. 

After testing, they can develop laxative side effects, like bloating or a mild headache. They can also experience constipation or upset stomach. Another very rare risk of DCBE is bowel perforation.


  • More affordable than a colonoscopy.
  • Sedation isn’t necessary.
  • It can find abnormalities and lesions in the narrowest sections of the colon.


  • Has a similar prep procedure to a colonoscopy.
  • Exposes the body to radiation.


A colonoscopy is a preferred method of screening for colon cancer. Since it can be uncomfortable and can come with risks, many people are looking for colonoscopy alternatives. 

These can include sigmoidoscopy, FIT, stool DNA, FOBT, or barium enema. Consult with a specialist to find the best screening method that works for you.

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  1. Randle HJ, Gorin A, Manem N, Feustel PJ, Antonikowski A, Tadros M. Colonoscopy screening and surveillance disparities during the COVID-19 pandemic. Cancer Epidemiol. 2022 Oct;80:102212.
  2. Stauffer CM, Pfeifer C. Colonoscopy. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
  3. Tomaszewski M, Sanders D, Enns R, Gentile L, Cowie S, Nash C, Petrunia D, Mullins P, Hamm J, Azari-Razm N, Bykov D, Telford J. Risks associated with colonoscopy in a population-based colon screening program: an observational cohort study. CMAJ Open. 2021 Oct.
  4. Zhong GC, Sun WP, Wan L, Hu JJ, Hao FB. Efficacy and cost-effectiveness of fecal immunochemical test versus colonoscopy in colorectal cancer screening: a systematic review and meta-analysis. Gastrointest Endosc. 2020 Mar.


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